Trainee doctors in medicine prefer case-based learning compared to didactic teaching

Experience of focused workshop intervention in presentation skills - Importance of foundational skills for ophthalmologists in training

Background

The study was conducted to assess the impact of a workshop intervention designed to enhance presentation skills of ophthalmology fellows in training.

Methods

A 10-hour workshop on presentation skills was conducted for ophthalmology fellows in the 2022 cohort at a single institution. An email was sent to the 2022 cohort to recruit participants. A total of 29 fellows (19 females, 10 males) volunteered to participate in the study. Participants completed a self-rating questionnaire to assess improvement in their presentation skills at four different time points of the workshop. The self-rating questionnaire utilized a ten-point rating scale (1-10) and evaluated properties and content (PC) and soft skills (SS). Data were analysed using SPSS software. Friedman and post-hoc tests compared self-ratings at four time points. Statistical significance was set at p-value < 0.05.

Results

Both properties & content (PC) and soft skills (SS) showed significant difference (p < 0.001) post workshop compared to earlier stages. The higher self-rating (PC4 and SS4) highlights increased awareness towards the scope of improving the presentation after the workshop intervention.

Conclusions

Presentation skills empower medical professionals to better communicate with diverse audiences, demonstrating their currency in medical knowledge, lobbying for correct understanding, and bringing praxis to pedagogy. The findings support the integration of similar workshops into medical curricula to foster well-rounded medical professionals.

Medical students' perceptions towards implementing case-based learning in the clinical teaching and clerkship training

BACKGROUND

Depending on the subject area and the 'case' used, many methods can be used to describe case-based learning (CBL). The majority of health professional education is patient-centered. As a result, clinical presentations and diseases are combined with social and clinical sciences, and student learning is linked to real-world applications. The purpose of this study was to evaluate how medical students at the Faculty of Medicine, National Ribat University, felt about the implementation of CBL.

METHODS

This descriptive cross-sectional study was conducted on 171 final-year medical students (100 females and 71 males). Students were voluntarily invited to complete a self-administered questionnaire consisting of 15 closed-ended questions with 5-point Likert scale responses, covering data on perception, awareness, and barriers to CBL.

RESULTS

The CBL satisfaction rate among medical students was 92.4%. The mean value of the medical student's perception was 3.7 out of 5. Regarding perceptions of CBL, 65.5% of students agreed with the positive impact of CBL on their academic performance. "8.2%" (14/171) of students strongly concur that CBL improved teamwork, while "31.6%" (54/171) strongly disagree. "36.3%" of students strongly believe that CBL improved their ability to use clinical reasoning. Regarding CBL barriers, 53% of medical students considered a group of twenty participants per session to be a barrier. (69%) of students refused to consider physical presence as a barrier. "76.6%" of the students agreed that the moderator's approach and style can have a big influence on the CBL session's outcome.

CONCLUSION

Overall, students had positive perceptions of CBL. Academic performance, clinical reasoning, teamwork, and information retention and retrieval were all improved by incorporating CBL into training modules. Students agreed that the group size of 20 students per session was a barrier, despite their moderate to excellent knowledge of CBL. Preparation for CBL is both time-consuming and tiring. Despite this, students agree that CBL has a positive impact on the learning process.

Need of LGBTQ+ Curriculum in Nepalese Medical Education

The need for LGBTQ+ inclusivity in medical education and their active enrollment in healthcare delivery is evident in Nepal due to ongoing healthcare disparities. These inequities, resulting from barriers in access, discrimination, and provider bias, demand an immediate action. To address these issues effectively, a deliberate shift in medical education is crucial. This involves making LGBTQ+ content a compulsory part of the curriculum, providing comprehensive instruction on sexual orientation and gender identity, and training students to create inclusive, respectful healthcare settings. This transformation aims to ensure equitable, respectful, and dignified care for LGBTQ+ patients, underlining the pivotal role of faculty development and training. By integrating LGBTQ+ health topics into the curriculum and promoting a culture of inclusivity, medical schools and institutions can produce healthcare providers who are not only knowledgeable but also compassionate and culturally competent in their practice.

Comparative study between "case-based learning" and "flipped Classroom" for teaching clinical and applied aspects of physiology in "competency-based UG curriculum"

Background

The new curriculum is competency-based and revised. The student must be imparted and should have learned these competencies. New teaching-learning methods such as "Case-based learning (CBL)" and "Flipped classroom (FCR)" can help medical students to be competent Indian medical graduates.

Aims and Objectives

This study was aimed to evaluate the effectiveness of "CBL" over "FCR" for teaching clinical and applied aspects of physiology.

Materials and Methods

Faculty and residents of the department of physiology and first-year MBBS students were introduced and oriented to the study and concept of CBL and FCR. Students were divided into two groups; one was taught clinical and applied aspects of cardiovascular physiology by CBL and another group by FCR. Pre- and post-test with a validated questionnaire were conducted for both groups. Feedback from the students was collected on 5-point Likert's scale and the marks obtained by them were analyzed statistically by paired t-test.

Results

Both CBL and FCR improved the post-test marks significantly when compared to pre-test marks (P < 0.0001). CBL and FCR methods showed no significant difference, but the mean post-test marks were higher in FCR. As per the students' feedback, 62% of students strongly agreed that CBL is useful for clinical and applied aspects of physiology.

Conclusion

CBL and FCR both are equally important and complementary to each other. CBL was found to be slightly more effective for later days of clinical practices, whereas FCR slightly more effective for better performance in university examinations.

The effect of interprofessional education on interprofessional professionalism behaviors of the surgical team members

INTRODUCTION

Interprofessional professionalism (IPP) has been introduced as one of the critical sub-competencies of interprofessional collaboration. This study aimed to assess the effect of interprofessional education on the behavior of interprofessional professionalism among the surgical team in the intervention compared to the control group.

METHODS

This is a quasi-experimental study. The participants were nurses in anesthetist and surgical technology and surgical residents of Shahid Sadoughi Hospital (n = 150) who were included in the study by the census. The intervention employed an interprofessional case-based learning strategy to explore themes of interprofessional professionalism. Two assessors used the Interprofessional Professionalism Assessment (IPA) tool to measure learners' performance while observing them in practice prior to the intervention, one and three months after the intervention. Data were analyzed using descriptive tests (mean and SD) and RM-ANOVA.

RESULTS

In this study, the participants in the intervention (n = 78) and the control (n = 72) groups entered the study. The Baseline IPA scores of participants were reported as 1.25 (0.12) and 1.21 (0.1) in the intervention and control groups, respectively. The IPA score of the participants in the intervention group (2.59 (0.26) and 2.54 (0.24)) was higher than the control group (1.17 (0.08) and 1.12 (0.07)) after one and three months of the intervention (P = 0.0001). The effect of educational interventions was reported at the large level (Eta Square = 0.89).

CONCLUSION

Interprofessional professionalism in surgical teams has been recognized as a critical element of team-based care. The present study used an interprofessional education strategy to develop IPP behavior. All professions benefited from interprofessional education. It is suggested that all surgical team professionals participate in interprofessional education.

Meet EBE: The Development of an Evidence-Based Endoscopy Simulator

BACKGROUND AND AIMS

In the digital era of evidence-based medicine, there is a paucity of video endoscopy teaching platforms that use evidence-based medicine principles, or that allow for cognitive simulation of endoscopic management strategies. We created a guideline-based teaching platform for fellows that incorporates these features, and tested it.

METHODS

A pilot video module with embedded questions was drafted, and after incorporation of feedback from several attending gastroenterologists, an additional 2 modules were created. The embedded questions were designed to simulate cognitive management decisions as if the viewer were doing the endoscopy procedure in the video. A narrator explained the evidence behind the task being performed, and its certainty based on endoscopic guidelines. Quizzes and surveys were developed and administered to a sample of attendings and fellows who completed the video modules to test efficacy, usability, and likeability.

RESULTS

Three video modules, named evidence-based endoscopy (EBE), incorporating low fidelity simulation, and utilizing evidence-based medicine principles, were created. Eight fellows and 10 attendings completed the video modules and all quizzes and surveys. Mean test scores improved from before to after completing the video modules (56% to 92%; mean difference = -35%; 95% confidence interval, 27%-47%). Surveys indicated that the product was viewed favorably by participants, and that there is a strong desire for this type of educational product.

CONCLUSIONS

The EBE simulator is a unique, desirable, and effective educational platform based on evidence-based medicine principles that fills a gap in available tools for endoscopy education. Further studies are needed to assess whether EBE can aid in long-term knowledge retention and increase adherence to guideline recommendations.

An exploration into the application of specialty-orientated CBL pedagogy in undergraduate teaching in pediatric surgery

OBJECTIVE

This study aims to identify whether the specialty-oriented case-based learning (CBL) pedagogy contributes to the teaching of basic theory and practical operation in undergraduate clinical teaching in pediatric surgery, and to assess the satisfaction of undergraduates.

METHODS

A total of 72 undergraduates in Grade 2016 who interned at Qilu Hospital of Shandong University were enrolled in this study. All these undergraduates voluntarily participated in this experimental study. They were randomly divided into the experimental group (the CBL group, n = 36) and the control group [the traditional lecture-based learning (LBL) group, n = 36] with the assistance of random number tables. In the control group, a traditional pedagogy was adopted and the knowledge in the textbook was explained according to the syllabus. In the experimental group, a specialty-oriented CBL pedagogy was adopted under the guidance of clinical instructors. After the teaching, a comparison was drawn between both groups in respect of the theoretical exam and practical exam scores. In addition, the teaching results were evaluated by a questionnaire survey.

RESULTS

The average theoretical exam scores and comprehensive scores of undergraduates in the CBL group were higher than those in the LBL group (P < 0.05). There was no significant difference in the practical exam scores between the CBL group and the LBL group (P > 0.05). However, those undergraduates in the CBL group attained higher scores in doctor-patient communication and perioperative diagnosis and treatment (P < 0.05). According to the questionnaire survey, the undergraduates in the CBL group had higher satisfaction than those in the LBL group. Besides, this specialty-oriented CBL pedagogy had higher performance in improving their ability to solve problems independently and cultivating and expanding their knowledge compared with the traditional pedagogy. Meanwhile, this specialty-oriented CBL pedagogy can cultivate the critical thinking of undergraduates, which could increase their learning efficiency and improve their interest in learning.

CONCLUSION

This specialty-oriented CBL pedagogy could improve the mastery of professional knowledge, course satisfaction, doctor-patient communication ability in clinical practice, and perioperative diagnosis and treatment ability of these undergraduates. Therefore, it is worthwhile to recommend and popularize this pedagogy in undergraduate clinical teaching in pediatric surgery.

Teaching LGBT+ Health and Gender Education to Future Doctors: Implementation of Case-Based Teaching

Improving the education of medical students and physicians can address the disparities in LGBT+ (lesbian, gay, bisexual, transgender, and others) health care. This study explored how teachers used case-based teaching to teach medical students about gender and LGBT+ health care and discussed the implementation and effectiveness of case-based teaching from the perspective of the teachers and students. This study employed the case study method and collected data through semi-structured interviews. This study used two gender courses in clinical psychiatric education as case studies. Two teachers and 19 medical students were recruited as participants. The findings of this study were as follows: (1) effective cases links theory to clinical practice and competency learning; (2) experience sharing by LGBT+ is highly effective; (3) discussions promote the effectiveness of case-based teaching; and (4) the challenges of case-based teaching included time limitations, the multiplexity of the cases, and multilevel learning. This study also found that using narrative cases is a form of narrative pedagogy, which can help students to integrate medicine, gender, and LGBT+ competency education. A successful narrative case–based teaching strategy involves teachers integrating knowledge related to gender, guiding students through the cases to understand the importance of these cases, and reflecting on the medical profession to make improvements. However, teachers face challenges in this approach, such as changes in the school’s teaching culture and a lack of institutional support.

Radiation Oncology Virtual Education Rotation (ROVER) for Medical Students

PURPOSE

We describe the implementation of a novel virtual educational program for medical students, Radiation Oncology Virtual Education Rotation (ROVER), and its effect on student interest and knowledge in radiation oncology.

METHODS AND MATERIALS

ROVER comprised a series of virtual educational panels with case-based discussions across disease sites tailored to medical students. The panels were moderated by radiation oncology residents and included faculty panelists from academic radiation oncology programs across the country. Student pre- and postsession surveys were collected. Paired t tests were used to compare the pre- and postsession assessment results.

RESULTS

Six ROVER sessions were held from June 4, 2020, to August 20, 2020, with a total of 427 medical students registering for at least 1 session. Of these, 231 students attended at least 1 session, with 140 completing at least 1 postsession survey (60.6% response rate). Fourth-year medical students were the largest group represented among attendees (32.0%). Most attendees had exposure to radiation oncology (78.8%) before the sessions. The majority of students signed up for these sessions for education (90.6%). Some students signed up for the sessions to help with specialty selection (30.9%) and to network (30.4%). Medical students' understanding of the role of radiation oncology in each disease site (breast, sarcoma, central nervous system, pediatrics, gastrointestinal, genitourinary, gynecologic, lymphoma, lung, and head and neck) was improved by attending each session (pre- vs postsession; P < .0001 for all disease sites). Over three-quarters of respondents stated they were considering applying or were likely to apply to radiation oncology both before and after the sessions.

CONCLUSIONS

ROVER improved medical student perceived knowledge of radiation oncology across all disease sites covered. ROVER fulfills a need for a national medical student education platform for radiation oncology. Future work is warranted to augment virtual and open educational platforms to improve access to radiation oncology education.

A pilot study on case-based learning (CBL) in medical microbiology; students perspective

Background

Traditional teaching of medical microbiology has revolved around an organism centric, didactic lecture approach, lacking clinical relevance and appeal. Studies have shown that case-based learning in comparison to didactic lectures leads to a greater comprehension and understanding of the subject. To conduct a pilot study in our medical. College for the current MBBS batch (2019) (following the old pattern of syllabus), on student perceptions on case based learning (CBL) before the new Competency based undergraduate curriculum is rolled out for 2021 batch coming to second year of MBBS.

Methods

This pilot study was conducted at a medical college. The study was designed as an observational study on educational research and was approved by the institutional ethical committee (IEC). Study participants were second MBBS students willing to participate in the study (n = 60). Four topics were chosen to be taught as casebased scenarios as per the new CBME syllabus. Six weeks after the first CBL session was conducted, a survey questionnaire was given to the students to share their perceptions anonymously. The questionnaire had questions framed to assess the students' perception about CBL. The evaluation was done on a 5-point Likert. The responses collected were compiled in Microsoft excel sheet and the data was analysed statistically. Faculty perspective was also gathered.

Results

Majority of the students perceived CBL positively. There was a shift in the student's perspective towards the subject of microbiology, from being perceived earlier as theoretical and non-clinical to being perceived as appealing and clinically relevant.

Family Medicine Clerkship Teaching About Contraception: Meeting a Need

INTRODUCTION

Women's healthcare including preventive care, obstetric care, and family planning and counseling are important medical education topics that student physicians frequently encounter during their Family Medicine Clerkship in medical training; however, despite its brief emphasis, many students feel underprepared to counsel patients in a clinical setting. With this in mind, a case-based curriculum focused on women's health was developed for students enrolled in the Family Medicine Clerkship.

METHODS

During the 2018-2019 academic year, 127 students on the Family Medicine Clerkship at the Florida International University Herbert Wertheim College of Medicine (HWCOM) participated in three two-hour sessions on the topics of adolescent preventive health care, obstetric care, and contraceptive counseling. These sessions incorporated cases, role-play activities, and pre-session readings. An optional, anonymous, paper-based pre-session survey of Likert-type questions was administered prior to the first session and a post-session survey of Likert-type questions was given following the final session. IRB exemption was obtained.

RESULTS

The pre-session survey showed that 41.67% of students agreed or strongly agreed that they were confident in their ability to perform female contraceptive counseling. After the sessions, 92.68% of students agreed or strongly agreed that the case addressing contraceptive counseling was of clinical value to their learning needs.

CONCLUSION

Given that less than half of the students felt confident in their counseling abilities prior to these sessions, this curriculum is potentially addressing an unmet educational need. Students found this session to be relevant, indicating that a case-based discussion curriculum that incorporates both pre-session reading materials and role-play interactions may be a promising educational approach.