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Janssen L, Schick K, Neurohr T, Pittroff SID, Reiser S, Bauer J, Berberat PO, Gartmeier M. Reflect to interact - fostering medical students' communication through reflection-focused e-learning. BMC MEDICAL EDUCATION 2024; 24:541. [PMID: 38750528 PMCID: PMC11097513 DOI: 10.1186/s12909-024-05368-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 03/28/2024] [Indexed: 05/18/2024]
Abstract
BACKGROUND Previous research indicates that reflection can foster medical communication competence. However, best practices for embedding reflection in online medical education are missing. This study examined how reflection processes can be promoted and embedded in an e-learning course on physician-patient communication to foster learning. METHODS We investigated three differently designed e-learning conditions featuring different proportions of reflection triggers and compared their effects on students' reflections. We had 114 medical students in their first clinical year complete one of the variants: video modelling (VM, n = 39), video reflection (VR, n = 39), or a variant merging both approaches (VMR, n = 36). Each student wrote a total of nine reflections based on the same guiding questions at three time points embedded in the course. The students' levels of reflection were measured using an adapted version of the REFLECT rubric (scale 0-18). RESULTS Students of all course variants achieved good levels of reflection beyond the descriptive level at all three time points, with no significant differences between the variants. The mean reflection scores at the end of the course were M = 14.22 for VM (SD = 2.23), M = 13.56 for VR (SD = 2.48), and M = 13.24 for VMR (SD = 2.21). Students who completed VM showed significantly improved levels of reflection over the course, whereas we found no statistically significant development for those in VR or VMR. The reflection scores correlated significantly positively with each other, as did the text lengths of the written reflections. Reflection scores also correlated significantly positively with text length. CONCLUSIONS Our study offers a teaching strategy that can foster good levels of reflection, as demonstrated in the three e-learning variants. The developed reflection prompts can be easily embedded in various e-learning environments and enable reflections of good quality, even in settings with limited available teaching time.
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Affiliation(s)
- Laura Janssen
- Department Clinical Medicine - TUM School of Medicine and Health, Technical University of Munich, TUM Medical Education Center, Munich, Germany.
| | - Kristina Schick
- Department Clinical Medicine - TUM School of Medicine and Health, Technical University of Munich, TUM Medical Education Center, Munich, Germany
| | - Tiziana Neurohr
- Department Clinical Medicine - TUM School of Medicine and Health, Technical University of Munich, TUM Medical Education Center, Munich, Germany
| | - Sylvia Irene Donata Pittroff
- Department Clinical Medicine - TUM School of Medicine and Health, Technical University of Munich, TUM Medical Education Center, Munich, Germany
| | - Sabine Reiser
- Educational Research and Methodology, University of Erfurt, Erfurt, Germany
| | - Johannes Bauer
- Educational Research and Methodology, University of Erfurt, Erfurt, Germany
| | - Pascal O Berberat
- Department Clinical Medicine - TUM School of Medicine and Health, Technical University of Munich, TUM Medical Education Center, Munich, Germany
| | - Martin Gartmeier
- Department Clinical Medicine - TUM School of Medicine and Health, Technical University of Munich, TUM Medical Education Center, Munich, Germany
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Tabassum N, Higbee S, Miller S. A Qualitative Study of Biomedical Engineering Student Critical Reflection During Clinical Immersion Experiences. BIOMEDICAL ENGINEERING EDUCATION 2024; 4:15-31. [PMID: 38558546 PMCID: PMC10978014 DOI: 10.1007/s43683-023-00124-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Accepted: 08/11/2023] [Indexed: 04/04/2024]
Abstract
Purpose Clinical immersion experiences provide engineering students with opportunities to identify unmet user needs and to interact with clinical professionals. These experiences have become common features of undergraduate biomedical engineering curricula, with many published examples in the literature. There are, however, few or no published studies that describe rigorous qualitative analysis of biomedical engineering student reflections from immersion programs. Methods Fifteen reflection prompts that align with program learning goals were developed and structured based on the DEAL model for critical reflection. Undergraduate participants in a summer immersion program responded to these prompts throughout five weeks of clinical rotations. Data from two summer cohorts of participants (n = 20) were collected, and thematic analysis was performed to characterize student responses. Results Students reported learning about key healthcare topics, such as medical insurance, access to healthcare (and lack thereof), stakeholder perspectives, and key medical terminology and knowledge. Most reflections also noted that students could apply newly gained medical knowledge to biomedical engineering design. Further, clinical immersion provided students with a realistic view of the biomedical engineering profession and potential areas for future professional growth, with many reflections identifying the ability to communicate with a variety of professionals as key to student training. Some students reflected on conversations with patients, noting that these interactions reinvigorated their passion for the biomedical engineering field. Finally, 63% of student reflections identified instances in which patients of low socioeconomic status were disadvantaged in health care settings. Conclusions Clinical immersion programs can help close the gap between academic learning and the practical experience demands of the field, as design skills and product development experience are becoming increasingly necessary for biomedical engineers. Our work initiates efforts toward more rigorous analysis of students' reactions and experiences, particularly around socioeconomic and demographic factors, which may provide guidance for continuous improvement and development of clinical experiences for biomedical engineers.
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Affiliation(s)
- Nawshin Tabassum
- Department of Economics, Indiana University Purdue University Indianapolis, Indianapolis, IN, USA
| | - Steven Higbee
- Department of Biomedical Engineering, Indiana University Purdue University Indianapolis, Indianapolis, IN, USA
| | - Sharon Miller
- Department of Biomedical Engineering, Indiana University Purdue University Indianapolis, Indianapolis, IN, USA
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Sawang S, Seangrung R, Tontisirin N, Wanpiroon P. Assessing the effectiveness of a digital, case-based learning platform for cancer pain management in residency training. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2023; 14:187-192. [PMID: 38109336 DOI: 10.5116/ijme.6563.251d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Accepted: 11/26/2023] [Indexed: 12/20/2023]
Abstract
Objectives To determine the effectiveness of self-directed, case-based learning in cancer pain management via a digital learning platform (e-CBL) in interdisciplinary residents' knowledge and critical thinking skill level. Methods The prospective observational study was conducted on 51 first- and second-year residents from anesthesiology, surgery, and family medicine who had not received training in the management of cancer pain and were invited to participate by their Program Director. Participants voluntarily underwent e-CBL in cancer pain management using four modules (pain assessment, principles of pain management, pharmacological techniques, and non-pharmacological techniques) at their convenience within seven days via the Moodle platform. All participants underwent pre-and post-test assessments of knowledge and rated their satisfaction with the training on a 0-10 scale. Thirty-two residents completed Cornell Critical Thinking Test Level Z. Paired t-tests assessed changes, and the effect size was estimated by Cohen's d. A p-value < .05 was considered statistically significant. Results Knowledge and critical thinking test results significantly improved after the training (M=68, SD=16.99 to M=86, SD=13.96 correct responses; t(50)=11.24, p<.001, Cohen's d=1.56 for knowledge) and (M=39.8, SD=13.7 vs. M=46.1, SD=10.2 correct responses; t(31)=-3.67, p=.001, Cohen's d=0.65 for critical thinking test). Satisfaction of learning experiences for convenience and understandability was high (M=9.4, SD=0.8). Conclusions Use of the e-CBL improved knowledge in cancer pain management and critical thinking skills. This digital platform could play an important role in the future of pain education. Further investigation, including a control group, is warranted.
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Affiliation(s)
- Saowanee Sawang
- Department of Anesthesiology, Faculty of Medicine Ramathibodi Hospital, Bangkok, Thailand
| | - Rattaphol Seangrung
- Department of Anesthesiology, Faculty of Medicine Ramathibodi Hospital, Bangkok, Thailand
| | - Nuj Tontisirin
- Department of Anesthesiology, Faculty of Medicine Ramathibodi Hospital, Bangkok, Thailand
| | - Panita Wanpiroon
- Department of Education Technology and Information Science, Faculty of Technical Education, King Mongkut's Universi-ty of Technology North Bangkok, Bangkok, Thailand
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Cheraghbeigi N, Molavynejad S, Rokhafroz D, Elahi N, Rezaei E. Nursing students' learning strategies for e-learning during the Covid-19 pandemic in Iran: a qualitative study. BMC MEDICAL EDUCATION 2023; 23:321. [PMID: 37158882 PMCID: PMC10166048 DOI: 10.1186/s12909-023-04270-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2023] [Accepted: 04/17/2023] [Indexed: 05/10/2023]
Abstract
BACKGROUND In response to the emergency brought about by the Covid-19 pandemic, many universities around the world had to change their teaching methods from in-person classes to e-learning. The purpose of this study was to identify the learning strategies of nursing students in e-learning during the pandemic. METHODS This study had a qualitative design and used content analysis approach to collect and analyze the data. Sixteen semi-structured interviews were conducted with 12 Iranian undergraduate nursing students who were selected using purposive sampling method. RESULTS Most nursing students in this study generally used two different strategies for e-learning, namely self-centered learning strategies and collaborative learning strategies. Some students, on the other hand, adopted a passive approach in which they did not take any effective action to contribute to their learning. CONCLUSION In e-learning during the pandemic, students adopted different learning strategies. Therefore, designing teaching strategies tailored to the students' strategies can promote their learning and academic achievement. Also, knowledge of these strategies helps policy makers and nursing educators to take necessary measures in order to optimize and facilitate student learning in an e-learning environment.
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Affiliation(s)
- Nesa Cheraghbeigi
- Student Research Committee, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Shahram Molavynejad
- Nursing Care Research Center in Chronic Diseases, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Dariush Rokhafroz
- Nursing Care Research Center in Chronic Diseases, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Nasrin Elahi
- Nursing Care Research Center in Chronic Diseases, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Eisa Rezaei
- Department of Educational Technology in Medical Sciences, Smart University of Medical Sciences, Tehran, Iran
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Ballouk R, Mansour V, Dalziel B, McDonald J, Hegazi I. Medical students' self-regulation of learning in a blended learning environment: a systematic scoping review. MEDICAL EDUCATION ONLINE 2022; 27:2029336. [PMID: 35086439 PMCID: PMC8803058 DOI: 10.1080/10872981.2022.2029336] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/11/2022] [Accepted: 01/11/2022] [Indexed: 05/24/2023]
Abstract
BACKGROUND Medical curricula are constantly evolving in response to the needs of society, accrediting bodies and developments in education and technology. The integration of blended learning modalities has challenged traditional methods of teaching, offering new prospects in the delivery of medical education. The purpose of this review is to explore how medical students adapt their learning behaviours in a Blended Learning environment to become more independent and self-regulated, in addition to highlighting potential avenues to enhance the curriculum and support student learning. METHODS Using the approach described by Levac et al. (2010), which builds on Arksey and O'Malley's framework, we conducted a literature search of the following databases: MEDLINE (Ovid), ERIC, EBSCO, SCOPUS and Google Scholar, utilising key terms and variants of "medical student', 'self-regulated learning' and 'blended learning'. The search yielded 305 studies which were further charted and screened according to the Joanna Briggs Institute. RESULTS Forty-four studies were identified and selected for inclusion in this review. After full analysis of these studies, underpinned by Self-regulation theory, five major concepts associated with students' learning behaviours in a Blended Learning environment were identified: Scaffolding of instructional guidance may support self-regulated learning; Self-regulated learning enhances academic performance; Self-regulated Learning improves study habits through resource selection; Blended learning drives student motivation and autonomy; and the Cognitive apprenticeship approach supports Self-regulated learning. CONCLUSION This review uncovers medical students' learning behaviours within a Blended learning environment which is important to consider for curricular adaptations and student support.
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Affiliation(s)
- Rouba Ballouk
- School of Medicine, University of Western Sydney, Sydney, Australia
| | - Victoria Mansour
- School of Medicine, University of Western Sydney, Sydney, Australia
| | - Bronwen Dalziel
- School of Medicine, University of Western Sydney, Sydney, Australia
| | - Jenny McDonald
- School of Medicine, University of Western Sydney, Sydney, Australia
| | - Iman Hegazi
- School of Medicine, University of Western Sydney, Sydney, Australia
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Modelling the Effect of Age, Semester of Study and Its Interaction on Self-Reflection of Competencies in Medical Students. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19159579. [PMID: 35954936 PMCID: PMC9367769 DOI: 10.3390/ijerph19159579] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 07/27/2022] [Accepted: 08/01/2022] [Indexed: 11/24/2022]
Abstract
Objectives: Accurate self-assessment and -reflection of competencies are crucial skills for all health professions. The National Competence-Based Learning Objectives Catalogue (NKLM) guiding medical faculties in Germany points out reflection as a non-technical skill and competency-based medical education (CBME) as important approaches. In this context, the role and structure of curricula and skills labs evolved. Especially in peer-assisted trainings, reflection of competencies is important to improve self-regulated learning. Traditionally, we assume self-reflection skills to evolve automatically with learners’ experience. This approach aims to find empirical evidence for this assumption and implements self-reflection of competencies in clinical skills education. Here, we quantify the influence of age and semester of study and its interaction on the concordant self-reflection of students’ own competencies. Methods: Investigation was based on a retrospective analysis of evaluation data from peer-assisted “first aid” and “physical examination” courses in the skills labs of the medical faculty at the Ruhr-University Bochum, Germany. Participants were asked for self-assessed competencies before (pre) and after (post) the course. Additionally, they were asked to retrospectively re-rate their “before” competencies after completing the course (post-pre). Differences between pre and post-pre competencies were assessed as the concordant self-reflection in a moderated regression analysis. Group means and standard deviation were depicted using univariate analysis of variance (ANOVA) with post-hoc Tukey HSD testing in IBM SPSS Statistics V.28. Moderated regression and simple slope analyses were conducted to calculate interaction effects of age and semester of study on the concordant self-reflection. Results: As expected, participants (n = 168) showed significant progress in subjective self-assessment (pre vs. post) in all 18 assessed domains in the course (all p < 0.001). Additionally, participants self-assessed their previous competencies after the course (post-pre) differently than before the course (pre) in 11 out of 18 domains. Hereby, the interaction of age and semester of study explained a significant part of variance in the first aid course (∆R2 = 0.008, ∆F (1;1020) = 8.53, p < 0.005) and in the physical examination course (ΔR2 = 0.03, ΔF (1;10,280) = 10.72, p < 0.001). Conclusions: We quantified that interaction of age and semester has a significant influence on concordant self-reflection skills using a moderated regression analysis. Assumed as an indicator, we conclude that advanced and older students show less differences in pre- vs. post-pre-ratings. This has implications for curriculum development, postulating that an exposure to self-reflection as a metacognitive process should be introduced early in order to train competencies in health professionals. Prospective studies with competency-based assessments are necessary to validate findings.
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Goldman J, Smeraglio A, Lo L, Kuper A, Wong BM. Theory in quality improvement and patient safety education: A scoping review. PERSPECTIVES ON MEDICAL EDUCATION 2021; 10:319-326. [PMID: 34609733 PMCID: PMC8633332 DOI: 10.1007/s40037-021-00686-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/16/2021] [Revised: 08/20/2021] [Accepted: 08/25/2021] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Theory plays an important role in education programming and research. However, its use in quality improvement and patient safety education has yet to be fully characterized. The authors undertook a scoping review to examine the use of theory in quality improvement and patient safety education. METHODS Eligible articles used theory to inform the design or study of a quality improvement or patient safety curriculum. The authors followed scoping review methodology and searched articles referenced in 20 systematic reviews of quality improvement and patient safety education, or articles citing one of these reviews, and hand searched eligible article references. Data analysis involved descriptive and interpretive summaries of theories used and the perspectives the theories offered. RESULTS Eligibility criteria were met by 28 articles, and 102 articles made superficial mention of theory. Eligible articles varied in professional group, learning stage and journal type. Theories fell into two broad categories: learning theories (n = 20) and social science theories (n = 11). Theory was used in the design (n = 12) or study (n = 17) of quality improvement and patient safety education. The range of theories shows the opportunity afforded by using more than one type of theory. DISCUSSION Theory can guide decisions regarding quality improvement and patient safety education practices or play a role in selecting a methodology or lens through which to study educational processes and outcomes. Educators and researchers should make deliberate choices around the use of theory that relates to aspects of an educational program that they seek to illuminate.
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Affiliation(s)
- Joanne Goldman
- Centre for Quality Improvement and Patient Safety, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada.
- The Wilson Centre, Toronto, Ontario, Canada.
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
| | - Andrea Smeraglio
- Department of Medicine, Oregon Health & Science University, Portland, OR, USA
- Division of Hospital & Specialty Medicine, Portland Veterans Administration Medical Center, Portland, OR, USA
| | - Lisha Lo
- Centre for Quality Improvement and Patient Safety, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Ayelet Kuper
- The Wilson Centre, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Brian M Wong
- Centre for Quality Improvement and Patient Safety, Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
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van Bonn SM, Grajek JS, Schneider A, Oberhoffner T, Mlynski R, Weiss NM. Interactive live-stream surgery contributes to surgical education in the context of contact restrictions. Eur Arch Otorhinolaryngol 2021; 279:2865-2871. [PMID: 34424381 PMCID: PMC8381709 DOI: 10.1007/s00405-021-06994-0] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 07/13/2021] [Indexed: 11/26/2022]
Abstract
BACKGROUND Attendance teaching is the predominant teaching method at universities but needs to be questioned in the context of digital transformation. This study establishes and evaluates a method to accomplish electronic learning to supplement traditional attendance courses. MATERIALS AND METHODS Surgery was transmitted in real-time conditions via an online live stream from the surgical theater. Visualization was transferred from a fully digital surgical microscope, an endoscope or an environmental camera in high definition quality. Students were able to participate at home from their personal computer. After following the surgery, they participated in an online-evaluation. RESULTS A total of 65 students participated in the live stream. The majority of students (61.54%) indicated a significant subjective increase in knowledge after participation. The majority of students (53.85%) indicated that live surgeries should be offered as a permanent component in addition to classroom teaching. Likewise, a broader offer was desired by many students (63.08%). CONCLUSIONS Live streaming of surgery is a promising approach as an alternative or supplement to traditional attendance teaching. An expansion of digital teaching can be explicitly supported on the basis of this study.
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Affiliation(s)
- Sara M van Bonn
- Department of Otorhinolaryngology, Head and Neck Surgery, Otto Körner", Rostock University Medical Center, Doberaner Strasse 137-139, D-18057, Rostock, Germany
| | - Jan S Grajek
- Department of Otorhinolaryngology, Head and Neck Surgery, Otto Körner", Rostock University Medical Center, Doberaner Strasse 137-139, D-18057, Rostock, Germany
| | - Armin Schneider
- Munich Surgical Imaging GmbH, Türkenstraße 89, 80799, Munich, Germany
- Research Group Minimally Invasive Interdisciplinary Therapeutical Intervention (MITI), KlinikumRechts Der Isar", Technical University Munich (TUM), Munich, Germany
| | - Tobias Oberhoffner
- Department of Otorhinolaryngology, Head and Neck Surgery, Otto Körner", Rostock University Medical Center, Doberaner Strasse 137-139, D-18057, Rostock, Germany
| | - Robert Mlynski
- Department of Otorhinolaryngology, Head and Neck Surgery, Otto Körner", Rostock University Medical Center, Doberaner Strasse 137-139, D-18057, Rostock, Germany
| | - Nora M Weiss
- Department of Otorhinolaryngology, Head and Neck Surgery, Otto Körner", Rostock University Medical Center, Doberaner Strasse 137-139, D-18057, Rostock, Germany.
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9
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[Electronic learning for otorhinolaryngology students using the content management system ILIAS]. HNO 2021; 69:642-649. [PMID: 33537879 PMCID: PMC7857105 DOI: 10.1007/s00106-021-01008-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/15/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND With increasing access to online teaching materials, traditional teaching methods at universities need to be questioned in the context of digital transformation. The aim of this study was to evaluate whether electronic learning may serve as or replace conventional internship in otorhinolaryngology. MATERIALS AND METHODS A completely digital electronic learning concept was created and made available at the online learning platform ILIAS. Students were introduced to the program. Four learning units (neck [I], pharynx/larynx [II], nose [III], ear [IV]) were set up, with a topic-related multiple-choice test at the end of each unit. The students took part in the evaluation before and after completion of the course. RESULTS A total of 105 students participated in the evaluation before and 85 students after the electronic learning program. After completing the courses, the majority of students (52.94%) stated to be more satisfied with the content and the presentation of the learning sequences as well as with their own self-control concerning learning pace and time management compared to the situation before completing the program (34.29%; p < 0.0001). The majority of students (54.12%) stated that they would appreciate the electronic learning program in addition to practical internship. CONCLUSION The electronic learning program is a promising approach to supplement traditional learning and internships. An expansion of digital teaching proposals should be supported based on this study.
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Ancy AV, Thangaraj P, Hemalatha K, Bethubarani M. Effect of an e-learning tool on knowledge of recent Revised National Tuberculosis Control Programme guidelines among Medical Interns. JOURNAL OF EDUCATION AND HEALTH PROMOTION 2020; 9:257. [PMID: 33225001 PMCID: PMC7657408 DOI: 10.4103/jehp.jehp_744_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/13/2019] [Accepted: 03/18/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Medical students should have adequate knowledge on tuberculosis (TB) and national guidelines pertaining to its control, which is a major public health problem in developing countries. The present study aims to evaluate the knowledge on TB and Revised National TB Control Programme (RNTCP) among medical interns and the change in the level of knowledge following the dissemination of self-directed learning (SDL) modules using an e-learning tool (WhatsApp). MATERIALS AND METHODS A prospective, nonrandomized, pre- and posttest study was done among 124 medical interns in a private medical college during July-August 2019. A semi-structured, self-administered questionnaire was prepared and filled by the interns in the pretest. Following the educational intervention, the same questionnaire was administered and posttest data were collected. The pre- and posttest results were expressed in frequency and percentage. Wilcoxon signed rank test was used to compare the change in the total mean score of knowledge using the e-learning tool following the dissemination of SDL modules. RESULTS The mean age of the interns was 22.82 ± 0.82 years. Of the total 124 interns, 60 (48.3%) had heard about the recent changes in RNTCP. The Internet (25.8%) and textbooks (23.4%) were the most common source of recent information regarding TB and RNTCP. The mean pretest score was 12.9 ± 3.08, which increased to 15.3 ± 2.62 during the posttest (z = -9.75, P < 0.05) following the intervention. CONCLUSIONS The knowledge regarding TB and RNTCP among the interns was inadequate. The usage of an e-learning tool "WhatsApp" was found to be effective in improving the knowledge in posttest as compared to pretest.
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Affiliation(s)
- A. V. Ancy
- Department of Community Medicine, Trichy SRM Medical College Hospital and Research Centre, Trichy, Tamil Nadu, India
| | - Prabha Thangaraj
- Department of Community Medicine, Trichy SRM Medical College Hospital and Research Centre, Trichy, Tamil Nadu, India
| | - Kumaraswamy Hemalatha
- Department of Community Medicine, Trichy SRM Medical College Hospital and Research Centre, Trichy, Tamil Nadu, India
| | - M. Bethubarani
- Department of Community Medicine, Trichy SRM Medical College Hospital and Research Centre, Trichy, Tamil Nadu, India
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11
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Weiss NM, Schneider A, Hempel JM, Uecker FC, van Bonn SM, Schraven SP, Rettschlag S, Schuldt T, Müller J, Plontke SK, Mlynski R. Evaluating the didactic value of 3D visualization in otosurgery. Eur Arch Otorhinolaryngol 2020; 278:1027-1033. [PMID: 32613353 PMCID: PMC7954761 DOI: 10.1007/s00405-020-06171-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2020] [Accepted: 06/23/2020] [Indexed: 11/25/2022]
Abstract
Introduction Improvements of surgical visualization add value to the quality of clinical routine and offer the opportunity to improve surgical education of medical staff. The aim of this study was to determine whether otorhinolaryngology trainees gain additional comprehension of the anatomical structures and the surgical site when 3D visualization is used. Methods Data were collected from ENT trainees of microsurgical courses of the middle ear, inner ear and lateral skull base at four university ENT departments (Charité (Berlin), Martin Luther University Halle-Wittenberg (Halle/Saale), Ludwig Maximilian University (Munich) and Rostock University Medical Center). Participants were asked to complete a questionnaire assessing the subjective value of identical surgical field visualization in 3D for surgeon and observer. Results A total of 112 participants completed the questionnaire. The majority of participants stated a high additional value of 3D visualization compared to 2D visualization, with 75% fully agreeing to the statement that 3D visualization of the surgical field is superior to perceive the anatomical topography and structures compared to 2D representation. Participants encouraged the storage of data in online learning platforms. Conclusion The results show that 3D visualization with identical imaging for surgeon and observer is a useful tool in teaching of microsurgery. It addresses perception of anatomical topography and structures as well as conception of the surgical workflow. Electronic supplementary material The online version of this article (10.1007/s00405-020-06171-9) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Nora M Weiss
- Department of Otorhinolaryngology, Head and Neck Surgery, "Otto Körner", Rostock University Medical Center, Doberaner Strasse 137-139, 18057, Rostock, Germany.
| | - Armin Schneider
- ARRI Medical GmbH, Türkenstraße 89, 80799, Munich, Germany
- Research Group Minimally Invasive Interdisciplinary Therapeutical Intervention (MITI), "Klinikum rechts der Isar", Technical University Munich (TUM), Munich, Germany
| | - John M Hempel
- Department of Otorhinolaryngology, Head and Neck Surgery, "Ludwig Maximilian University", University Medical Center Munich, Munich, Germany
| | - Florian C Uecker
- Department of Otorhinolaryngology, Head and Neck Surgery, "Charité" University Medical Center, Berlin, Germany
| | - Sara M van Bonn
- Department of Otorhinolaryngology, Head and Neck Surgery, "Otto Körner", Rostock University Medical Center, Doberaner Strasse 137-139, 18057, Rostock, Germany
| | - Sebastian P Schraven
- Department of Otorhinolaryngology, Head and Neck Surgery, "Otto Körner", Rostock University Medical Center, Doberaner Strasse 137-139, 18057, Rostock, Germany
| | - Stefanie Rettschlag
- Department of Otorhinolaryngology, Head and Neck Surgery, "Otto Körner", Rostock University Medical Center, Doberaner Strasse 137-139, 18057, Rostock, Germany
| | - Tobias Schuldt
- Department of Otorhinolaryngology, Head and Neck Surgery, "Otto Körner", Rostock University Medical Center, Doberaner Strasse 137-139, 18057, Rostock, Germany
| | - Joachim Müller
- Department of Otorhinolaryngology, Head and Neck Surgery, "Ludwig Maximilian University", University Medical Center Munich, Munich, Germany
| | - Stefan K Plontke
- Department of Otorhinolaryngology, Head and Neck Surgery, Martin Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Robert Mlynski
- Department of Otorhinolaryngology, Head and Neck Surgery, "Otto Körner", Rostock University Medical Center, Doberaner Strasse 137-139, 18057, Rostock, Germany
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12
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Bottcher B, Abu-El-Noor N, Abuowda Y, Alfaqawi M, Alaloul E, El-Hout S, Al-Najjar I, Abu-El-Noor M. Attitudes of doctors and nurses to patient safety and errors in medical practice in the Gaza-Strip: a cross-sectional study. BMJ Open 2019; 9:e026788. [PMID: 31383695 PMCID: PMC6687030 DOI: 10.1136/bmjopen-2018-026788] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 06/17/2019] [Accepted: 07/10/2019] [Indexed: 10/31/2022] Open
Abstract
OBJECTIVES This study examined the attitudes of nurses and doctors to key patient safety concepts, evaluated differences and similarities between professional groups and assessed positive and negative attitudes to identify target areas for future training. SETTING Four major governmental hospitals in the Gaza-Strip. PARTICIPANTS A convenience sample of 424 nurses and 150 physicians working for at least 6 months in the study hospitals. PRIMARY AND SECONDARY OUTCOME MEASURES The primary outcome measures were mean scores with SD as measured for individual items and nine main patient safety domains assessed by the Attitudes to Patient Safety Questionnaire. Secondary outcome measures were the proportions of doctors and nurses, that gave a positive response to each item, represented as percentage of each group. RESULTS Nurses and doctors held moderately positive attitudes towards patient safety with five out of nine domain scores >3.5 of 5. Doctors showed slightly more positive attitudes than nurses, despite a smaller proportion of doctors having received patient safety training with 37.5% compared with 41.9% of nurses. Both professions displayed their most positive patient safety attitudes in the same domains ('team functioning' and 'working hours as a cause for error'), as well as their two most negative attitudes ('importance of patient safety in the curriculum' and 'professional incompetence as a cause of error'), demonstrating significant deficits in understanding medical errors. A specific challenge will be the negative attitudes of both professions towards patient safety training for wider dissemination of this content in the postgraduate curriculum. CONCLUSION Patient safety attitudes were moderately positive in both professional groups. Target of future patient safety training should be enhancing the understanding of error in medicine. Any training has to be motivating and relevant for clinicians, demonstrating its importance in ongoing professional learning.
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Affiliation(s)
- Bettina Bottcher
- Islamic University of Gaza, Faculty of Medicine, Gaza, State of Palestine
| | | | - Yousef Abuowda
- Islamic University of Gaza, Faculty of Medicine, Gaza, State of Palestine
| | - Maha Alfaqawi
- Islamic University of Gaza, Faculty of Medicine, Gaza, State of Palestine
| | - Enas Alaloul
- Palestinian Ministry of Health, Gaza, State of Palestine
| | - Somaya El-Hout
- Palestinian Ministry of Health, Gaza, State of Palestine
| | - Ibrahem Al-Najjar
- Islamic University of Gaza, Faculty of Medicine, Gaza, State of Palestine
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Gaupp R, Dinius J, Drazic I, Körner M. Long-term effects of an e-learning course on patient safety: A controlled longitudinal study with medical students. PLoS One 2019; 14:e0210947. [PMID: 30657782 PMCID: PMC6338364 DOI: 10.1371/journal.pone.0210947] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Accepted: 01/06/2019] [Indexed: 12/02/2022] Open
Abstract
Background To improve patient safety, educational interventions on all system levels, including medical school are necessary. Sound theoretical knowledge on elements influencing patient safety (such as error management or team work) is the basis for behavioral changes of health care professionals. Methods A controlled, quasi-experimental study with repeated measures was deployed. The intervention group participated in a mandatory e-learning course on patient safety (ELPAS) between October 2016 and December 2016. The control group did not receive any didactic session on patient safety. In both groups we measured technical knowledge and attitudes towards patient safety before the intervention (T0), directly after the intervention (T1) and one year after the intervention (T2). Participants were 309 third-year medical students in the intervention group and 154 first- and second-year medical students in the control group. Results Technical knowledge in the intervention group (but not the control group) improved significantly after the intervention and remained high after one year (F(2, 84) = 13.506, p < .001, η2 = .243). Students of the intervention group felt better prepared for safe patient practice, even one year after the intervention F(2, 85) = 6.743, p < .002, η2 = .137). There was no sustainable significant effect on attitudes towards patient safety. Conclusion This study shows, that eLearning interventions can produce significant long-term effects on patient safety knowledge, however, the study did not show long-term effects on attitudes towards patient safety. Our study implies two potential developments for future research: e-learning might be used in combination with face-to-face sessions, or more intensive (in terms of frequency and duration) e-learning sessions may be needed to achieve lasting changes in attitude.
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Affiliation(s)
- Rainer Gaupp
- Freiburg University, Medical Faculty, Medical Psychology and Medical Sociology, Hebelstrasse, Freiburg, Germany
- * E-mail:
| | - Julia Dinius
- Freiburg University, Medical Faculty, Medical Psychology and Medical Sociology, Hebelstrasse, Freiburg, Germany
| | - Ivana Drazic
- SRH University Berlin, Ernst-Reuter-Platz, Berlin, Germany
| | - Mirjam Körner
- Freiburg University, Medical Faculty, Medical Psychology and Medical Sociology, Hebelstrasse, Freiburg, Germany
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