The effect of interactive learning method on nursing students' learning of movement requirement: A randomized controlled study

BACKGROUND

Interactive learning is one of the active learning methods used to develop students' knowledge and skills.

OBJECTIVES

This study was conducted to determine the effect of the interactive learning method with questions prepared according to Bloom's taxonomy on nursing students' learning of the need for movement.

DESIGN

It is a randomized controlled study conducted in May 2023.

PARTICIPANTS

This study was conducted with 134 first-year nursing students taking the Fundamentals of Nursing course. The students were randomly divided into control (n = 67) and experimental (n = 67).

METHOD

The data was collected by using a form delineating descriptive characteristics, a test assessing the necessity of movement knowledge, an analysis of a specific case study, and an assessment form for gathering student opinions on interactive learning. The queries within the data collection form were tailored to align with Bloom's taxonomy. Following the theoretical instruction, each student participated in the mobility needs knowledge test and case analysis (pre-test). The instructional session for the control group involved conventional lecture-style teaching supplemented with a question-and-answer format, while the experimental group received instruction through an interactive learning approach. One week subsequent to this, all students retook the mobility needs knowledge test and case analysis (post-test). Subsequently, feedback regarding the interactive learning method was solicited from the students.

RESULTS

The knowledge test revealed a statistically significant difference, with the control group exhibiting a higher median comprehension score in the post-test compared to the experimental group (p < 0.05). Regarding the case analysis, statistical analysis demonstrated that the experimental group surpassed the control group in median scores for comprehension, synthesis, and total scores, with a significant difference (p < 0.05). Additionally, most students expressed favorable opinions toward the interactive learning approach.

CONCLUSIONS

It is recommended that studies on interactive learning be repeated in different subjects in nursing education.

CLINICALTRIALS

gov ID:NCT05868278.

Designing formative assessments to improve anatomy exam performance

Formative assessments are primarily used as a tool to gauge learning throughout an anatomy course. They have also been demonstrated to improve student mastery and exam performance, although the precise nature of this relationship is poorly understood. In this study, it is hypothesized that formative assessment questions targeting higher cognitive levels, integrating topics from multiple lessons, and including visuospatial elements will increase student exam performance. Formative and summative questions provided to students during the Clinical Anatomy block at the University of Arizona College of Medicine-Phoenix between 2015 and 2018 were assessed for cognitive level, integration of targeted learning objectives, and presence or absence of visuospatial elements. These variables were entered into a hierarchical linear model along with demographic variables for each cohort to assess the relationships between these variables and cohort performance on exam questions. The best predictor of exam performance was the inclusion of constituent learning objectives within the formative assessment. Additionally, students performed better on exam questions with visuospatial elements when the targeted learning objectives were also associated with visuospatial elements on the formative assessment. Surprisingly, the cognitive level of formative questions and the integration of learning objectives within them were not correlated with student exam performance. This study demonstrates the importance of including a broad range of topics in formative assessments and highlights a potential benefit of adopting consistent question formats for formative assessments and exams.

Evaluation of Multiple-Choice Questions by Item Analysis, from an Online Internal Assessment of 6th Semester Medical Students in a Rural Medical College, West Bengal

Background:

Properly constructed single best-answer multiple choice questions (MCQs) or items assess higher-order cognitive processing of Bloom's taxonomy and accurately discriminate between high and low achievers. However, guidelines for writing good test items are rarely followed, leading to generation and application of faulty MCQs.

Materials and Methods:

During lockdown period in 2020, internal assessment was taken through online mode using Google Forms. There were 60 'single response type' MCQs, each consisting of single stem and four options including one correct answer and three distractors. Each item was analyzed for difficulty index (Dif I), discrimination index (DI), and distractor efficiency (DE).

Results:

The mean of achieved marks was 42.92± (standard deviation [SD], 5.07). Dif I, DI, and DE were 47.95± (SD 16.39) in percentage, 0.12± (SD 0.10), and 18.42± (SD 15.35), respectively. 46.67% of the items were easy and 21.66% were of acceptable discrimination. Very weak negative correlation was found between Dif I and DI. Out of total 180 distractors, 51.66% were nonfunctional one.

Conclusion:

Item analysis and storage of MCQs with their indices provides opportunity for an examiner to select MCQs of appropriate difficulty level as per the need of assessment and decide their placement in the question paper.

Evidentiary and theoretical foundations for virtual simulation in nursing education

Virtual simulation has been used extensively in nursing education since the beginning of the COVID-19 pandemic due to the unavailability of clinical sites. Extant research supports substitution of up to 50% of nursing clinical hours with simulation. However, in many nursing programs virtual simulation is currently substituting more than half of traditional clinical hours, and the knowledge gaps and limitations surrounding virtual simulation exist. The purpose of this paper is to describe the evidentiary and theoretical foundations for virtual simulation. Through examination of adult learning theories, learning styles and Bloom's Revised Taxonomy, recommendations for maximizing the use of virtual simulation in the current clinical learning environment are outlined. Debriefing is a vital component of virtual simulation. Synchronous debriefing with nursing students, faculty, preceptors, and peers provides the opportunity for scaffolding to support students' learning needs and foster reflection and evaluation to mitigate shortcomings of virtual simulation in the current clinical learning environment.

Training Radiology Residents, Bloom Style

Bloom's Taxonomy, an integral component of learning theory since its inception, describes cognitive skill levels in increasing complexity (Remember, Understand, Apply, Analyze, Evaluate, and Create). Considering Bloom's Taxonomy when writing learning objectives and lecture material, teaching residents at the workstation and creating multiple choice questions can increase an educator's effectiveness. The incorporation of higher Bloom levels aids in cultivating critical thinking skills vital to image interpretation and patient care, and becomes increasingly important as the radiologist's role evolves with the continued development of artificial intelligence. Following established tenets of multiple choice question writing, involving trainees in the question writing process, and incorporating audience response systems into lectures are all strategies in which higher Bloom level skills can be accomplished.

Applying Bloom's taxonomy in clinical surgery: Practical examples

Bloom's cognitive learning taxonomy is widely used in medical education. The revised taxonomy published by David Kathwohl (1956) and his group describes the levels in action forms: Remember, Understand, Apply, Analyze, Evaluate, and Innovate. The taxonomy has been commonly used to design and structure educational goals and objectives. However, most uses occur at the course or program curriculum level, as was originally described. Whereas applying the taxonomy at the level of individual educational activities remained limited for different reasons. Hence, the aim of this article is to promote applying the taxonomy in daily clinical teaching by providing practical clinical examples in a simplified way.

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Bloom's taxonomy of cognitive learning is widely used in medical education to design educational curricula.

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The taxonomy can be efficiently used in daily educational clinical activities.

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Clinician educators are encouraged to apply the taxonomy at clinical encounters.

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Understanding the taxonomy through clinical examples can enhance the application of the taxonomy.

Examining Bloom's Taxonomy in Multiple Choice Questions: Students' Approach to Questions

BACKGROUND

Analytic thinking skills are important to the development of physicians. Therefore, educators and licensing boards utilize multiple-choice questions (MCQs) to assess these knowledge and skills. MCQs are written under two assumptions: that they can be written as higher or lower order according to Bloom's taxonomy, and students will perceive questions to be the same taxonomical level as intended. This study seeks to understand the students' approach to questions by analyzing differences in students' perception of the Bloom's level of MCQs in relation to their knowledge and confidence.

METHODS

A total of 137 students responded to practice endocrine MCQs. Participants indicated the answer to the question, their interpretation of it as higher or lower order, and the degree of confidence in their response to the question.

RESULTS

Although there was no significant association between students' average performance on the content and their question classification (higher or lower), individual students who were less confident in their answer were more than five times as likely (OR = 5.49) to identify a question as higher order than their more confident peers. Students who responded incorrectly to the MCQ were 4 times as likely to identify a question as higher order than their peers who responded correctly.

CONCLUSIONS

The results suggest that higher performing, more confident students rely on identifying patterns (even if the question was intended to be higher order). In contrast, less confident students engage in higher-order, analytic thinking even if the question is intended to be lower order. Better understanding of the processes through which students interpret MCQs will help us to better understand the development of clinical reasoning skills.

Higher-Order Assessment in Gross Anatomy: A Comparison of Performance on Higher- Versus Lower-Order Anatomy Questions between Undergraduate and First-Year Medical Students

Gross anatomy is considered by many the backbone of medical education. While learning anatomy has a reputation of requiring mainly rote memorization, modern day anatomy education often involves instruction and assessment at cognitive levels that foster higher-order thinking. In many instances, these higher-order anatomical concepts are taught to graduate students in healthcare-related fields, such as medicine. At this level, students are expected to apply and analyze anatomical information since that is what will ultimately be expected of them as professionals. In contrast, undergraduate anatomy education is typically more introductory in nature and often takes place in the setting of a large-enrollment course that serves as a prerequisite for many health sciences degree programs. In this study, variables related to the assessment of higher-order concepts in clinical anatomy were compared between first-year medical students and undergraduate students enrolled in an upper-level human gross anatomy course. Results demonstrate that undergraduate students perform lower than medical students overall, but the degree of difference in how they perform on higher- versus lower-order questions is comparable. The most notable exception is on practical examinations, where undergraduate students tend to struggle more with applying and analyzing information. Exploration of additional variables provides insight into how the cognitive level being assessed affects the time it takes to answer a question and how different practical examination question types and formats influence student performance. Findings presented in this study have implications for designing anatomy courses and underscore the importance of blueprinting assessments.

Stirring deep thinking and learning through student-designed assessment problems

BACKGROUND AND PURPOSE

Deep thinking is a desirable trait for higher education especially at a time where knowledge application, rather than knowledge acquisition, is premium. As assessment plays a critical role in shaping learning behaviors, this study attempted to evaluate the benefits of administering a 'student-designed assessment problems' (SDAP) assignment as a tool to instill deeper learning among students. The supposition was that when tasked to design assessment problems, students are challenged to higher cognitive levels of thinking on the Bloom's revised taxonomy scale.

EDUCATIONAL SETTING AND ACTIVITY

This study was conducted on a group of third year pharmacy students taking an elective module on pharmacokinetics and toxicokinetics. Students were shown an example of a finished product and were given three weeks to complete the take-home assignment. The questions that students designed were characterized according to the revised Bloom's taxonomy category by two independent reviewers. Feedback on students' experience was also evaluated.

FINDINGS

All 18 students reading the module submitted their SDAP with questions that demonstrated all levels of thinking, with application-based questions being most significant, followed by analytical questions. Feedback from the students was positive, with clear indications of self-directed and peer learning.

SUMMARY

This exercise offered a surprising insight into students' way of thinking, by externalizing their inquiring minds and translating their thoughts into written questions. This positive outcome informed that it has stirred deep thinking and learning among the students who participated. Evidently, SDAP is impactful as an assessment for and of learning.

Revised Bloom's taxonomy as a mentoring framework for successful promotion

INTRODUCTION

Promotion is both a rewarding and challenging milestone in an academic career, and the process is enriched by intentional mentorship. Junior faculty often seek a stepwise mentorship approach that allows them to accurately self-reflect on their progress toward promotion, while more seasoned faculty may benefit from guidance on how to effectively mentor their colleagues through the process.

PERSPECTIVE

Fortunately, the revised Bloom's taxonomy, the same tool commonly utilized to guide curricular development and assessment, serves both of these purposes very effectively.

IMPLICATIONS

This tale of four pharmacy academicians uses the construct of the revised Bloom's taxonomy knowledge dimension to define various stages of an academic career while drawing parallels with aspects of the cognitive process dimension in each stage and describes a mentoring framework that successfully leads faculty toward the next step of their careers.

Presentations beyond the matrix: The Fred MacLeod JPS lecture, CAPS 2019

Current research calculates the time between development of new evidence-based knowledge into established clinical practice as 17 years. This is the knowledge translation gap. The factors influencing this delay are multiple, but it is clear across the history of medicine that knowledge from new, well-constructed studies does not lead directly to change. A significant factor within the knowledge translation gap is the nature of the presentations as they are currently delivered. In the 1999 film The Matrix, there is a discussion between two characters regarding the concept that the world we perceive is, in fact, a virtual reality. As we inhabit this construct, we have a fleeting awareness that the world may not be as we perceive it, but the truth of what that entails is overwhelming. The implicit beliefs underpinning a presentation are that reading out a presentation is teaching, and the corollary, that listening to that presentation is learning. The evidence in the psychological and educational literature is clear that this is false. The implications of this are significant. This is The Matrix of knowledge translation.

A gross anatomy flipped classroom effects performance, retention, and higher-level thinking in lower performing students

A flipped classroom is a growing pedagogy in higher education. Many research studies on the flipped classroom have focused on student outcomes, with the results being positive or inconclusive. A few studies have analyzed confounding variables, such as student's previous achievement, or the impact of a flipped classroom on long-term retention and knowledge transfer. In the present study, students in a Doctor of Physical Therapy program in a traditional style lecture of gross anatomy (n = 105) were compared to similar students in a flipped classroom (n = 112). Overall, students in the flipped anatomy classroom had an increase in semester average grades (P = 0.01) and performance on higher-level analytical questions (P < 0.001). Long-term retention and knowledge transfer was analyzed in a subsequent semester's sequenced kinesiology course, with students from the flipped anatomy classroom performing at a higher level in kinesiology (P < 0.05). Student's pre-matriculation grade point average was also considered. Previously lower performing students, when in a flipped anatomy class, outperformed their traditional anatomy class counterparts in anatomy semester grades (P < 0.05), accuracy on higher-level analytical anatomy multiple-choice questions (P < 0.05) and performance in subsequent course of kinesiology (P < 0.05). This study suggests that the flipped classroom may benefit lower performing student's knowledge acquisition and transfer to a greater degree than higher performing students. Future studies should explore the underlying reasons for improvement in lower performing students.

Role of comprehension on performance at higher levels of Bloom's taxonomy: Findings from assessments of healthcare professional students

The first four levels of Bloom's taxonomy were used to create quiz questions designed to assess student learning of the gross anatomy, histology, and physiology of the gastrointestinal (GI) system. Information on GI histology and physiology was presented to separate samples of medical, dental, and podiatry students in computer based tutorials where the information from the two disciplines was presented either separately or in an integrated fashion. All students were taught GI gross anatomy prior to this study by course faculty as part of the required curriculum of their respective program. Student responses to the quiz questions were analyzed to assess both the validity of Bloom's cumulative hierarchy and the effectiveness of an integrated curriculum. No statistically significant differences were found between quiz scores from students who received the integrated tutorial and from those who received the separate tutorials. Multiple regression analyses provided partial support for a cumulative hierarchy where scores on the lower levels of Bloom's taxonomy predicted scores on higher levels. Notably, in the majority of regression analyses, the comprehension score was the key foundational predictor for application and analysis scores. This study supports the suggestion that educators increase the number of comprehension level questions, even at the expense of knowledge level questions, in course assessments both to evaluate lower order cognitive skills and also as a predictor of success on questions requiring application and analysis levels of the higher order cognitive skills of Bloom's taxonomy. Anat Sci Educ 11: 433-444. © 2018 American Association of Anatomists.

Design, implementation, and evaluation of educational workshop on management of Parkinson's and Alzheimer's disease patients for third-year pharmacy students

BACKGROUND AND PURPOSE

Increasing aging populations in the United States means an increasing number of persons with Parkinson's disease (PD) and Alzheimer's disease (AD) requiring competent pharmaceutical care. The workshop was designed and implemented to integrate pharmacology and therapeutics in management of PD and AD, and evaluate efficacy of students' high-cognitive thinking, and self-rated knowledge improvement, confidence, and interest in the subject.

EDUCATION ACTIVITY AND SETTING

Third-year pharmacy students participated in a three-hour workshop comprised of a foundational knowledge quiz from pathophysiology, pharmacology and therapeutics, performance on high-cognitive thinking in clinical scenarios, and hands-on activities in pharmacology and therapeutics related to PD and AD care. Pre- and post-education, Likert-style questions assessed students' self-rated confidence, interest and knowledge improvement. Descriptive statistics, paired t-test, and chi-square analyses were performed using Stata 10.1 statistical software (College Station, TX: Stata Corp LP).

FINDINGS

Eighty-four of 93 students (90.3%) completed all workshop activities. Students' ability to apply knowledge in complex case mediation problems was not associated with performance on baseline quiz questions (Pearson r: 0.03-0.17). Completion of structured, hands-on active learning integrating clinical pharmacology and therapeutics had measurable immediate benefit solving high-cognitive order problems in clinical scenarios (p < 0.05). Hands-on activity also increased mean self-rated confidence (p < 0.01). Students (85.6%) reported knowledge improved "somewhat" or "very much" after the activity. Mean scores before and after hands-on activity were not associated with interest in the topic.

SUMMARY

Structured, hands-on workshops can aid comprehension of taught/lectured material and its application to PD and AD, and is a way for instructors to close gaps between didactic lecture and clinical practice.

Utilizing Bloom's taxonomy to design a substance use disorders course for health professions students

BACKGROUND

Substance use disorders (SUDs) are a public health problem affecting millions of Americans. Despite their prevalence, there are few health care resources allocated for SUDs treatment. Relatively few health care professionals are exposed to SUDs education in their respective programs, which may be one reason for this resource insufficiency. In hopes of rectifying this gap, the authors developed a SUDs course for health professions students combining classroom learning with practical application to patient care.

METHODS

The authors used Bloom's taxonomy of cognitive, affective, and psychomotor learning domains as an educational framework to create numerous opportunities for students to deepen their knowledge, assess their attitudes, and develop their motivational interviewing skills. The primary outcome of the study was a comparison of students' scores on the Substance Abuse Attitude Scale (SAAS) pre- and post-course completion. Secondary outcome was to compare students' self-assessment scores of their patient counseling with residents' assessments of them on the Liverpool Communication Skills Assessment Scale (LCSAS).

RESULTS

One hundred twelve students participated in the authors' SUDs course over a 9-month period. Ninety-five students completed both the pre- and post-course SAAS surveys. The total SAAS survey score and individual domain scores for nonmoralizing, treatment optimism, and treatment intervention demonstrated significant improvement post-course. Eighty-nine students completed a motivational interview with a patient. Eighty students had a LCSAS self-assessment paired with a residents' assessment. Mean scores for individual items on the LCSAS for both groups' assessment were approximately 3.5, indicating that students' communication was assessed as "acceptable" to "good."

CONCLUSIONS

This study demonstrates that Bloom's taxonomy was a useful educational framework to ensure a systematic development of the authors' SUDs course. Through participation in our course, students touched each of the 3 domains in Bloom's taxonomy. The authors believe their course design may serve as a framework for future SUDs courses.

Active methodology and blended learning: An experience in pharmaceutical care

BACKGROUND AND PURPOSE

The aim of this study was to analyze the implementation of an active methodology in a blended model of education in the teaching-learning processes of students enrolled in two disciplines: Pharmaceutical Care I and Pharmaceutical Care II, both part of the undergraduate Bachelor of Pharmacy program at the Federal University of Paraná.

EDUCATIONAL ACTIVITY AND SETTING

The study design was quasi-experimental, prospective, comparative, following a pre/posttest format, where Pharmaceutical Care classes were the intervention. Identical pre- and post-intervention tests were designed based on Anderson and Krathwohl's (2001) revision of Bloom's taxonomy, and according to the three levels of the cognitive domain: remember and understand; apply and analyze; evaluate and create.

FINDINGS

Participants were 133 students enrolled in the two Pharmaceutical Care classes. A significant difference between pre- and posttest results was observed, showing an increase in students' performance in the applied tests at all cognitive levels. This is the first study of its kind involving Pharmaceutical Care and Blended Learning.

DISCUSSION AND SUMMARY

By comparing the results of the diagnostic and summative assessments based on Bloom's taxonomy at all levels of the cognitive domain, positive results were observed regarding the students' performance in the two disciplines (Pharmaceutical Care I and II).

Climbing Bloom's taxonomy pyramid: Lessons from a graduate histology course

Bloom's taxonomy was adopted to create a subject-specific scoring tool for histology multiple-choice questions (MCQs). This Bloom's Taxonomy Histology Tool (BTHT) was used to analyze teacher- and student-generated quiz and examination questions from a graduate level histology course. Multiple-choice questions using histological images were generally assigned a higher BTHT level than simple text questions. The type of microscopy technique (light or electron microscopy) used for these image-based questions did not result in any significant differences in their Bloom's taxonomy scores. The BTHT levels for teacher-generated MCQs correlated positively with higher discrimination indices and inversely with the percent of students answering these questions correctly (difficulty index), suggesting that higher-level Bloom's taxonomy questions differentiate well between higher- and lower-performing students. When examining BTHT scores for MCQs that were written by students in a Multiple-Choice Item Development Assignment (MCIDA) there was no significant correlation between these scores and the students' ability to answer teacher-generated MCQs. This suggests that the ability to answer histology MCQs relies on a different skill set than the aptitude to construct higher-level Bloom's taxonomy questions. However, students significantly improved their average BTHT scores from the midterm to the final MCIDA task, which indicates that practice, experience and feedback increased their MCQ writing proficiency. Anat Sci Educ 10: 456-464. © 2017 American Association of Anatomists.

Measuring the impact of the flipped anatomy classroom: The importance of categorizing an assessment by Bloom's taxonomy

The flipped classroom (FC) model has emerged as an innovative solution to improve student-centered learning. However, studies measuring student performance of material in the FC relative to the lecture classroom (LC) have shown mixed results. An aim of this study was to determine if the disparity in results of prior research is due to level of cognition (low or high) needed to perform well on the outcome, or course assessment. This study tested the hypothesis that (1) students in a FC would perform better than students in a LC on an assessment requiring higher cognition and (2) there would be no difference in performance for an assessment requiring lower cognition. To test this hypothesis the performance of 28 multiple choice anatomy items that were part of a final examination were compared between two classes of first year medical students at the University of Utah School of Medicine. Items were categorized as requiring knowledge (low cognition), application, or analysis (high cognition). Thirty hours of anatomy content was delivered in LC format to 101 students in 2013 and in FC format to 104 students in 2014. Mann Whitney tests indicated FC students performed better than LC students on analysis items, U = 4243.00, P = 0.030, r = 0.19, but there were no differences in performance between FC and LC students for knowledge, U = 5002.00, P = 0.720 or application, U = 4990.00, P = 0.700, items. The FC may benefit retention when students are expected to analyze material. Anat Sci Educ 10: 170-175. © 2016 American Association of Anatomists.

Intraoperative questioning to advance higher-order thinking

BACKGROUND

The type of question asked elicits a particular response. The purpose of this study was to determine what types and levels of questions were asked in the operating room. These insights are important for understanding how questions are used to advance learners.

METHODS

12 laparoscopic cholecystectomy operations were observed and recorded at a single institution. Intraoperative questions asked by faculty were transcribed for all cases. Using revised Bloom's taxonomy, questions were classified into one of 5 levels: (1) remembering, (2) understanding, (3) applying, (4) analyzing, (5) evaluating.

RESULTS

141 questions were asked by faculty and ranged from 0 to 34 questions per case. Classification of questions showed there were 43 remembering, 29 understanding, 47 applying, 13 analyzing, and 8 evaluating questions asked.

CONCLUSIONS

Questioning was predominately classified at lower-order and mid-level thinking skills (120/141). Integrating intraoperative questions at higher-order levels has the potential to guide trainees into progressively complex thinking and decision making.

Application of a utility analysis to evaluate a novel assessment tool for clinically oriented physiology and pharmacology

Multiple-choice questions are a gold-standard tool in medical school for assessment of knowledge and are the mainstay of licensing examinations. However, multiple-choice questions items can be criticized for lacking the ability to test higher-order learning or integrative thinking across multiple disciplines. Our objective was to develop a novel assessment that would address understanding of pathophysiology and pharmacology, evaluate learning at the levels of application, evaluation and synthesis, and allow students to demonstrate clinical reasoning. The rubric assesses student writeups of clinical case problems. The method is based on the physician's traditional postencounter Subjective, Objective, Assessment and Plan note. Students were required to correctly identify subjective and objective findings in authentic clinical case problems, to ascribe pathophysiological as well as pharmacological mechanisms to these findings, and to justify a list of differential diagnoses. A utility analysis was undertaken to evaluate the new assessment tool by appraising its reliability, validity, feasibility, cost effectiveness, acceptability, and educational impact using a mixed-method approach. The Subjective, Objective, Assessment and Plan assessment tool scored highly in terms of validity and educational impact and had acceptable levels of statistical reliability but was limited in terms of acceptance, feasibility, and cost effectiveness due to high time demands on expert graders and workload concerns from students. We conclude by making suggestions for improving the tool and recommend deployment of the instrument for low-stakes summative assessment or formative assessment.

The Blooming Anatomy Tool (BAT): A discipline-specific rubric for utilizing Bloom's taxonomy in the design and evaluation of assessments in the anatomical sciences

Bloom's taxonomy is a resource commonly used to assess the cognitive level associated with course assignments and examination questions. Although widely utilized in educational research, Bloom's taxonomy has received limited attention as an analytical tool in the anatomical sciences. Building on previous research, the Blooming Anatomy Tool (BAT) was developed. This rubric provides discipline-specific guidelines to Blooming anatomy multiple-choice questions (MCQs). To test the efficacy of the BAT, a group of volunteers were randomly split up and asked to Bloom a series of anatomy MCQs using either the BAT or a traditional Bloom's reference called Bloom's Learning Objectives (BLO). Both groups utilized each rubric for a different series of MCQs. Examination question categorizations made using each rubric were tested for accuracy and interrater reliability. In addition, previous experience in anatomy and Bloom's taxonomy were considered. Results demonstrated that volunteers using the BAT had consistently higher levels of interrater reliability, but accuracy varied and was similar between rubrics. Neither measure was substantially impacted by experience in Bloom's taxonomy or anatomy. A poststudy survey indicated that volunteers strongly preferred the BAT and felt it was more helpful in categorizing anatomy MCQs than the BLO. These results suggest that the BAT can be useful in educational research in the anatomical sciences to aid in aligning observer judgment on Bloom taxonomic levels and improve consistency, especially when used in conjunction with a norming session prior to data collection.

Asking a Great Question: A Librarian Teaches Questioning Skills to First-Year Medical Students

In a single one-hour session, first-year medical students were taught a framework for differentiating between lower-order questions that lead to knowledge of facts and higher-order questions that lead to integration of concepts and deeper learning, thereby preparing them for problem-based learning (PBL). Students generated lists of questions in response to an assertion prompt and categorized them according to Bloom's Taxonomy. These data were analyzed in addition to data from the course exam, which asked them to formulate a higher-level question in response to a prompt. Categorizing questions according to Bloom's Taxonomy was a more difficult task for students than was formulating higher-order questions. Students reported that the skills that they learned were used in subsequent PBL sessions to formulate higher-order learning objectives that integrated new and previously-learned concepts.

The 2014 Claude Bernard Distinguished Lecture: the social contract of learning

The shift to competency-based education expands the role of the teacher from that of a provider of information and into a shaper of knowledge, skills, and attitudes. These roles are facilitated by establishing a social contract between the instructor and learner, a contract that clearly defines the rights and duties of each. Adopting greater responsibility for the development of competencies in our learners allows faculty members to truly have an impact by shaping the behaviors of learners.

Reviewing Tribunal cases and nurse behaviour: putting empathy back into nurse education with Bloom's taxonomy

Recent events in the UK and Australia have shown how poor patient outcomes are achieved when the behaviour of nurses lacks empathy. The UK's Francis Inquiry and the Keogh Report both call for an increase in the 'caring and compassion' of health care workers. A review of cases presented to the nurses' disciplinary tribunal in New South Wales' (Australia) also suggests that the majority of complaints against nurses in this jurisdiction is the result of callousness or lack of empathy. Such events reinforce the need for nurse educators to support nursing students to develop the affective attributes of caring and empathy. This paper considers how to raise the awareness of undergraduate students as a first step to developing empathy by using Bloom's Taxonomy of Educational Objectives; and includes a description of how to facilitate interactions with undergraduate nursing students about caring with empathy. Enculturating empathy is an evidence-based method of increasing compassionate care in health organisations generally.

Oral anatomy laboratory examinations in a physical therapy program

The process of creating and administering traditional tagged anatomy laboratory examinations is time consuming for instructors and limits laboratory access for students. Depending on class size and the number of class, sections, creating, administering, and breaking down a tagged laboratory examination may involve one to two eight-hour days. During the time that a tagged examination is being created, student productivity may be reduced as the anatomy laboratory is inaccessible to students. Further, the type of questions that can be asked in a tagged laboratory examination may limit student assessment to lower level cognitive abilities and may limit the instructors' ability to assess the students' understanding of anatomical and clinical concepts. Anatomy is a foundational science in the Physical Therapy curriculum and a thorough understanding of anatomy is necessary to progress through the subsequent clinical courses. Physical therapy curricula have evolved to reflect the changing role of physical therapists to primary caregivers by introducing a greater scope of clinical courses earlier in the curriculum. Physical therapy students must have a thorough understanding of clinical anatomy early in the education process. However, traditional anatomy examination methods may not be reflective of the clinical thought processes required of physical therapy students. Traditional laboratory examination methods also reduce student productivity by limiting access during examination set-up and breakdown. To provide a greater complexity of questions and reduced overall laboratory time required for examinations, the Physical Therapy Program at Mercer University has introduced oral laboratory examinations for the gross anatomy course series.