Meeting report: IUPS and ADInstruments 2017 Teaching Workshop

Every 4 yr, the International Union of Physiological Sciences (IUPS) Teaching Workshop is held as a traditional satellite event of the IUPS Congress. The 2017 satellite workshop was held August 5-8, 2017 in Búzios, Rio de Janeiro, Brazil. The workshop provided an opportunity for discussion and experiences in physiology teaching for educators at various levels, graduate students, and undergraduate students. This report describes the workshop activities and reports the participants' perceptions of this event. For evaluation of perception, an anonymous questionnaire was sent by e-mail to all participants, addressing nine items: appropriate topics, time of activities, poster session, congress venue, registration fee, attention of the organizing committee before and during the event, social event, and food. Responses were ranked according to a five-point Likert scale. Of the 145 participants, 77 answered the questionnaire. The participants' perception was positive, noting in particular opportunities to share knowledge, space for reflection of teaching practice, contact networks for future, exchanges of experience, and collaborations in research in physiological education.

Progressive disclosure cases: The design and evaluation of use in multiple therapeutics courses

BACKGROUND AND PURPOSE

Case-based learning is used frequently throughout pharmacy education. Although beneficial, stand-alone cases may result in segmented learning that does not simulate realistic longitudinal patient care. We report the development, implementation, and evaluation of a longitudinal progressive disclosure case surrounding a single patient spanning two different therapeutics courses.

EDUCATIONAL ACTIVITY AND SETTING

A patient case was developed surrounding topics in two third professional year therapeutics courses occurring sequentially in the same semester. Changes to the patient's status were provided to students longitudinally via "disclosures." Students were assessed via quizzes and written assessment and plans. Students completed four perceptions of confidence surveys via a four-point Likert Scale. Surveys included questions surrounding confidence in areas of the pharmacists' patient care process (PPCP) before and after courses utilizing the progressive disclosure case. Case assessment grades were used to evaluate the impact on student performance on course examinations. Students also completed a survey on final perceptions of the activity.

FINDINGS

Seventy students were enrolled in the two courses participating in the progressive disclosure case and there were 50 (71.4%) matched, completed surveys completed for analysis. Significant improvements were seen in several questions surrounding confidence in the areas of the PPCP between the beginning and conclusion of courses that contained the progressive disclosure case. No correlation between case activity grades and examination performance was found.

DISCUSSION AND CONCLUSION

Overall, student confidence in patient care skills associated with information collection, assessment, plan design, and monitoring improved with the use of progressive disclosure cases within two sequential therapeutics courses.

Multiuser virtual worlds in healthcare education: A systematic review

BACKGROUND

The use of multiuser virtual worlds (MUVWs) for collaborative learning has generated interest among healthcare educators. Published evidence to support its use is growing, but none has synthesized the evidence to guide future work.

OBJECTIVE

This study sought to provide a comprehensive and systematic evaluation of MUVWs in healthcare education.

DESIGN

A systematic review METHODS: A systematic search of five databases including CINAHL, Cochrane library, EMBASE, PubMed, and Scopus, was conducted from inception up to January 2017. Two independent researchers selected studies that met the inclusion criteria and assessed for methodological quality using the Medical Education Research Study Quality Instrument (MERSQI). A total of 18 studies were reviewed and their data were synthesized narratively using a 3-P model (presage-process-product).

RESULTS

Average scores in the MERSQI for methodological quality are 10/18, which is modest. A rally by the government or professional bodies towards more collaborative working among healthcare professionals is a key driver behind implementing MUVWs. Funding is important for its development and evaluation. Team training in acute care and communication training were the most frequent learning objectives, and predominant learning activities include practice on simulation scenario and debriefing. Two-thirds of the studies did not explain their theoretical framework that underpinned their design and implementation of MUVWs. While MUVWs in healthcare education is generally well-received, learning outcomes remain inconclusive.

CONCLUSION

Despite a growth of studies on the use of MUVW in healthcare education, there is a need for more understanding of the application of theories to inform the learning activities. Therefore, we suggest educators to incorporate a theoretical model to explain the learning processes behind MUVWs. To improve the quality of evidence, we call for researchers to employ a more rigorous and broader approach to evaluation that explicates longer-term outcomes, including cost benefit analyses.

Learning organic chemistry day by day: The best choice of the best pharmacy students

BACKGROUND AND PURPOSE

During over ten years of experience in teaching organic chemistry at the Department of Pharmacy we have tried to answer the following question: why do most students tend to take the exam one, two, or more years after the end of the course they have attended? Several reasons could justify this delay, but three seem to be the most common drawbacks for our students: a) time needed for the comprehension of the arguments; b) the number of mandatory exams to pass before organic chemistry; c) lack of a self-evaluation method.

EDUCATIONAL ACTIVITY AND SETTING

To increase the number of students in the exam sessions of the semester just after the course we have proposed two strategies: 1) a systematic, but stressless, approach by which homework and everyday life examples concerning organic chemistry are used to increase the sense of responsibility in studying; 2) the modification of the number of mandatory exams required for organic chemistry.

FINDINGS

The rate of successful students in the exam sessions at the end of the course increased from 38.3 up to 61.3%. Interestingly, the highest scores tend to be obtained by students in the first session available just after the conclusion of the course.

DISCUSSION AND SUMMARY

The combined effect of Strategy 1 and Strategy 2 seems to be effective in promoting the learning of organic chemistry and points out that the best performances tend to be associated with students which follow organized studying.

Forty years of medical education through the eyes of Medical Teacher: From chrysalis to butterfly

To mark the 40th Anniversary of Medical Teacher, issues this year will document changes in medical education that have taken place over the past 40 years in undergraduate, postgraduate and continuing education with regard to curriculum themes and approaches, teaching and learning methods, assessment techniques and management issues. Trends such as adaptive learning will be highlighted and one issue will look at the medical school of the future. An analysis of papers published in the journal has identified four general trends in medical education - increased collaboration, greater international interest, student engagement with the education process and a move to a more evidence-informed approach to medical education. These changes over the years have been dramatic.

Improved medical student perception of ultrasound using a paired anatomy teaching assistant and clinician teaching model

This study describes a new teaching model for ultrasound (US) training, and evaluates its effect on medical student attitudes toward US. First year medical students participated in hands-on US during human gross anatomy (2014 N = 183; 2015 N = 182). The sessions were facilitated by clinicians alone in 2014, and by anatomy teaching assistant (TA)-clinician pairs in 2015. Both cohorts completed course evaluations which included five US-related items on a four-point scale; cohort responses were compared using Mann-Whitney U tests with significance threshold set at 0.05. The 2015 survey also evaluated the TAs (three items, five-point scale). With the adoption of the TA-clinician teaching model, student ratings increased significantly for four out of five US-items: "US advanced my ability to learn anatomy" increased from 2.91 ± 0.77 to 3.35 ± 0.68 (P < 0.0001), "Incorporating US increased my interest in anatomy" from 3.05 ± 0.84 to 3.50 ± 0.71 (P < 0.0001), "US is relevant to my current educational needs" from 3.36 ± 0.63 to 3.54 ± 0.53 (P = 0.015), and "US training should start in Phase I" from 3.36 ± 0.71 to 3.56 ± 0.59 (P = 0.010). Moreover, more than 84% of students reported that TAs enhanced their understanding of anatomy (mean 4.18 ± 0.86), were a valuable part of US training (mean 4.23 ± 0.89), and deemed the TAs proficient in US (mean 4.24 ± 0.86). By using an anatomy TA-clinician teaching team, this study demonstrated significant improvements in student perceptions of the impact of US on anatomy education and the relevancy of US training to the early stages of medical education. Anat Sci Educ 11: 175-184. © 2017 American Association of Anatomists.

A Simulated Case of Acute Salicylate Toxicity From an Intentional Overdose

INTRODUCTION

Salicylate poisoning is a serious toxicologic problem with a complex pathophysiology that requires prompt diagnosis and action for a favorable outcome. A simulated experience in the evaluation and management of an aspirin-overdose patient allows learners to construct a differential diagnosis from an array of symptoms and signs, analyze a mixed acid-base disturbance, and explore the multistep management of this disorder.

METHODS

This simulation exercise was designed for second-year medical students. At the start of the session, teams received a 10-minute introduction to the activity. Upon entering a room in a simulated Emergency Department, teams had 15 minutes to complete a focused history and physical exam of the patient, interpret arterial blood gas and basic metabolic panel data, and administer treatment based on key findings and a presumptive diagnosis. The scenario was followed by a 90-minute facilitated debriefing session. An alternative 45-minute debriefing guideline is also included.

RESULTS

Students voluntarily completed a 13-question, 5-point Likert-scale survey about the educational exercise immediately following the session. They evaluated the preparatory materials and briefing, the simulation scenario, the usefulness of the debriefing, and their confidence in their understanding of salicylate poisoning following the session. Students reported a favorable response to the overall experience and the debriefing, as well as an increase in confidence following the session.

DISCUSSION

This simulation exercise was successful in exposing students to the clinical presentation of salicylate toxicity and giving them the opportunity to apply and synthesize basic science knowledge during the scenario.

Integrating Scaffolding and Deliberate Practice Into Focused Cardiac Ultrasound Training: A Simulator Curriculum

INTRODUCTION

Focused cardiac ultrasound (FoCUS) is widely used for the point-of-care evaluation of basic cardiac pathology, and there is a need for efficient and consistent training in this modality. We designed a simulator-based FoCUS curriculum that integrates instructional scaffolding and deliberate practice to create a directed, self-regulated learning experience for novices. The goal of this strategy was to guide the novice's learning efforts more efficiently and moderate cognitive load while retaining the benefits of independent learning.

METHODS

The complex task of learning cardiac ultrasound is broken into discrete steps, with focused didactic information immediately followed by targeted simulator practice for each module. The practice complexity increases through successive modules, and learners ultimately apply their skills by completing unassisted simulator cases. Immediate visual and quantitative feedback is provided by the simulator whenever an ultrasound image was captured during practice. The entire curriculum is self-guided.

RESULTS

Sixteen nurse practitioners and resident physicians completed this FoCUS curriculum. In comparison to a previously validated, lecture-before-practice-style curriculum, the average time to completion decreased from 8.0 ± 2.5 hours to 4.7 ± 1.9 hours (p < .0001). There was no difference in posttraining cognitive or psychomotor outcomes between the curricula as measured by a simulator posttest.

DISCUSSION

A curriculum integrating scaffolding and deliberate practice provides a more efficient, but equally effective, means of teaching psychomotor and cognitive skills in FoCUS. These instructional design principles may translate to other operational learning tasks and allow novices to build skills and reach basic competency more rapidly.

Culturally Effective Care for Refugee Populations: Interprofessional, Interactive Case Studies

Introduction

Within health sciences education literature, the majority of reported student experiences with refugee populations are limited to traditional, professionally independent, elective courses and extracurricular volunteer opportunities. A simulated patient exercise is a learning opportunity that helps participants engage with material in real time in a realistic environment, demanding higher levels of learning. This session utilized a simulated patient facilitator in interprofessional small groups to explore common health needs and barriers to care among refugee populations.

Methods

Health professions students from nine degree programs participated in a refugee health session in interprofessional teams of nine to 10 students to explore patient cases. The session concluded with a debriefing discussing the outcomes of the student-patient interaction, best practices, and exemplary practice models as takeaways. The simulated patient facilitators completed an Observation Checklist to assess students' grasp of learning objectives.

Results

Five hundred twenty-four students participated in the refugee session, divided into 61 groups. Observation Checklists were completed for 58 groups (95%). Assessment of student engagement focused on general health needs common to refugee populations: barriers to health care, team and individual roles, bias, consequences of nontreatment, and social determinants of health. Most of the groups (95%) reported engagement between the simulated patient facilitator and the group of student providers. Qualitative data indicated student groups were knowledgeable in each of the overarching learning objectives.

Discussion

This session allowed health sciences students to focus on culturally effective patient care for refugee populations as a part of an interprofessional team.

A Mixed-Methods Approach to Humanistic Interprofessional Faculty Development

INTRODUCTION

This study evaluated the effectiveness of the Mentoring and Professionalism in Training (MAP-IT) program, a longitudinal, interprofessional faculty development curriculum designed to enhance clinicians' humanistic mentoring skills, specifically nurses and physicians.

METHODS

During 2014 to 2016, two consecutive cohorts of nurses and physicians completed the MAP-IT program. Participants included 169 high potential mentors (HPMs) and 61 facilitator leaders. Each 10-month program consisted of small group work, experiential learning, and critical reflection aimed at enhancing humanistic mentoring skills. Throughout the program, facilitator leaders served as mentors for the HPMs. Both quantitative and qualitative data were collected to measure changes in skill levels specific to humanistic teaching practices, as well as overall evaluation of the program's curriculum and logistics. Quantitative data were analyzed using the Wilcoxon signed-rank test, descriptive statistics, and Fisher exact test, as appropriate. Qualitative data assessing the overall impact and applicability of the program to the clinical setting were analyzed using content analysis methodology.

RESULTS

Across cohorts, HPMs demonstrated significant increases in perceptions of humanistic teaching skills. During objective structured teaching simulations, significant increases were also found in HPMs' self-reported mentoring skills and their skills as rated by a standardized RN/MD. Qualitative analyses revealed themes of the program to be skill development and application, mentorship, humanism, mindfulness, self-care, and acknowledgment of overlapping interprofessional roles.

DISCUSSION

Utilizing an interprofessional education approach, the MAP-IT program was determined to be a feasible strategy to positively impact the personal and professional development of nurses and physicians.

The coming changes in psychoanalytic education: Part II

This paper is the second part of a general analysis of problems in contemporary psychoanalytic education. Having proposed changes in the training analysis and supervisory systems in Part I, here the author focuses on concrete proposals regarding changes in the curriculum, seminars and classroom teaching; the governance of psychoanalytic institutes, relationship of institutes with their respective psychoanalytic society and the role of the university in the development of science and research; the admission, progression, and graduating processes; certification and accreditation.

An Evidence-Based Approach to Teaching Obesity Management to Medical Students

Introduction

The need for education of future and current providers in evidence-based management of obesity and the release of new treatment guidelines prompted the development of a resource for use in the education of medical students and residents.

Methods

A self-contained module was developed to provide an overview of recent guidelines for obesity management utilizing evidence-based medicine while debunking popular myths associated with available weight-loss strategies. The module was delivered over 15 months to six groups of learners (N = 180) and was continuously improved through feedback from content experts and the learners. After completion of the module, one subset of learners responded to a three-question survey using a 5-point Likert scale (1 = strongly disagree, 5 = strongly agree).

Results

Formal evaluation of the module was completed by a subset of the learners (N = 32, 64% response rate). The majority agreed or strongly agreed with these survey statements: "Overall this module was valuable as an educational tool" (97%, Mdn = 4); "After completion of this module, I am confident of my knowledge on how to manage obesity in adult patients" (84%, Mdn = 4); and "It was easy to navigate the module" (94%, Mdn = 5).

Discussion

This module could be implemented as is at other institutions that strive to educate medical students or residents on the most recent guidelines and evidence-based medicine regarding obesity management.

Peer teaching as an educational tool in Pharmacy schools; fruitful or futile

BACKGROUND

In the past decade, various health care programs have implemented diverse types of peer-assisted learning (PAL) programs, in particularly peer teaching (PT), due to their reported benefits for students (both those undertaking teaching and those being taught), teachers, and educational institutes. Unfortunately, peer teaching is still under-recognized in pharmacy programs worldwide when compared to other health care programs. The aim of this review is to provide an overview of the published literature centered on formal PT programs that are implemented in pharmacy schools. In addition, this review focuses on the methodologies adopted for peer teacher recruitment and training as well as the benefits gained by students (both those undertaking teaching and those being taught). The rationales behind PT implementation are recapitulated as well. Finally, a simple scheme for successful implementation of PT activity is provided to serve as a groundwork for educators.

METHODS

Pre-defined key terms were used to search for experimental peer teaching activities in pharmacy schools between January 2000 and June 2016. Titles were selected based on pre-set eligibility criteria. Only complete research articles with clear design and evaluation sections were included in this review. Studies about inter-professional peer teaching activities between pharmacy students and other healthcare professions were also included.

RESULTS

Six relevant educational research articles containing peer teaching activities were included. A lot of variety exists between different pharmacy courses implementing PT, the format/setting of PT, how peer teachers are selected, and how training and evaluation are implemented. The studies reviewed confirmed that PT was well received by most of the students and had a positive impact on their learning outcome. These findings cannot be generalized due to the insufficient number of studies published beside their methodological limitations and inadequate descriptions of the PT format.

IMPLICATIONS

Though PT may be regarded as a feasible teaching strategy, care must be taken during implementation to ensure the fulfillment of the educational objectives. Proper validation of any PT initiative is required before incorporation into the pharmacy curriculum. More research using proper design and suitable sample sizes are recommended to determine the effect of PT activity on students' learning, skills development and confidence.

Simulation Clinical Scenario Design Workshop for Practicing Clinicians

INTRODUCTION

Faculty development is important to developing skilled faculty members who are able to effectively design and deliver educational content. There has been an increase in courses designed to help faculty better teach at the bedside, but fewer options for those interested in developing their skills as simulation-based educators. Our goal was to create a workshop to train prospective simulation educators on the skills and knowledge necessary to design a clinical scenario.

METHODS

Learners participate in a 90-minute workshop utilizing short, didactic teaching and practical hands-on practice. Faculty guide learners through the process of developing targeted goals and learning outcomes, setting the scene for a clinical scenario, and storyboarding the main action. Learners work individually, but engage in peer-to-peer feedback, as well as instructor feedback, throughout the session.

RESULTS

We have run four iterations of this workshop at our institution in the past year, and developed a modified version for an international meeting. A total of 51 learners from our hospital have completed the workshop. Overall, learners agree that the workshop is informative and increases their knowledge. For each educational objective, more than 70% of participants indicated the workshop increased their competence in the area either "extremely" or "quite a bit."

DISCUSSION

This workshop provides learners hand-on practice in developing a scenario for simulation-based education. Learners leave with the tools and knowledge necessary to take the work developed in the session and create a complete scenario that can be used at our simulation center or at another facility.

Teaching Animal Physiology: a 12-year experience transitioning from a classical to interactive approach with continual assessment and computer alternatives

In response to the Bologna Declaration and contemporary trends in Animal Physiology education, the Animal Physiology course at the Faculty of Sciences, University of Novi Sad, Serbia, has evolved over a 12-yr period (2001-2012): from a classical two-semester course toward a one-semester course utilizing computer simulations of animal experiments, continual assessment, lectures, and an optional oral exam. This paper presents an overview of student achievement, the impact of reforms on learning outcomes, and lessons that we as educators learned during this process. The reforms had a positive impact on the percentage of students who completed the course within the same academic year. In addition, the percentage of students who completed the practical exam increased from 54% to >95% following the transition to a Bologna-based approach. However, average final grades declined from 8.0 to 6.8 over the same period. Students also appear reluctant to take the optional oral exam, and 82-91% of students were satisfied with the lower final grade obtained from only assessments and tests administered during the semester. In our endeavor to achieve learning outcomes set during the pre-Bologna period, while adopting contemporary teaching approaches, we sought to increase students' motivation to strive toward better performance, while ensuring that the increased quantity of students who complete the course is coupled with increased quality of education and a more in-depth understanding of animal physiology.

The trilayer approach of teaching physiology, pathophysiology, and pharmacology concepts in a first-year pharmacy course: the TLAT model

This paper describes the development, implementation, and students' perceptions of a new trilayer approach of teaching (TLAT). The TLAT model involved blending lecture, in-class group activities, and out-of-class assignments on selected content areas and was implemented initially in a first-year integrated pharmacy course. Course contents were either delivered by traditional lectures or by the TLAT. A survey instrument was distributed by SurveyMonkey to determine students' perceptions of the TLAT model. Descriptive statistics were used for data analysis. Students' performance in a total of 225 examination and quiz questions was analyzed to evaluate whether the TLAT model improved students' learning. Students' (n = 98) performance scores for TLAT-based and lecture-based questions were 83.3 ± 10.2 and 79.5 ± 14.0, respectively (P < 0.05). Ninety-three percent of students believed that in-class group activities enhanced conceptual understanding of course materials, helped them take responsibility of their own learning, and enhanced their overall learning experiences. More than 80% of respondents felt that solving cases and developing concept maps helped them sharpen creative and critical thinking skills. In addition, 90% of the respondents indicated that the homework throughout the semester helped them stay up to date and focused with the progress of the course. The use of the TLAT model led to an improvement in student learning of complex concepts. Moreover, the results suggest that this model improves students' self-reliance and attitudes toward learning. Our findings should serve as an impetus for inclusion of diverse active learning strategies in pharmacy education.

Can Facebook pages be a mode of blended learning to supplement in-class teaching in Saudi Arabia?

The aim of this study was to examine the potential of a self-designed Facebook page on Neuroscience, to supplement in-class teaching as a mode of blended learning. Posts were split into multiple choice questions (MCQs), general interest articles, neuroscience-related external links and resources, and lecture notes and PowerPoint presentations. The study was divided into three distinct phases: before, during, and after the Neuroscience block. Student responses were evaluated via a self-developed questionnaire. Grades achieved by students undertaking the block in 2015 and 2014 were recorded, as were the grades achieved by the same cohort in concurrent blocks in the same year of study. Results showed that ~80% of students reported that use of the page enhanced their overall subject knowledge and exam preparation. Highest page activity occurred during the Neuroscience block. Peak activity occurred directly before summative assessments, with MCQ posts having the highest impact. The cohort of students with access to the Facebook page achieved better grades in the block compared with the previous cohort, despite similar average performance in other subjects. We demonstrate the utility of Facebook as a powerful tool for undergraduate education, supplementing in-class teaching, and assisting in exam preparation, potentially increasing average student performance.

Integration and assessment of the situation-background-assessment-recommendation framework into a pharmacotherapy skills laboratory for interprofessional communication and documentation

BACKGROUND AND PURPOSE

The situation-background-assessment-recommendation (SBAR) framework is a commonly used method to structure verbal communication in the nursing and medicine disciplines and increases the effectiveness of interprofessional communication. The purpose of this manuscript is to describe how the SBAR framework is integrated into a pharmacotherapy skills laboratory for interprofessional communication and to report on student agreement of perceived realism, preparedness, and fairness of assessment relating to simulated SBAR activities.

EDUCATIONAL ACTIVITY AND SETTING

Simulated, authentic interactions with healthcare providers were incorporated into a pharmacotherapy skills laboratory using the SBAR framework. Activities culminated with a performance-based assessment (PBA) exam which included verbal and written SBAR stations. Students completed a PBA exit survey reporting level of agreement with perceived realism, preparedness, and fairness of assessment related to the exam and answered open-ended questions reporting what they most and least liked.

FINDINGS

After completion of the PBA exam, students reported they agreed or strongly agreed (78%) the PBA was realistic to practice. Students reported increased agreement they were prepared to verbally communicate recommendations compared to document recommendations in the written SBAR framework (64% and 52% agreed or strongly agreed, respectively). Thematic content analysis revealed students preferred to document in the SBAR format and felt it was more realistic than the subjective-objective-assessment-plan (SOAP) note format.

DISCUSSION AND SUMMARY

The SBAR framework is relevant for pharmacist verbal communication and written documentation. Incorporation of the SBAR framework into a skills laboratory appears to prepare students for a PBA that was perceived as both realistic and fair.

Incorporating age-related special populations into a pharmacy skills laboratory course sequence

BACKGROUND AND PURPOSE

The purpose was this study was to evaluate the incorporation of geriatric and pediatric therapeutic concepts into a pharmacy skills laboratory (PSL) course sequence. Secondary outcomes were to describe the incorporation and evaluate the assessment effectiveness of these topics. Educational activity and setting Teaching materials and assessment data from the PSL course were evaluated for inclusion of content regarding age-related special populations.

FINDINGS

Materials reviewed from 205 PSL sessions held over four years demonstrated 89 (41.5%) sessions incorporated age-related topics using a variety of methods. Quiz and exam item performance was acceptable with an average difficulty index of 77.2% ± 21.3 and 85.8% ± 12.8, respectively. The average objective structured clinical exam (OSCE) score was also satisfactory at 83.2% ± 3.

DISCUSSION AND CONCLUSIONS

Age-related topics were included in several PSL sessions. These incorporation strategies were deemed to be effective as students performed well on written assessments and OSCEs. Additional PSL sessions were identified as potential targets for incorporating age-related special populations into future PSL offerings.