Learning styles in two otolaryngology residency programs

Analysis of learning styles in a laparoscopic technical skills course. Implications for surgical training

INTRODUCTION

Learning surgical techniques is a dynamic process. In the 1980s David Kolb described developed a learning model that enabled teaching styles to adapt for better learner outcomes. The aim of this study was to identify the Kolb learning styles of the participants in a laparoscopic technical skills course and to check see if there was any relationship with performance.

METHODS

An observational descriptive study was conducted with 64 participants in an intensive course in which they performed laparoscopic manual intestinal anastomoses. All completed Kolb's inventory of learning styles. For each anastomosis, join quality was assessed and the performing time recorded. After that, they were analyzed through statistical studies.

RESULTS

The most frequent learning style was assimilating type (39.1%). No significant differences were observed between different learning styles and gender, professional category, the time taken or the quality of the anastomoses.

CONCLUSIONS

Assimilating type was the most frequent Kolb learning style, with no differences observed between categories, age or gender. There is no relationship between the learning style of the participants and the results obtained in the course.

Analysis of learning styles in a laparoscopic technical skills course. Implications for surgical training

INTRODUCTION

Learning surgical techniques is a dynamic process. In the 1980s David Kolb described developed a learning model that enabled teaching styles to adapt for better learner outcomes. The aim of this study was to identify the Kolb learning styles of the participants in a laparoscopic technical skills course and to check see if there was any relationship with performance.

METHODS

An observational descriptive study was conducted with 64 participants in an intensive course in which they performed laparoscopic manual intestinal anastomoses. All completed Kolb's inventory of learning styles. For each anastomosis, join quality was assessed and the performing time recorded. After that, they were analyzed through statistical studies.

RESULTS

The most frequent learning style was assimilating type (39.1%). No significant differences were observed between different learning styles and gender, professional category, the time taken or the quality of the anastomoses.

CONCLUSIONS

Assimilating type was the most frequent Kolb learning style, with no differences observed between categories, age or gender. There is no relationship between the learning style of the participants and the results obtained in the course.

Preferred Learning Styles among Ophthalmology Residents: An Iranian Sample

Purpose

This study was performed to assess the learning styles of a sample of Iranian residents through Kolb's and VARK questionnaires.

Methods

In this descriptive-analytical study, 45 ophthalmology residents of Mashhad University of Medical Sciences were enrolled. Kolb's and VARK questionnaires were provided, and residents were oriented and guided on how to complete them.

Results

Forty-three out of the forty-five ophthalmology residents completed the questionnaire (95.5% response rate). The preferred learning style among ophthalmology residents was assimilative (51.2%), followed by convergent (37.2%), accommodative (7.7%), and divergent (4.7%), based on Kolb's questionnaire. According to the results of the VARK questionnaire, most ophthalmology residents were auditory learners (34.9%), followed by multimodal learners (30.2%). In addition, there was no significant relation between genders, stage of residency, and Kolb's and VARK learning styles (P> 0.05 for all).

Conclusion

The most preferred learning styles of ophthalmology residents were assimilative and auditory. Considering the dominant learning styles of learners and incorporating various teaching methods are recommended to enhance the learning among residents.

Maximizing Plastic Surgery Education Impact: Lessons from Resident Learning Styles and Experiential Learning Theory

Residents in many surgical disciplines express a strong preference for hands-on learning, but no studies have focused on plastic surgery. This initial study aims to ascertain the learning styles of plastic surgery residents, and identify potential trends that may better guide curriculum development.

Methods

Kolb Learning Style Index v. 3.1 was administered to plastic surgery residents across all training levels at three residency programs. The Kolb Learning Style Index is a 12-item questionnaire that characterizes an individual's learning style into 1 of 4 major categories: converging; accommodating; assimilating; and diverging.

Results

The surveyed cohort of plastic surgery residents (n = 45) demonstrated a diverse mix of learning styles: converging (38%, n = 17); accommodating (24%, n = 11); diverging (20%, n = 9); and assimilating (16%, n = 7). One resident was balanced between converging and accommodating (2%, n = 1). Despite varied learning styles, the majority (64%, n = 29) demonstrated a preference for "active experimentation," for example, hands-on learning.

Conclusions

A preliminary assessment of learning styles among plastic surgery residents suggests that they have mixed learning styles. This contrasts with the existing literature from other surgical specialties where a single learning style dominates. However, like these other specialties, active experimentation is particularly valued. As such, it behooves the plastic surgery educator to continue to strive for balance between book learning and hands-on experience for residents at all levels of training, to engage residents with all learning styles.

Learning Styles in Pathology: A Comparative Analysis and Implications for Learner-Centered Education

Initiatives like “American Medical Association (AMA)-Reimagining Residency” and “Accreditation Council for Graduate Medical Education (ACGME)-Next Accreditation System” are examples of a paradigm shift toward learner-centered pedagogy in resident education. Such interventions require an understanding of the basics of the learning process itself. This study aimed to identify preferred learning styles in pathology with the intent to use specialty-specific pattern data, if any, to improve pathology training modalities. Kolb’s learning tool questionnaire was sent to pathology-inclined medical students, pathology residents, fellows, and faculty in 5 academic programs. Data from 84 respondents (6 students, 37 residents, 12 fellows, 29 attendings) were analyzed. There was remarkable similarity in learning styles of fellows and faculty, revealing a dominance of observational learning styles (“assimilating” and “diverging”) that was consistent with pathology being a visual field. In contrast, residents showed dominance of “learn by doing” styles (“converging” and “accommodating”). Residents’ stratification by training year showed a scattered distribution with an upward trend toward “learn by doing” behavior. While the difference in styles between residents and faculty/fellows may be due to a generational gap, transition from medical school, or acquisition of technical skills required for grossing specimens, this is an opportunity for adopting blended learning models and active learning processes to cater to residents’ different styles and to allow for flexibility to use all styles as and when needed. Based on these findings, we hypothesize that partnering juniors and seniors with similar styles has a potential for successful mentorship and exploration of other psychometrics is recommended for further understanding and improvement of pathology training.

Mobile app technology is associated with improved otolaryngology resident in-service performance

OBJECTIVE

Otolaryngology residents face time-management challenges between clinical duties and self-directed learning. Mobile devices provide a new medium for education that could aid with educational efficiency. The objective of this study was to investigate whether spaced repetition mobile app use of an otolaryngology question bank was associated with improving factual knowledge as measured by in-service exam performance.

METHODS

For approximately 6 months prior to the 2016 in-service examination, 12 otolaryngology residents at a single institution were provided access to a spaced-repetition app with a preloaded licensed otolaryngology review question bank. The number of questions answered, as well as the time spent on the app, were electronically tracked. The associations of app usage on in-service results were analyzed using an autoregressive model adjusted for prior historical Otolaryngology Trainee Examination performance and postgraduate year.

RESULTS

Eleven residents used the mobile app and were included in the analysis for an average of 304 minutes (range: 3 to 1,020) and reviewed on average 679 questions (range: 6 to 1,934). Controlling for residency year and prior performance, app usage was associated with an improvement by 2.92 percentage points (pp) (95% confidence interval [CI]: 0.14, 5.70) on overall in-service score. Allergy and pediatric subsection scores improved by 11.3 pp (95% CI: 3.8, 18.8) and 15.2 pp. (95% CI: 8.9, 21.5), respectively. Increased app use was associated with a score improvement by 0.008 pp per minute of use (95% CI: 0.004, 0.012).

CONCLUSION

Use of mobile spaced-repetition technology can aid resident factual knowledge retention measured by improved in-service exam performance.

LEVEL OF EVIDENCE

4 Laryngoscope, 129:E15-E20, 2019.

A High-Definition Video Teaching Module for Thyroidectomy Surgery

OBJECTIVE

With the changing landscape of postgraduate surgical education to competency-based curricula, there emerges a need for alternative forms of training. Video teaching modules have been shown to be effective tools in surgical education, complementing traditional postgraduate curricula. There is a lack of validated modules described in the literature, specifically for teaching thyroidectomy. The primary objective of this study was to develop and validate a high definition video-based teaching module instructing thyroidectomy surgery to Otolaryngology-Head and Neck Surgery trainees.

DESIGN

This prospective study included intermediate to senior Otolaryngology-Head and Neck Surgery residents. Each participant first performed a thyroid lobectomy, serving as the initial assessment. After a washout period of at least 3 weeks, each participant was given the teaching module. The 15-minute module was developed using a 3-camera system and detailed a step-by-step approach to the surgery. After exposure to the module, each trainee performed the same procedure. Recordings of both procedures were deidentified and reviewed by a blinded, independent evaluator. Scoring was done using the Observational Clinical Human Reliability Assessment (OCHRA) system.

SETTING

University of Alberta Hospital and Royal Alexandra Hospital, Edmonton, Alberta, Canada.

PARTICIPANTS

A total of 6 intermediate to senior Otolaryngology-Head and Neck Surgery residents entered and completed the study.

RESULTS

The mean error rate was 8.8 errors per procedure before module exposure and 4.5 errors per procedure after exposure, representing a 49% decrease in error occurrence (p < 0.05). The mean staff takeover event rate was 10.5 takeovers per procedure prior to module exposure and 5.0 takeovers per procedure after exposure, representing a 52% decrease in error occurrence (p < 0.05).

CONCLUSION

High-definition video teaching modules are a useful complement to traditional surgical training. In a climate where new innovations for teaching thyroid surgery are needed, properly constructed and validated video teaching modules can serve as important tools in supplementing traditional surgical training.

High-Quality Feedback Regarding Professionalism and Communication Skills in Otolaryngology Resident Education

Objective

The Accreditation Council for Graduate Medical Education (ACGME) requires competency-based education for residents and recommends 5 basic features of high-quality feedback. Our aim was to examine the incorporation of feedback in articles regarding professionalism and interpersonal/communication skills for otolaryngology residency training curriculum.

Data Sources

PubMed, Embase, ERIC, Cochrane Library, Web of Science, Scopus, and ClinicalTrials.gov .

Methods

We used studies identified during a systematic review of all indexed years through October 4, 2016.

Results

Eighteen studies were included in this review. Professionalism was discussed in 16, of which 15 (94%) examined aspects of feedback. Interpersonal/communication skills were the focus of 16 articles, of which 14 16 (88%) discussed aspects of feedback. Our assessment demonstrated that timeliness was addressed in 8 (44%) articles, specificity in 4 (22%), learner reaction and reflection in 4 (22%), action plans in 3 (20%), and balancing reinforcing/corrective feedback in 2 (13%). Two articles did not address feedback, and 6 did not address aspects of high-quality feedback. The ACGME-recommended feedback systems of ADAPT (ask, discuss, ask, plan together) and R2C2 (relationship, reactions, content, and coach) were not reported in any of the studies.

Conclusion

Feedback is an essential component of graduate medical education and is required by the ACGME milestones assessment system. However, the core feedback components recommended by the ACGME are rarely included in the otolaryngology resident education literature.

Learning styles and the prospective ophthalmologist

PURPOSE

Understanding the learning styles of individual trainees may enable trainers to tailor an educational program and optimise learning. Surgical trainees have previously been shown to demonstrate a tendency towards particular learning styles. We seek to clarify the relationship between learning style and learned surgical performance using a simulator, prior to surgical training.

METHODS

The Kolb Learning Style Inventory was administered to a group of thirty junior doctors. Participants were then asked to perform a series of tasks using the EyeSi virtual reality cataract surgery simulator (VR Magic, Mannheim, Germany). All completed a standard introductory programme to eliminate learning curve. They then undertook four attempts of level 4 forceps module binocularly. Total score, odometer movement (mm), corneal area injured (mm(2)), lens area injured (mm(2)) and total time taken (seconds) recorded.

RESULTS

Mean age was 31.6 years. No significant correlation was found between any learning style and any variable on the EyeSi cataract surgery simulator.

CONCLUSION

There is a predominant learning style amongst surgical residents. There is however no demonstrable learning style that results in a better (or worse) performance on the EyeSi surgery simulator and hence in learning and performing cataract surgery.

The learning styles of orthopedic residents, faculty, and applicants at an academic program

BACKGROUND

To train surgeons effectively, it is important to understand how they are learning. The Kolb Learning Style Inventory (LSI) is based on the theory of experiential learning, which divides the learning cycle into 4 stages: active experimentation (AE), abstract conceptualization (AC), concrete experience, and reflective observation. The purpose of this investigation was to assess the learning styles of orthopedic residents, faculty, and applicants at an east-coast residency program.

METHODS

A total of 90 Kolb LSI, Version 3.1 surveys, and demographic questionnaires were distributed to all residency applicants, residents, and faculty at an academic program. Data collected included age, sex, type of medical school (MD or DO), foreign medical graduate status, and either year since college graduation, postgraduate year level (residents only), or years since completion of residency (faculty only). Seventy-one completed Kolb LSI surveys (14 residents, 14 faculty members, and 43 applicants) were recorded and analyzed for statistical significance.

RESULTS

The most prevalent learning style among all participants was converging (53.5%), followed by accommodating (18.3%), diverging (18.3%), and assimilating (9.9%) (p = 0.13). The applicant and resident groups demonstrated a high tendency toward AE followed by AC. The faculty group demonstrated a high tendency toward AC followed by AE. None of the 24 subjects who were 26 years or under had assimilating learning styles, in significant contrast to the 12% of 27- to 30-year-olds and 18% of 31 and older group (p < 0.01).

CONCLUSIONS

The majority of applicants, residents, and faculty in the orthopedic residency program were "convergers." The converging learning style involves problem solving and decision making, with the practical application of ideas and the use of hypothetical-deductive reasoning. Learning through AE decreased with age, whereas learning through AC increased.

Learning styles and teaching perspectives of Canadian pharmacy practice residents and faculty preceptors

OBJECTIVE

To characterize and compare learning styles of pharmacy practice residents and their faculty preceptors, and identify teaching perspectives of faculty preceptors.

METHODS

Twenty-nine pharmacy residents and 306 pharmacy faculty members in British Columbia were invited to complete the Pharmacists' Inventory of Learning Styles (PILS). Faculty preceptors also were asked to complete the Teaching Perspectives Inventory (TPI).

RESULTS

One hundred percent of residents and 61% of faculty members completed the PILS, and 31% of faculty members completed the TPI. The most common dominant learning style among residents and faculty preceptors was assimilator, and 93% were assimilators, convergers, or both. The distribution of dominant learning styles between residents and faculty members was not different (p=0.77). The most common dominant teaching perspective among faculty members was apprenticeship.

CONCLUSION

Residents and preceptors mostly exhibited learning styles associated with abstract over concrete thinking or watching over doing. Residency programs should steer residents more toward active learning and doing, and maximize interactions with patients and other caregivers.

Learning styles of first-year undergraduate nursing and midwifery students: a cross-sectional survey utilising the Kolb Learning Style Inventory

It is important that educators understand their students' learning styles. In this study we investigate the learning styles of first-year undergraduate nursing and midwifery university students and whether these learning styles are influenced by student demographic characteristics. A cross-sectional survey including demographic questions and the Kolb Learning Style Inventory was utilised. There was a 78% response rate (n=345). The majority of first-year students investigated in this study were divergers (29.5%), followed by assimilators (28.8%), accommodators (23.9%) and convergers (17.9%). Female students had a higher reflective observation (RO) score than male students (p=0.0078). Those with English as first language showed a higher active experimentation score (p=0.0543) and a lower concrete experience (CE) score (p=0.0038). Australian citizens and permanent residents had a higher RO score (p=0.0560) and a lower CE score (p=0.0100) than migrants and international students. Nursing/arts students had a higher abstract conceptualisation (AC) score than nursing students (p=0.0013). Students enrolled in 4-5 subject units had a higher AC score than those enrolled in 1-2 units (p=0.0244). Nursing and midwifery students are mainly of the diverger and assimilating learning styles. Some student demographic characteristics show a significant influence on learning styles. This study has teaching and research implications.

Learning styles in otolaryngology fellowships

OBJECTIVES/HYPOTHESIS

Previous studies have identified a predominant learning style in trainees from different specialties, more recently in otolaryngology residents. The purpose of our study was to determine a predominant learning style within otolaryngology fellowships and to identify any differences between otolaryngology fellows and residents.

STUDY DESIGN

We conducted a survey of otolaryngology fellows at 25 otolaryngology fellowship programs accredited by the Accreditation Council for Graduate Medical Education.

METHODS

We emailed Kolb's Learning Style Index version 3.1 to 16 pediatric otolaryngology (PO) and 24 otology/neurotology (ON) fellows. This index is a widely used 12-item questionnaire. The participants answered each item in the questionnaire as it applied to their preferred learning style: accommodating, converging, diverging, or assimilating. Results were then analyzed and compared between each subspecialty and the previously reported preferred styles of otolaryngology residents.

RESULTS

Ten PO and 20 ON fellows completed the survey, with an overall response rate of 75%. PO and ON fellows (60% of each group) preferred a learning style that was "balanced" across all four styles. For ON fellows, 35% preferred converging and 5% preferred accommodating styles. For PO fellows, converging and accommodating styles accounted for 20% each.

CONCLUSIONS

It was previously reported that 74.4% of otolaryngology residents prefer either converging or accommodating styles. We believe that the fellowship training environment calls for fellows to use more than one learning style to become proficient physicians, hence the trend toward potentially developing a balanced style when at this level.