“Flipped OR”: a modified didactical concept for a surgical clerkship in Oral and Maxillofacial Surgery

How can we raise awareness and educate medical undergraduate students about OMFS?

In recent years there has been a rise in medicine-first graduates pursuing a career within OMFS, yet many studies report that undergraduate medical students lack sufficient knowledge about the specialty. The COVID-19 pandemic has demonstrated that online methods of delivering undergraduate education are successful. We organised an online conference that comprised six lectures covering common clinical problems that OMF surgeons encounter, and the academic pathway. Delegates were asked to complete an optional pre/post-conference survey which aimed to assess students' interest in the specialty and their attitudes to online conferences. Participants were invited to undertake a semi-structured interview about their attitudes towards the use of online conferences and their ideas about how to interest students further. The interview was thematically analysed. The pre-conference and post-conference questionnaires were answered by 21 and 22 participants, respectively. The demographic consisted largely of undergraduate medical students. Most participants reported increased interest in the specialty after the conference. The interest of delegates wanting to follow an academic pathway decreased. Fewer delegates after the conference believed that online conferences could replace in-person conferences. Five participants undertook a semi-structured interview. Key themes identified were: a lack of exposure drives a lack of interest in OMFS, a desire to learn more about the specialty, and in-person conferences provide more opportunities for delegates. Online conferences can be used to increase student interest in OMFS, but students value in-person conferences more. Students are keen to learn more about the specialty.

Virtual learning in maxillofacial surgery in the post-COVID world: where are we now?

During the COVID-19 pandemic we developed a post-graduate virtual learning environment (PGVLE) in the West Midlands region for higher trainees in oral and maxillofacial surgery. We continued to develop this following the pandemic and sought to examine the trainee experience with this resource as restrictions eased. The PGVLE comprises a total of nine semesters mapping General Medical Council (GMC) learning objectives in the specialty across a total of 63 events using BigBlueButton™. Webinars are delivered on a weekly basis by subspecialty experts. Trainee feedback was sought using SurveyMonkey™ examining self-assessed confidence levels using visual analogue scores (VAS) and Likert items regarding trainers and content. A focus group was convened and the transcript analysed using grounded theory analysis (GTA). Likert items revealed overwhelmingly positive responses, with 96.2% (n = 281) of responses being positive regarding content and 97.5% (n = 475) agreeing with positive comments regarding faculty. VAS scores improved by an average of 39.0% and improvements were statistically significant for most sessions. The focus group highlighted the relevance of teaching to GMC learning objectives, the achievement of consistently high standards, the potential for conflict with clinical commitments and issues surrounding peer interaction. Satisfaction scores remain high with the PGVLE programme, which is very much here to stay in the post-graduate education of our trainees. With the easing of restrictions, we have moved to a hybrid method of learning with the potential for 'flipped classroom' methodology moving forwards.

Effect of an endodontic e-learning application on students' performance during their first root canal treatment on real patients: a pilot study

BACKGROUND

E-learning has found its way into dental teaching in general and endodontic teaching in particular. The present study aimed to implement a newly developed multimedia learning application and assess its effect on students' first root canal treatment on real patients. With the COVID-19 outbreak, the application's performance was investigated during the pandemic.

METHODS

A total of 138 students in the initial clinical endodontic course participated in this study. The control group (n = 49) followed the traditional curriculum, including practice on artificial teeth and face-to-face teaching events. In addition to the traditional curriculum, test group 1 (n = 54) had access to an endodontic e-learning application containing videos demonstrating artificial teeth and patient cases. With the COVID-19 outbreak, test group 2 (n = 35) had no face-to-face teaching; however, endodontic patient treatments were included. The quality of students' first root canal treatment on real patients was compared using performance and radiographic assessment items. Statistical analysis was done using Kruskal-Wallis and chi-squared tests. Test groups received a questionnaire to assess the learning application. Test group 2 also completed a COVID-19-specific survey to measure students' perceptions of how the pandemic affected their endodontic education.

RESULTS

The results of endodontic treatments were significantly better for test group 1 (P < 0.001) and 2 (P < 0.001) than for the control group. Likewise, there were significantly fewer treatment errors in test group 1 (P < 0.001) and 2 (P < 0.001). No significant differences were found between test groups 1 and 2. Students of the test groups positively evaluated the e-learning application. Students of test group 2 expressed their fear of negative impacts on their course performance.

CONCLUSION

The e-learning application was well-received and seemed to improve endodontic education. The results imply that the quality of education may be maintained by implementing e-learning to compensate for face-to-face teaching. As no difference was found between online and face-to-face teaching, students' and lecturers' concerns that endodontic education is suffering because of the pandemic may be eased.

Neurosurgery Lectures Benefit from a Flipped Class Approach

BACKGROUND

In a flipped classroom, students learn lecture material before class then participate in active learning during in-person sessions. This study examines preferences for flipped classroom activities during a neurosurgery presentation on Traumatic Brain Injury (TBI).

METHODS

225 third- and fourth-year medical students on their core Neurology rotation watched an online podcast about TBI before meeting for in-person, active learning activities with a neurological surgeon. Before and after the class, students were given rank-based surveys with an optional section for comments. The initial survey assessed preference for specific active learning activities, and the final survey assessed satisfaction with the experience. The students also answered an online 20-question post-lecture test as part of the standard Neurology class assessment.

RESULTS

Every student scored over 90% on the post-lecture test. Of the 81 students who answered the first survey, most students (83.95%) strongly preferred or preferred case scenarios with group discussion. The average Likert score for case scenario preference (4.37/5) was significantly higher than the score for all other activities (p < 0.05). Of the 207 students who answered the second survey, 80.19% of students reported that they would probably or definitely like to see more flipped classroom activities.

CONCLUSIONS

Medical students highly preferred case scenarios because, according to their comments, this method was relevant to real-life situations and led to higher information retention. This information suggests that the flipped classroom model for neurosurgical based lectures is preferred, beneficial, and should incorporate case scenarios. This methodology may also apply to neurosurgical residency training.

Flipped Classroom Experiences in Clinical Dentistry – A Strategic Mini-Review

Background:

Pedagogy in dental education has evolved over the decades. Today, many alternative modes of content delivery are being used as an adjunct to the traditional classroom. A flipped classroom is one among those that are being explored for teaching clinical dentistry.

Objective:

This mini-review is aimed at evaluating the available evidence in the efficacy of flipped classrooms and its related aspects in the learning curve of clinical dentistry.

Methods:

A thorough literature search on electronic databases for all the studies focusing on the following evidence-based question: “Is Flipped classroom in clinical dentistry a useful mode of pedagogy delivery? was performed. A combination of MeSH terms using Boolean operators “AND,” “OR:” FLIPPED [All Fields] AND (“dental health services” [MeSH Terms] AND “health” [All Fields] AND “services” [All Fields]) OR “dental” [All Fields]) AND (“learning” [MeSH Terms] OR “learning” [All Fields]). Specific terms such as “Perio” OR “Prostho” OR “Restorative” OR “Ortho” OR “Oral medicine” OR “Maxillofacial surgery” OR “Pediatric” OR “endo” was also used. Data from these articles addressing the aim of this study was extracted.

Results:

A total of 16 articles were considered for the review. The majority of the studies considered flipped classroom as a successful model of pedagogy. The most common mode of outside classroom activity was pre-recorded videos. In-classroom activities, a combination of seminars, interactive discussions, and quiz were explored. Time constraints, lack of faculty development programs are considered to be negative factors for the success of the flipped classroom.

Conclusion:

Within the limitation of the study, flipped classroom can be adapted as a method of pedagogy in clinical dentistry.

One year of COVID-19 pandemic: a cross sectional study on teaching oral and maxillofacial surgery

Background

The pandemic has challenged educational institutions to catalyze digitalization and rapidly develop online teaching formats. The aim of the study was to evaluate the teaching offered for oral and maxillofacial surgery at our university during the pandemic and to investigate the students’ perceptions of the current situation.

Methods

A 38-item questionnaire with five sections (demographic information, lectures, internships, e-learning, and pandemic-related solutions/effects) was created online. Most questions were answered on a 10-point Likert scale, with 1 indicating “fully agree/positive” and 10 indicating “totally disagree/negative.” The remaining questions were either answered with yes/no, percent value, or open-ended text responses. All 3rd-5th year dental students were invited to voluntarily participate and were sent a link by email in a general mail shot.

Results

A total of 63.7% of the participants had no prior experience with online courses before the pandemic. The students stated that the change from face-to-face to online teaching worked very well in the last two semesters (mean = 2.73, standard deviation = 2.05). Overall, the pandemic had a rather positive influence on the acquisition of theoretical skills and a negative influence on the acquisition of practical skills (p < 0.0001). The evaluation showed that, compared to other dental clinics at our university, the department for oral and maxillofacial surgery was well prepared for the pandemic.

Conclusion

Digitalization of oral and maxillofacial surgery teaching in dental education is possible but depends on the institution’s preparatory work and technological possibilities. The students declared a high acceptance of digital learning formats and indicated an increased motivation to learn due to e-learning. The pandemic’s influence on the students’ education was rated ambivalent.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13005-021-00304-z.

Evaluating Usability in Blended Learning Programs Within Health Professions Education: a Scoping Review

Knowledge was mapped about how usability has been applied in the evaluation of blended learning programs within health professions education. Across 80 studies, usability was explicitly mentioned once but always indirectly evaluated. A conceptual framework was developed, providing a foundation for future instruments to evaluate usability in this context.

SUPPLEMENTARY INFORMATION

The online version contains supplementary material available at 10.1007/s40670-021-01295-x.

Development of a tailor-made surgical online learning platform, ensuring surgical education in times of the COVID19 pandemic

Background

During the worldwide COVID-19 pandemic, the quality of surgical education experiences sudden major restrictions. Students’ presence in the operating theater and on wards is reduced to a bare minimum and face-to-face teaching is diminished. Aim of this study was therefore to evaluate alternative but feasible educational concepts, such as an online-only-platform for undergraduates.

Objective

A new online platform for undergraduate surgical education was implemented. A virtual curriculum for online-only education was designed.

Methods

A video-based online platform was designed. Following this, a cohort of medical students participating in a (voluntary) surgical course was randomized into a test and control group. Prior to conducting a written exam, students in the test group prepared using the video platform. Students in the control group prepared with standard surgical text books. Results of the exam were used to compare educational means.

Results

Students in the test group preparing through the video-based online platform reached significantly higher scores in the written exams (p = 0.0001) than students of the control group. A trend towards reduced preparation time that did not reach statistical significance was detectable in the test group (p = 0.090). Scores of “perceived workload” and “desire to become a surgeon” offered no differences between the groups. (p = 0.474 and 1.000).

Conclusions

An online-only, virtual curriculum proved feasible for surgical education in undergraduates. While blended learning concepts were applied in both groups, only the test group had access to case-based videos of surgical procedures and scored significantly better in the written exams. Thus, video-based virtual education offers a realistic alternative to face-to-face teaching or conventional text books in times of restricted access to the operating theatre.

Providing national level teaching to OMFS specialty trainees in a virtual classroom setting using learning theories of education

COVID-19 has resulted in an expansion of webinar-based teaching globally. Socially distanced e-learning is the new normal. The delivery of regional OMFS teaching programmes in the UK and the Republic of Ireland, for Specialty Trainees (ST's) under the Joint Committee on Surgical Training (JCST) and Intercollegiate Surgical Curriculum Programme (ISCP) umbrellas is variable. We recognised the need to provide additional teaching to supplement this teaching, at a time of crisis in our countries and healthcare systems, which had jointly led to a significant impact on the progression of training. The membership category of Specialty Trainees within the national specialty association-the British Association of Oral and Maxillofacial Surgeons (BAOMS) is Fellows in Training abbreviated to FiT. We designed an OMFS FiT (Fellows in Training) webinar series based on the current Oral and Maxillofacial Surgery (OMFS) curriculum. Senior trainers delivered weekly national web-based teaching using learning theories of education. Thirteen webinars were conducted between the 14th of May and the 4th of August 2020. Webinars were attended by 40-75 ST's with 98 percent of trainees rating the webinars as 'excellent' or 'very good', and 99% found the content 'extremely useful' or 'very useful'. We discuss the learning theories used for this teaching which include - Bloom's taxonomy, Bruner's spiral model, Vygotsky's zone of proximal development, the flipped classroom model, and Knowles' andragogy model. This pilot national teaching programme has been extremely well received by OMFS trainees and is here to stay!

Feasibility and impact of inverted classroom methodology for coronavirus disease 2019 (COVID-19) pandemic preparedness at an urban community hospital

Strategies for pandemic preparedness and response are urgently needed for all settings. We describe our experience using inverted classroom methodology (ICM) for COVID-19 pandemic preparedness in a small hospital with limited infection prevention staff. ICM for pandemic preparedness was feasible and contributed to an increase in COVID-19 knowledge and comfort.