Does self-reflection and peer-assessment improve Saudi pharmacy students' academic performance and metacognitive skills?

Do students' self-reflections of performance align with their graded performance in objective structured clinical exams?

INTRODUCTION

Self-awareness of strengths and weaknesses through self-reflection are important for life-long learning and development. The aim of this study was to assess the alignment in third-year undergraduate pharmacy students' self-reflections of their objective structured clinical exam (OSCE) performance to their actual OSCE scores and explore the most common aspects students reflected on as markers of perceived performance.

METHODS

Students completed a three-station OSCE and a written self-reflection about their performance. These reflections were coded using a latent pattern content analysis, with categories defined as "doing well (≥ 50% on exam)" and "not doing well (< 50% on exam)" and compared to their actual OSCE exam scores, to determine the degree of alignment.

RESULTS

Two hundred sixty-nine students completed the OSCE and reflection. Students had a low degree of alignment between their self-reflections and actual OSCE performance. Low alignment was overwhelmingly prevalent and significant in high-achieving students with OSCE scores of ≥90%. Most common aspects students reflected on as indicators of performance were finishing on time and communicating effectively. High-achieving students reflected on aspects such as empathy, systematic questioning, and patient teach-back as aspects of their performance.

CONCLUSIONS

Student reflections on exam performance do not align with their actual performance, particularly amongst the high-achieving students. High-achieving students were more aware of the different aspects that affected their performance. To ensure that high-achieving students are aware of their strengths, educators should provide more targeted feedback mechanisms and positive reassurances to help these students become more confident in their decision-making skills.

Cognitive and Metacognitive Processes Demonstrated by Pharmacy Students When Making Therapeutic Decisions

Objective. To characterize the types of cognitive and metacognitive processes demonstrated by third-year pharmacy students during a therapeutic reasoning activity.Methods. A qualitative, descriptive study following a think-aloud protocol was used to analyze the cognitive (analytical) and metacognitive processes observed by third-year pharmacy students as they completed a 25-minute therapeutic reasoning activity. Using a deductive codebook developed from literature about reasoning, two independent coders characterized processes from students' audio-recorded, transcribed think-aloud episodes while making therapeutic decisions about simulated clinical cases.Results. A total of 40 think-aloud episodes were transcribed among the cohort. Categorization of the think-aloud transcriptions revealed a series of cognitive analytical and metacognitive processes demonstrated by students during the therapeutic decision-making activity. A total of 1792 codes were categorized as analytical processes, falling into six major themes: 69% gathering information (1232/1792), 13% processing information (227/1792), 7% making assessments (133/1792), 1% synthesizing information (19/1792), 7% articulating evidence (117/1792), and 4% making a recommendation (64/1792). In comparison to gathering information, a much lower frequency of processing and assessment was observed for students, particularly for those that were unable to resolve the case. Students' movement between major analytical processes co-occurred commonly with metacognitive processes. Of the 918 codes categorized as metacognitive processes, two major themes arose: 28% monitoring for knowledge or emotions (257/918) and 72% controlling the planning of next steps or verification of correct information (661/918). Sequencing the codes and co-occurrences of processes allowed us to propose an integrated cognitive/metacognitive model of therapeutic reasoning for students.Conclusion. This study categorizes the cognitive (analytical) and metacognitive processes engaged during pharmacy students' therapeutic reasoning process. The findings can inform current instructional practices and further research into educational activities that can strengthen pharmacy students' therapeutic reasoning skills.

Self-Reflection and Peer-Assessments Effect on Pharmacy Students' Performance at Simulated Counselling Sessions

INTRODUCTION

Verbal communication is a vital skill for pharmacists and essential for improving patient care. The aim of this study was to explore students' perception of the impact of self-reflection and self- and peer-assessment on simulated patient counselling sessions.

METHODS

Focus groups explored student perceptions of how this course and way of learning has impacted their performance at counselling patients. Data were analysed using iterative inductive thematic analysis procedures and mapped to the self-determination theory.

RESULTS

Nine focus groups with 47 pharmacy students. We identified three main themes and ten associated subthemes. These were learning style (sub-themes gradual introduction to assessment, learning through self-reflection videos, authentic assessment, individual learning compared to group learning, and learning through observation of best practice), feedback (sub-themes inconsistent feedback, summative feedback, perception of self and relationship with peers informing peer assessment) and benefits in real life practice. These themes mapped well to self-determination theory and highlighted that additional focus may be required for benefits in real-life practice.

CONCLUSION

Students' perceptions of self-reflection and self- and peer-assessment centred on learning style, feedback, and benefits in real-life practice. Additional focus on benefits of this unit of study in real-life practice and work integrated learning on placements may further strengthen the impact of these learning activities.

Self-Assessment of Therapeutic Decision-Making Skills in Pharmacy Students

Objective. The ability of pharmacy students to self-regulate and reflect on knowledge and skills is important as proficient self-assessment skills guide learning strategies and prompt students to bridge their knowledge gaps. The objectives for this study were to determine how well third-year pharmacy students self-assess, explore the rationales behind their self-assessments and determine whether there is a correlation between self-assessment accuracy and academic performance.Methods. A quasi-experimental one-group pre-/post-test design was conducted with third-year pharmacy students. Examiner grades, student self-assessment grades, comparative reports, and end-of-semester grades were collected. Students were categorized into tertiles based on academic performance for data analysis. Paired t tests, Pearson r and percentage agreements were conducted to investigate self-assessment accuracy. Correlational statistical tests were implemented to examine the relationships between self-assessment accuracy and academic performance.Results. One hundred sixty-two third-year pharmacy students were included. On average, students demonstrated poor self-evaluation skills and underestimated themselves by 4.9%. Lower performing students were generally overconfident in evaluating their performance. There was no significant correlation between students' self-assessment accuracy and academic performance on the subsequent end-of-semester examination questions.Conclusion. Overall, students tended to underestimate their academic performance. Further research on self-assessment is needed to better understand how students think about their performance, which may help to improve education methods, such as inclusion of reflective practices after case-based activities.

The effect of abusive supervision on safety behaviour of Chinese underground miners: a multi-level moderated mediation analysis

Purpose

Prior research has suggested that abusive supervision has negative impacts on various work outcomes. However, little attention has been paid to the relationship between abusive supervision and employees’ safety behaviour. The purpose of this study is, therefore, to address these limitations by developing and testing a theoretically based conceptual model that explicitly considers the underlying mechanism and boundary condition of the relationship between abusive supervision and safety behaviour of underground coal miners in China.

Design/methodology/approach

At Time 1, the authors conducted a survey of 630 employees to assess their supervisors’ abusive leadership behaviours, their own power distance beliefs and their self-reflection. At Time 2, the authros sent questionnaires to the leaders and invited them to evaluate employees’ safety behaviour in the workplace. After cleaning the survey data, the authors tested our model using a multi-level analysis on a sample (n = 458) of underground miners across 96 coal mining sites in China.

Findings

The authors propose that abusive supervision decreases employees’ safety compliance/participation by reducing reflection but strengthening rumination. The authors further find that the linkage from abusive supervision to reflection/rumination to safety compliance/participation is affected by power distance.

Originality/value

To the best of the authors’ knowledge, This is one of the first empirical studies to investigate the mediating effects of a deep cognitive processing variable – namely, self-reflection – and the moderating effects of power distance on the relationship between abusive supervision and safety behaviour.

Instruments to measure the ability to self-reflect: A systematic review of evidence from workplace and educational settings including health care

INTRODUCTION

Self-reflection has become recognised as a core skill in dental education, although the ability to self-reflect is valued and measured within several professions. This review appraises the evidence for instruments available to measure the self-reflective ability of adults studying or working within any setting, not just health care.

MATERIALS AND METHODS

A systematic review was conducted of 20 electronic databases (including Medline, ERIC, CINAHL and Business Source Complete) from 1975 to 2017, supplemented by citation searches. Data were extracted from each study and the studies graded against quality indicators by at least two independent reviewers, using a coding sheet. Reviewers completed a utility analysis of the assessment instruments described within included studies, appraising their reported reliability, validity, educational impact, acceptability and cost.

RESULTS

A total of 131 studies met the inclusion criteria. Eighteen were judged to provide higher quality evidence for the review and three broad types of instrument were identified, namely: rubrics (or scoring guides), self-reported scales and observed behaviour.

CONCLUSIONS

Three types of instrument were identified to assess the ability to self-reflect. It was not possible to recommend a single most effective instrument due to under reporting of the criteria necessary for a full utility analysis of each. The use of more than one instrument may therefore be appropriate dependent on the acceptability to the faculty, assessor, student and cost. Future research should report on the utility of assessment instruments and provide guidance on what constitutes thresholds of acceptable or unacceptable ability to self-reflect, and how this should be managed.

The use of active learning strategies in healthcare colleges in the Middle East

BACKGROUND

Multiple studies have explored the use of active learning strategies among faculty members in different healthcare colleges worldwide, however, very few have described the use of these strategies in the Middle East. The aim of this study was to evaluate the extent of the implementation of active learning and its various techniques across different fields of healthcare education in various countries in the Middle East.

METHODS

A Web-based questionnaire was developed to obtain information on the use of active learning methods. This survey was disseminated among faculty members in healthcare colleges in 17 Middle Eastern countries.

RESULTS

Out of 22,734 online invitations that were sent to faculty members in different healthcare colleges, 2085 (9.17%) accepted the invitations, however, only 722 (34.63%) of those who agreed to participate filled out the questionnaire. Eighty-seven percent of the responders utilized at least one technique of active learning. Active learning was used more frequently by female responders. For example, 54.30% of the female responders reported using learning by teaching as one of their teaching methods compared to 41.30% of their male counterparts (p = 0.0005). The various forms of active learning were used at similar levels in both public and private healthcare colleges. Only minor differences were seen among different age groups or academic positions of the responders, but significant variabilities were noted among the several fields of healthcare education. For example, 61.54% of responders from the nursing faculty reported using reaction to videos as one of their teaching methods compared to 31.11% of their counterparts in the faculty of dentistry (p = 0.0021). The most frequently reported obstacles interfering with the effectuation of active learning include the lack of technical support and time constraints.

CONCLUSIONS

Although some barriers to the implementation of active learning exist, it is extensively used by faculty members in healthcare colleges in the Middle East.

Clinical Reasoning in Physical Therapy: A Concept Analysis

BACKGROUND

Physical therapy, along with most health professions, struggles to describe clinical reasoning, despite it being a vital skill in effective patient care. This lack of a unified conceptualization of clinical reasoning leads to variable and inconsistent teaching, assessment, and research.

OBJECTIVE

The objective was to conceptualize a broad description of physical therapists' clinical reasoning grounded in the published literature and to unify understanding for future work related to teaching, assessment, and research.

DESIGN/METHODS

The design included a systematic concept analysis using Rodgers' evolutionary methodology. A concept analysis is a research methodology in which a concept's characteristics and the relation between features of the concept are clarified.

RESULTS

Based on findings in the literature, clinical reasoning in physical therapy was conceptualized as integrating cognitive, psychomotor, and affective skills. It is contextual in nature and involves both therapist and client perspectives. It is adaptive, iterative, and collaborative with the intended outcome being a biopsychosocial approach to patient/client management.

LIMITATIONS

Although a comprehensive approach was intended, it is possible that the search methods or reduction of the literature were incomplete or key sources were mistakenly excluded.

CONCLUSIONS

A description of clinical reasoning in physical therapy was conceptualized, as it currently exists in representative literature. The intent is for it to contribute to the unification of an understanding of how clinical reasoning has been conceptualized to date by practitioners, academicians, and clinical educators. Substantial work remains to further develop the concept of clinical reasoning for physical therapy, including the role of movement in our reasoning in practice.

Does personalized goal setting and study planning improve academic performance and perception of learning experience in a developing setting?

Objective

The learning process for pharmacists must enable the skillful harnessing of metacognition, critical thinking, and effective application of specialized skills. This study assessed the impact of self-developed academic goals and study plans on pharmacy students' academic performance and perception of learning experience in a developing setting.

Methods

A prospective cohort study was conducted at the College of Clinical Pharmacy, King Faisal University, KSA, in a compulsory 4th year course (Pharmacy management). The study group was exposed to goal setting and study planning while the control group had only routine teaching and learning activities planned for the course. Academic performance was determined with quizzes, midterm, and final exams, and the percentage achievement for the course objectives. An end-of-course evaluation, with a pre-tested questionnaire, was used to assess the perception of learning experience.

Results

The study group constituted 41.4% (29), while 58.6% (41) were in the control group, with a mean ± SD age of 22.9 (SD = 3.2) and 21.6 (SD = 6.1) years, respectively. The mean ± SD scores for quizzes (8.4 (SD = 2.2), mid-term (21.9 (SD = 3.7), and final exams (42.8 (SD = 5.3), and the percentage achievement for the course objectives A (77%) and B (78%) were significantly higher in the study group (P < 0.001). The end-of-course feedbacks showed key differences in the perception of learning experience between the study and control groups.

Conclusion

Personalized goal setting and study planning appeared to significantly improve continuous engagement with learning, focus on academic goals, and academic performance.

Assessing a traditional case-based application exercise and a student question creation exercise on student performance and perceptions

BACKGROUND AND PURPOSE

To compare the impact of a traditional case-based application exercise with a student question creation exercise on a) student exam performance, b) student perceptions of enjoyment, competence, understanding, effort, interest in continuing participation, and interest in the subject.

EDUCATIONAL ACTIVITY AND SETTING

Subjects were 84 second-year pharmacy students in a pharmacotherapy course. The research focus was active learning involving the topic of chronic kidney disease-mineral bone disorder. Student teams were randomly assigned to either case-based or student question creation exercises using PeerWise. Student performance was assessed by a pre- and posttest and on block and final exams. After completion, an online survey assessed student perceptions of both exercises.

FINDINGS

Statistically significant differences were revealed in favor of the student question creation group on enjoyment and interest in the subject matter. No statistically differences were found between the traditional case-based group and the student question creation group on gain score from pre-test to posttest. The student question creation group performed slightly better than the case-based application group on two of the five questions on the block exam but none of these differences reached statistical significance.

DISCUSSION AND CONCLUSIONS

Students randomly assigned to groups that created and reviewed questions exhibited slightly improved summative exam performance and reported significantly more positive perceptions than students engaging in a more traditional case-based learning activity. Student question creation has demonstrated potential as a useful learning activity. Despite inherent difficulties in designing studies involving educational research in a controlled environment, students who have submitted, created, rated, and answered peers' questions have overall performed well.