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Narayan RR, Kadri H, Muhammad HA, Qadan M. Critical Appraisal of Content Quality of YouTube Videos on the Whipple Pancreaticoduodenectomy. J Surg Res 2024; 295:690-698. [PMID: 38134739 DOI: 10.1016/j.jss.2023.11.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 04/07/2023] [Accepted: 11/13/2023] [Indexed: 12/24/2023]
Abstract
INTRODUCTION The coronavirus pandemic has demonstrated profound issues with using the Internet to research health information. For patients recommended a complex operation, such as the Whipple pancreaticoduodenectomy, the quality of health information online has not been appraised. The objective of this study was to define the readability and content quality of YouTube search results for the Whipple pancreaticoduodenectomy. METHODS The first 100 search results for "whipple procedure" less than 10 min long in English with audio and or text were transcribed. The Flesch-Kincaid Grade defined the reading grade level. High content quality videos were accredited by YouTube in accordance with principles specified by the National Academy of Medicine or mentioned the standard components for a surgical consent. The Anderson-Lau score is a composite of these consent criteria out of a maximum of 8/8. The simplicity of videos for patient education was defined by the DISCERN tool. RESULTS The reading level of 23% of the top 100 search results met the American average (8th grade). Accreditation was present for 45% and associated with an earlier median search ranking (36 versus 68, P = 0.002) and more 5th-8th grade level material (70% versus 38%, P = 0.014). The median Anderson-Lau score was 3/8 (range = 0/8-7/8) with only 5% achieving 7/8. Only 4% were high quality per DISCERN. CONCLUSIONS Although accredited videos were more readable, most videos, especially those targeting patients, were beyond the comprehension of the average American. Simpler and higher quality educational materials are needed to inform patients on Whipple pancreaticoduodenectomy beyond their date of clinical diagnosis or surgical consenting.
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Affiliation(s)
- Raja R Narayan
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts; Department of Surgery, Stanford University School of Medicine, Stanford, California
| | - Haaris Kadri
- Department of Surgery, Stanford University School of Medicine, Stanford, California
| | - Huda A Muhammad
- Department of Surgery, Stanford University School of Medicine, Stanford, California
| | - Motaz Qadan
- Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.
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Boutros P, Kassem N, Nieder J, Jaramillo C, von Petersdorff J, Walsh FJ, Bärnighausen T, Barteit S. Education and Training Adaptations for Health Workers during the COVID-19 Pandemic: A Scoping Review of Lessons Learned and Innovations. Healthcare (Basel) 2023; 11:2902. [PMID: 37958046 PMCID: PMC10649637 DOI: 10.3390/healthcare11212902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Revised: 10/25/2023] [Accepted: 11/02/2023] [Indexed: 11/15/2023] Open
Abstract
Introduction: The COVID-19 pandemic has considerably impacted the clinical education and training of health workers globally, causing severe disruptions to learning environments in healthcare facilities and limiting the acquisition of new clinical skills. Consequently, urgent adaptation measures, including simulation training and e-learning, have been implemented to mitigate the adverse effects of clinical education. This scoping review aims to assess the impact of COVID-19 on medical education and training, examine the implemented adaptation measures, and evaluate their effectiveness in improving health workers' education and training during the pandemic. Methods: Employing the PRISMA-ScR framework and Arksey and O'Malley's methodological guidance, we conducted a scoping review, systematically searching PubMed, medRxiv, Google, and DuckDuckGo databases to account for the grey literature. The search included studies published between 1 December 2019 and 13 October 2021, yielding 10,323 results. Of these, 88 studies focused on health worker education and training during the pandemic. Results: Our review incorporated 31,268 participants, including physicians, medical trainees, nurses, paramedics, students, and health educators. Most studies (71/88, 81%) were conducted in high-income and lower-middle-income countries. The pandemic's effects on health workers' clinical skills and abilities have necessitated training period extensions in some cases. We identified several positive outcomes from the implementation of simulation training and e-learning as adaptation strategies, such as enhanced technical and clinical performance, increased confidence and comfort, and an expanded global educational outreach. Conclusions: Despite challenges like insufficient practical experience, limited interpersonal interaction opportunities, and internet connectivity issues, simulation training, e-learning, and virtual training have proven effective in improving clinical education and training during the COVID-19 pandemic. Further research is required to bolster preparedness for future pandemics or similar situations.
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Affiliation(s)
- Perla Boutros
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine, Heidelberg University Hospital, Heidelberg University, 69120 Heidelberg, Germany
| | - Nour Kassem
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine, Heidelberg University Hospital, Heidelberg University, 69120 Heidelberg, Germany
| | - Jessica Nieder
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine, Heidelberg University Hospital, Heidelberg University, 69120 Heidelberg, Germany
| | - Catalina Jaramillo
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine, Heidelberg University Hospital, Heidelberg University, 69120 Heidelberg, Germany
| | - Jakob von Petersdorff
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine, Heidelberg University Hospital, Heidelberg University, 69120 Heidelberg, Germany
| | - Fiona J Walsh
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine, Heidelberg University Hospital, Heidelberg University, 69120 Heidelberg, Germany
| | - Till Bärnighausen
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine, Heidelberg University Hospital, Heidelberg University, 69120 Heidelberg, Germany
- Africa Health Research Institute (AHRI), Somkhele, Mtubatuba 3935, KwaZulu-Natal, South Africa
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Sandra Barteit
- Heidelberg Institute of Global Health (HIGH), Faculty of Medicine, Heidelberg University Hospital, Heidelberg University, 69120 Heidelberg, Germany
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Naing C, Whittaker MA, Aung HH, Chellappan DK, Riegelman A. The effects of flipped classrooms to improve learning outcomes in undergraduate health professional education: A systematic review. Campbell Syst Rev 2023; 19:e1339. [PMID: 37425620 PMCID: PMC10326838 DOI: 10.1002/cl2.1339] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
Background The 'flipped classroom' approach is an innovative approach in educational delivery systems. In a typical flipped class model, work that is typically done as homework in the didactic model is interactively undertaken in the class with the guidance of the teacher, whereas listening to a lecture or watching course-related videos is undertaken at home. The essence of a flipped classroom is that the activities carried out during traditional class time and self-study time are reversed or 'flipped'. Objectives The primary objectives of this review were to assess the effectiveness of the flipped classroom intervention for undergraduate health professional students on their academic performance, and their course satisfaction. Search Methods We identified relevant studies by searching MEDLINE (Ovid), APA PsycINFO, Education Resources Information Center (ERIC) as well as several more electronic databases, registries, search engines, websites, and online directories. The last search update was performed in April 2022. Selection Criteria Included studies had to meet the following criteria: Participants: Undergraduate health professional students, regardless of the type of healthcare streams (e.g., medicine, pharmacy), duration of the learning activity, or the country of study. Intervention: We included any educational intervention that included the flipped classroom as a teaching and learning tool in undergraduate programs, regardless of the type of healthcare streams (e.g., medicine, pharmacy). We also included studies that aimed to improve student learning and/or student satisfaction if they included the flipped classroom for undergraduate students. We excluded studies on standard lectures and subsequent tutorial formats. We also excluded studies on flipped classroom methods, which did not belong to the health professional education(HPE) sector (e.g., engineering, economics). Outcomes: The included studies used primary outcomes such as academic performance as judged by final examination grades/scores or other formal assessment methods at the immediate post-test, as well as student satisfaction with the method of learning. Study design: We included randomised controlled trials (RCTs), quasi-experimental studies (QES), and two-group comparison designs. Although we had planned to include cluster-level RCTs, natural experiments, and regression discontinuity designs, these were not available. We did not include qualitative research. Data Collection and Analysis Two members of the review team independently screened the search results to assess articles for their eligibility for inclusion. The screening involved an initial screening of the title and abstracts, and subsequently, the full text of selected articles. Discrepancies between the two investigators were settled through discussion or consultation with a third author. Two members of the review team then extracted the descriptions and data from the included studies. Main Results We found 5873 potentially relevant records, of which we screened 118 of them in full text, and included 45 studies (11 RCTs, 19 QES, and 15 two-group observational studies) that met the inclusion criteria. Some studies assessed more than one outcome. We included 44 studies on academic performance and eight studies on students' satisfaction outcomes in the meta-analysis. The main reasons for excluding studies were that they had not implemented a flipped class approach or the participants were not undergraduate students in health professional education. A total of 8426 undergraduate students were included in 45 studies that were identified for this analysis. The majority of the studies were conducted by students from medical schools (53.3%, 24/45), nursing schools (17.8%, 8/45), pharmacy schools (15.6%, 7/45). medical, nursing, and dentistry schools (2.2%, 1/45), and other health professional education programs (11.1%, 5/45). Among these 45 studies identified, 16 (35.6%) were conducted in the United States, six studies in China, four studies in Taiwan, three in India, two studies each in Australia and Canada, followed by nine single studies from Brazil, German, Iran, Norway, South Korea, Spain, the United Kingdom, Saudi Arabia, and Turkey. Based on overall average effect sizes, there was better academic performance in the flipped class method of learning compared to traditional class learning (standardised mean difference [SMD] = 0.57, 95% confidence interval [CI] = 0.25 to 0.90, τ 2: 1.16; I 2: 98%; p < 0.00001, 44 studies, n = 7813). In a sensitivity analysis that excluded eleven studies with imputed data from the original analysis of 44 studies, academic performance in the flipped class method of learning was better than traditional class learning (SMD = 0.54, 95% CI = 0.24 to 0.85, τ 2: 0.76; I 2: 97%; p < 0.00001, 33 studies, n = 5924); all being low certainty of evidence. Overall, student satisfaction with flipped class learning was positive compared to traditional class learning (SMD = 0.48, 95% CI = 0.15 to 0.82, τ 2: 0.19, I 2:89%, p < 0.00001, 8 studies n = 1696); all being low certainty of evidence. Authors' Conclusions In this review, we aimed to find evidence of the flipped classroom intervention's effectiveness for undergraduate health professional students. We found only a few RCTs, and the risk of bias in the included non-randomised studies was high. Overall, implementing flipped classes may improve academic performance, and may support student satisfaction in undergraduate health professional programs. However, the certainty of evidence was low for both academic performance and students' satisfaction with the flipped method of learning compared to the traditional class learning. Future well-designed sufficiently powered RCTs with low risk of bias that report according to the CONSORT guidelines are needed.
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Affiliation(s)
- Cho Naing
- Division of Tropical Health and MedicineJames Cook UniversityTownsvilleAustralia
| | - Maxine A. Whittaker
- Division of Tropical Health and MedicineJames Cook UniversityTownsvilleAustralia
| | - Htar Htar Aung
- Department of Human Biology, School of MedicineInternational Medical UniversityKuala LumpurMalaysia
| | - Dinesh Kumar Chellappan
- Department of Life Sciences, School of PharmacyInternational Medical UniversityKuala LumpurMalaysia
| | - Amy Riegelman
- University LibrariesUniversity of MinnesotaMinneapolisMinnesotaUSA
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Chen YL, Hou MC, Chang SC, Huang CC. Using a Flipped Classroom to Compare 2 Ultrasonography Operating Methods to Improve Practice in Ultrasound Detection Acupuncture. Med Acupunct 2023; 35:82-88. [PMID: 37213262 PMCID: PMC10196079 DOI: 10.1089/acu.2022.0053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2023] Open
Abstract
Objective Ultrasound (US) detection acupuncture (UDA) is an innovative acupuncture technique that uses ultrasonography (USG) to detect the depth of the lung before performing acupuncture on the points around the chest to avoid puncturing the lungs. For acupuncturists to use UDA appropriately, it is crucial to have a good operating method to identify the pleura with USG. This study compared 2 US operating methods through active learning in a "flipped classroom" setting for acupuncture students. Materials and Methods Students and interns were recruited to complete the UDA flipped classroom course and evaluate the operations of 2 US methods on either of 2 simulation models: (1) a single B-mode or (2) a combined M-mode + B-mode. Participants were interviewed and satisfaction surveys were administered to obtain feedback. Results A total of 37 participants completed the course and evaluations. The combined mode had better measurement accuracy, acupuncture safety, and operating time (P < 0.05), and no pneumothoraxes occurred. Among both participant groups, the combined mode allowed the student group to learn quickly and the intern group to become more proficient. Both interviews and satisfaction surveys yielded positive feedback. Conclusions Using a combined mode for UDA can improve its performance greatly. The combined mode is definitely helpful for learning and promotion of UDA.
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Affiliation(s)
- Ying-Ling Chen
- School of Chinese Medicine, China Medical University, Taichung City, Taiwan
- Department of Chinese Medicine, China Medical University Hospital, Taichung City, Taiwan
| | - Mark C. Hou
- Department of Chinese Medicine, Changhua Christian Hospital, Changhua, Taiwan
- Department of Beauty Science, Chienkuo Technology University, Changhua, Taiwan
| | - Shun-Chang Chang
- Department of Chinese Medicine, Changhua Christian Hospital, Changhua, Taiwan
| | - Chih-Chung Huang
- Department of Biomedical Engineering, National Cheng Kung University, Tainan, Taiwan
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Yoosoof F, Liyanage I, de Silva R, Samaraweera S. Videos of demonstration versus text and image-based material for pre-skill conceptualisation in flipped newborn resuscitation training for medical students: a pilot study. BMC Med Educ 2022; 22:839. [PMID: 36471390 PMCID: PMC9721000 DOI: 10.1186/s12909-022-03926-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 11/28/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND The flipped skills lab is a student-centred approach which incorporates pre-class preparation (pre-skill conceptualization) followed by repeated, hands-on practice for practical skills training. Objective measures of skills acquisition in the flipped literature are few and conflicting. The importance of pre-skill conceptualization in flipped skills training suggests that pedagogically informed pre-skill conceptualization can enhance outcomes. METHODS A mixed quasi-experimental study was conducted on 41 final year medical students who followed a flipped newborn resuscitation skills lab. Pre-class preparatory material covered conceptual and procedural knowledge. Students in the traditional group (n = 19) and those in the interventionalmental group (n = 22) received identical reading material covering conceptual knowledge. Procedural knowledge was shared with the interventional group as demonstration videos, while the traditional group received a PowerPoint presentation with text and images covering the same material. Knowledge acquisition was assessed by 20 single best answer questions before and after hands-on practice in the skills lab and skill performance was tested post-intervention with a simulated scenario. Students' perceptions were collected by survey. Quantitative data was analysed using Wilcoxon Signed Ranks test and Mann-Whitney U test as appropriate. Qualitative data was analysed by thematic analysis. RESULTS Overall student rating of the intervention was positive with ratings of 4.54 and 4.46 out of 5 by the traditional group and the experimental group respectively. Post-intervention skill performance in the experimental group was significantly better (p < .05) in the interventional group (M = 87.86%, SD = 5.89) than in the traditional group (M = 83.44, SD = 5.30) with a medium effect size (r = .40). While both groups showed significant knowledge gains, only students in the experimental group showed a statistically significant gain in procedural knowledge (p < .05) following the flipped skills lab. Finally, while both groups self-reported feeling more knowledgeable and confident following the intervention, the level of confidence was superior in the experimental group. CONCLUSIONS Flipping the skills lab with pre-skill conceptualisation combining text-based conceptual knowledge and video-based procedural knowledge followed by simulation-based hands-on practice improves procedural knowledge and skills acquisition in newborn resuscitation training for medical students. This study shows that in addition to temporal benefits, pedagogically informed pre-skill conceptualization can confer procedure-specific cognitive and emotional benefits supporting skills acquisition.
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Affiliation(s)
- Farah Yoosoof
- Department of Paediatrics, General Sir John Kotelawala Defence University, Rathmalana, 10390 Sri Lanka
| | - Indika Liyanage
- Department of Paediatrics, General Sir John Kotelawala Defence University, Rathmalana, 10390 Sri Lanka
| | - Ranjith de Silva
- Sri Lanka College of Obstetricians and Gynaecologists, No.112 Model Farm Rd, Colombo, Sri Lanka
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Abstract
Flipped classroom is an educational technique in which content is delivered online for students to study at their own pace in preparation for in-class learning. Benefits include increased flexibility, enhanced student engagement and satisfaction, and more effective use of time spent during face-to-face teaching. However, the development and implementation of flipped classroom teaching are also associated with challenges, including time required to develop learning materials and getting students to engage with the preparatory work. This teaching tip describes a structured approach to designing and implementing the flipped classroom approach for clinical skills to allow a greater focus on practicing the hands-on skills and the provision of feedback during the laboratory session. First, the rationale for flipping the classroom and the expected benefits should be considered. On a practical level, decisions need to be made about what to include in the flipped component, how it will complement the face-to-face class, and how the resources will be created. In the design phase, adopting a structured template and aligning with established pedagogical principles is helpful. A well-designed flipped classroom motivates learners by including different elements such as quality educational media (e.g., videos), the opportunity to self-assess, and well-defined connections to relevant knowledge and skills. Student engagement with the flipped material can be promoted through different strategies such as clear communication to manage student expectations and adapting the delivery of the face-to-face component. Finally, gathering feedback and evaluating the initiative are important to inform future improvements.
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Ballouk R, Mansour V, Dalziel B, McDonald J, Hegazi I. Medical students' self-regulation of learning in a blended learning environment: a systematic scoping review. Med Educ Online 2022; 27:2029336. [PMID: 35086439 PMCID: PMC8803058 DOI: 10.1080/10872981.2022.2029336] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/11/2022] [Accepted: 01/11/2022] [Indexed: 05/24/2023]
Abstract
BACKGROUND Medical curricula are constantly evolving in response to the needs of society, accrediting bodies and developments in education and technology. The integration of blended learning modalities has challenged traditional methods of teaching, offering new prospects in the delivery of medical education. The purpose of this review is to explore how medical students adapt their learning behaviours in a Blended Learning environment to become more independent and self-regulated, in addition to highlighting potential avenues to enhance the curriculum and support student learning. METHODS Using the approach described by Levac et al. (2010), which builds on Arksey and O'Malley's framework, we conducted a literature search of the following databases: MEDLINE (Ovid), ERIC, EBSCO, SCOPUS and Google Scholar, utilising key terms and variants of "medical student', 'self-regulated learning' and 'blended learning'. The search yielded 305 studies which were further charted and screened according to the Joanna Briggs Institute. RESULTS Forty-four studies were identified and selected for inclusion in this review. After full analysis of these studies, underpinned by Self-regulation theory, five major concepts associated with students' learning behaviours in a Blended Learning environment were identified: Scaffolding of instructional guidance may support self-regulated learning; Self-regulated learning enhances academic performance; Self-regulated Learning improves study habits through resource selection; Blended learning drives student motivation and autonomy; and the Cognitive apprenticeship approach supports Self-regulated learning. CONCLUSION This review uncovers medical students' learning behaviours within a Blended learning environment which is important to consider for curricular adaptations and student support.
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Affiliation(s)
- Rouba Ballouk
- School of Medicine, University of Western Sydney, Sydney, Australia
| | - Victoria Mansour
- School of Medicine, University of Western Sydney, Sydney, Australia
| | - Bronwen Dalziel
- School of Medicine, University of Western Sydney, Sydney, Australia
| | - Jenny McDonald
- School of Medicine, University of Western Sydney, Sydney, Australia
| | - Iman Hegazi
- School of Medicine, University of Western Sydney, Sydney, Australia
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Zeldin ER, Charles SC, Tumin D, Lawson L, Faulk C, Norbury JW. Impact of a Hybrid-Virtual Teaching Model on the Physical Examination Skills of Fourth-Year Medical Students. Am J Phys Med Rehabil 2022; 101:960-4. [PMID: 35473890 DOI: 10.1097/PHM.0000000000002032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
ABSTRACT A required fourth-year advanced core neurology-physical medicine and rehabilitation clerkship was adapted to hybrid format (2-wk remote; 2-wk in-person) during the COVID-19 pandemic. With teaching of the neurological physical examination being shifted to the remote component, we sought to determine whether this negatively affected student performance on an Objective Structured Clinical Examination, particularly the physical examination component. Mean pandemic-era total Objective Structured Clinical Examination scores ( n = 79, 85.1 ± 7.3) were similar to prepandemic era ( n = 137, 83.5 ± 6.0, P = 0.082). Pandemic-era physical examination scores were slightly higher than prepandemic (86.9 ± 6.5 vs. 84.9 ± 6.6). Despite conversion of the clerkship to a hybrid curriculum, the performance of the students on the Objective Structured Clinical Examination and the physical examination were unchanged. Reasons for this lack of change may include the constructiveness and integration of the case-based virtual demonstrations combined with in-person learning or the flexibility of the virtual course to allow students more time to prepare for the Objective Structured Clinical Examination and the physical examination. Our findings demonstrate that a hybrid-virtual model can be used to teach foundational skills such as the basics of the physical examination, while allowing faculty to address higher-order skills such as integration of clinical data with medical knowledge.
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Shen AH, Alfonso AR, Cuccolo NG, Johnson AR, Lee BT, Lin SJ. Designing a Plastic and Reconstructive Surgery Virtual Curriculum (PRSVC): Assessment of Medical Student Knowledge, Surgical Skill, and Community Building. Plast Reconstr Surg 2022. [PMID: 35819982 DOI: 10.1097/PRS.0000000000009462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
BACKGROUND The COVID-19 pandemic displaced medical students from their rotations and into virtual classrooms. We aimed to develop a virtual curriculum with the goals for students to gain knowledge in plastic surgery, to acquire technical skills, and to be able to promote community. METHODS We developed a four-week educational curriculum of topics in plastic surgery using the American Society of Plastic Surgeons Resident Education Curriculum and an online plastic surgery curriculum. Virtual flipped classroom case discussions and weekly surgical skills workshops were offered. Pre- and post-course surveys were administered, and results analyzed using IBM SPSS Statistics version 25.0. RESULTS 303 medical students and recent graduates enrolled in the course in June 2020. 182 students completed the pre-course survey (60% response rate), and of those, 50.0% (n=91) completed the post-course survey for paired comparison. Students reported significant improvement in confidence discussing the relevant anatomy, work-up and surgical approaches to clinical cases, as well as confidence in knowledge of all topic areas (p<0.001). Confidence in suturing and knot-tying techniques significantly improved among workshop participants (p<0.001). Students applying to residency programs this cycle felt significantly more prepared for sub-internships (p<0.001) and significantly more connected to the community of applicants (p<0.001). CONCLUSIONS The Plastic and Reconstructive Surgery Virtual Curriculum (PRSVC) improved knowledge, surgical skills, and community in the field among medical student participants. This course may serve to provide a framework for structured virtual learning activities for students interested in plastic surgery and may have significant long-lasting utility for students interested in the field.
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Hassan EA, Elsaman SEA. The effect of simulation-based flipped classroom on acquisition of cardiopulmonary resuscitation skills: A simulation-based randomized trial. Nurs Crit Care 2022; 28:344-352. [PMID: 35801367 DOI: 10.1111/nicc.12816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 06/09/2022] [Accepted: 06/14/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Cardiopulmonary resuscitation (CPR) is an essential skill required by critical care nurses. Evidence has shown that the use of a novel method called simulation-based flipped classroom (SBFC) can save training time in nursing laboratories and, to some extent, enhance social distancing during the current COVID-19 pandemic. AIM To evaluate the effects of SBFC on nursing students' acquisition of CPR skills. STUDY DESIGN A two-parallel prospective, single-centre, simulation-based, randomized, controlled trial. METHODS The total sample size was 326 students. A CPR video was recorded and uploaded on Microsoft Teams channel for the SBFC group only. Thereafter, both groups demonstrated and redemonstrated the CPR procedure. Both groups were then compared according to the simulation experience satisfaction scale and CPR skills acquisition checklist. RESULTS Two equally randomly selected groups of 163 undergraduate nursing students completed the study. The SBFC group had a significantly better satisfaction with the simulation experience than the traditional simulation (TS) group (p = 0.03). As regards the mean score of the CPR checklist after simulation, the SBFC group had a significantly higher score than TS group (p = 0.01). CONCLUSIONS SBFC using a pre-recorded video can be an effective method that can reduce the time needed for CPR clinical simulation and can be used for the CPR simulation among critical care nurses. RELEVANCE TO CLINICAL PRACTICE This study provides critical care nursing educators with a deep understanding regarding the benefits and value of utilizing the SBFC method in the clinical training of CPR skills. SBFC can be used to increase critical care nurses' satisfaction and skill acquisition during CPR training.
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Affiliation(s)
- Eman Arafa Hassan
- Critical Care and Emergency Nursing Department, Faculty of Nursing, Alexandria University, Alexandria, Egypt
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Pham J, Tran A, O'Leary KS, Youm J, Tran DK, Chen JW. Neurosurgery Lectures Benefit from a Flipped Class Approach. World Neurosurg 2022; 164:e481-e491. [PMID: 35552037 DOI: 10.1016/j.wneu.2022.04.134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 04/28/2022] [Accepted: 04/29/2022] [Indexed: 11/26/2022]
Abstract
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.
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Affiliation(s)
- Judy Pham
- Department of Neurological Surgery, School of Medicine, University of California, Irvine, Orange, California, USA
| | - Antalique Tran
- Department of Neurological Surgery, School of Medicine, University of California, Irvine, Orange, California, USA
| | - Kevin S O'Leary
- Department of Neurological Surgery, School of Medicine, University of California, Irvine, Orange, California, USA
| | - Julie Youm
- Department of Medical Education, School of Medicine, University of California Irvine, Irvine, California, USA
| | - Diem Kieu Tran
- Department of Neurological Surgery, School of Medicine, University of California, Irvine, Orange, California, USA
| | - Jefferson W Chen
- Department of Neurological Surgery, School of Medicine, University of California, Irvine, Orange, California, USA.
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Barrett G, Seniors R, Okoli J, Chase A, Henry B, Mubasher M, Turner J. Validation of Use of Flipped Classroom for Surgery Core Clerkships. J Surg Educ 2022; 79:668-675. [PMID: 34972671 DOI: 10.1016/j.jsurg.2021.12.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 11/20/2021] [Accepted: 12/04/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND The flipped classroom (FC) is an integrated learning paradigm that equips students with self-directed study materials before scheduled meeting times allowing for the deeper application of acquired knowledge with an instructor. There is limited data on the application of FC to clinical undergraduate medical education and particularly as it applies to a surgical clerkship. METHODS This study is a four-year retrospective study that includes two cohorts of students who matriculated through two training paradigms, traditional classroom (TC) and FC. Information regarding the FC cohort was collected from June 2018 to July 2020 (N=166). A two-year matched historical cohort of students enrolled in the clerkship and taught with the TC paradigm from June 2016 to July 2018 was used for comparison (N=157). The primary aim of this study is to assess the National Board of Medical Examiners (NBME) surgery shelf performance when the FC model is utilized compared to the TC model. This study will validate a prior similar study that had a smaller cohort with different secondary endpoints. Therefore, the secondary aim of this study assesses how teaching style can affect other performance metrics of a rotation (such as clinical performance, quizzes, Objective Structured Clinical Examinations (OSCE), and practicums) and how time was utilized by faculty, staff, and students. RESULTS There was no difference in overall NBME surgery shelf performance when comparing the FC to the traditional classroom teaching (68.94 vs 70.34, P= 0.1667). Likewise, there was no difference in quiz performance. The FC did allow instructors to spend more time in other clinical components of the curriculum leading to a significant difference in student practicum (84.2 vs 88.26, P = 0.0186) and OSCE grades (87.54 vs 90.58, P <0.0001). CONCLUSION The surgery NBME shelf performance is not compromised by FC and therefore can be used as an alternative to traditional classroom setting for teaching medical knowledge to surgery clerkship students. In addition, the FC can improve time management for instructors allowing for improved teaching and development in other components of the surgery curriculum.
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Affiliation(s)
- Gregory Barrett
- Department of Surgery, Division of Surgical Education, Morehouse School of Medicine, Atlanta, Georgia.
| | - Robert Seniors
- Department of Surgery, Division of Surgical Education, Morehouse School of Medicine, Atlanta, Georgia.
| | - Joel Okoli
- Department of Surgery, Division of Surgical Education, Morehouse School of Medicine, Atlanta, Georgia.
| | - Ayana Chase
- Department of Surgery, Division of Surgical Education, Morehouse School of Medicine, Atlanta, Georgia.
| | - Brandon Henry
- Department of Surgery, Division of Surgical Education, Morehouse School of Medicine, Atlanta, Georgia.
| | - Mohemed Mubasher
- Department of Community Health and Preventive Medicine, Morehouse School of Medicine, Atlanta, Georgia.
| | - Jacquelyn Turner
- Department of Surgery, Division of Surgical Education, Morehouse School of Medicine, Atlanta, Georgia.
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Ji M, Luo Z, Feng D, Xiang Y, Xu J. Short- and Long-Term Influences of Flipped Classroom Teaching in Physiology Course on Medical Students' Learning Effectiveness. Front Public Health 2022; 10:835810. [PMID: 35419334 PMCID: PMC8995769 DOI: 10.3389/fpubh.2022.835810] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2021] [Accepted: 02/28/2022] [Indexed: 11/13/2022] Open
Abstract
The flipped classroom (FC) teaching has been increasingly employed in medical education. Many studies have shown this “student-centered” pedagogical model improves students' overall achievement in the course, with students showing more motivation and better self-directed learning skills when compared to the traditional classroom teaching. However, most of the previous studies have been evaluating the short-term effects of FC teaching conducted upon completion of the course. The retention of the promotion and the long-term effects on learning of students' subsequent courses deserve further attention and evaluation. By adopting and running FC teaching in the whole course of physiology, this study aimed to determine the short-term impact of FC teaching on students' learning of physiology course and also the long-term influences in students' learning of follow-up medical curriculums within 18 months after the completion of physiology course. 119 sophomore students majoring in clinical medicine from Central South University were recruited and they were assigned randomly into two groups: the control group (n =61) who received the traditional lecture (TL) teaching, and the experimental group (n =58), who received the FC teaching. In this study, students' final exam scores were used to assess their learning effectiveness and an independent samples t-test was conducted to compare scores between the two groups. Our study showed that FC teaching significantly improved the learning outcome of physiology in the experimental group compared with the control group (P = 0.0001) without obvious impact on the learning of other subjects conducted in the same period of time. Moreover, our results also demonstrated the long-term benefit of FC teaching, with students from the experimental group scoring higher in pathophysiology (P = 0.006), pathology (P = 0.029), pharmacology (P = 0.0089), diagnostics (P = 0.01) and internal medicine (P = 0.0004) than those from the control group. The study results indicate that FC is a promising teaching approach to increase students' learning effectiveness in physiology course, and the long-term effects of FC facilitate the learning of the follow-up medical courses. Furthermore, this study also demonstrates that although the time investment on physiology is increased by FC teaching, it does not weaken students' learning of other courses conducted in the same period of time.
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Affiliation(s)
- Ming Ji
- Department of Physiology, School of Basic Medical Science, Central South University, Changsha, China
| | - Ziqiang Luo
- Department of Physiology, School of Basic Medical Science, Central South University, Changsha, China
| | - Dandan Feng
- Department of Physiology, School of Basic Medical Science, Central South University, Changsha, China
| | - Yang Xiang
- Department of Physiology, School of Basic Medical Science, Central South University, Changsha, China
| | - Jianping Xu
- Department of Physiology, School of Basic Medical Science, Central South University, Changsha, China
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Parker AS, Hill KA, Steffes BC, Mangaoang D, O’Flynn E, Bachheta N, Bates MF, Bitta C, Carter NH, Davis RE, Dressler JA, Eisenhut DA, Fadipe AE, Kanyi JK, Kauffmann RM, Kazal F, Kyamanywa P, Lando JO, Many HR, Mbithi VC, McCoy AJ, Meade PC, Ndegwa WY, Nkusi EA, Ooko PB, Osilli DJ, Parker ME, Rankeeti S, Shafer K, Smith JD, Snyder D, Sylvester KR, Wakeley ME, Wekesa MK, Torbeck L, White RE, Bekele A, Parker RK. Design of a Novel Online, Modular, Flipped-classroom Surgical Curriculum for East, Central, and Southern Africa. Ann Surg Open 2022; 3:e141. [PMID: 37600110 PMCID: PMC10431259 DOI: 10.1097/as9.0000000000000141] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 01/31/2022] [Indexed: 11/26/2022] Open
Abstract
Objective We describe a structured approach to developing a standardized curriculum for surgical trainees in East, Central, and Southern Africa (ECSA). Summary Background Data Surgical education is essential to closing the surgical access gap in ECSA. Given its importance for surgical education, the development of a standardized curriculum was deemed necessary. Methods We utilized Kern's 6-step approach to curriculum development to design an online, modular, flipped-classroom surgical curriculum. Steps included global and targeted needs assessments, determination of goals and objectives, the establishment of educational strategies, implementation, and evaluation. Results Global needs assessment identified the development of a standardized curriculum as an essential next step in the growth of surgical education programs in ECSA. Targeted needs assessment of stakeholders found medical knowledge challenges, regulatory requirements, language variance, content gaps, expense and availability of resources, faculty numbers, and content delivery method to be factors to inform curriculum design. Goals emerged to increase uniformity and consistency in training, create contextually relevant material, incorporate best educational practices, reduce faculty burden, and ease content delivery and updates. Educational strategies centered on developing an online, flipped-classroom, modular curriculum emphasizing textual simplicity, multimedia components, and incorporation of active learning strategies. The implementation process involved establishing thematic topics and subtopics, the content of which was authored by regional surgeon educators and edited by content experts. Evaluation was performed by recording participation, soliciting user feedback, and evaluating scores on a certification examination. Conclusions We present the systematic design of a large-scale, context-relevant, data-driven surgical curriculum for the ECSA region.
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Affiliation(s)
- Andrea S. Parker
- From the Department of Surgery, Tenwek Hospital, Bomet, Kenya
- Department of Surgery, Alpert Medical School of Brown University, Providence, RI
- College of Surgeons of East, Central, and Southern Africa, Arusha, Tanzania
| | - Katherine A. Hill
- Department of Surgery, University of Pittsburgh Medical Center, Pittsburgh, PA
| | | | - Deirdre Mangaoang
- Institute of Global Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Eric O’Flynn
- Institute of Global Surgery, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Niraj Bachheta
- College of Surgeons of East, Central, and Southern Africa, Arusha, Tanzania
| | - Maria F. Bates
- Department of Surgery, Dartmouth Hitchcock Medical Center, Lebanon, NH
| | - Caesar Bitta
- Department of Surgery, Maseno University, Kisumu, Kenya
| | | | | | | | | | | | - John K. Kanyi
- Department of Surgery, AIC Litein Hospital, Litein, Kenya
| | - Rondi M. Kauffmann
- Department of Surgery, Vanderbilt University Medical Center, Division of Oncologic and Endocrine Surgery, Nashville, TN
| | - Frances Kazal
- Warren Alpert Medical School at Brown University, Providence, RI
| | - Patrick Kyamanywa
- Department of Surgery, Kampala International University, Kampala, Uganda
| | - Justus O. Lando
- From the Department of Surgery, Tenwek Hospital, Bomet, Kenya
| | - Heath R. Many
- Department of Surgery, University of Tennessee Medical Center, Knoxville, TN
| | | | - Amanda J. McCoy
- Department of Orthopedic Surgery, UPMC Children’s Hospital of Pittsburgh, Pittsburgh, PA
| | | | - Wairimu Y.B. Ndegwa
- Department of Surgery, Jomo Kenyatta University of Agriculture and Technology, Nairobi, Kenya
| | - Emmy A. Nkusi
- Department of Surgery, Rwanda Military Hospital, Kigali, Rwanda
| | - Philip B. Ooko
- Department of Surgery, AIC Litein Hospital, Litein, Kenya
| | - Dixon J.S. Osilli
- Department of Surgery, Barking, Havering, and Redbridge University Hospitals NHS Trust, Romford, England, UK
| | | | | | | | - James D. Smith
- Department of Surgery, Oregon Health & Science University, Portland, OR
| | - David Snyder
- Pan-African Academy of Christian Surgeons, Palatine, Illinois
| | | | - Michelle E. Wakeley
- Department of Surgery, Alpert Medical School of Brown University, Providence, RI
| | | | - Laura Torbeck
- Department of Surgery, Indiana University School of Medicine, Indianapolis, IN
| | - Russell E. White
- From the Department of Surgery, Tenwek Hospital, Bomet, Kenya
- Department of Surgery, Alpert Medical School of Brown University, Providence, RI
- College of Surgeons of East, Central, and Southern Africa, Arusha, Tanzania
| | - Abebe Bekele
- College of Surgeons of East, Central, and Southern Africa, Arusha, Tanzania
- University of Global Health Equity, Kigali, Rwanda
- Department of Surgery, Addis Ababa University, Addis Ababa, Ethiopia
| | - Robert K. Parker
- From the Department of Surgery, Tenwek Hospital, Bomet, Kenya
- Department of Surgery, Alpert Medical School of Brown University, Providence, RI
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Abdulrazeq F, Kheirallah KA, Al-Mistarehi AH, Al Bashir S, ALQudah MA, Alzoubi A, Alsulaiman J, Al Zoubi MS, Al-Maamari A. Effectiveness of interactive teaching intervention on medical students' knowledge and attitudes toward stem cells, their therapeutic uses, and potential research applications. PeerJ 2022; 10:e12824. [PMID: 35116201 PMCID: PMC8785657 DOI: 10.7717/peerj.12824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 01/03/2022] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Stem cell science is rapidly developing with the potential to alleviate many non-treatable diseases. Medical students, as future physicians, should be equipped with the proper knowledge and attitude regarding this hopeful field. Interactive teaching, whereby the teachers actively involve the students in the learning process, is a promising approach to improve their interest, knowledge, and team spirit. This study aims to evaluate the effectiveness of an interactive teaching intervention on medical students' knowledge and attitudes about stem cell research and therapy. METHODS A pre-post test study design was employed. A six-session interactive teaching course was conducted for a duration of six weeks as an intervention. Pre- and post-intervention surveys were used. The differences in the mean scores of students' knowledge and attitudes were examined using paired t-test, while gender differences were examined using an independent t-test. RESULTS Out of 71 sixth-year medical students from different nationalities invited to participate in this study, the interactive teaching course was initiated by 58 students resulting in a participation rate of 81.7%. Out of 58 students, 48 (82.8%) completed the entire course. The mean age (standard deviation) of students was 24 (1.2) years, and 32 (66.7%) were males. The results showed poor knowledge about stem cells among the medical students in the pre-intervention phase. Total scores of stem cell-related knowledge and attitudes significantly improved post-intervention. Gender differences in knowledge and attitudes scores were not statistically significant post-intervention. CONCLUSIONS Integrating stem cell science into medical curricula coupled with interactive learning approaches effectively increased students' knowledge about recent advances in stem cell research and therapy and improved attitudes toward stem cell research and applications.
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Affiliation(s)
- Fayez Abdulrazeq
- Department of Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Khalid A. Kheirallah
- Department of Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Abdel-Hameed Al-Mistarehi
- Department of Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Samir Al Bashir
- Department of Pathology and Microbiology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Mohammad A. ALQudah
- Department of Pathology and Microbiology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Abdallah Alzoubi
- College of Medicine, Ajman University of Science & Technology, Ajman, United Arab Emirates,Department of Pharmacology, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| | - Jomana Alsulaiman
- Department of Pediatrics, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Mazhar S. Al Zoubi
- Department of Basic Medical Sciences, Faculty of Medicine, Yarmouk University, Irbid, Jordan
| | - Abdulwahab Al-Maamari
- Department of Private Law, Faculty of Law, Al-Isra Private University, Amman, Jordan
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Ciano JD, Acerra J, Tang A. Development of a remote learning educational model for international Emergency Medicine trainees in the era of COVID-19. Int J Emerg Med 2022; 15:2. [PMID: 34991459 PMCID: PMC8733921 DOI: 10.1186/s12245-021-00405-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 12/27/2021] [Indexed: 11/12/2022] Open
Abstract
Background The COVID-19 pandemic has pressured post-graduate medical education programs to shift from traditional in-person teaching to remote teaching and learning. Remote learning in medical education has been described in the literature mostly in the context of local in-country teaching. International remote medical education poses unique challenges for educators, especially in low-middle income countries (LMICs) who need continued Emergency Medicine (EM) specialty development. Our objective is to describe the development and implementation of our remote educational curriculum for EM trainees in West Bengal, India, and to assess trainee satisfaction with our remote learning curriculum. Methods Our curriculum was developed by adapting remote learning techniques used in Western post-graduate medical education, conducting literature searches on remote learning modalities, and through collaboration with local faculty in India. We assessed resident satisfaction in our curriculum with feedback surveys and group discussions. Results The remote educational curriculum had overall high trainee satisfaction ratings for weekly livestream video lectures and throughout our monthly educational modules (median ratings 9-10 out of a 10-point Likert scale). Qualitative feedback regarding specific lecture topics and educational modules were also received. Conclusions International remote education in LMICs poses a unique set of challenges to medical educators. Residents in our study reported high satisfaction with the curriculum, but there is a lack of clarity regarding how a remote curriculum may impact academic and clinical performance. Future studies are needed to further evaluate the efficacy and academic and clinical implications of remote medical education in LMICs.
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Affiliation(s)
- Joseph D Ciano
- Department of Emergency Medicine, NSLIJ Health System: Northwell Health, Queens, New York, USA.
| | - John Acerra
- Department of Emergency Medicine, NSLIJ Health System: Northwell Health, Queens, New York, USA
| | - Aimee Tang
- Department of Emergency Medicine, NSLIJ Health System: Northwell Health, Queens, New York, USA
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Bezerra de Lima AC, Moura dos Santos DC, Lima de Almeida S, da Silva EL, Batista Ferreira e Pereira E. Ensino híbrido na formação em saúde: uma revisão sistemática. Rev Cuid 2022. [DOI: 10.15649/cuidarte.2051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Introdução: A partir da necessidade de reestruturação das instituições de ensino em saúde devido à pandemia da COVID-19, o ensino híbrido vem se destacando como possibilidade de reorganização das atividades educativas. O objetivo deste estudo foi escrever o desenvolvimento do ensino híbrido na formação de profissionais da área da saúde. Materiais e Métodos: Revisão sistemática da literatura, baseada nas recomendações da Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). A pesquisa foi desenvolvida em pares, entre julho a setembro de 2020, em quatro bases de dados eletrônicas. Os descritores foram os termos “Educação a Distância”, “Educação Superior”, “Aprendizagem”, “Saúde”, “Enfermagem”, “Medicina”, “Odontologia” e “Fisioterapia” e “Ensino híbrido”. Os artigos foram classificados conforme seu Nível de Evidência. Resultados: 49 artigos foram selecionados, entre estudos quantitativos, qualitativos e de método misto. Foram encontradas experiências do desenvolvimento do ensino híbrido nos diferentes cursos de formação na área da saúde. Observou-se aplicação do ensino híbrido segundo o modelo de Rotação, modelo à la carte e o modelo Flex. Discussão: o ensino híbrido vem ganhando destaque cada vez maior no cenário da educação acadêmica em saúde. Foi visto que, a partir dele, o aluno destaca-se em sua aprendizagem, pois é o principal gerenciador deste processo, aprendendo ativamente por diversos instrumentos educativos a partir da condução do professor. Conclusões: O êxito do ensino híbrido pode estar relacionado ao seu caráter inovador, flexível, com boa relação custo-benefício e capaz de tornar os alunos protagonistas do seu processo de ensino-aprendizagem, influenciando no desempenho acadêmico dos alunos.
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Newman JR, Fink J, Clough LA, Johnston S. Internal Medicine Clerkship ID Curriculum Flip: Will They Prefer to Pre-learn? Med Sci Educ 2021; 31:1751-1755. [PMID: 34490068 PMCID: PMC8409700 DOI: 10.1007/s40670-021-01384-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 08/14/2021] [Indexed: 06/13/2023]
Abstract
Varying pedagogical approaches of undergraduate medical education are utilized in clerkships to supplement bedside teaching. The flipped classroom mode, in which self-paced study precedes the in-person session, is often used in pre-clinical education. This shift allows time with the instructor to focus on guided application of pre-learned concepts. At our institution, the Internal Medicine Clerkship Infectious Diseases lecture was substituted to a flipped classroom with two pre-learning videos. Student satisfaction scores were higher for the flipped classroom and comments were more negative for the traditional lecture. This suggests that senior medical students favor flipped classroom pedagogy despite pre-learning requirements.
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Affiliation(s)
- Jessica R. Newman
- Division of Infectious Diseases, Department of Internal Medicine, University of Kansas Health System, Mailstop 1028, Kansas City, KS 66160 USA
| | - Jennifer Fink
- Division of General and Geriatric Medicine, Department of Internal Medicine, University of Kansas Health System, Kansas City, USA
| | - Lisa A. Clough
- Division of Infectious Diseases, Department of Internal Medicine, University of Kansas Health System, Mailstop 1028, Kansas City, KS 66160 USA
| | - Shane Johnston
- Office of Medical Education, School of Medicine, University of Kansas, Kansas City, USA
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Topor L, Balser D, Bruhnding P, Dvorak J, Anderson C, Tanguay B, Seidel E, Tonkin B, Senk A. How to One Up a Pandemic: University of Minnesota's Physical Medicine and Rehabilitation Virtual Clerkship-A Model for Alternative Clinical Training and Preliminary Validation Study. Am J Phys Med Rehabil 2021; 100:1100-4. [PMID: 33443855 DOI: 10.1097/PHM.0000000000001688] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
ABSTRACT Drastic and rapid changes to medical education are uncommon because of regulations and restrictions designed to ensure consistency among medical school curriculums and to safeguard student well-being. As a consequence of the COVID-19 pandemic, medical education had to break away from its conventions and transition from time-honored teaching methods to innovative solutions. This article explores the anticipated and actual efficacy of the swift conversion of a specialty elective from a traditional in-person format to a fully virtual clerkship. In addition, it includes a noninferiority study to determine where a virtual classroom may excel or fall short in comparison with conventional clinical rotations.
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Franco-Tantuico MA. Active Learning: A Concept Analysis With Implications for Nursing Education. Nurs Educ Perspect 2021. [PMID: 34652329 DOI: 10.1097/01.NEP.0000000000000895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
AIM The aim of this study was to understand the concept of active learning and its potential use in nursing academia. BACKGROUND The demands for innovative teaching-learning strategies in higher education increased in the past decade to foster higher level of thinking. The nurse educator must prepare students entering the nursing profession, which mandates safe patient care, using a pedagogical learning process such as active learning. METHOD The Walker and Avant method guided this concept analysis. RESULTS The attributes of the concept are learner-centered; dynamic, meaningful, and engaging learning environment; bidirectional collaborative interaction between educator and learner; and ongoing constructive and nonjudgmental feedback. The identified antecedents include the educator's active learning expertise and the learner's capacity for higher order thinking. CONCLUSION Nurse educators are responsible for providing effective learning environments based on a sound pedagogical approach. Active learning's desirable outcomes call for educator support as experts in implementation.
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Grabow Moore K, Ketterer A, Wheaton N, Weygandt PL, Caretta-Weyer HA, Berberian J, Jordan J. Development, Implementation, and Evaluation of an Open Access, Level-Specific, Core Content Curriculum for Emergency Medicine Residents. J Grad Med Educ 2021; 13:699-710. [PMID: 34721800 PMCID: PMC8527934 DOI: 10.4300/jgme-d-21-00067.1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2021] [Revised: 06/02/2021] [Accepted: 06/03/2021] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Leaders in graduate medical education must provide robust clinical and didactic experiences to prepare residents for independent practice. Programs traditionally create didactic experiences individually, requiring tremendous resources with variable content exposure and quality. OBJECTIVE We sought to create and implement a free, open access, learner-centric, level-specific, emergency medicine (EM) residency curriculum. METHODS We developed Foundations of Emergency Medicine (FoEM) Foundations I and II courses using Kern's model of curriculum development. Fundamental topics were identified through content guidelines from the American Board of Emergency Medicine. We incorporated learner-centric strategies into 2 flipped classroom, case-based courses targeting postgraduate year (PGY) 1 and PGY-2 residents. The curriculum was made freely available online in 2016. Faculty and resident users were surveyed annually for feedback, which informed iterative refinement of the curriculum. RESULTS Between 2016 and 2020, registration for FoEM expanded from 2 sites with 36 learners to 154 sites and 4453 learners. In 2019, 98 of 102 (96%) site leaders and 1618 of 2996 (54%) learners completed the evaluative survey. One hundred percent of responding leaders and 93% of learners were "satisfied" or "very satisfied" with FoEM content. Faculty and residents valued FoEM's usability, large volume of content, quality, adaptability, organization, resident-faculty interaction, and resident-as-teacher opportunities. Challenges to implementation included resident attendance, conference structure, technology limitations, and faculty engagement. CONCLUSIONS We developed and implemented a learner-centric, level-specific, national EM curriculum that has been widely adopted in the United States.
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Affiliation(s)
- Kristen Grabow Moore
- Kristen Grabow Moore, MD, MEd, is Assistant Professor, Department of Emergency Medicine, Emory University
| | - Andrew Ketterer
- Andrew Ketterer, MD, MA, is Clinical Instructor and Assistant Residency Program Director, Department of Emergency Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School
| | - Natasha Wheaton
- Natasha Wheaton, MD, is Associate Clinical Professor, Associate Program Director, and Medical Student Clerkship Director, Department of Emergency Medicine, David Geffen School of Medicine at University of California, Los Angeles (UCLA)
| | - Paul Logan Weygandt
- Paul Logan Weygandt, MD, MPH, is Assistant Professor, Department of Emergency Medicine, Johns Hopkins University School of Medicine
| | - Holly A. Caretta-Weyer
- Holly A. Caretta-Weyer, MD, MHPE, is Assistant Professor and Associate Residency Program Director, Department of Emergency Medicine, Stanford University School of Medicine
| | - Jeremy Berberian
- Jeremy Berberian, MD, is Assistant Professor, Department of Emergency Medicine, Christiana Care Health System
| | - Jaime Jordan
- Jaime Jordan, MD, MAEd, is Associate Professor of Clinical Emergency Medicine, Associate Program Director, and Vice Chair, Acute Care College, Department of Emergency Medicine, David Geffen School of Medicine at UCLA
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Hammond JB, Sheaffer WW, Teven CM, Wasif N, Mishra N, Davila VJ, Casey WJ, Polveroni TM, Moore LW, Smith AA. Formative Feedback with In-Class Question Bank Utilization Improves Resident Satisfaction with General Surgery Didactics. Adv Med Educ Pract 2021; 12:1033-1041. [PMID: 34552367 PMCID: PMC8450676 DOI: 10.2147/amep.s323002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 08/12/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Formative feedback provides low-stakes opportunities for educational improvement. To enrich our basic science didactics, formative feedback measures were incorporated into our didactics using mobile devices. MATERIALS AND METHODS Lecture changes included institutional paid access to a commercial question bank, a 5-item in-class pre-didactic quiz curated from the question bank and taken on the resident's mobile device, and group discussion of quiz topics. An anonymous survey was sent to participating residents. RESULTS Overall response rate was 71% among residents. All reported that the new lecture format was a valuable addition to the basic science curriculum (100% Agree/Strongly Agree), and formative assessments provided valuable feedback about the progress of their learning (Strongly Agree = 42%, Agree =58%). All residents reported that in-class use of their mobile device for quizzes was convenient, with majority (84%) preferring it over paper printouts. Residents were more motivated to study before lecture (Strongly Agree = 42%, Agree =42%), with majority also reporting the new format helped identify weaknesses in their knowledgebase (Strongly Agree = 58%, Agree =33%). While majority of residents agreed that quizzes motivated them to study more after lecture, a large portion disagreed (42%). Majority of senior residents reported that the process of composing quizzes prior to lecture enriched their own learning (57%) and helped them find gaps in their knowledge (71%). CONCLUSION Incorporating a commercial question bank within didactics gives general surgery residents formative feedback and encourages learning outside the classroom, leading to improved satisfaction with basic science didactics.
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Affiliation(s)
| | | | - Chad M Teven
- Department of Surgery, Mayo Clinic, Phoenix, AZ, USA
| | - Nabil Wasif
- Department of Surgery, Mayo Clinic, Phoenix, AZ, USA
| | - Nitin Mishra
- Department of Surgery, Mayo Clinic, Phoenix, AZ, USA
| | | | | | | | - Leah W Moore
- Department of Surgery, Mayo Clinic, Phoenix, AZ, USA
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Ponce Beti MS, Pereyra Ferrero R, Bono GM, Panichelli L, Liaño JE, Palacios Huatuco RM. Surgical education in the COVID-19 era: What did the general surgery residents' report in Argentina leave us? Part 2. Ann Med Surg (Lond) 2021; 68:102684. [PMID: 34394923 PMCID: PMC8351256 DOI: 10.1016/j.amsu.2021.102684] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 07/29/2021] [Accepted: 08/03/2021] [Indexed: 11/24/2022] Open
Abstract
Social distancing to curb the COVID-19 pandemic has impacted medical and surgical education. This health crisis led us to raise doubts, controversies, and dilemmas in health care in general, and in surgery in particular, understanding that residents are possibly as or more vulnerable than all health professionals. During the 32nd International Congress of General Surgery in Cordoba, which was the first general surgery congress held in Argentina during 2021; The Association of Residents and Concurrent Surgery of Cordoba presented its official report about the current challenges faced by residents during their surgical training.
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Affiliation(s)
- María S Ponce Beti
- Department of General Surgery, Hospital Militar Regional Córdoba, Av. Cruz Roja Argentina 1174, Córdoba Capital, Argentina
| | - Rafael Pereyra Ferrero
- Department of General Surgery, Hospital Privado Universitario de Córdoba, Av. Naciones Unidas 346, Córdoba Capital, Argentina
| | - Gonzalo M Bono
- Department of General Surgery, Instituto Médico Río Cuarto, Hipólito Yrigoyen 1020, Río Cuarto, Córdoba, Argentina
| | - Lucas Panichelli
- Department of General Surgery, Hospital Privado Universitario de Córdoba, Av. Naciones Unidas 346, Córdoba Capital, Argentina
| | - Julian E Liaño
- Department of General Surgery, Clínica Universitaria Reina Fabiola, Universidad Católica de Córdoba, Oncativo 1248, Córdoba Capital, Argentina
| | - René M Palacios Huatuco
- Department of General Surgery, Clínica Universitaria Reina Fabiola, Universidad Católica de Córdoba, Oncativo 1248, Córdoba Capital, Argentina
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Londgren MF, Baillie S, Roberts JN, Sonea IM. A Survey to Establish the Extent of Flipped Classroom Use Prior to Clinical Skills Laboratory Teaching and Determine Potential Benefits, Challenges, and Possibilities. J Vet Med Educ 2021; 48:463-469. [PMID: 32516079 DOI: 10.3138/jvme-2019-0137] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The flipped classroom is a technique that involves a reordering of classroom and at-home activities. Content provided prior to classroom interactions is used to prepare students for face-to-face classes. The flipped classroom has been shown to benefit students, including improving examination results, and there is increasing interest in using it in veterinary education. The current study aimed to investigate the potential of the flipped classroom approach to preparing students for practicals in a clinical skills laboratory. An online survey was distributed to the international veterinary clinical skills community to determine the extent to which a flipped classroom is used prior to teaching in a clinical skills laboratory and how educators viewed the benefits, challenges, and possibilities. There were 101 survey participants representing 22 countries, and all were involved in clinical skills teaching; 42 were using flipped classroom techniques prior to teaching in a clinical skills laboratory, and 55 others would consider using the technique in this context in the future. Videos were the most common resource used. The main benefits, experienced or anticipated, were positive changes in student behavior, including preparation and better use of time during practicals by both the students and instructors. The main challenges were the time needed for instructors to develop the materials, lack of student engagement with the flipped classroom, space in the curriculum, and institutional issues. In conclusion, many potential benefits could be realized with a flipped classroom approach embedded prior to clinical skills laboratory practicals.
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Thomas C, Plumblee L, Dieffenbaugher S, Talley C. Teaching on Rounds and in Small Groups. Surg Clin North Am 2021; 101:555-563. [PMID: 34242599 DOI: 10.1016/j.suc.2021.05.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Bedside teaching plays a vital role the training future physicians, allowing for instruction in history taking, physical examination skills, differential diagnosis development, professionalism, teamwork integration, effective communication, and discussions of medical ethics. Due to changes in the health care system, accreditation bodies, and shortened admittance of patients, rates of bedside teaching have declined. Attending surgeons feel increased external pressures to meet performance metrics while resident physicians adhere to duty hour restrictions. This article highlights popular methods, including bedside rounds, near-peer teaching, and resident versus attending preceptors, and discusses how teaching on rounds has an impact on patients.
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Affiliation(s)
- Christopher Thomas
- Medical University of South Carolina, Department of Surgery, 96 Jonathan Lucas Street, Charleston, SC 29425, USA
| | - Leah Plumblee
- Medical University of South Carolina, Department of Surgery, 96 Jonathan Lucas Street, Charleston, SC 29425, USA
| | - Sean Dieffenbaugher
- Carolinas Medical Center, Atrium Health, Department of Surgery, 1000 Blythe Boulevard, MEB Office 601, Charlotte, NC 28203, USA
| | - Cynthia Talley
- Medical University of South Carolina, Department of Surgery, 96 Jonathan Lucas Street, Charleston, SC 29425, USA.
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Vishwanathan K, Patel GM, Patel DJ. Impact and perception about distant online medical education (tele-education) on the educational environment during the COVID-19 pandemic: Experiences of medical undergraduate students from India. J Family Med Prim Care 2021; 10:2216-2224. [PMID: 34322415 PMCID: PMC8284219 DOI: 10.4103/jfmpc.jfmpc_2306_20] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 02/02/2021] [Accepted: 03/17/2021] [Indexed: 11/04/2022] Open
Abstract
INTRODUCTION The impact of online medical education using videoconferencing platforms on the education environment during the present COVID-19 pandemic is not known. The objectives were to evaluate the impact of online teaching using videoconferencing platforms on the education environment, satisfaction, and perception of the medical undergraduate students to online teaching. METHODS This prospective observational survey undertaken at a medical college included voluntarily participating medical undergraduate students from first (2nd semester), second (4th semester), and third year MBBS (6th and 8th semesters). The education environment was evaluated using the validated Dundee Ready Education Environment Measure (DREEM). The perception of the students was evaluated using questionnaire with five point Likert scale response. RESULTS The response rate in our survey was 77.5% (465 out of 600 students). The mean DREEM score of medical undergraduate students was 132.3 ± 19.8. Domains of DREEM evaluated were students' perception of learning (30.1 ± 6.3), students' perception of teachers (29.7 ± 4.6), students' academic self-perception (21.3 ± 4.9), students' perception of atmosphere (32.5 ± 6.2), and students' social self-perception (18.7 ± 3.5). Two hundred and fifty five students (54.8%) were extremely satisfied and quite satisfied with the online teaching-learning modalities. Two hundred and fifty eight students (55.5%) rated online learning methods to be very useful and quite useful during the lockdown period. CONCLUSION The educational environment at our medical college was positive and students had a positive perception and attitude toward the role of the videoconferencing platforms for learning (telemedicine) during the COVID-19 pandemic lockdown.
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Affiliation(s)
- Karthik Vishwanathan
- Department of Orthopaedics, Medical Education Unit, Parul Institute of Medical Sciences and Research, Parul University, Vadodara, Gujarat, India
| | - Geetika Madan Patel
- Department of Community Medicine, Medical Education Unit, Parul Institute of Medical Sciences and Research, Parul University, Vadodara, Gujarat, India
| | - Devanshu Jayeshbhai Patel
- Department of Pharmacology, Medical Education Unit, Parul Institute of Medical Sciences and Research, Parul University, Vadodara, Gujarat, India
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Kim Y, Kim N, Chae M. Effects of flipped learning on nursing students: A mixed methods study. Jpn J Nurs Sci 2021; 18:e12425. [PMID: 34002486 DOI: 10.1111/jjns.12425] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 03/08/2021] [Accepted: 03/19/2021] [Indexed: 11/30/2022]
Abstract
AIM Improving the learning capability of nursing students is imperative to their development as healthcare professionals. This study aimed to verify the effects of flipped learning on class participation, academic self-regulation, co-regulation, and academic performance, and to offer suggestions regarding educational strategies related to flipped learning. METHOD In the Community Health Nursing I course, 32 junior-year students (the experimental group) were provided with flipped learning, and 30 other junior-year students (the control group) received traditional instructor-led education. Flipped learning consisted of pre-learning, readiness assessment, a mini-lecture, group activities, and formative assessment. The pretest-posttest quasi-experimental and convergent parallel study designs were used in this study. RESULTS After participating in flipped learning, the experimental group exhibited a significant improvement in class participation, academic self-regulation, and co-regulation compared to the control group, but academic performance exhibited an insignificant improvement. The participants experienced a "change in attitude toward academic participation," "improved academic competence," and "pressure from learning" related to flipped learning. CONCLUSION Flipped learning can positively change students' approach to learning. We propose that flipped learning be applied more widely to the education of nursing students.
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Affiliation(s)
- Younkyoung Kim
- School of Nursing, Chonnam National University, Gwangju, South Korea
| | - Nooree Kim
- Department of Liberal Arts, Mokpo National Maritime University, Mokpo, South Korea
| | - Myeongjeong Chae
- Department of Nursing, Kwangju Women's University, Gwangju, South Korea
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Pinilla S, Cantisani A, Klöppel S, Strik W, Nissen C, Huwendiek S. Curriculum Development with the Implementation of an Open-Source Learning Management System for Training Early Clinical Students: An Educational Design Research Study. Adv Med Educ Pract 2021; 12:53-61. [PMID: 33488137 PMCID: PMC7814239 DOI: 10.2147/amep.s284974] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Accepted: 12/22/2020] [Indexed: 06/12/2023]
Abstract
BACKGROUND Learning management systems (LMSs) have not been explored from an educational design research (EDR) perspective for developing clinical curricula and supporting novice clinical students with self-regulated learning during their early clinical rotations. METHODS An EDR approach was used to inform a de novo implementation of an LMS during an early clinical rotation of medical students. The EDR consisted of three phases: analysis and exploration; design and construction; and evaluation and reflection. Process and evaluation data (including academic years 2018 and 2019) from two student cohorts (total n = 190, 107 without and 83 with LMS exposure) at one academic teaching hospital were analyzed. RESULTS Learning theories and concepts of self-regulated learning were used to develop and implement an LMS clerkship prototype. For design and construction, the maturing prototype design included flipped-classroom elements, in-class activation, voluntary digital self-assessments, and clinical teaching videos. For evaluation and reflection, global satisfaction improvement was significant (from 3.9 to 4.4 on a 5-point Likert scale, p < 0.05). There was a positive evaluation trend for all evaluation items related to learning climate, self-regulated learning, and perceived usefulness of the LMS prototype; however, these changes were not statistically significant. The teaching hospital also improved its ranking after the introduction of the LMS prototype. Nearly all students (94%) used the LMS material. The average number of times the LMS course was accessed per student was 70 (range: 7-172), and the average duration students spent online was 58 minutes (range: 9-165). CONCLUSION Our data indicate that using an EDR approach was helpful for systematically introducing an LMS in a clerkship curriculum informed by learning theory. Our evidence-oriented curriculum reform was associated with higher student satisfaction and appeared to support self-regulated learning in the workplace. Further research should explore which elements of an LMS most effectively help to achieve educational outcomes.
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Affiliation(s)
- Severin Pinilla
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
- Institute for Medical Education, Department for Assessment and Evaluation, University of Bern, Bern, Switzerland
| | - Andrea Cantisani
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Stefan Klöppel
- University Hospital of Old Age Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Werner Strik
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Christoph Nissen
- University Hospital of Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Sören Huwendiek
- Institute for Medical Education, Department for Assessment and Evaluation, University of Bern, Bern, Switzerland
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Dominguez Torres LC, Vega NV, Pepín-Rubio JJ, Sierra-Barbosa DO, Lotero JD. Se hace camino al andar: Educación médica de pregrado en el Departamento de Cirugía. Rev Colomb Cir 2021. [DOI: 10.30944/20117582.648] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
La educación en cirugía en Colombia esta experimentando una acelerada transformación. No obstante, la documentación de la transformación educativa en el país es limitada. En este estudio se presenta una revisión cronológica de la enseñanza en el Departamento de Cirugía de la Universidad de la Sabana. La revisión se focaliza en las estrategias e hitos alcanzados en el pregrado, luego de transformar el modelo de enseñanza tradicional de principios de siglo XXI. La revisión esta basada en la síntesis de una serie de estudios originales, los cuales ofrecen evidencia sobre las intervenciones realizadas en el departamento, y sobre sus resultados. Finalmente, se presenta una reflexión en torno a los retos futuros.
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Al-Maroof RA, Al-Emran M. Research Trends in Flipped Classroom: A Systematic Review. Studies in Systems, Decision and Control 2021:253-275. [DOI: 10.1007/978-3-030-47411-9_15] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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Abstract
The COVID-19 pandemic accelerated the adoption of telemedicine internationally. The reproductive clinics that thrived in this tumultuous time had access to fully electronic medical records with user-friendly telehealth platforms and remote support staff for physicians. However, complete transition from in-person visits to telehealth uncovered many opportunities for innovation. At-home semen testing is not yet widely recognized, and patients still require an in-person visit for ultrasounds, procedures, and physical examinations. Although emergency policies and waivers have made it easier for providers to legally practice across state borders and receive payments from insurance companies, they vary from state to state and have not been cemented into law. Finally, clinical training for medical students, residents, and fellows has been affected by decreased clinical and surgical volume. However, trainees have also proven to be the most adaptable, quickly shifting to remote learning practices through social media, online surgical atlases, and wide distribution of “virtual visiting professor” lectures. As countries have eased physical distancing guidelines, patients ultimately benefit from having the option of a telehealth appointment. Although there is still much work to be done to improve telehealth, the COVID-19 pandemic has at least proven that it is a safe method of patient care and teaching.
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Affiliation(s)
- Katherine Rotker
- Department of Urology, University of Massachusetts Medical School, Worcester, Massachusetts
| | - Danielle Velez
- Department of Urology, University of Illinois, Chicago, Illinois.
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Morse R, Smith A, Fitzgerald-Wolff S, Stoltzfus K. Population Health in the Medical School Curriculum: a Look Across the Country. Med Sci Educ 2020; 30:1487-1493. [PMID: 34457816 PMCID: PMC8368151 DOI: 10.1007/s40670-020-01083-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 09/21/2020] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Population health (PH) is an important component of medical school education and is required for physicians to practice effectively. Identifying the number of medical schools teaching population health and the individual curricular components could lead to a better understanding of the current status of population health implementation into medical education. MATERIALS AND METHODS Between February and March 2019, medical schools in the USA were surveyed about the structure and content of their population health curriculum. Differences were analyzed by school funding and class size. RESULTS Respondents were gathered from 28 (68%) public and 13 (32%) private schools; 27 (66%) schools having fewer than 150 students and 14 (34%) having greater than or equal to 150. Thirty-two schools (78%) had a structured PH curriculum. Seven (22%) only had a dedicated preclinical module and 33 (83%) had a longitudinal curriculum throughout multiple years of school. Many programs utilized flipped classroom models (n = 19, 46%); however, only 8 (20%) utilized standardized patients. Health disparities (100%), community health initiatives (88%), and preventative health guidelines (88%) are among the most commonly taught subjects. Quality improvement was taught by 34 of 41 programs (83%), but only sixteen (39%) schools required students to complete a quality improvement project. DISCUSSION Differences in population health curricula were found between school size and funding. As evidenced by this study, most medical schools recognize the importance of population health by including it in their curriculum and a majority are incorporating the subject longitudinally into multiple years of school.
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Affiliation(s)
- Ryan Morse
- Department of Internal Medicine, University of Kansas School of Medicine, Kansas City, KS USA
| | - Abigail Smith
- Department of Anesthesiology and Pain Medicine, UC Davis School of Medicine, Sacramento, CA USA
| | - Sharon Fitzgerald-Wolff
- Department of Population Health, University of Kansas School of Medicine, Kansas City, KS USA
| | - Ky Stoltzfus
- Department of Internal Medicine, University of Kansas School of Medicine, Kansas City, KS USA
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Bock A, Heitzer M, Lemos M, Peters F, Elvers D, Kniha K, Hölzle F, Modabber A. “Flipped OR”: a modified didactical concept for a surgical clerkship in Oral and Maxillofacial Surgery. Br J Oral Maxillofac Surg 2020; 58:1245-50. [DOI: 10.1016/j.bjoms.2020.03.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2019] [Accepted: 03/09/2020] [Indexed: 01/20/2023]
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Abstract
This review aims to explore the perception of technology-enhanced learning by medical students. From the initial 2947 records found, 38 studies from journals indexed in the Web of Science database were included after screening. Several main topics were isolated, based on a thematic analysis: student's attitude towards e-learning and modern technologies in medical education; social networks, video, and mobile devices as information source and communication tool; and barriers to the use of technologies in medical education. The results have shown that a positive attitude towards technologies in medical education and learning is prevalent among students. The popularity of blended learning was confirmed.
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Affiliation(s)
- Lukáš Plch
- Department of Educational Sciences, Faculty of Arts, Masaryk University, Arna Novaka 1, 602 00 Brno, Czech Republic
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Ferriss JS, Rose S, Rungruang B, Urban R, Spencer R, Uppal S, Sinno AK, Duska L, Walsh C. Society of Gynecologic Oncology recommendations for fellowship education during the COVID-19 pandemic and beyond: Innovating programs to optimize trainee success. Gynecol Oncol 2020; 160:271-278. [PMID: 33077260 PMCID: PMC7568037 DOI: 10.1016/j.ygyno.2020.10.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 10/09/2020] [Indexed: 12/19/2022]
Abstract
In approximately ten months' time, the novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has infected over 34 million people and caused over one million deaths worldwide. The impact of this virus on our health, relationships, and careers is difficult to overstate. As the economic realities for academic medical centers come into focus, we must recommit to our core missions of patient care, education, and research. Fellowship education programs in gynecologic oncology have quickly adapted to the “new normal” of social distancing using video conferencing platforms to continue clinical and didactic teaching. United in a time of crisis, we have embraced systemic change by developing and delivering collaborative educational content, overcoming the limitations imposed by institutional silos. Additional innovations are needed in order to overcome the losses in program surgical volume and research opportunities. With the end of the viral pandemic nowhere in sight, program directors can rethink how education is best delivered and potentially overhaul aspects of fellowship curriculum and content. Similarly, restrictions on travel and the need for social distancing has transformed the 2020 fellowship interview season from an in-person to a virtual experience. During this time of unprecedented and rapid change, program directors should be particularly mindful of the needs and health of their trainees and consider tailoring their educational experiences accordingly. The novel coronavirus pandemic has disrupted medical education at all levels. Fellowship programs must adapt to the realities of social distancing, workforce redeployments, and laboratory closures. The integration of teleconferencing into clinical practice and learning provides both challenges and growth opportunities. Program directors should be aware of new stressors our fellows, particularly underrepresented minorities, are facing. Programs should take advantage of the opportunity to rethink fellowship education and the needs of our recent graduates.
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Affiliation(s)
- J Stuart Ferriss
- Kelly Gynecologic Oncology Service, Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Steve Rose
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Wisconsin, Madison, WI, USA
| | - Bunja Rungruang
- Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Renata Urban
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Washington School of Medicine, Seattle, WA, USA
| | - Ryan Spencer
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Wisconsin, Madison, WI, USA
| | - Shitanshu Uppal
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Michigan, Ann Arbor, MI, USA
| | - Abdulrahman K Sinno
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Miami, Miami, FL, USA
| | - Linda Duska
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Virginia, Charlottesville, VA, USA
| | - Christine Walsh
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, Cedars Sinai Medical Center, Los Angeles, CA, USA
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Dedeilia A, Sotiropoulos MG, Hanrahan JG, Janga D, Dedeilias P, Sideris M. Medical and Surgical Education Challenges and Innovations in the COVID-19 Era: A Systematic Review. In Vivo 2020; 34:1603-1611. [PMID: 32503818 DOI: 10.21873/invivo.11950] [Citation(s) in RCA: 333] [Impact Index Per Article: 83.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2020] [Revised: 05/13/2020] [Accepted: 05/14/2020] [Indexed: 12/17/2022]
Abstract
The aim of this systematic review was to identify the challenges imposed on medical and surgical education by the COVID-19 pandemic, and the proposed innovations enabling the continuation of medical student and resident training. A systematic review on the MEDLINE and EMBASE databases was performed on April 18th, 2020, and yielded 1288 articles. Sixty-one of the included manuscripts were synthesized in a qualitative description focused on two major axes, "challenges" and "innovative solutions", and two minor axes, "mental health" and "medical students in the frontlines". Shortage of personal protective equipment, suspension of clinical clerkships and observerships and reduction in elective surgical cases unavoidably affect medical and surgical education. Interesting solutions involving the use of virtual learning, videoconferencing, social media and telemedicine could effectively tackle the sudden cease in medical education. Furthermore, trainee's mental health should be safeguarded, and medical students can be involved in the COVID-19 clinical treatment if needed.
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Affiliation(s)
- Aikaterini Dedeilia
- Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Marinos G Sotiropoulos
- Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, U.S.A
| | | | - Deepa Janga
- North Middlesex University Hospital NHS Trust, London, U.K
| | - Panagiotis Dedeilias
- Cardiovascular and Thoracic Surgery Department, Evangelismos General Hospital of Athens, Athens, Greece
| | - Michail Sideris
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, U.K.
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Ding C, Li S, Chen B. Effectiveness of flipped classroom combined with team-, case-, lecture- and evidence-based learning on ophthalmology teaching for eight-year program students. BMC Med Educ 2019; 19:419. [PMID: 31727043 PMCID: PMC6854635 DOI: 10.1186/s12909-019-1861-y] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 10/29/2019] [Indexed: 05/17/2023]
Abstract
BACKGROUND This study aimed to investigate the benefits and challenges of the flipped classroom combined with team-, case-, lecture- and evidence-based learning (FC-TCLEBL) for ophthalmology teaching for eight-year program students. METHODS FC-TCLEBL and the traditional lecture-based classroom (LBC) were compared based on student and teacher feedback questionnaires, student learning burden, and scores on standardized tests as well as their effects on the abilities of clinical thinking, scientific research, active-learning, practical application, humanistic care and communication with patients. RESULTS Both the students and teachers were more satisfied with the FC-TCLEBL model. More students in the FC-TCLEBL group agreed that the course helped them to develop skills in creative thinking, problem solving, and teamwork. Students in the FC-TCLEBL group spent significantly more time preparing for class than those in the LBC group, but the time spent on review was significantly lower in the FC-TCLEBL group. The students from the FC-TCLEBL group performed better in a post-test on diabetic retinopathy (DR) as compared to the LBC group. CONCLUSIONS FC-TCLEBL teaching model is effective and suitable for ophthalmology teaching.
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Affiliation(s)
- Chun Ding
- Department of Ophthalmology, The Second Xiangya Hospital of Central South University, Changsha, 410011 China
| | - Shengguo Li
- Department of Ophthalmology, The Second Xiangya Hospital of Central South University, Changsha, 410011 China
| | - Baihua Chen
- Department of Ophthalmology, The Second Xiangya Hospital of Central South University, Changsha, 410011 China
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Bilello LA. Turning The Tables On Tradition: Flipped High-Fidelity Simulation To Potentiate Learning. Adv Med Educ Pract 2019; 10:959-961. [PMID: 31814790 PMCID: PMC6858456 DOI: 10.2147/amep.s205967] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 05/25/2019] [Indexed: 06/10/2023]
Abstract
Innovative teaching modalities are more popular than ever within medical education. Examples include the flipped classroom model, incorporation of digital media and use of high-fidelity simulation technology. Our novel flipped simulation curriculum proposes the use of the flipped teaching method within the simulation lab for undergraduate and graduate medical education. With a focus on case-based learning, procedural skill development, and clinical excellence, flipped simulation incorporates many of the most important facets of medical education.
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Affiliation(s)
- Leslie A Bilello
- Department of Emergency Medicine, Instructor, Harvard Medical School, Associate Program Director, Harvard Affiliated Emergency Medicine Residency, Beth Israel Deaconess Medical Center, Boston, MA02115, USA
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Kraut AS, Omron R, Caretta-Weyer H, Jordan J, Manthey D, Wolf SJ, Yarris LM, Johnson S, Kornegay J. The Flipped Classroom: A Critical Appraisal. West J Emerg Med 2019; 20:527-536. [PMID: 31123556 PMCID: PMC6526887 DOI: 10.5811/westjem.2019.2.40979] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2018] [Revised: 12/16/2018] [Accepted: 02/16/2019] [Indexed: 11/12/2022] Open
Abstract
Introduction The objective of this study was to review and critically appraise the medical education literature pertaining to a flipped-classroom (FC) education model, and to highlight influential papers that inform our current understanding of the role of the FC in medical education. Methods A search of the English-language literature querying Education Resources Information Center (ERIC), PsychINFO, PubMed, and Scopus identified 296 papers related to the FC using either quantitative, qualitative, or review methods. Two reviewers independently screened each category of publications using previously established exclusion criteria. Eight reviewers then independently scored the remaining 54 publications using either a qualitative, quantitative, or review-paper scoring system. Each scoring system consisted of nine criteria and used parallel metrics that have been previously used in critical appraisals of education research. Results A total of 54 papers (33 quantitative, four qualitative, and 17 review) on FC met a priori criteria for inclusion and were critically appraised and reviewed. The top 10 highest scoring articles (five quantitative studies, two qualitative studies, and three review papers) are summarized in this article. Conclusion This installment of the Council of Emergency Medicine Residency Directors (CORD) Academy Critical Appraisal series highlights 10 papers that describe the current state of literature on the flipped classroom, including an analysis of the benefits and drawbacks of an FC approach, practical implications for emergency medicine educators, and next steps for future research.
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Affiliation(s)
- Aaron S Kraut
- University of Wisconsin School of Medicine and Public Health, Berbee Walsh Department of Emergency Medicine, Madison, Wisconsin
| | - Rodney Omron
- Johns Hopkins School of Medicine, Department of Emergency Medicine, Baltimore, Maryland
| | - Holly Caretta-Weyer
- Stanford University School of Medicine, Department of Emergency Medicine, Palo Alto, California
| | - Jaime Jordan
- David Geffen School of Medicine at UCLA, Department of Emergency Medicine, Los Angeles, California
| | - David Manthey
- Wake Forest School of Medicine, Department of Emergency Medicine, Winston-Salem, North Carolina
| | - Stephen J Wolf
- Denver Health Medical Center, Department of Emergency Medicine, Denver, Colorado
| | - Lainie M Yarris
- Oregon Health and & Science University, Department of Emergency Medicine, Portland, Oregon
| | - Stephen Johnson
- University of Wisconsin School of Medicine and Public Health, Library Services, Madison, Wisconsin
| | - Josh Kornegay
- Oregon Health and & Science University, Department of Emergency Medicine, Portland, Oregon
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Ram AM, Rajasekaran S. Clinical Pharmacology Learning Tools for the Tech Savvy in a Physician Assistant (MPA) Program. FASEB J 2019. [DOI: 10.1096/fasebj.2019.33.1_supplement.803.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Jun Rong VP, Au B, Arundhati A, Long QB. Impact of extracapsular cataract extraction surgical instructional video on self-directed learning of surgical skills in a tertiary eye care centre. BMJ STEL 2019; 5:114-115. [DOI: 10.1136/bmjstel-2017-000256] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 10/13/2017] [Indexed: 11/04/2022]
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Castillo-Angeles M, Calvillo-Ortiz R, Acosta D, Watkins AA, Evenson A, Atkins KM, Kent TS. Mistreatment and the Learning Environment: A Mixed Methods Approach to Assess Knowledge and Raise Awareness Amongst Residents. J Surg Educ 2019; 76:305-314. [PMID: 30318301 DOI: 10.1016/j.jsurg.2018.07.019] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2018] [Revised: 06/07/2018] [Accepted: 07/25/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE Trainee mistreatment, either intentional or unintentional, negatively affects the learning environment. This study was undertaken to evaluate the impact of an educational intervention about mistreatment and the learning environment on general surgery residents. DESIGN Video-based modules were developed and added to the residency curriculum. Modules provided definitions and examples of active and passive mistreatment and components of positive and negative learning environments. A mixed-methods approach was used to assess the impact of this intervention. Residents completed a previously validated pre and post-test of related knowledge and attitudes (Abuse Sensitivity Questionnaire). Wilcoxon Signed Rank test was used to compare test results. During video-review sessions, discussion was prompted amongst residents using a semistructured interview guide. Immersion crystallization method was used to identify dominant themes. SETTING Beth Israel Deaconess Medical Center, an academic tertiary care facility located in Boston, Massachusetts. PARTICIPANTS All general surgery residents in our institution (n = 58) were invited to complete a survey at 3 time points. RESULTS Fifty-eight residents (55% male) responded to the survey (100% response rate). Mean age was 30.2 year (SD 3.9). Perception of nicknames related to personal identifiers (p = 0.0065) and name-calling (p = 0.02) changed significantly postintervention (Table 1). Regarding standards of behavior, 42 (72.4%) residents considered yelling not to be abusive unless it occurred frequently or constantly; 15 (25.8%) residents considered swearing (not directed at a person) as "not abuse"; 6 (10.3%) considered constructive criticism to be abusive if it was frequent or constant; and 24 (41%) residents feel powerless to intervene in these scenarios. Multiple themes emerged regarding resident-student interactions: (1) resident perception that description of behavior as mistreatment depends on medical student sensitivity; (2) neglect of medical students avoids trouble (e.g., being labeled as active mistreatment); (3) failure to integrate students into the surgical team may occur due to perceived lack of student interest; and (4) communication with the medical student is key. Residents reported that discussion along with video review was more effective than video review alone. CONCLUSIONS The video-based curriculum on mistreatment and the learning environment created awareness amongst residents about this important topic. Knowledge and attitudes about mistreatment changed in some areas postintervention. These findings suggest a need for development of complementary curricula to improve resident awareness and understanding of components of a positive learning environment and definition/examples of mistreatment.
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Affiliation(s)
| | | | - Danilo Acosta
- Department of Obstetrics & Gynecology, Maimonides Medical Center, Brooklyn, New York.
| | - Ammara A Watkins
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
| | - Amy Evenson
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
| | - Katharyn M Atkins
- Department of Obstetrics & Gynecology, Beth Israel Deaconess Medical Center, Boston, Massachusetts; Carl J. Shapiro Institute for Education and Research, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
| | - Tara S Kent
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
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Changoor NR, Udyavar NR, Morris MA, Torain M, Mullen JT, Kent TS, Smink DS, Green A, Haider AH. Surgeons’ Perceptions Toward Providing Care for Diverse Patients: The Need for Cultural Dexterity Training. Ann Surg 2019; 269:275-82. [DOI: 10.1097/sla.0000000000002560] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Riley B. Using the Flipped Classroom With Simulation-Based Medical Education to Engage Millennial Osteopathic Medical Students. J Osteopath Med 2018; 118:673-678. [DOI: 10.7556/jaoa.2018.147] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Abstract
With advances in technology and the advent of social media and social networking sites, the way medical education is taught to millennials must evolve. The “flipped classroom,” which occurs when students are exposed to learning materials before their assigned face-to-face class or didactic session, can help engage all learning styles. A flipped classroom paired with simulation-based medical education (SBME) engages millennial learners to acquire the large amount of information required in osteopathic medical school. Using this paired approach in osteopathic medical education can help students meet the requirements outlined by the Accreditation Council for Graduate Medical Education (ACGME). With the single accreditation system for graduate medical education, finalizing in 2020, this article proposes mandating a flipped classroom with SBME to better prepare osteopathic medical students for their training in ACGME-accredited programs.
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Thomson JE, Poudrier G, Stranix JT, Motosko CC, Hazen A. Current status of simulation training in plastic surgery residency programs: A review. Arch Plast Surg 2018; 45:395-402. [PMID: 30282409 DOI: 10.5999/aps.2017.01585] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Accepted: 02/03/2018] [Indexed: 01/22/2023] Open
Abstract
Increased emphasis on competency-based learning modules and widespread departure from traditional models of Halstedian apprenticeship have made surgical simulation an increasingly appealing component of medical education. Surgical simulators are available in numerous modalities, including virtual, synthetic, animal, and non-living models. The ideal surgical simulator would facilitate the acquisition and refinement of surgical skills prior to clinical application, by mimicking the size, color, texture, recoil, and environment of the operating room. Simulation training has proven helpful for advancing specific surgical skills and techniques, aiding in early and late resident learning curves. In this review, the current applications and potential benefits of incorporating simulation-based surgical training into residency curriculum are explored in depth, specifically in the context of plastic surgery. Despite the prevalence of simulation-based training models, there is a paucity of research on integration into resident programs. Current curriculums emphasize the ability to identify anatomical landmarks and procedural steps through virtual simulation. Although transfer of these skills to the operating room is promising, careful attention must be paid to mastery versus memorization. In the authors’ opinions, curriculums should involve step-wise employment of diverse models in different stages of training to assess milestones. To date, the simulation of tactile experience that is reminiscent of real-time clinical scenarios remains challenging, and a sophisticated model has yet to be established.
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Udyavar R, Smink DS, Mullen JT, Kent TS, Green A, Harlow AF, Castillo-Angeles M, Columbus AB, Haider AH. Qualitative Analysis of a Cultural Dexterity Program for Surgeons: Feasible, Impactful, and Necessary. J Surg Educ 2018; 75:1159-1170. [PMID: 29456075 DOI: 10.1016/j.jsurg.2018.01.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Revised: 12/19/2017] [Accepted: 01/21/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVES Ineffective cross-cultural communication contributes to adverse outcomes for minority patients. To address this, the authors developed a novel curriculum for surgical residents built on the principle of cultural dexterity, emphasizing adaptability to clinical and sociocultural circumstances to tailor care to the needs of the individual patient. This study's objective was to evaluate the feasibility, acceptability, and perception of this program upon conclusion of its first year. DESIGN, SETTING, AND PARTICIPANTS The curriculum was implemented at 3 general surgery programs. The flipped classroom model combined independent study via e-learning modules with interactive role-playing sessions. Sessions took place over 1 academic year. Four focus groups were held, each with 6 to 9 participants, to gain feedback on the curriculum. Focus groups were recorded and transcribed, and the data were analyzed using a grounded theory approach. RESULTS Five major themes emerged: (1) Role modeling from senior colleagues is integral in developing communication/interpersonal skills and attitudes toward cultural dexterity. (2) Cultural dexterity is relevant to the provision of high-quality surgical care. (3) Barriers to providing culturally dexterous care exist at the system level. (4) "Buy-in" at all levels of the institution is necessary to implement the principles of cultural dexterity. (5) The shared experience of discussing the challenges and triumphs of caring for a diverse population was engaging and impactful. CONCLUSION Early implementation of the curriculum revealed that the tension between surgical residents' desire to improve their cultural dexterity and systemic/practical obstacles can be resolved. Combining surgically relevant didactic materials with experiential learning activities can change the paradigm of cross-cultural training.
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Affiliation(s)
- Rhea Udyavar
- Department of Surgery, Brigham and Women's Hospital, Center for Surgery and Public Health, Boston, Massachusetts.
| | - Douglas S Smink
- Department of Surgery, Brigham and Women's Hospital, Center for Surgery and Public Health, Boston, Massachusetts; Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts
| | - John T Mullen
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Tara S Kent
- Department of Surgery, Beth Israel Deaconess Medical Center, Boston, Massachusetts
| | - A Green
- Department of Surgery, Massachusetts General Hospital, Boston, Massachusetts
| | - Alyssa F Harlow
- Department of Surgery, Brigham and Women's Hospital, Center for Surgery and Public Health, Boston, Massachusetts
| | - Manuel Castillo-Angeles
- Department of Surgery, Brigham and Women's Hospital, Center for Surgery and Public Health, Boston, Massachusetts
| | - Alexandra B Columbus
- Department of Surgery, Brigham and Women's Hospital, Center for Surgery and Public Health, Boston, Massachusetts; Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts
| | - Adil H Haider
- Department of Surgery, Brigham and Women's Hospital, Center for Surgery and Public Health, Boston, Massachusetts; Department of Surgery, Brigham and Women's Hospital, Boston, Massachusetts
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Gostelow N, Barber J, Gishen F, Berlin A. Flipping social determinants on its head: Medical student perspectives on the flipped classroom and simulated patients to teach social determinants of health. Med Teach 2018; 40:728-735. [PMID: 29457923 DOI: 10.1080/0142159x.2018.1436757] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
BACKGROUND Inequalities in healthcare are increasing. Engaging medical students to tackle this urgent challenge alongside clinical sciences can be demanding. This study examines medical student perceptions of a flipped approach to health inequalities co-designed by faculty and sixth-year students. INNOVATION A flipped learning session was piloted for year 4 medical students combining an online lesson followed by a tutorial with a simulated patient. METHODS A mixed-methods approach collected questionnaire data using 4-point Likert scales and free text answers. A semi-structured group interview was conducted with six voluntary participants. RESULTS Two hundred and eighty-nine students completed questionnaires. 85% (n = 246) completed the online lesson. Students agreed the session helped their understanding of key concepts (mean 3.2), was improved by having an actor (mean = 3.6), and was enjoyable (mean = 3.2). Thematic analysis of qualitative questionnaire and interview data revealed three themes: engagement; structure; and attitudes towards social determinants of health. The simulation increased clinical relevance and students gained understanding of the impact of health inequalities upon individuals. CONCLUSIONS This paper indicates flipped learning can increase clinical relevance and engagement in population health and person-centered care. Further work could assess changes in practice and attitudes of future doctors in tackling such global health challenges.
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Affiliation(s)
- N Gostelow
- a Medical School , University College London Medical School , London , UK
| | - J Barber
- b Department of Primary Care and Population Health , University College London , London , UK
| | - F Gishen
- c University College London Medical School , London , UK
| | - A Berlin
- c University College London Medical School , London , UK
- d Barts and the London School of Medicine and Dentistry , Queen Mary's University , London , UK
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Abstract
Challenge: The "flipped classroom" is a pedagogical model in which instructional materials are delivered to learners outside of class, reserving class time for application of new principles with peers and instructors. Active learning has forever been an elusive ideal in medical education, but the flipped class model is relatively new to medical education. What is the evidence for the "flipped classroom," and how can these techniques be applied to the teaching of dermatology to trainees at all stages of their medical careers?
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Affiliation(s)
| | | | - Susan Burgin
- Harvard Medical School, Boston, MA, USA.,Department of Dermatology, Beth Israel Deaconess Medical Center, Boston, MA, USA
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Chiu HY, Kang YN, Wang WL, Huang HC, Wu CC, Hsu W, Tong YS, Wei PL. The Effectiveness of a Simulation-Based Flipped Classroom in the Acquisition of Laparoscopic Suturing Skills in Medical Students-A Pilot Study. J Surg Educ 2018; 75:326-332. [PMID: 28734948 DOI: 10.1016/j.jsurg.2017.07.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Revised: 06/29/2017] [Accepted: 07/01/2017] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To evaluate the effectiveness of a simulation-based flipped classroom in gaining the laparoscopic skills in medical students. DESIGN An intervention trial. SETTING Taipei Medical University Hospital, an academic teaching hospital. PARTICIPANTS AND METHODS Fifty-nine medical students participating in a 1-hour laparoscopic skill training session were randomly assigned to a conventional classroom (n = 29) or a flipped classroom approach (n = 30) based on their registered order. At the end of the session, instructors assessed participants' performance in laparoscopic suturing and intracorporeal knot-tying using the assessment checklist based on a modified Objective Structured Assessment of Technical Skills tool. RESULTS Students in the flipped group completed more numbers of stitches (mean [M] = 0.47; standard deviation [SD] = 0.507) than those in the conventional group (M = 0.10; SD = 0.310) (mean difference: 0.37; 95% CI: 0.114-582; p = 0.002). Moreover, students in the flipped group also had higher stitch quality scores (M = 7.17; SD = 2.730) than those in the conventional group (M = 5.14; SD = 1.767) (mean difference = 2.03; 95% CI: 0.83-3.228; p = 0.001). Meanwhile, students in the flipped group had higher pass rates for the second throw (p < 0.001), third throw (p = 0.002), appropriate tissue reapproximation without loosening or strangulation (p < 0.001), needle cut from suture under direct visualization (p = 0.004), and needle safely removed under direct visualization (p = 0.018) than those in the conventional group. CONCLUSIONS Comparing with traditional approach, a simulation-based flipped classroom approach may improve laparoscopic intracorporeal knot-tying skill acquisition in medical students.
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Affiliation(s)
- Hsin-Yi Chiu
- Division of Thoracic Surgery, Department of Surgery, Taipei Medical University Hospital, Taipei, Taiwan; Department of Medical Education, Taipei Medical University Hospital, Taipei, Taiwan; Department of Education and Humanities in Medicine, School of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Surgery, School of Medicine, Taipei Medical University, Taipei, Taiwan; Department of Animal Science and Technology, National Taiwan University, Taipei, Taiwan
| | - Yi-No Kang
- Department of Medical Education, Taipei Medical University Hospital, Taipei, Taiwan; Department of Education and Humanities in Medicine, School of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Wei-Lin Wang
- Division of Acute Care Surgery and Traumatology, Department of Surgery, Taipei Medical University Hospital, Taipei, Taiwan
| | - Hung-Chang Huang
- Division of Acute Care Surgery and Traumatology, Department of Surgery, Taipei Medical University Hospital, Taipei, Taiwan; Department of Surgery, School of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Chien-Chih Wu
- Department of Medical Education, Taipei Medical University Hospital, Taipei, Taiwan; Department of Education and Humanities in Medicine, School of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Wayne Hsu
- Division of Acute Care Surgery and Traumatology, Department of Surgery, Taipei Medical University Hospital, Taipei, Taiwan
| | - Yiu-Shun Tong
- Division of Acute Care Surgery and Traumatology, Department of Surgery, Taipei Medical University Hospital, Taipei, Taiwan
| | - Po-Li Wei
- Department of Medical Education, Taipei Medical University Hospital, Taipei, Taiwan; Division of Colorectal Surgery, Department of Surgery, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan; Department of Surgery, School of Medicine, Taipei Medical University, Taipei, Taiwan; Cancer Research Center, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan; Department of Medical Research, Translational Laboratory, Taipei Medical University Hospital, Taipei Medical University, Taipei, Taiwan; Graduate Institute of Cancer Biology and Drug Discovery, Taipei Medical University, Taipei, Taiwan.
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Rose E, Jhun P, Baluzy M, Hauck A, Huang J, Wagner J, Kearl YL, Behar S, Claudius I. Flipping the Classroom in Medical Student Education: Does Priming Work? West J Emerg Med 2017; 19:93-100. [PMID: 29383062 PMCID: PMC5785208 DOI: 10.5811/westjem.2017.8.35162] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2017] [Revised: 07/18/2017] [Accepted: 09/06/2017] [Indexed: 12/29/2022] Open
Abstract
Introduction The emergency medicine (EM) clerkship curriculum at Los Angeles County + University of Southern California Medical Center includes monthly lectures on pediatric fever and shortness of breath (SOB). This educational innovation evaluated if learning could be enhanced by "priming" the students with educational online videos prior to an in-class session. Factors that impacted completion rates were also evaluated (planned specialty and time given for video viewing). Methods Twenty-minute videos were to be viewed prior to the didactic session. Students were assigned to either the fever or SOB group and received links to those respective videos. All participating students took a pre-test prior to viewing the online lectures. For analysis, test scores were placed into concordant groups (test results on fever questions in the group assigned the fever video and test results on SOB questions in the group assigned the SOB video) and discordant groups (crossover between video assigned and topic tested). Each subject contributed one set of concordant results and one set of discordant results. Descriptive statistics were performed with the Mann-Whitney U test. Lecture links were distributed to students two weeks prior to the in-class session for seven months and three days prior to the in-class session for eight months (in which both groups included both EM-bound and non-EM bound students). Results In the fifteen-month study period, 64% of students rotating through the EM elective prepared for the in class session by watching the videos. During ten months where exclusively EM-bound students were rotating (n=144), 71.5% of students viewed the lectures. In four months where students were not EM-bound (n=54), 55.6% of students viewed the lectures (p=0.033). Participation was 60.2% when lecture links were given three days in advance and 68.7% when links were given two weeks in advance (p=0.197). In the analysis of concordant scores, the pre-test averaged 56.7% correct, the immediate post-test averaged 78.1% correct, and the delayed post-test was 67.2%. In the discordant groups, the pretest averaged 51.9%, the immediate posttest was 67.1% and the delayed by 68.8%. In the concordant groups, the immediate post-test scores improved by 21.4%, compared with 15.2% in the discordant groups (p = 0.655). In the delayed post-test the concordant scores improved by 10.5% and discordant scores by 16.9 percent (p=0.609). Sixty-two percent of students surveyed preferred the format of online videos with in-class case discussion to a traditional lecture format. Conclusion Immediate post-tests and delayed post-tests improved but priming was not demonstrated to be a statistically superior educational method in this study. Medical student completion of the preparatory materials for the EM rotation session increased when the students were EM-bound. Participation rates were not significantly different when given at two weeks versus three days.
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Affiliation(s)
- Emily Rose
- Los Angeles County-University of Southern California Medical Center, Department of Emergency Medicine, Los Angeles, California
| | - Paul Jhun
- University of California San Francisco, San Francisco General Hospital, Department of Emergency Medicine, San Francisco, California
| | - Matthew Baluzy
- Los Angeles County-University of Southern California Medical Center, Department of Emergency Medicine, Los Angeles, California
| | - Aaron Hauck
- Keck School of Medicine of the University of Southern California, Los Angeles, California
| | - Jonathan Huang
- Keck School of Medicine of the University of Southern California, Los Angeles, California
| | - Jonathan Wagner
- Los Angeles County-University of Southern California Medical Center, Department of Emergency Medicine, Los Angeles, California
| | - Yvette L Kearl
- Los Angeles County-University of Southern California Medical Center, Department of Emergency Medicine, Los Angeles, California
| | - Solomon Behar
- Los Angeles County-University of Southern California Medical Center, Department of Emergency Medicine, Los Angeles, California
| | - Ilene Claudius
- Los Angeles County-University of Southern California Medical Center, Department of Emergency Medicine, Los Angeles, California
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