Successful lecturing: a prospective study to validate attributes of the effective medical lecture

Continuing medical education program completion and influencing factors: a cross-sectional study in Sichuan Province, China

Objectives

This cross-sectional study was designed to explore the completion of continuing medical education (CME) programs and identify the factors influencing their completion.

Methods

The data for this study were generated from the National CME Program Application and Information Feedback Online System and the Sichuan CME Administrative Platform. The data were processed using descriptive analysis, Chi-square test, and binary logistic regression methods. The completion of each CME program was determined by the research team members according to the criteria created by the Office of the Sichuan CME Commission.

Results

A total of 180 hospitals and 3,622 CME programs were included. Among the 3,622 CME programs, 2,936 (81.1%) were determined to be completed. Comparative analysis showed that in terms of hospital characteristics, specialist hospitals, county hospitals, hospitals with 500-1,000 beds, and hospitals in the regions with government medical expenditure input equal to or more than 3,000 million RMB displayed the highest completion rates. For program attributes, national programs, programs in the field of pharmacy, and programs with 1-3 duration days demonstrated the highest completion rates. The binary logistic regression analysis showed that hospital region with different government medical expenditure input had the strongest positive association with the completion of CME programs [OR = 2.922, 95%CI (1.642-5.198)], while the duration time showed the strongest negative association [OR = 0.235, 95%CI (0.141-0.393)].

Conclusion

This is the first study in China to analyze the completion of CME programs and identify its influencing factors at the provincial level. It is recommended that the government in the region should pay great attention to the construction of measures regarding the factors affecting the completion of CME programs. This includes providing more financial support to CME providers to ensure the formal operation of their CME activities, formulating guidelines on the application of CME programs to reasonably allocate and control the distribution of accredited CME programs across different hospital scales and disciplines, especially offering more training support to county hospitals, promulgating administrative documents to raise attention to the completion of CME programs, and special scrutiny on CME programs with longer durations to provide and protect training opportunities for those in need.

Audience response system smartphone application as an adjunct to tuberculosis teaching for medical students during the coronavirus disease 2019 pandemic

OBJECTIVE

The growing availability of devices for mobile learning has created new opportunities for teaching. With the development of smartphone apps based on audience response systems, there is a possibility to quickly assess student knowledge. The education of health professionals, including medical students, is an essential strategy for tuberculosis control. In the context of the coronavirus disease 2019 pandemic, audience response systems are very useful as online assessment tools. The aim of this study was to use the audience response systems Socrative to assess medical students during a class on tuberculosis.

METHODS

This is a quasi-experimental before-and-after study, with pre- and post-tests carried out through the Socrative app, respectively, before and after a lecture on tuberculosis for medical students. Also, a cross-sectional study was carried out after the course to evaluate the participant's satisfaction through an electronic, structured questionnaire with a Likert-type scale.

RESULTS

A total of 126 students were included in the study. The overall mean pre- and post-test scores were 5.98±1.59 and 8.37±1.36, respectively, with a statistically significant difference (p<0.0001). Almost all students were totally satisfied with the use of Socrative on pre- and post-tests.

CONCLUSION

This study describes how the use of Socrative in a tuberculosis class was well received by students. In addition, the baseline knowledge on tuberculosis was low in some topics, with some improvement after the lecture. These findings emphasize the need to further improve the students' knowledge on tuberculosis and help instructors customize the lecture based on the gaps identified in the Socrative assessment.

Presentation design and delivery to improve knowledge translation in a remote world

The practical dissemination of new knowledge is not given adequate attention despite large investment in undertaking high-quality research and the desire for evidence-based practice. It is important that those involved in knowledge translation and continuing medical education understand the fundamental principles of effective presentations, whether at scientific conferences, workshops or group teaching sessions. The switch to remote presentations has made this a more challenging endeavour. We describe established presentation techniques that improve knowledge translation and how to use them in both face-to-face and remote settings.

Implementation of an Audience Response System in a Case Conference Curriculum: Results of a Placebo-Controlled Trial

Audience response systems engage learners and facilitate the assimilation of the material. We assessed whether incorporation of one system into a resident case conference would increase retention of information and attentiveness. Pre-tests were administered prior to case conferences. The University Hospital incorporated Poll Everywhere into a conference and the Veterans Administration hospital did not. Participants rated self-perceived attentiveness and completed a post-test following conference. There was an increase in post-test scores compared to pre-tests. There was no significant difference in self-perceived attentiveness or post-test scores between sites. The use of audience response did not increase retention of material or perceived attentiveness when incorporated into the conference.

Chinese physician perceptions regarding industry support of continuing medical education programs: a cross-sectional survey

Background: Industry funding in continuing medical education has been extensively studied in the USA. Although continuing medical education is also a requirement for Chinese physicians, little is known about Chinese physician perceptions of industry support in continuing medical education.Objective: We aim to determine perceptions regarding industry support for CME among Chinese physicians at a large CME course, examine potential associations between Chinese physicians' perceptions and their demographic characteristics, and compare Chinese and US physicians' perceptions of industry support for CME.Design: We performed a cross-sectional survey of physicians at a nephrology continuing medical education conference in China. All participants received a previously published, anonymous survey consisting of 4 items, with questions asked in English and Mandarin Chinese. Responses were compared with those of a previous cohort in the USA.Results: The response rate was 24% (128/541). Most respondents were nephrologists (112/126, 89%), women (91/128, 71%), and aged 20 to 40 years (79/127, 62%). Most respondents preferred industry-supported continuing medical education (84/123, 68%) or had no preference (33/123, 27%). More clinicians than clinical researchers supported industry offsetting costs (76.9% vs 58.3%; P = .03). Almost half of participants (58/125, 46%) stated that industry-supported continuing medical education was biased in support of industry. Compared with US physicians, Chinese physicians were more likely to believe, or had no opinion, that industry-supported courses were biased (67.2% vs 47.0%; P < .001).Conclusions: Chinese continuing medical education participants preferred industry-sponsored continuing medical education and were strongly in favor of industry offsetting costs, but almost half believed that such education was biased in favor of supporting companies. Concern for bias was higher among Chinese than US physicians. Given participants' concerns, further study examining industry bias in Chinese continuing medical education is recommended.Abbreviations: CME: Continuing medical education; US: USA.

Phone-based audience response system as an adjunct in orthodontic teaching of undergraduate dental students: a cross-over randomised controlled trial

BACKGROUND

The advent of electronic teaching facilities improves tutor-student communication. This study aims to explore the effectiveness of Phone-Based Audience Response System (PB-ARS), as an adjunctive pedagogy tool to enhance the retention of orthodontic information by dental students; and to explore the students' perception of PB-ARS.

METHODS

This cross-over clustered randomised control trial included 34 males who were in the final year of their undergraduate dental training. Participants were allocated to one of two event groups (G1 and G2) using computer-generated randomisation. Both groups simultaneously attended two different traditional lectures (L 1 and L2) a week apart. During L1, PB-ARS was used as an adjunct to conventional presentation to teach G1 participants, (PB-ARS group) while G2's participants acted as a control group (CG), and were taught using a traditional presentation. In the second week (L2), the interventions were crossed-over. Participants from both groups completed pre- and post-lecture multiple-choice questionnaires (MCQ) to assess their short-term retention of information. Their performance in the final MCQ exam (10 weeks following L2) was tracked to assess the long-term retention of the information. Participants also completed post-lecture questionnaires to evaluate their perceptions.

RESULTS

Twenty-nine and 31 participants from the CG and PB-ARS group completed this trial, respectively. Although 87.5% of students in the PB-ARS group showed an improvement in their immediate post-lecture scores compared with 79.3% for the CG, it was statistically insignificant (p = 0.465). Similarly, the intervention showed an insignificant effect on the long-term retention of the knowledge (p = 0.560). There was a mildly but favourable attitude of students towards the use of PB-ARS. However, the difference in the overall level of satisfaction between both groups was statistically insignificant (p = 0.183).

CONCLUSION

PB-ARS has a minimal and insignificant effect on the short- and long-term retention of orthodontic knowledge by male undergraduate dental students. PB-ARS was the preferred adjunct tool to conventional classroom teaching. Due to the limitations of this trial, a long-term randomised controlled trial with a larger sample size is recommended.

A Pilot Study of a Direct Teaching Observation Tool for Residents

It is important to empower physicians to teach effectively so they are prepared to provide high quality education to medical trainees. The residency experience is recognized as an opportunity to help future faculty enhance their teaching skills, but there are few formalized tools available to facilitate this. We piloted a new observation tool for faculty to use when observing residents teach. The goal of our study was to determine if our observation tool is a useful and well accepted mode to facilitate feedback from faculty to residents about their teaching. A small number of senior residents were observed using the tool without prior knowledge of the tool components. Our early findings suggest that the tool is well-accepted by faculty and residents and may be useful as a catalyst in discussing a teaching framework. More data are being collected to determine if the tool is useful in improving resident teaching skills over time.

Fifty ways to improve presentations in urology

BACKGROUND

Our profession permanently demands intercommunication of medical knowledge among colleagues; either in small environments such as hospitals or at larger ones such as congresses or academic courses. New technologies such as PowerPoint® are not developed enough to provide good presentations, and its employment does not always grant effective results.

OBJECTIVE

In order to improve our academic presentations, we present several tools that may help us avoid the most common mistakes.

EVIDENCE ACQUISITION

Literature search in PubMed and Google Scholar. We have divided the analysis into 3 sections: structure of the presentation, slide design, presentation to the audience. Each section includes a list of 50 short tips.

RESULTS

Fifty tips following the study objectives.

CONCLUSIONS

The scientific evidence that supports the information on how to improve presentations is mostly based on expert opinions. However, almost every work agrees that presentations must use simple structures which does not make them less scientific; their content must be developed for a specific audience, and it must be the speaker, not the slides, who captures the audience attention. Making a simple and didactic presentation of complex content supported by multimedia tools is one of the speaker's highest intellectual challenges of these days.

Pros and Cons of Audience Response Systems in the Education of Health Professionals

This article was migrated. The article was marked as recommended. Well over 1000 articles have been written on the subject of Audience Response Systems in the education of health professionals. These studies have involved the students at the undergraduate, graduate and continuing professional education levels. From the articles found, a subset of over 120 articles of ARS use in health professional education was reviewed. A holistic view of the results in these studies showed that there are clear benefits and drawbacks to ARS use from the perspective of the students and teachers. Benefits were found to fit ten (10) distinct categories while drawbacks fit into six (6) discrete categories. This paper summarizes and discusses the benefits (i.e. pros) and drawbacks (i.e. cons) of the use of ARS in the educational process of health professionals.

Hybrid Interactive and Didactic Teaching Format Improves Resident Retention and Attention Compared to Traditional Lectures

PURPOSE

To compare the traditional lecture to a hybrid interactive and didactic teaching format with regards to radiology resident short- and long-term retention, as well as attention.

MATERIALS AND METHODS

The tested hybrid format consists of a 30-minute didactic lecture followed by 30 minutes of interactive cases based on material from the lecture portion. Faculty members were randomly selected to give a 60-minute lecture or a hybrid presentation. To assess short- and long-term retention, a test developed from the presenter's slides was sent to all residents approximately 15 minutes after each presentation, and again approximately 3 months later. The presenters were blinded to the survey questions. Attention was assessed by comparing the proportion of questions answered correctly from each quarter of the presentation. Equality in difficulty of questions was validated across teaching methods.

RESULTS

For 6 hybrid presentations, 106 and 60 retention tests were submitted, answering 848 and 480 short- and long-term survey questions, respectively. For 6 lectures, 91 and 55 retention tests were submitted, answering 728 and 440 short- and long-term survey questions, respectively. Short-term retention was 75.7% (640/848) for hybrid presentations, versus 63.2% (460/728) for lectures (p < 0.0001). Long-term retention was 59.4% (285/480) for hybrid presentations, versus 49.3% (217/440) for lectures (p = 0.002). Regarding attention, 61.6% (554/600) of questions from the first 3 quarters of traditional lectures were answered correctly versus 49.3% (148/300) of final quarter questions (p = 0.0003). No significant drop-off was noted for hybrid presentations.

CONCLUSION

A hybrid interactive and didactic teaching format for radiology residents demonstrates better short-term retention, long-term retention, and attention when compared to traditional lectures.

A cross-sectional study of learning styles among continuing medical education participants

PURPOSE

Experiential learning has been suggested as a framework for planning continuing medical education (CME). We aimed to (1) determine participants' learning styles at traditional CME courses and (2) explore associations between learning styles and participant characteristics.

MATERIALS AND METHODS

Cross-sectional study of all participants (n = 393) at two Mayo Clinic CME courses who completed the Kolb Learning Style Inventory and provided demographic data.

RESULTS

A total of 393 participants returned 241 surveys (response rate, 61.3%). Among the 143 participants (36.4%) who supplied complete demographic and Kolb data, Kolb learning styles included diverging (45; 31.5%), assimilating (56; 39.2%), converging (8; 5.6%), and accommodating (34; 23.8%). Associations existed between learning style and gender (p = 0.02). For most men, learning styles were diverging (23 of 63; 36.5%) and assimilating (30 of 63; 47.6%); for most women, diverging (22 of 80; 27.5%), assimilating (26 of 80; 32.5%), and accommodating (26 of 80; 32.5%).

CONCLUSIONS

Internal medicine and psychiatry CME participants had diverse learning styles. Female participants had more variation in their learning styles than men. Teaching techniques must vary to appeal to all learners. The experiential learning theory sequentially moves a learner from Why? to What? to How? to If? to accommodate learning styles.

Development and Validation of a Lecture Assessment Tool for Emergency Medicine Residents

BACKGROUND

Delivering quality lectures is a critical skill for residents seeking careers in academia yet no validated tools for assessing resident lecture skills exist.

OBJECTIVES

The authors sought to develop and validate a lecture assessment tool.

METHODS

Using a nominal group technique, the authors derived a behaviorally anchored assessment tool. Baseline characteristics of resident lecturers including prior lecturing experience and perceived comfort with lecturing were collected. Faculty and senior residents used the tool to assess lecturer performance at weekly conference. A postintervention survey assessed the usability of the form and the quantity and quality of the feedback. Analysis of variance was used to identify relationships in performance within individual domains to baseline data. Generalizability coefficients and scatterplots with jitter were used to assess inter-rater reliability.

RESULTS

Of 64 residents assessed, most (68.8%) had previous lecturing experience and 6.3% had experience as a regional/national speaker. There was a significant difference in performance within the domains of Content Expertise (p < 0.001), Presentation Design/Structure (p = 0.014), and Lecture Presence (p = 0.001) for first-year versus fourth-year residents. Residents who had higher perceived comfort with lecturing performed better in the domains of Content Expertise (p = 0.035), Presentation Design/Structure (p = 0.037), and Lecture Presence (p < 0.001). We found fair agreement between raters in all domains except Goals and Objectives. Both lecturers and evaluators perceived the feedback delivered as specific and of adequate quantity and quality. Evaluators described the form as highly useable.

CONCLUSIONS

The derived behaviorally anchored assessment tool is a sufficiently valid instrument for the assessment of resident-delivered lectures.

Validation of a Teaching Effectiveness Assessment in Psychiatry Continuing Medical Education

OBJECTIVE

Little is known about factors associated with effective continuing medical education (CME) in psychiatry. The authors aimed to validate a method to assess psychiatry CME teaching effectiveness and to determine associations between teaching effectiveness scores and characteristics of presentations, presenters, and participants.

METHODS

This cross-sectional study was conducted at the Mayo Clinic Psychiatry Clinical Reviews and Psychiatry in Medical Settings. Presentations were evaluated using an eight-item CME teaching effectiveness instrument, its content based on previously published instruments. Factor analysis, internal consistency and interrater reliabilities, and temporal stability reliability were calculated. Associations were determined between teaching effectiveness scores and characteristics of presentations, presenters, and participants.

RESULTS

In total, 364 participants returned 246 completed surveys (response rate, 67.6%). Factor analysis revealed a unidimensional model of psychiatry CME teaching effectiveness. Cronbach α for the instrument was excellent at 0.94. Item mean score (SD) ranged from 4.33 (0.92) to 4.71 (0.59) on a 5-point scale. Overall interrater reliability was 0.84 (95% CI, 0.75-0.91), and temporal stability was 0.89 (95% CI, 0.77-0.97). No associations were found between teaching effectiveness scores and characteristics of presentations, presenters, and participants.

CONCLUSIONS

This study provides a new, validated measure of CME teaching effectiveness that could be used to improve psychiatry CME. In contrast to prior research in other medical specialties, CME teaching effectiveness scores were not associated with use of case-based or interactive presentations. This outcome suggests the need for distinctive considerations regarding psychiatry CME; a singular approach to CME teaching may not apply to all medical specialties.

The Council of Emergency Medicine Residency Directors Speaker Evaluation Form for Medical Conference Planners

OBJECTIVES

No summative speaker evaluation form with validity and reliability evidence currently exists in the English medical education literature specifically to help conference planners make future decisions on speakers. We seek to perform a proof-of-concept evaluation of a concise, effective evaluation form to be filled out by audience members to aid conference planners.

METHODS

We created the Council of Emergency Medicine Residency Directors (CORD-EM) form, a novel, three-question speaker evaluation form for the CORD-EM national conference and evaluated it for proof of concept. The CORD-EM form was analyzed with three evaluators and randomized to select only two evaluators' ratings to make results more generalizable to a generic audience evaluating the speaker.

RESULTS

Forty-six total evaluations ranged from 6 to 9 (mean ± standard deviation = 8.1 ± 1.2). The form demonstrated excellent internal consistency (Cronbach's alpha = 0.923) with good inter-rater reliability (intraclass correlation = 0.617) in the conference context.

CONCLUSIONS

The CORD-EM speaker evaluation form is, to our knowledge, the first evaluation form with early reliability and validity evidence specifically designed to help conference planners. Our results suggest that a short speaker evaluation form can be an effective instrument in the toolbox for conference planners.

Quantitative analysis of the text and graphic content in ophthalmic slide presentations

OBJECTIVE

To determine the characteristics of ophthalmic digital slide presentations.

DESIGN

Retrospective quantitative analysis.

METHODS

Slide presentations from a 2015 Canadian primary eye care conference were analyzed for their duration, character and word count, font size, words per minute (wpm), lines per slide, words per slide, slides per minute (spm), text density product (wpm × spm), proportion of graphic content, and Flesch Reading Ease (FRE) score using Microsoft PowerPoint and Word. The median audience evaluation score for the lectures was used to dichotomize the higher scoring lectures (HSL) from the lower scoring lectures (LSL). A priori we hypothesized that there would be a difference in the wpm, spm, text density product, and FRE score between HSL and LSL. Wilcoxon rank-sum tests with Bonferroni correction were utilized.

RESULTS

The 17 lectures had medians of 2.5 spm, 20.3 words per slide, 5.0 lines per slide, 28-point sans serif font, 36% graphic content, and text density product of 136.4 words × slides/minute². Although not statistically significant, the HSL had more wpm, fewer words per slide, more graphics per slide, greater text density, and higher FRE score than LSL. There was a statistically significant difference in the spm of the HSL (3.1 ± 1.0) versus the LSL (2.2 ± 1.0) at p = 0.0124.

CONCLUSION

All presenters showed more than 1 slide per minute. The HSL showed more spm than the LSL. The descriptive statistics from this study may aid in the preparation of slides used for teaching and conferences.

The effect of written standardized feedback on the structure and quality of surgical lectures: A prospective cohort study

BACKGROUND

Lectures remain an important teaching method to present and structure knowledge to many students concurrently. Adequate measures are necessary to maintain the quality of the lectures. The aim of this study was to determine the impact on the lecture quality using written structured feedback and to compare the ratings of surgical lectures between students and surgical peers.

METHODS

Prospective analysis of two consecutive surgical lecture series for undergraduate students at Goethe-University Medical School was performed before and after evaluation of the lecturers via independent written feedback from trained undergraduate students and surgeons. The 22-item feedback instrument covered three areas of performance: content, visualization, and delivery. Additional suggestions for improvement were provided from both students and surgical peers who anonymously attended the lectures. The lecturers, experienced surgeons, as well as the student and peer raters were blinded in terms of the aim and content of the study. Their response to the feedback was collected using a web-based 13-item questionnaire. The Kendall's-W coefficient was computed to calculate inter-rater reliability (IRR). Differences between ratings before and after feedback were analyzed using Student's t-test for dependent samples. The Kolmogorov-Smirnov-test was used for independent samples.

RESULTS

A total of 22 lectures from a possible 32 given by 13 lecturers were included and analyzed by at least three surgeons and two students. There were significant improvements in overall score as well as in the details of 9 of the 13 items were found. The average inter-rater reliability was 0.71. There were no differences in the ratings as a function of the rater's level of expertise (peers vs. students). We found that 13/23 lecturers (56.5%) answered the questionnaire, and 92% strongly agreed that the written feedback was useful. 76.9% of the lecturers revised their lecture based on the written feedback requiring on average 112.5 min (range from 20 to 300 min).

CONCLUSIONS

Overall, this study indicates that structured written feedback provided by trained peers and students that is subsequently discussed by the lecturers concerned is a highly effective and efficient method to improve aspects of lecturing. We anticipate that structured written feedback by trained students that is discussed by the lecturers concerned will improve lecturing.

Does Faculty Follow the Recommended Structure for a New Classroom-based, Daily Formal Teaching Session for Anesthesia Residents?

Background: A newly implemented 15-minute classroom-based, formal teaching session for anesthesia residents is given three times daily by the same faculty. The faculty member was provided a suggested template for the presentation. The template structure was developed by a group of residents and faculty to include best teaching practices. The goal of the current study was to measure how frequently the faculty teaching these sessions followed the template. Methods: From February 20, 2015 to February 6, 2016, a research assistant trained in education mapped a total of 48 teaching sessions to determine how frequently the teaching sessions included each of the elements in the recommended template structure. The assistant was chosen from outside the anesthesia department so as to minimize biases.

Results: It was found that 98% of the sessions used the teaching template's suggestion of using computer slides (e.g., a Powerpoint presentation). We observed that 75% of the sessions provided specific recommendations about patient care, 65% had reinforcement of learning points, 56% had a test or a quiz, 49% provided references and directions for further reading, 44% provided take-home messages, and 31% used a clinical case vignette presentation to introduce the keyword. The most common visuals were the use of a picture (38%) and a chart or a graph (35%). We also saw that 65% of the sessions had active involvement of residents. With respect to time and slide limitations mentioned in the template, we saw that 35% of the sessions finished within the recommended time limit of 15 mins and 21% had the recommended 10 or fewer slides. 

Conclusion: Compliance by the faculty to the recommended structure was variable. Despite this, the sessions have been well received and have become a permanent part of the residency curriculum more than two years after their implementation. 

Quantitative Study of the Characteristics of Effective Internal Medicine Noon Conference Presentations

Background Increasing demands on residents' time have made it critically important to maximize the effectiveness of didactic activities and motivate independent study. Objective Our aim was to correlate characteristics of noon conferences with internal medicine (IM) residents' ratings of perceived effectiveness and intent to pursue independent reading. Methods We assessed characteristics of each noon conference by direct observation using predetermined metrics. We surveyed IM residents to assess their perception of the conference's effectiveness and their intention to pursue additional reading. A variety of modeling techniques were used to discern meaningful correlations of effectiveness and motivation. Results A total of 649 evaluations of 29 conferences were submitted by 153 of 185 (83%) residents in the program. Median effectiveness score was 6 (on a scale of 1 to 7). Clinicopathological conferences had 0.55-point higher effectiveness scores than traditional conferences (P = .011). In multivariable analyses focusing on traditional conferences, summary statement inclusion was significantly associated with 0.43-point higher effectiveness scores (P = .016), and having resident speakers was associated with 0.50-point higher effectiveness scores than unfamiliar faculty (P = .045). Conferences with higher effectiveness scores had significantly higher proportions of respondents indicating intention to read. Conclusions This is the first study to quantitatively assess correlations of high effectiveness ratings of noon conferences in a residency program. Intention to read improved with increasing effectiveness scores of conferences, suggesting residents are more inclined to pursue self-directed learning when topics are well presented. Considering these attributes in designs of didactic sessions may enhance their educational value.

Frame-of-Reference Training: Establishing Reliable Assessment of Teaching Effectiveness

INTRODUCTION

Frame-of-reference (FOR) training has been used successfully to teach faculty how to produce accurate and reliable workplace-based ratings when assessing a performance. We engaged 21 Harvard Medical School faculty members in our pilot and implementation studies to determine the effectiveness of using FOR training to assess health professionals' teaching performances.

METHODS

All faculty were novices at rating their peers' teaching effectiveness. Before FOR training, we asked participants to evaluate a recorded lecture using a criterion-based peer assessment of medical lecturing instrument. At the start of training, we discussed the instrument and emphasized its precise behavioral standards. During training, participants practiced rating lectures and received immediate feedback on how well they categorized and scored performances as compared with expert-derived scores of the same lectures. At the conclusion of the training, we asked participants to rate a post-training recorded lecture to determine agreement with the experts' scores.

RESULTS

Participants and experts had greater rating agreement for the post-training lecture compared with the pretraining lecture. Through this investigation, we determined that FOR training is a feasible method to teach faculty how to accurately and reliably assess medical lectures.

DISCUSSION

Medical school instructors and continuing education presenters should have the opportunity to be observed and receive feedback from trained peer observers. Our results show that it is possible to use FOR rater training to teach peer observers how to accurately rate medical lectures. The process is time efficient and offers the prospect for assessment and feedback beyond traditional learner evaluation of instruction.

Associations between teaching effectiveness scores and characteristics of presentations in hospital medicine continuing education

BACKGROUND

There is little research regarding characteristics of effective continuing medical education (CME) presentations in hospital medicine (HM). Therefore, we sought to identify associations between validated CME teaching effectiveness scores and characteristics of CME presentations in the field of HM.

DESIGN/SETTING

This was a cross-sectional study of participants and didactic presentations from a national HM CME course in 2014.

MEASUREMENTS

Participants provided CME teaching effectiveness (CMETE) ratings using an instrument with known validity evidence. Overall CMETE scores (5-point scale: 1 = strongly disagree; 5 = strongly agree) were averaged for each presentation, and associations between scores and presentation characteristics were determined using the Kruskal-Wallis test. The threshold for statistical significance was set at P < 0.05.

RESULTS

A total of 277 out of 368 participants (75.3%) completed evaluations for the 32 presentations. CMETE scores (mean [standard deviation]) were significantly associated with the use of audience response (4.64 [0.16]) versus no audience response (4.49 [0.16]; P = 0.01), longer presentations (≥30 minutes: 4.67 [0.13] vs <30 minutes: 4.51 [0.18]; P = 0.02), and larger number of slides (≥50: 4.66 [0.17] vs <50: 4.55 [0.17]; P = 0.04). There were no significant associations between CMETE scores and use of clinical cases, defined goals, or summary slides.

CONCLUSIONS

To our knowledge, this is the first study regarding associations between validated teaching effectiveness scores and characteristics of effective CME presentations in HM. Our findings, which support previous research in other fields, indicate that CME presentations may be improved by increasing interactivity through the use of audience response systems and allowing longer presentations.

Impact of peer feedback on the performance of lecturers in emergency medicine: a prospective observational study

Background

Although it is often criticised, the lecture remains a fundamental part of medical training because it is an economical and efficient method for teaching both factual and experimental knowledge. However, if administered incorrectly, it can be boring and useless.

Feedback from peers is increasingly recognized as an effective method of encouraging self-reflection and continuing professional development. The aim of this observational study is to analyse the impact of written peer feedback on the performance of lecturers in an emergency medicine lecture series for undergraduate students.

Methods

In this prospective study, 13 lecturers in 15 lectures on emergency medicine for undergraduate medical students were videotaped and analysed by trained peer reviewers using a 21-item assessment instrument. The lecturers received their written feedback prior to the beginning of the next years’ lecture series and were assessed in the same way.

Results

In this study, we demonstrated a significant improvement in the lecturers’ scores in the categories ‘content and organisation’ and ‘visualisation’ in response to written feedback. The highest and most significant improvements after written peer feedback were detected in the items ‘provides a brief outline’, ‘provides a conclusion for the talk’ and ‘clearly states goal of the talk’.

Conclusion

This study demonstrates the significant impact of a single standardized written peer feedback on a lecturer’s performance.

Adult learning principles and presentation pearls

Although lectures are one of the most common methods of knowledge transfer in medicine, their effectiveness has been questioned. Passive formats, lack of relevance and disconnection from the student's needs are some of the arguments supporting this apparent lack of efficacy. However, many authors have suggested that applying adult learning principles (i.e., relevance, congruence with student's needs, interactivity, connection to student's previous knowledge and experience) to this method increases learning by lectures and the effectiveness of lectures. This paper presents recommendations for applying adult learning principles during planning, creation and development of lectures to make them more effective.

Resident and attending physician attitudes regarding an audience response system

PURPOSE

Audience response system (ARS) technology is increasingly being incorporated into radiology education. The aim of this study was to gauge resident and attending physician attitudes regarding the use of an ARS in resident conferences.

METHODS

An anonymous survey was sent to 38 residents and 57 attending physicians to gauge their attitudes regarding the use of an ARS in resident lectures using a 5-point, Likert-type scale (1 = strongly disagree, 2 = disagree, 3 = neither agree nor disagree, 4 = agree, and 5 = strongly agree).

RESULTS

A total of 30 of 38 residents (78.9%) and 26 of 57 attending radiologists (45.6%) responded. Residents viewed the incorporation of an ARS into lectures positively, replying that they learned better from lectures incorporating an ARS (mean, 4.03; 95% confidence interval [CI], 3.74-4.32), felt more comfortable answering questions using it (mean, 4.53; 95% CI, 4.25-4.81), and were more likely to attend a lecture that incorporated its use (mean, 3.70; 95% CI, 3.37-4.03). The use of an ARS by attending physicians was limited (9 of 26 [34.6%]), with respondents citing a lack of adequate training. Those attending physicians who used it viewed the system positively, stating that residents were more engaged when they used an ARS (mean, 4.33; 95% CI, 3.87-4.79). An ARS somewhat helped the faculty members gauge resident understanding of the lecture material (mean, 3.67; 95% CI, 2.95-4.40) and prepare future lectures (mean, 3.33; 95% CI 2.68-3.98).

CONCLUSIONS

Both residents and attending physicians favorably view audience response technology as a means to enhance education in didactic and case-based settings. Increased training on how to incorporate its use into teaching may drive additional utilization.

Improving participant feedback to continuing medical education presenters in internal medicine: a mixed-methods study

BACKGROUND

Feedback is essential for improving the skills of continuing medical education (CME) presenters. However, there has been little research on improving the quality of feedback to CME presenters.

OBJECTIVES

To validate an instrument for generating balanced and behavior-specific feedback from a national cross-section of participants to presenters at a large internal medicine CME course.

DESIGN, SETTING, AND PARTICIPANTS

A prospective, randomized validation study with qualitative data analysis that included all 317 participants at a Mayo Clinic internal medicine CME course in 2009.

MEASUREMENTS

An 8-item (5-point Likert scales) CME faculty assessment enhanced study form (ESF) was designed based on literature and expert review. Course participants were randomized to a standard form, a generic study form (GSF), or the ESF. The dimensionality of instrument scores was determined using factor analysis to account for clustered data. Internal consistency and interrater reliabilities were calculated. Associations between overall feedback scores and presenter and presentation variables were identified using generalized estimating equations to account for multiple observations within talk and speaker combinations. Two raters reached consensus on qualitative themes and independently analyzed narrative entries for evidence of balanced and behavior-specific comments.

RESULTS

Factor analysis of 5,241 evaluations revealed a uni-dimensional model for measuring CME presenter feedback. Overall internal consistency (Cronbach alpha = 0.94) and internal consistency reliability (ICC range 0.88-0.95) were excellent. Feedback scores were associated with presenters' academic ranks (mean score): Instructor (4.12), Assistant Professor (4.38), Associate Professor (4.56), Professor (4.70) (p = 0.046). Qualitative analysis revealed that the ESF generated the highest numbers of balanced comments (GSF = 11, ESF = 26; p = 0.01) and behavior-specific comments (GSF = 64, ESF = 104; p = 0.001).

CONCLUSIONS

We describe a practical and validated method for generating balanced and behavior-specific feedback for CME presenters in internal medicine. Our simple method for prompting course participants to give balanced and behavior-specific comments may ultimately provide CME presenters with feedback for improving their presentations.

Developing expert-derived rating standards for the peer assessment of lectures

PURPOSE

For peer review of teaching to be credible and reliable, peer raters must be trained to identify and measure teaching behaviors accurately. Peer rater training, therefore, must be based on expert-derived rating standards of teaching performance. The authors sought to establish precise lecture rating standards for use in peer rater training at their school.

METHOD

From 2008 to 2010, a panel of experts, who had previously helped to develop an instrument for the peer assessment of lecturing, met to observe, discuss, and rate 40 lectures, using a consensus-building model to determine key behaviors and levels of proficiency for each of the instrument's 11 criteria. During this process, the panelists supplemented the original instrument with precise behavioral descriptors of lecturing. The reliability of the derived rating standards was assessed by having the panelists score six sample lectures independently.

RESULTS

Intraclass correlation coefficients of the panelists' ratings of the lectures ranged from 0.75 to 0.96. There was moderate to high positive association between 10 of the 11 instrument's criteria and the overall performance score (r = 0.752-0.886). There were no statistically significant differences among raters in terms of leniency or stringency of scores.

CONCLUSIONS

Two relational themes, content and style, were identified within the instrument's variables. Recommendations for developing expert-derived ratings standards include using an interdisciplinary group for observation, discussion, and verbal identification of behaviors; asking members to consider views that contrast with their own; and noting key teaching behaviors for use in future peer rater training.

Instructional analysis of lecture video recordings and its application for quality improvement of medical lectures

PURPOSE

The lecture is a technique for delivering knowledge and information cost-effectively to large medical classes in medical education. The aim of this study was to analyze teaching quality, based on triangle analysis of video recordings of medical lectures, to strengthen teaching competency in medical school.

METHODS

The subjects of this study were 13 medical professors who taught 1st- and 2nd-year medical students and agreed to a triangle analysis of video recordings of their lectures. We first performed triangle analysis, which consisted of a professional analysis of video recordings, self-assessment by teaching professors, and feedback from students, and the data were crosschecked by five school consultants for reliability and consistency.

RESULTS

Most of the distress that teachers experienced during the lecture occurred in uniform teaching environments, such as larger lecture classes. Larger lectures that primarily used PowerPoint as a medium to deliver information effected poor interaction with students. Other distressing factors in the lecture were personal characteristics and lack of strategic faculty development.

CONCLUSION

Triangle analysis of video recordings of medical lectures gives teachers an opportunity and motive to improve teaching quality. Faculty development and various improvement strategies, based on this analysis, are expected to help teachers succeed as effective, efficient, and attractive lecturers while improving the quality of larger lecture classes.

Lectures based on cardinal symptoms in undergraduate medicine - effects of evaluation-based interventions on teaching large groups

Despite critical voices lectures are still an important teaching format in current medical curricula. With the curricular reform at Hamburg Medical Faculty in the year 2004, all subject specific lectures were replaced by cardinal symptom oriented lectures (LSV) in the new clinical curriculum. LSVs are taught throughout all six thematic blocks in years three to five. Since regular student evaluations after each thematic block seemed to demand improvement of the LSVs, this study was carried out using evaluations of individual LSVs by the participating students and by trained auditors (final year students and academic staff). Based on these evaluations feedback containing the individual evaluation data was given in written form to the lecturers combined with information material on planning an LSV using modern didactic techniques. In a second evaluation period, the effects of this intervention were studied. Only small improvements in the LSVs’ quality were noted regarding the level of marks achieved. When individual items were evaluated, especially the didactic quality, significant improvements were noticeable. Overall, on the basis of individual items students ranked the quality of the LSVs significantly higher than trained auditors during the first evaluation period. This effect was no longer seen after the second evaluation period. The inter rater reliability among the auditors was very good. This study shows that regular quality assurance is needed on the structural levels and for staff to accompany the process of embedding teaching formats into curricular concepts. Further investigation is needed to determine the adequate frequency of evaluation and the format of feedback to guarantee sustainable effects of the didactic quality of lectures.

Evidence-based medicine training in a resource-poor country, the importance of leveraging personal and institutional relationships

RATIONALE, AIMS AND OBJECTIVES

Efforts to implement evidence-based medicine (EBM) training in developing countries are limited. We describe the results of an international effort to improve research capacity in a developing country; we conducted a course aimed at improving basic EBM attitudes and identified challenges.

METHOD

Between 2005 and 2009, we conducted an annual 3-day course in Perú consisting of interactive lectures and case-based workshops. We assessed self-reported competence and importance in EBM using a Likert scale (1 = low, 5 = high).

RESULTS

Totally 220 clinicians participated. For phase I (2005-2007), self-reported EBM competence increased from a median of 2 to 3 (P < 0.001) and the perceived importance of EBM did not change (median = 5). For phase II (2008-2009), before the course, 8-72% graded their competence very low (score of 1-2). After the course, 67-92% of subjects graded their increase in knowledge very high (score of 4-5). The challenges included limited availability of studies relevant to the local reality written in Spanish, participants' limited time and lack of long-term follow-up on practice change. Informal discussion and written evaluation from participants were universally in agreement that more training in EBM is needed.

CONCLUSIONS

In an EBM course in a resource-poor country, the baseline self-reported competence and experience on EBM were low, and the course had measurable improvements of self-reported competence, perceived utility and readiness to incorporate EBM into their practices. Similar to developed countries, translational research and building the research capacity in developing countries is critical for translating best available evidence into practice.

The educational attributes and responsibilities of effective medical educators

Of the many roles that the academic-educator may fulfill, that of teacher is particularly challenging. Building on prior recommendations from the literature, this article identifies the skill set of teachers across the medical education continuum-characteristics of attitude and attributes, knowledge, and pedagogic skills that permit effective teaching to be linked with effective learning and understanding. This examination which characterizes teachers' attitudes, knowledge, and skills serves to reemphasize the centrality of teaching within medical education, provides direction for faculty and institutions alike in the discharge of academic responsibilities, and makes educational accountability clear. This listing of teacher attitudes and responsibilities was vetted in 2009 by medical education leaders from across North America during a national conference on faculty development.A set of recommendations concerning faculty development issues for medical teachers is offered. The recommendations are intended to establish an academic culture in medical education that values and rewards-academically and fiscally-those centrally committed to the role of teacher. The challenges of defining skills, developing and funding programs, and ongoing evaluation must be faced to achieve success in teaching throughout medical education, now and in the future. Faculty members, fellow learners, and patients deserve no less.

Perspectives on presentation and pedagogy in aid of bioinformatics education

Using live presentation to communicate the interdisciplinary and abstract content of bioinformatics to its educationally diverse studentship is a sizeable challenge. This review collects a number of perspectives on multimedia presentation, visual communication and pedagogy. The aim is to encourage educators to reflect on the great potential of live presentation in facilitating bioinformatics education.

What if continuing education became mandatory? Opinions of Belgian community pharmacists

Objective In July 2003, a survey (n = 1032) was conducted on issues related to continuing education for community pharmacists. This study aims to explore specific results of this survey in-depth. The objectives were to examine how current continuing education courses can be optimised, how much interest pharmacists have in distance learning, and how pharmacists think about mandatory continuing education.

Setting Community pharmacy in the Dutch-speaking part of Belgium.

Method Six focus group discussions were held: two with attenders (n = 14), two with non-attenders (n = 13), and two with the management of the Institute for Permanent Study for Pharmacists (n = 12). A theme plan was used to moderate discussions. Framework analysis was applied to analyse data.

Key findings To optimise live courses, continuing education providers should select good speakers, provide extensive course notes, and focus on issues that are relevant to day-to-day pharmacy practice. The interest in distance learning as a continuing education format was limited. Non-attenders are likely to need a formal obligation to engage in continuing education, with the preferred format being live courses. By increasing patients' awareness and appreciation of pharmacists' capabilities, pharmacists could be more motivated to counsel patients, to engage in continuing education, and to accept a system of mandatory continuing education.

Conclusion Implementation of mandatory continuing education in Belgium might encourage more pharmacists to take part in live continuing education courses than in distance learning. The arguments for and against mandatory continuing education as well as the suggestions for improvement of live continuing education courses should be taken into account when implementing a system of mandatory continuing education.

Radiologist/Educator knowledge of the audience response system and limitations to its use

RATIONALE AND OBJECTIVES

Audience response systems (ARS) have been proven to increase residents' retention in the short and long terms. The purpose of this study was to determine what teaching faculty members know about the ARS at one institution, what the obstacles are to its use, and ways to increase its use.

MATERIALS AND METHODS

An anonymous and voluntary survey was sent to teaching faculty members. Fifty-two faculty members received the survey request and were included in the study set. The survey included questions regarding the faculty members' prior use of, understanding of, and ideas about ways to improve the ARS, as well as obstacles to its use.

RESULTS

Thirty of 52 faculty members (58%) responded. Eight (27%) reported prior use of the ARS. Impediments to using the system more, for infrequent users, included "no need for it again," that it was "a bit tedious to incorporate into lectures," and time limitations. However, most users felt that the system was overall easy to use, and they did so by incorporating it into existing lectures. Perceptions that residents learned more effectively with the ARS motivated faculty members to use it more. They noted that residents seemed to like the ARS lectures more and were more engaged than with other didactic techniques. Faculty members would increase their use of the ARS if more information technology support were available, if training sessions were held, and if they had knowledge that residents preferred this lecture format.

CONCLUSIONS

Faculty members at the authors' academic institution used its ARS infrequently but expressed an overall desire to use it more. They suggested methods that would increase their use of the device and were particularly motivated by residents' satisfaction with their lectures. If their suggestions can be implemented, use of the ARS should increase.

Use of an audience response system during peer teaching among physical therapy students in human gross anatomy: perceptions of peer teachers and students

An audience response system (ARS) has become popular among educators in medicine and the health professions because of the system's ability to engage listeners during a lecture presentation. No one has described the usefulness of ARS technology during planned nonlecture peer teaching sessions in gross anatomy instruction for health professionals. The unique feature of each peer teaching session was a nongraded 12-15 item ARS quiz assembled by six second-year doctor of physical therapy (DPT) students and purposely placed at the beginning of the review session for those first-year DPT students in attendance. This study used a ten-item questionnaire and a five-point Likert scale in addition to three open ended questions to survey perceptions of both first-year and second-year DPT students about the usefulness of ARS technology implemented during weekly interactive peer teaching sessions during a semester course in Anatomy for Physical Therapists. First-year students overwhelmingly acknowledged the ARS system permitted each student to self-assess his/her preparedness for a quiz or examination and compare his/her performance with that of classmates. Peer teachers recognized an ARS quiz provided them an opportunity to: (1) estimate first-year students' level of understanding of anatomical concepts; and (2) effectively prepare first-year students for their weekly quizzes and future examinations. On the basis of the mutual benefits derived by both students/tutees and teachers/tutors, physical therapist educators may wish to consider using ARS technology to enhance teaching methods for a class in gross human anatomy.

Developing a peer assessment of lecturing instrument: lessons learned

Peer assessment of teaching can improve the quality of instruction and contribute to summative evaluation of teaching effectiveness integral to high-stakes decision making. There is, however, a paucity of validated, criterion-based peer assessment instruments. The authors describe development and pilot testing of one such instrument and share lessons learned. The report provides a description of how a task force of the Shapiro Institute for Education and Research at Harvard Medical School and Beth Israel Deaconess Medical Center used the Delphi method to engage academic faculty leaders to develop a new instrument for peer assessment of medical lecturing. The authors describe how they used consensus building to determine the criteria, scoring rubric, and behavioral anchors for the rating scale. To pilot test the instrument, participants assessed a series of medical school lectures. Statistical analysis revealed high internal consistency of the instrument's scores (alpha = 0.87, 95% bootstrap confidence interval [BCI] = 0.80 to 0.91), yet low interrater agreement across all criteria and the global measure (intraclass correlation coefficient = 0.27, 95% BCI = -0.08 to 0.44).The authors describe the importance of faculty involvement in determining a cohesive set of criteria to assess lectures. They discuss how providing evidence that a peer assessment instrument is credible and reliable increases the faculty's trust in feedback. The authors point to the need for proper peer rater training to obtain high interrater agreement measures, and posit that once such measures are obtained, reliable and accurate peer assessment of teaching could be used to inform the academic promotion process.

Scholarship opportunities for trainees and clinician educators: learning outcomes from a case report writing workshop

INTRODUCTION

Publishing a case report demonstrates scholarly productivity for trainees and clinician-educators.

AIM

To assess the learning outcomes from a case report writing workshop.

SETTING

Medical students, residents, fellows and clinician-educators attending a workshop.

PROGRAM DESCRIPTION

Case report writing workshop conducted nine times at different venues.

PROGRAM EVALUATION

Before and after each workshop, participants self-rated their perceived competence to write a case report, likelihood of submitting a case report to a meeting or for publication in the next 6-12 months, and perceived career benefit of writing a case report (on a five-point Likert scale). The 214 participants were from 3 countries and 27 states or provinces; most participants were trainees (64.5 %). Self-rated competence for writing a case report improved from a mean of 2.5 to 3.5 (a 0.99 increase; 95% CI, 0.88-1.12, p < 0.001). The perceived likelihood of submitting a case report, and the perceived career benefit of writing one, also showed statistically significant improvements (p = 0.002, p = 0.001; respectively). Nine of 98 participants published a case report 16-41 months after workshop completion.

DISCUSSION

The workshop increased participants' perception that they could present or publish a case report.

Perceptions of learning as a function of seminar group factors

CONTEXT

Small-group learning is advocated for enhancing higher-order thinking and the development of skills and attitudes. Teacher performance, group interaction and the quality of assignments have been shown to affect small-group learning in hybrid and problem-based curricula.

OBJECTIVES

This study aimed to examine the perceptions of student groups as to how teacher performance, group interaction and the quality of assignments are related to one another and to learning effects in seminars of 15-30 students in a hybrid curriculum.

METHODS

We constructed a 28-item questionnaire and administered it to 639 students attending 32 seminars in Years 1-4 of an undergraduate veterinary curriculum. We performed factor analysis and reliability analysis of the questionnaire. We used correlation and regression analyses to explore the interactions of the four-factor model, with teacher performance, group interaction and quality of assignments as independent variables and the perceived learning effect of the seminars as the dependent variable.

RESULTS

The response rate was 99%. Teacher performance (beta = 0.78) and group interaction (- 0.28) significantly influenced the perceived learning effect. The total effect of the quality of assignments (through effects on teacher performance and group interaction) was 0.47.

DISCUSSION

The strong relationship between teacher performance and learning effect suggests that students rely strongly on their teachers. The negative effect of group interaction may reflect poor alignment of teaching and assessment and poor organisation of group processes. This should be further examined. Comparative studies on seminars are also recommended.

Audience response systems: technology to engage learners

An audience response system (ARS) provides a means of infusing interaction into a traditional didactic lecture format, enhancing student attention and learning. It can be used in a variety of ways, with both large and small audiences, to evaluate participants' knowledge, attitudes, and opinions or to verify student attendance at a lecture. The technology of ARS has markedly improved over the years, resulting in systems that are less costly and easier to use. Commercial systems that can be rented or purchased as well as local systems that can be downloaded free via the Internet are available. In this essay, the author reviews the components of an ARS, the history of ARS, educational outcomes related to ARS use, the benefits and limitations of ARS, tips for using an ARS, and current developments in ARS.

Audience response systems in medical student education benefit learners and presenters

RATIONALE AND OBJECTIVES

We sought to assess how the use of an audience response system (ARS) in medical student radiology instruction affects the self-confidence, ability to gauge mastery, and insights for future preparation in students when they participate as audience members and when they give peer teaching presentations.

MATERIALS AND METHODS

Twenty-seven medical students discussed radiology case files in groups and used an ARS to present their assigned cases to peers. Students' views of interactive audience response versus traditional pedagogy were surveyed using a 5-point Likert scale (1, strongly agree; 2, agree; 3, neither agree nor disagree; 4, disagree; 5, strongly disagree).

RESULTS

Students reported that instruction with interactive ARS lectures gave them more confidence to verbally answer questions in subsequent lectures when compared to instruction with standard didactic lectures, where a presenter asks questions and a single student responds (2.35 versus 3.14, p < .024). Students found it easier to gauge their level of mastery of material by answering ARS questions than by hearing classmates' verbal responses to questions posed in lecture (1.77 versus 2.68, p < .002). When giving peer teaching presentations, students reported that the ARS lecture format helped them to gauge their audience's level of understanding (1.55, 95% CI [1.27-1.82], p < .001).

CONCLUSION

Radiology instruction utilizing an ARS can help build students' confidence, knowledge of self-mastery, and insights for future studying. Similarly, student presenters using an ARS improve their confidence, better gauge their audience, and develop helpful insights for future teaching presentations.

The anatomy of an outstanding CME meeting

Organizing a continuing medical education (CME) meeting should not be a casual undertaking. It requires experience, staff support, and adequate funding. The sponsoring entity should have a thorough grounding in the Accreditation Council for Continuing Medical Education mind-set, and the course should be within the mission of the organization. Needs of the potential attendees should be assessed and objectives developed to meet those needs. An evaluation process should be in place to ensure that the needs were addressed and met. Ideally, a postcourse evaluation should assess the impact of the meeting on the behavior and practice patterns of the registrants. Excellent teachers should be selected as faculty members. These educators should be given advance information about the characteristics of the attendees, their needs, and their expectations. Topics should be chosen for their relevance to the registrants, as opposed to the convenience of the faculty members. This paper deals with these issues and several related topics. It is based on the author's experience and supplemented by relevant peer-reviewed scientific literature. The CME "market" has a "caveat emptor" approach.

Nodding and napping in medical lectures: an instructive systematic review

A comprehensive, international systematic review, spanning more than 100 years of data collection, suggests that soporific lectures at medical meetings are common, annoying and persistent. Low lights and boring material are prominent risk factors for nodding off during presentations. Extreme remedial measures are warranted.

The 10-minute oral presentation: what should I focus on?

BACKGROUND

Little empirical evidence is available in the medical field defining the most important features of a scientific presentation. We sought to empirically identify what features of a scientific oral presentation experienced reviewers focus on when asked to identify the best features and areas to improve.

METHODS

Observational study of 44 presenters at a scientific meeting over a 4-year period. Reviewers observed presenters and identified the best features and made suggestions for improvement using an open-ended form. We developed a coding form based on three domains: content, slides, and presentation style. Two raters blinded to the presenter then coded the comments, and disagreement was resolved by concurrent review.

RESULTS

Reviewers made at least one comment about content in 42 (95.5%) of the presentations, about slides in 38 (86.4%), and about presentation style in 42 (95.5%). The most frequently extracted comments on best features of presentations in the domain "content" were identifying a key concept (43.2% of presentations) and relevance (43.2%). Similarly, best features in the domain regarding "slides" were clarity (50.0% of presentations), graphics (27.3%), and readability of the text and font size (22.7%). Finally, best features in the domain regarding "presentation style" were clarity (59.1% of presentations), pace (52.3%), voice (47.7%), engaging with the audience (43.2%), addressing questions (34.1%), and eye contact (22.7%). Various other comments were noted to improve presentations.

CONCLUSIONS

Important features during oral presentations relate to specific areas of content, clear slides, and a presentation style that was well paced, engaging, and clear. Nonverbal communication is important in oral presentations.

Optimizing electronic presentations

RATIONALE AND OBJECTIVES

Radiologists often use electronic presentations for educational and research purposes. Many physician educators may not know how to best utilize this technology.

MATERIALS AND METHODS

A literature search was performed to find information regarding optimal use of electronic presentations.

RESULTS AND CONCLUSION

Information from a variety of sources was compiled to provide a guideline for creating electronic presentations.

Evaluation of an audience response system for the continuing education of health professionals

INTRODUCTION

Continuing medical education (CME) for physicians and other health personnel is becoming increasingly important in light of recertification requirements. Interactive learning is more effective and may be useful in a continuing education setting. This study examines the use of an audience response system (ARS) as an interactive learning tool for health care providers.

METHOD

We conducted a national randomized controlled trial to evaluate the utility of an ARS to enhance attention and learning. Speakers at 42 clinical round table (CRT) programs in five regions across the United States were randomized to "use" or "no use" of an ARS during their lectures. We surveyed participants to collect data regarding presentation and speaker quality, impressions of the ARS, and knowledge of the material presented. We collected information from speakers regarding ease of use and overall opinions of the ARS.

RESULTS

A total of 283 surveys were completed (164 from participants using the ARS and 119 from participants not using the ARS). ARS participants rated the quality of the presentation, the quality of the speaker, and their level of attention more highly than non-ARS participants (p < .05). Knowledge scores (of material presented) were not significantly different between the two groups. Both participants and speakers felt that the ARS was easy to use and preferred to use the system in future CRTs.

DISCUSSION

Participants in CRTs with the ARS rated presentation and speaker quality more favorably than those participants in CRTs without the tool. Participant knowledge scores, however, were not significantly different. ARSs may provide easy-to-use tools to enhance attention and enthusiasm in CME learners.