PBL.2.0: blended learning for an interactive, problem-based pedagogy

What Does the Future Hold for a Surgical Trainee? This Lockdown Is Not a Letdown Yet: A Survey on Moodle Learning Management System as a Part of Blended Learning During COVID-19 Pandemic

Background

The COVID-19 pandemic brought about a major shift in the educational training of surgical trainees. As the Lockdown was implemented and the daily workforce reduced, an alternate method was employed to provide uninterrupted learning. Blended learning that includes virtual learning with face-to-face learning/teaching was utilized for the surgical trainees. MOODLE (Modular object-oriented dynamic learning environment), an open-source learning management system, was integrated as an Online Component of our Blended Learning Program. We aimed to evaluate the perception of postgraduate trainees of General Surgery regarding the benefits and limitations of Blended Learning, particularly its online component, i.e., Moodle LMS, for the betterment of surgical -education during the COVID-19 pandemic.

Material and Methods

Thirty-three postgraduate general surgery trainees were enrolled in a blended learning program, in which its online component, Moodle LMS, comprised four major topics on General Surgery. A questionnaire was provided to the trainees to obtain feedback on blended learning in general, and Moodle LMS was mainly themed on the Likert scale.

Results

The approach of blended learning was positively received by the participants, the majority of whom were females (75%) and comprising of Year 1 residents (33.3%). Nearly half of the participants found Moodle LMS user-friendly, practical and a good platform for learning. However, nearly two thirds (60.6%) were uncertain if it ever helped in applying knowledge to interpret laboratory and radiological results for patient management. Even then, most of them found that the face-to-face component of blended learning helped them develop specific clinical and surgical skills (42.4%). Emphatically, 78.7% would recommend it for surgical training.

Conclusion

Blended learning was found to be beneficial in the training process of surgical postgraduates in the current COVID-19 pandemic situation. We recommend it for the training of doctors for optimized learning.

Student perspective of classroom and distance learning during COVID-19 pandemic in the undergraduate dental study program Universitas Indonesia

BACKGROUND

The COVID-19 pandemic has become a global health issue and has had a major impact on education. Consequently, half way through the second semester of the academic year 2019/2020, learning methods were delivered through distance learning (DL). We aimed to evaluate the student perspective of DL compared to classroom learning (CL) in the undergraduate dentistry study program at the Faculty of Dentistry Universitas Indonesia.

METHODS

An online questionnaire was sent at the end of the semester. A total of 301 students participated in the study.

RESULTS

Duration of study influenced student preference. Higher number of first-year students preferred DL compared to their seniors (p < 0.001). Students preferred CL for group discussion, as DL resulted in more difficult communication and gave less learning satisfaction. Only 44.2% students preferred DL over CL, although they agreed that DL gave a more efficient learning method (52.6%), it provided more time to study (87.9%) and to review study materials (87.3%). Challenges during DL included external factors such as unstable internet connection, extra financial burden for the internet quota and internal factors such as time management and difficulty to focus while learning online for a longer period of time.

CONCLUSION

Despite some challenges, dental students could adapt to the new learning methods of full DL and the majorities agreed blended learning that combined classroom and distance learning can be implemented henceforth. This current COVID-19 pandemic, changes not only the utilization of technology in education but the pedagogy strategies in the future.

Interactive whiteboard use in clinical reasoning sessions to teach diagnostic test ordering and interpretation to undergraduate medical students

BACKGROUND

Over-testing of patients is a significant problem in clinical medicine that can be tackled by education. Clinical reasoning learning (CRL) is a potentially relevant method for teaching test ordering and interpretation. The feasibility might be improved by using an interactive whiteboard (IWB) during the CRL sessions to enhance student perceptions and behaviours around diagnostic tests. Overall, IWB/CRL could improve their skills.

METHODS

Third-year undergraduate medical students enrolled in a vertically integrated curriculum were randomized into two groups before clinical placement in either a respiratory disease or respiratory physiology unit: IWB-based CRL plus clinical mentoring (IWB/CRL + CM: n = 40) or clinical mentoring only (CM-only: n = 40). Feasibility and learning outcomes were assessed. In addition, feedback via questionnaire of the IWB students and their classmates (n = 233) was compared.

RESULTS

Analyses of the IWB/CRL sessions (n = 40, 27 paperboards) revealed that they met validated learning objectives. Students perceived IWB as useful and easy to use. After the IWB/CRL + CM sessions, students mentioned more hypothesis-based indications in a test ordering file (p <  0.001) and looked for more nonclinical signs directly on raw data tests (p <  0.01) compared with students in the CM-only group. Last, among students who attended pre- and post-assessments (n = 23), the number of diagnostic tests ordered did not change in the IWB/CRL + CM group (+ 7%; p = N.S), whereas it increased among CM-only students (+ 30%; p <  0.001). Test interpretability increased significantly in the IWB/CRL + CM group (from 4.7 to 37.2%; p <  0.01) but not significantly in the CM-only group (from 2.4 to 9.8%; p = 0.36).

CONCLUSIONS

Integrating IWB into CRL sessions is feasible to teach test ordering and interpretation to undergraduate students. Moreover, student feedback and prospective assessment suggested a positive impact of IWB/CRL sessions on students' learning.

Educational technologies in problem-based learning in health sciences education: a systematic review

Background

As a modern pedagogical philosophy, problem-based learning (PBL) is increasingly being recognized as a major research area in student learning and pedagogical innovation in health sciences education. A new area of research interest has been the role of emerging educational technologies in PBL. Although this field is growing, no systematic reviews of studies of the usage and effects of educational technologies in PBL in health sciences education have been conducted to date.

Objective

The aim of this paper is to review new and emerging educational technologies in problem-based curricula, with a specific focus on 3 cognate clinical disciplines: medicine, dentistry, and speech and hearing sciences. Analysis of the studies reviewed focused on the effects of educational technologies in PBL contexts while addressing the particular issue of scaffolding of student learning.

Methods

A comprehensive computerized database search of full-text articles published in English from 1996 to 2014 was carried out using 3 databases: ProQuest, Scopus, and EBSCOhost. Eligibility criteria for selection of studies for review were also determined in light of the population, intervention, comparison, and outcomes (PICO) guidelines. The population was limited to postsecondary education, specifically in dentistry, medicine, and speech and hearing sciences, in which PBL was the key educational pedagogy and curriculum design. Three types of educational technologies were identified as interventions used to support student inquiry: learning software and digital learning objects; interactive whiteboards (IWBs) and plasma screens; and learning management systems (LMSs).

Results

Of 470 studies, 28 were selected for analysis. Most studies examined the effects of learning software and digital learning objects (n=20) with integration of IWB (n=5) and LMS (n=3) for PBL receiving relatively less attention. The educational technologies examined in these studies were seen as potentially fit for problem-based health sciences education. Positive outcomes for student learning included providing rich, authentic problems and/or case contexts for learning; supporting student development of medical expertise through the accessing and structuring of expert knowledge and skills; making disciplinary thinking and strategies explicit; providing a platform to elicit articulation, collaboration, and reflection; and reducing perceived cognitive load. Limitations included cumbersome scenarios, infrastructure requirements, and the need for staff and student support in light of the technological demands of new affordances.

Conclusions

This literature review demonstrates the generally positive effect of educational technologies in PBL. Further research into the various applications of educational technology in PBL curricula is needed to fully realize its potential to enhance problem-based approaches in health sciences education.

Blended learning in situated contexts: 3-year evaluation of an online peer review project

BACKGROUND

Situated and sociocultural perspectives on learning indicate that the design of complex tasks supported by educational technologies holds potential for dental education in moving novices towards closer approximation of the clinical outcomes of their expert mentors. A cross-faculty-, student-centred, web-based project in operative dentistry was established within the Universitas 21 (U21) network of higher education institutions to support university goals for internationalisation in clinical learning by enabling distributed interactions across sites and institutions. This paper aims to present evaluation of one dental faculty's project experience of curriculum redesign for deeper student learning.

METHODS

A mixed-method case study approach was utilised. Three cohorts of second-year students from a 5-year bachelor of dental surgery (BDS) programme were invited to participate in annual surveys and focus group interviews on project completion. Survey data were analysed for differences between years using multivariate logistical regression analysis. Thematic analysis of questionnaire open responses and interview transcripts was conducted.

RESULTS

Multivariate logistic regression analysis noted significant differences across items over time indicating learning improvements, attainment of university aims and the positive influence of redesign. Students perceived the enquiry-based project as stimulating and motivating, and building confidence in operative techniques. Institutional goals for greater understanding of others and lifelong learning showed improvement over time. Despite positive scores, students indicated global citizenship and intercultural understanding were conceptually challenging.

CONCLUSIONS

Establishment of online student learning communities through a blended approach to learning stimulated motivation and intellectual engagement, thereby supporting a situated approach to cognition. Sociocultural perspectives indicate that novice-expert interactions supported student development of professional identities.

High efficacy and students' satisfaction after voluntary vs mandatory use of an e-learning program in traumatology and orthopedics--a follow-up study

INTRODUCTION

Within the last decade, e-learning has gained a consistent place in surgical teaching. However, as the use of new programs is often voluntary, more information on the implications of the data regarding user acceptance and knowledge with mandatory use is desirable, especially in the context of the long-term developments of courses.

MATERIALS

Starting in 2009, the e-learning program Network for Students in Traumatology and Orthopedics was offered in a voluntary blended learning context. Students' satisfaction and increase in knowledge were evaluated using questionnaires and written tests. With proven effectiveness, the program became a mandatory part of the curriculum, and students' attitudes and gain of knowledge were re-evaluated in 2010 and 2011 to detect differences in voluntary vs mandatory use.

RESULTS

In the evaluation questionnaires (n = 108 voluntary vs n = 361 mandatory), the overall appreciation regarding the offerings remained high. Significantly more students felt better prepared for clinical situations (p < 0.001) and asked for e-tutoring (p = 0.025) with mandatory use. In written tests, both voluntary (n = 70) and mandatory (n = 147) users showed significantly increased knowledge (p < 0.001). Starting with a lower base level (p < 0.001), mandatory users had a significantly higher absolute increase compared with voluntary users (p = 0.015), leading to a similar final level.

DISCUSSION

The presented blended learning concept was an efficient way to teach students orthopedics and traumatology. Data can support the assumption that even if the voluntary evaluation of e-learning offerings might be subject to a selection bias, the results can serve as a representative impression for the students' overall mood and their gain in knowledge. However, as changes would have to be anticipated when shifting to mandatory use, users' perceptions should be constantly evaluated.

Is remediation program using team-based learning effective for at-risk medical students?

PURPOSE

Although remediation and reassessment of at-risk students are essential functions of medical education, there are no guidelines on how best to remediate such students. In this study, we described and examined the effectiveness of a remediation program that was delivered as team-based learning (TBL) sessions.

METHODS

After a written examination, 15 of 145 fourth-year students were found to require remediation, and assigned to teams of four to five students. Clinical topics related to items of the Korean Medical License Examination were taught in the remediation period of 3 weeks, and all students took reexamination. Changes in test scores were analyzed, and student feedback was documented.

RESULTS

Students who participated in the remediation program had significantly better total scores on re-examination (remediation group 225.8 to 263.0 vs. control group 290.8 to 304.0, p<0.05). Most students found that the remediation program was instructive and helped them prepare for the examination. Moreover, students gained confidence, and all of them passed the graduation examination.

CONCLUSION

TBL is an effective method of remediating at-risk students. Further research with regard to the successful design and implementation of a remediation program for at-risk students is needed.

Designing, implementing and evaluating an online problem-based learning (PBL) environment--a pilot study

Problem-based learning (PBL) has been shown to be effective for promoting student competencies in self-directed and collaborative learning, critical thinking, self-reflection and tackling novel situations. However, the need for face-to-face interactions at the same place and time severely limits the potential of traditional PBL. The requirements of space and for meeting at a specific location at the same time create timetabling difficulties. Such limitations need to be tackled before all potentials of PBL learning can be realized. The present study aimed at designing and implementing an online PBL environment for undergraduate speech/language pathology students, and assessing the associated pedagogical effectiveness. A group of eight PBL students were randomly selected to participate in the study. They underwent 4 weeks of online PBL using Adobe Connect. Upon completion of the experiment, they were assessed via a self-reported questionnaire and quantitative comparison with traditional PBL students based on the same written assignment. The questionnaire revealed that all participating students enjoyed online PBL, without any perceived negative effects on learning. Online PBL unanimously saved the students travel time to and from school. Statistical analysis indicated no significant difference in assignment grades between the online and traditional PBL groups, indicating that online PBL learning appears to be similarly effective as traditional face-to-face PBL learning.