The objective structured video examination of medical students

The "Talk-to-Me" MOOC intervention for suicide prevention and mental health education among tertiary students: Protocol of a multi-site cross-over randomised controlled trial

INTRODUCTION

Mental health problems are common among tertiary education students, with concerning levels of suicide ideation frequently observed in this population. There is a need for evidence-based mental health education and suicide prevention programs designed to meet the specific needs of these students. The "Talk-to-Me" Mass Open Online Course (MOOC) is a strengths-based mental health education program underpinned by a six-phase model for managing a suicidal crisis.

METHODS

To evaluate the efficacy of the "Talk-to-Me" MOOC in improving student knowledge of appropriate responses to suicide crisis via a randomised control trial (RCT) comparing tertiary education health science and education students attending the program to a waitlist control group. Overall, 170 will be screened and randomly allocated to either the "Talk-to-Me" MOOC or a waitlist control group, with data collection occurring at three-time points (baseline, 10-weeks and 24-weeks from baseline) over one year. The primary outcome will be participants' knowledge and responses to suicidal statements as measured by the Suicide Intervention Response Inventory. Secondary outcomes will be knowledge of mental health and coping skills as well as the overall utility of the program.

CONCLUSIONS

This pragmatic RCT will demonstrate the efficacy of the "Talk-to-Me" MOOC in improving the students' ability to respond to suicidal and mental health concerns compared to the waitlist group. This design will enable rigorous evaluation of the "Talk-to-Me" MOOC, contributing to a greater understanding of the online-delivered safe-paced suicide prevention programs for tertiary students. Australian New Zealand Clinical Trials Registry (ANZCTR): #12619000630112.

Physical examination in undergraduate medical education in the field of general practice - a scoping review

BACKGROUND

Physical examination (PE) is an essential clinical skill and a central part of a physician's daily activity. Teaching of PE has been integrated into medical school by many clinical disciplines with respective specific examination procedures. For instance, PE teaching in general practice may include a full-body examination approach. Studies show that PE-skills of medical students often need enhancement. The aim of this article was to scope the literature regarding the teaching and research of PE within general practice during undergraduate medical education. We evaluated a wide breadth of literature relating to the content, study design, country of research institution and year of publication.

METHODS

Literature search in Medline along the PRISMA-P protocol was performed by search syntax ("physical examination" AND "medical education" AND "undergraduate" AND general practice) considering Medline MeSH (Medical Subject Heading)-Terms and Medline search term tree structure. Independent title, abstract and full-text screening with defined inclusion and exclusion criteria was performed. Full texts were analyzed by publication year, country of origin, study design and content (by categorizing articles along their main topic according to qualitative content analysis of Mayring).

RESULTS

One-hundred seven articles were included. The annual number of publications ranged from 4 to 14 and had a slightly rising trend since 2000. Nearly half of the publications originated from the United States (n = 54), 33 from Canada and the United Kingdom. Overall, intervention studies represented the largest group (n = 60, including uncontrolled and controlled studies, randomized and non-randomized), followed by cross-sectional studies (n = 29). The 117 studies could be assigned to five categories "teaching methods (n = 53)", "teaching quality (n = 33)", "performance evaluation and examination formats (n=19)", "students' views (n = 8)" and "patients' and standardized patients' views (n=4)".

CONCLUSIONS

The present work shows a wide spectrum of teaching and research activities and a certain level of evidence for the effectiveness of individual teaching methods. It can be used as orientation and impulse generator for the further development of medical education in the field of PE.

Assessing medical student competency in communication in the pre-clinical phase: objective structured video exam and SP exam

OBJECTIVE

The aim of our study was to present the structure, process and results of the objective structured video exam and One-Station standardized patient exam that have been used to assess second year medical students' communication skills.

METHODS

Scores of 1137 students between the years 2007 and 2010 were analyzed. Means and standard deviations were calculated for scores and ratings. Internal consistency was assessed using Cronbach's alpha coefficient. To analyze reliability and generalizability, multivariate generalizability theory was employed.

RESULTS

Students' total and item scores on the objective structured video exam (60.5-68.8) were lower than on the One-Station standardized patient exam (90.4-96.6). Internal consistencies of both exams were moderate. Generalizability analysis and D-study results showed that both the objective structured video exam and the One-Station standardized patient exam need improvement.

CONCLUSION

Both exams need measures to improve them, such as increasing the number of video cases or stations, and further standardization of raters.

PRACTICE IMPLICATIONS

This study might encourage medical teachers to consider assessing validity and reliability of written and performance exams on the basis of generalizability theory, and to find out feasible actions to improve assessment procedures by conducting a D-study.