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Si J. Fostering clinical reasoning ability in preclinical students through an illness script worksheet approach in flipped learning: a quasi-experimental study. BMC MEDICAL EDUCATION 2024; 24:658. [PMID: 38872172 DOI: 10.1186/s12909-024-05614-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 05/29/2024] [Indexed: 06/15/2024]
Abstract
BACKGROUND The consensus that clinical reasoning should be explicitly addressed throughout medical training is increasing; however, studies on specific teaching methods, particularly, for preclinical students, are lacking. This study investigated the effects of an illness script worksheet approach in flipped learning on the development of clinical reasoning abilities in preclinical students. It also explored whether the impact of this intervention differed depending on clinical reasoning ability after dividing the students into high and low groups based on their pre-diagnostic thinking inventory (DTI) scores. METHODS This study used a one-group pre-post test design and convenience sampling. Forty-two second-year medical students were invited to participate in this study. The course, "clinical reasoning method," was redesigned as an illness script worksheet approach in flipped learning. The course was an eight-week long program. The students met once or twice per week with a different professor each time and engaged with 15 clinical cases in small groups in one classroom. Each time, one professor facilitated seven groups in a single classroom. The effectiveness of the intervention was measured using DTI before and after the intervention. A learning experience survey was conducted with post-DTI assessment. RESULTS Thirty-six students participated in the survey and their data were analyzed. The mean pre-DTI score was 170.4, and the mean post-DTI score was 185.2, indicating an 8.68% increase (p < .001). Significant differences were also found in both high and low groups between the pre- and post-DTI assessments. However, the low group improved much more than the high group and exhibited a significant increase in one of the DTI subscales as well. The overall average score on the learning experience survey was 3.11 out of 4. CONCLUSION The findings indicated that the intervention was an effective instructional method for the development of clinical reasoning in preclinical students and was more beneficial for students with a low level of clinical reasoning ability. This study demonstrated that the intervention can be a feasible and scalable method to effectively and efficiently train clinical reasoning in preclinical students in a classroom.
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Affiliation(s)
- Jihyun Si
- Department of Medical Education, Dong-A University College of Medicine, 32 Daesingongwon-ro, Seo-gu, Busan, 49201, Korea.
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2
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Doherty M, Abdullah QK. Using Project ECHO to deliver a tele-mentoring and teaching program on palliative care in South Asia: Interpretive description of participants' experiences with a community of practice for learning. Palliat Support Care 2024:1-9. [PMID: 38736371 DOI: 10.1017/s1478951524000762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2024]
Abstract
OBJECTIVES To explore the learning experiences of participants (learners and teachers), in a yearlong tele-teaching and mentoring program on pediatric palliative care, which was conducted using the Project ECHO (Extension for Community Healthcare Outcomes) model and consisted of 27 teaching and clinical case discussion sessions for palliative medicine residents in India and Bangladesh. The goal of the study is to explore how participation and learning is motivated and sustained for both residents and teachers, including the motivators and challenges to participation and learning in a novel online format. METHODS Qualitative interviews with ECHO participants, including learners and teachers were conducted. Interviews were recorded and transcribed. Thematic analysis of interview data was conducted within an interpretive description approach. RESULTS Eleven physicians (6 residents, 5 teachers) participated in interviews. Key elements of the ECHO program which participants identified as supporting learning and participation include small group discussions, a flipped classroom, and asynchronous interactions through social media. Individual learner characteristics including effective self-reflection and personal circumstances impact learning. Providing opportunities for a diverse group of learners and teachers, to interact in communities of practice (COP) enhances learning. Three major themes and 6 subthemes describing learning processes were identified. Themes included (1) ECHO program structure, (2) learner characteristics, and (3) COP. Subthemes included flipped classroom, breakout rooms, learning resources, personal circumstances, self-awareness of learning needs, and community interactions. SIGNIFICANCE OF RESULTS Project ECHO suggests a novel model to train health providers, which is effective in low- and middle-income countries. Online learning programs can lead to learning through community of practice when learners and teachers are able to interact and engage in peer support and reflective practice. Educators should consider incorporating small group discussions, a flipped classroom design, and opportunities for asynchronous interactions to enhance learning for participants in online learning programs.
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Affiliation(s)
- Megan Doherty
- Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada
- Department of Pediatrics, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
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3
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Schmitz L, Betz CS, Böttcher A, Häußler SM, Praetorius M. [How much digitization do ENT curricula need? : Opportunities and limits from the perspective of students and teachers]. HNO 2024; 72:325-333. [PMID: 38372803 PMCID: PMC11045585 DOI: 10.1007/s00106-024-01437-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2024] [Indexed: 02/20/2024]
Abstract
BACKGROUND Digitalization has long been an integral part of students' everyday lives and increasingly also of their medical training. It seems to be an unwritten law that "digital natives" want as much digitalization as possible. This study aims to shed more light on how students in the clinical phase of medical studies perceive the increasing digitalization of teaching and what they need for good education. MATERIALS AND METHODS This study analyzed two surveys that were conducted using an online questionnaire. On the one hand, students in the 5th-9th semesters of the medical faculty at the University of Hamburg (n = 282) were surveyed (survey 1). Another survey addressed all employees of ENT clinics in Germany (n = 175; survey 2). RESULTS A total of 76 students took part in survey 1 and 123 lecturers in survey 2. The results show that both students and lecturers do not want face-to-face teaching to be completely replaced by digital formats. A total of 72.7% of students reject the possibility of teaching practical skills through digital formats. The majority of students surveyed stated that offline formats improve their concentration (61.1%), participation probability (63.9%), and motivation to learn (76.6%). In contrast, 40.2% of lecturers see digitalization as a way to reduce the workload without any relevant loss in teaching quality. CONCLUSION Digital teaching formats have a negative impact on the medical education of the students surveyed. Interaction and physical presence are needed to increase the motivation to learn. This leads to the first conclusion that students are critical of the increasing digitalization of medical studies.
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Affiliation(s)
- Lisa Schmitz
- Klinik und Poliklinik für Hals‑, Nasen‑, Ohrenheilkunde, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland.
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Kopf- und Neurozentrum, Universitätsklinikum Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Deutschland.
| | - Christian S Betz
- Klinik und Poliklinik für Hals‑, Nasen‑, Ohrenheilkunde, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - Arne Böttcher
- Klinik und Poliklinik für Hals‑, Nasen‑, Ohrenheilkunde, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - Sophia M Häußler
- Klinik und Poliklinik für Hals‑, Nasen‑, Ohrenheilkunde, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
| | - Mark Praetorius
- Klinik und Poliklinik für Hals‑, Nasen‑, Ohrenheilkunde, Universitätsklinikum Hamburg-Eppendorf, Hamburg, Deutschland
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Lu F, Luo Z, Huang T, Lv X, Wang H, Wang Y, Yin H. Effectiveness evaluation of flipped classroom in emergency medicine online teaching for medical undergraduates. MEDICAL TEACHER 2024; 46:689-696. [PMID: 37910012 DOI: 10.1080/0142159x.2023.2273780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Indexed: 11/03/2023]
Abstract
INTRODUCTION Due to policy changes in the context of COVID-19 pandemic, online teaching has become the main form of class in many Chinese universities. Flipped classroom has been widely used in other disciplines, but there is a dearth of evidence available about the use in online teaching of emergency medicine. This study aimed to develop a flipped classroom for online emergency medicine teaching and evaluate its effectiveness by comparing it with traditional lecture-based online teaching. METHODS A total of 62 clinical medical undergraduates from Jinan University participated in this study from September to December in 2022. An online flipped classroom approach was developed (FC group, n = 31). Traditional lecture-based online teaching was applied as a contrast (LBT group, n = 31). The undergraduates completed examinations and questionnaires at the end of the course. A course experience questionnaire and course examination score were used to evaluate the effectiveness of the flipped classroom approach. RESULTS Regarding the five dimensions of the course experience questionnaire, the scores for good teaching (3.47 ± 0.50 vs. 2.34 ± 0.48, p < .001), appropriate assessment (3.31 ± 0.68 vs. 2.95 ± 0.71, p = .043) and generic skills (3.16 ± 0.60 vs. 2.72 ± 0.39, p < .001) were higher for the FC group than for the LBT group. There was no significant difference between the two groups in clear goals and standards, and appropriate workload. The undergraduates in the FC group showed significantly higher overall satisfaction than those in the LBT group (3.52 ± 0.1.03 vs. 2.87 ± 0.92, p = .012). The examination scores (77.936 ± 11.573 vs. 70.484 ± 7.434, p < .001), especially the scores for questions related to case analysis (33.032 ± 5.363 vs. 26.968 ± 7.657, p < .001), were significantly higher in the FC group than in the LBT group. CONCLUSIONS The flipped classroom for online teaching was efficient in improving undergraduates' emergency medical academic performance and promoting the development of clinical case analysis ability. These findings provide an alternative flipped classroom approach for online teaching of emergency medicine.
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Affiliation(s)
- Fan Lu
- Intensive Care Unit, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Zhiquan Luo
- Science and Education Office, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Ting Huang
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Xiuxiu Lv
- Department of Pathophysiology, School of Medicine, Jinan University, Guangzhou, China
| | - Huadong Wang
- Department of Pathophysiology, School of Medicine, Jinan University, Guangzhou, China
| | - Yiyang Wang
- Department of Pathophysiology, School of Medicine, Jinan University, Guangzhou, China
| | - Haiyan Yin
- Intensive Care Unit, The First Affiliated Hospital of Jinan University, Guangzhou, China
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Hildenbrand T, Kuhn S, Everad F, Hassepaß F, Neudert M, Offergeld C. [Views of assistant professors on digital transformation in otorhinolaryngology education : Current status and perspectives in undergraduate and advanced training]. HNO 2024; 72:303-309. [PMID: 38587662 PMCID: PMC11045641 DOI: 10.1007/s00106-024-01468-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND Digital transformation in curricular teaching in medicine comprises the use of digital teaching and learning formats as well as the transfer of digital skills for medical staff. Concepts of knowledge transfer and competency profiles also have to be adapted and transferred in advanced training due to necessary changes. OBJECTIVE The aim of this study was an evaluation of the current state of digital transformation in otorhinolaryngology teaching in undergraduate and advanced training at otorhinolaryngology departments of university medical centers in Germany. MATERIALS AND METHODS A questionnaire with nine questions on digital transformation was sent to the assistant professors of 37 national university ENT departments. The anonymous survey was conducted online via the online platform SurveyMonkey®. RESULTS Of the contacted assistant professors, 86.5% participated in the survey. Teaching sessions on digital skills for medical students are part of the curriculum in only 25% of ENT departments. Digital teaching formats are used by half of the departments in undergraduate training. Only 56.25% of the assistant professors receive support to realize the changes required by digital transformation. In 40.62% of departments, the issue of digital transformation is broached during advanced training, but only 28.12% use digital teaching methods to train junior doctors. CONCLUSION Aspects of digital transformation are implemented mainly in undergraduate education, partly driven by the COVID 19 pandemic. Overall, there is still considerable backlog in undergraduate and advanced training in ENT.
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Affiliation(s)
- T Hildenbrand
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland.
| | - S Kuhn
- Institut für Digitale Medizin, Universitätsklinikum Gießen-Marburg & Philipps-Universität Marburg, Marburg, Deutschland
| | - F Everad
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland
| | - F Hassepaß
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland
| | - M Neudert
- Klinik für Hals-Nasen- und Ohrenheilkunde, Universitätsklinikum Carl-Gustav-Carus, Dresden, Deutschland
| | - C Offergeld
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, Universitätsklinikum Freiburg, Killianstr. 5, 79106, Freiburg, Deutschland
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Mand SK, Cico SJ, Haas MRC, Schnabel NE, Schnapp BH. Let's get active: The use of technology-enhanced audience interaction to promote active learning. AEM EDUCATION AND TRAINING 2024; 8:S50-S55. [PMID: 38774823 PMCID: PMC11102944 DOI: 10.1002/aet2.10950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 12/04/2023] [Accepted: 12/27/2023] [Indexed: 05/24/2024]
Affiliation(s)
- Simanjit K. Mand
- BerbeeWalsh Department of Emergency MedicineUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Stephen J. Cico
- Department of Clinical SciencesUniversity of Central Florida College of MedicineOrlandoFloridaUSA
| | - Mary R. C. Haas
- Department of Emergency MedicineUniversity of Michigan Medical SchoolAnn ArborMichiganUSA
| | - Nicole E. Schnabel
- Department of Emergency MedicineUniversity of Michigan Medical SchoolAnn ArborMichiganUSA
| | - Benjamin H. Schnapp
- BerbeeWalsh Department of Emergency MedicineUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
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Manspeaker SA, DeIuliis ED, Delehanty AD, McCann M, Zimmerman DE, O'Neil C, Shaffer J, Crytzer TM, Loughran MC. Impact of a Grand Rounds Interprofessional Workshop: student perceptions of interprofessional socialization and cultural humility. J Interprof Care 2024; 38:460-468. [PMID: 38126233 DOI: 10.1080/13561820.2023.2287671] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 11/15/2023] [Indexed: 12/23/2023]
Abstract
While uniprofessional education programs develop strong student identities, they may limit the development of behaviors needed for interprofessional socialization. Interprofessional education (IPE) creates an essential platform for student engagement in the development of interprofessional socialization and cultural humility, thus enabling improvement in collaborative communication. In this quasi-experimental observational study, health professional students attended one of three Grand Rounds Interprofessional Workshops (GRIW) and completed online pre- and post-workshop surveys including sociodemographic background, the Interprofessional Socialization and Valuing Scale (ISVS), and the Cultural Competence Self-Assessment Checklist (CCSAC). A total of 394 students from eight professions participated in the workshop with 287 (73%) of attendees completing both pre- and post-workshop surveys. No significant differences were observed in ISVS and CCSAC scores between students across workshops. Significant pre- to post-workshop differences were found in ISVS [t (284) = 13.5, p < .001, 95%], CCSAC [t (286) = 13.8, p < .001] and the cultural competence components of cultural awareness [t (285) = 12.9, p < .001, 95%], knowledge [t (285) = 9.5, p < .001, 95%], and skills [t (286) = 13.3, p < .001, 95%]. Interprofessional education learning opportunities that integrate socialization with health professional students and cultural humility education can improve educational awareness of cultural values and communication for collaborative professional practice.
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Affiliation(s)
| | | | | | - Michelle McCann
- Athletic Training, Duquesne University, Pittsburgh, Pennsylvania, USA
| | - David E Zimmerman
- Athletic Training, Duquesne University, Pittsburgh, Pennsylvania, USA
| | - Christine O'Neil
- Athletic Training, Duquesne University, Pittsburgh, Pennsylvania, USA
| | - Joseph Shaffer
- Athletic Training, Duquesne University, Pittsburgh, Pennsylvania, USA
| | | | - Mary C Loughran
- Athletic Training, Duquesne University, Pittsburgh, Pennsylvania, USA
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Ohlenburg H, Arnemann PH, Hessler M, Görlich D, Zarbock A, Friederichs H. Flipped Classroom: Improved team performance during resuscitation training through interactive pre-course content - a cluster-randomised controlled study. BMC MEDICAL EDUCATION 2024; 24:459. [PMID: 38671434 PMCID: PMC11046966 DOI: 10.1186/s12909-024-05438-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Accepted: 04/17/2024] [Indexed: 04/28/2024]
Abstract
BACKGROUND Resuscitation is a team effort, and it is increasingly acknowledged that team cooperation requires training. Staff shortages in many healthcare systems worldwide, as well as recent pandemic restrictions, limit opportunities for collaborative team training. To address this challenge, a learner-centred approach known as flipped learning has been successfully implemented. This model comprises self-directed, asynchronous pre-course learning, followed by knowledge application and skill training during in-class sessions. The existing evidence supports the effectiveness of this approach for the acquisition of cognitive skills, but it is uncertain whether the flipped classroom model is suitable for the acquisition of team skills. The objective of this study was to determine if a flipped classroom approach, with an online workshop prior to an instructor-led course could improve team performance and key resuscitation variables during classroom training. METHODS A single-centre, cluster-randomised, rater-blinded study was conducted on 114 final year medical students at a University Hospital in Germany. The study randomly assigned students to either the intervention or control group using a computer script. Each team, regardless of group, performed two advanced life support (ALS) scenarios on a simulator. The two groups differed in the order in which they completed the flipped e-learning curriculum. The intervention group started with the e-learning component, and the control group started with an ALS scenario. Simulators were used for recording and analysing resuscitation performance indicators, while professionals assessed team performance as a primary outcome. RESULTS The analysis was conducted on the data of 96 participants in 21 teams, comprising of 11 intervention groups and 10 control groups. The intervention teams achieved higher team performance ratings during the first scenario compared to the control teams (Estimated marginal mean of global rating: 7.5 vs 5.6, p < 0.01; performance score: 4.4 vs 3.8, p < 0.05; global score: 4.4 vs 3.7, p < 0.001). However, these differences were not observed in the second scenario, where both study groups had used the e-learning tool. CONCLUSION Flipped classroom approaches using learner-paced e-learning prior to hands-on training can improve team performance. TRIAL REGISTRATION German Clinical Trials Register ( https://drks.de/search/de/trial/DRKS00013096 ).
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Affiliation(s)
- Hendrik Ohlenburg
- Institute of Education and Student Affairs, Studienhospital Münster, University of Münster, 48149, Münster, Germany.
| | - Philip-Helge Arnemann
- Department of Anaesthesiology, Intensive Care and Pain Medicine, Münster University Hospital, Münster, Germany
| | - Michael Hessler
- Department of Anaesthesiology, Intensive Care and Pain Medicine, Münster University Hospital, Münster, Germany
| | - Dennis Görlich
- Institute of Biostatistics and Clinical Research, University of Münster, Münster, Germany
| | - Alexander Zarbock
- Department of Anaesthesiology, Intensive Care and Pain Medicine, Münster University Hospital, Münster, Germany
| | - Hendrik Friederichs
- Medical Education Research Group, Medical School OWL, Bielefeld University, Bielefeld, Germany
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Geyer PK, Hoffmann DS, Barr JY, Widmayer HA, Blaumueller CM. Granting access: Development of a formal course to demystify and promote predoctoral fellowship applications for graduate students. PLoS One 2024; 19:e0301480. [PMID: 38669240 PMCID: PMC11051599 DOI: 10.1371/journal.pone.0301480] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 03/16/2024] [Indexed: 04/28/2024] Open
Abstract
Strong scientific writing skills are the foundation of a successful research career and require training and practice. Although these skills are critical for completing a PhD, most students receive little formal writing instruction prior to joining a graduate program. In 2015, the University of Iowa Medical Scientist Training Program (MSTP) addressed this issue by developing the scientific writing course Grant Writing Basics (GWB). Here we describe the structure of this course and its effectiveness. GWB is an interactive, workshop-based course that uses a National Institutes of Health (NIH) F30 predoctoral fellowship proposal as a platform for building writing expertise. GWB incorporates established pedagogical principles of adult learning, including flipped classrooms, peer teaching, and reiterative evaluation. Time spent in class centers on active student analysis of previously submitted fellowship applications, discussion of writing resources, active writing, facilitated small group discussion of critiques of student writing samples, revision, and a discussion with a panel of experienced study section members and a student who completed a fellowship submission. Outcomes of GWB include a substantial increase in the number of applications submitted and fellowships awarded. Rigorous evaluation provides evidence that learning objectives were met and that students gained confidence in both their scientific writing skills and their ability to give constructive feedback. Our findings show that investment in formal training in written scientific communication provides a foundation for good writing habits, and the knowledge and skills needed to succeed in this vital aspect of a scientific research career. Furthermore, they highlight that evaluation is valuable in guiding course evolution. Strategies embedded in GWB can be adapted for use in any graduate program to advance scientific writing skills among its trainees.
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Affiliation(s)
- Pamela K. Geyer
- Department of Biochemistry and Molecular Biology, University of Iowa, Iowa City, Iowa, United States of America
- Medical Scientist Training Program, University of Iowa, Iowa City, Iowa, United States of America
| | - Darren S. Hoffmann
- Medical Scientist Training Program, University of Iowa, Iowa City, Iowa, United States of America
- Department of Anatomy and Cell Biology, University of Iowa, Iowa City, Iowa, United States of America
| | - Jennifer Y. Barr
- Scientific Editing and Research Communication Core, Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States of America
| | - Heather A. Widmayer
- Scientific Editing and Research Communication Core, Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States of America
| | - Christine M. Blaumueller
- Scientific Editing and Research Communication Core, Carver College of Medicine, University of Iowa, Iowa City, Iowa, United States of America
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Algarni A. Biomedical students' self-efficacy and academic performance by gender in a flipped learning haematology course. BMC MEDICAL EDUCATION 2024; 24:443. [PMID: 38658898 PMCID: PMC11040756 DOI: 10.1186/s12909-024-05421-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 04/12/2024] [Indexed: 04/26/2024]
Abstract
INTRODUCTION This study investigated the impact of flipped learning versus traditional instruction on medical students' academic performance and self-efficacy in a haematology course, and examined gender differences. Flipped learning is an instructional approach where students review pre-recorded lecture content at home, and active learning occurs in the classroom. Self-efficacy refers to students' beliefs in their ability to succeed and accomplish learning goals. METHODS A quasi-experimental study was conducted with 86 third-year Saudi medical students (46 males, 40 females) in a 10-week haematology course. Students were assigned to flipped learning group (n = 41) or traditional lecture group (n = 45). Both groups completed pre- and post-intervention academic tests and self-efficacy surveys. Data were analyzed using descriptive statistics and t-tests. RESULTS The flipped learning group showed an increase in academic scores (p <.05) and self-efficacy scores (p <.05) compared to the traditional group, but between group differences were not statistically significant. Female students in the flipped learning group showed the greatest increase in academic scores and self-efficacy. Most students perceived flipped learning positively for enhancing learning and preparation for class. CONCLUSION Flipped learning promoted self-efficacy compared to traditional lectures in medical students. Gender-specific benefits were observed, highlighting the need to design instruction to meet diverse student needs.
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Affiliation(s)
- Abdulrahman Algarni
- Department of Medical Laboratory Technology, Faculty of Applied Medical Sciences, Northern Border University, 91431, Arar, Kingdom of Saudi Arabia.
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Stenberg E, Milosavljevic A, Götrick B, Lundegren N. Continuing professional development in general dentistry-experiences of an online flipped classroom. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2024. [PMID: 38654701 DOI: 10.1111/eje.13013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 04/07/2024] [Indexed: 04/26/2024]
Abstract
INTRODUCTION Continuing professional development is a lifelong learning process. One pedagogical approach that can be used is active learning. Flipped classroom is a method that has been shown to improve deeper conceptual understanding. In an online setting, the method saves travel, time, and costs. To our knowledge, flipped classroom is rarely used in continuing professional education. This study in general dentistry explored experiences of an online flipped classroom course in continuing professional development. MATERIALS AND METHODS Fifteen dental hygienists, clinically active in general dental care, were interviewed. They were recruited from an online course on the latest classification system for periodontal diseases. The course had been conducted using an active learning and flipped classroom model. The interviews were semi-structured. Data were extracted using qualitative content analysis. RESULTS The experiences of the dental hygienists could be summarized in three themes: Stimulation of knowledge gain through self-paced studies, The ease of virtual networking among colleagues, and Fostering of direct practical application through collaboration. CONCLUSION New and emerging communication technology seems to open new possibilities for continuing professional development in general dentistry. Study participants felt that, in an online environment, mixing asynchronous and synchronous communication in a flipped classroom model facilitated learning in continuing professional development. Online active learning seems to work well in continuous professional development in general dentistry. After the course, the participating dental hygienists stated that they were able to use their new knowledge clinically and felt confident doing so.
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Affiliation(s)
- Emelie Stenberg
- Department of Oral Health, Faculty of Odontology, Malmö University, Malmö, Sweden
| | | | - Bengt Götrick
- Department of Orofacial Medicine, Faculty of Odontology, Malmö University, Malmö, Sweden
| | - Nina Lundegren
- Department of Oral Diagnostics, Faculty of Odontology, Malmö University, Malmö, Sweden
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Overskott HL, Markholm CE, Sehic A, Khan Q. Different Methods of Teaching and Learning Dental Morphology. Dent J (Basel) 2024; 12:114. [PMID: 38668026 PMCID: PMC11049323 DOI: 10.3390/dj12040114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2024] [Revised: 04/08/2024] [Accepted: 04/12/2024] [Indexed: 04/28/2024] Open
Abstract
Dental anatomy education is traditionally structured into theoretical and practical modules to foster both cognitive and psychomotor development. The theoretical module typically involves didactic lectures where educators elucidate dental structures using visual aids. In contrast, practical modules utilize three-dimensional illustrations, extracted and plastic teeth, and tooth carving exercises on wax or soap blocks, chosen for their cost, ease of handling, and fidelity in replication. However, the efficacy of these traditional methods is increasingly questioned. The criticism in this concern is that oversized carving materials may distort students' understanding of anatomical proportions, potentially affecting the development of necessary skills for clinical practice. Lecture-driven instruction, on the other hand, is also criticized for its limitations in fostering interactive learning, resulting in a gap between pre-clinical instruction and practical patient care. In this study, we review the various educational strategies that have emerged to enhance traditional dental anatomy pedagogy by describing the effectiveness of conventional didactic lectures, wax carving exercises, the use of real and artificial teeth, the flipped classroom model, and e-learning tools. Our review aims to assess each method's contribution to improving clinical applicability and educational outcomes in dental anatomy, with a focus on developing pedagogical frameworks that align with contemporary educational needs and the evolving landscape of dental practice. We suggest that the optimal approach for teaching tooth morphology would be to integrate the digital benefits of the flipped classroom model with the practical, hands-on experience of using extracted human teeth. To address the challenges presented by this integration, the creation and standardization of three-dimensional tooth morphology educational tools, complemented with concise instructional videos for a flipped classroom setting, appears to be a highly effective strategy.
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Affiliation(s)
| | | | - Amer Sehic
- Institute of Oral Biology, Faculty of Dentistry, University of Oslo, Blindern, P.O. Box 1052, 0316 Oslo, Norway; (H.L.O.); (C.E.M.); (Q.K.)
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Chen YL, Chiu YW, Yu CH, Chang YC, Chen YT. Flipped classroom teaching model with video instruction improves skills in local anesthesia training. J Dent Sci 2024; 19:1070-1074. [PMID: 38618056 PMCID: PMC11010660 DOI: 10.1016/j.jds.2024.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2024] [Revised: 02/02/2024] [Indexed: 04/16/2024] Open
Abstract
Background/purpose Local anesthesia (LA) training is an essential clinical skill in dental education. However, the traditional teaching method of student-to-student injection has ethical concerns. This study investigated whether a flipped classroom (FC) teaching model with instructional videos improves students' skills in administering LA. Materials and methods Fourth-year dental students in 2017 (traditional teaching, n = 70) and 2018 (FC model, n = 79) were assessed for their ability to perform an inferior alveolar nerve block and lingual nerve block. The FC group watched pre-recorded videos prior to a hands-on training session. Skills were evaluated using a 24-item checklist converted to letter grades. Perceptions of the FC approach were also surveyed. Results The FC group showed statistically significantly higher final grades than the traditional teaching group (P < 0.05). Most FC students agreed that the videos improved clarity and learning objectives. Conclusion The FC teaching model with procedural video instruction improved skills and confidence in administering LA over traditional teaching methods. Videos can be a beneficial supplement in pre-clinical dental training.
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Affiliation(s)
- Yen-Lin Chen
- School of Dentistry, Chung Shan Medical University, Taichung, Taiwan
- Department of Oral and Maxillofacial Surgery, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Yu-Wei Chiu
- School of Dentistry, Chung Shan Medical University, Taichung, Taiwan
- Department of Oral and Maxillofacial Surgery, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Chuan-Hang Yu
- School of Dentistry, Chung Shan Medical University, Taichung, Taiwan
- Department of Dentistry, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Yu-Chao Chang
- School of Dentistry, Chung Shan Medical University, Taichung, Taiwan
- Department of Dentistry, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Yi-Tzu Chen
- School of Dentistry, Chung Shan Medical University, Taichung, Taiwan
- Department of Oral and Maxillofacial Surgery, Chung Shan Medical University Hospital, Taichung, Taiwan
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Wehling J, Dombrowski T, Johannsen K, Volkenstein S, Dazert S, Weiss NM. [Providing practical skills in curricular teaching-effect of SkillsLab and flipped classroom]. HNO 2024; 72:143-153. [PMID: 38224355 PMCID: PMC10879220 DOI: 10.1007/s00106-023-01408-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2023] [Indexed: 01/16/2024]
Abstract
BACKGROUND In the course of the restructuring of medical studies, practical competencies are clearly defined as learning objectives for the first time. In order to make most effective use of the short attendance time available in otolaryngology, the aim of this study was to teach practical skills with the help of flipped classroom, digital teaching, and a newly established SkillsLab. MATERIALS AND METHODS During their ENT internship, two groups of students-group A = 93 students (male n = 42, female n = 51) and group B = 113 students (male n = 42, female n = 71)-first worked through material provided online, which explained the individual examinations. This was followed by face-to-face teaching, which consisted of observation and practical exercise of the different examination techniques. While group A practiced on each other or on dummies, group B used structured workstations in the ENT SkillsLab, which was newly built for this purpose. The effects on motivation and subjective competence were measured using a questionnaire developed for this study. RESULTS After working through the online material, both groups showed a high level of motivation and competence. On the day of face-to-face teaching, there was a gain in motivation and competence, which was statistically significant only in the SkillsLab group (p < 0.001). Although the SkillsLab group was inferior in terms of its subjective competence at the beginning, it was superior to the other group after the face-to-face teaching. CONCLUSION Combination of digitized teaching in the flipped classroom with structured workstations in the setting of a SkillsLab enables more effective teaching of practical skills, which was reflected by increases in motivation and subjective competence in group B. In particular, the presentation of all collected findings on monitors allows verification of learning success and stimulates discussion.
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Affiliation(s)
- Judith Wehling
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, St. Elisabeth-Hospital, Ruhr-Universität Bochum, Bochum, Deutschland.
| | - Tobias Dombrowski
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, St. Elisabeth-Hospital, Ruhr-Universität Bochum, Bochum, Deutschland
- Klinik für Hals-Nasen-Ohrenheilkunde, Universitätsmedizin Göttingen, Göttingen, Deutschland
| | - Katharina Johannsen
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, St. Elisabeth-Hospital, Ruhr-Universität Bochum, Bochum, Deutschland
| | - Stefan Volkenstein
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, St. Elisabeth-Hospital, Ruhr-Universität Bochum, Bochum, Deutschland
- Klinik für Hals‑, Nasen‑, Ohrenheilkunde der Ruhr-Universität Bochum, Johannes Wesling Klinikum Minden, Minden, Deutschland
| | - Stefan Dazert
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, St. Elisabeth-Hospital, Ruhr-Universität Bochum, Bochum, Deutschland
| | - Nora M Weiss
- Klinik für Hals‑, Nasen- und Ohrenheilkunde, St. Elisabeth-Hospital, Ruhr-Universität Bochum, Bochum, Deutschland
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, Klinikum rechts der Isar der Technischen Universität München, München, Deutschland
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Xiao J. Improving student learning and performance through a continuous flipped anatomy teaching model. ANATOMICAL SCIENCES EDUCATION 2024; 17:219-226. [PMID: 37916536 DOI: 10.1002/ase.2351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Revised: 10/15/2023] [Accepted: 10/17/2023] [Indexed: 11/03/2023]
Abstract
The flipped classroom teaching model has been widely used in anatomy education to embrace a blended learning strategy. However, the impact that a continuous flipped classroom teaching model exerts on student learning of human topographic anatomy remains unclear. To address this question, student learning experience and performance were compared between third-year undergraduate students who participated in a continuous flipped anatomy classroom teaching since their first year (n = 65, experimental group) and those under the flipped anatomy teaching model only in their third year (n = 45, control group). A five-point Likert scale learning and teaching survey was conducted to evaluate students' perceptions of the flipped classroom model. Students under a continuous flipped classroom teaching model rated significantly higher on the impact of the flipped model on learning difficult anatomy concepts than the control group (*p = 0.0346). The rating on independent learning remained not statistically different between the two groups, although a trend difference was detected (p = 0.0604). Analysis of learning performance revealed that the experimental group significantly outperformed the control group when answering questions focusing on regional anatomy (*p = 0.0207). No significant difference was identified in students' marks of case-based studies between the two groups. In summary, the results of this study indicate that the flipped classroom model implemented over a long term continues to advance students' learning experience and performance in anatomy, indicating a "dose" effect on active learning. The findings of this study will assist the best practices of the flipped anatomy classroom and develop evidence-informed approaches to advance anatomy education in the future.
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Affiliation(s)
- Junhua Xiao
- Department of Health Sciences and Biostatistics, School of Health Sciences, Swinburne University of Technology, Hawthorn, Victoria, Australia
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Guinat M, Staffoni L, Santschi V, Didier A, Gachoud D, Greppin-Bécherraz C. Evaluating the impact of a blended interprofessional education course on students' attitudes towards interprofessional education: a pre-post study. BMC MEDICAL EDUCATION 2024; 24:204. [PMID: 38413938 PMCID: PMC10900638 DOI: 10.1186/s12909-024-05170-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Accepted: 02/12/2024] [Indexed: 02/29/2024]
Abstract
BACKGROUND Since 2011, five educational and healthcare institutions have implemented a short interprofessional education (IPE) course to bring together undergraduates from five disciplines. To meet the logistical challenges of IPE implementation, more specifically, the large number of classrooms needed to gather students together and the need for human resources to guide learning activities, a face-to-face IPE course was redesigned into a blended (online and face-to-face collaborative learning activities) IPE course. In March 2023, 183 medical, 378 nursing, 46 radiologic technology, 69 physiotherapy, and 74 occupational therapy students participated in a one-day IPE blended course to learn interprofessional team functioning and dynamics, role clarification and responsibilities of other professions, and interprofessional communication skills. This study aimed to assess students' changes in attitudes towards IPE after being involved in a large-scale interprofessional blended learning course. METHODS A before-after study was conducted using a French translation of the validated questionnaire "University of West of England Interprofessional Questionnaire" (UWE-IP questionnaire). Students' attitudes towards interprofessional (IP) relationships and IP learning were measured before and after the course. In March 2023, two hundred fifty-six students from five professions answered two subscales of the UWE-IP questionnaire before and after the course (response rate 34%). RESULTS Students' attitudes towards IP relationships improved significantly after the course. The score on this subscale (min 8; max 24) changed from 11.18 (SD 2,67) before the course to 10,38 (SD 2,55) after the course, indicating a significant improvement in attitudes towards IP relationships (p < 0,001). More specifically, students had more positive attitudes on the item "I have a good understanding of the roles of different health and social care professionals." and the item "I feel that I am respected by people from other health and social care disciplines." after the course. A positive change in students' attitudes towards IP learning was observed, but the results were not significative. CONCLUSION A face-to-face IPE course redesigned as a blended course helped overcome existing challenges to implementing an IPE course. The results suggest a blended IPE course improves students' attitudes towards interprofessionality.
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Affiliation(s)
- M Guinat
- Department of Intensive Care Medicine, Lausanne University Hospital (CHUV), Lausanne, Switzerland.
- Medical Education Unit of the School of Medicine FBM, University of Lausanne, Lausanne, Switzerland.
| | - L Staffoni
- Haute Ecole de Santé Vaud (HESAV), School of Health Sciences, HES-SO, University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - V Santschi
- La Source, School of Nursing Sciences, HES-SO, University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - A Didier
- Haute Ecole de Santé Vaud (HESAV), School of Health Sciences, HES-SO, University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
| | - D Gachoud
- Medical Education Unit of the School of Medicine FBM, University of Lausanne, Lausanne, Switzerland
- Department of Internal Medicine, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - C Greppin-Bécherraz
- Haute Ecole de Santé Vaud (HESAV), School of Health Sciences, HES-SO, University of Applied Sciences and Arts Western Switzerland, Lausanne, Switzerland
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Karimian Z, Mokarram P, Zarifsanaiey N. Comparison of the teaching clinical biochemistry in face-to-face and the flex-flipped classroom to medical and dental students: a quasi-experimental study from IRAN. BMC MEDICAL EDUCATION 2024; 24:137. [PMID: 38350863 PMCID: PMC10863239 DOI: 10.1186/s12909-024-05051-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 01/10/2024] [Indexed: 02/15/2024]
Abstract
INTRODUCTION Biochemistry is one of the main courses of basic sciences in the medical curriculum, along with other difficult subjects that are difficult to learn. The emergence of new technologies has made it possible to test new methods such as e-Learning. In this study, we compared two methods of Flex-Flipped Classroom (FFC) and face-to-face. METHOD A quasi-experimental research was done which involved both medical and dental students studying the clinical biochemistry course in the joint semester in 2019. A total of 100 medical students were trained in biochemistry through face-to-face teaching, and 60 dental students were trained in the same course through the FFC model. Three researcher-made tools were used to compare the two groups to assess the student's satisfaction, scores, and self-evaluation. The content validity of the tools was checked using the opinions of 10 experts through the CVI index. The results were analyzed using one-sample t-tests, independent t-tests, and ANOVA. RESULTS Both groups scored significantly more than the cut-off-point (Mean > 3.5) in their average scores of the total and sub-components of the self-evaluation questionnaire (P < 0.05). Face-to-face teaching was viewed more favorably than the FFC teaching except for considering the flexibility (4.14 ± 1.55), but the difference was not significant (P > 0.05). The students' knowledge score in the FFC was slightly higher than that in the face-to-face method, but this difference was not significant(P = 0.758). CONCLUSION Both face-to-face and FFC methods were effective according to the students, but the level of satisfaction with the face-to-face method was higher. It seems that teacher-student interaction is an important factor in students' preferences. However, the students preferred the flexibility of multimedia. It seems necessary to use the advantages of each method in a model appropriate to the students' conditions and available facilities.
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Affiliation(s)
- Zahra Karimian
- Department of E-Learning in Medical Sciences, Virtual School and Center of Excellence in E-Learning, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Pooneh Mokarram
- Autophagy Research Center, Department of Biochemistry, School of Medicine, Shiraz University of Medical Sciences, Zand Street, Shiraz, Iran.
| | - Nahid Zarifsanaiey
- Department of E-Learning in Medical Sciences, Virtual School and Center of Excellence in E-Learning, Shiraz University of Medical Sciences, Shiraz, Iran
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Shen J, Qi H, Mei R, Sun C. A comparative study on the effectiveness of online and in-class team-based learning on student performance and perceptions in virtual simulation experiments. BMC MEDICAL EDUCATION 2024; 24:135. [PMID: 38347571 PMCID: PMC10863100 DOI: 10.1186/s12909-024-05080-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/07/2023] [Accepted: 01/22/2024] [Indexed: 02/15/2024]
Abstract
BACKGROUND The swift transition to online teaching in medical education has presented the challenge of replicating in-class engagement and interaction essential for active learning. Despite online team-based learning (TBL) offering potential solutions through structured cooperative activities, its efficacy in virtual simulation experiment courses remains scantily researched. This study investigates the effectiveness of online TBL for teaching virtual patient experiments in a basic medical laboratory course and contrasts it with traditional offline teaching in terms of student performance and perceptions. METHODS A comparative analysis involved 179 Year 3 medical students using online TBL, face-to-face TBL (FTF-TBL), and the flipped classroom (FC) approach. The learning outcomes were assessed based on experiment reports, IRAT scores, TRAT scores, and final exam performance. Students' perceptions of both online and in-class TBL methodologies were also surveyed. RESULTS Both online and in-class TBL groups demonstrated comparable academic outcomes and surpassed the FC group in academic performance. Students displayed a marked preference for the TBL format (whether online or in-class), valuing its enhancement of learning interest and practical knowledge application. Nevertheless, refinements in discussion efficiency, platform convenience, and student-instructor interaction were indicated as potential areas of improvement in the online setting. CONCLUSIONS Online TBL, along with its in-class counterpart, showed superior academic performance and a more positive learning experience compared to the FC group. These findings underscore the potential of online TBL in adapting to modern pedagogical challenges and enriching medical education through virtual simulation experiments.
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Affiliation(s)
- Jing Shen
- Department of Pathology and Pathophysiology, Zhejiang University School of Medicine, 310058, Hangzhou, China.
| | - Hongyan Qi
- Experimental Teaching Center of Basic Medicine, Zhejiang University School of Medicine, 310058, Hangzhou, China
| | - Ruhuan Mei
- Experimental Teaching Center of Basic Medicine, Zhejiang University School of Medicine, 310058, Hangzhou, China
| | - Cencen Sun
- Experimental Teaching Center of Basic Medicine, Zhejiang University School of Medicine, 310058, Hangzhou, China
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Frikha M, Mezghanni N, Chaâri N, Ben Said N, Alibrahim MS, Alhumaid MM, Hassan MM, Alharbi RS, Amira MS, Abouzeid N. Towards improving online learning in physical education: Gender differences and determinants of motivation, psychological needs satisfaction, and academic achievement in Saudi students. PLoS One 2024; 19:e0297822. [PMID: 38319952 PMCID: PMC10846739 DOI: 10.1371/journal.pone.0297822] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 01/12/2024] [Indexed: 02/08/2024] Open
Abstract
Studies on students' perceptions and expectations during physical education (PE) online learning remain scarce. Centered on self-determination theory, the present cross-sectional study aims to identify gender differences and predictors affecting motivation, psychological needs satisfaction (PNS), and academic achievement during PE online learning. Data were collected from Saudi students' (N = 308, 161 females and 147 males) responses to the PE autonomy, relatedness, competence, and motivation questionnaires. Welch's t-test for unequal sample sizes, multiple linear regression, and binary logistic regression were used to compare means and to predict the relationships between the independent and dependent variables. The results showed higher autonomy and competence perceptions in female than in male students, but no differences were observed in relatedness. Female students presented higher intrinsic motivations, lower amotivation perceptions than males. However, no gender differences were recorded in extrinsic motivation. Students with less experience in online learning and weak grade point averages (GPAs) are more susceptible to having a high level of amotivation. Gender, GPA, and prior experience with online learning are the common predictors for all PNS and amotivation, while GPA and prior experience with online learning are the determinants of intrinsic motivation. GPA is affected by prior experience with online learning, autonomy, competence, intrinsic motivation, and amotivation. Therefore, teachers are encouraged to adapt their didactic-pedagogical behaviors during PE online learning according to students' motivation and autonomy perceptions. Structuring teaching activities with more individualized support for autonomy, competence, intrinsic motivation, and students' online skills/competencies ensures better learning efficiency and academic achievements.
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Affiliation(s)
- Mohamed Frikha
- Department of Physical Education, College of Education, King Faisal University, Al-Ahsa, Saudi Arabia
- Research Laboratory Education, Motricity, Sport and Health (LR19JS01), High Institute of Sport and Physical Education, Sfax University, Sfax, Tunisia
| | - Nourhen Mezghanni
- Department of Sport Sciences, College of Education, Taif University, Taif, Saudi Arabia
| | - Nesrine Chaâri
- Research Laboratory Education, Motricity, Sport and Health (LR19JS01), High Institute of Sport and Physical Education, Sfax University, Sfax, Tunisia
| | - Noureddine Ben Said
- Department of Biomechanics and Motor Behavior, College of Sport Sciences and Physical Activity, King Saud University, Riyadh, Saudi Arabia
| | - Mohammed S. Alibrahim
- Department of Physical Education, College of Education, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Majed M. Alhumaid
- Department of Physical Education, College of Education, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Marwa M. Hassan
- Department of Physical Education, College of Education, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Raghad S. Alharbi
- Department of Physical Education, College of Education, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Mostafa S. Amira
- Department of Physical Education, College of Education, King Faisal University, Al-Ahsa, Saudi Arabia
| | - Nasser Abouzeid
- Department of Physical Education, College of Education, King Faisal University, Al-Ahsa, Saudi Arabia
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Ni ZH, Huang J, Yang DP, Wang J. Nursing students'experience of flipped classroom combined with problem-based learning in a paediatric nursing course: a qualitative study. BMC Nurs 2024; 23:88. [PMID: 38308302 PMCID: PMC10835821 DOI: 10.1186/s12912-024-01744-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 01/18/2024] [Indexed: 02/04/2024] Open
Abstract
BACKGROUND Problem-based learning (PBL) is a student-centred approach that triggers learning by presenting problems cenarios early in the learning process.Flipped classrooms have been used in various disciplines using various models.Pre-class e- learning in aflipped classrooms can enrich knowledge acquisition in PBL teaching. This study was conducted to explore nursing students'experience of flipped classroom combined with problem-based learning in a paediatric nursing course. METHOD This descriptive qualitative study was conducted between January and June 2022.Semi-structured interviews were conducted with nursing students who were participated in flipped classrooms combined with PBL teaching in a paediatric nursing course at Soochow university in China. Nursing students were selected using a purposive sampling method until no new data were generated (n = 16). RESULTS We identified ten sub-themes and four higher-order themes based on these sub-themes: (1)stimulating interest in learning and enhancing autonomous learning,(2)improving independent thinking and problem-solving skills,(3)cultivating team work spirit, and (4) gaining knowledge and improving skills.The findings of our research contribute to show the effectiveness of the flipped classroom combined with PBL in a paediatric nursing course. CONCLUSION The flipped classroom combined with PBL in a paediatric nursing course can enhances communication and cooperation abilities among nursing students, promoting common progress and the comprehensive development of nursing students.
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Affiliation(s)
- Zhi Hong Ni
- Children's Hospital of Soochow University, No. 92, Zhong nan St, 215025, Suzhou, China.
| | - Jie Huang
- Children's Hospital of Soochow University, No. 92, Zhong nan St, 215025, Suzhou, China
| | - Dao Ping Yang
- Children's Hospital of Soochow University, No. 92, Zhong nan St, 215025, Suzhou, China
| | - Jing Wang
- Children's Hospital of Soochow University, No. 92, Zhong nan St, 215025, Suzhou, China
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Vesco KK, Brooks NB, Francisco MC, Leo MC, Anderson TM, Kalter M, Clark AL. Resident training to optimize patient-focused menopause management: a multispecialty menopause curriculum to enhance knowledge and preparedness. Menopause 2024; 31:93-100. [PMID: 38166240 DOI: 10.1097/gme.0000000000002291] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2024]
Abstract
OBJECTIVE Surveys of residents in obstetrics and gynecology, internal medicine, and family medicine have demonstrated low levels of knowledge and comfort in treating patients with menopausal symptoms, suggesting a need for improved training during residency. To address this problem, we used a flipped classroom design to deliver a novel menopause curriculum for medical residents. The curriculum included six podcast episodes followed by an interactive case-based classroom session. We then assessed effects of the curriculum on the residents' knowledge and preparedness to manage menopause symptoms. METHODS We targeted 200 residents (43 obstetrics and gynecology, 86 internal medicine, and 71 family medicine) from six residency programs from 2019 to 2020. Of these, 115 (58%) completed both pre- and postcurriculum assessments, including a 15-item knowledge test and self-ratings of their knowledge, comfort, and preparedness to manage menopause. RESULTS Following the curriculum, the proportion of correctly answered knowledge questions rose from 60.8% to 79.1% (+18.3%; 95% confidence interval, 15.4-21.2; Cohen's d = 1.2). Improvement did not significantly differ by specialty or year of residency. There were higher gains for residents who listened to the entirety of all six podcast episodes ( b = 11.4, P < 0.001) and who attended the classroom session ( b = 11.6, P = 0.003). Residents' self-ratings of knowledge, comfort, and preparedness also improved following the curriculum across all medical specialties (Cohen's d = 0.47-1.2). Residents rated the podcast format as convenient (73%) and effective (65%) compared with an equivalent amount of reading. CONCLUSIONS Pairing a podcast with a classroom discussion was found to be an effective combination for improving menopause knowledge.
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Affiliation(s)
| | - Neon B Brooks
- From the Kaiser Permanente Center for Health Research, Kaiser Permanente Northwest, Portland, OR
| | - Melanie C Francisco
- From the Kaiser Permanente Center for Health Research, Kaiser Permanente Northwest, Portland, OR
| | - Michael C Leo
- From the Kaiser Permanente Center for Health Research, Kaiser Permanente Northwest, Portland, OR
| | | | - Marlene Kalter
- From the Kaiser Permanente Center for Health Research, Kaiser Permanente Northwest, Portland, OR
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Karaca O, Çınarcık BŞ, Aşık A, Sağlam C, Yiğit Y, Hakverdi G, Yetkiner AA, Ersin N. Impact of fully online flipped classroom on academic achievement in undergraduate dental education: An experimental study. EUROPEAN JOURNAL OF DENTAL EDUCATION : OFFICIAL JOURNAL OF THE ASSOCIATION FOR DENTAL EDUCATION IN EUROPE 2024; 28:212-226. [PMID: 37574773 DOI: 10.1111/eje.12938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 07/08/2023] [Indexed: 08/15/2023]
Abstract
INTRODUCTION The last two decades have seen a shift towards blended learning in education due to technological advancements. This study focuses on dental education, comparing two blended learning models -enriched virtual and fully online flipped classroom - in terms of academic achievement, aligning with the Association for Dental Education in Europe's competencies. MATERIALS AND METHODS The research was modelled in a quantitative design with a pre-post-test control group experimental design. The study was conducted at Ege University Faculty of Dentistry in Turkey for 4 weeks with the experimental (n = 44) and control (n = 39) groups divided into two groups by impartial assignment. To the experimental group, the theoretical part of the course was tried to be conveyed before each lesson with video lessons prepared with EdPuzzle containing reinforcement questions and a question set consisting of case questions. The practical learning objectives of the course were tried to be gained through the discussion of the previously presented case questions in the online synchronous course. As tools for collecting data, a unique academic achievement test, a course evaluation form and a semi-structured qualitative data collection form were used. RESULTS It was seen that the flipped classroom model had a more positive effect on students' academic achievement than the enriched virtual classroom model. The general satisfaction levels of the participants regarding these two models are also higher in favour of the flipped classroom model. CONCLUSION This study provides significant findings for educational institutions, policymakers and educators about the impact of fully online teaching methods on academic achievement. In this context, the flipped classroom method can be preferred both in cases where education is blocked and in dental education institutions that want to ensure digital transformation efficiently and partially remotely.
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Affiliation(s)
- Ozan Karaca
- Department of Medical Education, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Buğse Şakı Çınarcık
- Department of Pedodontics, Faculty of Dentistry, Ege University, Izmir, Turkey
| | - Aslı Aşık
- Department of Pedodontics, Faculty of Dentistry, Ege University, Izmir, Turkey
| | - Ceren Sağlam
- Department of Pedodontics, Faculty of Dentistry, Ege University, Izmir, Turkey
| | - Yasemin Yiğit
- Department of Pedodontics, Faculty of Dentistry, Ege University, Izmir, Turkey
| | - Gülden Hakverdi
- Department of Biostatistics and Medical Informatics, Faculty of Medicine, Ege University, Izmir, Turkey
| | - Arzu Aykut Yetkiner
- Department of Pedodontics, Faculty of Dentistry, Ege University, Izmir, Turkey
| | - Nazan Ersin
- Department of Pedodontics, Faculty of Dentistry, Ege University, Izmir, Turkey
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Patel R, Bannister SL, Degelman E, Sharma T, Beran TN, Lewis M, Novak C. Online Learning in Medical Student Clerkship: A Survey of Student Perceptions and Future Directions. Cureus 2024; 16:e54541. [PMID: 38516469 PMCID: PMC10956628 DOI: 10.7759/cureus.54541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/19/2024] [Indexed: 03/23/2024] Open
Abstract
Background The coronavirus disease 2019 (COVID-19) pandemic had a major impact on medical education with clerkship students abruptly removed from clinical activities in 2020 and hastily immersed in online learning to maintain medical education. In 2022, students returned to in-person clinical experiences, but synchronous learning sessions continued online with extensive use of asynchronous online resources. This change offers a unique opportunity to gather information about students' perspectives regarding the acceptability and effectiveness of online learning strategies. This study aims to explore the clerkship student experience with the integration of online learning and in-person learning into formalized educational sessions in clerkship. Methodology The authors administered an online survey to clerkship students at the Cumming School of Medicine at the University of Calgary, Canada in spring 2022. The survey consisted of primarily Likert-style questions to explore the perceived effectiveness of various online learning strategies. Results are reported as the proportion selecting "quite effective" or "extremely effective." Results A total of 89 students responded to the survey (57.4% of graduating class). For synchronous online learning, case-based learning was perceived as the most effective teaching strategy (61.8%), and audience response systems were the most effective strategy for improving audience engagement (70.1%). For asynchronous online learning, interactive cases (84.9%) and student-developed online study guides (83.6%) were perceived as the most effective. Students held varying perceptions regarding how online learning impacted their well-being. When considering future clerkship curricula, the majority of clerkship students preferred a blend of in-person and online learning. Conclusions This study identified that most clerkship students prefer a hybrid of in-person and online learning and that ideal online learning curricula could include case-based learning, audience response systems, and a variety of asynchronous learning resources. These results can guide curriculum development and design at other medical institutions.
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Affiliation(s)
- Rina Patel
- Postgraduate Medical Education, University of Calgary, Calgary, CAN
| | | | - Erin Degelman
- Postgraduate Medical Education, University of Calgary, Calgary, CAN
| | - Tejeswin Sharma
- Postgraduate Medical Education, University of Manitoba, Winnipeg, CAN
| | - Tanya N Beran
- Community Health Sciences, University of Calgary, Calgary, CAN
| | | | - Chris Novak
- Pediatrics, University of Calgary, Calgary, CAN
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Zhang S, Zhu D, Wang X, Liu T, Wang L, Fan X, Gong H. Effects of six teaching strategies on medical students: protocol for a systematic review and network meta-analysis. BMJ Open 2024; 14:e079716. [PMID: 38296281 PMCID: PMC10828868 DOI: 10.1136/bmjopen-2023-079716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 01/16/2024] [Indexed: 02/03/2024] Open
Abstract
INTRODUCTION Mounting evidence has suggested that novel teaching strategies have a positive impact on the quality and efficiency of medical education. However, the comprehensive evidence about the superiority among various strategies is not clear. To address this issue, we aim to conduct a systematic review and network meta-analysis (NMA) to evaluate the effects of six main strategies on medical education, including case-based learning, problem-based learning, team-based learning, flipped classrooms, simulation-based education and bridge-in, objective, preassessment, participatory learning, postassessment and summary. METHODS AND ANALYSIS A systematic search will be conducted in PubMed, Embase, Web of Science and the Cochrane Library, covering studies published from database inception to November 2023. Randomised controlled trials which evaluated the different teaching methods and meet the eligibility criteria will be included. The effectiveness of medical students' learning, which is evaluated by theoretical test score, experimental or practical test score, will be analysed as the primary outcomes. Besides, the secondary outcomes consist of learning satisfaction of students and formative evaluation score. The study selection and data extraction will be independently performed by two authors. The risk of bias in each study will be assessed using V.2 of the Cochrane risk-of-bias tool for randomised controlled trials. To compare the effects of six teaching strategies, pairwise meta-analysis and NMA will be performed using Rev Man, STATA and R software. Statistical analyses including homogeneity tests, sensitivity analysis, consistency tests, subgroup analysis, Egger's test and publication bias will also be completed. ETHICS AND DISSEMINATION No formal research ethics approval is required because this study is a meta-analysis based on published studies. The results will be disseminated to a peer-reviewed journal for publication. PROTOCOL REGISTRATION NUMBER CRD42023456050.
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Affiliation(s)
- Shuailong Zhang
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University (Army Medical University), Chongqing 40038, China
- Battalion 2022 of the Cadet Brigade, Third Military Medical University (Army Medical University), Chongqing 40038, China
| | - Dongmei Zhu
- Department of Hospital Infection Control, Chongqing Health Center for Women and Children, Chongqing 401147, China
- Department of Hospital Infection Control, Women and Children's Hospital of Chongqing Medical University, Chongqing 401147, China
| | - Xiaqing Wang
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University (Army Medical University), Chongqing 40038, China
| | - Tianyao Liu
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University (Army Medical University), Chongqing 40038, China
| | - Lian Wang
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University (Army Medical University), Chongqing 40038, China
| | - Xiaotang Fan
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University (Army Medical University), Chongqing 40038, China
| | - Hong Gong
- Department of Military Cognitive Psychology, School of Psychology, Third Military Medical University (Army Medical University), Chongqing 40038, China
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Blake BN, Bookbinder S, Lazenby G, Marshall A, Weed E, Meglin M. Knowledge of Oral Emergency Contraception Among Pharmacy Students. WOMEN'S HEALTH REPORTS (NEW ROCHELLE, N.Y.) 2024; 5:40-45. [PMID: 38288390 PMCID: PMC10823165 DOI: 10.1089/whr.2023.0175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/26/2023] [Indexed: 01/31/2024]
Abstract
Background Access to emergency contraception is an important consideration in preventing unintended pregnancies. Inconsistent information about emergency contraceptive given to patients at retail pharmacies may limit access. Objective In this study, we aimed to assess pharmacy students' knowledge of oral emergency contraception. Methods Students in a Doctor of Pharmacy program completed a confidential survey about their knowledge of and training on oral emergency contraception. Respondents self-reported demographics included age, race, ethnicity, gender, and year in pharmacy school. The survey questions assessed student knowledge of indications, availability, side effects, and mechanisms of action of oral emergency contraception, as well as their training on emergency contraception. Chi-squared and Fisher's exact tests were used to determine if demographics influenced knowledge outcomes. A multivariate logistic regression, including age, gender, ethnicity, religion, year of training, hours of education, and source of knowledge acquisition, was used to adjust for confounding variables. Results Among 296 pharmacy students, 31% (92/296) completed the survey. Among respondents, 34% (31/92) showed adequate knowledge of oral emergency contraception based on four critical knowledge questions. Third- and fourth-year students were more likely to have adequate knowledge than first- and second-year students (odds ratio [OR], 2.70; confidence interval [95% CI], 1.07-6.80). Students who reported learning about emergency contraception through reading assignments were more likely to have adequate knowledge than students who did not report learning from reading assignments (OR, 2.09; 95% CI, 1.30-3.35). Conclusions Most pharmacy students at a single academic center did not have adequate knowledge of oral emergency contraception. These findings highlight the need for trainings to improve pharmacy student knowledge of oral emergency contraception.
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Affiliation(s)
- Bria Nikole Blake
- Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Samantha Bookbinder
- College of Medicine, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Gweneth Lazenby
- Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Amari Marshall
- College of Pharmacy, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Elizabeth Weed
- Department of Clinical Pharmacy and Outcome Sciences, Medical University of South Carolina, Charleston, South Carolina, USA
| | - Michelle Meglin
- Department of Obstetrics and Gynecology, Medical University of South Carolina, Charleston, South Carolina, USA
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Congdon M, Goldstein L, Maletsky KD, Craven M, Rose S, Devon EP. Pediatric Intersession: An Upfront Flipped-Classroom Curriculum to Promote Pediatric Clerkship Readiness. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2024; 11:23821205241229774. [PMID: 38327827 PMCID: PMC10848795 DOI: 10.1177/23821205241229774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 01/12/2024] [Indexed: 02/09/2024]
Abstract
OBJECTIVES Best practices for content selection, mode of delivery, and timing of pediatric clerkship readiness curricula for medical students have, by and large, not been established. Capitalizing on changes in structure of the clinical clerkships during the COVID-19 pandemic, we created an upfront clerkship readiness curriculum, termed Pediatric Intersession (PI), to replace the existing weekly lecture-based clerkship didactics. METHODS Our goal was to develop an interactive curriculum with innovative instructional design methodology intended to promote broad foundational pediatric knowledge and clerkship preparedness using case-based learning. We first conducted a needs assessment and crafted curriculum content using guiding principles from the 2019 Council on Medical Student Education in Pediatrics (COMSEP) curriculum. We then organized material into four daily modules prior to the start of the clerkship and employed flipped classroom (FC) methodology. RESULTS Sixty-six percent of students completed course evaluations, and >90% of the 100 respondents reported that the PI enhanced their clinical learning. Pre-/post-testing demonstrated some knowledge gain following the small-group sessions and there was no change on the National Board of Medical Examiners (NBME) Subject Exam mean scores compared to prior cohorts of students. CONCLUSIONS The global pandemic provided an opportunity to re-envision our pediatric clerkship didactics content, while also incorporating instructional design methodology preferred by students. Our curriculum promotes a small group-based, interactive approach to clerkship readiness that fosters learning in the clinical environment that can be adapted for various settings. Our evaluation suggests that the transition to a FC readiness curriculum can be done successfully while effectively preparing students for their pediatric clerkship.
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Affiliation(s)
- Morgan Congdon
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA, USA
| | - Laura Goldstein
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA, USA
| | - Kristin D. Maletsky
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Meghan Craven
- Department of Pediatrics, Texas Children's Hospital, Houston, TX, USA
- Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA
| | - Stacey Rose
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA, USA
| | - Erin Pete Devon
- Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Perelman School of Medicine, The University of Pennsylvania, Philadelphia, PA, USA
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Lin Y, Xiu X, Lin J, Chen Z, Zheng CX, Pan X, Lin L, Yan J. Application of Team-Based Flipped Classroom and Traditional Learning on the Antenatal Education Center Course. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2023; 14:1379-1390. [PMID: 38106922 PMCID: PMC10725629 DOI: 10.2147/amep.s429806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 11/28/2023] [Indexed: 12/19/2023]
Abstract
Background The goal is to evaluate the effects of a flipped class strategy on knowledge, self-directed learning ability, learning satisfaction and pregnancy outcomes in primiparas undergoing antenatal education. Methods A random sampling method was adopted. A total of 600 primiparas who were diagnosed with early pregnancy in a first-class hospital in southeast China and received continuous prenatal health education from May to July 2020 were selected as the research subjects. In order to make the baseline of the two groups of primipara comparable, we divided the two groups in the antenatal education centre according to the odd-even number of the lesson card number. The odd-numbered group was the experimental group, who used the prenatal health education model based on blended learning; the even-numbered group was the control group, who used the traditional mode of prenatal health education. The two groups were compared on the following outcomes: knowledge, self-directed learning ability, learning satisfaction and pregnancy outcomes. Results Compared with traditional learning, the blended learning approach can effectively controlled the gestational weight gain (GWG), alleviated the anxiety and depression during pregnancy, improved the natural delivery rate of the primipara, shortened the delivery process and reduced the risk of gestational diabetes mellitus (GDM), the difference was statistically significant (all P<0.05). Conclusion Blended learning may be an effective strategy because of its validity and practicality in antenatal education.
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Affiliation(s)
- Yingying Lin
- Department of Healthcare, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, People’s Republic of China
| | - Xiaoyan Xiu
- Department of Health Education, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, People’s Republic of China
| | - Juan Lin
- Department of Obstetrics, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, People’s Republic of China
| | - Zhiwei Chen
- Department of Obstetrics, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, People’s Republic of China
| | - Cui Xian Zheng
- Department of Obstetrics, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, People’s Republic of China
| | - Xuehong Pan
- Department of Health Education, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, People’s Republic of China
| | - Lihua Lin
- Department of Healthcare, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, People’s Republic of China
| | - Jianying Yan
- Department of Obstetrics, Fujian Maternity and Child Health Hospital, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, People’s Republic of China
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Alipour F, Samavati K, Abdi P, Shirazi M, Tavassoly MT. An innovative optics lab design for residency training in ophthalmology. Sci Rep 2023; 13:21844. [PMID: 38071227 PMCID: PMC10710502 DOI: 10.1038/s41598-023-44688-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Accepted: 10/11/2023] [Indexed: 12/18/2023] Open
Abstract
Proper understanding of the optical function of the eye is the foundation of clinical understanding of ophthalmologists. Although teaching principals of optics has always been a part of ophthalmology residency curriculum, it seems that successful strategies other than lecture-based methods are needed to engage students and facilitate the understanding of optical principals. A collaborative team of physicists (optics Ph.D.), ophthalmologists and medical education experts designed an optics lab for ophthalmology residents to help them practically simulate different optical phenomena. The educational course consisted of 4 sessions of 90 min to practice the optical tests using the lab instruments. Each class consisted of 6-9 residents, divided into 3 groups with a fully equipped unit, and two mentors (an optics Ph.D. professor and an ophthalmology professor). A quasi-experimental design with pre-post test was used to evaluate the effectiveness of the training workshop in changing the ophthalmology residents' optical knowledge and attitude. Thirty-five residents participated in the study. The average score of residents' performance before the workshop was 5.21 (out of 100), which increased significantly to 66.1 after the workshop. Also, the average knowledge of residents, which was measured as self-reported, increased significantly from 28.85 to 71.09. The average score of students' attitudes and interest was increased from 40.49 to 74.81. It seems that training workshops and labs are effective to bring about change in knowledge and attitude of ophthalmology residents toward optics as a new teaching strategy that would be implemented in their curriculum.
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Affiliation(s)
- Fateme Alipour
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin Square, Tehran, 1336616351, Iran
| | - Katayoon Samavati
- Department of Physics, North Tehran Branch, Islamic Azad University, Tehran, Iran
| | - Parisa Abdi
- Eye Research Center, Farabi Eye Hospital, Tehran University of Medical Sciences, Qazvin Square, Tehran, 1336616351, Iran.
| | - Mandana Shirazi
- Department of Medical Education, School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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Murphy EE, Ordal L, Niendorf K, Ketelsen K, Eichmeyer JN, Mills R. Genetic counseling graduate program faculty perspectives on sharing education materials among programs. J Genet Couns 2023; 32:1174-1183. [PMID: 37740462 DOI: 10.1002/jgc4.1796] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Revised: 08/03/2023] [Accepted: 09/08/2023] [Indexed: 09/24/2023]
Abstract
Rapid advancements in genetics care requires responsive genetic counseling (GC) training capable of integrating new discoveries and practice into their curricula. The utilization of shared or standardized educational resources may address this need. Recognizing the potential of shared resources, the Pharmacogenetics (PGx) Working Group of the NSGC Precision Medicine Special Interest Group (SIG) launched a standardized education module using a flipped-classroom format to provide all GC programs equal access to PGx expertise and alleviate the burden of curriculum development. Following the initial success of the program, we aimed to explore the utilization of shared and standardized education resources more broadly, and better understand the perspectives of GC program faculty regarding their use. Twenty-nine program faculty representing at least 14 programs responded to an online survey. The majority (n = 21) reported sharing educational materials with another GC program, and 90% of those reported the shared materials to be beneficial as they promote collaboration, efficiency, address a gap in content, and provide access to experts. Similar benefits were described when using a standardized curriculum, which was defined as standardized lectures and activities created about a particular topic and made available to all genetic counseling programs; 16 participants indicated they would be very likely or likely to use a standardized curriculum. A secondary aim of the survey was to assess the existing PGx module that utilizes a flipped-classroom format. Overall, the PGx module was well received, indicating that a standardized shared module is well-suited for instruction on emerging and specialty topics. All participants believed the flipped-classroom format to be very or somewhat beneficial. In summary, results indicate that shared educational materials, including standardized education modules, are a potential solution to challenges related to efficiency and access to content experts in GC education, and program leadership is receptive to using them.
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Affiliation(s)
- E Emma Murphy
- Genetic Counseling, School of Allied Health Sciences, College of Health Sciences, Boise State University, Boise, Idaho, USA
| | - Leslie Ordal
- Genetic Counseling, School of Allied Health Sciences, College of Health Sciences, Boise State University, Boise, Idaho, USA
| | - Kristin Niendorf
- Genetic Counseling Program, Indiana State University, Terre Haute, Indiana, USA
| | - Kirk Ketelsen
- School of Public and Population Health, Boise State University, Boise, Idaho, USA
| | - Jennifer N Eichmeyer
- Genetic Counseling, School of Allied Health Sciences, College of Health Sciences, Boise State University, Boise, Idaho, USA
| | - Rachel Mills
- MS Genetic Counseling Program, University of North Carolina, Greensboro, North Carolina, USA
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Hardin J, Mourad A, Desy J, Paget M, Ma I, Traboulsi D, Johnson NA, Ali AA, Parsons L, Harvey A, Weeks S, McLaughlin K. Mitigating diagnostic performance bias in a skin-tone balanced dermatology curriculum. CLINICAL TEACHER 2023; 20:e13613. [PMID: 37649356 DOI: 10.1111/tct.13613] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2022] [Accepted: 07/10/2023] [Indexed: 09/01/2023]
Abstract
INTRODUCTION Individuals with skin of colour (SoC) have delayed diagnosis and poorer outcomes when presenting with some dermatologic conditions when compared to individuals with light skin (LS). The objective of this study was to determine if diagnostic performance bias can be mitigated by a skin-tone balanced dermatology curriculum. METHODOLOGY A prospective randomised intervention study occurred over 2 weeks in 2020 at a Canadian medical school. A convenience sample of all first-year medical students (n = 167) was chosen. In week 1, all participants had access to dermatology podcasts and were randomly allocated to receive non-analytic training (NAT; online patient 'cards') on either SoC cases or LS cases. In week 2, all participants received combined training (CT; NAT and analytic training through workshops on how to apply dermatology diagnostic rules for all skin tones). Participating students completed two formative assessments after weeks 1 and 2. RESULTS Ninety-two students participated in the study. After week 1, both groups had a lower diagnostic performance on SoC (p = 0.0002 and p = 0.002 for students who trained on LS 'cards' and SoC 'cards', respectively). There was a significant decrease in mean skin tone difference in both groups after week 2 (initial training on SoC: 5.8% (SD 12.2) pre, -1.4% (14.7) post, p = 0.007; initial training on LS: 7.8% (15.4) pre, -4.0% (11.8%) post, p = 0.0001). Five students participated in a post-study survey in 2023, and all found the curriculum enhanced their diagnostic skills in SoC. CONCLUSIONS SoC performance biases of medical students disappeared after CT in a skin tone-balanced dermatology curriculum.
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Affiliation(s)
- Jori Hardin
- Division of Dermatology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Ahmed Mourad
- Division of Dermatology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Janeve Desy
- Division of General Internal Medicine, Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Mike Paget
- Section of Academic Technologies, Undergraduate Medical Education, University of Calgary, Calgary, Alberta, Canada
| | - Irene Ma
- Section of Academic Technologies, Undergraduate Medical Education, University of Calgary, Calgary, Alberta, Canada
| | - Danya Traboulsi
- Division of Dermatology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Nicole A Johnson
- Section of Rheumatology, Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada
| | - Asma Amir Ali
- Division of Dermatology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Laurie Parsons
- Division of Dermatology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Adrian Harvey
- Department of Surgery, University of Calgary, Calgary, Alberta, Canada
| | - Sarah Weeks
- Division of Cardiology, Department of Cardiac Sciences, University of Calgary, Calgary, Alberta, Canada
| | - Kevin McLaughlin
- Division of Nephrology, Department of Medicine, University of Calgary, Calgary, Alberta, Canada
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Thomae AV, Verweij L, Witt CM, Blum D, Feusi E, Fringer A, Huber M, Roos M, Lal JA, Naef R. Evaluation of a newly developed flipped-classroom course on interprofessional practice in health care for medical students. MEDICAL EDUCATION ONLINE 2023; 28:2198177. [PMID: 37021707 PMCID: PMC10081083 DOI: 10.1080/10872981.2023.2198177] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Revised: 03/21/2023] [Accepted: 03/29/2023] [Indexed: 06/19/2023]
Abstract
Interprofessional education is expected to promote collaborative practice and should therefore be included in health professionals' curricula. Reports on interprofessional curricular development and its evaluation are rare. We therefore undertook a comprehensive quantitative and qualitative evaluation of a new, mandatory course on interprofessional collaboration for medical students during their third year of the Bachelor of Medicine study programme. The newly developed and implemented course spans over six weeks and was designed in a hybrid, flipped-classroom format. It incorporates experience- and case-based learning as well as interactions with other health professionals. Each student completes an eLearning and a clinical workshadowing individually before attending the - due to the pandemic - virtual live lectures. To assess quality and usefulness of teaching-learning formats and course structure to learn about interprofessional collaboration and to develop interprofessional competencies and identity, a quantitative and qualitative evaluation was performed with more than 280 medical students and 26 nurse educators from teaching hospitals using online surveys (open & closed-ended format). Data were analyzed descriptively and using content analysis processes. Students appreciated the flipped-classroom concept, the real-world case-based learning scenarios with interprofessional lecturer teams, and the possibility of an experience-based learning opportunity in the clinical setting including interaction with students and professionals from other health professions. Interprofessional identity did not change during the course. Evaluation data showed that the course is a promising approach for teaching-learning interprofessional competencies to medical students. The evaluation revealed three factors that determined the success of this course, namely, a flipped-classroom concept, the individual workshadowing of medical students with another health professional, mainly nurses, and live sessions with interprofessional teaching-learning teams. The course structure and teaching-learning methods showed potential and could serve as a template for interprofessional course development in other institutions and on other course topics.
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Affiliation(s)
- Anita V. Thomae
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - Lotte Verweij
- Institute for Implementation Science in Health Care, University of Zurich, Switzerland & Centre of Clinical Nursing Science, University Hospital Zurich, Zurich, Switzerland
| | - Claudia M. Witt
- Institute for Complementary and Integrative Medicine, University Hospital Zurich and University of Zurich, Zurich, Switzerland
| | - David Blum
- Competence Center Palliative Care, Department of Radiooncology, University Hospital Zurich, Zurich, Switzerland
| | - Emanuel Feusi
- Institute of Public Health, School of Health Sciences, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland
| | - André Fringer
- Institute of Nursing, School of Health Sciences, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Marion Huber
- Institute of Public Health, School of Health Sciences, ZHAW Zurich University of Applied Sciences, Winterthur, Switzerland
| | - Melanie Roos
- Faculty of Medicine, Student Affairs, Curricula Development, University of Zurich, Zurich, Switzerland
| | - Jasmin Anita Lal
- Faculty of Medicine, Student Affairs, Curricula Development, University of Zurich, Zurich, Switzerland
| | - Rahel Naef
- Institute for Implementation Science in Health Care, University of Zurich, Switzerland & Centre of Clinical Nursing Science, University Hospital Zurich, Zurich, Switzerland
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Bergmans E, Billington A, Thies KC. From tradition to innovation: a comparison of the traditional 4-step approach versus a blended learning modification for technical skills teaching. Scand J Trauma Resusc Emerg Med 2023; 31:80. [PMID: 37964361 PMCID: PMC10644658 DOI: 10.1186/s13049-023-01127-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 10/08/2023] [Indexed: 11/16/2023] Open
Abstract
BACKGROUND This experimental study was performed to evaluate the role of blended learning for technical skill teaching on the European Trauma Course (ETC). While online modules are extensively used for theoretical teaching, their role in skills training remains less well explored. The ETC currently relies on the established 4-step technique for teaching technical skills. However, the required large cohort of skilled instructors and the time intensity prove increasingly challenging in a current climate of staff shortages and funding constraints. This study assesses if blended learning, combining pre-course online elements with face-to-face training matches the effectiveness of the traditional 4-step approach whilst being more time-efficient. METHODS In a randomised, multi-centre trial, the conventional face-to-face 4-step technique for teaching a skill of medium complexity, the application of a pelvic binder, was compared with an innovative blended approach. It was hypothesised that the blended approach was non-inferior for skill performance measured after the teaching session and after two days (skill retention) with the time needed for teaching and student/teacher satisfaction as secondary outcomes. RESULTS Ninety participants, divided into 44 traditional and 46 blended method students, were analysed. Independent-samples t-test showed no significant difference in performance scores and non-inferiority of the blended approach with a half of one standard deviation margin. A statistically significant difference in mean retention scores favored the blended approach. A Mann-Whitney U Test revealed no significant difference in candidate satisfaction levels but a statistically significant difference in instructors' satisfaction levels in favour of the blended approach. Analysis with Welch' t-test demonstrated that the face-to-face teaching time needed for the blended approach was significantly shorter (by 6 min). CONCLUSIONS The integration of a blended approach with the 4-step technique for teaching pelvic binder application in the ETC streamlined teaching without compromising skill acquisition quality. This innovative approach addresses traditional limitations and shows promise in adapting medical education to modern learning and teaching demands. We suggest that blended learning could also be applied for other skills taught on life support courses. TRIAL REGISTRATION University of Dundee (Schools of Medicine and Life sciences Research Ethics Committee, REC number 22/59, 28th June 2022).
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Affiliation(s)
- Elonka Bergmans
- Klinik für Anästhesiologie, Intensiv-, Notfallmedizin, Transfusionsmedizin und Schmerztherapie, Ev. Klinikum Bethel, Universitätsklinikum OWL der Universität Bielefeld, Campus Bielefeld, Bethel, Burgstieg 13, 33617, Bielefeld, Germany.
- Centre for Medical Education, University of Dundee, Nethergate, Dundee, Scotland, UK.
| | - Alistair Billington
- European Trauma Course Organisation, PO Box 452, Market Drayton, TF9 9FB, UK
| | - Karl-Christian Thies
- Klinik für Anästhesiologie, Intensiv-, Notfallmedizin, Transfusionsmedizin und Schmerztherapie, Ev. Klinikum Bethel, Universitätsklinikum OWL der Universität Bielefeld, Campus Bielefeld, Bethel, Burgstieg 13, 33617, Bielefeld, Germany
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Chang CL, Dyess NF, Johnston LC. Simulation in a blended learning curriculum for neonatology. Semin Perinatol 2023; 47:151824. [PMID: 37748941 DOI: 10.1016/j.semperi.2023.151824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/27/2023]
Abstract
Blended learning is a learner-centered educational method that combines online and traditional face-to-face educational strategies. Simulation is a commonly utilized platform for experiential learning and an ideal component of a blended learning curriculum. This section describes blended learning, including its strengths and limitations, educational frameworks, uses within health professions education, best practices, and challenges. Also included is a brief introduction to simulation-based education, along with theoretical and real-world examples of how simulation may be integrated into a blended learning curriculum. Examples of blended learning in Neonatal-Perinatal Medicine, specifically within the Neonatal Resuscitation Program, procedural skills training, and the National Neonatology Curriculum, are reviewed.
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Affiliation(s)
- Catherine L Chang
- Department of Pediatrics, Weill Cornell Medicine, New York, NY, United States
| | - Nicolle Fernández Dyess
- Department of Pediatrics, University of Colorado School of Medicine, Aurora, CO, United States
| | - Lindsay C Johnston
- Department of Pediatrics, Yale University School of Medicine, New Haven, CT, United States.
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Domínguez LC, Mora CM, Restrepo JA. "Learning to learn" in the Extended Inverted Classroom: An evaluation of the effects of interactive teaching on knowledge and cognitive regulation in medical students. REVISTA COLOMBIANA DE PSIQUIATRIA (ENGLISH ED.) 2023; 52:314-319. [PMID: 38008674 DOI: 10.1016/j.rcpeng.2021.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Accepted: 07/05/2021] [Indexed: 11/28/2023]
Abstract
INTRODUCTION The evidence regarding the effects of the Inverted Classroom on students' metacognitive skills is limited. This study evaluates these effects on student perceptions about knowledge and cognitive regulation during a surgical course. METHODS We measured student perceptions before and after a conventional Inverted Classroom in surgery using the Metacognitive Awareness Inventory. We evaluated the mean differences between the scores of the two measurements using Student's t-test (p < 0.05), and the size of the effect on knowledge and cognitive regulation using Cohen's d test (95%CI). RESULTS A total of 158 students (pre-intervention) and 155 students (post-intervention) were included in the analysis. Significant differences were found (p < 0.05) in, as well as positive effects on, the students' abilities to know their own learning (declarative knowledge) (d = 0.24; 95%CI, 0.02-0.47), to use learning strategies (procedural knowledge) (d = 0.19; 95%CI, -0.02 to 0.41) and to understand when and why to use these strategies (conditional knowledge) (d = 0.20; 95%CI, -0.01 to 0.42), in addition to the abilities to plan (d = 0.31; 95%CI, 0.09-0.53) and to evaluate their learning (d = 0.31; 95%CI, 0.08-0.53). CONCLUSIONS The Inverted Classroom has positive effects on metacognitive skills according to students' perceptions. Further studies are required that compare these effects with other methodologies for teaching in the classroom and the workplace.
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Mostafa I, Kakarougkas A. Blended/flipped biology classes during COVID-19. BIOCHEMISTRY AND MOLECULAR BIOLOGY EDUCATION : A BIMONTHLY PUBLICATION OF THE INTERNATIONAL UNION OF BIOCHEMISTRY AND MOLECULAR BIOLOGY 2023; 51:540-547. [PMID: 37283272 DOI: 10.1002/bmb.21753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Revised: 04/23/2023] [Accepted: 05/18/2023] [Indexed: 06/08/2023]
Abstract
Higher education has been significantly affected by the COVID-19 pandemic, disrupting universities worldwide. Unexpectedly, the global academic community was forced to transition to remote and online learning. In many cases, fragilities in the systems of the higher education institutions were exposed, pointing to the need for investment in developing more digital solutions, infrastructure, and teaching modalities. In the post-COVID-19 era, the development and adoption of robust pedagogical modalities is crucial to provide the education systems with effective strategies for designing high-quality courses. Since 2008, MOOCs have been widely used to support billions of students worldwide with flexible, accessible, and high-quality learning experiences. This study attempts to investigate the effectiveness of adopting the MOOC-based flipped approach. We present findings and lessons learned from adopting this approach in two different biology classes using the MITx online materials. Findings on students' preparedness, students' performance, MOOCs integration evaluation, and during-pandemic approach assessment are also explained. In general, the results indicated that students favored the overall experience and the implemented approach. Since the online learning is currently at an evolving stage in Egypt, we believe this study's results might be beneficial for policymakers and Egyptian education institutions in designing strategies to improve the education process.
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Affiliation(s)
- Iman Mostafa
- Department of Biology, School of Sciences and Engineering, The American University in Cairo, Cairo, Egypt
| | - Andreas Kakarougkas
- Department of Biology, School of Sciences and Engineering, The American University in Cairo, Cairo, Egypt
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Yao J, Yuan H, Zhu M, Wang J, Wang Q, Chen Z, Chen Y, Zhang X. Nursing student learning of evidence-based nursing through case-based learning and flipped learning: A mixed study. Nurs Open 2023; 10:6551-6558. [PMID: 37394713 PMCID: PMC10416045 DOI: 10.1002/nop2.1910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2022] [Revised: 05/02/2023] [Accepted: 06/05/2023] [Indexed: 07/04/2023] Open
Abstract
AIM To evaluate a teaching experience in evidence-based nursing learning through case-based learning (CBL) and flipped learning (FL). DESIGN Embedded mixed methods study. METHODS In the first phase, a questionnaire on utility, satisfaction and perceived competency development is used to collect quantitative data, and the open question instrument is used to collect qualitative data. After the first phase, an in-depth semi-structured interview is used. RESULTS Five themes are identified: the enhancement of learning content, knowledge integration and transfer, the development of teamwork competency, the didactic support of FL and the difficulties and challenges faced by students. Regarding utility, 'combine theory and practice' and 'select the best evidence from what is found in the search' have the highest values. The most developed skills are communication and critical thinking ability. Finally, most participants are satisfied. CONCLUSIONS The combination of CBL and FL is an innovative strategy for learning evidence-based nursing courses. No Patient or Public Contribution.
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Affiliation(s)
- Jiannan Yao
- Department of Fundamental Nursing, School of NursingJilin UniversityChangchunChina
- The First Affiliated Hospital of the China Medical UniversityShenyangChina
| | - Hua Yuan
- Department of Fundamental Nursing, School of NursingJilin UniversityChangchunChina
| | - Mingyue Zhu
- Department of Fundamental Nursing, School of NursingJilin UniversityChangchunChina
| | - Jia Wang
- Department of Fundamental Nursing, School of NursingJilin UniversityChangchunChina
| | - Qiuchen Wang
- Department of Fundamental Nursing, School of NursingJilin UniversityChangchunChina
| | - Zhiming Chen
- Department of Fundamental Nursing, School of NursingJilin UniversityChangchunChina
| | - Yahong Chen
- China‐Japan Union Hospital of Jilin UniversityChangchunChina
| | - Xiuying Zhang
- Department of Fundamental Nursing, School of NursingJilin UniversityChangchunChina
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Salmon MK, Triantafillou V, Frost AS, Maina IW, Kearney JJ, Ruckenstein MJ, Chao TN. Flipping the Otolaryngology Didactics Curriculum: Results of a Novel Resident Course Structure. Laryngoscope 2023; 133:2129-2134. [PMID: 36478209 DOI: 10.1002/lary.30503] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Revised: 09/29/2022] [Accepted: 11/07/2022] [Indexed: 12/12/2022]
Abstract
OBJECTIVE To assess the impact of a novel flipped-classroom (FC) otolaryngology resident didactic curriculum on resident learning. METHODS Based on the preferences elicited in a survey of preferred learning styles of residents, a hybrid web-based and in-person FC otolaryngology didactic curriculum was implemented over a 6-month period in 2020-2021. Resident reactions to the new curriculum were assessed via a second survey. Kruskal Wallis tests were used to compare mean stanine scores on the Otolaryngology Training Examination (OTE) exam for topics taught in the new format with topics delivered in the old format. RESULTS After instituting the curriculum reform, engagement in at least a moderate amount of the pre-didactic work and synchronous case discussions was reported by 67% and 88% of the residents, respectively. After the curriculum change, residents in years PGY2 and above reported statistically significant increases in self-reported ability to retain information from didactics, to feel prepared for the OTE, and to feel confident in fund of knowledge (p < 0.001, p = 0.004, and p = 0.004, respectively). Compared to the prior year, mean stanine increased on OTE scores for residents in years PGY2-PGY5 to a statistically significant degree (5.45 vs. 4.41, p = 0.001) for the topics delivered in the new format compared to topics delivered in the traditional format (5.13 vs. 4.70, p = 0.07). CONCLUSION By organizing a didactic curriculum through online modules that incorporate pre-recorded lectures and external resources, residents reported and demonstrated improved knowledge retention. LEVEL OF EVIDENCE NA Laryngoscope, 133:2129-2134, 2023.
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Affiliation(s)
- Mandy K Salmon
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Vasiliki Triantafillou
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Ariel S Frost
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Ivy W Maina
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - James J Kearney
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Michael J Ruckenstein
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Tiffany N Chao
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Naing C, Whittaker MA, Aung HH, Chellappan DK, Riegelman A. The effects of flipped classrooms to improve learning outcomes in undergraduate health professional education: A systematic review. CAMPBELL SYSTEMATIC REVIEWS 2023; 19:e1339. [PMID: 37425620 PMCID: PMC10326838 DOI: 10.1002/cl2.1339] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
Background The 'flipped classroom' approach is an innovative approach in educational delivery systems. In a typical flipped class model, work that is typically done as homework in the didactic model is interactively undertaken in the class with the guidance of the teacher, whereas listening to a lecture or watching course-related videos is undertaken at home. The essence of a flipped classroom is that the activities carried out during traditional class time and self-study time are reversed or 'flipped'. Objectives The primary objectives of this review were to assess the effectiveness of the flipped classroom intervention for undergraduate health professional students on their academic performance, and their course satisfaction. Search Methods We identified relevant studies by searching MEDLINE (Ovid), APA PsycINFO, Education Resources Information Center (ERIC) as well as several more electronic databases, registries, search engines, websites, and online directories. The last search update was performed in April 2022. Selection Criteria Included studies had to meet the following criteria: Participants: Undergraduate health professional students, regardless of the type of healthcare streams (e.g., medicine, pharmacy), duration of the learning activity, or the country of study. Intervention: We included any educational intervention that included the flipped classroom as a teaching and learning tool in undergraduate programs, regardless of the type of healthcare streams (e.g., medicine, pharmacy). We also included studies that aimed to improve student learning and/or student satisfaction if they included the flipped classroom for undergraduate students. We excluded studies on standard lectures and subsequent tutorial formats. We also excluded studies on flipped classroom methods, which did not belong to the health professional education(HPE) sector (e.g., engineering, economics). Outcomes: The included studies used primary outcomes such as academic performance as judged by final examination grades/scores or other formal assessment methods at the immediate post-test, as well as student satisfaction with the method of learning. Study design: We included randomised controlled trials (RCTs), quasi-experimental studies (QES), and two-group comparison designs. Although we had planned to include cluster-level RCTs, natural experiments, and regression discontinuity designs, these were not available. We did not include qualitative research. Data Collection and Analysis Two members of the review team independently screened the search results to assess articles for their eligibility for inclusion. The screening involved an initial screening of the title and abstracts, and subsequently, the full text of selected articles. Discrepancies between the two investigators were settled through discussion or consultation with a third author. Two members of the review team then extracted the descriptions and data from the included studies. Main Results We found 5873 potentially relevant records, of which we screened 118 of them in full text, and included 45 studies (11 RCTs, 19 QES, and 15 two-group observational studies) that met the inclusion criteria. Some studies assessed more than one outcome. We included 44 studies on academic performance and eight studies on students' satisfaction outcomes in the meta-analysis. The main reasons for excluding studies were that they had not implemented a flipped class approach or the participants were not undergraduate students in health professional education. A total of 8426 undergraduate students were included in 45 studies that were identified for this analysis. The majority of the studies were conducted by students from medical schools (53.3%, 24/45), nursing schools (17.8%, 8/45), pharmacy schools (15.6%, 7/45). medical, nursing, and dentistry schools (2.2%, 1/45), and other health professional education programs (11.1%, 5/45). Among these 45 studies identified, 16 (35.6%) were conducted in the United States, six studies in China, four studies in Taiwan, three in India, two studies each in Australia and Canada, followed by nine single studies from Brazil, German, Iran, Norway, South Korea, Spain, the United Kingdom, Saudi Arabia, and Turkey. Based on overall average effect sizes, there was better academic performance in the flipped class method of learning compared to traditional class learning (standardised mean difference [SMD] = 0.57, 95% confidence interval [CI] = 0.25 to 0.90, τ 2: 1.16; I 2: 98%; p < 0.00001, 44 studies, n = 7813). In a sensitivity analysis that excluded eleven studies with imputed data from the original analysis of 44 studies, academic performance in the flipped class method of learning was better than traditional class learning (SMD = 0.54, 95% CI = 0.24 to 0.85, τ 2: 0.76; I 2: 97%; p < 0.00001, 33 studies, n = 5924); all being low certainty of evidence. Overall, student satisfaction with flipped class learning was positive compared to traditional class learning (SMD = 0.48, 95% CI = 0.15 to 0.82, τ 2: 0.19, I 2:89%, p < 0.00001, 8 studies n = 1696); all being low certainty of evidence. Authors' Conclusions In this review, we aimed to find evidence of the flipped classroom intervention's effectiveness for undergraduate health professional students. We found only a few RCTs, and the risk of bias in the included non-randomised studies was high. Overall, implementing flipped classes may improve academic performance, and may support student satisfaction in undergraduate health professional programs. However, the certainty of evidence was low for both academic performance and students' satisfaction with the flipped method of learning compared to the traditional class learning. Future well-designed sufficiently powered RCTs with low risk of bias that report according to the CONSORT guidelines are needed.
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Affiliation(s)
- Cho Naing
- Division of Tropical Health and MedicineJames Cook UniversityTownsvilleAustralia
| | - Maxine A. Whittaker
- Division of Tropical Health and MedicineJames Cook UniversityTownsvilleAustralia
| | - Htar Htar Aung
- Department of Human Biology, School of MedicineInternational Medical UniversityKuala LumpurMalaysia
| | - Dinesh Kumar Chellappan
- Department of Life Sciences, School of PharmacyInternational Medical UniversityKuala LumpurMalaysia
| | - Amy Riegelman
- University LibrariesUniversity of MinnesotaMinneapolisMinnesotaUSA
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Enoch LC, Abraham RM, Singaram VS. Factors That Enhance and Hinder the Retention and Transfer of Online Pre-Clinical Skills Training to Facilitate Blended Learning. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2023; 14:919-936. [PMID: 37645657 PMCID: PMC10461612 DOI: 10.2147/amep.s398376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 02/18/2023] [Indexed: 08/31/2023]
Abstract
Purpose During the SARS-CoV-2 pandemic, various online instructional strategies in clinical skills training were piloted. The sudden transition to the remote platform circumvented the rigorous planning associated with curriculum reform. This study aimed to explore students' and tutors' perceptions of factors that promoted or hindered successful learning transfer and to propose a blended conceptual model to guide affective, cognitive, and psychomotor clinical skills training in the pre-clinical phase of medical education. Methods A mixed-method quasi-experimental study assessed third-year students' transfer of clinical skills and knowledge following online learning in 2021. Students and their tutors completed online surveys that included open and closed-ended questions regarding factors influencing their experience of the adapted teaching methods. Descriptive statistical analysis was used for the quantitative data. Qualitative responses were thematically analyzed. Results One hundred fourteen students (48%) and seven tutors (100%) responded to the surveys. The questionnaires' internal consistency and construct validity were determined using Cronbach's α-Coefficient. There was an overall positive response (86%) to the acceptability of the online platform in clinical skills training. Using online simulations with targeted onsite practice was reported as effective in clinical skills training. Tutors perceived students as well-prepared for the skills laboratory. Five emergent themes, qualified by a linear model of asynchronous and synchronous online and onsite teaching with the evaluation of the instructional design and institutional support, informed the proposed blended learning guide for clinical skills training in the pre-clinical phase. Conclusion Blended clinical skills learning that included the flipped classroom concept was well-accepted. Virtual patients proved a convenient cognitive preparation tool for skills training and potentially optimized teaching delivery. The study found that the adapted teaching frameworks incorporating an online clinical skills component into a modified onsite curriculum augmented learners' ability to transfer knowledge to the clinical skills laboratory. An integrated five-step blended model is proposed for future interventions.
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Affiliation(s)
- L C Enoch
- School of Clinical Medicine, Clinical and Professional Practice, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - R M Abraham
- School of Clinical Medicine, Clinical and Professional Practice, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - V S Singaram
- School of Clinical Medicine, Clinical and Professional Practice, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
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Lupan-Mureșan EM, Bonsano M. Young Emergency Medicine Doctors refresher course: a decade of education to harmonize emergency medicine training in Europe. Eur J Emerg Med 2023; 30:227-228. [PMID: 37115980 DOI: 10.1097/mej.0000000000001038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Affiliation(s)
- Eugenia Maria Lupan-Mureșan
- Young Emergency Medicine Doctors of EUSEM, Antwerp, Belgium
- Emergency Medicine Discipline, 'Iuliu Hatieganu' University of Medicine and Pharmacy Cluj-Napoca, Cluj-Napoca, Romania
| | - Marco Bonsano
- Pre-Hospital Emergency Medicine, East Anglian Air Ambulance (EAAA), UK
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Inamochi Y, Kohno EY, Wada J, Murakami N, Takaichi A, Arai Y, Ueno T, Fueki K, Wakabayashi N. Knowledge acquisition efficacy of a remote flipped classroom on learning about removable partial dentures. J Prosthodont Res 2023; 67:444-449. [PMID: 36418083 DOI: 10.2186/jpr.jpr_d_22_00147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/01/2023]
Abstract
PURPOSE Coronavirus disease 2019 has forced the use of remote education worldwide. In 2020, the authors conducted a fully digitized, remote flipped (RF) classroom focusing on removable partial dentures. This study aimed to evaluate the learning outcomes of the RF classroom and compare these with those of the on-site classroom. METHODS The fourth-year dental students in 2017-2019 attended on-site flipped classroom (OF; n=70) or on-site lecture classroom (OL; n=67), and those in 2020 (n=58) attended the RF classroom. Lecture videos and text were provided online in the OF and RF groups, while only the text was given to the OL group. Individual and group tests were conducted to assess knowledge acquisition one week after all the classes ended. A one-way analysis of variance following Tukey's test was performed to compare individual/group test scores among the OF, OL, and RF groups. Multilevel linear regression analysis was performed to identify the factors associated with an increase in each test score. RESULTS The mean individual test scores in the RF and OF groups were significantly higher than in the OL group (P<0.01). The mean group test score in the RF group was significantly higher than in the OF and OL groups (P<0.001). The multilevel analysis identified remote and flipped classroom styles in the individual test, and the remote style in the group test, as significant effective factors in learning (P<0.05). CONCLUSIONS These results suggest that the RF classroom is more effective than the on-site lecture in knowledge acquisition in undergraduate prosthodontic education.
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Affiliation(s)
- Yuka Inamochi
- Department of Masticatory Function and Health Science, Graduate School, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Eiko Yoshida Kohno
- Institute of Research, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Junichiro Wada
- Department of Advanced Prosthodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Natsuko Murakami
- Department of Advanced Prosthodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Atsushi Takaichi
- Department of Advanced Prosthodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Yuki Arai
- Department of Advanced Prosthodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
- Department of Orthodontics, University of Texas Health Science Center at Houston School of Dentistry, Houston, TX, United States
| | - Takeshi Ueno
- Department of Advanced Prosthodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Kenji Fueki
- Department of Masticatory Function and Health Science, Graduate School, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
| | - Noriyuki Wakabayashi
- Department of Advanced Prosthodontics, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University (TMDU), Tokyo, Japan
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Sierra-Fernández CR, Alejandra HD, Trevethan-Cravioto SA, Azar-Manzur FJ, Mauricio LM, Garnica-Geronimo LR. Flipped learning as an educational model in a cardiology residency program. BMC MEDICAL EDUCATION 2023; 23:510. [PMID: 37460995 DOI: 10.1186/s12909-023-04439-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 06/10/2023] [Indexed: 07/20/2023]
Abstract
INTRODUCTION Flipped learning (FL) is a model which allows students to adjust their study rhythm by taking advantage of class time to apply their knowledge. Although FL meets many of the needs of the traditional lecture-based model and the exclusively virtual model, its effectiveness in medical residency programs has not been thoroughly studied. Our study evaluates the efficacy of an FL model in a cardiology residency program based on the satisfaction and academic performance of the participants. METHOD A prospective, observational, and descriptive study was conducted at Ignacio Chávez National Institute of Cardiology in Mexico City to evaluate the satisfaction and effectiveness of an FL model for acquiring competencies in electrocardiographic diagnosis among thirty-one first-year cardiology residents. The Advanced Electrocardiography Workshop and a virtual classroom were designed for the intervention. Four teachers taught the workshop and video classes, and ten medical specialists from the participants' areas of work performed evaluations of practical skills before and after the intervention. RESULTS 75% of the participants rated the intervention as very favorable compared to the traditional and virtual models. The main advantages offered by the FL model were identified. An improvement of high statistical significance was observed in participants' academic performance after the intervention (P value < 0.001). CONCLUSION The FL model has a high degree of acceptance among participants and teachers. Our study shows an improvement in academic performance after the intervention. Considering that the FL model is flexible and reproducible in other areas of medicine, it represents an excellent educational alternative that meets current needs.
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Akhouri S, Virani A, Minor S, Samuels MN, Stumbar SE. Student Teaching in the Family Medicine Clerkship: Opportunities for Interactive Virtual Learning. South Med J 2023; 116:542-544. [PMID: 37400099 DOI: 10.14423/smj.0000000000001574] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/05/2023]
Abstract
OBJECTIVES It often is challenging to deliver clerkship didactic sessions in a time-effective and engaging manner for learners. The flipped classroom approach, which fosters independent learning before applying knowledge in group settings, is an evidence-based way to enhance engagement and learning. Electronic learning methodologies were used widely during the coronavirus disease 2019 pandemic to ensure student safety while continuing didactics remotely. Student teaching of didactics delivers key content in innovative ways while also providing students with the opportunity to teach their peers. METHODS During the Family Medicine clerkship at Florida International University Herbert Wertheim College of Medicine, students deliver an interactive, 15-minute presentation on a core Society of Teachers of Family Medicine National Clerkship Curriculum topic. During the first year of the pandemic (2020), this assignment was transitioned to be conducted remotely via Zoom. For the 2020-2021 academic year, students completed an anonymous, optional, computer-based, postactivity survey to assess their satisfaction with and perceptions of the assignment. RESULTS The majority (80%) of respondents reported that they enjoyed teaching in the online format. In addition, students reported that this assignment made them feel confident in their teaching abilities, that they learned from their peers, and that teaching helped clarify their understanding of the topic. CONCLUSIONS Student-led teaching is beneficial to learners because it enhances engagement. It can be easily implemented and help reduce faculty burden for curricular development. In a distributed, community-based clinical model such as ours, electronic learning allows for coordinated teaching efforts across geographical boundaries.
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Affiliation(s)
- Shweta Akhouri
- From the Department of Humanities, Health and Society, Florida International University Herbert Wertheim College of Medicine, Miami
| | - Anna Virani
- From the Department of Humanities, Health and Society, Florida International University Herbert Wertheim College of Medicine, Miami
| | - Suzanne Minor
- From the Department of Humanities, Health and Society, Florida International University Herbert Wertheim College of Medicine, Miami
| | - Marquita N Samuels
- From the Department of Humanities, Health and Society, Florida International University Herbert Wertheim College of Medicine, Miami
| | - Sarah E Stumbar
- From the Department of Humanities, Health and Society, Florida International University Herbert Wertheim College of Medicine, Miami
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Van Haute M, Monzon JD. Examination performance with flipped classroom as instructional strategy in the carbohydrate metabolism course unit at a Philippine medical school: Estimation of average treatment effect from observational data. BIOCHEMISTRY AND MOLECULAR BIOLOGY EDUCATION : A BIMONTHLY PUBLICATION OF THE INTERNATIONAL UNION OF BIOCHEMISTRY AND MOLECULAR BIOLOGY 2023; 51:428-438. [PMID: 37148496 DOI: 10.1002/bmb.21740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 04/03/2023] [Accepted: 04/18/2023] [Indexed: 05/08/2023]
Abstract
While the innovativeness of the flipped classroom (FC) approach promotes active participation and higher-order thinking among students, there are concerns about its effectiveness in terms of knowledge retention. Currently, there are no studies involving medical school biochemistry that evaluate this aspect of effectiveness. Thus, we conducted a historical control study that analyzed observational data from two freshman batches of the Doctor of Medicine program in our institution. Class 2021 (n = 250) served as the traditional lecture (TL) group while Class 2022 (n = 264) served as the FC group. Data on relevant observed covariates (age, sex, National Medical Admission Test or NMAT score, undergraduate degree) and the outcome variable (carbohydrate metabolism course unit examination percentage scores, as indicator of knowledge retention) were included in the analysis. Propensity scores were calculated using logit regression conditional on these observed covariates. Afterwards, 1:1 nearest-neighbor propensity score matching (PSM) was performed to produce an estimated average treatment effect (ATE) measure afforded by FC (as adjusted mean difference in examination scores between the two batches), balancing on the covariates. Nearest-neighbor matching using the calculated propensity scores effectively balanced the two groups (standardized bias <10%), producing 250 matched student-pairs that received either TL or FC. Following PSM, the FC group was found to have a significantly higher adjusted mean examination score compared to the TL group (adjusted mean difference = 5.62%, 95% CI: 2.54%, 8.72%; p < 0.001). Using this approach, we were able to demonstrate benefit of FC over TL in terms of knowledge retention, as reflected by the estimated ATE.
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Affiliation(s)
- Michael Van Haute
- Department of Biochemistry, De La Salle Medical and Health Sciences Institute-College of Medicine, Dasmariñas, Philippines
| | - Jan David Monzon
- Department of Biochemistry, De La Salle Medical and Health Sciences Institute-College of Medicine, Dasmariñas, Philippines
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Ruzafa-Martínez M, Molina-Rodríguez A, Pérez-Muñoz V, Leal-Costa C, Ramos-Morcillo AJ. Effectiveness of the flipped classroom methodology on the learning of evidence-based practice of nursing students: Quasi-experimental design. NURSE EDUCATION TODAY 2023; 128:105878. [PMID: 37352765 DOI: 10.1016/j.nedt.2023.105878] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Revised: 04/24/2023] [Accepted: 06/12/2023] [Indexed: 06/25/2023]
Abstract
BACKGROUND International organizations recognize the importance of evidence-based practice (EBP) for nurses. The objective of teaching EBP in the Nursing degree is to train future nurses on this subject. Different teaching models exist for this, from less active traditional models to more active ones such as the flipped classroom. OBJECTIVE To compare the degree of EBP competence of undergraduate nursing students after an EBP course, through the application of a traditional methodology versus a flipped classroom methodology. DESIGN Quasi-experimental study of non-equivalent groups. SETTING The study was composed by a group of students who received training on EBP with the traditional model (face-to-face), and another intervention group with whom the flipped classroom model was utilized, using the online teaching platform EBP-eToolkit. PARTICIPANTS The study was conducted with 4th-year Nursing degree students enrolled in the course evidence-based practice, in academic years 2019/20 and 2021/2022. METHODS Before and after the course, the students completed a questionnaire about EBP competence (EBP-COQ), and an objective test was given at the end of the year. RESULTS A sample of 152 students in the face-to-face group (control), and 143 students in the flipped classroom group (intervention) participated. The intervention group significantly improved its competence on attitude (p = 0.01, η2 = 0.022), skills (p = 0.019, η2 = 0.018), and global competence in EBP (p = 0.003, η2 = 0.030), with respect to those who were taught using the traditional method. However, there were no significant differences in the impact on knowledge, neither through the self-report dimension of the EBP-COQ (p = 0.188) nor the final test score, control group 6.89 (SD: 1.35) and flipped classroom group 7.12 (SD: 1.53) (p = 0.206). CONCLUSIONS The flipped classroom model is adequate for the teaching of EBP to undergraduate nursing students. It produced a slight increase in attitude, as well as in skills and global competence in EBP. Nevertheless, this increase was not significantly different from face-to-face learning in terms of impact on EBP knowledge.
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Affiliation(s)
| | | | - Verónica Pérez-Muñoz
- University of Murcia, Department of Sociosanitary Care, Faculty of Social and Health Sciences, Spain.
| | - César Leal-Costa
- Department of Nursing, Faculty of Nursing, University of Murcia, Spain.
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Hashim MJ, Govender R, Ghenimi N, Kieu A, Khan MAB. LecturePlus: a learner-centered teaching method to promote deep learning. ADVANCES IN PHYSIOLOGY EDUCATION 2023; 47:175-180. [PMID: 36759147 DOI: 10.1152/advan.00237.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 02/07/2023] [Accepted: 02/07/2023] [Indexed: 06/18/2023]
Abstract
A new teaching format, the LecturePlus, was formulated as a lecture followed by small-group learning activities. This study assessed the effectiveness of LecturePlus in medical education. An interventional study was conducted among final-year medical students, with 74 students in the experimental group and 96 students in the control group. Each LecturePlus lasted ∼1 h and was conducted with 12-18 students. A LecturePlus session comprised of a lecture followed by small-group problem-solving exercises. The exercises were clinical cases with open-ended short-answer questions. Students were divided into groups of three (triads) for these exercises. A faculty tutor assisted the small groups as needed. Closure was achieved through a discussion moderated by the tutor. Learning outcomes were assessed via the National Board of Medical Examiners (NBME) subject scores and compared with those of the preceding academic year. An additional multiple-choice question (MCQ) test was administered before and after the clerkship. The MCQ test showed improvement in knowledge application (P < 0.001, partial eta squared = 0.42). There was a statistically significant improvement in adjusted NBME scores among female students (74.8 vs. 71.8; P = 0.017) but not among male students. An anonymous written questionnaire survey showed high ratings for LecturePlus (95% selecting yes or partly yes to overall satisfaction). LecturePlus is an instructional strategy that integrates a lecture with learning activities. It can be scaled to large class sizes facilitated by one teacher. By combining didactic teaching with problem-solving, this new instructional strategy may foster application of knowledge.NEW & NOTEWORTHY We developed a new structured teaching format, the LecturePlus, to promote deep learning. A LecturePlus session consists of a brief lecture, followed by small-group problem-solving exercises, ending with a closing discussion moderated by the teacher. During the small-group exercises, students were divided into groups of three (triads) and given case-based problems. One faculty tutor supervised the entire session. LecturePlus resulted in improved learning outcomes and was rated highly by medical students.
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Affiliation(s)
- Muhammad Jawad Hashim
- Department of Family Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Romona Govender
- Department of Family Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Nadirah Ghenimi
- Department of Family Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Alexander Kieu
- Department of Family Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
| | - Moien A B Khan
- Department of Family Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, United Arab Emirates
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Fischer K, Sullivan AM, Cohen AP, King RW, Cockrill BA, Besche HC. Using cognitive load theory to evaluate and improve preparatory materials and study time for the flipped classroom. BMC MEDICAL EDUCATION 2023; 23:345. [PMID: 37198639 DOI: 10.1186/s12909-023-04325-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Accepted: 05/05/2023] [Indexed: 05/19/2023]
Abstract
BACKGROUND Preclinical medical education is content-dense and time-constrained. Flipped classroom approaches promote durable learning, but challenges with unsatisfactory student preparation and high workload remain. Cognitive load theory defines instructional design as "efficient" if learners can master the presented concepts without cognitive overload. We created a PReparatory Evaluation Process (PREP) to systematically assess and measure improvement in the cognitive-load efficiency of preparatory materials and impact on study time (time-efficiency). METHODS We conducted this study in a flipped, multidisciplinary course for ~ 170 first year students at Harvard Medical School using a naturalistic post-test design. For each flipped session (n = 97), we assessed cognitive load and preparatory study time by administering a 3-item PREP survey embedded within a short subject-matter quiz students completed before class. Over three years (2017-2019), we evaluated cognitive load- and time- based efficiency to guide iterative revisions of the materials by content experts. The ability of PREP to detect changes to the instructional design (sensitivity) was validated through a manual audit of the materials. RESULTS The average survey response rate was ≥ 94%. Content expertise was not required to interpret PREP data. Initially students did not necessarily allocate the most study time to the most difficult content. Over time, the iterative changes in instructional design increased the cognitive load- and time-based efficiency of preparatory materials with large effect sizes (p < .01). Furthermore, this increased the overall alignment of cognitive load with study time: students allocated more time to difficult content away from more familiar, less difficult content without increasing workload overall. CONCLUSIONS Cognitive load and time constraints are important parameters to consider when designing curricula. The PREP process is learner-centered, grounded in educational theory, and works independently of content knowledge. It can provide rich and actionable insights into instructional design of flipped classes not captured by traditional satisfaction-based evaluations.
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Affiliation(s)
- Krisztina Fischer
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Amy M Sullivan
- Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA
| | - Amy P Cohen
- Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Randall W King
- Department of Cell Biology, Harvard Medical School, Boston, Massachusetts, USA
| | - Barbara A Cockrill
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Henrike C Besche
- Program in Medical Education, Harvard Medical School, Boston, Massachusetts, USA.
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Chen LYC, Quach TTT, Dayan R, Giustini D, Teunissen PW. Academic half days, noon conferences and classroom-based education in postgraduate medical education: a scoping review. CMAJ Open 2023; 11:E411-E425. [PMID: 37160324 PMCID: PMC10174266 DOI: 10.9778/cmajo.20210203] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/11/2023] Open
Abstract
BACKGROUND Classroom-based education (CBE) is ubiquitous in postgraduate medical education (PGME), but to date no studies have synthesized the literature on the topic. We conducted a scoping review focusing on academic half days and noon conferences. METHODS We searched 4 databases (MEDLINE [OVID], Embase [OVID], ERIC [EBSCO] and Web of Science) from inception to December 2021, performed reference and citation harvesting, and applied predetermined inclusion and exclusion criteria to our screening. We used 2 frameworks for the analysis: "experiences, trajectories and reifications" and "description, justification and clarification." RESULTS We included 90 studies, of which 55 focused on resident experiences, 29 on trajectories and 6 on reification. We classified 44 studies as "description," 38 as "justification" and 8 as "clarification." In the description studies, 12 compared academic half days with noon conferences, 23 described specific teaching topics, and 9 focused on resources needed for CBE. Justification studies examined the effects of CBE on outcomes, such as examination scores (17) and use of teaching strategies in team-based learning, principles of adult learning and e-learning (15). Of the 8 clarification studies, topics included the role of CBE in PGME, stakeholder perspectives and transfer of knowledge between classroom and workplace. INTERPRETATION Much of the existing literature is either a description of various aspects of CBE or justification of particular teaching strategies. Few studies exist on how and why CBE works; future studies should aim to clarify how CBE facilitates resident learning within the sociocultural framework of PGME.
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Affiliation(s)
- Luke Y C Chen
- Centre for Health Education Scholarship (Chen, Quach); Division of Hematology (Chen); Department of Obstetrics and Gynaecology (Dayan); Biomedical Branch Library (Giustini), University of British Columbia, Vancouver, BC; School of Health Professions Education, Faculty of Health Medicine and Life Sciences (Teunissen), Maastricht University; Department of Obstetrics and Gynecology (Teunissen), Maastricht University Medical Centre, Maastricht, Netherlands
| | - Tien T T Quach
- Centre for Health Education Scholarship (Chen, Quach); Division of Hematology (Chen); Department of Obstetrics and Gynaecology (Dayan); Biomedical Branch Library (Giustini), University of British Columbia, Vancouver, BC; School of Health Professions Education, Faculty of Health Medicine and Life Sciences (Teunissen), Maastricht University; Department of Obstetrics and Gynecology (Teunissen), Maastricht University Medical Centre, Maastricht, Netherlands
| | - Riki Dayan
- Centre for Health Education Scholarship (Chen, Quach); Division of Hematology (Chen); Department of Obstetrics and Gynaecology (Dayan); Biomedical Branch Library (Giustini), University of British Columbia, Vancouver, BC; School of Health Professions Education, Faculty of Health Medicine and Life Sciences (Teunissen), Maastricht University; Department of Obstetrics and Gynecology (Teunissen), Maastricht University Medical Centre, Maastricht, Netherlands
| | - Dean Giustini
- Centre for Health Education Scholarship (Chen, Quach); Division of Hematology (Chen); Department of Obstetrics and Gynaecology (Dayan); Biomedical Branch Library (Giustini), University of British Columbia, Vancouver, BC; School of Health Professions Education, Faculty of Health Medicine and Life Sciences (Teunissen), Maastricht University; Department of Obstetrics and Gynecology (Teunissen), Maastricht University Medical Centre, Maastricht, Netherlands
| | - Pim W Teunissen
- Centre for Health Education Scholarship (Chen, Quach); Division of Hematology (Chen); Department of Obstetrics and Gynaecology (Dayan); Biomedical Branch Library (Giustini), University of British Columbia, Vancouver, BC; School of Health Professions Education, Faculty of Health Medicine and Life Sciences (Teunissen), Maastricht University; Department of Obstetrics and Gynecology (Teunissen), Maastricht University Medical Centre, Maastricht, Netherlands
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Tyrrell EG, Knox R, Saha R, Berry K, Taggar JS. Comparison of the effectiveness of exclusively facilitated clinical teaching as an alternative to traditional practice-based primary care placements. EDUCATION FOR PRIMARY CARE 2023; 34:152-160. [PMID: 37278347 DOI: 10.1080/14739879.2023.2217795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 05/17/2023] [Accepted: 05/22/2023] [Indexed: 06/07/2023]
Abstract
INTRODUCTION COVID-19 presented major challenges to undergraduate GP placement capacity and there was an increased reliance on clinical training using facilitated simulation. The authors present a novel comparison of the effectiveness and cost-effectiveness of delivering a one-week primary care course using entirely GP-facilitated clinical teaching outside the GP setting against traditional practice-based GP clinical education. METHODS A one-week GP placement was redeveloped from a traditional teaching model (TT-M) to an exclusively facilitated teaching model (FT-M) delivered outside the GP practice setting, using principles of blended learning, flipped classroom methods, e-learning and simulation. Both teaching models, delivered in different locations during 2022 to pre-clinical students, were evaluated using student feedback surveys for attainment of learning outcomes and course satisfaction. RESULTS The students reported their consultation skills and clinical knowledge (amalgamated mean score 4.36 for FT-M versus 4.63 for TT-M; P = 0.05), as well as preparation for the clinical phases (mean scores 4.35 for FT-M versus 4.41 for TT-M; P = 0.68), were well developed and similar for both courses. Students reported similar enjoyment across both teaching models (FT-M mean score 4.31 versus 4.41 for TT-M; P = 0.49). The costs for delivering teaching per 4-h session for 100 students were £1,379 and £5,551 for FT-M and TT-M, respectively. CONCLUSION Delivery of a one-week primary care attachment to third year medical students using an FT-M was similarly effective and more cost effective than delivering it by a TT-M. FT-M potentially offers an important adjunct to clinical learning and resilience to capacity challenges for GP placements.
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Affiliation(s)
| | - Richard Knox
- School of Medicine, University of Leicester, Leicester, UK
| | - Runa Saha
- Lincoln Medical School, Universities of Nottingham and Lincoln, Lincoln, UK
| | - Kathryn Berry
- Lincoln Medical School, Universities of Nottingham and Lincoln, Lincoln, UK
| | - Jaspal S Taggar
- School of Medicine, University of Nottingham, Nottingham, UK
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He R, Xie Y, Liu F, Zhao L, Zhang O, Xiang W, Kong L, Miao L, Zhang P. Implementing case-based collaborative learning curriculum via webinar in internal medicine residency training: A single-center experience. Medicine (Baltimore) 2023; 102:e33601. [PMID: 37083783 PMCID: PMC10118346 DOI: 10.1097/md.0000000000033601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 04/03/2023] [Indexed: 04/22/2023] Open
Abstract
This study aimed to investigate the effects of the Case-based collaborative learning (CBCL) curriculum in webinar format on internal medicine residents' knowledge covering cardiologic topics and their attitudes toward the CBCL teaching module. CBCL is a novel small-group approach, that incorporates elements of problem-based learning and case-based learning, and it has shown to improve medical students' knowledge mastery. However, few studies have explored its applicability for internal medicine residents, especially in the webinar format. This prospective cohort study included internal medicine residents in a residency program in Beijing, China. Eight CBCL sessions in webinar format covering cardiologic topics were delivered to them from February to April 2020. Pre-session reading materials included textbook and guidelines published by the academic societies. Multiple-choice questions were delivered to assess participants' knowledge before and after the sessions. Changes in participants' knowledge were determined using the paired t test to compare mean values. In addition, surveys based on 5-point Likert scale scores assessed satisfaction at the end of the second and eighth sessions. The Wilcoxon signed-rank test was used to identify any potential satisfaction improvement. In total, 9 internal medicine residents participated in the study, of whom 33.3% were male, and the overall rate of participation in CBCL sessions in webinar format was 94.4%. The mean scores of 50 multiple-choice questions were 68.0 ± 12.3 and 75.1 ± 9.9 in the pre- and post-curriculum assessments (P = .029). In the first survey performed at the second week, 5 (55.6%) residents chose "like" or "extremely like" in overall satisfaction, "neutral" by 3 (33.3%) residents and "dislike" by 1 (11.1%) resident. In the second survey, only 1 (11.1%) resident selected a neutral reply in satisfactory assessment, and the other 8 (88.9%) residents selected either "like" or "extremely like" choices. Compared with the results of the first survey, the overall satisfaction rate significantly improved (P = .031). Implementing the CBCL sessions in webinar format for cardiology residents was resulted in the improved knowledge mastery and a high acceptance rate.
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Affiliation(s)
- Rong He
- Department of Cardiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Ying Xie
- Department of Cardiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Fang Liu
- Department of Cardiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Lanting Zhao
- Department of Cardiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Ou Zhang
- Department of Cardiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Wei Xiang
- Department of Cardiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Lingyun Kong
- Department of Cardiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Le Miao
- Postgraduate Office, School of Clinical Medicine, Tsinghua University, Beijing, China
| | - Ping Zhang
- Department of Cardiology, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, Beijing, China
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