Comparison of the effectiveness of lectures based on problems and traditional lectures in physiology teaching in Sudan

Efficacy of Google Form-based MCQ tests for formative assessment in medical biochemistry education

BACKGROUND

Biochemistry, being a vast and complex subject, can be challenging for Phase I MBBS students to comprehend and retain. Embracing rapidly evolving technology can facilitate a more accessible learning experience. In this study, we investigated the effectiveness of using Google Form-based multiple-choice question (MCQ) tests as a formative assessment tool after each biochemistry lecture series. The aim was to assess the improvement and gather feedback of Phase I MBBS students on the utility of this assessment tool.

MATERIALS AND METHODS

This educational prospective longitudinal study was conducted by the Department of Biochemistry at a university-affiliated medical college and tertiary care hospital. The study included 150 Phase I MBBS students as participants. Google Form-based MCQ tests were implemented as educational interventions after each lecture series during the study period. The study compared the internal assessment (IA) MCQ marks of students before and after the implementation of the intervention. In addition, feedback questionnaires were collected from the students.

RESULTS

There was a significant improvement in students' scores between the first IA (mean ± standard deviation [SD], 8.16 ± 3.08) and second IA (mean ± SD, 17.64 ± 2.02) (P < 0.0001). According to students' feedback, 149 out of 150 (99.3%) students found the use of Google Form-based MCQ tests as a formative assessment tool in the teaching-learning process to be highly beneficial and motivated them to engage in their biochemistry studies.

CONCLUSION

With the shift toward competency-based medical education (CBME) in India, it is crucial for educators to embrace novel teaching-learning and evaluation approaches. Our study highlighted the efficacy of employing Google Form-based MCQ tests in enhancing students' comprehension of the biochemistry subject, evaluating their scores and improving the overall quality of learning. Through this mode of assessment, teachers were able to provide targeted feedback on areas that required improvement, thereby enhancing the learning experience.

Performance of ChatGPT on the India Undergraduate Community Medicine Examination: Cross-Sectional Study

BACKGROUND

Medical students may increasingly use large language models (LLMs) in their learning. ChatGPT is an LLM at the forefront of this new development in medical education with the capacity to respond to multidisciplinary questions.

OBJECTIVE

The aim of this study was to evaluate the ability of ChatGPT 3.5 to complete the Indian undergraduate medical examination in the subject of community medicine. We further compared ChatGPT scores with the scores obtained by the students.

METHODS

The study was conducted at a publicly funded medical college in Hyderabad, India. The study was based on the internal assessment examination conducted in January 2023 for students in the Bachelor of Medicine and Bachelor of Surgery Final Year-Part I program; the examination of focus included 40 questions (divided between two papers) from the community medicine subject syllabus. Each paper had three sections with different weightage of marks for each section: section one had two long essay-type questions worth 15 marks each, section two had 8 short essay-type questions worth 5 marks each, and section three had 10 short-answer questions worth 3 marks each. The same questions were administered as prompts to ChatGPT 3.5 and the responses were recorded. Apart from scoring ChatGPT responses, two independent evaluators explored the responses to each question to further analyze their quality with regard to three subdomains: relevancy, coherence, and completeness. Each question was scored in these subdomains on a Likert scale of 1-5. The average of the two evaluators was taken as the subdomain score of the question. The proportion of questions with a score 50% of the maximum score (5) in each subdomain was calculated.

RESULTS

ChatGPT 3.5 scored 72.3% on paper 1 and 61% on paper 2. The mean score of the 94 students was 43% on paper 1 and 45% on paper 2. The responses of ChatGPT 3.5 were also rated to be satisfactorily relevant, coherent, and complete for most of the questions (>80%).

CONCLUSIONS

ChatGPT 3.5 appears to have substantial and sufficient knowledge to understand and answer the Indian medical undergraduate examination in the subject of community medicine. ChatGPT may be introduced to students to enable the self-directed learning of community medicine in pilot mode. However, faculty oversight will be required as ChatGPT is still in the initial stages of development, and thus its potential and reliability of medical content from the Indian context need to be further explored comprehensively.

The effect of a bone-preserving board game program on the knowledge, attitudes and preventive behaviors of osteoporosis in older adults

Osteoporosis predisposes to fractures, which affect the quality of life and can be life-threatening. However, the knowledge, attitudes and preventive behaviors of osteoporosis in older adults are insufficient. The aim of this paper was to develop and test the effect of a bone-preserving board game program among older adults. A convenience sample of 85 older adults recruited from two community activity centers in southern Taiwan were assigned to either an experimental group or a control group. The experimental group played a bone-preserving board game for 4 weeks, and the control group participated in routine community center activities. The generalized estimating equation showed significantly larger improvements in knowledge, attitudes, and preventive behaviors in the experimental group than in the control group. Board games designed for older adults can support public health education and help prevent osteoporosis. Our results provide a reference for educators, clinical practitioners and researchers.

Knowledge and perceptions of French community pharmacists and pharmacy students about the papillomavirus vaccine

INTRODUCTION

In a French context of low vaccination coverage for human papillomavirus (HPV) disease, we conducted a study on pharmacy students and community pharmacists to assess their self-reported knowledge about HPV infection and vaccination and their perceptions of vaccination.

MATERIAL AND METHODS

A prospective volunteered-based study was conducted in the French Franche-Comté region based on a questionnaire targeting pharmacy students (from the 2nd to 6th years) and community pharmacists.

RESULTS

All in all, 220 students and 55 pharmacists completed a questionnaire. Fewer than a third knew which HPV genotypes are considered to be high-risk (p-value = 0.11) and were aware of the diversified nature of HPV-induced cancers (p-value = 0.02). Their overall level of general knowledge about vaccination was estimated to be good by 62% of students and 85% of pharmacists (p-value = 10-3). More than 75% of students and pharmacists considered that HPV vaccination has a positive benefit-risk balance (p-value = 0.44) but that its low coverage is due to non-confirmed adverse events that were suggested in the past (p-value = 0.60). Pharmacists had a better perception of the safety of HPV vaccination (84% versus 64%, p-value = 6·10-3). More than 50% of students and pharmacists agreed with mandatory HPV vaccination for girls and boys (11-14 years).

CONCLUSION

This study allowed us to assess the knowledge of students and community pharmacists and their more or less favorable perceptions of HPV vaccination. It helped us to suggest their needs in terms of practical training. Future changes should include pharmacists in the implementation of public health policies and to improve vaccination coverage.

Employment of Small-Group Discussions to Ensure the Effective Delivery of Medical Education

The changing landscape of medical education has made small-group discussions crucial components. These sessions, including problem-based learning (PBL), case-based learning (CBL), and team-based learning (TBL), revolutionize learning by fostering active participation, critical thinking, and practical skills application. They bridge theory with practice, preparing future healthcare professionals for the dynamic challenges of modern healthcare. Despite their transformative potential, there are challenges in faculty preparation, resource allocation, and effective evaluation. The best practices include aligning discussions with curriculum goals, skilled facilitation, promoting active participation, and robust assessment strategies. Looking ahead, adapting to emerging health trends, ongoing research, and evolving healthcare demands will ensure the continued relevance and effectiveness of small-group discussions, shaping competent and adaptable healthcare providers equipped for the ever-evolving healthcare landscape.

Impact of teaching, learning, and assessment of medical law on cognitive, affective and psychomotor skills of medical students: a systematic review

BACKGROUND

It is necessary to improve medical students' legal cognitive, affective, and psychomotor skills to prevent further legal issues in the medical profession. Choosing the proper teaching and assessment methods is crucial in this matter. This study aimed to investigate the impact of teaching, learning, and assessment of medical law on the cognitive, affective, and psychomotor skills of medical students.

METHODS

A systematic review was conducted in PubMed, Embass, and Web of Science databases, and Google Scholar search engine using MECIR and PRISMA, AMEE Guide 94 for 1980 to 2022.12.30. Nineteen articles met the inclusion criteria. MERSQI checklist was used to assess the quality of the articles, and URSEC (theoretical underpinning of the development, resources required, setting, educational methods employed, and content) used to assess the risk of educational bias.

RESULTS

Internship courses called Medical Education Humanities and Society (MESH), clinical scenario design, seminars and small group discussions, web-based interactive training, legal training courses, PBL, and mind maps have been used to improve the medico-legal knowledge of medical students. MESH clerkship, simulation of a legal event, medico-legal advocacy program based on interdisciplinary education, group discussion, integration, and court-based learning used to improve student attitudes. Multidisciplinary training, small group discussions after the seminar, mock trial competition, and interdisciplinary education are used to teach psychomotor skills. All studies, except one on knowledge, reported positive effects of legal education on students' knowledge, attitudes, and legal performance. Written assessments were used for cognitive and affective domains, while performance was assessed by OSCE, simulated court, and evaluation of patient referrals.

CONCLUSION

There are few studies to examine the cognitive, affective, and legal psychomotor skills of medical students. The texts have not yet fully explored the high level of affective and psychomotor domains, which is evidence of a gap in this sector. Recognizing that medico-legal problems are prevented through proper education and assessment, it is recommended that this area be considered a research priority and that effective educational policies are adopted.

Experience of emergency medicine residents toward an implemented modified teaching approach

Lecturing has always been one of the traditional instructional methods in medical education. It is cost-effective, especially when it comes to conveying a large amount of information to many students at once. However, disadvantages are plenteous, one of which is its passive way of knowledge delivery and learning. Active learning, on the contrary, has better students' engagement and longer retention, and it results in better students' achievement. The emergency medicine residency training program at KAMC-Jeddah has modified the educational activity to become more aligned with the end-of-year assessment in the form of active learning. This study aimed to explore the experience of the residents regarding the implementation of the new educational approach. An exploratory-qualitative study utilizing constructive grounded theory was conducted, collecting our data through an in-depth 1:1 interview using semi-structured open-ended questions. Purposeful sampling was used, and saturation was reached after interviewing 24 residents. The general perception of residents toward the new teaching modes slightly varied, highlighting the positivity of the new educational environment, the desired impact on their learning, the challenges they encountered, and finally their high satisfaction level and support for this new experience. It was asserted that such experience could be permanently implemented to increase the efficacy of teaching and learning.

Audience Response System (ARS) Use in the SCORE (Surgical Council on Resident Education) Surgery Training Curriculum: A Mixed Methodology Study

Background Audience Response Systems (ARS) could help overcome the limitations of traditional lectures by providing interactivity, engagement, and assessment. The perception of ARS use in surgical education is not well documented. Objective Examine the use of an ARS in teaching This Week In SCORE (Surgical Council on Resident Education)sessions to general surgery residents and medical students. Methods  ARS was used at weekly SCORE question sessions in a new general surgery residency program by four residents, 97 medical students, and 20 faculty. The study employed a mixed quantitative and qualitative method: two separate 10-question surveys for faculty and trainees (49% response rate) and a focus group discussion that included one faculty member, two residents, and two students. Results In 85 (85%) responses, the faculty favored the use of ARS in SCORE. Among the total of 510 responses from 51 residents and students, 57% agreed with the favorable use of ARS, while 28% were neutral and, in 14% of cases, negative. A greater proportion of faculty and learners preferred ARS over traditional lectures. The focus group content analysis showed a positive effect and preference from learners and faculty. Engagement, thinking stimulation, and group participation were the most common positive comments. No significant negative influence on ARS use was reported. Conclusions The use of an ARS in This Week In SCORE ​​​sessions were preferred by most of the faculty and a majority of learners. The benefits are ease of use and stimulation of discussion. ARS has the potential for more widespread utilization in additional educational settings.

The rationale and guiding principles to design a psychiatric curriculum for primary care nurses of India

Background

The National Mental Health Survey reports a huge treatment gap for all mental disorders. There is an acute shortage of mental health professionals in India. Hence, there is a dire need to support task-shift interventions by nurses in providing non-pharmacological interventions for persons suffering from mental health issues. The traditional psychiatric nursing curriculum emphasizes nurses' knowledge and skills rather than their competency in providing mental health care. We designed an innovative, digitally driven, modular-based primary care psychiatry program for nurses (PCPP-N) to incorporate mental health with physical health and emphasize redesigning nursing practice. In this paper, we discuss the rationale and guiding principles behind designing the curriculum of PCPP-N.

Discussion

The PCPP-N program is based on nine guiding principles to provide skill-based, pragmatic, and feasible modules of a higher collaborative care quotient (CCQ) and translational quotient (TQ) that are essential for upskilling primary care nurses. In this program, nurses are trained through telemedicine-based 'on-consultation training' augmented with collaborative video consultations. A tele-psychiatrist/tele-psychiatric nurse will demonstrate how to screen, identify, and plan treatment for patients with psychiatric disorders from patients coming for general medical care using the manual Clinical Schedules of Primary care psychiatry Nursing (CSP-N). The CSP-N manual includes a screener, simplified diagnosing guidelines relevant for nurses and primary care settings, nursing management, pharmacological management, and related side effects, counseling, and follow-up guidelines. This program helps the nurses in identifying the most commonly prevalent adult psychiatric disorders presenting to primary care.

Conclusion

This PCPN curriculum contains pragmatic modules with higher CCQ and TQ. This curriculum is dynamic as the learning is interactive. Upskilling primary care nurses in integrating mental health with physical health may reduce the mental health burden. Further, the policymakers and administrators plan to integrate mental health along with physical health in national health programs.

Interactive Learning: Online Audience Response System and Multiple Choice Questions Improve Student Participation in Lectures

Background and Objective Multiple Choice Questions (MCQs) are commonly used in medical education for formative and summative assessment. However, the use of MCQs as a pedagogical tool in lectures is an area that is yet to be fully explored. This study aimed to gather feedback on including MCQs in lectures using an Online Audience Response System (OARS). Methods This quasi-experimental study involved 114 first professional MBBS students. A lecture with strategically integrated MCQs was delivered in a traditional classroom setting. Students answered the ten MCQs and provided feedback via OARS using their mobile phones. The feedback included eleven questions about student engagement, attentiveness, and critical thinking skills. Students' perception of the advantages and limitations of OARS in lectures was also collected. Data are presented as percentages and median with an interquartile range. Results Higher levels of engagement were reported by 80% of students; 81% felt improvement in understanding of the learning objectives and lecture content; 5% felt that mobile phone usage caused distractions; 79% reported increased focus and concentration; 84% reported that MCQs promoted their critical thinking skills; 75% reported enhanced overall learning experience without causing any discomfort; 69% believed that asking questions individually by the instructor is less effective than MCQs with OARS; 83% felt motivated to come prepared with study material when MCQs were included in the lecture; 67% preferred an even distribution of MCQs throughout the lecture; 53% preferred six to ten MCQs per lecture. Conclusion This study suggests that integrating MCQs in lectures using OARS can be a valuable pedagogical strategy in medical education and can potentially improve the learning experience by enhancing student engagement, attentiveness, and critical thinking skills. However, educators should also be aware of the potential limitations and take steps to mitigate them.

Factors influencing acceptance and trust of chatbots in juvenile offenders' risk assessment training

Introduction

Research has identified simulation-based training with chatbots and virtual avatars as an effective educational strategy in some domains, such as medicine and mental health disciplines. Several studies on interactive systems have also suggested that user experience is decisive for adoption. As interest increases, it becomes important to examine the factors influencing user acceptance and trust in simulation-based training systems, and to validate applicability to specific learning tasks. The aim of this research is twofold: (1) to examine the perceived acceptance and trust in a risk assessment training chatbot developed to help students assess risk and needs of juvenile offenders, and (2) to examine the factors influencing students' perceptions of acceptance and trust.

Methods

Participants were 112 criminology students in an undergraduate course in a Canadian university. Participants were directed to use a custom-designed chatbot with a virtual 3D avatar for juvenile offenders' risk assessment training, to complete online questionnaires and a risk assessment exercise.

Results

Results show satisfactory levels of acceptance and trust in the chatbot. Concerning acceptance, more than half appeared to be satisfied or very satisfied with the chatbot, while most participants appeared to be neutral or satisfied with the benevolence and credibility of the chatbot.

Discussion

Results suggest that acceptance and trust do not only depend on the design of the chatbot software, but also on the characteristics of the user, and most prominently on self-efficacy, state anxiety, learning styles and neuroticism personality traits. As trust and acceptance play a vital role in determining technology success, these results are encouraging.

Language of actions: The effects of teacher's kinesics on student learning and learning environment

BACKGROUND

A teacher's appropriate use of nonverbal communication skills, mainly kinesics, can play a crucial role in the success of the students. Medical educators are unaware of the effective use of nonverbal communication as an instructional skill that can be used to engage learners, balance learners' participation by controlling the classroom environment, and motivate them to have a passion for learning. The purpose of the study was to explore the students' perceptions regarding the effect of teachers' kinesics on students' learning and their learning environment. This can be helpful for teachers in modifying their teaching styles and delivering quality education.

MATERIALS AND METHODS

A qualitative study with an exploratory design was conducted at a private medical institute in 2021 for a duration of 6 months. Fourteen medical students volunteered to participate in the study. Focus group discussions were conducted with the students to explore the experiences of the medical students regarding the use of nonverbal communication skills by their teachers and its effect on their learning in the classroom. The data collected was analyzed manually.

RESULTS

The results of the study revealed that teachers' nonverbal behaviors in the classroom significantly influence students' motivation, engagement, and learning in the classroom. Students preferred interaction with the teachers who were friendly and confident and used their nonverbal communication skills (eye contact, facial expressions, hand gestures) effectively, compared to strict and judgmental teachers.

CONCLUSION

Teachers need to motivate their students by improving their teaching styles and incorporating nonverbal behaviors positively in the classroom. By creating an impactful learning environment, students' participation and learning will increase, which will, in turn, improve their academic performance.

Knowledge about the emergency management of dental injuries among field hockey coaches

BACKGROUND/AIM

Field hockey is frequently associated with oro-dental injuries. In such acute situations, appropriate management of the injury by coaches can contribute to a better clinical outcome and prognosis. Therefore, the aim of this study was to investigate the knowledge of hockey coaches in the Netherlands about the emergency management of dental injuries.

MATERIAL AND METHODS

A 25-item questionnaire about the prevalence and management of oro-dental injuries was distributed amongst hockey coaches in the Netherlands. A sub-analysis was done regarding the knowledge on the management of dental injuries by using a 5-point scoring system.

RESULTS

Two hundred and six hockey coaches participated in this survey. A small majority (53%) of the coaches knew the treatment of choice in the event of a permanent tooth injury. The median score of coaches' knowledge regarding management of oro-dental injuries was 3.0 (2.0-4.0) points. Coaches with a (para)medical training/occupation, and coaches with >10 years of experience had significantly higher scores compared with the other groups (p < .01 and p = .03, respectively).

CONCLUSIONS

The knowledge level of hockey coaches in the Netherlands about oro-dental injuries needs to be improved, as many coaches are not aware of the appropriate first aid measures.

Work station learning activities (WSLA) through the ICAP framework: a qualitative study

BACKGROUND

Engaging, student-centered active learning activities, such as team-based learning (TBL) and laboratory practices, is beneficial to integrate knowledge, particularly in Medicine degree. Previously, we designed and implemented workstation learning activities (WSLA) inspired by TBL, which proved effective for learning requiring higher-order thinking skills. We now hypothesize that WSLA may also have the potential to be framed into a theoretical model that stratifies learning into interactive, constructive, active and passive modes (ICAP hypothesis).

METHODS

An interpretive qualitative research study was conducted to evaluate this idea. Semi-structured interviews were conducted with students enrolled in health science programs after WSLA sessions, consisting of a series of activities accompanying a traditional lecture. Interviews were analyzed according to a deductive approach. Theoretical themes and subthemes driving the analysis were organized around the ICAP modes: passive, active, constructive, and interactive. An inductive approach was applied to provide additional insights.

RESULTS

Students valued preparatory lectures as well as corresponding WSLA activities as highly motivating, especially for the ability to integrate concepts. Although previous research shows that not all activities require high levels of cognitive engagement, students appreciated the opportunity the WSLA provided to discuss and clarify concepts as a group. Furthermore, feedback from professors and peers was highly appreciated, and helped students to construct new knowledge.

CONCLUSION

In this work, by focusing in understanding the student's experience, we have evaluated for the first time the WSLA approach in relation to the ICAP model. We found that not only the activity type determines the learning mode, but also the environment accompanying WSLA is a determining factor. Our findings can guide future development of the WSLA approach, which represents an interactive learning methodology with strong potential within the ICAP framework.

TRIAL REGISTRATION

Not applicable.

Support for learning under naturalistic conditions

Educational opportunities occur through naturalistic everyday life experiences (e.g., reading a newspaper, listening to a podcast, or visiting a museum). Research primarily examines learning under controlled conditions, such as in a classroom or laboratory. There is relatively little known about the extent to which adults extract semantic content, beyond factual recall, from naturalistic educational experiences. In the present work, we focused on virtual museum exhibits. The materials were sourced directly from an art history museum. The naturalistic nature of this work stems from the type of content used though an important component of naturalistic learning—motivational processes—was not measured. In each of three experiments, we assessed adult learners’ performance on tests of factual recall, inferential reasoning, and self-derivation through memory integration from naturalistic virtual museum exhibits. In anticipation of the potential challenge associated with learning outcomes under naturalistic conditions, we administered a yoked protocol under which participants had opportunities to engage in retrieval practice (Experiment 2a) or restudy (Experiment 2b) as explicit mechanisms of support for the three tests of learning. In all experiments, participants performed successfully on all three tests of learning; factual recall was the most accessible of the three learning outcomes. There was no difference in performance at the group level across experiments, but there was at the individual level, such that idea units generated during retrieval practice predicted learning outcomes, whereas restudy of those exact idea units did not. The current work provides novel insight into mechanisms underlying adult learning from naturalistic educational opportunities.

Improving medical student recruitment into neurosurgery through teaching reform

OBJECTIVE

This study aimed to determine whether a combination of case-based learning (CBL) and problem-based learning (PBL) methods in teaching can improve the academic performance and recruitment of medical students for neurosurgery.

METHODS

Four classes of fourth-year medical students were randomly divided into two groups. The traditional model group received the traditional teaching method, and the CBL-PBL group received the combined teaching methods of CBL and PBL. After the courses, the differences between the two groups in self-perceived competence, satisfaction with the course, post-class test scores, and clinical practice abilities were compared, and the proportions of neurosurgery major selection in pre- and post-curriculum between the two groups were also analyzed.

RESULTS

Self-perceived competence, post-class test scores, and clinical practice abilities in the CBL-PBL group were better than those in the traditional model group. The students in the CBL-PBL group showed a higher degree of satisfaction with the course than those in the traditional model group (χ2 = 12.03, P = 0.007). At the end of the semester, the proportion of students who chose neurosurgery majors in the CBL-PBL group was 13.3%, more than the 3.4% in the traditional model group (χ2 = 3.93, P = 0.048).

CONCLUSION

Compared with the traditional teaching method, the CBL and PBL integrated method is more effective for improving the performance of medical students and enhancing their clinical capabilities in neurosurgery teaching. The CBL-PBL method effectively improved students' interests in neurosurgery, potentially contributing to increasing medical student recruitment into neurosurgery.

Use of simplex learning index to identify a course deficit

Difficulty index and its derivative performance index (PFI) have been commonly used to measure student learning outcomes. However, these indexes have a high volatility and low sensitivity. This work has established the simplex learning index (SLI), which has a low volatility and high sensitivity. To construct SLI, students were divided into two groups based on their scores on the whole quiz. The item SLI and lecture SLI were derived from the results of students in the high-scoring group. Exam results from nine cohorts of medical students in two phases of learning were analyzed. The volatility, measured by the ratio between the standard deviation and the mean, was >65% lower in SLI than in PFI. Using the lecture SLI as a metric, one lecture B22 (Metabolism of Amino Acids), was identified that had an average SLI of 0.66 in earlier four student cohorts in phase 1 learning. Two major changes were made on the lecture, lecture organization and the delivery method, in phase 2. Students from recent five cohorts in phase 2 had an average SLI of 0.84, which was 26.6% higher than that in phase 1 (P < 0.02). In contrast, when PFI was used, the change was only 13.46% and insignificant (P = 0.29). In the same period, implementation of the same delivery method did not yield significant changes in learning outcomes in lecture B24 (Metabolism of Nucleotides). Taken together, this work shows that SLI is a better indicator for learning outcomes and suggests that lecture reorganization is the key to improved student learning.

CASCADE your teaching session!

Medical education has seen a shift toward interactive teaching in small groups that actively involves students in learning. However, didactic teaching, despite drawbacks such as student isolation and low stimulation of critical thinking, is still a very commonly used teaching method. For didactic teaching to be effective, teachers must possess strategies and skills that enable them to teach effectively in large groups and increase students' knowledge retention. This can be achieved if class sessions are planned in advance with the aim of making them interactive and engaging with all students. In the following article, I write about my experiences using the CASCADE method, an acronym of the words "create," "assess," "sequence," "charisma," "activate," "discussion," and "e-device," which creates interactive didactic sessions.

Developing an innovative medical ethics and law curriculum-constructing a situation-based, interdisciplinary, court-based learning course: a mixed methods study

BACKGROUND

Traditional lecture-based medical ethics and law courses deliver knowledge but may not improve students' learning motivation. To bridge this theory-to-practice gap and facilitate students' learning effectiveness, we applied situated-learning theory to design an interdisciplinary court-based learning (CBL) component within the curriculum. Our study aimed to investigate students' learning feedbacks and propose a creative course design.

METHODS

A total of 135 fourth-year medical students participated in this course. The CBL component included 1 h of introduction, 1 h of court attendance, and 2 h of interdisciplinary discussion with senior physicians, judges, and prosecutors. After the class, we conducted a survey using a mixed-methods approach to gauge students' perceptions of engagement, performance, and satisfaction.

RESULTS

A total of 97 questionnaires were received (72% response rate). Over 70% of respondents were satisfied and felt that the class was useful except for role-playing activities (60%). More than 60% reported a better understanding of the practical applications of medical law. Approximately half (54%) reported less anxiety about medical disputes. 73% reported that the lecture provided awareness of potential medical disputes, and most respondents expressed an interest in medical law courses after the court visit (78%). 80% of the respondents were able to display empathy and apply mediation skills. Qualitative analyses showed that students demonstrated new knowledge, including recognizing the significance of the medical profession, distinguishing the importance of physician-patient communication, having confidence in the fairness of the justice system, and being willing to increase their legal knowledge.

CONCLUSIONS

CBL curriculum increases students' learning motivation in strengthening medical professionalism and medical law, develops students' empathy for patients and communication skills, as well as builds up students' trust in the justice system. This novel course design can be applied to teach medical ethics and law.

Implementation of a Surgical Problem-Based Learning Curriculum: A One-Year Single-Center Experience

Background

Problem-Based Learning (PBL) has become an integral part of medical student education for preclinical curricula, but few studies have evaluated the benefits of a PBL curriculum for clinical education. This study aims to assess the 1-year experience after implementing a resident-led PBL program for the third-year (MS3) surgery clerkship and compare students’ self-reported preparedness following PBL sessions to traditional faculty-led lectures.

Methods

Surgical faculty and residents developed a PBL curriculum to address common topics in surgical education. Pandemic requirements necessitated a switch from in-person to virtual sessions during the experience. Students enrolled in the MS3 surgical clerkship were asked to participate in a survey. Demographics and clerkship data were obtained. Quality of PBL and faculty-led lectures were assessed using a ten-point Likert scale, and standard statistical analyses were performed.

Results

During the study period, 165 students rotated through surgery, of which 129 (78%) responded to the survey (53% female, 59% white). PBLs were held in-person (53%), exclusively virtual (32%) or hybrid (15%) platforms. In-person PBLs were preferred to faculty-led lectures for preparing students for NBME examinations (6.9 vs 6.0), oral examinations (7.8 vs 6.3), and surgical cases (6.3 vs 5.8), all P < .001. Virtual PBLs were also preferred to lectures for preparing students for NBME examinations (6.8 vs 5.8, P < .001) and surgical cases (5.6 vs 4.8, P = .05).

Conclusions

PBL is a valuable adjunct for medical student education. Resident-led PBLs were preferred to faculty-led lectures for preparing students for examinations and clerkship experiences and may be useful adjuncts to clinical education.

Instructor Methods and Curricular Effects on Students' Value of Lectures

BACKGROUND

Lectures remain a common instructional method in medical education. Instructor methods, curricular factors, and technology affect students' use of scheduled live lectures that may impact faculty job satisfaction.

AIM

This study identified instructor methods and curriculum issues that influenced preclinical medical students' use of scheduled lectures as well as faculty perceptions of lectures and students' attendance.

METHODS

First- and second-year osteopathic medical students (n = 304) were invited to complete a voluntary, anonymous semantic differential scale, Likert scale, and dichotomous question survey, rating 22 lecturer methods and 9 curriculum factors that influence use of live lectures. Preclinical faculty (n = 35) were also asked to complete a differential scale survey, rating 17 issues regarding live lectures and student attendance. Student and faculty surveys were analyzed using the appropriate central tendency and variability measures.

RESULTS

Students that completed the survey (n = 144) rated the ability to explain complex concepts in an understandable manner as "Very Important" and wearing professional attire as "Not Important" for attending lectures, respectively. Availability of recorded lectures, time to an upcoming exam, and unscheduled time gaps between lectures were rated as Very Important curricular factors for attending lectures. Faculty completed the survey (n = 21) and agree that lectures should continue as a major mode of instruction, while the majority reported spending over 9 h preparing new lectures.

CONCLUSIONS

Faculty lecture methods and overarching curricular decisions greatly impact students' attendance of live lectures. Regardless, most students and faculty believe that scheduled lectures should continue as an option for students who prefer to attend live lectures.

Comparing the effectiveness of blended learning and traditional learning in an orthopedics course

Introduction

The ongoing COVID-19 pandemic is forcing medical schools to replace substantial parts of the traditional lecture method with online formats to maintain social distancing guidelines and reduce face-to-face contact in the classroom. To our knowledge, there have to date been few studies comparing the effectiveness of traditional teaching with blended teaching based on the students' final grades which the efficacy of online learning is still controversial, and this study aimed to compare the efficacy of blended teaching with conventional teaching in an orthopedics course.

Methods

This study was a retrospective cohort study based on data collected from fifth-year medical students between April 2019 and March 2021. The students were divided into two groups which based on years of study. The summative assessment was based on summing the MCQs plus KFs, the MEQ plus oral exam, OSCE, simulated patient chart reviews, and OPD work. All students took the same end-of-course quizzes with no differences between the groups regarding the kinds of knowledge tested. The results of these quizzes were used to compare the effectiveness of the conventional teaching in 2019 and the blended teaching in 2020. The paired t-test was used to analyze the data.

Results

A total of 252 students were enrolled in the study, of whom 128 and 124 students were in the traditional teaching group or blended teaching groups, respectively. The grade point averages of the students were 3.2 ± 0.4 and 3.3 ± 0.4 in 2019–2020 and 2020–2021, respectively, without significant difference (p-value = 0.06). The scores in the blended learning group were higher than in the traditional learning group in all assessment tools (MCQ, KF, Oral, and OSCE scores) except the MEQ.

Conclusions

Blended learning was not less effective than traditional learning for teaching medical students.

•

During covid19 pandemic, blended was a potential method in undergraduate medical to teach the medical students.

•

Blended learning was as effective as traditional learning for teaching medical students.

•

The implications for the role of blended learning can apply to the curriculum when return to normal after Covid19 cessation.

Improving Medical Education: A Narrative Review

With the advancement in basic and clinical sciences, medical education is also constantly evolving. The Accreditation Council for Graduate Medical Education (ACGME) has endorsed six core competencies to improve teaching and learning. This narrative review was conducted after searching the article databases (PubMed, PubMed Central, Embase, and Scopus) about the core competencies such as medical knowledge (problem-based learning), interpersonal communication, patient care, professionalism, practice-based learning and improvement, and system-based care endorsed by ACGME. We included randomized and quasi-experimental trials, cohorts, and case-control studies in this narrative review. In a problem-based learning modality, a real-life scenario is allocated to a group of students. Studies have shown that it is more effectively demonstrated by a better post-test score, improved concentration, and application of knowledge. Interpersonal communication skills promote collaboration with interdisciplinary teams, work quality, and patient adherence to treatment. Professionalism is a human attribute that creates a pleasant work environment and is an essential trait that improves patients' adherence to treatment. In system-based care, patients are benefitted through a well-structured plan of care. Finally, in practice-based learning, medical trainees learn to systematically evaluate the pattern of care and practice the best modality to improve the overall patient care and physician satisfaction. These core competencies need to be incorporated into all levels of medical training.

Evaluation of Team-Based Learning to Increase Nurses' Knowledge of the Ventricular Assist Device

Ventricular assist devices (VAD) are used to extend life expectancy for patients with advanced heart failure. Approximately 102 hospitals nationwide have a VAD program, but the majority implant only a small number of devices each year. This low-volume and high-acuity patient population can create concerns for maintaining nursing knowledge skill levels. Nursing staff from a step-down telemetry floor in a large urban hospital completed an Individual Readiness Assessment Test to assess their knowledge and accuracy in the care of mechanical circulatory support patients using the Immediate Feedback Assessment Technique. The nurses were then assigned to small groups and worked as a team to complete the same test known as the Group Readiness Assessment Test. Study results suggest that team-based learning was effective in increasing knowledge of mechanical circulatory support. [J Contin Educ Nurs. 2021;52(1):13-20.].

The use of educational technology for interactive teaching in lectures

Students often feel overwhelmed by the volume and complexity of knowledge and skills required to learn. Along with this challange, educational technology has been gradually introduced in medical education to facilitate learning and improve outcomes. It became an essential part of communication, storing and transferring information, audio-visual media use and production, and knowledge sharing. Technology's role has been expanding from a mere tool of study and inquiry to an approach and integrated use in education. Its use in medical education is continuously evolving. However, the impact and optimal use of various technology applications are not clearly defined. There are multiple challenges facing educators to choose the right application for the specific educational purpose. Hence, studies and evaluation reviews are needed to inform the better-defined use of educational technology. This review aims to discuss and evaluate various educational technology applications in medical education, focusing on interactive learning during lectures. Lectures and other group learning sessions are common activities used by medical schools. Promoting interactive learning in large groups is known to be challenging. The advances in technology to facilitate communication and promote interaction is a promising adjunct for lectures interactivity.

Medical Student Education During COVID-19: Electronic Education Does Not Decrease Examination Scores

BACKGROUND

During the COVID-19 emergency, medical students were mandated to remain home, creating challenges to providing education remotely for third-year clinical rotations. This study aims to assess student reception and investigate objective outcomes to determine if online learning is a suitable alternative.

METHODS

Medical students enrolled in the third-year surgical clerkship during COVID-19 were asked to participate in a survey. 19 of 27 (70%) students participated. Content, faculty-led lectures, and resident-led problem-based learning (PBL) sessions were assessed using a ten-point Likert scale. National Board of Medical Examiners (NBME) examination, weekly quiz, and oral examination scores were compared to previous years. Student t-tests compared the groups.

RESULTS

The median age was 25 years. Comparing in-person to electronic sessions, there was no difference in effectiveness of faculty sessions preparing students for NBME (6.2 vs. 6.7, P = .46) or oral examinations (6.4 vs. 6.8, P = .58); there was also no difference in resident-led PBL sessions preparing students for NBME (7.2 vs. 7.2, P = .92) or oral examinations (7.4 vs. 7.6, P = .74). Comparing this group to students from the previous academic year, there was no difference in weekly quiz (85.3 vs. 87.8, P = .13), oral examination (89.8 vs. 93.9, P = .07), or NBME examination (75.3 vs. 77.4, P = .33) scores.

DISCUSSION

Surgical medical didactic education can effectively be conducted remotely through faculty-led lectures and resident-led PBL sessions. Students did not have a preference between in-person and electronic content in preparation for examinations. As scores did not change, electronic education may be adequate for preparing students for examinations in times of crisis such as COVID-19.

Comparison Between Problem-Based Learning and Lecture-Based Learning: Effect on Nursing Students' Immediate Knowledge Retention

BACKGROUND

The basic role of teaching at any degree of training is to bring a rudimentary change within the student. To facilitate the method of information transmission, educators ought to apply acceptable teaching strategies that best suit specific objectives and outcomes. Identifying the best method through comparison of problem-based learning (PBL) and the lecture method; so as to improve students' overall academic performance appear to be important.

OBJECTIVE

The aim of the study was to undertake comparison between problem-based and lecture-based learning methodologies for immediate knowledge retention of nursing students at Dire Dawa University.

METHODS

Quantitative research method which used a pre-experimental two group pretest and post-test research design was employed to identify effective teaching methods for immediate knowledge retention on 38 nursing students from June 1 to June 15, 2019. The students were grouped randomly into problem-based learning and lecture methods. The pretest-posttest analysis was done after an intervention made: a two-hour lecture and four-hour problem-based learning accordingly. Content validity ratio and content validity index was conducted for authentication of instruments and Cronbach alpha was computed to verify its reliability. A paired t-test was conducted to identify mean score change, and p<0.05 was cut off value to determine if there is a significant mean change in the posttest.

RESULT

Both methods showed significant knowledge score improvement (t=13.6, p< 0.001) for lecture-based method and (t=11.302, p< 0.001) for problem-based learning. But as compared to the lecture method, problem-based learning has little effect on students' immediate knowledge retention, and 63.2% of the nursing students prefer the lecture method as the best teaching method.

CONCLUSION

The lecture method is the best teaching method for immediate knowledge retention for nursing students; it is also the most preferred method of teaching method by the students.

Rubric-based debriefing to enhance nursing students' critical thinking via simulation

Introduction

Debriefing plays a vital role in effective simulation-based learning by providing feedback to students to foster their development of critical thinking in the learning.

Objectives

We evaluated the effects of rubric-based debriefing on students' critical thinking, level of confidence in performing tasks and communication.

Method

This is a quasi-experimental study. Final year nursing undergraduates (n=204) of a local university participated in the study. In the intervention group, students performed two 20 min simulation sessions individually with simulated patients followed by a 15 min individual rubric-based debriefing between the two sessions and had a 5 min of that at the end. In the control group, students performed the same simulation sessions followed by a 20 min individual rubric-based debriefing at the end. The primary outcome was comparing the critical thinking of students between two groups, which was assessed by The Northeastern Illinois University Critical Thinking Rubric. The qualitative data were collected by an open-ended question.

Results

Based on generalised estimating equation models, the intervention effect over time was found to be statistically significant (β=2.06, 95% CI 1.04 to 3.08) in enhancing students' critical thinking. No statistically significant differences were reported in the self-perceived confidence levels between the intervention group and control group. Qualitative data reflected positive feedback from students on simulation activities.

Conclusions

This is the first study to provide evidence that a rubric-based debriefing enhances students' critical thinking in simulation learning.