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Balslev T, Muijtjens AMM, Maarbjerg SF, de Grave W. Selection and ranking of patient video cases in paediatric neurology in relation to learner levels. Eur J Paediatr Neurol 2018; 22:498-506. [PMID: 29274891 DOI: 10.1016/j.ejpn.2017.11.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Revised: 06/14/2017] [Accepted: 11/22/2017] [Indexed: 10/18/2022]
Abstract
BACKGROUND Teaching and learning with patient video cases may add authenticity, enhance diagnostic accuracy and improve chances of early diagnosis. The aim of this study is firstly to identify selection criteria for key Patient video cases (PVCs), secondly to identify trends in relevance of PVCs for learner levels and thirdly, to rank PVCs for learner levels. METHODS Based on a literature review, we identified criteria for key PVCs for use in paediatric neurology. We then performed a multi-round Delphi analysis to obtain agreement between 28 expert clinician teachers concerning key PVCs for four learner levels. RESULTS We identified two major criteria: key PVCs should demonstrate key movements, and these movements should be subtle and/or difficult to note. The expert clinician teachers subsequently assessed a list of 14 topics for key PVCs. We found a clear, increasing trend in relevance scores, from medical students to young residents to experienced residents and specialists. For medical students and residents, epileptic spasms, Down syndrome, developmental delay, cerebral palsy and absence epilepsy were highly ranked. For specialists, conditions like chorea, focal seizures or eye movement disorders topped the ranking list, although ranking was less clear for this group of advanced learners. DISCUSSION AND CONCLUSION Key PVCs should demonstrate movements that are difficult to note for learners. Ranked lists of key PVCs for teaching and learning at different learner levels are now available and may help institutions build validated local libraries of PVCs.
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Affiliation(s)
- Thomas Balslev
- Department of paediatrics, Viborg Regional Hospital, Heibergs Alle 4, DK-8200 Viborg, Denmark; Centre for Health Sciences Education, CESU, Palle Juul Jensen Boulevard 82, Health, Aarhus University, DK-8200 Aarhus, Denmark.
| | - Arno M M Muijtjens
- Maastricht University, Department of Educational Development & Research, Faculty of Health, Medicine and Life Sciences (FHML), 6200 MD, Maastricht, The Netherlands
| | | | - Willem de Grave
- Maastricht University, Department of Educational Development & Research, Faculty of Health, Medicine and Life Sciences (FHML), 6200 MD, Maastricht, The Netherlands
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Crowe A, Dotson-Blake KP, Vazquez M, Malone A. Enhancing Clinical Training with Video Grand Rounds in Counselor Education. JOURNAL OF CREATIVITY IN MENTAL HEALTH 2018. [DOI: 10.1080/15401383.2018.1456993] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Balslev T, Rasmussen AB, Skajaa T, Nielsen JP, Muijtjens A, De Grave W, Van Merriënboer J. Combining bimodal presentation schemes and buzz groups improves clinical reasoning and learning at morning report. MEDICAL TEACHER 2015; 37:759-766. [PMID: 25496711 DOI: 10.3109/0142159x.2014.986445] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Morning reports offer opportunities for intensive work-based learning. In this controlled study, we measured learning processes and outcomes with the report of paediatric emergency room patients. Twelve specialists and 12 residents were randomised into four groups and discussed the same two paediatric cases. The groups differed in their presentation modality (verbal only vs. verbal + text) and the use of buzz groups (with vs. without). The verbal interactions were analysed for clinical reasoning processes. Perceptions of learning and judgment of learning were reported in a questionnaire. Diagnostic accuracy was assessed by a 20-item multiple-choice test. Combined bimodal presentation and buzz groups increased the odds ratio of clinical reasoning to occur in the discussion of cases by a factor of 1.90 (p = 0.013), indicating superior reasoning for buzz groups working with bimodal materials. For specialists, a positive effect of bimodal presentation was found on perceptions of learning (p < 0.05), and for residents, a positive effect of buzz groups was found on judgment of learning (p < 0.005). A positive effect of bimodal presentation on diagnostic accuracy was noted in the specialists (p < 0.05). Combined bimodal presentation and buzz group discussion of emergency cases improves clinicians' clinical reasoning and learning.
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Affiliation(s)
- Thomas Balslev
- a Viborg Regional Hospital , Denmark
- b Aarhus University , Denmark
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Abstract
Patient video cases (PVCs) are brief video recordings of patients during spontaneous or instructed activity. PVCs are true to life and can be replayed, enabling the establishment of highly interactive, contextual and safe learning environments, with a minimum of facilitation. This article describes the use of workshops in which PVCs are used to assist with the development of observational skills and clinical reasoning in medical students and postgraduates. We describe why PVCs are a valuable addition to an educator's portfolio of resources, what evidence there is for their effectiveness, how to use videos for teaching, and some practical advice and tips on their collection and storage.
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Affiliation(s)
- Damian Roland
- SAPPHIRE Group, Health Sciences, Leicester University, Leicester, UK Paediatric Emergency Medicine Leicester Academic (PEMLA) Group, Leicester Royal Infirmary, Leicester, UK
| | - Thomas Balslev
- Centre of Postgraduate Medical Education, Aarhus University, Aarhus N, Denmark
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Malon M, Cortes D, Greisen GO. Medical students' assessment of pediatric patients - teaching and evaluation using video cases. BMC MEDICAL EDUCATION 2014; 14:241. [PMID: 25391289 PMCID: PMC4233092 DOI: 10.1186/s12909-014-0241-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/10/2014] [Accepted: 10/24/2014] [Indexed: 06/04/2023]
Abstract
BACKGROUND We introduced video-based teaching in pediatrics. We evaluated the impact of a pediatric video program on student performance in assessing pediatric patients presented as video cases. The program consisted of a library of pediatric videos, and inclusion of these in the teaching and examination for pediatric medicine. METHODS Medical students on a pediatric clerkship at the University of Copenhagen assessed eight short pediatric video cases during autumn 2011 and spring 2012. Two independent observers evaluated a subset of records in a pilot study. A blind evaluation was made of the written records of 37 students before, and 58 students after, the introduction of the program using a Rubric score with four domains. RESULTS The intraobserver interclass correlation coefficient was 0.94 and the interobserver interclass correlation was 0.71(n=25). The students' mean total Rubric score in spring 2012 (7.0) was significantly higher (p<0.001, 95% CI 1.34-3.20) than autumn 2011 (4.7). Cohen's d was 1.1 (95% CI 0.6-1.7). Single domains scores increased significantly for general assessment (1.30 versus 0.57) (p<0.002, 95% CI 0.45-1.18), recognition of principal symptoms (1.38 versus 0.81) (p<0.008, 95% CI 0.22-0.91), appropriate diagnosis (2.28 versus 1.78) (p<0.002, 95% CI 0.16-0.82) and consistency between observed symptoms and diagnosis (1.94 versus 1.57) (p=0.0482, 95% CI 0.00-0.79). CONCLUSIONS Students improved in evaluating pediatric patients presented as video cases after the introduction of the program. The impact on real-life situations remains to be established.
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Affiliation(s)
- Michelle Malon
- />Neonatal Division, Rigshospitalet, Copenhagen, Denmark
- />Department for Child and Adolscent Psychiatry, Region Sjaelland, Smedegade 16, Roskilde, Denmark
| | - Dina Cortes
- />Department of Pediatrics, Hvidovre Hospital, Faculty of Health Science, University of Copenhagen, Copenhagen, Denmark
| | - Gorm Ole Greisen
- />Neonatal Division, Faculty of Health Science, University of Copenhagen, Rigshospitalet, Copenhagen, Denmark
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Chi DL, Pickrell JE, Riedy CA. Student Learning Outcomes Associated with Video vs. Paper Cases in a Public Health Dentistry Course. J Dent Educ 2014. [DOI: 10.1002/j.0022-0337.2014.78.1.tb05653.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Donald L. Chi
- Department of Oral Health Sciences; School of Dentistry, University of Washington
| | | | - Christine A. Riedy
- Department of Oral Health Policy and Epidemiology; Harvard School of Dental Medicine
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McColgan P, McKeown PP, Selai C, Doherty-Allan R, McCarron MO. Educational interventions in neurology: a comprehensive systematic review. Eur J Neurol 2013; 20:1006-16. [DOI: 10.1111/ene.12144] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Accepted: 02/14/2013] [Indexed: 11/30/2022]
Affiliation(s)
- P. McColgan
- Department of Neurodegenerative Disease; UCL Institute of Neurology and National Hospital for Neurology and Neurosurgery, Queen Square; London UK
| | - P. P. McKeown
- School of Medicine, Dentistry and Biomedical Sciences; Queen's University of Belfast Centre for Medical Education; Belfast UK
| | - C. Selai
- Institute of Neurology, Queen Square; London UK
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Tolsgaard MG, Todsen T, Sorensen JL, Ringsted C, Lorentzen T, Ottesen B, Tabor A. International multispecialty consensus on how to evaluate ultrasound competence: a Delphi consensus survey. PLoS One 2013; 8:e57687. [PMID: 23469051 PMCID: PMC3585207 DOI: 10.1371/journal.pone.0057687] [Citation(s) in RCA: 107] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2012] [Accepted: 01/24/2013] [Indexed: 11/24/2022] Open
Abstract
Objectives To achieve international consensus across multiple specialties on a generic ultrasound rating scale using a Delphi technique. Methods Ultrasound experts from Obstetrics-Gynaecology, Surgery, Urology, Radiology, Rheumatology, Emergency Medicine, and Gastro-Enterology representing North America, Australia, and Europe were identified. A multi-round survey was conducted to obtain consensus between these experts. Of 60 invited experts, 44 experts agreed to participate in the first Delphi round, 41 remained in the second round, and 37 completed the third Delphi round. Seven key elements of the ultrasound examination were identified from existing literature and recommendations from international ultrasound societies. All experts rated the importance of these seven elements on a five-point Likert scale in the first round and suggested potential new elements for the assessment of ultrasound skills. In the second round, the experts re-rated all elements and a third round was conducted to allow final comments. Agreement on which elements to include in the final rating scale was pre-defined as more than 80% of the experts rating an element four or five, on importance to the ultrasound examination. Results Two additional elements were suggested by more than 10% of the experts in the first Delphi round. Consensus was obtained to include these two new elements along with five of the original elements in the final assessment instrument: 1) Indication for the examination 2) Applied knowledge of ultrasound equipment 3) Image optimization 4) Systematic examination 5) Interpretation of images 6) Documentation of examination and 7) Medical decision making. Conclusion International multispecialty consensus was achieved on the content of a generic ultrasound rating scale. This is the first step to ensure valid assessment of clinicians in different medical specialties using ultrasound.
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Affiliation(s)
- Martin G Tolsgaard
- Department of Obstetrics, Copenhagen University Hospital Rigshospitalet, Copenhagen, Denmark.
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Roland D, Coats T, Matheson D. Towards a conceptual framework demonstrating the effectiveness of audiovisual patient descriptions (patient video cases): a review of the current literature. BMC MEDICAL EDUCATION 2012; 12:125. [PMID: 23256787 PMCID: PMC3542158 DOI: 10.1186/1472-6920-12-125] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/30/2012] [Accepted: 12/12/2012] [Indexed: 06/01/2023]
Abstract
BACKGROUND Technological advances have enabled the widespread use of video cases via web-streaming and online download as an educational medium. The use of real subjects to demonstrate acute pathology should aid the education of health care professionals. However, the methodology by which this effect may be tested is not clear. METHODS We undertook a literature review of major databases, found relevant articles relevant to using patient video cases as educational interventions, extracted the methodologies used and assessed these methods for internal and construct validity. RESULTS A review of 2532 abstracts revealed 23 studies meeting the inclusion criteria and a final review of 18 of relevance. Medical students were the most commonly studied group (10 articles) with a spread of learner satisfaction, knowledge and behaviour tested. Only two of the studies fulfilled defined criteria on achieving internal and construct validity. The heterogeneity of articles meant it was not possible to perform any meta-analysis. CONCLUSIONS Previous studies have not well classified which facet of training or educational outcome the study is aiming to explore and had poor internal and construct validity. Future research should aim to validate a particular outcome measure, preferably by reproducing previous work rather than adopting new methods. In particular cognitive processing enhancement, demonstrated in a number of the medical student studies, should be tested at a postgraduate level.
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Affiliation(s)
- Damian Roland
- Emergency Medicine Academic Group, Emergency Department secretaries c/o Elizabeth Cadman-Moore, Leicester Royal Infirmary, Leicester, LE1 5WW, UK
| | - Tim Coats
- Emergency Medicine Academic Group, Emergency Department secretaries c/o Elizabeth Cadman-Moore, Leicester Royal Infirmary, Leicester, LE1 5WW, UK
| | - David Matheson
- Room B94C Medical School, Queens Medical Centre, Nottingham, NG7 2UH, UK
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Webb EA, Davis L, Muir G, Lissauer T, Nanduri V, Newell SJ. Improving postgraduate clinical assessment tools: the introduction of video recordings to assess decision making. MEDICAL TEACHER 2012; 34:404-410. [PMID: 22471914 DOI: 10.3109/0142159x.2012.668242] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Competency in the management of acutely unwell patients has not previously been formally assessed as part of an objective structured clinical examination (OSCE). AIM The reliability of the paediatric postgraduate OSCE was calculated. An objective structured video examination was designed to assess candidates' clinical decision making ability when managing acutely unwell children. METHODS The performance of 3522 postgraduate paediatric trainees was assessed (2006-2008). OSCE reliability was determined using Cronbach's alpha and mean inter-item correlation. Performance in the video station was compared with overall performance (not including video station; Mann-Whitney U) and video station scores correlated with individual station scores (Spearman's Rho correlation coefficient). RESULTS Clinical examination pass rates for the 684 UK graduates, 1608 overseas candidates training in the UK and 1104 overseas candidates training overseas were 69.7%, 28% and 22.3%, respectively (graduation information not available for 126 candidates). Cronbach's alpha was 0.62. Mean inter-item correlation was 0.15. Candidates who passed the OSCE overall had significantly higher scores on the video station (t(3520) = 14.48); p < 0.001). There was significant positive correlation between scores on the video station, individual stations and overall total score (r's = 0.300; p = 0.001). CONCLUSIONS The postgraduate paediatric OSCE provides a sound and valid means of assessing clinical skills at the postgraduate level. The video station provides an important new method of assessment. Its use in other postgraduate clinical examinations should be explored.
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Affiliation(s)
- E A Webb
- Clinical and Molecular Genetics Unit, Department of Paediatric and Adolescent Endocrinology, Institute of Child Health, Great Ormond Street Children’s Hospital, 30 Guilford Street, London, WC1N 1EH, UK.
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Balslev T, Jarodzka H, Holmqvist K, de Grave W, Muijtjens AMM, Eika B, van Merriënboer J, Scherpbier AJJA. Visual expertise in paediatric neurology. Eur J Paediatr Neurol 2012; 16:161-6. [PMID: 21862371 DOI: 10.1016/j.ejpn.2011.07.004] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2011] [Revised: 06/03/2011] [Accepted: 07/17/2011] [Indexed: 11/28/2022]
Abstract
BACKGROUND Visual expertise relies on perceptive as well as cognitive processes. At present, knowledge of these processes when diagnosing clinical cases mainly stems from studies with still pictures. In contrast, patient video cases constitute a dynamic diagnostic challenge that may simulate seeing and diagnosing a patient in person. AIMS This study investigates visual attention and the concomitant cognitive processes of clinicians diagnosing authentic paediatric video cases. METHODS A total of 43 clinicians with varying levels of expertise took part in this cross-sectional study. They diagnosed four brief video recordings of children: two with seizures and two with disorders imitating seizures. We used eye tracking to investigate time looking at relevant areas in the video cases and a concurrent think-aloud procedure to explore the associated clinical reasoning processes. RESULTS More experienced clinicians were more accurate in visual diagnosis and spent more of their time looking at relevant areas. At the same time, they explored data less, yet they built and evaluated more diagnostic hypotheses. CONCLUSIONS Clinicians of varying expertise analyse patient video cases differently. Clinical teachers should take these differences into account when optimising educational formats with patient video cases.
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Affiliation(s)
- Thomas Balslev
- Aarhus University, Centre of Medical Education, Brendstrupgaardsvej 102, 8200 Aarhus N, Denmark.
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Adams EC, Rodgers CJ, Harrington R, Young MDB, Sieber VK. How we created virtual patient cases for primary care-based learning. MEDICAL TEACHER 2011; 33:273-278. [PMID: 21456983 DOI: 10.3109/0142159x.2011.544796] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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