An investigation into the factors that encourage learner participation in a large group medical classroom

Use of Top Hat Audience Response Software in a Third-Year Veterinary Medicine and Surgery Course

Audience response devices are useful tools that can improve student engagement and learning during instructional sessions. The purpose of this article is to describe our experience with a new cloud-based application known as Top Hat, which includes audience response tools in its application suite. The software was used in a multi-specialty, multi-instructor medicine and surgery course in the third year of a veterinary curriculum. In addition to standard multiple-choice and short-answer questions, Top Hat has several unique question types and methods of displaying the responses given. These include displaying free-text responses in a word cloud format and a "click-on-target" question type that allows students to indicate their response by clicking on a location within an image. Responses for this latter question type are displayed in a heat map format. A discussion tool is also available, which allows students to respond, read other students' responses in real time, and then reply again if warranted. This feature also supports drawing-based responses. The variety of question types was very useful in keeping students engaged during teaching sessions, giving this application several advantages over systems that are limited to multiple-choice questions only. In addition, the application allowed rapid identification of areas of student knowledge and misunderstandings, which facilitated the direction of further discussion and clarification of important learning issues.

Is computer-assisted instruction more effective than other educational methods in achieving ECG competence amongst medical students and residents? A systematic review and meta-analysis

OBJECTIVES

It remains unclear whether computer-assisted instruction (CAI) is more effective than other teaching methods in acquiring and retaining ECG competence among medical students and residents.

DESIGN

This systematic review and meta-analysis followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.

DATA SOURCES

Electronic literature searches of PubMed, databases via EBSCOhost, Scopus, Web of Science, Google Scholar and grey literature were conducted on 28 November 2017. We subsequently reviewed the citation indexes for articles identified by the search.

ELIGIBILITY CRITERIA

Studies were included if a comparative research design was used to evaluate the efficacy of CAI versus other methods of ECG instruction, as determined by the acquisition and/or retention of ECG competence of medical students and/or residents.

DATA EXTRACTION AND SYNTHESIS

Two reviewers independently extracted data from all eligible studies and assessed the risk of bias. After duplicates were removed, 559 papers were screened. Thirteen studies met the eligibility criteria. Eight studies reported sufficient data to be included in the meta-analysis.

RESULTS

In all studies, CAI was compared with face-to-face ECG instruction. There was a wide range of computer-assisted and face-to-face teaching methods. Overall, the meta-analysis found no significant difference in acquired ECG competence between those who received computer-assisted or face-to-face instruction. However, subanalyses showed that CAI in a blended learning context was better than face-to-face teaching alone, especially if trainees had unlimited access to teaching materials and/or deliberate practice with feedback. There was no conclusive evidence that CAI was better than face-to-face teaching for longer-term retention of ECG competence.

CONCLUSION

CAI was not better than face-to-face ECG teaching. However, this meta-analysis was constrained by significant heterogeneity amongst studies. Nevertheless, the finding that blended learning is more effective than face-to-face ECG teaching is important in the era of increased implementation of e-learning.

PROSPERO REGISTRATION NUMBER

CRD42017067054.

Comparative study of virtual and traditional teaching methods on the interpretation of cardiac dysrhythmia in nursing students

INTRODUCTION

Due to the importance of correct interpretation of electrocardiogram (ECG) in the quality of healthcare delivery, new educational methods are increasingly being implemented and evaluated. In this regard, the purpose of this study was to compare the traditional and virtual teaching methods on the interpretation of cardiac dysrhythmia in nursing students.

METHODS

The present study is a quasi-experimental research with pretest and posttest design. Sixty nursing students in the seventh semester from schools of nursing in Urmia and Khoy cities were randomly assigned to two virtual and traditional education groups. Students' knowledge was measured by a researcher-made 30-item test.

RESULTS

The mean and standard deviation of the students' scores in the traditional education group was 11.20 ± 4.41 and 14.40 ± 4.62 and in the virtual group was 11.30 ± 2.74 and 18.43 ± 4.68, pre- and post-training, respectively. Paired t-test showed a significant difference between the mean score of pretest and posttest in both types of training (P < 0.001). According to the results of independent sample t-test, there were no significant differences between the two groups before the training (P > 0.05). However, in the posttraining period, there were significant differences between traditional and virtual education groups (P < 0.001).

CONCLUSION

Considering the results of this study, which shows the positive effects of virtual education method on nursing students' knowledge about cardiac dysrhythmia, this method can be used as an alternative or complementary method to the traditional education.

Audience Response Systems and Missingness Trends: Using Interactive Polling Systems to Gather Sensitive Health Information From Youth

BACKGROUND

The widespread availability and cost-effectiveness of new-wave software-based audience response systems (ARSs) have expanded the possibilities of collecting health data from hard-to-reach populations, including youth. However, with all survey methods, biases in the data may exist because of participant nonresponse.

OBJECTIVE

The aims of this study were to (1) examine the extent to which an ARS could be used to gather health information from youths within a large-group school setting and (2) examine individual- and survey-level response biases stemming from this Web-based data collection method.

METHODS

We used an ARS to deliver a mental health survey to 3418 youths in 4 high schools in the Midwestern United States. The survey contained demographic questions, depression, anxiety, and suicidality screeners, and questions about their use of offline resources (eg, parents, peers, and counselors) and Web-based resources (ie, telemental health technologies) when they faced stressful life situations. We then examined the response rates for each survey item, focusing on the individual- and survey-level characteristics that related to nonresponse.

RESULTS

Overall, 25.39% (868/3418) of youths answered all 38 survey questions; however, missingness analyses showed that there were some survey structure factors that led to higher rates of nonresponse (eg, questions at the end of survey, sensitive questions, and questions for which precise answers were difficult to provide). There were also some personal characteristics that were associated with nonresponse (eg, not identifying as either male or female, nonwhite ethnicity, and higher levels of depression). Specifically, a multivariate model showed that male students and students who reported their gender as other had significantly higher numbers of missed items compared with female students (B=.30 and B=.47, respectively, P<.001). Similarly, nonwhite race (B=.39, P<.001) and higher depression scores (B=.39, P<.001) were positively related to the number of missing survey responses.

CONCLUSIONS

Although our methodology-focused study showed that it is possible to gather sensitive mental health data from youths in large groups using ARSs, we also suggest that these nonresponse patterns need to be considered and controlled for when using ARSs for gathering population health data.

Are fishbowl activities effective for teaching pharmacotherapy and developing postformal thought in pharmacy students? A pilot study

BACKGROUND AND PURPOSE

Case based learning is a commonly used pedagogy to facilitate active learning and development of problem-solving skills, however its utility may be limited in a large lecture environment. Fishbowl activities have been utilized in higher education to encourage discussion and postformal thinking and may be useful in engaging large class sizes in collective problem-solving activities.

EDUCATIONAL ACTIVITY AND SETTING

The fishbowl activity took place in a second-year six-credit hour infectious disease course delivered in the spring of 2017, consisting 95 students. A pre-post survey was administered via Google^® forms and consisted of demographic items (age, race, gender), students' self-reported level of preparation, perceived benefits of the activity, strengths and weakness of the fishbowl activity, and postformal thought using the Complex Postformal Thought (PFT) questionnaire.

FINDINGS

Aggregate mean postformal thinking score was 51.98 in the pre-survey and 56.26 in the post-survey (p < 0.05). A majority of respondents agreed or strongly agreed that the activity helped them learn, was better than traditional lecture, and helped them prepare for material that would be on the exam.

DISCUSSION

Overall, this activity was generally well received by the students and may have positively impacted their postformal thinking. It appears that the fishbowl activity concept may transfer easily to pharmacy education and be an additional active learning tool for pharmacy educators based on these limited pilot results.

SUMMARY

Fishbowl activities may be a valuable educational tool for the development of postformal thinking skills in pharmacy students. Further studies are needed to evaluate the effectiveness and applicability of using this active learning approach in pharmacy education.

Presenting With Confidence

Often, advanced practitioners must give clinical presentations. Public speaking, which is a major fear for most individuals, is a developed skill. Giving an oral presentation is a good way to demonstrate work, knowledge base, and expertise. Giving an effective presentation can help obtain recognition of skills and proficiency as an advanced practitioner or expert in the field. This paper will highlight skills and techniques that can help to improve presentation style and the ability to connect with an audience.

Is computer-assisted instruction more effective than other educational methods in achieving ECG competence among medical students and residents? Protocol for a systematic review and meta-analysis

INTRODUCTION

Although ECG interpretation is an essential skill in clinical medicine, medical students and residents often lack ECG competence. Novel teaching methods are increasingly being implemented and investigated to improve ECG training. Computer-assisted instruction is one such method under investigation; however, its efficacy in achieving better ECG competence among medical students and residents remains uncertain.

METHODS AND ANALYSIS

This article describes the protocol for a systematic review and meta-analysis that will compare the effectiveness of computer-assisted instruction with other teaching methods used for the ECG training of medical students and residents. Only studies with a comparative research design will be considered. Articles will be searched for in electronic databases (PubMed, Scopus, Web of Science, Academic Search Premier, CINAHL, PsycINFO, Education Resources Information Center, Africa-Wide Information and Teacher Reference Center). In addition, we will review citation indexes and conduct a grey literature search. Data extraction will be done on articles that met the predefined eligibility criteria. A descriptive analysis of the different teaching modalities will be provided and their educational impact will be assessed in terms of effect size and the modified version of Kirkpatrick framework for the evaluation of educational interventions. This systematic review aims to provide evidence as to whether computer-assisted instruction is an effective teaching modality for ECG training. It is hoped that the information garnered from this systematic review will assist in future curricular development and improve ECG training.

ETHICS AND DISSEMINATION

As this research is a systematic review of published literature, ethical approval is not required. The results will be reported according to the Preferred Reporting Items for Systematic Review and Meta-Analysis statement and will be submitted to a peer-reviewed journal. The protocol and systematic review will be included in a PhD dissertation.

PROSPERO REGISTRATION NUMBER

CRD42017067054; Pre-results.

Exploring medical student learning in the large group teaching environment: examining current practice to inform curricular development

BACKGROUND

Lectures continue to be an efficient and standardised way to deliver information to large groups of students. It has been well documented that students prefer interactive lectures, based on active learning principles, to didactic teaching in the large group setting. Despite this, it is often the case than many students do not engage with active learning tasks and attempts at interaction. By exploring student experiences, expectations and how they use lectures in their learning we will provide recommendations for faculty to support student learning both in the lecture theatre and during personal study time.

METHODS

This research employed a hermeneutic phenomenological approach. Three focus groups, consisting of 19 students in total, were used to explore the experiences of second year medical students in large group teaching sessions. Using generic thematic data analysis, these accounts have been developed into a meaningful account of experience.

RESULTS

This study found there to be a well-established learning culture amongst students and with it, expectations as to the format of teaching sessions. Furthermore, there were set perceptions about the student role within the learning environment which had many implications, including the way that innovative teaching methods were received. Student learning was perceived to take place outside the lecture theatre, with a large emphasis placed on creating resources that can be taken away to use in personal study time.

CONCLUSIONS

Presented here is a constructive review of reasons for student participation, interaction and engagement in large group teaching sessions. Based on this are recommendations constructed with the view to aid educators in engaging students within this setting. Short term, educators can implement strategies that monopolise on the established learning culture of students to encourage engagement with active learning strategies. Long term, it would be beneficial for educators to consider ways to shift the current student learning culture to one that embraces an active learning curriculum.