MedEdPublish (2016)最新文献

{"title":"\"Grabbing\" Autonomy When the Learning Environment Doesn't Support it: An Evidence-based Guide for Medical Learners.","authors":"Adam Neufeld","doi":"10.12688/mep.19182.2","DOIUrl":"10.12688/mep.19182.2","url":null,"abstract":"<p><p>According to self-determination theory (SDT), environments which support the basic psychological needs for autonomy, competence, and relatedness will facilitate autonomous motivation, learning, and wellness. On the other hand, environments which introduce external controls and power dynamics into the equation will do the opposite. Educational studies support these principles, yet most have focused on learners' need satisfaction as a passive process (e.g., via support or hindrance by educators), rather than the agentic pursuit that SDT emphasizes. In this commentary, I draw on my experience as a practicing physician and SDT researcher, and focus on how medical learners can \"grab\" more autonomy when the learning environment does not support it. I present a hypothetical case of a preceptor whose teaching style is controlling and unfortunately well-known to medical learners. I then unpack the case and outline different strategies that medical learners can use to navigate this type of interpersonal conflict.</p>","PeriodicalId":74136,"journal":{"name":"MedEdPublish (2016)","volume":"12 ","pages":"43"},"PeriodicalIF":0.0,"publicationDate":"2023-07-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10450255/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10482868","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A mixed methods, longitudinal study: characterizing the differences in engagement and perceived learning of medical students in online and in-person team-based learning classes","authors":"I. Lee, P. Wong","doi":"10.12688/mep.19535.1","DOIUrl":"https://doi.org/10.12688/mep.19535.1","url":null,"abstract":"Background: The rapid transition to online delivery of medical curriculum has facilitated the continuation of medical education during the COVID-19 pandemic. Whilst active learning approaches, including Team-Based Learning (TBL), are generally more supportive of the learner’s needs during such transition, it remains elusive how different learning environments affect a learner’s motivation, engagement, and perceived learning over a prolonged period. We leveraged on Self-Determination Theory (SDT) and key learners’ characteristics to explore the levels of student’s engagement and perceived learning in two TBL learning environments, online and in-person, over an extended period. We hypothesize that students’ self-reported perceptions of engagement and learning will be lower in online compared to in-person TBL classes. Methods: This is a mixed methods study with 49 preclinical graduate medical students completing the same questionnaire twice for each learning environment, online TBL and in-person TBL, over an eight-month period. Quantitative data were collected on learners’ characteristics, basic psychological needs satisfaction, motivation, student’s engagement and perceived learning. The final questionnaire also explored participants’ perception on which learning environment better supported their learning. Results: We found that autonomy support, perceived competence and needs satisfaction, and perceived learning were higher in-person than online. Additionally, most learners felt that in-person TBL was better for learning, as the concepts of learning space and the community of practice were mediated by being in-person. Conclusions: TBL, being an active instructional method, can maintain students’ engagement because it supports many aspects of SDT constructs and perceived learning. However, online TBL is unable to fully support the students’ needs and perceived learning. Hence, we strongly advocate for any in-person opportunities to be included in a course, as in-person classes best supports students’ engagement and perceived learning.","PeriodicalId":74136,"journal":{"name":"MedEdPublish (2016)","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-07-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"66550312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluating the Amyloidosis Speakers Bureau: the influence of amyloidosis patients' narratives on medical students' knowledge, attitudes, and behavioral intent.","authors":"Adebanke L Adebayo,&nbsp;Katherine E Rowan,&nbsp;Vaishali Sanchorawala,&nbsp;Mackenzie N Boedicker,&nbsp;Deborah D Boedicker","doi":"10.12688/mep.19631.1","DOIUrl":"10.12688/mep.19631.1","url":null,"abstract":"<p><p><b>Background:</b>  Amyloidosis is a complex multi-systemic disease. Lack of knowledge about amyloidosis and subsequent mis- or under-diagnosis are major obstacles to treatment, which result in life-threatening organ damage, morbidity, and mortality. Hence, the purpose of this study is to explore the effectiveness of amyloidosis patients' narratives on medical students. <b>Methods:</b>  The Amyloidosis Speakers Bureau (ASB) arranges for amyloidosis patients to speak about their diagnostic and treatment experiences with medical students. Using a randomized post-test only experiment, we compared the effectiveness of patients' narratives between two groups (treatment and control). Outcome measures included medical students' intent to actively communicate with patients, acquire knowledge about amyloidosis, and reconsider diagnoses when warranted. <b>Results: </b> The treatment group (those who listened to an ASB patient speaker) had higher mean differences on all measures, including the desire to improve communication with patients, acquire and apply knowledge of amyloidosis, and willingness to reconsider diagnoses when symptoms are puzzling. <b>Conclusions: </b> ASB patient educators widened awareness of an under-diagnosed disease. Listening to a patient's narrative was associated with positive attitudes toward communication with patients, interest in acquiring and applying knowledge of amyloidosis, and humility about diagnosis. Narrative and persuasion theory are used to explain this quantitative evidence of the power of patient narratives.</p>","PeriodicalId":74136,"journal":{"name":"MedEdPublish (2016)","volume":"13 ","pages":"32"},"PeriodicalIF":0.0,"publicationDate":"2023-06-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10518845/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41142912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A systematic review of effective quality feedback measurement tools used in clinical skills assessment.","authors":"Akram Alsahafi, Davina Li Xin Ling, Micheál Newell, Thomas Kropmans","doi":"10.12688/mep.18940.2","DOIUrl":"10.12688/mep.18940.2","url":null,"abstract":"<p><strong>Background: </strong>Objective Structured Clinical Examination (OSCE) is a valid tool to assess the clinical skills of medical students. Feedback after OSCE is essential for student improvement and safe clinical practice. Many examiners do not provide helpful or insightful feedback in the text space provided after OSCE stations, which may adversely affect learning outcomes. The aim of this systematic review was to identify the best determinants for quality written feedback in the field of medicine.   Methods: PubMed, Medline, Embase, CINHAL, Scopus, and Web of Science were searched for relevant literature up to February 2021. We included studies that described the quality of good/effective feedback in clinical skills assessment in the field of medicine. Four independent reviewers extracted determinants used to assess the quality of written feedback. The percentage agreement and kappa coefficients were calculated for each determinant. The ROBINS-I (Risk Of Bias In Non-randomized Studies of Interventions) tool was used to assess the risk of bias.</p><p><strong>Results: </strong>14 studies were included in this systematic review. 10 determinants were identified for assessing feedback. The determinants with the highest agreement among reviewers were specific, described gap, balanced, constructive and behavioural; with kappa values of 0.79, 0.45, 0.33, 0.33 and 0.26 respectively. All other determinants had low agreement (kappa values below 0.22) indicating that even though they have been used in the literature, they might not be applicable for good quality feedback. The risk of bias was low or moderate overall.</p><p><strong>Conclusions: </strong>This work suggests that good quality written feedback should be specific, balanced, and constructive in nature, and should describe the gap in student learning as well as observed behavioural actions in the exams.  Integrating these determinants in OSCE assessment will help guide and support educators for providing effective feedback for the learner.</p>","PeriodicalId":74136,"journal":{"name":"MedEdPublish (2016)","volume":"12 ","pages":"11"},"PeriodicalIF":0.0,"publicationDate":"2023-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10331851/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9818449","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Framework for virtual education of COVID-19 vaccines for Mandarin-speaking learners: an educational intervention module","authors":"JiCi Wang, Benjamin M. Moy, Ross T. Kaufhold, Aurelio Muzaurieta, Yang Xia, Shannon Jiang, Angela Yim, Jane Chang Miller, Shiwei Zhou, Pearl Lee, Lisa Hou, Janilla Lee, Michael Heung","doi":"10.12688/mep.19207.2","DOIUrl":"https://doi.org/10.12688/mep.19207.2","url":null,"abstract":"<ns3:p>Background: In the United States, patients with limited English proficiency face significant barriers to comprehending and acting upon health-related information, particularly during the COVID-19 pandemic. The ability of health professionals to communicate COVID-19-related information to Mandarin-speaking patients has proved critical in discussions about vaccine efficacy, side effects, and post-vaccine protection.</ns3:p><ns3:p> </ns3:p><ns3:p> Methods: The authors created a one-hour educational module to help Mandarin-speaking medical students better convey COVID-19 vaccine information to Mandarin-only speakers. The module is composed of an educational guide, which introduced key terminology and addressed commonly asked questions, and pre- and post-surveys. The authors recruited 59 Mandarin-speaking medical students all of whom had previously completed a medical Mandarin elective. The module and surveys were distributed and completed in August 2021. Data analysis measured the change in aggregate mean for subjective five-point Likert-scale questions and change in percent accuracy for objective knowledge-based questions.</ns3:p><ns3:p> </ns3:p><ns3:p> Results: 86.4% of participants were primary English speakers with variable levels of Mandarin proficiency. The educational module significantly improved participants' subjective comfort level in discussing the COVID-19 vaccine in English and Mandarin. The largest improvement in both English and Mandarin was demonstrated in participants' ability to explain differences between the COVID-19 vaccines, with an aggregate mean improvement of 0.39 for English and 1.48 for Mandarin. Survey respondents also demonstrated increased percent accuracy in knowledge-based objective questions in Mandarin.</ns3:p><ns3:p> </ns3:p><ns3:p> Conclusions: This module provides Mandarin-learning medical students with skills to deliver reliable information to the general population and acts as a model for the continued development of educational modules for multilingual medical professionals.</ns3:p>","PeriodicalId":74136,"journal":{"name":"MedEdPublish (2016)","volume":"32 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135571874","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Undergraduate medical education at a district general hospital: facilitating the transition from student to medical professional","authors":"Neil Cunningham, Vicky O'Neil, Christopher Leng, Babulal Sethia","doi":"10.12688/mep.19111.2","DOIUrl":"https://doi.org/10.12688/mep.19111.2","url":null,"abstract":"<ns3:p><ns3:bold><ns3:underline>Background</ns3:underline></ns3:bold>: The transition from student to medical professional represents a major challenge for all medical students. Every intake of newly qualified doctors increases potential risks to patients. In the UK, this is often colloquially referred to as the ‘August Effect’. At one District General Hospital, a ‘Ward-Craft and Bleep Simulation Programme’ was implemented for final year medical students. This aimed to equip students with the procedural knowledge and soft skills to support the transition from undergraduate training to professional working life as a junior doctor.</ns3:p><ns3:p> <ns3:bold><ns3:underline>Methods</ns3:underline></ns3:bold>: A series of six, weekly, two-hour workshops which focussed on common clinical problems encountered by newly qualified doctors was delivered to final year medical students (‘Ward-Craft Programme’). Students then participated in a two-hour high fidelity, in-situ, ‘Bleep Simulation Programme. The programme was facilitated by a Clinical Teaching Fellow and evaluated through an anonymous feedback survey</ns3:p><ns3:p> <ns3:bold><ns3:underline>Results</ns3:underline></ns3:bold>: 98.9% of students (n=259) agreed, or strongly agreed, that the programme helped them feel more prepared and confident for life as a junior doctor. Participants provided overwhelmingly positive feedback, specifically noting that the programme addressed feelings of confusion, anxiety, and the feeling of being overwhelmed by the work of junior doctor.</ns3:p><ns3:p> <ns3:bold><ns3:underline>Conclusions</ns3:underline>: </ns3:bold>The Ward-Craft and Bleep Simulation Programme has been positively received by medical students from universities with very different types of learning styles and courses. The replication of similar programmes for final year medical students is a valuable training opportunity for final year medical students and may help mitigate the challenges posed by the ‘August effect’.</ns3:p>","PeriodicalId":74136,"journal":{"name":"MedEdPublish (2016)","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135215019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A commentary on the National Medical Licensing Examination in Vietnam: why, what, who and how","authors":"Thuy Minh Ha","doi":"10.12688/mep.19654.1","DOIUrl":"https://doi.org/10.12688/mep.19654.1","url":null,"abstract":"<ns4:p>As a result of increasing societal demands and economic development, the number of medical schools in Vietnam has increased significantly over the past decade. In order to ensure physician competency, it is imperative that medical training meets a minimal threshold before entering clinical practice. The prospects of the National Medical Licensing Exam (NMLE) have been discussed extensively and are expected to be instrumental in influencing curriculum reform, thus enhancing the quality of medical education. This paper discusses briefly why NMLE is necessary for Vietnam, what should be considered when establishing it, who could be the responsible organization, and how good practices can be learned and used as personal recommendations for educators and policymakers.</ns4:p>","PeriodicalId":74136,"journal":{"name":"MedEdPublish (2016)","volume":"38 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135085549","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A pilot clinical skills coaching program to reimagine remediation: a cohort study","authors":"Jean E. Klig, William M. Kettyle, Joshua M. Kosowsky, William R. Phillips, Jr., Susan E. Farrell, Edward M. Hundert, John L. Dalrymple, Mary Ellen J. Goldhamer","doi":"10.12688/mep.19621.1","DOIUrl":"https://doi.org/10.12688/mep.19621.1","url":null,"abstract":"<ns4:p><ns4:bold>Background</ns4:bold></ns4:p><ns4:p> New approaches are needed to improve and destigmatize remediation in undergraduate medical education (UME). The COVID-19 pandemic magnified the need to support struggling learners to ensure competency and readiness for graduate medical education (GME). Clinical skills (CS) coaching is an underutilized approach that may mitigate the stigma of remedial learning.</ns4:p><ns4:p> </ns4:p><ns4:p> <ns4:bold>Methods</ns4:bold></ns4:p><ns4:p> A six-month CS coaching pilot was conducted at Harvard Medical School (HMS) as a destigmatized remedial learning environment for clerkship and post-clerkship students identified as ‘at risk’ based on objective structured clinical examinations (OSCE). The pilot entailed individual and group coaching with five faculty, direct bedside observation of CS, and standardized patient encounters with video review. Strengths-based coaching principles and appreciative inquiry were emphasized. </ns4:p><ns4:p> </ns4:p><ns4:p> <ns4:bold>Results</ns4:bold></ns4:p><ns4:p> Twenty-three students participated in the pilot: 14 clerkship students (cohort 1) and 9 post-clerkship students (cohort 2). All clerkship students (cohort 1) demonstrated sustained improvement in CS across three OSCEs compared to baseline: at pilot close, at 6-months post pilot, and at 21-24 months post-pilot all currently graduating students (10/10, 100%) passed the summative OSCE, an HMS graduation requirement. All post-clerkship students (cohort 2) passed the HMS graduation OSCE (9/9,100%). Feedback survey results included clerkship students (9/14; 64%) and post-clerkship students (7/9; 78%); all respondents unanimously agreed that individual coaching was “impactful to my clinical learning and practice”. Faculty and leadership fully supported the pilot as a destigmatized and effective approach to remediation. </ns4:p><ns4:p> </ns4:p><ns4:p> <ns4:bold>Conclusion</ns4:bold></ns4:p><ns4:p> Remediation has an essential and growing role in medical schools. CS coaching for remedial learning can reduce stigma, foster a growth mindset, and support sustained progress for ‘at risk’ early clerkship through final year students. An “implementation template” with suggested tools and timelines can be locally adapted to guide CS coaching for UME remediation. The CS coaching pilot model is feasible and can be generalized to many UME programs.</ns4:p>","PeriodicalId":74136,"journal":{"name":"MedEdPublish (2016)","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-05-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135767981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Practical tips for starting a successful national postgraduate course","authors":"M. Sundbom","doi":"10.12688/mep.19636.1","DOIUrl":"https://doi.org/10.12688/mep.19636.1","url":null,"abstract":"Background: Few start national courses, and those that do usually do it once. The aim of this paper is to outline an approach to conduct a successful national postgraduate course. Methods: The practical tips were derived from personal experience. Results: The 12 tips identified are: define learning needs and curriculum, create a functioning structure, recruit a committed faculty, obtain legitimacy, promote your course, try out the concept, establish administrative support, use modern techniques and accessories, create course-related social activities, keep all on board, collect ongoing evaluation, and stay in control. Conclusion: It is hoped that these tips will make it easier for others to take the decisive first step in the exciting task of starting a national course; that is: ‘to know the road ahead - ask those coming back’.","PeriodicalId":74136,"journal":{"name":"MedEdPublish (2016)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46779403","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Interactive e-learning course versus virtual traditional teaching on fetal motility, a cohort comparison of medical students","authors":"J. Tjon, A. Ledebt, I. Linskens, B. J. van der Knoop, H. Jarodzka, J. de Vries","doi":"10.12688/mep.19562.1","DOIUrl":"https://doi.org/10.12688/mep.19562.1","url":null,"abstract":"Background: Ultrasound examination is an important application in obstetrics. Fetal motor assessment can help to discriminate severe diseases, such as those underlying abnormal fetal joint position. However, standardized training is lacking. It was investigated whether virtual traditional teaching (TT) initiated by the coronavirus 2019 (COVID-19) pandemic gave equal outcome, compared to the prior blended teaching (BT) course on fetal motility. Methods: In total 96 medical students were included, 51 underwent BT versus 45 TT. BT underwent live supervised interactive e-learning and TT plenary virtual lecture. Both groups made the same individual assignments. The first assignment evaluated course knowledge in four video fragments on single specific movement patterns (SMPs), the second assignment consisted of three fragments with various SMPs, students were asked to score differentiation and qualitative performance. Results: BT and TT showed equally high correct answers on four individual SMPs. The second assignment revealed that BT and TT scored similarly in differentiation of SMPs. Two fetuses with normal motility were equally well scored in half of the items, BT scored speed and amplitude better, TT scored better in speed (other fetus) and overall conclusion. The one fetus with abnormal movements was scored by BT and TT similarly, 75% of both groups scored the fetus as moving suspect or abnormal. Conclusions: Evaluation of medical students’ motor assessment skills after BT and TT revealed a nearly equally high yield of the courses in distinguishing SMPs and similar judgement of aspects and overall qualitative performance.","PeriodicalId":74136,"journal":{"name":"MedEdPublish (2016)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42606863","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}