Exploring dental and oral hygiene students' interprofessional readiness: a cross-sectional study in joint paediatric outreach training.

BACKGROUND: Interprofessional education is vital in oral healthcare education and should be integrated into both theoretical and work-based education. Little research addresses interprofessional education in dental hands-on training in authentic oral healthcare settings. The aim of the study was to examine the readiness and attitudes of dental and oral hygiene students towards interprofessional education during joint paediatric outreach training. METHODS: In the spring of 2022, a cross-sectional study was done involving dental and oral hygiene students using the Readiness for Interprofessional Learning Scale (RIPLS) during joint paediatric outreach training. The 19-item tool was answered on a five-point Likert scale (1 = strongly disagree, 2 = disagree, 3 = neutral, 4 = agree, and 5 = strongly agree). Means, standard deviations, minimums, maximums, and medians were calculated for each subscale and overall score. Students grouped according to their categorical variables were compared for statistically significant differences. The Mann-Whitney U-test was used for groups of two and the Kruskal-Wallis one-way analysis for groups of three or more. The internal consistency of the scale was measured with Cronbach's alpha. Statistical level was set at 0.05. RESULTS: The survey included 111 participants, consisting of 51 oral hygiene students and 60 dental students, with a response rate of 93%. The questionnaire yielded a high overall mean score of 4.2. Both oral hygiene (4.3) and dental students (4.2) displayed strong readiness for interprofessional education measured by the RIPLS. The subscale of teamwork and collaboration achieved the highest score of 4.5. Students lacking prior healthcare education or work experience obtained higher RIPLS scores. Oral hygiene students rated overall items (p = 0.019) and the subscales of positive professional identity (p = < 0.001) and roles and responsibilities (p = 0.038) higher than dental students. The Cronbach's alpha represented high internal consistency for overall RIPLS scores on the scale (0.812). CONCLUSIONS: Both oral hygiene and dental students perceived shared learning as beneficial and showcased high readiness for interprofessional education, as evident in their RIPLS scores. Integrating interprofessional learning into oral hygiene and dental curricula is important. Studying together can form a good basis for future working life collaboration.

Mentorship in health professions education - an AMEE guide for mentors and mentees: AMEE Guide No. 167.

This AMEE guide discusses theoretical principles and practical strategies for health professions educators to promote impactful mentoring relationships. Traditional definitions are challenged, distinctions are made between roles such as mentor, advisor, coach and sponsor. As educational environments change and options for professional development expand, we argue that the traditional dyadic format of mentoring alone will not help mentees to maximise their professional growth. Newer formats of mentoring are discussed in detail and their advantages and disadvantages compared. We use a variety of theoretical concepts to anchor the practice of mentorship: self-focussed and other-focussed motives; psychological safety; personal interpretive framework; Daloz model for balancing support and challenge; zone of proximal development; communities of practice; and development along multiple layers of competence. Recommended strategies for effective mentoring are based on extensive review of literature, as well as combined professional mentoring experiences of the authors. We use key principles from the theories described and phases of mentoring relationships as foundations for the suggested best practices of mentorship. Finally, we emphasise the role of mentees in their own professional development and provide tips for them on seeking mentors, expanding their mentoring network and taking the lead in setting the agenda during mentoring meetings and formulating action plans for their own advancement.

Synthesis and perspectives from the Ottawa 2022 conference on the assessment of competence.

INTRODUCTION: The Ottawa Conference on the Assessment of Competence in Medicine and the Healthcare Professions was first convened in 1985 in Ottawa. Since then, what has become known as the Ottawa conference has been held in various locations around the world every 2 years. It has become an important conference for the community of assessment - including researchers, educators, administrators and leaders - to share contemporary knowledge and develop international standards for assessment in medical and health professions education. METHODS: The Ottawa 2022 conference was held in Lyon, France, in conjunction with the AMEE 2022 conference. A diverse group of international assessment experts were invited to present a symposium at the AMEE conference to summarise key concepts from the Ottawa conference. This paper was developed from that symposium. RESULTS AND DISCUSSION: This paper summarises key themes and issues that emerged from the Ottawa 2022 conference. It highlights the importance of the consensus statements and discusses challenges for assessment such as issues of equity, diversity, and inclusion, shifts in emphasis to systems of assessment, implications of 'big data' and analytics, and challenges to ensure published research and practice are based on contemporary theories and concepts.

Comparison of voluntary and forced digital leaps in higher education - Teachers' experiences of the added value of using digital tools in teaching and learning.

The study examines the benefits of digital tools in teaching and learning as experienced by university teachers in two different time periods: 1) during the controlled digital leap before the Covid-19 pandemic (2017-2019) and 2) during the emergency imposition of remote teaching in response to the lockdown aimed at containing the Covid-19 pandemic (2020). Teachers in different academic fields at a large multidisciplinary Finnish university (N1 = 303 and N2 = 265) responded to two open-ended questions as part of a broader questionnaire. The research identified four kinds of benefits related to digital teaching: (1) practical and administrative and (2) independence of time and place, implying practical and technical benefits; as well as (3) enhancing learning and (4) developing teaching, which are primarily pedagogical benefits, related to teaching and learning. Voluntary and forced digital leaps provided different kinds of consequences in teaching and learning. Digital tools generally provided practical and technological benefits for teaching and learning during the controlled digital leap, but they also had positive pedagogical effects. The forced digital leap, in turn, demonstrated the value of time-and-place-independent online teaching and learning. It also exposed differences among academic fields in how teachers experienced the benefits of using digital tools. Support of and training for university teachers should take into account the different needs of faculties and disciplines, and promote dialogue between pedagogical and technological interests.

Comparison of two different mindfulness interventions among health care students in Finland: a randomised controlled trial.

We investigated the short- and long-term effects of two different evidence-based mindfulness training on students' stress and well-being. A randomised controlled trial with three measurement points (baseline, post-intervention, and 4 months post-intervention) was conducted among undergraduate students of medicine, dentistry, psychology, and logopaedics at the University of Helsinki. The participants were randomly assigned into three groups: (1) face-to-face mindfulness training based on the Mindfulness Skills for Students course (n = 40), (2) a web-based Student Compass program using Mindfulness and Acceptance and Commitment therapy (n = 22), and (3) a control group that received mental health support as usual (n = 40). The primary outcome was psychological distress measured using the Clinical Outcomes in Routine Evaluation Outcome Measure (CORE-OM). Secondary outcomes included hair cortisol concentrations and a wide range of well-being indicators. Psychological distress increased in all the groups from baseline to post-intervention, but significantly less so in the intervention groups than in the control group. At 4-month follow-up, were found no differences between the primary outcomes of the control and intervention groups, but the participants who continued practising mindfulness at least twice a week were less stressed than the others. Our results suggest that participating in a mindfulness course may mitigate health care students' psychological distress during the academic year, but only if the participants continue practising mindfulness at least twice a week.

Technology enhanced assessment: Ottawa consensus statement and recommendations.

INTRODUCTION: In 2011, a consensus report was produced on technology-enhanced assessment (TEA), its good practices, and future perspectives. Since then, technological advances have enabled innovative practices and tools that have revolutionised how learners are assessed. In this updated consensus, we bring together the potential of technology and the ultimate goals of assessment on learner attainment, faculty development, and improved healthcare practices. METHODS: As a material for the report, we used the scholarly publications on TEA in both HPE and general higher education, feedback from 2020 Ottawa Conference workshops, and scholarly publications on assessment technology practices during the Covid-19 pandemic. RESULTS AND CONCLUSION: The group identified areas of consensus that remained to be resolved and issues that arose in the evolution of TEA. We adopted a three-stage approach (readiness to adopt technology, application of assessment technology, and evaluation/dissemination). The application stage adopted an assessment 'lifecycle' approach and targeted five key foci: (1) Advancing authenticity of assessment, (2) Engaging learners with assessment, (3) Enhancing design and scheduling, (4) Optimising assessment delivery and recording learner achievement, and (5) Tracking learner progress and faculty activity and thereby supporting longitudinal learning and continuous assessment.

Using activity theory to transform medical work and learning.

This article introduces key concepts of activity theory and expansive learning. Expansive learning builds on the foundational ideas of the cultural-historical activity theory (CHAT). It is a research approach designed for studying the complexities and contradictions in authentic workplace environments. Change Laboratory is a formative intervention method developed for studying workplaces in transition and for stimulating collaborative efforts to design improved patterns of activity. We present concrete examples of formative interventions in healthcare, where good patient care was compromised by the fragmentation of care and disturbances in collaboration between the healthcare experts. This implies that physicians are challenged to develop collaborative and transformative expertise. We present three spearheads into a zone of proximal development, representing opportunities for change of medical expertise: (1) reconceptualizing expertise as object-oriented and contradiction-driven activity systems, (2) pursuing expertise as negotiated knotworking, and (3) building expertise as expansive learning. While medical expertise needs to expand, medical education must also look for ways to evolve and meet the challenges of the surrounding society. We call for adopting an interventionist approach for developing medical education and intensifying collaboration with the practitioners in healthcare units, their patients, and target communities.

Hurdles for adopting mobile learning devices at the outset of clinical courses.

BACKGROUND: Mobile devices provide medical students with easy access to medical information and educational resources. Since 2013, we have followed the study use of iPads among medical students. In 2016, we observed a notable drop in the mobile device usage in the first cohort of medical students entering their clinical courses. METHODS: The aim of the study was to identify the hurdles for adopting mobile devices at the beginning of the clinical courses. We examined how students evaluated their own and the clinical teachers' ability to use the iPad, how the study assignments fit into digital learning, and how students used the mobile device with patients. The data were collected with online surveys among three consecutive student cohorts and the distributions of closed-ended questions analyzed. RESULTS: Response rates ranged from 67.5 to 90.8%. Students evaluated their own ability to use the iPad as good or excellent and teachers' skills as relatively poor and wanted more digitally tailored assignments. They reported negative attitudes towards mobile device use in the clinical setting and were hesitant to use them in patient contact. Teachers seldom communicated suitable quality medical applications to students. CONCLUSIONS: Clinical teachers need support and training to implement a learning environment and assignments appropriate for mobile devices. Both students and teachers were concerned about using these devices with patients. To achieve the full potential of digitalisation in clinical courses, their use should be developed collectively with students.

The art of note taking with mobile devices in medical education.

BACKGROUND: Students use mobile devices extensively in their everyday life, and the new technology is adopted in study usage. Since 2013, the University of Helsinki has given new medical and dental students iPads for study use. Simultaneously, an action research project on mobile learning started focusing on these students' mobile device usage throughout their study years. Note taking is crucial in academic studies, but the research evidence in this area is scarce. The aims of this study were to explore medical and dental students' self-reported study uses of mobile devices and their best practices of mobile note taking. METHOD: An action research project began in 2013 and followed the first student cohort (124 medical and 52 dental students) with iPads from the first until the fifth study year. We explored students' descriptions of their most important study uses of mobile devices and their perceptions of note taking with iPads. The longitudinal data were collected with online questionnaires over the years. The answers to open-ended questions were examined using qualitative content analysis. The findings were triangulated with another question on note taking and focus-group interviews. RESULTS: The response rates varied between 73 and 95%. Note taking was the most frequently and consistently reported study use of iPads during the study years. While taking notes, students processed the new information in an accomplished way and personalised the digital learning materials by making comments, underlining, marking images and drawing. The visual nature of their learning materials stimulated learning. Students organised the notes for retention in their personalised digital library. In the clinical studies, medical students faced the teachers' resistance and ambivalence to mobile device usage. This hindered the full-scale benefit of the novel technology in the clinical context. CONCLUSIONS: Efficient digital note taking practices were pivotal to students in becoming mobile learners. Having all their notes and learning materials organised in their personal digital libraries enabled the students to retrieve them anywhere, anytime, both when studying for examinations and treating patients in the clinical practice. The challenges the medical students met using mobile devices in the clinical setting require further studies.

[Flipped classroom in basic medical education]. / Käänteinen oppiminen lääketieteen peruskoulutuksessa.

Medical education is facing changes in order to improve young doctors' competency to respond better to current needs of the patients and the society. Both curriculum content and teaching methods are revised. In addition to vibrant research in academic medical education, teachers are supported by the improved web-based learning environments and novel technical tools. Flipped classroom, a new paradigm that benefits from technical development, provides many opportunities for medical education. This teaching method always consists of two mutually complementary parts. The first part of the learning action takes place independently off classroom with video lectures or other stimuli for learning. The second part takes place in conjunction with the teacher and other students, and requires student group interactions.

How do tutors intervene when conflicts on knowledge arise in tutorial groups?

Recent research on problem-based learning (PBL) has shown that students need support when dealing with conflicting ideas in PBL-tutorial discussions. In the present study, we examined tutor facilitation during tutorial discussions, and particularly how the facilitation helped students to collaboratively resolve conflicts on knowledge. The study involved four PBL-tutorial sessions that included altogether 33 first-year medical and dental students. The sessions were videotaped and analysed using qualitative interaction analysis. Our aim was to find out how the tutor interventions encouraged students to elaborate on conflicting ideas, and how the interventions differed between conflict and non-conflict situations. We also examined how the tutors intervened during conflicts about factual or conceptual knowledge. The tutorial discussions included 92 tutor intervention episodes and 43 conflict episodes. The tutors intervened during 24 of the conflict episodes and resolved 13 of these episodes. Generally, the tutors often intervened by confirming what the students had said or by giving explanations, but they rarely asked questions that would stimulate the elaboration of knowledge. During conflicts on knowledge the tutors gave more explanations, but did little to encourage the students to deal with conflicting ideas. The tutors more often resolved conflicts on factual knowledge than conceptual knowledge. The findings suggest that tutor training should focus on promoting tutors' understanding on when to give direct explanations, and when and how to encourage students to collaboratively elaborate on conflicting ideas.

How we developed a role-based portfolio for teachers' professional development.

Faculty development requires practical tools for supporting teachers' professional development. In a modern medical education context, teachers need to adapt to various educational roles. This article describes how a role-based portfolio with a qualitative self-assessment scale was developed. It strives to encourage and support teachers' growth in different educational roles. The portfolio was developed between 2009 and 2012 at the University of Helsinki in dialogue with teachers involved in faculty development. It is based on the role framework presented by Harden and Crosby. Today, it also involves the educational premises of constructive alignment, reflection and a scholarly approach to teaching. The role-based portfolio has led the teachers to discover new educational roles and set goals in their professional development.

Dealing with conflicts on knowledge in tutorial groups.

The aim of our study was to gain understanding of different types of conflicts on knowledge in the discussions of problem-based learning tutorial groups, and how such conflicts are dealt with. We examined first-year medical and dental students' (N = 33) conflicts on knowledge in four videotaped reporting phase tutorials. A coding scheme was created for analysing verbatim transcripts of 43 conflict episodes in order to find out whether the conflict episodes were about factual or conceptual knowledge and how the students elaborated the knowledge. Conflict episodes were relatively rare (taking up 7.6 % of the time) in the videotaped groups. Conflict episodes were more frequently about factual knowledge (58 %) than conceptual knowledge (42 %), but conflicts on conceptual knowledge lasted longer and were more often elaborated. Elaboration was, however, more frequently done individually than collaboratively. Conflict episodes were generally fairly short (mean duration 28 s). This was due to a lack of thorough argumentation and collaborative elaboration of conflicting ideas. The results suggest that students' skills to bring out differences in each other's conceptual thinking, the depth of argumentation and the use of questions that elicit elaboration need to be improved. Tutors' skills to facilitate the collaborative resolving of conflicts on knowledge call for further study.

Comparing three experiential learning methods and their effect on medical students' attitudes to learning communication skills.

BACKGROUND: Despite numerous studies exploring medical students' attitudes to communication skills learning (CSL), there are apparently no studies comparing different experiential learning methods and their influence on students' attitudes. AIMS: We compared medical students' attitudes to learning communication skills before and after a communication course in the data as a whole, by gender and when divided into three groups using different methods. METHOD: Second-year medical students (n = 129) were randomly assigned to three groups. In group A (n = 42) the theatre in education method, in group B (n = 44) simulated patients and in group C (n = 43) role-play were used. The data were gathered before and after the course using Communication Skills Attitude Scale. RESULTS: Students' positive attitudes to learning communication skills (PAS; positive attitude scale) increased significantly and their negative attitudes (NAS; negative attitude scale) decreased significantly between the beginning and end of the course. Female students had more positive attitudes than the male students. There were no significant differences in the three groups in the mean scores for PAS or NAS measured before or after the course. CONCLUSIONS: The use of experiential methods and integrating communication skills training with visits to health centres may help medical students to appreciate the importance of CSL.

[Providing feedback in medical work]. / Palautteen antaminen lääkärin työssä.

During medical studies, young doctors have grown accustomed to both provide and receive feedback, and they also expect to receive it. Supervisors, on the other hand, have traditionally seldom received training in constructive provision of feedback. Constructive feedback to employees is also part of high-quality management. Feedback is most commonly directed to a concrete task and its realization in relation to the goals. To create good atmosphere it is helpful that the feedback provider pays attention to at least one well-conducted task or part of a task.

What do Finnish physiotherapists and physiotherapy students know about the neurophysiology of pain? The Finnish version of the revised Neurophysiology of Pain Questionnaire.

BACKGROUND: Understanding the concept of pain and its underlying biological mechanisms is an essential part of physiotherapists' professional knowledge. OBJECTIVES: The first aim of the study was to translate and cross-culturally adapt the revised Neurophysiology of Pain Questionnaire into Finnish (RNPQ-FI) and to evaluate its reliability (internal consistency and test-retest reliability) in a sample of Finnish physiotherapists and physiotherapy students. The second aim was to compare the knowledge of pain neurophysiology between these two groups. METHODS: Translation and cross-cultural adaptation followed the COSMIN Study Design checklist. Participants (202 physiotherapists and 97 physiotherapy students) completed an online survey containing RNPQ-FI. Internal consistency was assessed with Cronbach's alpha and test-retest reliability using Intraclass correlation coefficient (ICC3,1). RESULTS: Cronbach's alpha was 0.44 and ICC was 0.70 (p < .001). The mean percentage of correct responses was 61.4% for physiotherapists and 62.1% for students. Forty-seven percent of the physiotherapists and 35.1% of the students reported difficulties in understanding the items. A higher amount of pain education was associated with higher RNPQ-FI scores. CONCLUSIONS: The RNPQ-FI showed low internal consistency and moderate test-retest reliability among Finnish physiotherapists and physiotherapy students. Physiotherapists and students had equal amount of pain neurophysiology knowledge. Pain education is encouraged.

Psychometric properties and factor structure of the Finnish version of the Health Care Providers' Pain and Impairment Relationship Scale.

BACKGROUND: Health care providers' beliefs influence the outcomes of low back pain patients care. OBJECTIVES: The aim of this study was to translate and cross-culturally adapt the Health Care Providers' Pain and Impairment Relationship Scale into Finnish (HC-PAIRS-FI) and to evaluate its psychometric properties and factor structure in a sample of Finnish physiotherapists and physiotherapy students. METHODS: The translation was performed using established guidelines. Participants answered an online survey consisting of HC-PAIRS-FI and the Finnish Tampa Scale of Kinesiophobia adapted for health care providers (TSK-HC-FI). Internal consistency was assessed using Cronbach's alpha. Intraclass correlation coefficient (ICC) was used to determine test-retest reliability. A second round of analysis, exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) was performed as the fit indices of the initial CFA were not satisfactory. RESULTS: A sample of 202 physiotherapists and 97 physiotherapy students completed the survey. The second round of analysis EFA and CFA, conducted on a randomly split subsample, revealed and confirmed a three-factor, 11-item HC-PAIRS-FI scale with satisfactory model fit indices. Cronbach's alpha 0.79 and ICC = 0.82 (p < 0.001) indicate good internal consistency and test-retest reliability. The standard error of measurement was 2.12. HC-PAIRS-FI scores correlated moderately with TSK-HC-FI (r = 0.69, p < 0.001). CONCLUSIONS: The 11 items HC-PAIRS-FI appears to be a valid and reliable questionnaire to evaluate Finnish physiotherapists' and physiotherapy students' attitudes and beliefs about the relationship between chronic low back pain and impairment. Future studies are required to validate this scale for other health care providers.

Biomedical Courses Should Also Be Designed for Dental Students: The Perceptions of Dental Students.

INTRODUCTION: It can be challenging integrating biomedical sciences into dentistry programs. The aim was to examine students' perceptions of how joint biomedical courses with medical students and courses tailored for dental students supported their clinical studies. MATERIALS AND METHODS: The target group was clinical phase dental students. Cross-sectional survey data were collected using a questionnaire, which consisted of questions covering biomedical and clinical study content and learning methods. RESULTS: A total of 110 (82%) students completed the survey. Students had difficulty recognising the relevance of joint biomedical courses for clinical work, but when the link was clear, their interest in the content increased. The closer the respondents were to graduation, the less relevance they expressed the biomedical sciences had. Almost all students (95%) wanted more dental content for the early study years. DISCUSSION: The student perspective provides valuable information for the development of biomedical courses. Students should be offered customised courses that include dental content and perspectives on clinical work, whenever suitable to the didactic content of the basic science course. Our study shows that the dental perspective needs greater integration with the biomedical content. This also supports interprofessional learning and appreciation for the other field's contribution to human health.

Motivating medical students to learn teamwork skills.

BACKGROUND: This study examined teaching teamwork skills to first-year medical students. Teamwork skills focused on verbal communication in PBL-tutorial sessions and in healthcare teams. AIMS: The aim was to find out how to teach teamwork skills to first-year medical students and how to motivate them to learn these skills. METHOD: Three consecutive classes of first-year medical students (N = 342) participated in teamwork skills module in the years 2006, 2007 and 2008. After the first year, the introduction to the topic was revised in order to be more motivating to medical students. After each module data were collected with a feedback questionnaire containing numerical and open questions. By analyzing the students' numerical answers and the content of students' open answers regarding the module, we examined how the revised introduction affected students' perceptions of the usefulness of the module. RESULTS: Medical students' feedback in the years 1 (n = 81), 2 (n = 99) and 3 (n = 95) showed that the students found the module in the second and third years significantly more useful than in the first year. These results support earlier findings that clearly stated clinical relevance motivates medical students. CONCLUSIONS: When introducing multidisciplinary subjects to medical students, it is important to think through the clinical relevance of the topic and how it is introduced to medical students.