Assuntos
Educação a Distância/estatística & dados numéricos , Educação de Pós-Graduação em Medicina/estatística & dados numéricos , Aprendizagem Baseada em Problemas/estatística & dados numéricos , Fatores Sexuais , Estudantes de Medicina/estatística & dados numéricos , Centros Médicos Acadêmicos , Adulto , Educação de Pós-Graduação em Medicina/métodos , Feminino , Humanos , MasculinoRESUMO
During clinical reasoning case conferences, a learner-centered approach using teleconferencing can create a psychologically safe environment and help learners speak up. This study aims to measure the psychological safety of students who are supposed to self-explain their clinical reasoning to conference participants. This crossover study compared the effects of two clinical reasoning case conference methods on medical students' psychological safety. The study population comprised 4th-5th year medical students participating in a two-week general medicine clinical clerkship rotation, from September 2019 to February 2020. They participated in both a learner-centered approach teleconference and a traditional, live-style conference. Teleconferences were conducted in a separate room, with only a group of students and one facilitator. Participants in group 1 received a learner-centered teleconference in the first week and a traditional, live-style conference in the second week. Participants assigned to group 2 received a traditional, live-style conference in the first week and a learner-centered approach teleconference in the second week. After each conference, Edmondson's Psychological Safety Scale was used to assess the students' psychological safety. We also counted the number of students who self-explained their clinical reasoning processes during each conference. Of the 38 students, 34 completed the study. Six out of the seven psychological safety items were significantly higher in the learner-centered approach teleconferences (p<0.01). Twenty-nine (85.3%) students performed self-explanation in the teleconference compared to ten (29.4%) in the live conference (p<0.01). A learner-centered approach teleconference could improve psychological safety in novice learners and increase the frequency of their self-explanation, helping educators better assess their understanding. Based on these results, a learner-centered teleconference approach has the potential to be a method for teaching clinical reasoning to medical students.
Assuntos
Raciocínio Clínico , Educação de Graduação em Medicina/métodos , Estresse Psicológico/prevenção & controle , Estudantes de Medicina/psicologia , Telecomunicações , Adulto , Estágio Clínico/métodos , Estágio Clínico/estatística & dados numéricos , Competência Clínica/estatística & dados numéricos , Estudos Cross-Over , Educação de Graduação em Medicina/estatística & dados numéricos , Feminino , Humanos , Japão , Masculino , Aprendizagem Baseada em Problemas/métodos , Aprendizagem Baseada em Problemas/estatística & dados numéricos , Estresse Psicológico/etiologia , Estudantes de Medicina/estatística & dados numéricos , Adulto JovemRESUMO
Public health crises palpably demonstrate how social determinants of health have led to disparate health outcomes. The staggering mortality rates among African Americans, Native Americans, and Latinx Americans during the COVID-19 pandemic have revealed how recalcitrant structural inequities can exacerbate disparities and render not just individuals but whole communities acutely vulnerable. While medical curricula that educate students about disparities are vital in rousing awareness, it is experience that is most likely to instill passion for change. The authors first consider the roots of health care disparities in relation to the current pandemic. Then, they examine the importance of salient learning experiences that may inspire a commitment to championing social justice. Experiences in diverse communities can imbue medical students with a desire for lifelong learning and advocacy. The authors introduce a 3-pillar framework that consists of trust building, structural competency, and cultural humility. They discuss how these pillars should underpin educational efforts to improve social determinants of health. Effecting systemic change requires passion and resolve; therefore, perseverance in such efforts is predicated on learners caring about the structural inequities in housing, education, economic stability, and neighborhoods-all of which influence the health of individuals and communities.
Assuntos
COVID-19/psicologia , Educação Médica/ética , Etnicidade/estatística & dados numéricos , Racismo/etnologia , Negro ou Afro-Americano , Conscientização , COVID-19/diagnóstico , COVID-19/epidemiologia , COVID-19/virologia , Educação Médica/estatística & dados numéricos , Feminino , Disparidades em Assistência à Saúde/etnologia , Humanos , Masculino , Grupos Minoritários , Aprendizagem Baseada em Problemas/estatística & dados numéricos , Saúde Pública/ética , Saúde Pública/estatística & dados numéricos , SARS-CoV-2/genética , Determinantes Sociais da Saúde/etnologia , Determinantes Sociais da Saúde/estatística & dados numéricos , Justiça Social/ética , Participação dos Interessados , Estudantes de Medicina/estatística & dados numéricos , Estados Unidos/epidemiologiaRESUMO
Team-based learning (TBL), which encourages students to become active rather than passive learners, has gained world-wide popularity in medical education due to its proven positive effect on more than one aspect of the educational process. At King Abdulaziz University (KAU), clinical biochemistry is still taught in the form of didactic lectures, and while there is a need for introducing active learning, student learning response from TBL has not been explored. In this quasi-experimental non-equivalent comparison group design, we compared learning outcomes and student satisfaction in a clinical biochemistry course taught either via TBL to second year clinical nutrition students (n = 33) or via traditional lectures to same year nursing students (n = 70). The same summative post-course exam was given to both student groups to assess impact on learning. Focus group discussion and a self-administered questionnaire were used to gain insight into clinical nutrition students' level of satisfaction with TBL. In the post-course exam results of recall and reasoning questions, nursing students (Lectures) scored an average of 38% ± 2.4 in the recall questions while clinical nutrition students (TBL) scored higher with an average of 74.5% ± 4.3 (p < .0001). In reasoning questions, nursing students (Lectures) scored lower than clinical nutrition students (TBL), 23% ± 2.7 versus 40% ± 4.2, respectively (p < .001). In comparing results of pre- and post-test recall questions within each group, there was no significant difference between pre- and post-results for nursing students (Lectures) while clinical nutrition students (TBL) showed a significant increase in post-versus pre-test results of 71% versus 41% (p < .0001). In the final summative post-course exam, nursing students scored an average of 60% ± 2.4 while clinical nutrition students (TBL) scored significantly higher with an average of 78% ± 2.4 (p < .001). Qualitative studies revealed that accountability and team-work were positive aspects perceived by students regarding TBL. The study showed that 84% of surveyed students enjoyed the experience, however, when asked about challenges self-study was their main challenge. TBL proved to be a successful, learner-centered approach for clinical nutrition students at KAU in their clinical biochemistry course resulting in improved learning outcomes and higher student satisfaction when compared with traditional didactic methods of teaching.
Assuntos
Bioquímica/educação , Educação de Graduação em Medicina/métodos , Avaliação Educacional/métodos , Processos Grupais , Aprendizagem Baseada em Problemas/estatística & dados numéricos , Estudantes de Medicina/psicologia , Ensino/tendências , Educação Médica , Feminino , Humanos , Masculino , Satisfação Pessoal , Inquéritos e Questionários , UniversidadesRESUMO
PURPOSE: Student-run clinics (SRCs) are increasingly recognized as an educational experience in many health professions' curricula. Several benefits have been documented, including students with SRC experience using patient-centered approaches to care, showing interest in working with marginalized populations, and more fully appreciating the care provided by interprofessional teams. Yet, few studies have explored student experiences within SRCs or examined how these experiences affect and shape these documented attitudes. This study explored the experiences of students at an SRC and the effect of these experiences on their learnings. METHOD: From November 2016 to July 2017, 23 students in the Community Health Initiative by University Students SRC at the University of British Columbia participated in 2 focus group interviews: the first after their first clinic day and the second on their final clinic day. Open- and closed-ended questions were used to explore participants' learnings from the SRC. Using a grounded theory approach, the authors iteratively analyzed the transcribed interviews, adjusting questions for subsequent focus groups as new themes evolved. Three investigators each separately coded the data; the full team then collectively consolidated the themes and developed explanatory models for each theme. RESULTS: Two themes were identified from the focus group input: (1) through managing real, complex patients-in situations unlike those offered in classroom and case-based learning environments-students gained insights into the intricacies of incorporating the patient's perspective into their definition and management of the patient's problem, and (2) by working as a team instead of focusing on delineating scopes of practice, students gained a meaningful understanding of the roles of practitioners from other health professions. CONCLUSIONS: This study provides insights into the unique opportunities SRCs offer health care students early in their training, enabling them to develop a richer understanding and appreciation of holistic and interprofessional approaches to patient care.
Assuntos
Atenção à Saúde/organização & administração , Aprendizagem Baseada em Problemas/estatística & dados numéricos , Clínica Dirigida por Estudantes/estatística & dados numéricos , Estudantes de Medicina/estatística & dados numéricos , Centros Médicos Acadêmicos/organização & administração , Colúmbia Britânica , Currículo , Escolaridade , Grupos Focais/estatística & dados numéricos , Pessoal de Saúde/educação , Humanos , Relações Interprofissionais/ética , Entrevistas como Assunto/métodos , Aprendizagem/fisiologia , Assistência ao Paciente/ética , Assistência ao Paciente/métodos , Clínica Dirigida por Estudantes/organização & administração , Estudantes de Medicina/psicologiaRESUMO
BACKGROUND: As the population of older adults in the US steadily increases and becomes more diverse, there is an urgent need to integrate geriatric competencies into baccalaureate nursing education. PURPOSE: To integrate the Institute for Healthcare Improvement 4 Ms Framework into an existing baccalaureate nursing community clinical experience to build geriatric and interprofessional competencies and promote positive health outcomes. METHODS: As part of the Geriatric Workforce Enhancement Program, 15 students worked with bilingual social workers and community health workers in an affordable housing urban highrise, assessed building residents and implemented personalized plans of care using the 4Ms framework (what matters to the individual, medications, mentation, and mobility). RESULTS: Students demonstrated competence conducting cognition and depression screening, medication review, and functional and fall risk assessments. Student self-rated achievement of learning objectives ranged from 4.3 to 4.8 (1-5 scale). A retrospective pretest-posttest survey suggested learning about the importance of interprofessional teamwork, and integration of person-centered values when providing care to older adults in the community. Students reflected on barriers to health for older adults in low socioeconomic states and the importance of improving care across the continuum. CONCLUSION: The 4Ms framework provided a valuable construct to guide the community experience and teach geriatric evidence-based practice to nursing students.
Assuntos
Competência Clínica/normas , Enfermagem Geriátrica/métodos , Competência Clínica/estatística & dados numéricos , Participação da Comunidade/métodos , Participação da Comunidade/psicologia , Participação da Comunidade/estatística & dados numéricos , Enfermagem Geriátrica/normas , Enfermagem Geriátrica/estatística & dados numéricos , Humanos , New Jersey , Aprendizagem Baseada em Problemas/métodos , Aprendizagem Baseada em Problemas/normas , Aprendizagem Baseada em Problemas/estatística & dados numéricosRESUMO
PURPOSE: To characterize residents' practices around hospital discharge communication and their exposure to transitions-of-care instruction in graduate medical education (GME). METHOD: In 2019, internal medicine residents at 7 academic medical centers completed a cross-sectional survey reporting the types of transitions-of-care instruction they experienced during GME training and the frequency with which they performed 6 key discharge communication practices. The authors calculated a mean discharge communication score for each resident, and, using multiple logistic regression, they analyzed the relationship between exposure to types of educational experiences and discharge communication practices residents reported they performed frequently (> 60% of time). The authors used content analysis to explore factors that motivated residents to change their discharge practices. RESULTS: The response rate was 63.5% (613/966). Resident discharge communication practices varied. Notably, only 17.0% (n = 104) reported routinely asking patients to "teach-back" or explain their understanding of the discharge plans. The odds of frequently performing key discharge communication practices were greater if residents received instruction based on observation of and feedback regarding their communication (adjusted odds ratio 1.73; 95% confidence interval [CI], 1.07-2.81) or if they received explicit on-rounds teaching (adjusted OR 1.46; 95% CI, 1.04-2.23). In open-ended comments, residents reported that experiencing adverse patient events at some point in the postdischarge continuum was a major impetus for practice change. CONCLUSIONS: This study exposes gaps in hospital discharge communication with patients, highlights the benefits of workplace-based instruction on discharge communication skills, and reveals the influence of adverse events as a source of hidden curricula. The results suggest that developing faculty to incorporate transitions-of-care instruction in their rounds teaching and integrating experiences across the postdischarge continuum into residents' education may foster physicians-in-training who are champions of effective transitions of care within the fragmented health care system.
Assuntos
Educação de Pós-Graduação em Medicina/métodos , Medicina Interna/educação , Internato e Residência/estatística & dados numéricos , Aprendizagem Baseada em Problemas/estatística & dados numéricos , Competência Clínica/estatística & dados numéricos , Comunicação , Estudos Transversais , Escolaridade , Humanos , Modelos Logísticos , Alta do Paciente , Transferência de Pacientes/métodos , Aprendizagem Baseada em Problemas/tendências , Inquéritos e Questionários , Visitas de Preceptoria/métodosRESUMO
Resumo: Introdução: A qualidade de aprendizado de estudantes de escolas médicas tem sido tema recorrente da literatura mundial nas últimas décadas, mas há escassez de estudos nacionais acerca do assunto. O ambiente de ensino deve favorecer o aprendizado profundo, por estar intimamente relacionado com uma aprendizagem significativa. Metodologias ativas de aprendizagem são vinculadas a maior qualidade de aprendizado, por propiciarem ambiente favorável ao aprendizado profundo. Objetivo: Este estudo teve como objetivos avaliar a qualidade do aprendizado de estudantes de Medicina de um curso que adota metodologias ativas de aprendizagem e correlacioná-la com as percepções dos alunos acerca do ambiente educacional e com dados sociodemográficos. Método: Trata-se de estudo descritivo transversal realizado com estudantes do curso de Medicina da Universidade Federal de São Carlos (UFSCar), do primeiro ao sexto ano. Foram utilizados os instrumentos R-SPQ-2F, DREEM e questionário sociodemográfico. Realizou-se análise descritiva, e compararam-se as frequências por meio do teste do qui-quadrado ou teste exato de Fisher. As diferenças entre médias foram avaliadas por meio de teste t de Student ou teste de Mann-Whitney, quando se compararam somente dois grupos, ou por meio de análise de variância (ANOVA) ou teste de Kruskal-Wallis, quando comparados mais de dois grupos. As associações entre as variáveis quantitativas foram verificadas por meio do coeficiente de correlação de Pearson ou de Spearman. A análise estatística foi realizada com auxílio do programa IBM SPSS Statistics versão 25.0, e adotou-se como parâmetro de significância um valor de p < 0,05. Resultado: Entrevistaram-se 226 alunos. A pontuação média para abordagem profunda foi de 33,52 e, para a abordagem superficial, 17,42. Em relação à percepção do ambiente educacional, a média foi de 129,77 pontos. As variáveis objetivas que demonstraram influência sobre o aprendizado foram: sexo, idade de início do curso, contato prévio com metodologias ativas, prática de idiomas, ter graduação ou pós-graduação prévia, receber auxílio financeiro de familiares e ano da graduação. Conclusão: As metodologias ativas de aprendizagem podem estimular a adoção de estratégias de aprendizado profundo. O estudo dos fatores que influenciam na abordagem de aprendizado é complexo e envolve questões individuais subjetivas.
Abstract: Introduction: The quality of learning of medical students has been a recurring subject of research in recent decades, but there are scarce national studies on it. The learning environment should encourage deep learning, as it is intimately related to meaningful learning. Active learning methods are linked to better quality of learning, since they provide a favorable environment for deep learning. Objective: The aim of this study was to evaluate the quality of learning of students at a medical school that adopts active learning methods for all course years and correlate it to students' views on educational environment and sociodemographic data. Method: This is a cross-sectional descriptive study with 1st to 6th-year medical students from the Federal University of São Carlos. The R-SPQ-2f, DREEM and sociodemographic questionnaires were applied. Descriptive analysis was performed, and frequencies were compared using chi-square test or Fisher's exact test. Differences between means were evaluated with either Student's t-test or Mann-Whitney's test, when comparing only two groups, and with one-way analysis of variance (ANOVA) or Kruskal-Wallis' test, when comparing more than two groups. Associations between quantitative variables were verified with either Pearson's or Spearman's correlation coefficient. Statistical analysis was performed with IBM SPSS Statistics version 25.0. For significance, p-value<0.05 was adopted. Result: 226 students were interviewed. The average deep learning score was 33.52 points, and, for superficial learning, 17.42 points. As for how the environment was perceived, the average score was 129.77. The objective variables that showed influence in learning were sex, course start age, previous contact with active learning methods, language study, previous undergraduate training, or post-graduate degree, receiving financial help from family and current course year. Conclusion: Active learning methods may stimulate the adoption of deep learning strategies. The evaluation of factors that influence study approaches is complex, involving subjective individual parameters.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Adulto Jovem , Aprendizagem Baseada em Problemas/estatística & dados numéricos , Educação Médica/métodos , Aprendizado Profundo/estatística & dados numéricos , Faculdades de Medicina , Fatores Socioeconômicos , Estudos Transversais , Inquéritos e QuestionáriosRESUMO
OBJECTIVES: The objective was to identify the presence of the capacity for reflexive-critical thinking or similar, in Nursing Curricula in Iberian America. METHODS: The article gathers the results of one of the objectives of the macro-project developed by the Iberian American Network on Nursing Education Research, titled Strategies to develop reflective and critical thinking in nursing students: Iberian America situation. To achieve this, a descriptive and exploratory research was conducted with qualitative approach. An instrument created for this project was used, along with some guiding questions to focus the information. RESULTS: Eight countries participated (Bolivia, Brazil, Colombia, Ecuador, Spain, Mexico, Peru, and Venezuela), which contributed information from 189 curricular plans. The R&CT was found in the majority of the curricula, although with diverse denominations. The principal learning strategies used were problem-based learning, group dynamics, reflective reading, clinical practice, and simulation laboratories. The evaluation methods used are the knowledge test, case analysis, and practical exam. CONCLUSIONS: Significant stress exists in the discourse and curricular organization. Incongruences were found and a clear inclination toward the formation of professionals with broad technical skills under a traditional, memory, banking and knowledge accumulation education.
Assuntos
Currículo/estatística & dados numéricos , Bacharelado em Enfermagem/métodos , Pensamento , América Central , Bacharelado em Enfermagem/estatística & dados numéricos , Humanos , Pesquisa em Educação em Enfermagem , Aprendizagem Baseada em Problemas/métodos , Aprendizagem Baseada em Problemas/estatística & dados numéricos , América do Sul , EspanhaRESUMO
BACKGROUND: Ghana is challenged with shortage of critical human resources for health particularly nurses and midwives in rural hard-to-reach communities. This shortage potentially hinders efforts towards attaining universal access to basic healthcare. More importantly, poor quality of pre-service training for health trainees has the potential to worsen this predicament. There is therefore the need to leverage emerging digital innovations like e-learning to complement existing efforts. This study was conducted several months before the outbreak of COVID-19 to investigate the preparedness, acceptability and feasibility e-learning innovation for nursing and midwifery trainees. METHODS: The study is a cross-sectional descriptive survey involving nursing and midwifery students (n = 233) in one of Ghana's public universities, located in the Volta region of Ghana. Simple random sampling technique was used to collect responses from eligible respondents using a structured questionnaire. Descriptive statistical analysis was done using STATA software (version 12.0). RESULTS: It was found that nearly 100% of respondents owned smartphones that were used mostly for learning purposes including sharing of academic information. Over 70% of respondents particularly used social media, social networking applications and internet searches for learning purposes. Health trainees were however constrained by low bandwidth and lack of seamless internet connectivity within their learning environments to maximize the full benefits of these e-learning opportunities. CONCLUSION: Respondents were predominantly prepared for an e-learning pilot project. These feability findings suggest e-learning is a huge potential that can be used to augment existing approaches for pre-service training of health trainees in Ghana, when implementation threats are sufficiently addressed. Compelling findings of this study are therefore timely to inform evidence-based policy decisions on innovative digitial solutions for pre-service training of health workforce even as the world adapts to the "new normal" situation induced by COVID-19.
Assuntos
Instrução por Computador/estatística & dados numéricos , Bacharelado em Enfermagem/métodos , Tocologia/educação , Estudantes de Enfermagem/estatística & dados numéricos , Adulto , COVID-19/prevenção & controle , Estudos Transversais , Estudos de Viabilidade , Feminino , Gana , Humanos , Projetos Piloto , Aprendizagem Baseada em Problemas/estatística & dados numéricos , Adulto JovemRESUMO
Objective. To assess the degree of change in the level of scientific reasoning in first-year pharmacy students by applying active-learning methods during a physics course. Methods. The efficiency of the active-learning methods of experimentation and discussion in the development of scientific reasoning in 90 pharmacy students was determined by comparing it to the efficiency of using traditional learning methods (eg, lecture) with 60 students. The Lawson Classroom Test of Scientific Reasoning was used to measure change. Results. The data from this five-year study showed that of all pharmacy students in the active-learning group who were functioning on a stable or transitional level of thinking at the time of the pretest, 28.6% achieved a shift towards a higher level of scientific thinking. The active-learning group also achieved better overall results in the course. Conclusion. Using active-learning methods (experimentation and discussion) in a physics course enabled pharmacy students to better master the content. By elevating students' level of scientific reasoning, a foundation for using evidence-based medicine was established.
Assuntos
Educação em Farmácia/métodos , Educação em Farmácia/estatística & dados numéricos , Avaliação Educacional/estatística & dados numéricos , Física/estatística & dados numéricos , Aprendizagem Baseada em Problemas/estatística & dados numéricos , Estudantes de Farmácia/estatística & dados numéricos , Adulto , Currículo/estatística & dados numéricos , Humanos , Resolução de Problemas , Inquéritos e Questionários , Adulto JovemRESUMO
Objective. To assess pharmacy residency match/placement rates and student perceptions of a program designed to enhance Doctor of Pharmacy (PharmD) student competitiveness for postgraduate residency positions. Methods. The Scholars Program was developed to provide advanced training to select PharmD students who had an interest in postgraduate residency training and was completed during the third and fourth professional years. The program consisted of mentoring; elective coursework encompassing clinical practice, teaching, and leadership; modified experiential education; journal club meetings; teaching assistant duties; conducting research and/or scholarship; and delivering professional presentations. Residency match/placement rates of students who had completed the program were compared to national data and to students in the school who were not enrolled in the program. Perceptions of the program were assessed using an online survey. Results. Sixty-four students enrolled in and completed the Scholars Program from 2013 to 2019. Of these, 58 (91%) pursued postgraduate residency training. Students enrolled in the program had a higher combined phase 1/phase 2 match rate (91.4% vs 67.4%) than students in other PharmD programs across the United States. Similarly, students enrolled in the Scholars Program had a higher combined phase 1/phase 2 match rate (91.4% vs 62.9%) and overall residency placement rate (96.6% vs 67.0%) compared to students in the school who were not enrolled in the program. More than 85% of students enrolled in the Scholars Program who pursued residency training agreed that the program prepared them for and helped them attain a postgraduate residency. Conclusion. Pharmacy students enrolled in the Scholars Program experienced high residency match/placement rates and viewed the program as valuable preparation for postgraduate training.
Assuntos
Educação de Pós-Graduação em Farmácia/métodos , Internato e Residência/métodos , Residências em Farmácia/métodos , Estudantes de Farmácia/psicologia , Currículo/estatística & dados numéricos , Educação de Pós-Graduação em Farmácia/estatística & dados numéricos , Bolsas de Estudo/estatística & dados numéricos , Humanos , Internato e Residência/estatística & dados numéricos , Mentores/psicologia , Mentores/estatística & dados numéricos , Assistência Farmacêutica/estatística & dados numéricos , Farmácia/estatística & dados numéricos , Aprendizagem Baseada em Problemas/métodos , Aprendizagem Baseada em Problemas/estatística & dados numéricos , Faculdades de Farmácia/estatística & dados numéricos , Estudantes de Farmácia/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricos , Estados UnidosRESUMO
PURPOSE: Feedback is important for medical students' development. Recent conceptualizations of feedback as a dialogue between feedback provider and recipient point to longitudinal relationships as a facilitator of effective feedback discussions. This study illuminates how medical students experience feedback within a longitudinal relationship with a physician coach. METHOD: In this qualitative study, second-year medical students from the University of California, San Francisco, School of Medicine participated in semistructured interviews that explored their experiences discussing feedback within longitudinal, nonevaluative coaching relationships. Interviews occurred between May and October 2018. Interview questions addressed students' experiences receiving feedback from their coach, how and when they used this feedback, and how their relationship with their coach influenced engagement in feedback discussions. Interviews were analyzed using constructivist grounded theory. RESULTS: Seventeen students participated. The authors identified 3 major themes. First, students' development of a feedback mindset: Over time, students came to view feedback as an invaluable component of their training. Second, setting the stage for feedback: Establishing feedback routines and a low-stakes environment for developing clinical skills were important facilitators of effective feedback discussions. Third, interpreting and acting upon feedback: Students described identifying, receiving, and implementing tailored and individualized feedback in an iterative fashion. As students gained comfort and trust in their coaches' feedback, they reported increasingly engaging in feedback conversations for learning. CONCLUSIONS: Through recurring feedback opportunities and iterative feedback discussions with coaches, students came to view feedback as essential for growth and learning. Longitudinal coaching relationships can positively influence how students conceptualize and engage in feedback discussions.
Assuntos
Retroalimentação , Aprendizagem/fisiologia , Tutoria/métodos , Aprendizagem Baseada em Problemas/estatística & dados numéricos , Estudantes de Medicina/psicologia , Adulto , Competência Clínica/estatística & dados numéricos , Comunicação , Educação de Graduação em Medicina/métodos , Feminino , Humanos , Entrevistas como Assunto , Masculino , Tutoria/estatística & dados numéricos , Pesquisa Qualitativa , São Francisco/epidemiologia , Universidades/estatística & dados numéricosRESUMO
Background: Problem-based learning (PBL) is an essential element of the curriculum of the Medical University of Vienna (MUV) and is performed in an eight steps model with: clarifying, defining, analysing, shifting & sorting, identifying learning objectives, going to learn and coming back to talk and feedback. With an annual intake of up to 740 students the MUV has to recruit PBL tutors from various academic backgrounds including undergraduate near-peer students. Therefore, we were interested to see whether a tutor's academic background had an influence on the resulting PBL sessions as reflected by the percentage of learning objectives (LOs) which were actually achieved in relation to the intended LOs. Methods: For each PBL session "intended learning objectives" (ILOs) were defined. ILOs were communicated to all tutors by means of PBL session guides in order to provide homogenous learning opportunities to all students. However, it was not mandatory to reach all ILOs. The PBL coordination regarded a range of two thirds to three quarters of ILOs as a desirable goal. For analysis we retrieved data concerning ILOs, characteristics of tutors and PBL groups from the institution's PBL quality assurance system. Results: From 2012-2014, 216 PBL groups were facilitated by 106 tutors with different academic backgrounds. On average, 70.8% (95% CI: 69.2-72.5%) of the ILOs were achieved; MUV clinicians reached 74.3% (70.8-77.8%), MUV non-clinicians 74.2% (71.7-76.6%), external faculty (clinicians and non-clinicians) 68.6% (64.4-72.8%), and near-peer students 64.7% (61.8-67.7%). Statistically significant differences were found between near-peer students and MUV clinicians (p<.001) as well as MUV non-clinicians (p<.001). Conclusions: ILOs were reached within a satisfactory range. However, groups taught by near-peer students reached significantly fewer ILOs than groups taught by MUV faculty tutors. This finding raises the question whether tutor training for near-peer students should be intensified. Also, further research is needed to explore the group dynamics of student-led PBL groups.
Assuntos
Aprendizagem Baseada em Problemas/normas , Capacitação de Professores/classificação , Análise de Variância , Currículo/normas , Currículo/tendências , Educação de Graduação em Medicina/métodos , Retroalimentação , Humanos , Grupo Associado , Aprendizagem Baseada em Problemas/estatística & dados numéricos , Suíça , Capacitação de Professores/estatística & dados numéricosRESUMO
BACKGROUND AND PURPOSE: Combining pharmaceutics and pharmacy practice into nonsterile compounding is ideal to increase problem-solving skills. The objectives of this activity were to: (1) create a nonsterile compounding activity through a team-teaching collaboration, (2) increase students' independent problem-solving skills to compound a nonsterile natural product, and (3) assess student and faculty perceptions of the learning activity. EDUCATIONAL ACTIVITY AND SETTING: The activity was created, implemented, and assessed using a team-teaching technique between pharmacy practice and pharmaceutics faculty. The first week students were tasked with extraction of an active ingredient from a natural product, and the second week students independently compounded a nonsterile product using the concentrated extract. Faculty and students were asked to give their perceptions of the activity. FINDINGS: The activity has been taught to two cohorts of elective students. Students from both cohorts (n = 57) independently created a nonsterile compound, scoring an average (standard deviation) of 8.1 (1) and 8.6 (0.9) out of 10 points on their graded products for the 2018 and 2019 elective, respectively. Faculty collaboration and team-teaching adjustments to the content resulted in increased student performance (p = 0.0392). Student feedback on the activity was overwhelmingly positive. Faculty appreciated the collaborative approach and improved the course activity together. SUMMARY: A team-teaching approach created an activity that focused on elements of both pharmaceutics and pharmacy practice. Students developed problem-solving abilities by creating their own independent nonsterile compounded natural product. The collaboration between faculty was positive and well received by students.
Assuntos
Currículo/normas , Composição de Medicamentos/métodos , Resolução de Problemas , Estudantes de Farmácia/estatística & dados numéricos , Currículo/tendências , Composição de Medicamentos/normas , Composição de Medicamentos/estatística & dados numéricos , Educação em Farmácia/métodos , Educação em Farmácia/normas , Educação em Farmácia/estatística & dados numéricos , Docentes de Farmácia , Humanos , Equipe de Assistência ao Paciente/normas , Equipe de Assistência ao Paciente/estatística & dados numéricos , Aprendizagem Baseada em Problemas/métodos , Aprendizagem Baseada em Problemas/normas , Aprendizagem Baseada em Problemas/estatística & dados numéricos , Estudantes de Farmácia/psicologiaRESUMO
BACKGROUND AND PURPOSE: The main aim of this study was to evaluate the effect of a structured classroom debate format on teaching antimicrobial stewardship. EDUCATIONAL ACTIVITY AND SETTING: An active learning approach using a debate format was implemented to engage students in infectious diseases concepts to further develop critical thinking skills. This was a one-group, pre- and posttest design conducted in third year pharmacy students enrolled at the Philadelphia College of Osteopathic Medicine School of Pharmacy Georgia campus. A ten-item assessment survey was used prior to and after the course to evaluate student knowledge. Student perception of skill development was assessed by a survey using a five-point Likert scale. The skills assessed included critical thinking, communication, public speaking, research/drug information, and teamwork. FINDINGS: Thirty-three students participated in the six debates over the course of the semester. There was a statistically significant increase in post-knowledge assessment mean score (75%) compared to pre-knowledge assessment mean score (45%). The post-course survey showed improved confidence in perception of skills in all of the areas assessed. SUMMARY: The structured classroom debate format has a positive association with increasing students' knowledge level and perception of skills assessed.
Assuntos
Gestão de Antimicrobianos/métodos , Currículo/normas , Estudantes de Farmácia/estatística & dados numéricos , Ensino/normas , Gestão de Antimicrobianos/estatística & dados numéricos , Doenças Transmissíveis/tratamento farmacológico , Currículo/estatística & dados numéricos , Educação em Farmácia/métodos , Educação em Farmácia/normas , Educação em Farmácia/estatística & dados numéricos , Avaliação Educacional/métodos , Humanos , Aprendizagem Baseada em Problemas/métodos , Aprendizagem Baseada em Problemas/normas , Aprendizagem Baseada em Problemas/estatística & dados numéricos , Inquéritos e Questionários , Ensino/estatística & dados numéricos , PensamentoRESUMO
Medical education in mainland China has undergone massive expansion and reforms in the past decades. A nation-wide survey of the five-year clinical medicine programs aimed to examine the course hours, pedagogies, learning resources and teaching staff of anatomy both at present and over the past three decades (1990-1999, 2000-2009, and 2010-2018). The directors or senior teachers from 90 out of the 130 five-year clinical medicine programs were invited to fill out a factual questionnaire by email. Ultimately, sixty-five completed questionnaires were received from 65 different schools. It was found that the total number of gross anatomy course hours has decreased by 11% in the past 30 years and that systematic and regional anatomy have been increasingly taught separately among the surveyed medical schools. Problem-based learning has been adopted in thirty-five (54%) of the surveyed schools, and team-based learning is used in ten (15%) of the surveyed schools. The surveyed schools reported receiving more donated cadavers in recent years, with the average number increasing from 20.67 ± 20.29 in 2000-2009 to 36.10 ± 47.26 in 2010-2018. However, this has not resulted in a decrease in the number of students who needed to share one cadaver (11.85 ± 5.03 in 1990-1999 to 14.22 ± 5.0 in 2010-2018). A decreasing trend regarding the teacher-student ratio (1:25.5 in 2000-2009 to 1:33.2 in 2010-2018) was also reported. The survey demonstrated the historical changes in gross anatomy education in China over the past thirty years.
Assuntos
Anatomia/educação , Currículo/tendências , Educação de Graduação em Medicina/tendências , Faculdades de Medicina/tendências , Anatomia/estatística & dados numéricos , Anatomia/tendências , Cadáver , China , Currículo/estatística & dados numéricos , Dissecação/estatística & dados numéricos , Dissecação/tendências , Educação de Graduação em Medicina/história , Educação de Graduação em Medicina/estatística & dados numéricos , Docentes/estatística & dados numéricos , História do Século XX , História do Século XXI , Humanos , Aprendizagem Baseada em Problemas/estatística & dados numéricos , Faculdades de Medicina/história , Faculdades de Medicina/estatística & dados numéricos , Estudantes de Medicina/estatística & dados numéricos , Inquéritos e Questionários/estatística & dados numéricos , Ensino/história , Ensino/estatística & dados numéricos , Ensino/tendências , Fatores de TempoRESUMO
Challenge-based learning (CBL) is a learner-centred, experimental learning strategy that aims to prepare students to manage unforeseeable and complex global issues in the 21st century. It cultivates an active and authentic learning environment that requires students' creative input, collaboration and community involvement. Studies in the past decade have shown that CBL strengthens soft skills essential for future society, such as critical thinking and creativity. However, its effect on students' metacognitive abilities is scarcely mentioned. This study - a quasi-experimental study with non-equivalent groups conducted in a self-financing tertiary institution in Hong Kong - aims to evaluate the effect of CBL on approaches to learning among nursing students. First-year students in the nursing programme who attended a nursing course using CBL were recruited for the intervention group and senior year-one students were included in the control group. Their approach to learning was measured by the Revised Two-Factor Study Process Questionnaire administered at the beginning and at the end of the semester. Analysis of Covariance (ANCOVA) was used to compare the mean difference in scores of deep and surface approaches between the groups. A total of 209 participants were recruited, with 130 in the intervention group and 79 in the control group. The response rates were 65.3% (130/199) and 78.2% (79/101) for the intervention and control groups, respectively. In the intervention group, the mean post-test deep approach score was significantly higher than the pre-test score (F = 5.2, p = 0.023), even though it had only a small effect. There was no statistically significant difference in baseline post-test mean surface scores (F = 2.4, p = 0.125). The results of this study indicate that CBL may facilitate deep learning in nursing students.
Assuntos
Aprendizagem Baseada em Problemas/normas , Estudantes de Enfermagem/psicologia , Adulto , Análise de Variância , China , Bacharelado em Enfermagem/métodos , Bacharelado em Enfermagem/normas , Bacharelado em Enfermagem/estatística & dados numéricos , Avaliação Educacional/métodos , Feminino , Hong Kong , Humanos , Masculino , Metacognição , Aprendizagem Baseada em Problemas/métodos , Aprendizagem Baseada em Problemas/estatística & dados numéricos , Estudantes de Enfermagem/estatística & dados numéricos , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: As medical schools reform clinical curricula, an increasing amount of time is spent in active learning activities. The authors hypothesized that students who spent more time in active learning educational activities (e.g., team-based learning, small group activities, clinical simulation) would receive higher NBME Subject Exam scores compared to students with less. METHODS: This cohort study included 518 students from 2014 to 2016 who completed at least six contiguous weeks of a psychiatry clerkship. Active learning time percent was calculated by dividing the amount of time in active learning by the total in-classroom time during the clerkship. Analysis was conducted using ANOVA and linear regression. RESULTS: Analysis found that increasing the amount of active learning was not significantly associated with student scores on the NBME Subject Exam in psychiatry (F = 0.91, p = 0.402). However, when controlling for possible confounding variables (including clerkship length and order), clerkship order was a significant predictor of student performance (r = 0.19, ß = 0.18, p < 0.0001); students who took the clerkship later in the academic year-and after the internal medicine rotation-performed significantly better on the exam. CONCLUSIONS: This study found that increasing the amount of active learning did not improve student performance on the NBME Subject Exam in psychiatry. This study provides preliminary, but unexpected, evidence of interest to medical educators and curriculum reformers that increasing the amount of active learning is not significantly associated with improved student test performance.
Assuntos
Estágio Clínico , Avaliação Educacional/normas , Aprendizagem Baseada em Problemas/estatística & dados numéricos , Psiquiatria/educação , Educação de Graduação em Medicina , Humanos , Masculino , Estados UnidosRESUMO
PURPOSE: Although descriptions of interprofessional education often focus on interactions among students from multiple professions, embedding students from 1 profession in clinical settings may also provide rich opportunities for interprofessional learning (IPL). This study examines affordances and barriers to medical students' interactions with and opportunities to learn from health care professionals while learning health systems science in clinical workplaces. METHOD: In May 2017, 14 first-year medical students at the University of California, San Francisco participated in a semistructured interview about IPL experiences during a 17-month, weekly half-day clinical microsystem placement focused on systems improvement (SI) projects and clinical skills. Communities of practice and workplace learning frameworks informed the interview guide. The authors analyzed interview transcripts using conventional qualitative content analysis. RESULTS: The authors found much variation among the 14 students' interprofessional interactions and experiences in 12 placement sites (7 outpatient, 4 inpatient, 1 emergency department). Factors influencing the depth of interprofessional interactions included the nature of the SI project, clinical workflow, student and staff schedules, workplace culture, and faculty coach facilitation of interprofessional interactions. Although all students endorsed the value of learning about and from diverse health care professionals, they were reluctant to engage with, or "burden," them. CONCLUSIONS: There are significant IPL opportunities for early medical students in longitudinal placements focused on SI and clinical skills. Formal curricular activities, SI projects conducive to interprofessional interactions, and faculty development can enhance the quality of workplace-based IPL.