Self-evaluation and peer-feedback of medical students' communication skills using a web-based video annotation system. Exploring content and specificity.

OBJECTIVE: Self-evaluation and peer-feedback are important strategies within the reflective practice paradigm for the development and maintenance of professional competencies like medical communication. Characteristics of the self-evaluation and peer-feedback annotations of medical students' video recorded communication skills were analyzed. METHOD: Twenty-five year 4 medical students recorded history-taking consultations with a simulated patient, uploaded the video to a web-based platform, marked and annotated positive and negative events. Peers reviewed the video and self-evaluations and provided feedback. Analyzed were the number of marked positive and negative annotations and the amount of text entered. Topics and specificity of the annotations were coded and analyzed qualitatively. RESULTS: Students annotated on average more negative than positive events. Additional peer-feedback was more often positive. Topics most often related to structuring the consultation. Students were most critical about their biomedical topics. Negative annotations were more specific than positive annotations. Self-evaluations were more specific than peer-feedback and both show a significant correlation. Four response patterns were detected that negatively bias specificity assessment ratings. CONCLUSION: Teaching students to be more specific in their self-evaluations may be effective for receiving more specific peer-feedback. PRACTICE IMPLICATIONS: Videofragmentrating is a convenient tool to implement reflective practice activities like self-evaluation and peer-feedback to the classroom in the teaching of clinical skills.

Delivering endocrinology and reproduction in an integrated modular curriculum.

OBJECTIVE: To ascertain the perceptions of students and faculty of Shifa College of Medicine, Islamabad regarding the delivery of Endocrinology and Reproduction module as a component of the newly introduced Integrated Modular Curriculum. METHODS: A descriptive study, using mixed qualitative and quantitative method, starting from June 6 to August 15 2008. A period of 10 weeks was spent on the study including 8 weeks of planning, 2 weeks of delivery and assessment and a 2 weeks period of post hoc analysis and data collection. A multidisciplinary team of faculty developed themes, clinical cases, objectives and table of specification of the Endocrinology and Reproduction Module for Fourth Year MBBS Class. Continuous assessment was done by theme-based assignments and student presentations. Summative assessment was done by Multiple Choice and Short Answer Questions. Likert scale-based student feedback questionnaire was administered while the students were also encouraged to comment on the module for improvement. Feedback was obtained from the faculty in a similar manner. RESULTS: Out of a class of 86 students, 47 (55%) agreed to a balance between basic and clinical concepts addressed in the module, 21 (24%) agreed that emphasis on clinical concepts was appropriate, 37 (43%) agreed that learning strategies were well integrated, 50 (58%) were of the opinion that the assigned learning material was consistent with the session objectives, while 39 (45%) agreed that case-based instruction was useful, and 40 (47%) students were of the opinion that large group discussion was useful. Faculty feedback was positive towards integrated learning. CONCLUSIONS: Integrated Endocrinology and Reproduction module received mixed response from students. This led us to modify and tailor the curriculum to better cater for the needs of students. Feedback from students and faculty is essential for improvement in the quality of educational interventions.

Educating nurses about research ethics and practices with a self-directed practice-based learning program.

Learner-driven and practice-based education programs are recommended for integration of learning. A continuing education program on research ethics was introduced to five nurses in an ambulatory care setting at a Magnet® hospital, using a commercially available web-based course followed by a research practicum. The seasoned nurses reported little previous education in this area. Working with a nurse researcher, three nurses participated in a research project for improving clinic care delivery. The success of the continuing education program was determined by knowledge acquisition, satisfaction with learning activities, and perceived confidence in research participation. This continuing education program was effective in providing for knowledge and skill development in research ethics. The integrative learning format was well received.

First-year medical students' assessment of their own communication skills: a video-based, open-ended approach.

OBJECTIVE: Interpersonal and communication skills are a core area of competency for medical students, residents, and practicing physicians. As reflection and self-assessment are essential components of skill-building, we examined the content of medical students' assessments of their own developing communication skills. METHODS: Between 2000 and 2003, a total of 674 first-year medical students completed self-assessments of their communication skills after viewing videotapes of their interaction with simulated patients. Self-assessment forms were open-ended, providing ample space for students to write about the strengths and weaknesses they observed. Completed forms were coded by two members of the research team trained in content analysis. Students identified an average of 5.0 things that went well (range 1-15, S.D.=2.2) and 2.8 areas for improvement (range 1-9, S.D.=1.3). RESULTS: The most frequently observed strengths were: elicited information/covered important topics (54%); made a personal connection/established rapport (51%); was supportive/encouraging/helpful (40%); attended to conversational flow and transitions (34%); ensured patient comfort (32%). The most frequently noted weaknesses involved problems with: eliciting information/covering important topics (35%); paralanguage, particularly in terms of tone, rate, volume, and disfluencies such as "uh", "um" (32%); discussing health risks (26%); attending to conversational flow and transitions (23%); students' own comfort/organization/preparation (20%). CONCLUSION: We observed that a video-based, open-ended approach to self-assessment is feasible, practical, and informative. While the self-assessments covered a broad scope, students clearly attended to tasks and skills relevant to effective communication and relationship building. PRACTICE IMPLICATIONS: Videotaped clinical encounters allow learners to review their own behavior and make specific comments supported by tangible examples. An open-ended approach to self-assessment of communication skills can serve as one important component of a systematic education and evaluation program.

Self-evaluation and peer review--an example of action research in promoting self-determination of patients with rheumatoid arthritis.

AIMS AND OBJECTIVES: The aim of this paper was to describe the areas that have been performed well and the areas in need of further development of rheumatoid arthritis patients. BACKGROUND: Nurses' self-evaluation and peer review are important methods for ascertaining the changes and success in the development of nursing practice. To date, there has been minimal research regarding the use of those evaluation methods in nursing practice. DESIGN: The findings of self-evaluation and peer review of nurses are described in a participatory action research study aimed at promotion of self-determination for patients with rheumatoid arthritis. METHODS: In self-evaluation, the collection of data was accomplished using a self-evaluation instrument with the permanent nursing staff (n = 18), then analysed through quantitative methods. For peer review, the data were gathered through focus groups (n = 21) using a tool similar to the one used for self-evaluation. The participants included many of the same nurses as in self-evaluation. The data were analysed using qualitative content analysis. RESULTS: Well-performed areas in nursing of rheumatoid arthritis patients were found to be promoting patient participation, supporting self-determination, performing patient-centred nursing and raising patient self-respect. The areas in need of development were connected to the nursing staff themselves: increasing collaboration of nursing staff, decreasing authoritarianism in nursing care and developing nursing practice with colleagues. CONCLUSIONS: Self-evaluation and peer review are complementary and support one another, especially since nurses were found to be more critical in their self-evaluations than in peer review. RELEVANCE TO CLINICAL PRACTICE: Both evaluation tools proved to be useful methods in the evaluation phase of the action research process as a means of professional development. Also assisting in the development of clinical nursing practice.

El nuevo rostro de la calidad en la Universidad Mayor de San Andrés / The new quality y face in the San Andres University

La Universidad Mayor de San Andrés ha comenzado hace 5 años un proceso de evaluación académica: Autoevaluación y Evaluación y Acreditación Externa. Este cambio irreversible tiene diferentes grados de avance en las diversas facultadades de la Universidad, y se ha realizado con diversas caracteristicas. En este trabajo se presenta el estado actual de avance del proceso, con detalle respecto a las particularidades en cada facultad.

The Irvine Paraprofessional Program: promising practice for serving students with ADHD.

The Irvine Paraprofessional Program (IPP) looks promising for serving elementary-school children with attention-deficit/hyperactivity disorder (ADHD) in the general education classroom. This article describes the components of the IPP, preliminary research studies that support its efficacy, and the benefits of the model. The IPP is a 12-week intensive intervention that includes (a) direct intervention to children with ADHD by specially trained paraprofessionals, (b) teacher consultation by the school psychologist on the use of effective classroom management strategies, (c) school-based reinforcement, and (d) social skills training. Preliminary studies suggest that paraprofessionals can effect positive changes in children with ADHD that can be maintained by the teacher once the paraprofessional is removed from the classroom. The purpose of this article is to provide a description of the IPP as an effective model for serving children with ADHD in the general education classroom.

Experiences of encouraging student-centred learning within a wellness-oriented curriculum.

This paper describes the use of learning logs as a tool for self-assessment and reflection during a 'well people' module within a Bachelor of Nursing programme. A qualitative analysis of the students' learning goals and reflective accounts from the learning logs are presented, together with extracts from the written evaluation of the module. Recommendations are made for enhancing the potential of the learning log as a flexible learning tool which can help students to draw upon professional knowledge in order to make sense of their experiences.

Student self-evaluations: how useful? How valid?

Skill in self-evaluation is necessary for life-long learning, for competent performances--in short, for professional practice in the health sciences. In addition, self-evaluation skills can be learned and can be taught, although they are not now purposefully taught in most programs. There is research evidence that self-evaluation is more useful for learners as a formative rather than a summative tool. The purposes of this paper are (a) to provide a critical review of the literature on the accuracy of student self-evaluation and (b) to describe our experience and preliminary research findings at McMaster University regarding the most profitable approach to incorporating self-evaluation in baccalaureate nursing education.

Checklist self-evaluation in a standardized patient exercise.

BACKGROUND: Standardized patient (SP) exercises are expensive and time consuming. We hypothesized that self-evaluation would further the goals of teaching and evaluation for a group of medical students. METHODS: Students were given self-evaluation checklists (essentially identical to those filled out by the SPs) and completed them prior to reviewing the SP checklists. Agreement between student and SP checklists (whether each item was checked or not) and the extent of agreement on the interactional skills rating scales were assessed. RESULTS: Overall agreement was 93%, with 98% agreement on interactional items, 92% on physical examination items, and 89% on history items. Disagreements tended to be clustered on a few items in each scale. Scores on the interactional skills rating scales also showed strong agreement. CONCLUSION: The use of checklists and rating scales in this context is well established. At virtually no cost, a self-evaluation tool adds a valuable dimension to the exercise.

Self-evaluation in nursing students in Finland.

The article explores the self-evaluation in nursing students in clinical evaluation: the structure and topics in evaluation sessions and the student-teacher relationships. The data were collected by means of non-participant observation: evaluation sessions of 81 (= n) students were observed in hospitals and health centres. The results indicated the rather passive role of nursing students in self-evaluation; teacher-dominated relationships were the most frequent in sessions. In future there is a need for a deeper analysis of the clinical evaluation.