Virtual conference participant's perceptions of its effectiveness and future projections.

BACKGROUND: The virtual conference format has become an essential tool for professional development of researchers around the world since the outbreak of the COVID-19 pandemic. This study aims to identify empirical evidence of the benefits and challenges of virtual conferences by investigating participants' experiences with them. METHODS: The study participants were delegates to the 40th annual meeting of the Korean Society of Nephrology, which was held virtually in September, 2020. A questionnaire was developed and implemented among the conference attendees. The 44-item questionnaire included five sub-scales related to participant perceptions of the virtual conference, which were (a) convenience and accessibility, (b) planning and organization, (c) technology use, (d) social exchanges, and (e) overall satisfaction, their preferences of conference formats, and their views of future projections for a virtual conference. RESULTS: A total of 279 delegates completed and returned the questionnaires (18.8% response rate). Participants varied in gender, age, profession, work location, and prior experience with conferences. On a four-point Likert scale (1 = "strongly disagree" and 4 = "strongly agree"), participants showed positive perceptions of the virtual conference in general, where the total mean (M) was 3.03 and less positive perceptions on social exchanges (M = 2.72). Participant perceptions of the virtual conference differed across age groups, professions, and prior experience with conferences (p < .05). Approximately half of the participants (n = 139) preferred the virtual format, and 33% (n = 92) preferred the conventional format. Participant preferences for the virtual format were somewhat evenly distributed between asynchronous (32.9%) and synchronous (29.1%) modes. Participants predicted a virtual conference would continue to be a popular delivery format after the end of the COVID-19. CONCLUSIONS: Although participants had positive perceptions of the virtual conference, more support needs to be offered to those who may be less comfortable with using technology or with online interactions, and there is a need for improvement in supporting social exchange among attendees. Also, it is suggested that a blend of asynchronous and synchronous delivery methods should be considered to meet the varied needs of attendees.

A validation study of the Korean version of the Toronto empathy questionnaire for the measurement of medical students' empathy.

BACKGROUND: This study aimed to validate the Korean version of the Toronto Empathy Questionnaire (TEQ) and to determine its suitability for the measurement of empathy in medical students. METHODS: The study sample was Year 1 and 2 medical students at two medical schools on six-year undergraduate medical programs in South Korea. The study participants completed the Korean TEQ, which has a single factor structure and consists of 16 items; responses are scored using a 5-point Likert scale, giving a maximum possible score of 64. Psychometric validation of the questionnaire was performed by exploratory and confirmatory factor analyses and the goodness of fit test. Average variance extracted was calculated to establish convergent validity, and associations between factors and construct reliability were analyzed to establish discriminant validity. Cronbach's alpha values were utilized for reliability analysis. RESULTS: A total of 279 students completed and returned the questionnaire (a 96.2% response rate). Participant empathy scores ranged from 20 to 60 (M = 44.6, SD = 7.36). Empathy scores were higher for females than males (p < .05). The cumulative variance of the Korean TEQ was 32%, indicating that its explanatory power was rather weak. Consequently, goodness-of-fit testing was performed on four hypothetical models, among which a three-factorial structure consisting of 14 items demonstrated satisfactory fit indices and explained 55% of the variance. Reliability estimates of the three subscales were also satisfactory (Cronbach's α = .71-.81). This three-factorial model was validated by confirmatory factor analysis and demonstrated adequate convergent and discriminant validity. CONCLUSIONS: This study demonstrated psychometric validation of the Korean TEQ for measuring medical students' empathy. We suggest a modified 14-item model with a three-factorial structure, which demonstrated better psychometric properties than the original scale.

Enhancement of student perceptions of learner-centeredness and community of inquiry in flipped classrooms.

BACKGROUND: Flipped classrooms (FC) are expected to create a more student-centered, active learning environment than traditional lectures. This study assessed the effectiveness of FC in promoting a student-centered, active learning environment by examining the changes in student perceptions of the learning environment of FC in terms of student-centeredness and sense of community of inquiry (COI), which represents the elements of a successful learning environment. METHODS: Questionnaires were given to a cohort of Year 2 students in a six-year undergraduate medical education program, who had taken an introduction to medicine course in a FC format. The questionnaire included 7 items on the teaching orientation (i.e., teacher-centered vs. student-centered) and 34 items from the Community of Inquiry Survey Instrument, which consisted of three sub-scales - teaching, social, and cognitive presences. The questionnaires were administered in pre- and post-test format during the first and last week of the semester. RESULTS: A total of 55 students returned the questionnaires (100% response rate). The student perceptions of student-centeredness of FC increased significantly over time (p < 0.001), and their perceptions of COI in FC also increased significantly in all three presences (p < 0.001). The student perceptions of student-centeredness and sense of COI in FC increased significantly in both high-achieving and low-achieving students (p < 0.01). CONCLUSIONS: This study indicates that the flipped classroom model is an effective approach to fostering a learner-centered learning environment and developing a community of inquiry among medical students.

Digital report in an anatomy laboratory: a new method for team-based dissection, reporting, and evaluation.

PURPOSE: Digital report (DR), a new method for students' dissection report, has been introduced to replace the traditional method in the anatomy laboratory. METHODS: Laboratory tasks were assigned to groups of five students, and each group was asked to make a DR of their dissection tasks and upload it on the website for the anatomy course developed by the authors' institution. For creating the DR, students were instructed to take photographs of their findings with digital cameras, to mark the orientation and label the structures on the photograph. Students were assessed as a group by evaluating the DR. All the photographs of the DR were saved to construct a database that can be used by the students who will take the anatomy course in the following years. A questionnaire consisting of 14 questions was administered at the end of the anatomy course to evaluate the effectiveness of the DR. RESULTS: The results of the student survey showed that the DR was useful for making the students participate more actively in the teamwork for dissection, and for making dissection reports by referring to the DR made by the students from previous years. The DR was also more helpful for the anatomy teacher to assess student learning in the anatomy laboratory than conventional practical examinations and paper-based dissection reports. CONCLUSIONS: DR, a paperless report of team-based dissection, is concurrent with the 'digital' age and is in line with the need for a more systematic and objective evaluation of students' dissection.

Use of online clinical videos for clinical skills training for medical students: benefits and challenges.

BACKGROUND: Multimedia learning has been shown effective in clinical skills training. Yet, use of technology presents both opportunities and challenges to learners. The present study investigated student use and perceptions of online clinical videos for learning clinical skills and in preparing for OSCE (Objective Structured Clinical Examination). This study aims to inform us how to make more effective us of these resources. METHODS: A mixed-methods study was conducted for this study. A 30-items questionnaire was administered to investigate student use and perceptions of OSCE videos. Year 3 and 4 students from 34 Korean medical schools who had access to OSCE videos participated in the online survey. Additionally, a semi-structured interview of a group of Year 3 medical students was conducted for an in-depth understanding of student experience with OSCE videos. RESULTS: 411 students from 31 medical schools returned the questionnaires; a majority of them found OSCE videos effective for their learning of clinical skills and in preparing for OSCE. The number of OSCE videos that the students viewed was moderately associated with their self-efficacy and preparedness for OSCE (p < 0.05). One-thirds of those surveyed accessed the video clips using mobile devices; they agreed more with the statement that it was convenient to access the video clips than their peers who accessed the videos using computers (p < 0.05). Still, students reported lack of integration into the curriculum and lack of interaction as barriers to more effective use of OSCE videos. CONCLUSIONS: The present study confirms the overall positive impact of OSCE videos on student learning of clinical skills. Having faculty integrate these learning resources into their teaching, integrating interactive tools into this e-learning environment to foster interactions, and using mobile devices for convenient access are recommended to help students make more effective use of these resources.

Evaluation of an e-PBL model to promote individual reasoning.

AIM: Medical educators should promote the development of student clinical reasoning toward independence in clinical settings. The objective of this study was to evaluate an online problem-based learning (e-PBL) model designed to promote student individual reasoning in supplement to traditional PBL. METHODS: Twelve e-PBL modules were added to the fully problem-based curriculum for Year 2 at Sungkyunkwan University School of Medicine (SKKUSOM). In this e-PBL, students worked on the problems individually in an online setting, followed by face-to-face discussions in a colloquium. The cases were presented using interactive multimedia to enhance the authenticity of the case and stimulate student interest in learning. A formative evaluation study was conducted to determine student satisfaction with e-PBL and its effectiveness as perceived by the students using both quantitative and qualitative methods. A cohort of Year 2 students at SKKUSOM (n = 38) took part in this study. RESULTS: Students perceived e-PBL significantly more positively after they had taken a module in terms of its ability to foster problem-solving skills and its ability to allow them to learn in ways suited to individual learning styles. Additionally, student survey and interview revealed that a vast majority of students were satisfied with the overall learning process in e-PBL and perceived it positively in fostering knowledge acquisition and clinical reasoning. Moreover, students found the cases realistic and engaging. CONCLUSIONS: The results show the potential of e-PBL to enhance traditional PBL by promoting the development of individual reasoning in a flexible online-learning environment and offering cases in an interactive multimedia format, which warrants further investigation into its impact on student learning outcomes.

What is different about medical students interested in non-clinical careers?

BACKGROUND: The proportion of medical school graduates who pursue careers other than full-time clinical practice has increased in some countries as the physician's role has evolved and diversified with the changing landscape of clinical practice and the advancement of biomedicine. Still, past studies of medical students' career choices have focused on clinical specialties and little is known about their choice of non-clinical careers. The present study examined backgrounds, motivation and perceptions of medical students who intended non-clinical careers. METHODS: A questionnaire was administered to students at six Korean medical schools distributed across all provinces in the nation. The questionnaire comprised 40 items on respondents' backgrounds, their motivation for and interest in the study of medicine, their perceptions of medical professions, and their career intentions. Data was analyzed using various descriptive and inferential statistics. RESULTS: In total, 1,388 students returned the questionnaire (60% response rate), 12.3% of whom intended non-clinical careers (i.e., basic sciences, non-clinical medical fields, and non-medical fields). Those who planned non-clinical careers were comparable with their peers in their motivation for studying medicine and in their views of medical professions, but they were less interested in the study of medicine (P < 0.01). The two groups also differed significantly on their perceptions of what was uninteresting about the study of medicine (P < 0.01). The two groups were comparable in gender and entry-level ratios but their distributions across ages and years of study differed significantly (P < 0.01). A majority of respondents agreed with the statements that "it is necessary for medical school graduates to pursue non-clinical careers" and that "medical schools need to offer programs that provide information on such careers." Still, our finding indicates that medical school curricula do not address such needs sufficiently. CONCLUSIONS: Our study found some differences in backgrounds and perceptions of the study of medicine in medical students interested in non-clinical careers from their peers. Future studies are suggested to enhance our understanding of medical students" choice of non-clinical careers.

Faculty perceptions and use of e-learning resources for medical education and future predictions.

PURPOSE: This study aims to investigate medical faculties' perceptions and current practice of using e-learning resources, needs and suggestions for more effective use of such resources, and future directions of e-learning in medical education. METHODS: This descriptive study was conducted on full-time faculty members who were registered users of the e-learning portal of the consortium of Korean medical schools. Participants were invited to an online survey containing 45 items that addressed their perceptions and use of e-learning resources, and their predictions of future use. Descriptive analysis and reliability analysis were conducted as well as a thematic analysis of qualitative data. RESULTS: Ninety faculty members from 31 medical schools returned the questionnaires. Participants positively perceived e-learning resources and that they predicted their use would become increasingly popular. Still, only half of the respondents were using e-learning resources for teaching and agreed that they were willing to share their e-learning resources. Our study illustrates several barriers inhibit faculty use and sharing of e-learning resources, and a need for a more comprehensive, better-organized resource repository. Participants also pointed out the needs for more resources on multimedia assessment items, clinical videos, and virtual patients. CONCLUSION: Our study sheds light on medical faculty needs for institutional support and faculty development programs on e-learning, and institutional policies that address faculty concerns regarding ownership, intellectual property rights, and so forth on creating and sharing such resources. Collaborations among medical schools are suggested for creating a better organized around learning outcomes and more comprehensive repository of resources.

Gifted students' academic performance in medical school: a study of Olympiad winners.

BACKGROUND: The present study examines the performance of academically talented students (i.e., those who received awards in Olympiads, the international competitions for gifted students in science or mathematics) in medical school. PURPOSE: The goal is to investigate whether students exceptionally talented in science and mathematics excel in medical school. METHODS: A retrospective analysis of 13 cohorts of medical students (N = 475) was conducted to compare learning outcomes of academically talented students (ATS) with their peers in terms of their grade point averages (GPAs) and national licensing exam (KMLE) scores. RESULTS: ATS outperformed their peers in total GPAs (p < .001); yet there was a statistical trend of gradually diminishing performance gap between the groups as they progressed into the later years of the program. KMLE scores were comparable between the groups (p = .89). In addition, there was no significant difference in GPAs and KLME scores among ATS regardless of their areas of excellence. CONCLUSIONS: Academic merit alone is not a strong predictor of success in medical school, even among those with exceptional talent. Better understanding of nonacademic factors associated with medical school performance is warranted to improve our selection processes and to better help academically talented students succeed in medical school.

Moving forward: embracing challenges as opportunities to improve medical education in the post-COVID era.

Pandemics affect every aspect of life, and Coronavirus Disease 2019 (COVID-19) is no exception. The impact of COVID-19 might be even greater in medical education, which involves close contact with patients. This comment reviews current trends in medical education in response to COVID-19, especially in the pre-clerkship curriculum, and discusses opportunities and challenges in medical education in the post-pandemic era. COVID-19 has accelerated the adoption of online teaching and learning and is expected to boost innovation in medical education. First, blended learning, which is a mix of online and offline learning intended to incorporate the best of both worlds, is expected to become more widespread. Second, more novel approaches to learning that involve student-led initiatives likely become popular mediated by various technologies. Third, there will be more use of online learning resources and assessments. As online learning is expected to play a prominent role in the post-COVID-19 era, such transitions offer both opportunities and challenges. These challenges include faculty development on online teaching skills, creation and sharing of online resources, and effective design and implementation of online assessments. This comment calls for institutional support and collaborations for faculty development and for the development and sharing of learning resources, more models and guidelines for effective technology integration, and use of the virtual learning environment to promote student-centered learning to embrace the challenges as opportunities to improve medical education in the post-COVID era.

Benefits and Feasibility of Using Videos to Assess Medical School Applicants' Empathetic Abilities in Multiple Mini Interviews.

Purpose: We sought to evaluate the feasibility and benefits of using video-based scenarios in Multiple Mini Interviews (MMIs) to assess candidate's empathic abilities by investigating candidate perceptions and the acceptability, fairness, reliability, and validity of the test. Methods: The study sample was candidates for admission interviews held in the MMI format at a medical school in South Korea. In this six-station MMI, one station included a 2-min video clip of a patient-doctor communication scenario to assess candidate emphatic abilities, whereas paper-based scenarios were used in the other stations. Candidate's perceptions and acceptability of using the video-based scenario in the empathy station were examined using a 41-item post-MMI questionnaire. Fairness of the test was assessed by means of differences in candidate perceptions and performance across different demographics or backgrounds. Construct validity was assessed by examining the relationship of candidate performances in the empathy station with those in other stations. The G-coefficient was analyzed to estimate the reliability of the test. Results: Eighty-two questionnaires were returned, a 97.6% response rate. Candidates showed overall positive perceptions of the video-based scenario and they found it authentic and interesting. The test was fair as there were no differences in candidates' perceptions of the patient-doctor relationship presented in the video clip and neither in their performance nor in their perceived difficulty of the station across demographics or backgrounds. Construct validity was established as candidate performance in the empathy station was not associated with that of any other stations. The G-coefficient was 0.74. Conclusions: The present study demonstrates that the video-based scenario is a feasible tool to assess candidate's empathy in the MMI.

e-Learning for enhancement of medical student performance at the Objective Structured Clinical Examination (OSCE).

This study aimed to investigate the impact of student e-learning on the development of clinical competencies. The study participants were 3rd year students (n = 43) at a private mid-sized medical school located in a South Korean suburb on a four-year medical program. Educational intervention was implemented to enhance student clinical performance. Students engaged in learning activities that intended to promote their self-directed learning abilities and clinical performances using e-learning resources. Intervention was conducted for the duration of six months during the 3rd year and its effectiveness was investigated by comparing student performances in OSCEs in a pre- and post- comparison format and also by comparing them with national scores. In addition, student perceptions of the impact of e-learning on their OSCE performances were assessed using a questionnaire, which included 36 items that elicited student perceptions of their experiences of e-learning and readiness for e-learning. Student OSCE scores improved significantly after educational intervention in all domains of clinical competencies assessed and for total scores (p < 0.001). Furthermore, students achieved higher OSCE scores than national average scores in the post-test, whereas they had performed lower than national average scores in the pre-test. Students showed neutral or slightly positive responses to the effectiveness of e-learning, and their perceptions of e-learning were not associated with their e-learning readiness scores. The study shows student OSCE performance improved significantly after educational intervention, which indicate the effectiveness of e-learning to support student learning of clinical performance. Despite significant improvements in student OSCE scores after e-learning, their perceptions of its effectiveness were neutral. Furthermore, student perceptions of e-learning were not associated with their readiness for it. Suggestions are made to help students use e-learning more effectively to enhance their clinical competencies.

Reform of medical education in Korea.

There are 41 medical schools in South Korea with over 3500 students graduating from the medical schools annually with the appropriate qualifications to practice medicine. Korean medical educators have made significant efforts to enhance the effectiveness of medical education by preparing students for the rapidly changing global environment of medicine and healthcare. This article outlines the reform efforts made by Korean medical schools to meet such demands, which includes the adoption of student-centered and competency-based education, e-learning, and authentic assessment of clinical performance. It also discusses the recent reform of the medical education system, driven by the Government's policy to prepare Korean higher education for an increasingly knowledge-based society.

Project-based learning approach to increase medical student empathy.

This study investigated the impact of empathy training on medical students using a project-based learning approach on the development of their empathic abilities. Study participants were Year 2 students in the six-year medical program, to whom a one credit-hour course on empathic communication was offered over a semester. In this course, students worked on collaborative team projects in which they were asked to interview a person and to report the empathy that they shared with the interviewee. Development in student empathy was measured using the Interpersonal Reactivity Index inventory in a pre- and post-test format over the semester and their reflective reports were qualitatively analyzed to identify emerging themes on the lessons they learned from the project experience. A total of 45 students completed the questionnaires (a 97.8% response rate). Students' overall empathy scores did not change over time (t = 1.943, p = .06). Still, students with lower empathy in the pre-test improved significantly in their empathy scores (t = 3.44, p < .01). Students reported that the empathy project was beneficial in improving their understanding of empathy and enhancing their empathic communication skills. This study shows the project-based learning approach was effective in developing medical student empathy especially for those with lower empathy.

The efficacy of peer assessment in objective structured clinical examinations for formative feedback: a preliminary study.

PURPOSE: We sought to determine the impact of medical students' prior experience of assessing peers in the objective structured clinical examination (OSCE) on their clinical performance. METHODS: Forty-two year 4 medical students participated in an OSCE comprised of three 10-minute stations (syncope, hemoptysis, and back pain). Each student took part in two iterations of the three-station OSCE as either the examiner or examinee, and student performance was assessed using a checklist by a medical faculty member and a student simultaneously. Students were randomly assigned to two groups and their OSCE scores were compared. Students in the control group were tested at a station first and then participated at the same station as a peer examiner, and those in the intervention group participated as a peer examiner first and then as an examinee. Moreover, student OSCE scores rated by peer examiners were compared with those awarded by faculty to evaluate the accuracy of peer assessment. Following the test, students completed surveys on their perceptions of the usefulness of this formative OSCE. RESULTS: Student overall OSCE scores did not differ between groups. Students in the study group performed better at the hemoptysis station (p<0.001), but poorer at the syncope station (p<0.01). Student performances at the back-pain station were similar in these two groups (p=0.48). OSCE scores rated by faculty and peer examiners were moderately negatively associated at the hemoptysis station (p<0.05), but no such association was observed at the other two stations. This trend was similar in peer examiners who were high-achievers and low-achievers in OSCEs. Students showed positive perceptions of their experience with this OSCE. CONCLUSION: Student experience as peer assessor offers a feasible means of providing them greater access to OSCEs without consuming more resources, although its impact on enhancing performance in the OSCE is likely to differ across stations.

General physicians graduated from a PBL undergraduate medical curriculum: how well do they perform as PBL tutors?

BACKGROUND: A study was conducted on the effectiveness of general physicians recently graduated from a medical school with Problem-Based Learning (PBL) curriculum as PBL tutors to expand the school's tutor pool. AIMS: This study aims to investigate these non-staff tutors' effectiveness in terms of student satisfaction and learning outcomes. METHOD: An experimental study was conducted of 12 PBL groups of second-year medical students (n = 40). Four PBL groups were led by non-staff tutors; the other eight groups were led by staff tutors during the two PBL units. Tutor evaluation and student satisfaction questionnaires were administered and student performance scores were analysed to compare between groups led by staff tutors and non-staff tutors. RESULTS: The students' overall satisfaction with the non-staff tutors on a five-point Likert-scale was high (M = 4.5 +/-.638). Additionally, the student scores on written tests were comparable between groups. Yet, in one unit, the groups led by staff tutors received significantly higher scores on the group evaluation than those led by non-staff tutors. CONCLUSIONS: The results of this study show that the non-staff tutors performed as effectively as the staff tutors did with regard to student achievement in written exams. Still, the findings of this study suggest that different tutor backgrounds and experiences might affect student performance beyond the written exam scores.

Medical education in Korea: the e-learning consortium.

This article reports the latest development in e-learning in Korean medical education. The Korean Consortium for e-Learning in Medical Education was formed for collaboration in providing quality online learning resources for medical schools around the nation. This e-learning strategy is aimed at improving the quality of medical education at the national level by providing students with equal access to quality learning resources and fostering students' self-directed learning and, in doing so, enhancing the effectiveness and efficiency of developing online learning resources by sharing necessary resources among the medical schools. The consortium also plans to share e-learning content with medical schools in other countries by engaging more medical schools in the consortium and also by sharing e-learning content developed by other institutions or consortiums. The consortium is also dedicated to the research and development of effective online learning strategies for medical education, including interactive virtual patient cases and other innovative pedagogies using Web 2.0 technologies.

Enhancing students' active learning and self-efficacy using mobile technology in medical English classes.

PURPOSE: This study investigated student experiences of mobile technology in a medical English course using a free mobile classroom application, Socrative and its impact on student learning to help them achieve the competency expected in the course. METHODS: Questionnaires were administered of year 2 medical students enrolled in a medical English course between 2016 and 2017 to investigate their experience in using Socrative. Learning outcomes were assessed by comparing students' academic performance with that of the 2015 cohort, who had taken the same course without using mobile technology, and also by measuring changes in their self-efficacy in English over time during the course. RESULTS: This study found students' positive perceptions of and overall satisfaction with their experience in using mobile technology in the medical English course. There were no differences in the academic performance between the study cohort and the comparison group. The ratio of students who were in the remediation program after the mid-term examination was 11%, whereas the remediation ratio of the 2015 cohort was 21%. Students' self-efficacy in English improved significantly in the writing and reading domains (p<0.05). CONCLUSION: This study found several benefits of using Socrative in the medical English course. Socrative fostered the classroom interaction by encouraging input from every student and sharing it instantly with the whole class. There was also learning improvement with the use of Socrative. Furthermore, it has the potential to enhance assessment by offering more various forms of assessment than that of conventional audience response systems.