Words are just Noise, let your Actions Speak: Impact of Nonverbal Communication on Undergraduate Medical Education.

OBJECTIVE: To explore student's perceptions regarding impact of kinesics (facial expressions, gestures, head movements and postures) on undergraduate medical education. METHODS: A qualitative exploratory online survey was conducted from July-Sept 2020 among purposively chosen final year BDS students (n=150) of three dental colleges of Islamabad during COVID-19 lockdown phase. Semi-structured survey questions were validated and piloted before execution. Thematic analysis was performed, and consensus was built among all authors regarding findings, hence ensuring analytical triangulation. RESULTS: Response rate was 46% (69/150). Twenty sub-themes emerged under three domains of kinesics. Participants told that 'neutral expressions' frequently used by teachers create 'boring learning environment' and 'hesitation among students to ask questions.' A smile of teacher imparts 'new degree of interest in the subject' and gives 'freedom of expression' to the students. On contrary, anger 'demotivate' students, instills 'fear among them', make them anxious therefore, they are 'unable to understand lectures' which ultimately leads to 'loss interest in the subject'. Use of gestures by teachers creates 'enjoyable teaching-learning process' but movements such as clearing throat or shaky legs produce 'constant split-second interruption'. Moreover, standing posture of teachers bring 'interest and alertness among students'. CONCLUSION: Nonverbal communication can have positive or negative impact on undergraduate medical education. Therefore, teachers may start lecture with a smile and anger should be avoided to produce friendly and healthy learning environment. Faculty training is required for the effective use of nonverbal communication strategies to create an optimal learning environment for the students.

Impact Of Covid-19: Faculty Suggestions Regarding Online Medical Teaching.

BACKGROUND: As a result of the SARS-CoV-2 related government lockdown, academic institutions in Pakistan, including medical and dental colleges and universities, had to forgo on-site classes and make an emergency shift to online teaching. This study explores the perspective of the faculty, as a key stakeholder, on ways to increase the effectiveness of online teaching and learning at these medical and dental colleges and universities. METHODS: A descriptive cross-sectional qualitative survey was conducted in April-July 2020 in 32 medical and dental colleges of Pakistan. The sample size was not pre-determined and the participants included teaching faculty of both clinical and basic sciences. Data were iteratively collected and analyzed till data and time saturation were achieved. Thematic analysis of data was done by running two coding cycles. All authors ensured analytical triangulation by analyzing the data independently before developing consensus on the subthemes and themes. RESULTS: One hundred and thirty-two medical teachers responded. Data analysis revealed three themes regarding suggestions to improve teaching methods improve assessment and increase the effectiveness of online teaching and learning. The participants suggested supplementing real-time classes with recorded lectures, providing broadband internet services, using assignment-based and active learning strategies, continuous formative assessment, faculty training, and standardization of online teaching by higher authorities. CONCLUSIONS: The current study offers actionable steps to decision makers at medical colleges and universities to make online teaching and learning more efficient and valuable, based on the suggestions from their faculty.

Barriers And Facilitators To Write Good Quality MCQS For Dental Assessments: A Qualitative Case Study.

BACKGROUND: To explore barriers and facilitators to write good quality items for undergraduate dental assessments. METHODS: A qualitative case study was conducted from Feb-April 2021. Semi-structured interviews were conducted with a purposive sample of eighteen item writers from a public-sector dental institute of Rawalpindi, Pakistan. The data were transcribed verbatim and thematically analyzed to extract themes regarding barriers and facilitators to write good quality items. All quality assurance procedures of qualitative research were ensured during the research process.. RESULTS: Five themes related to barriers and three themes related to facilitators to write good quality items emerged from the data. The participants reported more barriers such as lack of frequent training and lack of peer review and feedback. Other barriers were demotivation due to lack of acknowledgement or monetary incentives, lack of content and construct expertise, clinical workload, and contextual barriers such as lack of internet facility, outdated library, and lack of place and time allocation for item construction. Facilitators were availability of peer review, feedback from post-hoc analysis, motivation due to the senior designation, clinical experience, and ample time for basic sciences faculty. CONCLUSIONS: Frequent item writing training, strong peer review process, pre-exam item vetting by the dental education department, and institutional improvements such as striving for content experts, time and place allocation for item construction, internet facility, updated library, and equal distribution of workload among faculty could enhance the quality of items. Moreover, ways to inculcate motivation among item writers such as appreciation or monetary incentives could be used to improve the quality of undergraduate assessments.

Actions Speak Louder Than Words: Impact Of Kinesics On Undergraduate Medical Education.

BACKGROUND: Nonverbal communication constitutes significant proportion of human communication besides spoken words. This study explored teacher's perceptions about impact of kinesics (facial expressions, gestures, head movements and postures) on undergraduate medical education within a classroom setting. METHODS: A survey-based exploratory research was carried out from July-August 2020. Medical teachers from two private dental colleges of Islamabad were included in the sampling frame. The survey questions were validated and approved by all authors before execution. Frequencies and percentages of closed-ended questions were calculated while thematic analysis for open-ended questions was done by all authors to get consensus on themes, hence ensuring analytical triangulation. RESULTS: Forty-six teachers responded to the survey. The most frequently shown facial expressions were 'happiness and enthusiasm' (76.1%) creating friendly, conducive, and motivating learning environment. 'Smile' was considered powerful communicative signal (95.7%) whereas 'anger' was thought to be communication barrier leading to stressful and demotivating learning environment. Neutral expressions were considered helpful to maintain class decorum. 'OK sign with raised thumb' (50%) was found helpful to develop special teacher-student connection and 'head nod' (84.8%) was encouraging students to continue giving answers. Standing posture (81%) exhibited teacher's commitment towards teaching and produced active learning environment. CONCLUSIONS: Teachers should start lecture with welcoming facial expressions, i.e., smile to build rapport with students. Anger should be avoided as it demotivates students by making learning environment stressful. We need to train faculty regarding effective use of nonverbal communication strategies to improve student's learning experience and to create positive learning environment.

Benefits of Reflective Writing in Health Care through the Vivid Lens of House Officers.

This article was migrated. The article was marked as recommended. Introduction: Reflective writing, a complex human activity is one of the innovative pedagogies to promote deep learning among medical students and doctors. Despite its potential to facilitate learning, there is limited literature on evaluation of various purposes of reflective writing in medical education. Hence, aim of this study is to develop an instrument and evaluate the perceptions of house officers about benefits of reflective writing. Methods:Mixed method study followed AMEE 87 guidelines for questionnaire development. The study was carried out from Oct 2018-Feb 2019 in a dental college in Islamabad. A 30-items questionnaire was developed by following these steps: (1) conduction of literature review, (2) item development, (3) conduction of cognitive interviews and (4) pilot testing. Coding and interpretation of transcribed data and notes taken during cognitive interviews was done to finalize three main themes (learning, self-regulation and alteration in clinical behavior) identified in literature review. In pilot testing, participants were asked to rate the purposes of reflective writing on a three-point Likert scale (Agree, do not know and disagree). Data was analyzed using SPSS version 22. Results: All of nineteen house officers (n= 3 for cognitive interviews, n= 16 for pilot testing) had previous experience of writing reflections using Gibb's reflective cycle. Thirteen (81%) out of sixteen house officers agreed that reflective writing improves learning, helps in self-regulation and alters clinical behavior, two (13%)did not know about the three themes that were finalized in cognitive interviews and one (6%) did not agree. Discussion and Conclusion:Reflective writing improves learning, helps in self-regulation and alters clinical behavior in the selected house officers. This study may inspire medical education experts to include reflective writing as a part of formal undergraduate medical and dental curriculum to enhance student's learning experience.