Two-stage collaborative group testing does not improve retention of anatomy among students studying medical radiation technology.

INTRODUCTION: Two-stage collaborative group testing is an assessment format where students first complete a summative assessment independently, and then immediately convene in a small group to complete the same assessment again. Research on two-stage collaborative group testing has shown that it increases immediate learning, improves communication and teamwork, and can lead to enhanced retention of course material; the latter of which is especially important for basic anatomical concepts among health care professionals such as medical radiation technologists. However, such previous research has often employed quasi-experimental designs that may limit both internal and external validity. METHODS: Using a randomized crossover design with both quantitative and qualitative data analyses including robust intra-individual statistical comparisons, this research compared the educational impact of the two-stage collaborative group testing format (the COL condition) to traditional independent testing (the IND condition). Students (n=196) from two successive renditions of an introductory anatomy course were randomly assigned into groups of 3-5 students. Groups worked together throughout the term on various course elements, including three in-class, non-cumulative term tests (TTs). After practicing the collaborative format during TT1, during TT2 half the groups were assigned to the COL condition while the other half were assigned to the IND condition. Groups crossed over for TT3. All students completed a cumulative final examination independently, with performance data from that examination coded and extracted according to previous TT condition. Educational impact was evaluated as both immediate learning (by comparing IND and COL performance on the associated TT) as well as retention (by comparing final examination performance for topics previously IND tested versus previously COL tested). Students' qualitative reflections were coded into categories and juxtaposed against quantitative Likert-style feedback to comprehensively explore students' perception of the testing format for evidence of enjoyment, acceptability, and influence on relevant CAMRT professional competencies. RESULTS: 167 students (85%) consented to data inclusion, with a final course grade of 75.5 ± 10.0%. On average, TT performance was 13.6 ± 11.6% greater on the COL test (90.4 ± 7.6%) than the IND test (76.7 ± 14.3%) (p<0.01, r = 0.76), results that support immediate learning. Contrary to expectations, final examination performance specific to the two experimental conditions was similar, with students earning an average of 69.6 ± 18.3% on questions that pertained to material they were previously IND tested on, and 67.4 ± 19.1% on questions they were previously COL tested on (ns). Students' overall perceptions of the two-stage collaborative group testing format were overwhelmingly positive, with 84% indicating a belief that the format was a constructive learning opportunity and 74% recommending continued use. Written reflections revealed that students believed that collaborative testing enhanced their learning by both clarifying previous mistakes and reinforcing correct knowledge. Relevant CAMRT professional competencies included oral communication and interprofessional skills, capacity for productive teamwork, and collaborative practice. SIGNIFICANCE: Although the results of this study do not support the use of two-stage collaborative group testing for retention of course material, they simultaneously reveal how the testing structure may be uniquely beneficial to students studying within the field of medical radiation sciences while also presenting a pragmatic example of how to implement this unique testing format.

"We Are All Students:" An Interprofessional Education Approach to Teaching Radiation Oncology Residents.

The principal goal of interprofessional education (IPE) is to cultivate collaborative practice for providing patient centered care. Introduction to Radiation Therapy (IRT) is a course designed to introduce radiation oncology residents to the radiation treatment process and the interprofessional nature of the radiation oncology environment. Each resident is paired with a radiation therapy student during the clinical portion of the IRT course. The intent behind the pairing is to facilitate opportunities for IPE and to establish a professional relationship for interprofessional collaboration in the future. The overall outcome of the IPE experience has been positive and beneficial to both groups. Results of the survey examining the residents' and the radiation therapy students' perception of their IPE experience within the IRT course showed that they were able to gain insight into each other's role, as well as learn with and from each other. However, the timing of the IPE experience had some impact on the participants' ability to reflect on their own practice and share it meaningfully.

Supporting Clinical Teachers: Developing Radiation Therapists' Preceptorship Skills.

Preceptorship is a valuable component of undergraduate radiation therapy education and allows students to develop clinical skills and professional attitudes under the supervision of experienced practitioners. Preceptor preparation in the form of continuing professional development is an important factor for successful preceptorship to occur. This article describes the development and evaluation of a short, flexible blended learning course by a group of Ontario educators. The course was designed to support radiation therapists teaching students from the joint University of Toronto and Michener Institute Medical Radiation Sciences (MRS) program undergoing the clinical practicum component of their 3-year program. The course comprises two workshops and a web-based component. Topics include adult education theories, orienting a student to clinic, feedback, fostering clinical reasoning, conflict resolution, formal evaluation, the MRS program structure/processes and the needs of the student with English as a second language. To date, three cohorts have completed the course (52 learners) from four Ontario radiation therapy departments. Evaluations have been positive, with high participant satisfaction and a noteworthy difference in self-perceived knowledge using the original course objectives between pre- and post-knowledge levels. It is hoped that this course will contribute to the success of the role and provide an opportunity for staff recognition and support.

Admission criteria and student success in a medical radiation sciences program.

Determining admission criteria that will predict successful student outcomes is a challenging undertaking for newly established health professional programs. This study examined data from the students who entered a medical radiation sciences program in September 2002. By analyzing the correlation between undergraduate GPA, grades in undergraduate science courses, performance in program coursework, and post-graduation certification examination results, the authors determined admission criteria that were linked to successful student outcomes for radiological technology and radiation therapy students.

Supporting Student Success.

Whether we are passionate about educating students or whether we believe that educating students is a job responsibility, as practicing medical radiation technologists/therapists, we are all clinical role models and clinical teachers. Although the majority of students adapt to the clinical environment and professional culture without too much difficulty, as clinical teachers, we have all encountered the student we felt was a challenge to educate. You may have experienced a student you thought was not motivated, did not effectively communicate, or was just a "problem"! As clinical teachers, we often struggle with how best to educate the student who is experiencing difficulty, which can lead to feeling helpless as to how to assist the student to be successful. Regardless of the time and effort spent with the student, when the student is unsuccessful, the reflective practitioner inevitably feels some responsibility. Before characterizing a student as a "problem," clinical teachers need to consider and recognize the many factors that may influence the poor performance. Using evidence from the literature, this article will describe common causes of difficulty that students may be experiencing, how to recognize the difficulty (including the complex nature of the difficulty), strategies for remedial intervention, and a structured framework for a remediation plan to enable the student to succeed.

Radiation Therapy Students' Teaching Expectations of Therapists over the Course of Clinical Practicums: A Longitudinal Study.

Students' expectations of clinical teachers have been well researched, yet little is known about whether expectations change as students become competent and approach graduation. Radiation therapists are usually engaged in clinical teaching; for their involvement to be of value to students, they must have an understanding of what students need from them. This longitudinal study sought to determine whether students' needs of clinical teachers changed over the length of the clinical practicum and whether those needs were in the category of clinical competence, teaching approach, personality traits, evaluation methods, or interpersonal relationships. An online survey required students to rate the importance of several clinical teaching characteristics in the fifth and twelfth months of a 12-month practicum. Submissions were coded, first analyzed individually, and then paired to assess longitudinal changes. Eighteen students (33%) completed both administrations. Analysis of the highest and lowest rated items revealed items in the Personality Traits and Clinical Competence categories being rated as most important. The only significant change was "identifying the role and responsibilities of staff versus students," which became less important to students. Relative ranking suggested importance was later placed on mentoring roles compared to evaluator roles. The importance placed on the responsibility of role model remained unchanged. The sample size was prohibitive of extensive analysis, though some trends were suggestive of changing importance. Students place importance on staff clinical competence and personality traits. There is evidence that students view staff as mentors rather than as evaluators as they approach graduation.

Helping learners in difficulty--the incidence and effectiveness of remedial programmes of the Medical Radiation Sciences Programme at University of Toronto and the Michener Institute for Applied Sciences, Toronto, Ontario, Canada.

INTRODUCTION: Academic difficulty can often be a significant problem for students in health professional programmes. Students in difficulty are often identified late in their training and run the risk of dismissal if remediation is not successful. Since the inception of the Medical Radiation Sciences Program (MRSP) at the University of Toronto, Faculty of Medicine, and the Michener Institute (MI) in 1999, a number of students have required remediation due to problems in the didactic or clinical component of their training. Not all remediation was successful, and a number of students have been dismissed. There is relatively sparse evidence in the educational literature regarding the nature of academic difficulties that health professional students encounter, and what constitutes appropriate remedial education. The purpose of this research was to evaluate the incidence and prevalence of remediation in the MRSP and the nature of the academic problems. In addition, this study looked at the type of remedial instruction that the Radiation Sciences Board of Examiners (BOE) recommended for these students as well as the effectiveness of these recommendations. MATERIALS AND METHODS: This study consisted of a review of the academic records of students who failed one or more courses and underwent pre-clinical or clinical remediation, and who were presented at the Medical Radiation Sciences Board of Examiners at the University of Toronto between September 1999 and December 2004. Data extraction forms were developed to obtain demographic information, the nature of the academic problems, the remedial recommendation, and their outcomes. RESULTS: This study identified 69 students who were presented to the BOE 95 times. Forty-four students (44/69, 64%) were from the Radiation Therapy stream, 16 students (16/69, 23%) were from the Nuclear Medicine stream and 9 students (9/69, 13%) were from the Radiographic Technology stream. Most of the remediation occurred due to pre-clinical 50 (50/69, 72%), clinical 15 (15/69, 22%) and both preclinical and clinical problems 4 students (4/69, 6%). Out of 54 students who required pre-clinical remediation, 40 (74%) were promoted. Out of 19 students who required clinical remediation, 10 (10/19, 53%) passed their remediation. Six students (6/69, 9%) were dismissed from the programme due to unsuccessful remediation; 2 due to pre-clinical and 4 due to clinical problems. Based on these results, the remediation process at the MRSP was successful; however, 6 students (6/69, 9%) were dismissed from the programme during the last 4 years despite lengthy unsuccessful remediation. CONCLUSION: Our study provided an important perspective about the remediation process at the MRSP at the Michener Institute for Applied Health Sciences. Despite its retrospective methodology, it attempted to identify the magnitude of learning problems that lead to remediation, and identified the efficacy of the remedial programmes.