Learning experiences from an online QI fellowship programme during COVID-19 - a qualitative study.

BACKGROUND: During the COVID-19 pandemic in the United Kingdom, multiple aspects of everyday human existence were disrupted. In contrast, almost all levels of educational learning continued, albeit with modifications, including adaptation to virtual-or online-classroom experiences. This pedagogic transition also occurred in the National Institute of Health and Care Research Applied Research Collaboration Northwest London's (NIHR ARC NWL) Improvement Leader Fellowship, an annual programme focusing on quality improvement (QI). This qualitative study aimed to understand how these changes impacted the Fellows' learning experience. METHODS: We explored the experiences of two cohorts of programme Fellows (n = 18, 2020-2021 and n = 15, 2021-2022) with focus groups, analysed under a constructivist qualitative research paradigm. RESULTS: The two primary and four sub-themes that emerged were: Online QI learning experience (benefits and challenges) and Implementing online QI learning (facilitators and barriers). While benefits had three further sub-themes (i.e., digital flexibility, connection between learners, and respite from impact of COVID-19), challenges had four (i.e., lack of interaction, technological challenges and digital exclusion, human dimension, and digital fatigue). While the facilitators had three sub-themes (i.e., mutual and programmatic support, online resource access, and personal resilience), barriers had one (i.e., preventing implementation and lack of protected time). CONCLUSION: Despite challenges to in-person ways of working, online learning generally worked for action-orientated QI learning, but changes are needed to ensure the effectiveness of future use of virtual learning for QI. Understanding the challenges of the translation of learning into action is crucial for implementation learning, gaining insight into how improvement Fellows navigated this translation when learning remotely and implementing directly in their workplace is key to understanding the evolving nature of implementation over the pandemic years and beyond.

Expanding the scope of problem-based-learning at Hackensack Meridian School of Medicine; integrating domain-general skills with domain-specific content.

The Master Adaptive Learner is a model used to develop students to become self-regulated and adaptable lifelong learners to practice medicine in a complex and ever-changing environment. The Hackensack Meridian School of Medicine (HMSOM) proposes a new course, Patient Presentation Problem-Based Learning Curriculum (PPPC), a dynamic and integrated course that goes beyond the scope of traditional Problem-Based-Learning (PBL). PPPC allows students to build domain-general skills in tandem with domain-specific content learned during a pre-clerkship curriculum. An integrated case provides weekly scaffolding, such that the course takes place throughout the week and is not isolated from the rest of the curriculum. Students receive iterative feedback and structured assignments which allows development of self-directed learning skills along with integration and consolidation of weekly curricular content. A layered analysis approach was used to outline the philosophies, principles and techniques that link to our course objectives. Techniques used could easily be translated to other pre-clerkship curriculum to promote development of self-directed learning and clinical reasoning skills, as well as promote more meaningful learning of basic, clinical, and health system science content.

Medical education challenges in Mainland China: An analysis of the application of problem-based learning.

BACKGROUND: The medical education system in mainland China faces numerous challenges and the lack of learner-centered approaches may contribute to passive learning and reduced student engagement. While problem-based learning (PBL) is common in Western medical schools, its feasibility in China is questioned due to cultural differences. This systematic review aims to summarize the application of PBL in medical education in mainland China based on existing literature, as well as to identify the challenges and opportunities encountered in its implementation. METHODS: A systematic literature review was conducted using electronic databases, including MEDLINE, Cochrane Library, EMBASE, Web of Science, Wan fang and CNKI databases. Grey literature sources were explored using Google Scholar. The search was limited to articles that include at least one English abstract up to May 1st, 2023. The inclusion criteria were studies that reported the use of PBL in medical education in mainland China. RESULTS: A total of 21 articles were included in the final analysis. The findings indicate that PBL is a well-adopted and effective learning method in most medical education, especially for developing critical thinking, problem-solving, and teamwork skills. However, the application of PBL in mainland China is limited due to various challenges, including faculty resistance, inadequate resources and cultural barriers. To effectively address these challenges, it is essential to provide faculty training, develop appropriate assessment methods to evaluate student progress within the PBL framework and create conducive spaces and resources that support collaborative learning and critical thinking. CONCLUSION: The utilization of PBL in mainland China holds potential for enhancing medical education. However, its successful implementation requires significant efforts to address the identified challenges. It is crucial to engage stakeholders in a collaborative effort to promote the application of PBL and ultimately improve the quality of medical education in mainland China.

The tools of the future are the challenges of today: The use of ChatGPT in problem-based learning medical education.

What is the educational challenge?Incorporation of large language model (LLM) or generative artificial intelligence (AI) software poses a challenge to various areas of medical education, including problem-based learning (PBL). LLMs, such as ChatGPT, have incredible potential to transform educational systems and enhance student learning outcomes when used responsibly.What are the proposed solutions?ChatGPT can provide several ways to support students and assist facilitators with course responsibilities. Here we address factors of implementation and describe how ChatGPT can be responsibly utilized to support key elements of PBL.How was the solution implemented?Providing reasonable access is an essential element of novel software implementation. Additionally, training for both faculty and staff is vital to foster responsible usage, provide base-line proficiency, and guide users to critically evaluate the quality of output.What lessons were learned that are relevant to a wider audience?The use of LLMs or other generative AI is dramatically rising in the world. Appropriate and conscientious incorporation of AI into educational programs can foster responsible use and potentially enhance student learning.What are the next steps?Assessment of learning outcomes, student self-efficacy, group dynamics, and stakeholder feedback are required to measure the effects of ChatGPT in the PBL curriculum. Additionally, software programs competitive with ChatGPT are currently under development and will also need to be investigated for their potential role in education.

The effect of different patient-based learning models on student perceptions of empathy, engagement, knowledge, and learning experience.

BACKGROUND: Problem-based learning is used widely in pharmacy and medical programmes, incorporating realistic patient scenarios into regular teaching as a way of linking theory to practice. Routine case-based learning lessons ranges from real patient involvement, scripted patient scenarios, digital simulations (avatars) as well as through media such as Zoom. The existing literature has explored the extensive benefits of using patients in clinical education, but fewer studies have directly compared the efficacy of each model as learning tools. AIM: To compare student perceptions of patient-based learning models to elicit student empathy, increase engagement, improve knowledge, and enrich learning experience. METHODS: A questionnaire was distributed to second-year pharmacy students in Swansea University to gather their perceptions on the nine different patient-based learning models in their routine teaching (SUMS RESC 2023-0011). Students were asked to rank their experience of the models explicitly against each other, based on the four pillars of (1) eliciting student empathy, (2) increasing engagement, (3) improving knowledge and (4) enriching the learning experience. Students were also asked to rate the significance of realism (i.e. knowing the patient demographics/having a visual representation of the patient) to their experience. RESULTS: Altogether, 31 student rankings of the nine learning models were weighted (9 = highest rank; 1 = lowest ranked). The data showed clear preferences for real-patient involvement over fictional cases, especially for eliciting empathy. Interestingly, scripted scenarios were rated highly for both engagement and learning experience only when avatars were involved, which suggests a role of animated visual representation of the patient in facilitating these outcomes. CONCLUSION: Whilst it is useful to have multiple patient-based learning models, this study serves as a guide for educators in preparing case-based learning sessions for achieving the desired outcomes of any of the four pillars above.

Situations that prompt teachers in problem-based curricula to reflect on their beliefs, identity and mission.

Teachers have different perceptions of how to enhance student learning. Whereas some take a teacher-centred perspective, others lean more towards a student-centred approach. Many studies in higher education have invoked Korthagen's onion model (2014) to explain how teachers' perspectives can impact their teaching practices. Spanning six interrelated layers, this model contains both outer (environment, behaviour, competencies) and inner (beliefs, identity, and mission) aspects. Focusing essentially on teachers' outer aspects, previous studies have paid scant attention to how particular situations affect teachers' inner aspects and, consequently, how teachers perceive student-centred learning. In this descriptive qualitative study, we explored situations that encouraged or discouraged teachers to embrace student-centred beliefs, identities and missions. We held three focus-group discussions with 18 teachers from two Indonesian medical schools, performing a thematic analysis of the data thus obtained. We found that certain situations made teachers reflect on their inner aspects, which either favourably or adversely affected their acceptance of a student-centred learning approach. Teachers' outer aspects (i.e. their prior problem-based teaching and learning experiences, learning situations from their own training as well as clinical duties) strongly interacted with their inner aspects, thereby shaping their teaching perspectives. Understanding how specific situations can influence teachers' inner aspects might help institutions to design faculty development programmes that address teachers' specific educational needs.

Employing students' evaluations and tutors' perceptions to evaluate a faculty development program on problem-based learning at the Faculty of Medicine, King Abdulaziz University.

BACKGROUND: Faculty development programs are crucial for promoting continuous learning, enhancing teaching effectiveness, and encouraging professional growth among medical educators. Problem-based learning was introduced as a teaching strategy in our Faculty of Medicine in 2007. Thereafter, several rounds of a faculty development program were conducted to help teachers recognize their role as facilitators and assess areas for improvement. METHODS: We conducted a mixed-methods study with a sample of 284 third-year medical students answering a questionnaire and 21 faculty members participating in focus groups. A validated 13-item questionnaire was used to investigate the students' evaluation of their tutors' performance in problem-based learning. Three sessions were then conducted with faculty members involved in problem-based learning to gain in-depth insights into their experiences and perspectives. RESULTS: The mean performance ranking for tutors awarded by the students was above halfway. There was a significant positive correlation between tutors' performance ranking and all five of the learning approaches examined herein: constructive/active learning, self-directed learning, contextual learning, collaborative learning, and intra-personal behavior (p < 0.05). The data from the focus groups were analyzed under five broad themes: tutors' insights into their strengths and weaknesses, challenges in conducting problem-based learning, tutors' ways of preparing for problem-based learning, feedback, and suggestions for improving problem-based learning workshops. CONCLUSIONS: This study recommends improvements and future directions for advanced program evaluation. Faculty development programs can be tailored to effectively address students and faculty members' goals and needs, which can benefit the teaching and learning process and foster a culture of continuous improvement and professional growth.

Comparing the effects of team-based and problem-based learning strategies in medical education: a systematic review.

BACKGROUND: Recently, there has been a concerted effort within medical schools to depart from conventional lecture-based learning approaches to alternative teaching methods such as team-based learning (TBL) and problem-based learning (PBL), with the aim of enhancing both student engagement and instructional efficacy. Despite this shift, a comprehensive review that directly compares the impacts of PBL and TBL methods in medical education is lacking. This study seeks to address this gap by conducting a meta-analysis that compares the effects of TBL and PBL in the context of medical education. METHODS: Studies from Embase, PubMed, Web of Science, China National Knowledge Infrastructure, and Chinese Wanfang Database were searched, from inception to July 11, 2023. A meta-analysis was performed using Stata 14.0, and a total of 10 studies (including 752 participants) were included. The standardized mean difference (SMD) was used to estimate pooled effects. Heterogeneity was detected using the I2 statistic and further explored using meta-regression analysis. RESULTS: Compared with PBL, TBL significantly increased the number of theoretical tests (SMD = 0.37, 95% CI: 0.02-0.73). Additionally, TBL greatly improved teamwork skills compared with PBL. However, there were no significant differences between the TBL and PBL groups concerning practical skill scores, learning interest, or understanding skills. CONCLUSION: TBL in the theoretical aspects of medical education appears to be more effective than PBL in improving theoretical test scores and teamwork skills, providing evidence for the implementation of TBL in medical education.

Self-efficacy of medical students in a hybrid curriculum course (traditional and problem-based learning) and associated factors.

Self-efficacy consists of the judgment of one's abilities to perform actions required to achieve a given performance, which has been considered predictive of performance. In academics, it means personal convictions in accomplishing a task to a defined degree of quality. Numerous studies have investigated medical students' self-efficacy in traditional and PBL curricula. However, few studies have addressed the hybrid PBL scenario (Hpbl) that simultaneously contemplates PBL, traditional teaching, and practical activities. An even smaller number have evaluated the factors associated with this entity. With these considerations, we aimed to investigate the self-efficacy belief in the hPBL curriculum and the factors associated with this entity. This quantitative observational cross-sectional study was held between August 2022 and November 2022 in Fortaleza, a city in Northeast Brazil with almost 3 million inhabitants. The medical course has 12 semesters. The first two semesters use traditional teaching and cover the basic cycle, followed by the third to eighth semesters which correspond to the pre-clinical and clinical cycle. From the third semester onwards, traditional teaching and PBL are used simultaneously, which we call a hybrid model of PBL. The scale "Scale of Self-efficacy in Higher Education" was applied, a questionnaire validated for the Portuguese language consisting of 34 questions, with answers on a Likert-type scale with ten points, divided into five dimensions. To verify the association between sociodemographic factors and self-efficacy, simple and multiple linear models with robust errors were used. In total, 412 students participated in this study, most of them women (70.1%). The average age of students was 22.9 years. All domains had medians greater than 8, which means strong self-efficacy. The following factors were associated with higher self-efficacy scores in general after the multivariate analysis: female gender (8.6 vs. 8.3, p-value = 0.014), working (8.8 vs. 8.5, p-value = 0.019) and participating in extracurricular activities (8.7 vs. 8.1, p-value = 0.019). We conclude that medical students studying in hybrid learning models showed strong levels of self-efficacy. In addition, participating in extracurricular activities was associated with higher self-efficacy scores and males presented lower levels of self-efficacy.

Impact of virtual problem-based learning of cardiopulmonary resuscitation on fourth-year nursing students' satisfaction and performance: a quasi-experimental study.

BACKGROUND: Regarding competency of nursing students in cardiopulmonary resuscitation (CPR), nursing students frequently exhibit inadequate performance and low satisfaction levels regarding CPR training methods. The problem-based learning (PBL) method, characterized by a constructivist approach, has been underutilized for CPR training, particularly in a virtual format. Hence, this study aims to assess the influence of virtual problem-based learning in cardiopulmonary resuscitation on the satisfaction and performance of fourth-year nursing students. METHODS: This quasi-experimental study, conducted in 2022, involved 80 final-year nursing students from Hamadan University of Medical Sciences, Iran. The participants were randomly assigned to either the experimental group (N = 40) or the control group (N = 40). The experimental group was further divided into six smaller groups on WhatsApp. Both groups initially received routine training sessions, after which the experimental group engaged in four problem-based learning sessions across three different scenarios. Data collection included demographic information, a teaching satisfaction questionnaire, and cardiopulmonary resuscitation checklists administered immediately and one month after the intervention. RESULTS: The study was initiated and concluded with 80 participants. The study commenced with no significant disparity in the mean scores of cardiopulmonary resuscitation performance, encompassing chest compressions (P = 0.451) and airway management (P = 0.378), as well as teaching satisfaction (p = 0.115) among the nursing students between the experimental and control groups. However, subsequent to the intervention, both immediately and one month later, the experimental group displayed notable enhancements in mean scores for cardiopulmonary resuscitation performance, comprising chest compressions (p < 0.001) and airway management (p < 0.001), as well as teaching satisfaction (p < 0.001) compared to the control group. CONCLUSION: Based on the study's findings, it is recommended that nursing educators implement this approach in their teaching practices.

Barriers to implementing problem-based learning at the school of medicine of Debre Berhan University, Ethiopia.

BACKGROUND: Implementing PBL in teaching and learning can be challenging due to a variety of complex barriers. Studies on barriers to the implementation of problem-based learning in Ethiopia are scarce. This study aimed to explore the barriers to the implementation of problem-based learning at the Debre Berhan University Medical School. METHODS: A qualitative study was conducted among faculty and medical students at the medical school. Purposive sampling was used to select participants. Semi-structured interviews were conducted with tutors and academic leaders, including the problem-based learning coordinator, the biomedical sciences coordinator, and the school dean. Data was also collected from students through focus group discussions. All interviews and discussions were recorded. The four steps of data analysis of Spradley, including domain analysis, taxonomic analysis, componential analysis, and theme analysis, were employed. RESULTS: The study identified student-related, tutor-related, case scenario-related, and assessment-related barriers as the most significant obstacles to implementing problem-based learning. These barriers included work overload for both students and tutors, lack of training and experience among tutors, student reluctance, absence of standardized case scenarios, subjectivity of assessment methods, and on-the-spot assessment of students. CONCLUSIONS AND RECOMMENDATIONS: Lack of both tutor and student commitment, lack of standardized cases, absence of a recognition of staff input, gap in communication skills, work overload, lack of continuous training, and at-spot evaluation of students were identified as the main barriers to the implementation of PBL.

Flipping the expert: faculty educator sensemaking during transition to an active learning-based curriculum.

PURPOSE: Curricular change is becoming a standard feature of medical schools as they respond to learners' evolving needs. Implementing change is not always straightforward, however, especially when it directly shifts the expected roles of faculty educators. The authors investigated how faculty educators navigated a significant transition to the Active, Competency-Based, and Excellence-Driven (ACE) curriculum at one state medical school. METHOD: The authors employed a qualitative descriptive design and conducted thematic analysis. From June 2018 to January 2019, the authors conducted individual, in-depth interviews with faculty educators and administrators involved in first-year medical student education. Data were analyzed inductively to identify the sensemaking process for faculty. RESULTS: Twenty-one faculty educators participated in interviews averaging 58 min. Four phases were identified among educators as they moved through the change: (1) Making Sense of the Change; (2) Grieving the Lecturer Educator Role; (3) Risking an Active Learning Educator Role; and (4) Identifying the Rewards of Active Learning-based Teaching. CONCLUSION: Faculty buy-in is an essential component of successful curricular change implementation. While most faculty in this study reported eventual enjoyment from the new interactional teaching that fostered critical thinking, navigating the change was not always smooth. This study suggests faculty development around curricular change should be tailored to address the varying faculty concerns relevant to the four phases that were identified. Effective and optimal faculty support during large-scale curricular change must take into account not just new skills but also the grief and risk faculty may experience as their roles shift.

From Slow Shifts to Fast Flips: Unraveling problem-based learning group function dynamics.

PURPOSE: Problem-Based Learning (PBL) relies on self-directed learning in small groups in the presence of a tutor. While the effectiveness of PBL is often attributed to the dynamics of group function, change in group function over time and factors influencing group function development are less understood. This study aims to explore the development of PBL group function over time to better understand the factors that give rise to high-functioning groups. METHOD: We examined time-function graphs of group function and conducted semi-structured focus group discussions in 2023 with medical students enrolled in a PBL curriculum. Students reflected on their experiences in four different PBL groups, creating time-function graphs to characterize development of group function over 8-12-week periods. We analyzed graphs and transcripts in a staged approach using qualitative description and direct content analysis, sensitized by two frameworks: Tuckman's Stages of Group Development and the Dimensions of PBL Group Function. RESULTS: Three archetypes of PBL group function development were identified: Slow Shifters, Fast Flippers, and Coasters. (1) Slow Shifters were characterized by a complex and extended pattern of growth consistent with Tuckman's model, typically occurring amongst inexperienced groups, or groups faced with a novel task. (2) Fast Flippers were characterized by abrupt state changes in group function arising from internal or external disruptions. (3) Coasters were characterized by plateaus, where maintenance of group function was a frequently cited challenge. Abrupt changes and plateaus occurred more among mature groups and groups with significant PBL experience. CONCLUSIONS: PBL group function varies over time in 3 different patterns. Classic Tuckman's stages are apparent among inexperienced groups, or groups facing novel tasks, whereas experienced groups often face abrupt change or plateaus. PBL educators and students should consider the need for novelty and disruption in more experienced groups to incite growth.

Online-to-offline combined with problem-based learning is an effective teaching modality in the standardized residency training of nephrology.

BACKGROUND: The online-to-offline (O2O) teaching method is recognized as a new educational model that integrates network learning into offline classroom education, while problem-based learning (PBL) is a teaching modality that guides students to apply acquired theoretical knowledge to solve practical problems. However, implementing O2O combined with PBL has not been extensively explored in nephrology residency training. This study aims to explore the efficacy of O2O combined with PBL in the standardized residency training of nephrology by comparing it with the traditional lecture-based teaching (LBT). METHODS: Sixty residency trainees who participated in the standardized training of internal medicine in the nephrology department of the Second Affiliated Hospital of Zhejiang University School of Medicine were equally allocated into O2O combined with PBL (O2O/PBL) or the LBT group demographically matched. Examinations of theory, practice skills, clinical thinking and teaching satisfaction surveys were utilized to assess the teaching effects of the two groups. RESULTS: Participants from the O2O/PBL group outperformed those from the LBT group in the examination of theory (81.233 ± 9.156 vs. 75.800 ± 7.009, mean ± SEM), practice skills (104.433 ± 3.569 vs.100.316 ± 4.628, mean ± SEM) and clinical thinking (88.933 ± 4.473 vs. 86.667 ± 3.844, mean ± SEM). There was no significant difference in the teaching satisfaction between the two groups. CONCLUSION: The current study shows the positive impact of O2O combined with PBL approach on standardized residency training in nephrology without reducing teaching satisfaction.

The effectiveness of problem-based learning and case-based learning teaching methods in clinical practical teaching in TACE treatment for hepatocellular carcinoma in China: a bayesian network meta-analysis.

PURPOSE: To investigate the effectiveness of problem-based learning (PBL) and case-based learning (CBL) teaching methods in clinical practical teaching in transarterial chemoembolization (TACE) treatment in China. MATERIALS AND METHODS: A comprehensive search of PubMed, the Chinese National Knowledge Infrastructure (CNKI) database, the Weipu database and the Wanfang database up to June 2023 was performed to collect studies that evaluate the effectiveness of problem-based learning and case-based learning teaching methods in clinical practical teaching in TACE treatment in China. Statistical analysis was performed by R software (4.2.1) calling JAGS software (4.3.1) in a Bayesian framework using the Markov chain-Monte Carlo method for direct and indirect comparisons. The R packages "gemtc", "rjags", "openxlsx", and "ggplot2" were used for statistical analysis and data output. RESULTS: Finally, 7 studies (five RCTs and two observational studies) were included in the meta-analysis. The combination of PBL and CBL showed more effectiveness in clinical thinking capacity, clinical practice capacity, knowledge understanding degree, literature reading ability, method satisfaction degree, learning efficiency, learning interest, practical skills examination scores and theoretical knowledge examination scores. CONCLUSIONS: Network meta-analysis revealed that the application of PBL combined with the CBL teaching mode in the teaching of liver cancer intervention therapy significantly improves the teaching effect and significantly improves the theoretical and surgical operations, meeting the requirements of clinical education.

Physiology education in China: the current situation and changes over the past 3 decades.

OBJECTIVE: As an experimental biological science, physiology has been taught as an integral component of medical curricula for a long time in China. The teaching effectiveness of physiology courses will directly affect students' learning of other medical disciplines. The purpose of this study is to investigate the current situation and changes in physiology teaching over 30 years in Chinese medical schools. METHODS: National survey was conducted online on the platform SoJump via WeChat and the web. The head of the physiology department in medical school was asked to indicate the information of physiology education from three periods: 1991-2000, 2001-2010, and 2011-2020. The responses of 80 leaders of the Department of Physiology from mainland Chinese medical schools were included in the study for analysis. RESULTS: The survey showed that the class hours, both of theory and practice, had been decreased. During the past 20 years, the total number of physiology teachers, the number of physiology teachers who had been educated in medical schools, and the number of technicians had been reduced, whereas teachers with doctor's degrees had been increased. In addition to traditional didactic teaching, new teaching approaches, including problem-based learning/case-based learning/team-based learning, integrated curriculum and formative evaluation systems, had been employed, mostly for more than 5 years, in some medical schools. CONCLUSION: The present study has provided historical data regarding the current status of physiology education in China and that in the past thirty years by showing that physiology education in China has developed quickly,even it faces many challenges.

Video feedback combined with peer role-playing: a method to improve the teaching effect of medical undergraduates.

OBJECTIVE: The purpose of this study was to investigate the effectiveness of implementation of video feedback combined with peer role-playing (PRP) teaching method in medical undergraduates adopting problem-based learning (PBL) teaching mode. METHODS: The undergraduates of five-year clinical medicine who get enrollment of Wuhan local University from 2016 and 2018 were selected to be the research objects. The same grade level is randomly divided into several groups to carry out PBL, with 6-10 students in each group. Following the principle of voluntary participation, 34 students were enrolled in the study group and 33 students in the control group finally. The research regards group as the unit, and study report in group should be carried out to fulfill the research. In the study group, the students were asked to perform PRP report, and the report videos were used for feedback. At the same time, the control group reported by PPT, and the feedback was carried out according to the PPT. At the end of the study, the "Competency Improvement Satisfaction Questionnaire (CISQ)" was distributed to investigate students' satisfaction with this teaching method to improve their ability, Arizona Clinical Interview Score (ACIR) was administered in Chinese by a trained teacher unrelated using PRP method to assess students' clinical inquiry ability and communication skills, and theory test was performed to assess mastery of theoretical knowledge. RESULTS: The results show that the study group is superior to the control group in improving the interest of learning and the ability of independent learning, interpersonal communication and active problem solving. Although it is in terms of the confidence in becoming a real doctor and the ability of teamwork, language expression, clinical thinking cultivated, active knowledge acquired and understood that study group are better than the control group, the difference was not statistically significant. ACIR shows that the study group is significantly better than the control group in organization, timeline planning, and transition statements, openly questioning, smooth progress, and avoiding repetition, summarizing, understandable language, documentation and total score. There is no significant difference in eye contact and no interruption. The differences between the two groups are not statistically significant in terms of responsing to concerns, positive feedback, and additional questions. The theoretical test scores of the study group are significantly higher than those of the control group. CONCLUSION: Video feedback combined with peer role-playing teaching method implemented in medical undergraduates adopting PBL teaching mode is effective, it could stimulate interest in learning actively, improve interpersonal communication ability, improve learning efficiency and clinical knowledge and skills, and improve the confidence of becoming a real doctor. It is worthy of further research and promotion.

Improving undergraduate education of occupational health and occupational medicine appling massive open online courses & problem-based learning.

BACKGROUND: The learning of Occupational Health and Occupational Medicine in undergraduate college students in China has been hindered by various factors. This study aimed to explore the effects of the application of Massive Open Online Courses (MOOC) & Problem-based learning (PBL) in the learning of Occupational Health and Occupational Medicine in undergraduate college students in China. METHODS: Students enrolled in 2017 and 2018 were categorized in the control group and study group, and received PBL learning and MOOC + PBL learning, respectively. The effects of learning were assessed by scores of final exam, satisfaction degree of students, and feedbacks. RESULTS: The mean score of the final exam was not significantly different between the two groups. However, the further comparison by levels of scores showed that the percentages of good and excellent were both significantly higher in the study group than control group. The overall satisfaction degree was significantly higher in the study group than control group. In addition, the scores of the 3 dimensions of satisfaction degree, i.e. learning preparation, learning process, and learning effect, were all significantly higher in the study group than control group. The feedbacks of the students showed that they thought MOOC + PBL learning could better improve the learning efficacy, despite a substantial proportion of students reported that MOOC + PBL learning more time-consuming. CONCLUSIONS: The findings showed that the combination of MOOC and PBL in the learning of Occupational Health and Occupational Medicine is an effective method capable of improving the learning efficacy in college students of Prophylactic Medicine. Further efforts are needed to optimize the MOOC platform to provide a friendlier interface.

Factors affecting pharmacology learning in integrated PBL in diverse medical students: a mixed methods study.

INTRODUCTION: Problem-based learning (PBL) was introduced to address passive teaching limitations. However, it is not fully characterised as a teaching modality in pharmacology. The present study investigated the factors affecting pharmacology learning in an integrated PBL-based curriculum in diverse learners. METHODS: Year 1 undergraduate medical students from two cohorts at St. George's University of London and University of Nicosia, participated. Statistical analysis of pharmacology knowledge scores, at the beginning (pre-test) and end of the academic year (post-test), investigated readiness to benefit from PBL based on diverse student characteristics (educational background, age, gender, country of origin, ethnicity, native language, PBL experience). Focus groups/interviews and a survey investigated aspects of integrated PBL impacting learning in depth. RESULTS: Pre- and post-test scores were positively correlated. Students with biomedical sciences degrees performed better at the pharmacology pre- and post-tests, while post-graduate degree holders performed better only at the pre-test. Effect size was of moderate magnitude. However, progress in learning (post-test performance after controlling for pre-test scores) was unaffected. Qualitative analysis revealed three major themes: 1) PBL as a learning environment; 2) PBL as a learning environment in pharmacology; and 3) PBL as a learning environment and confidence in prescribing. Under theme one, skill development, knowledge acquisition through collaboration and self-directed learning, group dynamics and preferred teaching methods were discussed. Under theme two, contextual learning, depth of knowledge and material correctness were raised. Under theme 3, students expressed variability in prescribing confidence. They perceived that learning could be improved by better integration, further references earlier on, more lectures and PBL facilitators with greater content expertise. The survey findings were consistent with those from focus groups/interviews. CONCLUSION: Pharmacology learning in a PBL-based curriculum is facilitated by constructive, collaborative and contextual learning. While baseline pharmacology knowledge may be advantageous, the other aforementioned characteristics studied may not affect readiness to benefit from PBL. However, further instructional scaffolding is needed, for example through further resources, lectures and self-assessment. The results from our study can inform evidence-based curriculum reform to support student learning further. Addressing learning needs could ultimately contribute to reducing medication errors through effective training of future prescribers.

The effect of serious game and problem-based learning on nursing students' knowledge and clinical decision-making skill regarding the application of transfusion medicine in pediatric nursing.

PURPOSE: Comparing the effect of serious game and problem-based learning on nursing students' knowledge and clinical decision-making skill regarding the application of transfusion medicine in pediatric nursing. DESIGN AND METHODS: In this quasi-experimental study, 76 undergraduate nursing students were enrolled through a convenience sampling method, and were allocated to one of the three groups of serious game, problem-based learning, and control through the block randomization method. Data were collected using a valid and reliable 3-part researcher-made tool, completed before and two weeks after the intervention. Statistical analysis was performed using paired t-test, analysis of covariance, and Bonferroni post hoc test. A significance level of <0.05 was considered. RESULTS: After the intervention, mean scores of both knowledge and clinical decision-making skill increased significantly in both intervention groups (p < 0.05). Mean post-test scores of both knowledge and clinical decision-making skill in the serious game group, and only clinical decision-making skill in the problem-based learning group were significantly higher than the control group (p < 0.05). However, no significant difference was observed regarding mean post-test scores of both knowledge and clinical decision-making skill between the intervention groups (p > 0.05). CONCLUSIONS: Both serious game and problem-based learning are proven to be effective in improving nursing students' knowledge and clinical decision-making skill regarding the application of transfusion medicine in pediatric nursing. PRACTICE IMPLICATIONS: Since learning now occurs beyond classrooms and the new generation of students spend most of their time in virtual places, utilizing technology-based teaching methods like serious games can benefit both educators and students by providing continuous education, saving their time and expenses, etc.