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Author: Brian S McGowan, PhD

MANUSCRIPT: Nervous system examination on YouTube.

Abstract

BACKGROUND:Web 2.0 sites such as YouTube have become a useful resource for knowledge and are used by medical students as a learning resource. This study aimed at assessing videos covering the nervous system examination on YouTube.METHODS:A research of YouTube was conducted from 2 November to 2 December 2011 using the following key words “nervous system examination”, “nervous system clinical examination”, “cranial nerves examination”, “CNS examination”, “examination of cerebellum”, “balance and coordination examination”. Only relevant videos in the English language were identified and related URL recorded. For each video, the following information was collected: title, author/s, duration, number of viewers, number of posted comments, and total number of days on YouTube. Using criteria comprising content, technical authority and pedagogy parameters, videos were rated independently by three assessors and grouped into educationally useful and non-educationally useful.RESULTS:A total of 2240 videos were screened; 129 were found to have relevant information to nervous system examination. Analysis revealed that 61 (47%) of the videos provided useful information on the nervous system examination. These videos scored (mean ± SD, 14.9 ± 0.2) and mainly covered examination of the whole nervous system (8 videos, 13%), cranial nerves (42 videos, 69%), upper limbs (6 videos, 10%), lower limbs (3 videos, 5%), balance and co-ordination (2 videos, 3%). The other 68 (53%) videos were not useful educationally; scoring (mean ± SD, 11.1 ± 3.0). The total viewers of all videos was 2,189,434. Useful videos were viewed by 1,050,445 viewers (48% of total viewers). The total viewership per day for useful videos was 1,794.5 and for non-useful videos 1,132.0. The differences between the three assessors were insignificant (less than 0.5 for the mean and 0.3 for the SD).CONCLUSIONS:Currently, YouTube provides an adequate resource for learning nervous system examination, which can be used by medical students. However, there were deficiencies in videos covering examination of the cerebellum and balance system. Useful videos can be used as learning resources to medical students.

via Nervous system examination on YouTube. [BMC Med Educ. 2012] – PubMed – NCBI.

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ABSTRACT: YouTube: An emerging tool in anatomy education

Abstract
The use of online social networks in medical education can remodel and enhance anatomy teaching and learning; one such network is the video-sharing site YouTube. Limited research in the literature exists on the use of YouTube as a platform for anatomy education. The aim of this study is to assess student’s perceptions and patterns of usage of this resource, as well as the effectiveness of YouTube videos within a problem-based learning (PBL) curriculum. The study was conducted on 91 second-year medical students for whom video links were suggested throughout the academic year. In addition, the Human Anatomy Education (HAE) Channel was launched on YouTube to support classroom teaching with videos that emphasized applied aspects of anatomy. The results demonstrated that 98% of the students used YouTube as an online information resource, albeit in different frequencies. Out of the 86% who have been to the HAE Channel, 92% agreed/strongly agreed that the channel helped them learn anatomy. The study also reports the popularity of and awareness about using YouTube as a social network as well as in learning. Based on these findings, YouTube can be considered as an effective tool to enhance anatomy instruction if the videos are scrutinized, diversified, and aimed toward course objectives. Faculty of average computer literacy should be enabled to produce videos on their own YouTube channels to support independent learning and integration in a PBL curriculum. The methods described for capturing and editing the videos can be used as a prototype.

via YouTube: An emerging tool in anatomy e… [Anat Sci Educ. 2012 May-Jun] – PubMed – NCBI.

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ABSTRACT: Can “YouTube” help students in learning surface anatomy?

Abstract
AIMS:
In a problem-based learning curriculum, most medical students research the Internet for information for their “learning issues.” Internet sites such as “YouTube” have become a useful resource for information. This study aimed at assessing YouTube videos covering surface anatomy.
METHOD:
A search of YouTube was conducted from November 8 to 30, 2010 using research terms “surface anatomy,” “anatomy body painting,” “living anatomy,” “bone landmarks,” and “dermatomes” for surface anatomy-related videos. Only relevant video clips in the English language were identified and related URL recorded. For each videotape the following information were collected: title, authors, duration, number of viewers, posted comments, and total number of days on YouTube. The data were statistically analyzed and videos were grouped into educationally useful and non-useful videos on the basis of major and minor criteria covering technical, content, authority, and pedagogy parameters.
RESULTS:
A total of 235 YouTube videos were screened and 57 were found to have relevant information to surface anatomy. Analysis revealed that 15 (27%) of the videos provided useful information on surface anatomy. These videos scored (mean ± SD, 14.0 ± 0.7) and mainly covered surface anatomy of the shoulder, knee, muscles of the back, leg, and ankle, carotid artery, dermatomes, and anatomical positions. The other 42 (73%) videos were not useful educationally, scoring (mean ± SD, 7.4 ± 1.8). The total viewers of all videos were 1,058,634. Useful videos were viewed by 497,925 (47% of total viewers). The total viewership per day was 750 for useful videos and 652 for non-useful videos. No video clips covering surface anatomy of the head and neck, blood vessels and nerves of upper and lower limbs, chest and abdominal organs/structures were found.
CONCLUSIONS:
Currently, YouTube is an inadequate source of information for learning surface anatomy. More work is needed from medical schools and educators to add useful videos on YouTube covering this area.

via Can “YouTube” help students in learning sur… [Surg Radiol Anat. 2012] – PubMed – NCBI.

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ABSTRACT: YouTube as a platform for publishing clinical skills training videos

Abstract
The means to share educational materials have grown considerably over the years, especially with the multitude of Internet channels available to educators. This article describes an innovative use of YouTube as a publishing platform for clinical educational materials.The authors posted online a series of short videos for teaching clinical procedures anticipating that they would be widely used. The project Web site attracted little traffic, alternatives were considered, and YouTube was selected for exploration as a publication channel. YouTube’s analytics tools were used to assess uptake, and viewer comments were reviewed for specific feedback in support of evaluating and improving the materials posted.The uptake was much increased with 1.75 million views logged in the first 33 months. Viewer feedback, although limited, proved useful. In addition to improving uptake, this approach also relinquishes control over how materials are presented and how the analytics are generated. Open and anonymous access also limits relationships with end users.In summary, YouTube was found to provide many advantages over self-publication, particularly in terms of technical simplification, increased audience, discoverability, and analytics. In contrast to the transitory interest seen in most YouTube content, the channel has seen sustained popularity. YouTube’s broadcast model diffused aspects of the relationship between educators and their learners, thereby limiting its use for more focused activities, such as continuing medical education.

via YouTube as a platform for publishing clinical skill… [Acad Med. 2013] – PubMed – NCBI.

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ABSTRACT: ‘Thinking on my feet’: an improvisation course to enhance students’ confidence and responsiveness in the medical interview

Abstract
BACKGROUND:
Effective patient-centred communication requires physicians to respond ‘in the moment’ to comments and questions. It is a valuable skill to be able to react to unexpected patient utterances with empathy and support, and these surprises may be most common in general practice where patients are encouraged to speak to their doctor about anything. We developed an elective for medical students to learn and practise improvisational skills that would optimise their communications with patients during medical encounters.
METHODS:
Nineteen second-year medical students during two consecutive years (n =38) participated in a four-session elective that introduced and allowed them to practise the principles and skills of improvisation, and reflect on the role of those skills in their communication with patients. Specific skills that were practised and emphasised included listening, affirmation, vocal tone modulation, nonverbal communication, agreement, collaboration, acceptance and validation. In addition to previously developed ‘Improv’ exercises, students created their own improvisation exercises targeted at specific communication skills.
RESULTS:
Twenty-seven (71%) of all participating students completed the post-curriculum assessment survey. Twenty-two (81%) rated their enjoyment as ‘tremendous’. The desire to experience something new and different from the standard medical curriculum served as the motivation for many of the students (67%) to sign up for the course. Most students (23/27; 85%) thought that the concepts that were addressed were either ‘very much’ or ‘tremendously’ relevant to the care of patients.
CONCLUSION:
We have found that an improvisational workshop geared towards enhancing medical student communication skills has the potential to impart valuable skills that are essential to providing empathic, supportive patient-centred care. Communication skills training programmes have become a cornerstone in medical student and postgraduate medical education over the past 20 years. Both national accreditation and expert panel consensus guidelines have stressed the importance and framed the structure for best communication practices. Exemplary curricula for teaching medical trainees in core communication strategies to use with patients have been published; many emphasise patient-centred and/or relationshipcentred strategies. Simulated patient technologies with video review can allow learners to practise their skills through both self-assessment and feedback from others. However, despite these newer learning resources, frameworks and behavioural checklists, learners naïve to clinical patient encounters must still learn how to function and adapt within the interpersonal communicative space that is created by the learner and patient.

via ‘Thinking on my feet’: an improvisation cours… [Educ Prim Care. 2013] – PubMed – NCBI.

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ABSTRACT: Grand rounds and a visiting professorship program in a department of radiology: how we do it.

Abstract
We discuss the benefits of maintaining an active, rigorous, and highly structured grand rounds (GR) program in an academic radiology department. These benefits include education for faculty (continuing medical education), fellows, and residents and a venue for building collaboration and camaraderie within the department and institution, while also allowing for building ties with the radiology community at large. In addition, we illustrate how to build and sustain a dynamic GR program based on our collective 6-year experience in running such a program at our institution that has offered more than 180 GR and hosted more than 90 visiting professors during this period. Maintaining such a program requires infrastructure, financial support, careful planning, and considerable effort. We believe that this article can serve as a “how-to” guide or framework to initiate and maintain such a program.

via Grand rounds and a visiting professorship progra… [Acad Radiol. 2012] – PubMed – NCBI.

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MANUSCRIPT: Summative assessments are more powerful drivers of student learning than resource intensive teaching formats

Abstract
BACKGROUND:Electrocardiogram (ECG) interpretation is a core clinical skill that needs to be acquired during undergraduate medical education. Intensive teaching is generally assumed to produce more favorable learning outcomes, but recent research suggests that examinations are more powerful drivers of student learning than instructional format. This study assessed the differential contribution of teaching format and examination consequences to learning outcome regarding ECG interpretation skills in undergraduate medical students.METHODS:A total of 534 fourth-year medical students participated in a six-group (two sets of three), partially randomized trial. Students received three levels of teaching intensity: self-directed learning (two groups), lectures (two groups) or small-group peer teaching facilitated by more advanced students (two groups). One of the two groups on each level of teaching intensity was assessed in a formative, the other in a summative written ECG examination, which provided a maximum of 1% credit points of the total curriculum. The formative examination provided individual feedback without credit points. Main outcome was the correct identification of [greater than or equal to]3 out of 5 diagnoses in original ECG tracings. Secondary outcome measures were time spent on independent study and use of additional study material.RESULTS:Compared with formative assessments, summative assessments increased the odds of correctly identifying at least three out of five ECG diagnoses (OR 5.14; 95% CI 3.26 to 8.09), of spending at least 2 h/week extra on ECG self-study (OR 4.02; 95% CI 2.65 to 6.12) and of using additional learning material (OR 2.86; 95% CI 1.92 to 4.24). Lectures and peer teaching were associated with increased learning effort only, but did not augment examination performance.CONCLUSIONS:Medical educators need to be aware of the paramount role of summative assessments in promoting student learning. Consequently, examinations within medical schools need to be closely matched to the desired learning outcomes. Shifting resources from implementing innovative and costly teaching formats to designing more high-quality summative examinations warrants further investigation.

via Summative assessments are more powerful drivers of s… [BMC Med. 2013] – PubMed – NCBI.

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ABSTRACT: Exposure to, understanding of, and interest in interventional radiology in american medical students

Abstract
RATIONALE AND OBJECTIVES:
The purposes of this study were to determine the degree to which medical students are exposed to interventional radiology (IR) in medical school, to assess their knowledge of the field, and to gauge their interest in IR as a career choice.
MATERIALS AND METHODS:
An institutional review board-approved survey was generated using the website www.surveymonkey.com. Medical student participation nationwide was elicited by sending e-mails to administrators of medical schools and radiology residency program directors and asking them to distribute the survey link to their students.
RESULTS:
Seven hundred twenty-nine medical students from 21 states responded to the survey. Although 58% of students said they were interested in a hands-on career, only 5.5% of students said they had participated in an IR rotation and only 12.7% were interested in IR. Less than half of the IR domain-related questions used to assess understanding of IR were answered correctly, with greater understanding found among the students who had participated in an IR rotation.
CONCLUSIONS:
Exposure to IR in accredited US medical education programs is inconsistent, although interest in the field is moderate among medical students compared with interest in other hands-on specialties. Understanding of IR is limited among the study population. Improved understanding of the field and recruitment could result from greater exposure.

via Exposure to, understanding of, and interest in i… [Acad Radiol. 2013] – PubMed – NCBI.

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ABSTRACT: Improving resident education in quality improvement: role for a resident quality improvement director

Abstract
RATIONALE AND OBJECTIVES:
As a component of the practice-based core competency of the Accreditation Council for Graduate Medical Education, all residents must receive training to be able to evaluate and improve their patient care practices. To further enhance our overall resident quality improvement (QI) educational experience, and to ensure resident involvement in the many aspects of a quality assurance program, we have established a resident educational leadership role and have appointed a resident as resident QI director.
MATERIALS AND METHODS:
We have designed and implemented a resident leadership position in QI in our department. A senior resident (postgraduate year 4 and above) is provided with dedicated training in QI methods, mentored opportunities to develop professional skills in QI, and didactic teaching in applications of QI to other residents.
RESULTS:
A leadership position in QI for trainees introduces this important concept early in their career. The resident QI director is provided dedicated training, receives a broader perspective of QI and is optimally positioned to introduce the concept to junior residents leading to greater acceptance of QI at a resident level.
CONCLUSION:
The introduction of a resident QI director enhances the importance of QI for trainees, prepares the individual for a strong academic and QI career, and improves acceptance of QI methods among trainees.

via Improving resident education in quality improvem… [Acad Radiol. 2013] – PubMed – NCBI.

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ABSTRACT: Self-evaluation: how well do surgery residents judge performance on a rotation?

Abstract
BACKGROUND:
Surgical trainees are evaluated based on the Accreditation Council for Graduate Medical Education 6 core competencies. The ability for a learner to recognize strengths and weaknesses in these areas allows for critical self-improvement.
METHODS:
Surgery residents rotating on a pediatric surgery rotation for 1 academic year were asked at an exit interview to provide a self-evaluation within the 6 core competencies on a Likert scale from 1 to 5. Self-evaluation scores were compared with a final group consensus attending evaluation. Further analyses included comparing residents as follows: less than R3 (junior residents) versus R3 (senior residents) residents, general surgery versus non-general surgery residents, university versus community residents, residents in the first half of the academic year versus residents in the second half, and top one third- and lowest one third-performing residents. Statistical analysis was performed using Student t tests with significance at P < .05.
RESULTS:
A total of 45 surgical residents (29 junior residents and 16 senior residents) gave overall self-evaluation scores that were lower than attending evaluations (3.4 vs 3.8, P = .0002). This underscoring occurred for most core competencies, especially medical knowledge, operative skills, and practice-based learning but not professionalism or communication. When sorting residents by variables, there was significant underscoring by senior residents, general surgery residents, and highest one third-performing residents compared with junior residents, non-general surgery residents, and lowest one third-performing residents. There were no differences between self-evaluations and attending evaluations when comparing university with community residents and residents in the first half of the academic year with residents in the second half of the academic year.
CONCLUSIONS:
Residents appear to have a more critical self-analysis than attending surgeons, with senior residents, general surgery residents, and highest one third-performing residents being the most critical of their own performance. Poorly performing residents appeared to lack insight into their abilities. This method of self-evaluation helps trainees reflect on their performance and highlights trainees who lack self-awareness and need counseling for improvement.

via Self-evaluation: how well do surgery residents jud… [Am J Surg. 2013] – PubMed – NCBI.

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