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Author: Brian S McGowan, PhD

ABSTRACT: Using video podcasting to enhance the learning of clinical skills

BACKGROUND:
Video podcasts, or vodcasts are increasingly used by a range of healthcare professions in the mastery of new skills. Little is known about the experiences of using vodcasts in physiotherapy education. Traditional pedagogic strategies have been employed in order to master those skills required for physiotherapy practice. There have been advances in the use of technology in medical education in the nursing, dentistry and medical fields. Vodcasts offer great versatility and potential when used as a pedagogical tool, embedded within a physiotherapy curriculum.
AIM:
To explore students’ experiences of using technology enhanced learning, namely vodcasts, in the Physiotherapy curriculum to develop the learning of clinical skills.
METHOD:
A series of focus groups were carried out with undergraduate and pre-registration physiotherapy students (n=31).
FINDINGS:
Students valued the versatility and audio-visual nature of vodcasts; helpful in revising for practical examinations and practising their skills prior to, during and after taught skills classes. Watching and practising simultaneously allowed students to practice repeatedly and formulate a process for each skill. When learning a new skill, a combination of teaching and learning approaches was favoured, marrying traditional approaches with those that utilise technology.
CONCLUSIONS:
This study’s findings add to the existing body of evidence in skills based teaching and support a multi-media, blended approach in those disciplines involved in the learning and teaching of clinical skills.

via Using video podcasting to enhance the learning of clinical skills: A qualitative study of physiotherapy students’ experiences. – PubMed – NCBI.

ABSTRACT: Flipping the Quality Improvement Classroom in Residency Education

PURPOSE:
The flipped classroom (FC), in which instructional content is delivered before class with class time devoted to knowledge application, has the potential to engage residents. A Mayo Clinic Internal Medicine Residency Program study was conducted to validate an FC perception instrument (FCPI); determine whether participation improved FC perceptions; and determine associations between resident characteristics, change in quality improvement (QI) knowledge, and FC perception scores.
METHOD:
All 143 internal medicine residents at Mayo Clinic, Rochester participated from 2014 to 2015; some experienced a flipped QI curriculum and others completed the traditional nonflipped course. The FCPI was developed, and factor analysis revealed an intuitive two-factor structure: preclass activity and in-class application. Residents were surveyed before and after the monthlong curriculum to measure changes in perception, and the QI Knowledge Assessment Tool was employed to measure knowledge improvement.
RESULTS:
Postcourse FCPI scores significantly increased for three of the eight items. QI knowledge increased significantly among residents who experienced the FC compared with residents who completed the non-FC curriculum. Those without prior FC exposure demonstrated a significant increase in QI knowledge compared with those with previous FC experience. The FCPI had compelling validity evidence with improved scores after curriculum exposure and associations with greater engagement in online modules.
CONCLUSIONS:
Residents who participated in the FC demonstrated improved QI knowledge compared with the control group. Residents valued the in-class application sessions more than the online component. These findings have important implications for graduate medical education as residency training programs increasingly use FC models.

via Flipping the Quality Improvement Classroom in Residency Education. – PubMed – NCBI.

COMMENTARY: Expanding Group Peer Review: A Proposal for Medical Education Scholarship

After participating in a group peer-review exercise at a workshop presented by Academic Medicine and MedEdPORTAL editors at the 2015 Association of American Medical Colleges Medical Education Meeting, the authors realized that the way their work group reviewed a manuscript was very different from the way by which they each would have reviewed the paper as an individual. Further, the group peer-review process yielded more robust feedback for the manuscript’s authors than did the traditional individual peer-review process. This realization motivated the authors to reconvene and collaborate to write this Commentary to share their experience and propose the expanded use of group peer review in medical education scholarship.The authors consider the benefits of a peer-review process for reviewers, including learning how to improve their own manuscripts. They suggest that the benefits of a team review model may be similar to those of teamwork and team-based learning in medicine and medical education. They call for research to investigate this, to provide evidence to support group review, and to determine whether specific paper types would benefit most from team review (e.g., particularly complex manuscripts, those receiving widely disparate initial individual reviews). In addition, the authors propose ways in which a team-based approach to peer review could be expanded by journals and institutions. They believe that exploring the use of group peer review potentially could create a new methodology for skill development in research and scholarly writing and could enhance the quality of medical education scholarship.

via Expanding Group Peer Review: A Proposal for Medical Education Scholarship. – PubMed – NCBI.

MANUSCRIPT: A comparative study: do “clickers” increase student engagement in multidisciplinary clinical microbiology teaching?

BACKGROUND:
Audience response devices, or “clickers”, have been used in the education of future healthcare professionals for several years with varying success. They have been reported to improve the learning experience by promoting engagement and knowledge retention. In 2014, our department evaluated the use of “clickers” in a newly introduced multidisciplinary approach to teaching large groups of third year medical students clinical cases developed around a microbiology theme.
METHODS:
Six multidisciplinary teaching sessions covering community-acquired pneumonia, tuberculosis, infective endocarditis, peritonitis, bloodstream infection with pyelonephritis and bacterial meningitis were included in the study. Three involved the use of the “clickers” and three did not. Consenting undergraduate students attended the designated classes and afterwards answered a short online quiz relating to the session. Students also answered a short questionnaire about the “clickers” to gauge their attitudes on the use of these devices.
RESULTS:
Of 310 students, 294 (94.8%) agreed to participate in the study. Interestingly, the grades of online quizzes after a session where a “clicker” was used were slightly lower. Looking only at the grades of students who engaged completely with the process (n = 19), there was no statistical difference to suggest that the devices had a positive or negative impact on knowledge retention. However, student attitudes to using the devices were positive overall. Fifty-five percent strongly agreed and 27% agreed that teaching sessions where the “clickers” were used were more engaging. Thirty-four percent strongly agreed and 36% agreed that the “clickers” made important concepts more memorable and 54% felt the device enhanced their understanding of the topic being covered.
CONCLUSIONS:
Overall, it appears that “clickers” help in improving student engagement in large classroom environments, enhance the learning experience, and are received positively by medical students but their impact on knowledge retention is variable.

via A comparative study: do “clickers” increase student engagement in multidisciplinary clinical microbiology teaching? – PubMed – NCBI.

ABSTRACT: Impact of a brief addiction medicine training experience on knowledge self-assessment among medical learners

BACKGROUND:
Implementation of evidence-based approaches to the treatment of various substance use disorders is needed to tackle the existing epidemic of substance use and related harms. Most clinicians, however, lack knowledge and practical experience with these approaches. Given this deficit, the authors examined the impact of an inpatient elective in addiction medicine amongst medical trainees on addiction-related knowledge and medical management.
METHODS:
Trainees who completed an elective with a hospital-based Addiction Medicine Consult Team (AMCT) in Vancouver, Canada, from May 2015 to May 2016, completed a 9-item self-evaluation scale before and immediately after the elective.
RESULTS:
A total of 48 participants completed both pre and post AMCT elective surveys. On average, participants were 28 years old (interquartile range [IQR] = 27-29) and contributed 20 days (IQR = 13-27) of clinical service. Knowledge of addiction medicine increased significantly post elective (mean difference [MD] = 8.63, standard deviation [SD] = 18.44; P = .002). The most and the least improved areas of knowledge were relapse prevention and substance use screening, respectively.
CONCLUSIONS:
Completion of a clinical elective with a hospital-based AMCT appears to improve medical trainees’ addiction-related knowledge. Further evaluation and expansion of addiction medicine education is warranted to develop the next generation of skilled addiction care providers.

via Impact of a brief addiction medicine training experience on knowledge self-assessment among medical learners. – PubMed – NCBI.

ABSTRACT: Predictors of Knowledge and Image Interpretation Skill Development in Radiology Residents

To investigate knowledge and image interpretation skill development in residency by studying scores on knowledge and image questions on radiology tests, mediated by the training environment. Materials and Methods Ethical approval for the study was obtained from the ethical review board of the Netherlands Association for Medical Education. Longitudinal test data of 577 of 2884 radiology residents who took semiannual progress tests during 5 years were retrospectively analyzed by using a nonlinear mixed-effects model taking training length as input variable. Tests included nonimage and image questions that assessed knowledge and image interpretation skill. Hypothesized predictors were hospital type (academic or nonacademic), training hospital, enrollment age, sex, and test date. Results Scores showed a curvilinear growth during residency. Image scores increased faster during the first 3 years of residency and reached a higher maximum than knowledge scores (55.8% vs 45.1%). The slope of image score development versus knowledge question scores of 1st-year residents was 16.8% versus 12.4%, respectively. Training hospital environment appeared to be an important predictor in both knowledge and image interpretation skill development (maximum score difference between training hospitals was 23.2%; P < .001). Conclusion Expertise developed rapidly in the initial years of radiology residency and leveled off in the 3rd and 4th training year. The shape of the curve was mainly influenced by the specific training hospital. © RSNA, 2017 Online supplemental material is available for this article.

via Predictors of Knowledge and Image Interpretation Skill Development in Radiology Residents. – PubMed – NCBI.

MANUSCRIPT: Evaluating the use of twitter as a tool to increase engagement in medical education

BACKGROUND:
Social media is regularly used by undergraduate students. Twitter has a constant feed to the most current research, news and opinions of experts as well as organisations. Limited evidence exists that examines how to use social media platforms, such as Twitter, effectively in medical education. Furthermore, there is limited evidence to inform educators regarding social media’s potential to increase student interaction and engagement.
AIM:
To evaluate whether social media, in particular Twitter, can be successfully used as a pedagogical tool in an assessment to increase student engagement with staff, peers and course content.
METHODS:
First year biomedical science students at Monash University completing a core public health unit were recruited into the study. Twitter-related activities were incorporated into the semester long unit and aligned with both formative and summative assessments. Students completed a structured questionnaire detailing previous use of social media and attitudes towards its use in education post engagement in the Twitter-specific activities. Likert scale responses compared those who participated in the Twitter activities with those who did not using student’s t-test.
RESULTS:
A total of 236 (79.4%) of invited students participated in the study. Among 90% of students who reported previous use of social media, 87.2% reported using Facebook, while only 13.1% reported previous use of Twitter. Social media was accessed most commonly through a mobile device (49.1%). Students actively engaging in Twitter activities had significantly higher end-of-semester grades compared with those who did not [Mean Difference (MD) = 3.98, 95% CI 0.40, 7.55]. Students perceived that the use of Twitter enabled greater accessibility to staff, was a unique method of promoting public health, and facilitated collaboration with peers.
DISCUSSION:
Use of social media as an additional, or alternate, teaching intervention is positively supported by students. Specific use of micro-blogs such as Twitter can promote greater student-staff engagement by developing an ongoing academic conversation.

via Evaluating the use of twitter as a tool to increase engagement in medical education. – PubMed – NCBI.

MANUSCRIPT: Creating a longitudinal database in medical education: Perspectives from the pioneers

The Jefferson Longitudinal Study of Medical Education (JLSME) is the longest running database in medical education and covers the collection and measurement of background, learning, performance, and psychosocial variables before, during, and after medical school. Recently, our research group at VU University Medical Center School of Medical Sciences launched a longitudinal study in medical education, called the “Student Motivation and Success Study.” While setting up this study, we faced many challenges and learning about the JLSME helped us gain a fresh perspective on our work. We interviewed Drs. Joseph Gonnella and Mohammadreza Hojat, the leaders of the JLSME, and present their experiences verbatim in this article and summarize the lessons we learned as tips for others. We conclude that by establishing a longitudinal database, medical educators can test and ensure the quality of the doctors they produce, justify curricular reforms, participate in a continuing inquiry into their educational practices, and produce more generalizable research findings.

via Creating a longitudinal database in medical education: Perspectives from the pioneers. – PubMed – NCBI.

ABSTRACT: A case study of healthcare providers’ goals during interprofessional rounds

Daily interprofessional rounds enhance collaboration among healthcare providers and improve hospital performance measures. However, it is unclear how healthcare providers’ goals influence the processes and outcomes of interprofessional rounds. The purpose of this case study was to explore the goals of healthcare providers attending interprofessional rounds in an internal medicine ward. The second purpose was to explore the challenges encountered by healthcare providers while pursuing these goals. Three focus groups were held with healthcare providers of diverse professional backgrounds. Focus group field notes and transcripts were analysed using thematic analysis. The data indicated that there was no consensus among healthcare providers regarding the goals of interprofessional rounds. Discharge planning and patient care delivery were perceived as competing priorities during rounds, which limited the participation of healthcare providers. Nevertheless, study participants identified goals of rounds that were relevant to most care providers: developing shared perspectives of patients through direct communication, promoting collaborative decision making, coordinating care, and strengthening interprofessional relationships. Challenges in achieving the goals of interprofessional rounds included inconsistent attendance, exchange of irrelevant information, variable participation by healthcare providers, and inconsistent leadership. The findings of this study underscore the importance of shared goals in the context of interprofessional rounding.

via A case study of healthcare providers’ goals during interprofessional rounds. – PubMed – NCBI.

RESOURCE: How long is short-term memory? Shorter than you might think.

So, cognitive psychologists divide memory into the first 15-30 seconds, and they call this short-term memory, and alllllll the rest of memory that lasts beyond 30 seconds is long-term memory. Why would we make such a skewed split, and why aren’t there more categories (like medium-term memory)? And what good is this type of memory process, if it falls apart after much less than a minute?

You might wonder, what do we use short-term memory for? Even though short-term is very short, you are, in fact, constantly using it. You use it to remember the beginning of this sentence as you get to the end. You use it to sustain a conversation, which involves listening, formulating what you are going to say, and then saying it. You use short-term memory when you are baking, to remember the quantity of flour you need to weigh out. Your waitress will use her working memory to write down your order as you’re speaking it – but note that if she takes the whole table’s order and then goes to the machine to punch it in, she’s probably transferring your order to long-term memory!

The reason why cognitive psychologists believe that there is something truly special about the 15-30 second range that can be separated from all other memory beyond that timeframe is that patients who present with apparently total memory loss are still able to keep things in memory for 15-30 seconds.

via How long is short-term memory? Shorter than you might think. — The Learning Scientists.