Perception of Simulation-Based Learning Among Medical Students at the University of Guayaquil, Within the Framework of the Sustainable Development Goals (SDG 3): Health and Well-Being

Objective: To evaluate the competence in clinical and surgical skills acquired by medical students in courses with simulation taken during the semester and their relationship with knowledge in the final academic year. Theoretical Framework: The main theoretical framework of the research is based on two fundamental pillars. On one hand, there is clinical and professional competence, which the study defines as the set of knowledge, skills, and attitudes a doctor must possess to efficiently solve health problems. On the other hand, the research is supported by simulation-based teaching as the principal pedagogical methodology for developing and evaluating this competence, highlighting its role in creating learning experiences in safe and controlled environments. Method: A cross-sectional study was conducted on a cohort of final-year medical students from the University of Guayaquil who took courses in Pediatrics, Surgery, and Gynecology with simulation between 2018 and 2019. To assess competence in clinical and surgical skills, a 45-question multiple-choice questionnaire was applied, while the level of knowledge was measured through the scores of parallel subjects in the Rotating Internship Program. Results and Discussion: A total of 233 students participated in the study; 63% were female. More than 60% of the students were competent in pediatrics and surgery, and 70% in gynecology. A statistically significant relationship was found mainly between the clinical and surgical competence questions and the score for the Pediatrics subject, only in one of the Gynecology subjects, and there was no relationship in the Surgical Clinic subject. Research Implications: The main implications of this research are that simulation-based teaching positively impacts the acquisition of clinical and surgical skills, but should not replace real clinical exposure. The study suggests that simulation must be complemented by supervised practice to address the deficiencies that still persist in complex procedures. Originality/Value: the value of originality of the research lies in the fact that, as of its completion, no detailed studies had been conducted at the Universidad de Guayaquil to evaluate the impact of simulation-based teaching on undergraduate medical students. Furthermore, the study addresses a little-explored area, as most research focuses on the development of simulation models, while the impact of this teaching on the knowledge level of final-year students is an "under-evaluated" scenario. This makes the research original by focusing on a specific geographical context and a little-studied aspect of the topic.

Bedside teaching is an important and established learning tool in medical education. However there is a decline in bedside teachings over the years throughout the world including Nepal, due to advancement in medical technology, clinical skills labs and simulation techniques. This study aimed to find out the perception of Nepalese medical students towards different domains of bedside teaching. This was a descriptive cross-sectional study. A questionnaire consisting of Likert scale, open ended and closed ended questions was developed on different aspect of bedside teaching and the filled questionnaires were included for analysis. Three hundred and six questionnaires were included. Almost all of medical students responded that bedside teaching is a useful learning modality in clinical teaching 304 (99.3%) and provides active learning in real context 291 (95%). The majority of medical students 233 (76%) were satisfied with the steps of history taking, examination followed by management discussion employed at bedside teaching. The students 223 (73%) were satisfied, how to elicit signs following demonstration of clinical exam by teachers at bedside. However majority 196 (64%) felt lack of individual opportunity at bedside. According to students, focussing more on practically oriented clinical skills with proper supervision would improve learning while hindering factors were large number of students and patient's uncooperativeness. Good communication was considered the best method of alleviating patient discomfort at bedside teaching in this study. The study concluded that medical students have positive response and learning attitudes towards different aspects of bedside teaching.

Mental Imagery as a Formal Educational Adjunct for Surgical Skills Development in Medical Students: A Scoping Review.

Patient interaction is a vital part of healthcare training. This study aimed to investigate patients' perceptions of the participation of medical students in their care. This descriptive cross-sectional study was conducted between October 2014 and March 2015 among 430 patients admitted to the medical and surgical wards at the King Abdulaziz Medical City, Riyadh, Saudi Arabia. An Arabic questionnaire was designed to assess the demographic characteristics of the patients and their perceptions of students' participation in their medical care. A total of 416 patients completed the survey (response rate: 97%). Overall, 407 patients (98%) acknowledged the educational benefit of involving medical students in their care. A total of 368 patients (88%) had no objection to a medical student being involved in their care. Of these, 98% were willing to be asked about their medical history by medical students, 89% would permit physical examinations by medical students and 39% preferred that the gender of the medical student match their own. Education level (P <0.003), a positive prior experience with a medical student (P <0.001) and perception of the medical students' attitudes (P <0.001) had a significant effect on patients' acceptance of medical students participating in their care. In general, the patients had a positive perception of medical students, with most patients acknowledging the educational benefit of student participation in patient care. As patients' perceptions of students' professionalism, confidence and respect for privacy were significantly related to acceptance of care, education on these aspects should be a priority in medical curricula.

Medical Student Education

Introduction: The rapid advancement of virtual tools in medical education has led to a debate on the most effective methods for teaching anatomy to medical students. This study aimed to assess the perceptions of first-year medical students in Bangladesh regarding traditional cadaveric and modern virtual methods in anatomy education. Methods: This cross-sectional descriptive and analytical study was conducted among 110 first-year medical students from two medical colleges in Dhaka, Bangladesh. A pre-tested, open-ended questionnaire was administered to collect data on demographic characteristics, student preferences in anatomy learning, and their level of agreement on the use of traditional and virtual methods. Non-parametric statistical tests were performed to evaluate score differences between teaching methods. Result: The study revealed a strong preference for a blended approach, integrating both cadaveric and virtual methods. Cadaveric methods were predominantly favored for tasks requiring a deep understanding of anatomical structures (76.36%), while virtual methods were preferred for understanding the anatomical basis of functional consequences (60.91%). A significant number of students strongly agreed that cadaveric dissection is vital in anatomy learning (29.09%). Conclusion: The study suggests that both traditional cadaveric and modern virtual methods have unique strengths and weaknesses in anatomy education. A blended approach, integrating both methods, could offer the most comprehensive learning experience for students. The findings have implications for curriculum designers, educators, and policymakers in medical education.

The University of Texas Medical School at Houston

Background: The demands on Medical Education have greatly increased in the 21st century. For this very reason, there has been an unprecedented growth in the number of medical colleges in India. The teacher’s role is to facilitate rather than to direct, to coordinate as much as to communicate. Small group teaching offers students’ opportunity to discuss and refine their understanding of complex issues, to problem solve and apply their knowledge to new situations and to reflect on their attitudes and feelings. The study aims to assess the perception of undergraduate medical students regarding small group teaching, the perception of faculty regarding Small group teaching, compare the perception of students on small group teaching, with respect to their academic performance and attendance. Methodology: 93 faculty and 499 undergraduate MBBS students participated in the study and were given a self- administered semi-structured questionnaire. The perception of undergraduate students and teaching faculty on small group teaching was assessed using the 5-point Likert Scale. Independent t-test was applied to find difference in mean perception. Students were categorized based on their academic performance and on their attendance aggregate for the concluded semester. Results: In total, 404 students and 45 faculty members responded thus giving response rates of 80.9% and 48.4% respectively. The overall response rate was 75.8% Conclusion: The study found that both students and faculty members are favorable to the concept of SGT. They found it not only enhances the academic performance of students but also contributes to the personality development of students. Clinical correlations in all the subjects is well appreciated by students and faculty. Suggestions for improvement of SGT such as exam-oriented study, use of innovative and interactive aids can make SGT sessions more effective.

Background: Effective learning is closely associated with effective teaching. Achieving effective learning requires a student cantered and outcome-focused approach.4 Various interactive techniques like Problem Based Learning (PBL), facilitated group discussion, E-learning, Massive Open Online Courses (MOOCS) etc., are being implemented in TL sessions in medical schools. These methods are found to be effective to foster better learning among medical students. The present study was an attempt to understand the perceptions of undergraduate medical students, posted at Government Medical College and Hospital, Mehabubnagar, Telangana about different teaching methodologiesMethods: A cross sectional study was conducted among 56 MBBS students of 4th semester. A pre-tested, self-administered, structured questionnaire was devised which consisted of ten questions with three to four options each. Study participants were asked to fill up the questionnaire under strict supervision and they were allotted 15 minutes to complete the same. Entire data was entered into Microsoft Office Excel Sheet and analysed.Results: Out of 56, 32 (57.14%) female students and 24 (42.85%) male students voluntarily participated in the study. large number of participants i.e., 66.07% thought that FGD is the best method of teaching. Most of participants i.e. 96.42% had favourable attitudes towards PPT as they felt that it improves their learning.Conclusions: Maximum number of undergraduate medical students knew about E learning. Facilitated Group Discussion (FGD) was the most preferred teaching learning methodology by students. The majority of them had positive perceptions towards the use of Power Point Presentation (PPT) as a powerful teaching tool in medical education.

The University of Vermont Larner College of Medicine.

BACKGROUND: Roleplay is not commonly used as a tool for teaching/learning and training in the majority of medical schools in Pakistan. Bilawal Medical College, the newly established constituent college of Liaquat University of Medical and Health Sciences Jamshoro, Sindh, Pakistan, organized roleplay sessions for second-year undergraduate medical students and took feedback from them. The objective of this study was to assess the perceptions of students about roleplay as a teaching-learning/learning and training tool. MATERIALS AND METHODS: This descriptive cross-sectional study was conducted on June 2022 with a purposive sampling technique. The questionnaire comprised 10 closed-ended questions on a Likert scale of 1–5 (5=strongly agree, 4=agree, 3=to-some-extent agree, 2=disagree, and 1=strongly disagree) besides age and comments as open-ended questions. The validity was checked with pilot testing. The data were entered in Microsoft Excel and analysis was done in SPSS version 23. The frequency with the percentage of each item and median with interquartile range were calculated. The reliability of the questionnaire was calculated using Cronbach α. RESULTS: The reliability of the questionnaire was confirmed by Cronbach’s α, which was 0.75 falls within the acceptable level. The mean age of students was 20.057 ± 1.027 years. The perceptions of students are notable; the median value on nine statements (items) is 4 and one is 5, whereas the interquartile range of eight statements is 4–5 and 2 statements 3–5. CONCLUSION: The perceptions of medical students were positive regarding the role of roleplay in teaching/learning and training learners. A remarkable percentage of students strongly agreed to agree on all 10 items related to the cognitive, skills, and attitude domain of learning.

Background:Evidence-based medicine seeks to improve medical education, which requires high competency levels in various clinical skills such as examination of patients and execution of clinical techniques on patients by integrating skill and simulation-based teaching and learning as supplementary to traditional methods of bedside clinical teaching. Hence, a safely prepared and controlled environment with trained interdisciplinary teams is very essential in providing such effective medical education to students as well as health-care professionals. The ongoing skill and simulation center project aims to provide teaching, training, and learning in various clinical procedures for both medical students and clinicians.Materials and Methods:The project management cycle framework was used which included the phases of planning, designing, training, and implementation. Having picked the model for the proposed skill and simulation center, that is, redefining medical education with skill and simulation-based teaching, training, and learning, it was decided to establish this skill and simulation center.Results:The functional skill and simulation center unit with the state-of-the-art infrastructure along with a trained multidisciplinary team was achieved. There are also academic programs, which include the demonstration of various clinical and surgical skills and workshops on simulation-based medical education.Conclusion:It was possible to establish a comprehensive skill and simulation center and achieve best practices in medical education by optimal investment in infrastructure and improving the available human resources. Detailed planning is required, across a variety of domains. We hope our experiences shared in this article will help other medical colleges and hospitals across the region, both nationally and globally, toward establishing similar educational facilities.

&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; Introduction&#x0D; At present, the Medical knowledge is expanding and changing rapidly and there is increasing need to concentrate on education based on competencies. Closed book exam is an established approach to assessment in medical education which is widely accepted method of superficial learning. Adding open book test to the formative assessment can assist in handling this growth of knowledge.&#x0D; Objectives&#x0D; To evaluate the effectiveness of open book test on student's performance in summative assessment and to know the perception of students on open book test.&#x0D; Methodology&#x0D; The study was conducted on I MBBS students (n=150), who were divided into 2 groups, Group I: subjected to open book test for 4 weeks and Group II: subjected to closed book tests for 4weeks. There was a cross-over of the two groups and Group I were subjected to the closed book test and Group II students were subjected to open book tests. The mean marks obtained in summative assessment were statistically compared. Perception of the students was taken through feedback questionnaire.&#x0D; Results&#x0D; The mean marks obtained by the students (n= 141) in the summative assessment after open book test (Mean± SD =26.37±6.235) are statistically significant than those after closed book tests(mean± SD =24.09± 6.3513(p value&lt; 0.005).&#x0D; Conclusion&#x0D; 71% of students recommended open book tests for the formative assessment. Hence, adding open book test to the medical curriculum along with regularly used closed book test are expected to stimulate deep learning.&#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D; &#x0D;

Simulation is a new pedagogical method in Africa that underscores the need to operationalize it and generate context-specific scholarship regarding clinical simulation in Africa. Despite the superior learning outcomes of using simulation in medical education, its use in developing countries is often limited, compounded by limited scholarship on simulation especially relevant to an African context. The research aimed to explore perceptions surrounding the use of simulation among undergraduate students. A mixed method convergent parallel design was used in which both the quantitative and qualitative approaches were employed currently to explore the perception of the undergraduate students towards the use of clinical simulation in teaching and learning. The quantitative approach assessed the perception of the students on a five-point Likert from strongly disagree to strongly agree scale while the qualitative approach employed a focused group discussion to explore the perception of the students in regards to clinical simulation. Quantitative data was analyzed using Stata Version 17. Qualitative results were analyzed through thematic analysis by Brauna and Clark. 298 participants were recruited into the study. The mean age of the participants was 27 years with a standard deviation of 5.81 years. The majority 152(51.01%) of the participants were males. Most 111(37.25%) of the participants were pursuing Bachelor of Medicine and Bachelor of Surgery. The grand mean of the perception scores of the students towards the use of simulation in clinical teaching was 3.875269 ±0.5281626. The participants strongly agreed that it is incredibly helpful to have someone who works in the field debrief with them after completing a scenario and their overall perception towards this was high (Mean =4.65241±0.6617337). This exploratory study revealed that medical, nursing, and midwifery students from the rural Universities of Busitema and Lira demonstrated a positive perception of the use of clinical simulation in teaching and learning. The results conclude that simulations help students better understand concepts in clinical settings, provide them with valuable learning experiences, and help them stimulate critical thinking abilities. Further, the participants perceive simulation to be realistic, and knowledge gained could be transferred to the clinical areas.

IntroductionPeer-assisted learning (PAL) is well described in medical education but there has been little research on its application in simulation-based education (SBE). This exploratory study aimed to determine the perceptions...