First-year Undergraduate Medical Students Research Articles

Leveraging medical imaging for medical education — A cinematic rendering-featured lecture

BackgroundThe integration of medical imaging into anatomical education offers advantages in understanding and learning. However, spatial orientation with conventional (2D) imaging data is challenging, and the students’ ability to imagine structures in three dimensions is individual. In addition, the quality of current volume rendering methods is limited. ObjectiveWe tested Cinematic Rendering (CR), a novel visualization technique that provides photorealistic volume rendering, in the setting of an interactive anatomy lecture with first-year undergraduate medical and dental students. Our goal was to estimate the acceptance and positive effects CR adds to the subjects. MethodsA total of 120 students were surveyed with specifically designed self-assessment questionnaires on the use of CR as a tool in anatomical education. ResultsOf 120 participating students (87 medical and 33 dental) a large majority of 95.9% (Q3) experienced CR as helpful to understand anatomy better. Overall a large majority of the students experienced CR as helpful for learning and understanding, 85% saw an improvement in anatomical education through the integration of CR (Q3–6) and could also imagine using CR as a self-study tool on an electronic device. ConclusionOur undergraduate medical and dental students experienced CR as a beneficial tool for anatomical education in the chosen setting (lecture) and see further opportunities for the sensible use of this technique. Future research on the topic should include other application possibilities as well.

Virtual reality and cardiac anatomy: Exploring immersive three‐dimensional cardiac imaging, a pilot study in undergraduate medical anatomy education

Cardiac anatomy can be challenging to grasp because of its complex three-dimensional nature and remains one of the most challenging topics to teach. In light of some exciting technological advances in the field of virtual reality (VR), we sought to test the viability and the assess efficacy of this computer-generated model for the purposes of teaching cardiac anatomy. Before learning cardiac anatomy, first-year undergraduate medical students participated in an anatomically correct VR simulation of the heart. Students were randomly distributed into control and variable groups. Each student completed a pre-intervention quiz, consisting of 10 multiple choice questions with 5 conventional cardiac anatomy questions and 5 visual-spatial (VS) questions. The control group continued to independent study, whereas the variable group subjects were exposed to a 30-min immersive cardiac VR experience. At the end of the intervention, both the groups underwent a separate post-intervention 10-question quiz. Forty-two students participated in the cardiac VR experiment, separated into 14 control and 28 variable subjects. They scored 50.9% on average on the pre-intervention quiz (SD = 16.5) and 70.2% on the post-intervention quiz (SD = 18.7). Compared to the control group, the students exposed to VR scored 21.4% higher in conventional content (P = 0.004), 26.4% higher in VS content (P < 0.001), and 23.9% higher overall (P < 0.001). VR offers an anatomically correct and immersive VS environment that permits learner to interact three-dimensionally with the heart's anatomy. This study demonstrates the viability and the effectiveness of VR in teaching cardiac anatomy. Clin. Anat. 32:238-243, 2019. © 2018 Wiley Periodicals, Inc.

Breaking down apoptosis: animating programmed cell death in 3D for a pathology curriculum

Contemporary medical education is expected to keep up with the rapidly expanding corpus of medical scientific knowledge to train informed doctors. Swift communication and assimilation of complex concepts are required, yet traditional teaching methods are often suboptimal means to this end. This paper details the making of a concise 3D animation on the apoptotic pathways, designed to improve first-year undergraduate medical students’ grasp of cell signalling. A simplified visual language was adopted to increase the effectiveness and expedite the production of beginner molecular biology animations. Favourable student feedback suggests that the chosen design approach could yield further positive results.

Peer-Assisted and Team-Based Learning: A new hybrid strategy for Medical Education

ABSTRACT Medical education has been significantly changing in the last years, mainly due to new conceptions of the teaching-learning processes that advocate the employment of active methods of learning, such as Team-Based Learning (TBL). Peer-Assisted Learning (PAL) is a long-established strategy that has been used in several undergraduate courses. This study describes a pilot test of a new model of PAL developed with an adapted TBL strategy, that was called “PAL-TBL method”. The test occurred during Human Physiology classes with first-year Medical undergraduate students from Universidade de Pernambuco - Garanhuns Campus, Brazil. The PAL-TBL was designed as a teaching-learning methodology to improve academic education. Here, the organizational dynamics and the design of the activities carried out from 2016 to 2017 are reported. The resulting PAL-TBL methodology is characterized as the following: (i) timing I or material preparation (context/scenario) and study/analysis of the material by the participants; (ii) timing II or verification of prior knowledge (individual and team test), questioning and feedback and (iii) timing III or applying the concepts learned. It is worth mentioning that the end of timing II consisted of a moment for evaluating the team’s work and the materials used. Material production happened through the interaction between student-tutors and the (supervising) professor, aiming to share experiences as well as to elucidate the importance of using active methods during the academic development of useful competencies for medical practice. The methodology developed allowed students to reflect extensively on the problems presented in the class discussions, allowing for a richer learning experience. Further applications of PAL-TBL in advanced years of the course will be done to confirm the benefits of this hybrid strategy for medical education.

Modified directed self-learning sessions in physiology with prereading assignments and Pecha Kucha talks: perceptions of students.

The present study reports perceptions of first-year undergraduate medical students ( n = 120), regarding modified directed self-learning (DSL) sessions in physiology. Students were provided with prereading assignments (faculty developed PowerPoint slides containing diagrams with incomplete labeling/flowcharts with missing steps) pertaining to the DSL topic 1 wk before the scheduled small-group DSL presentations. During DSL presentation sessions, which were facilitated by teachers, a few students individually presented learning objectives in the specified topic. Apart from that, students discussed answers for the questions in the prereading assignment. Students were also given an opportunity to use technology to support DSL, by way of involving them in Pecha Kucha (PK) talks. The impact of the modified DSL method was determined by requesting students to respond to a validated questionnaire. Frequency analysis of the responses revealed that >60% of students were positive about the modified DSL sessions improving their DSL, presentation, collaborative learning, and information retrieving skills. Students agreed that PK talks helped them to learn how to organize content (65%), present concise information (65.8%), and apply creativity (72.5%). Even though small in number, there were comments that the prereading assignments were useful for learning. The present study revealed that, even though students actively participated in modified DSL sessions, their perceptions on satisfaction and usefulness of the same toward achievement of various skills were not encouraging. The study generated significant results, which implies that undergraduate medical students should be oriented on the relevance of active learning strategies in their future studies.

Early exposure of laparoscopic anatomy to first year medical undergraduate students: is it necessary?

The teaching of undergraduate anatomy is particularly based on cadaveric dissection. Currently, medical curriculum is continually evolving and focusing on clinical application, especially for first year medical undergraduate students. Recently, surgical educators defined a role for laparoscopy in teaching anatomy. This study was conducted to know the opinion by first year medical undergraduate students, of current teaching practices and which teaching modalities should be emphasized. In this study a total of 200 first-year medical undergraduate students were exposed to a Diagnostic Laparoscopy with appendectomy video, with explanation/commentary by a laparoscopic surgeon. A pre-test and a post-test questionnaire were given before and after exposure to the video. The objective of the study was to collect students’ opinion by answering the questions in the questionnaire. All pre-test and post-test questionnaire results were analysed. The results were quantified in terms of percentage. The knowledge of anatomy of abdominal wall and peritoneal cavity improved from 62% to 91% of students after exposure to surgical video. Similarly, knowledge regarding laparoscopy improved from 37% to 85% and awareness about surgical video as an additional method of learning improved from 46% to 89%. Almost 93% of students were able to appreciate the organs and structures within intraperitoneal cavity. Hence, the clinicians/surgeons need to try their best and put in their maximum efforts to make the training of future medical graduates more efficient and knowledgeable in anatomy subject, by creating interest in learning of the subject by using such additional method (surgical videos) learning tool.

Introducing a molecular basis to physiology in undergraduate medical education.

Medical professionals in India need to understand the concepts of molecular genetics to stay up-to-date with clinical care as well as to strengthen basic research in the biomedical sciences. We introduced a modular course on 'Fundamentals in molecular and cellular biology' for first-year medical undergraduate students in the second semester of the first MBBS year in 2015, as part of 'Innovations in teaching physiology' at St John's Medical College. This was a voluntary, add-on course with didactic lectures, hands-on practical classes and a research paper presentation. Evaluation of students' performance in the course took into account their performance in the research paper presentation-based group activity and their attendance for the hands-on practical sessions. Feedback on the content, delivery, evaluation and future improvements of the course was sought from the students. About 65% of students regularly attended the 10-hour long course. Of the students evaluated for the course, 43% achieved the highest, and 11% achieved the lowest grade assigned. Nearly 72% of the students provided feedback on the course. This first outing of the modular course on 'Fundamentals in molecular and cellular biology' generated excitement among the students and achieved some learning for them. It also brought to light hidden challenges in conducting such a voluntary course for medical students in India. Our experience with the course will help in designing a better-integrated course for exposure of first-year medical students to advances in molecular biology and its applied aspects as they progress through the MBBS course.

Lessons learned from piloting mHealth informatics practice curriculum into a medical elective.

This case study reports the development and delivery of an mHealth elective piloted for first-year undergraduate medical students at Monash University (Australia) and the lessons learned by designers. The students were not as adept at using mHealth devices as the literature had predicted. Expert speakers using mHealth for practice perceptibly engaged students. Force-field analysis was a useful basis for devising end-user evaluative research tools for practice. Combining small- and large-group discussions with eLearning discussions promoted student engagement with new concepts and associated jargon. Assessment by mHealth informatics champions supported the students' independent learning. Promotion of mHealth curriculum must be transparent and clear. Our elective delivery was hampered by a lack of suitable mobile device ownership and limited availability of useful, free apps. Technological jargon required clarification. Educators require particular mHealth informatics and educational expertise to support mHealth pedagogies. This learning helps to prepare medical curriculum designers for addressing evolving mHealth practice horizons.

Have we got the selection process right? The validity of selection tools for predicting academic performance in the first year of undergraduate medicine.

This article was migrated. The article was marked as recommended. Content: There remains much debate over the 'best' method for selecting students in to medicine. This study aimed to assess the predictive validity of four different selection tools with academic performance outcomes in first-year undergraduate medical students. Methods: Regression analyses were conducted between admission scores on previous academic performance - the Australian Tertiary Admission Rank (ATAR), the Undergraduate Medicine and Health Sciences Admission Test (UMAT), Multiple-Mini Interview (MMI) and the Personal Qualities Assessment (PQA) with student performance in first-year assessments of Multiple Choice Questions, Short Answer Questions, Objective Structured Clinical Examinations (OSCE) and Problem-Based Learning (PBL) Tutor ratings in four cohorts of students (N = 604, 90%). Results: All four selection tools were found to have significant predictive associations with one or more measures of student performance in Year One of undergraduate medicine. UMAT, ATAR and MMI scores consistently predicted first year performance on a number of outcomes. ATAR was the only selection tool to predict the likelihood of making satisfactory progress overall. Conclusions: All four selection tools play a contributing role in predicting academic performance in first year medical students. Further research is required to assess the validity of selection tools in predicting performance in the later years of medicine.

Cadaver dissection: A positive experience among Saudi female medical students

ObjectivesThe objectives of this study were to evaluate first-year undergraduate female preclinical medical students' behaviours, experiences, and emotions regarding cadaver dissection. The evaluation was performed during the 2013–2014 academic year, six months after starting the dissection course.MethodsA 14-statement questionnaire was administered to a group of 200 first-year undergraduate female preclinical medical students at the College of Medicine, King Abdulaziz University (KAU), KSA. For each question, the students responded by selecting either “Yes,” “No,” or “Undecided.” Statistical analysis was performed after collection of the questionnaire responses.ResultsThe results showed that 90% of the students agreed that cadaver dissection provided the best and shortest way to study anatomy. Also, 89% were excited during their first visit to the dissection room, and 79% were satisfied that dissection of a cadaver was ethically acceptable. The majority of the students (over 90%) declared that dissection of a cadaver was one of the best teaching strategies for facilitating the acquisition of knowledge of human anatomy.ConclusionsSaudi female first-year undergraduate medical students at KAU showed positive attitudes toward cadaver dissection during their human anatomy course. This study prompts the need for exploration of gender differences in perception regarding cadaver dissection.

First-year medical undergraduate students opinion about the use of radiology in gross anatomy course

Abstract Introduction: Although the importance of anatomy teaching in the undergraduate medical curriculum is incontestable, the lack of knowledge retention and clinical application are the greatest challenges for anatomy teachers. New teaching methodologies are replacing cadaver' dissection in many schools around the world and the usage of radiologic images can become a valuable resource for student's learning the human body structures. The aim of this article was to analyze the perception of first-year undergraduate medical students in the usage of radiology in gross human anatomy course. Materials and methods: One hundred students answered a 30 questions survey using a 5-point Likert scale about the usage of radiologic images in the human anatomy classes. Results: Most subjects have shown desire and the availability to learn human anatomy using images. After the usage of radiologic images there has been an increase on the subjective aspects of the human body such as admiration and respect, an improvement in the correlation of human anatomy with clinical aspects and in the three dimensional perception of the human body anatomic structures. Conclusions: Most of the research participants evaluated the usage of radiologic images as positive and beneicial for the teaching and learning human anatomy as it increases the interest for anatomy and it can favor learning and clinical practice performance. Results shows that according to students' opinion the usage of radiology can be an excellent complement in human anatomy learning and can induce us to think it can prepare and train more competent doctors in diagnostic imaging.

Perceived stress and sources of stress among first-year medical undergraduate students in a private medical college - Tamil Nadu

Background: Medical education throughout the world poses the incoming student with many challenging situations and demands. This forms an ideal environment for the student to be under stress as he/she adapts to these stress-inducing conditions. Factors both psychosocial and otherwise, vary widely between institutions of learning, the demographic studied, the external influences of the environment/country, and the stage of learning of the student, among other factors. Aims and Objective: To assess the prevalence of stress among first-year medical undergraduate students and to segregate the potential stressors derived from the study. Materials and Methods: This is a cross-sectional study involving the first-year medical students. Prevalence of stress was assessed using Cohen’s Perceived Stress Scale (PSS-10), which is an internationally validated 10-item questionnaire. The effect of potential stressors was assessed using a 33-item questionnaire. The stressors were categorized as academic, psychosocial, and health-related. Result: Of the 147 respondents, the mean PSS score was 21.09 (SD: 4.7). Of them, 105 students (71.4%) reported moderate stress, 16 students (10.9%) had high stress, and 26 students (17.7%) reported low/no stress. The top five stressors were all academic or psychosocial stressors. Conclusion: The vast majority of students perceived moderate stress and analysis highlighted a greater association with academic factors compounded by psychosocial ones. Preventive mental health measures on the basis of this and further studies into the occurrences of stress in the early academic years of a medical professional, followed by effective management tools and programs could go a long way in counteracting the harmful long-term effects of stress on their careers, producing happier and more productive and efficient medical professionals.

The synaptic challenge

The synaptic challenge

Exposure to ACGME Core Competencies through Mentored Basic Science Research: A Pilot Analysis

Since 1998, the Short-Term Training Program (STTP) at the David Geffen School of Medicine at the University of California, Los Angeles has nearly tripled (from 30 to 89) in the number of first-year undergraduate medical students participants. STTP supports mentored research projects in the areas of basic sciences, clinical sciences, medical education, and public health (local and international). Although projects can be very specific in scope, the overall experience in STTP exposes students to some, if not all, of the Accreditation Council for Graduate Medical Education (ACGME) six core competencies–-Patient Care, Medical Knowledge, Practice-based Learning and Improvement, Interpersonal and Communication Skills, Professionalism, and Systems-based Practice. Thus, STTP has been an important aspect of medical education to prepare our students for residency programs. We describe and analyze the STTP as a model system to introduce the ACGME core competencies at an early point in undergraduate medical education. We conclude with a call to provide more mentored anatomical sciences basic and clinically applied research opportunities.

Learning through role-playing games: an approach for active learning and teaching

This study evaluates the use of role-playing games (RPGs) as a methodological approach for teaching cellular biology, assessing student satisfaction, learning outcomes, and retention of acquired knowledge. First-year undergraduate medical students at two Brazilian public universities attended either an RPG-based class (RPG group) or a lecture (lecture-based group) on topics related to cellular biology. Pre- and post-RPG-based class questionnaires were compared to scores in regular exams and in an unannounced test one year later to assess students' attitudes and learning. From the 230 students that attended the RPG classes, 78.4% responded that the RPG-based classes were an effective tool for learning; 55.4% thought that such classes were better than lectures but did not replace them; and 81% responded that they would use this method. The lecture-based group achieved a higher grade in 1 of 14 regular exam questions. In the medium-term evaluation (one year later), the RPG group scored higher in 2 of 12 questions. RPG classes are thus quantitatively as effective as formal lectures, are well accepted by students, and may serve as educational tools, giving students the chance to learn actively and potentially retain the acquired knowledge more efficiently.

Personal health records in the preclinical medical curriculum: modeling student responses in a simple educational environment utilizing Google Health

BackgroundVarious problems concerning the introduction of personal health records in everyday healthcare practice are reported to be associated with physicians’ unfamiliarity with systematic means of electronically collecting health information about their patients (e.g. electronic health records - EHRs). Such barriers may further prevent the role physicians have in their patient encounters and the influence they can have in accelerating and diffusing personal health records (PHRs) to the patient community. One way to address these problems is through medical education on PHRs in the context of EHR activities within the undergraduate medical curriculum and the medical informatics courses in specific. In this paper, the development of an educational PHR activity based on Google Health is reported. Moreover, student responses on PHR’s use and utility are collected and presented. The collected responses are then modelled to relate the satisfaction level of students in such a setting to the estimation about their attitude towards PHRs in the future.MethodsThe study was conducted by designing an educational scenario about PHRs, which consisted of student instruction on Google Health as a model PHR and followed the guidelines of a protocol that was constructed for this purpose. This scenario was applied to a sample of 338 first-year undergraduate medical students. A questionnaire was distributed to each one of them in order to obtain Likert-like scale data on the sample’s response with respect to the PHR that was used; the data were then further analysed descriptively and in terms of a regression analysis to model hypothesised correlations.ResultsStudents displayed, in general, satisfaction about the core PHR functions they used and they were optimistic about using them in the future, as they evaluated quite high up the level of their utility. The aspect they valued most in the PHR was its main role as a record-keeping tool, while their main concern was related to the negative effect their own opinion might have on the use of PHRs by patients. Finally, the estimate of their future attitudes towards PHR integration was found positively dependent of the level of PHR satisfaction that they gained through their experience (rho = 0.524, p <0.001).ConclusionsThe results indicate that students support PHRs as medical record keeping helpers and perceive them as beneficial to healthcare. They also underline the importance of achieving good educational experiences in improving PHR perspectives inside such educational activities. Further research is obviously needed to establish the relative long-term effect of education to other methods of exposing future physicians to PHRs.

Can Online Learning Adequately Prepare Medical Students to Undertake a First Female Pelvic Examination?

ObjectiveTo determine whether a novel web-based learning module could adequately prepare first-year undergraduate medical students to skilfully perform their first female pelvic examination. MethodsFirst-year Queen’s University medical students without prior training or experience in female pelvic examination were recruited for this study. After viewing key segments of the learning module, students were evaluated while performing a pelvic examination on a female volunteer using a standardized assessment checklist (total score = 30 points). Descriptive and comparative statistics were generated. ResultsForty-five students participated with a mean age of 24 years (range 20 to 40). The mean score (±SD) on the assessment checklist was 23.9 ± 3.6 points, (range 17 to 30). All study participants received a passing grade of ≥ 50% (15/30 points), and 53.3% (24/45) received an honours grade of ≥ 80% (24/30 points). Of the participants, 88.9% (40/45) agreed that they were well prepared for their first female pelvic examination after viewing the training video. Mean scores were similar for male students (23.9, n = 22) and female students (23.8, n = 23) (P = 0.90, t test). Mean scores were not higher in those who watched key segments of the learning module more than once. ConclusionThis learning module viewed immediately prior to a simulated clinic session afforded first-year medical students the necessary knowledge and skills to perform a first female pelvic examination. This was accomplished with as little as one viewing, and could lead to savings in organizational costs and instruction time for medical school curricula.

Exploring first-year undergraduate medical students' self-directed learning readiness to physiology

Medical students are expected to possess self-directed learning skills to pursue lifelong learning. Previous studies have reported that the readiness for self-directed learning depends on personal attributes as well as the curriculum followed in institutions. Melaka Manipal Medical College of Manipal University (Karnataka, India) offers a Bachelor of Medicine and Bachelor of Surgery (MBBS) twinning program that is of 5 yr in duration. Keeping in mind the amount of time that the curriculum has devoted for self-directed learning, we explored the self-directed learning readiness of first-year MBBS students (n = 130) using a self-directed learning readiness scale (SDLRS) and explored the correlation between SDLRS scores of high achievers, medium achievers, and low achievers with their academic performance in physiology examinations. Students were requested to respond to each item of the SDLRS on a Likert scale. Median scores of the three scales of the SDLRS were compared across the three groups of students using a Kruskall-Wallis test. SDLRS scores of the students (n = 130) were correlated with their marks in theory papers of first, second, and third block-end examinations using Spearmann's correlation coefficient. The mean item score for desire for learning was found to be higher followed by self-control and self-management. Data analyses showed significantly high (P < 0.03) median scores for self-control for high achievers compared with medium and low achievers. Between the groups, high achievers had a higher score for all the three scales of the SDLRS followed by low and medium achievers. SDLRS scores and academic performance of the three groups of students were found to exhibit a weak correlation. This study threw light on the fact that despite having a high desire for learning and ability of self-control, students need to be supported in their self-management skills.

Developing professionalism through the use of wikis: A study with first-year undergraduate medical students

Aim: Learning about professionalism occurs through collaboration, with peer groups being important sources of support for students [Sandars J, Homer M, Pell G, Croker T. 2008. Web 2.0 and social software: The medical student way of e-learning. Med Teach 14:1–5. Accessed 2008 February 14]. This study aimed to discover whether the use of wikis (collaborative websites) could enhance medical students’ development of professionalism.Methods: An online wiki was made available to four problem-based learning (PBL) groups, involving 32 students. Data collection comprised a small-scale student survey and four focus groups eliciting their views about wiki use, triangulated with facilitator interviews and wiki usage statistics.Results: Several factors affected individual student and group engagement with wikis, such as positive group dynamics. Students shared web links, helping clarify PBL discussions and increase their confidence.Conclusions: Two main benefits of using wikis for the development of professionalism with medical students were revealed. First, wikis acted as a shared knowledge base for hard-to-find resources on professionalism. Second, it was precisely when students reflected on the difference between interacting in wikis and their online social spaces, or when they considered whether or not to post a resource that their sense of professionalism emerged.

Formative assessment can be fun as well as educational

An understanding of the hormonal basis of normal growth and development, including the changes occurring at puberty, is important foundation knowledge for contemporary medical practice in most fields of medicine. A quiz, testing the important physiological concepts of growth and puberty, was designed using the format of the well-known television game "Who Wants to Be a Millionaire." An evaluation of this formative assessment activity revealed that a cohort of first-year undergraduate medical students valued learning with peers in an enjoyable, interactive environment, where they were able to admit to uncertainties and clarify answers. It also showed that making an educational activity fun need not detract from the focus of giving feedback on learning. Formative assessment, known to produce learning gains in a range of educational settings, is an important activity in contemporary medical education. With a greater emphasis on self-directed learning and less well-defined curriculum boundaries, feedback helps students to understand and apply the important physiological concepts that underpin the practice of medicine.