Large-group Sessions Research Articles

Group Size: An Active Ingredient of School-Based Language Therapy.

This study explored the relation between therapy group size and language outcomes for children receiving school-based language therapy through an implementation science lens. Data for the current study were gathered as part of the Speech-Language Therapy Experiences in Public Schools study. Participants included 273 English-speaking kindergarten through second-grade children with language impairment receiving business-as-usual therapy on the caseloads of 75 speech-language pathologists. Data were collected over an academic year, including weekly therapy logs, speech-language pathology questionnaires, and pre- and post-language measures. Descriptive analysis revealed that children primarily experienced small-group therapy sessions (two to four children); however, there was considerable variability in group size. Hierarchical general linear modeling indicated that caseload size did not explain group size variability. However, the number of student cancellations was positively associated with receipt of large-group sessions. Notably, a significant negative association was found between receipt of large-group sessions (i.e., five to 10 children) and language outcomes. Children who received more than the average number of sessions in large groups (i.e., more than 5% of total sessions) experienced 0.18 SD less language gain over the academic year compared to the mean (0.54 SD). No other group size configurations (i.e., individual, small group, and extra large) yielded significant associations with language outcomes. The findings suggest that young children receiving language-based therapy in large groups make substantially fewer language gains over an academic year. These results have considerable implications for educational policy and clinical practice, which are discussed through an implementation science frame.

Making narrative feedback meaningful.

Narrative written feedback given to students by faculty often fails to identify areas for improvement and recommended actions to lead to this improvement. When these elements are missing, it is challenging for students to improve and for medical schools to use narrative feedback in promotion decisions, to guide coaching plans and to pass on meaningful information to residency programs. Large-group faculty development has improved narrative written feedback, but less is known about individualised faculty development to supplement large-group sessions. To fill this gap, we built a curriculum with general and individualised faculty development to improve narrative written feedback from Internal Medicine faculty to clerkship students. We used Kern's steps to build a curriculum with general and individualised one-on-one faculty development to improve the problem of inadequate narrative written feedback. We used a novel narrative feedback rubric for pre and post-intervention faculty scores. Through general and individualised one-on-one faculty development with peer comparison scores, we were able to improve narrative written feedback from 3.7/6 to 4.6/6, for an increase of 23%. We found our faculty development program effective in improving feedback and was easy to implement. Our rubric was easy to use, and faculty were receptive to feedback in one-on-one meetings. We plan to extend this work locally to other divisions/departments and into graduate medical education; it should also be easily extended to other medical disciplines or health professions.

Near-peer tutoring: an effective adjunct for virtual anatomy learning.

With recent shifts in medical education to the virtual setting during the COVID-19 pandemic, previous methods of teaching anatomy have been challenged. As such, we created the Medical Students' Society Anatomy Club (MAC), a student-led near-peer tutoring initiative providing virtual anatomy learning opportunities through interactive large and small group sessions using cadaveric prosection images and models. Sessions had high attendance rates and satisfaction among students. This pilot project demonstrated that near-peer teaching in a virtual learning environment can be an effective adjunct to traditional medical anatomy curricula.

A Canadian survey of medical students and undergraduate deans on the management of patients living with obesity

BackgroundWith over 26% of Canadian adults living with obesity, undergraduate medical education (UGME) should prepare medical students to manage this chronic disease. It is currently unknown how the management of patients living with obesity is taught within UGME curricula in Canada. This study (1) examined the knowledge and self-reported competence of final-year medical students in managing patients living with obesity, and (2) explored how this topic is taught within UGME curricula in Canada.MethodsWe distributed two online surveys: one to final-year medical students, and another to UGME deans at 9 English-speaking medical schools in Canada. The medical student survey assessed students’ knowledge and self-reported competence in managing patients living with obesity. The dean’s survey assessed how management of patients living with obesity is taught within the UGME curriculum.ResultsOne hundred thirty-three (6.9%) and 180 (9.3%) out of 1936 eligible students completed the knowledge and self-reported competence parts of the survey, respectively. Mean knowledge score was 10.5 (2.1) out of 18. Students had greatest knowledge about etiology of obesity and goals of treatment, and poorest knowledge about physiology and maintenance of weight loss. Mean self-reported competence score was 2.5 (0.86) out of 4. Students felt most competent assessing diet for unhealthy behaviors and calculating body mass index. Five (56%) out of 9 deans completed the survey. A mean of 14.6 (5.0) curricular hours were spent on teaching management of patients living with obesity. Nutrition and bariatric surgery were most frequently covered topics, with education delivered most often via large-group sessions and clinical activities.ConclusionsCanadian medical students lack adequate knowledge and feel inadequately prepared to manage patients living with obesity. Changes to UGME curricula may help address this gap in education.

Basis, Process and Outcomes of a Student Involvement Project for Curriculum Review at the Imperial College School of Medicine.

Introduction: To help create a Bachelor of Medicine, Bachelor of Surgery (MBBS) curriculum centred around the student voice, the Imperial College School of Medicine (ICSM) recruited two medical students for a two-week student-staff collaboration in Summer 2019 for its wider curriculum review. This write-up discusses the background, processes, and outcomes of the collaboration and includes some student reflections. Methods: The team comprised a member of the faculty and two medical students (the authors). We met daily for two weeks and focussed on the Bioregulatory Systems (BRS) module of Year 1. There were three key areas of work: learning objectives, large-group sessions, and small-group sessions. Each aspect involved planning, implementation, and reflection. For example, learning objectives were recategorized and reorganised, students fed back on a new slide template for large-group sessions, and new small-group sessions were designed. Feedback from the staff was collected verbally, and the medical students submitted feedback in the form of a mid-project interview, a post-project report, and informally.Results: We achieved such outcomes as reorganising and refining learning objectives, improving large-group teaching sessions, and refining and creating small-group teaching sessions. Following the collaboration, we had a debrief session.Conclusions: This collaboration was highly valuable for both students and faculty; the feedback revealed that the ideas, discussions, and outputs had a substantial impact. Overall, student-staff collaboration will become increasingly valuable as we emerge from COVID-19; we hope this write-up informs and inspires more 'students as partners’ projects worldwide.

Can surgical skills be taught using technological advances online? A comparative study of online and face-to-face surgical skills training

IntroductionOnline teaching has rapidly emerged as a viable alternative to traditional face-to-face education. How to teach surgical skills in the online environment, however, has not yet been fully established nor evaluated.MethodsAn international 1-day online surgical skills course consisting of lectures, pre-recorded virtual workshops, live demonstrations and along with surgical skills teaching in breakout rooms was organised. Based on existing learning theories, new methods were developed to deliver skills teaching online. Simultaneously, traditional in-person surgical skills teaching was also conducted and used as a benchmark. Skills development was assessed by trained demonstrators and self-reported competency scores were compared between the online and face-to-face event.Results553 delegates from 20 different countries attended the online course. Of these, 64 were trained in breakout rooms with a 1:5 demonstrator-to-delegate ratio whilst the remaining 489 delegates participated in didactic skills development sessions. In a separate face-to-face course, 20 delegates were trained with traditional methods. Demonstrators rated the competency of delegates for suturing, tendon repair and vascular anastomosis. There was no significant difference in the competency ratings of delegates receiving online teaching or face-to-face teaching (p = 0.253, p = 0.084, p = 1.00, respectively). The development of the same skills to “articulation” were not different between formats (p = 0.841, p = 0.792, p = 1.00, respectively). Post course self-rated competency scores improved for all technical skills (p < 0.001). Small group sessions, both online and face-to-face, received higher satisfaction ratings compared to large group sessions in terms of clarity of instructions, answers to questions and demonstrator feedback. Overall feedback on teaching quality, however, was equivalent across both groups.DiscussionOnline teaching of surgical skills for early training years is an appropriate alternative to face-to-face teaching.

223 Development of Online Surgical Skills Education

Abstract Introduction Online teaching rapidly emerged as a viable alternative to traditional face-to-face education. However, how to teach surgical skills in the online environment has not been established nor evaluated yet. Method An international one-day online surgical skills course consisting of lectures, pre-recorded virtual workshops, live demonstrations, and surgical skills teaching in breakout rooms was organised. Simultaneously, a traditional face-to-face surgical skills teaching was held and used as benchmark. Skills development assessed by trained demonstrators and self-reported competency scores were compared between the online and face-to-face event. Results In total, 553 participants from 20 different countries attended the online course, 64 were trained in breakout rooms with a 1:5 demonstrator to candidate ratio whilst the remaining candidates participated in didactic skills development sessions. In a separate face-to-face course 20 candidates were trained with traditional methods. Post course competency ratings by demonstrators in suturing, tendon repair and vascular anastomosis were not significantly different between students receiving online breakout room or face-to-face teaching (ps&amp;gt;0.05). The development of the same skills to “articulation” were not different between formats (ps&amp;gt;0.05). Post course self-rated competency scores improved for all technical skills (p&amp;lt;0.001). Small group sessions, both online and face-to-face, received higher satisfaction ratings compared to large group sessions in terms of clarity of instructions, answers to questions and demonstrator feedback. Conclusions Online teaching of surgical skills for early training years is an appropriate alternative to face-to-face teaching with the ability to define clear learning objectives, effectively teach surgical skills and achieve similar learning outcomes.

Seminar for Chief Residents Inspires Future Leaders

Back to table of contents Previous article Next article Education & TrainingFull AccessSeminar for Chief Residents Inspires Future LeadersEve BenderEve BenderSearch for more papers by this authorPublished Online:28 Dec 2021https://doi.org/10.1176/appi.pn.2022.1.35AbstractThought-provoking sessions and frank discussions are part of what makes the Chief Residents Leadership Conference a smashing success, say attendees.Last fall, more than 60 chief residents of psychiatry programs from across the United States and Canada traveled to Armonk, N.Y., for a weekend of self-revelation and the development of strategies to resolve leadership dilemmas during their year as chief as well as throughout their career as part of the Chief Residents Leadership Conference (CRLC).CRLC Program Director Bruce Schwartz, M.D. (right), observed that chief residents and faculty interacting in person was part of the meeting’s great success. Due to the COVID-19 pandemic, organizers canceled the 2020 conference.Andrea WeissThe CRLC—once known as the Tarrytown Leadership Conference due to its former location in Tarrytown, N.Y.—began in 1972 and has continued annually since that time. However, the COVID-19 pandemic in 2020 halted the conference for the first time in almost 50 years. That meant residents and the faculty who co-led small and large group sessions during the conference had an especially intense feeling of connection with peers from other programs, CRLC Program Director and former APA President Bruce Schwartz, M.D., told Psychiatric News. “The residents and faculty were happy to end our social distancing. I think part of the success of the meeting was due to the fact that attendees could meet in person and share the experience,” he said.Others agreed.“One thing that COVID-19 halted was any interaction between residency programs,” Peter Spyrou, M.D., told Psychiatric News. Spyrou is chief resident of consultation-liaison psychiatry at the Montefiore Medical Center at Albert Einstein College of Medicine. “I especially enjoyed speaking with my peers from other NYC psychiatry residency programs.”Spyrou noted that the conference taught him to balance the concerns of administrators and residents simultaneously—helping both to feel heard and understood. “I also realized that most residency programs are in some degree of flux, and that as chief resident, it is important to be flexible,” he noted.Chief residents from 30 psychiatry residency programs across the United States and Canada traveled to New York to participate in the 48th annual Chief Residents Leadership Conference last fall.Andrea WeissSchwartz noted that there was a great deal of praise for the conference from chief residents, who shared that they had gained unique perspectives and received constructive feedback from peers. Among the anonymous feedback provided, one chief resident wrote that the group sessions “really encouraged me to think about my leadership style and be more self-aware, allowing me to be more adaptable.”Because the COVID-19 pandemic had slowed but not ended, both the CRLC leadership and conference center followed safety measures to protect meeting attendees—for instance, the conference center installed new HVAC systems for improved air circulation and doubled the size of some of the conference rooms.Faculty ran large and small group sessions with slightly fewer chief residents than in previous years, and as the weather was sunny and warm, some of the groups met outside without masks, according to Schwartz.“Once again, as I facilitated the group sessions and witnessed the chief residents gain tremendous insight over the course of the weekend, I have great confidence in the next generation of leaders in psychiatry,” APA CEO and Medical Director Saul Levin, M.D., M.P.A., told Psychiatric News.APA President-elect Rebecca W. Brendel, M.D., J.D., who also served on the CRLC faculty, noted that “without question, the conference is a once-in-a-lifetime opportunity for chief residents as they take on leadership roles in our profession. As faculty, we experience the gift of learning alongside the residents and reflecting on our own leadership and accomplishments.” ■More information about the Chief Residents Leadership Conference is posted here. ISSUES NewArchived

Considerations for Organizing Longitudinal Delivery of Pharmacology: the Impact of Content Delivery in Context.

The online version contains supplementary material available at 10.1007/s40670-021-01461-1.

SP2.1.2Online near-peer practical skills teaching for medical students: A cross-sectional study

AimsMedical students have reduced small-group teaching due to the COVID-19 pandemic. Online teaching typically involves large-groups and covers theoretical topics rather than practical skills. We investigated the effectiveness of a six-part online small-group tutorial series, teaching key practical skills to medical students in their first clinical year.MethodsTutors taught using Microsoft Teams, with a tutor:student ratio being between 1:3 to 1:5. Tutorial themes were: examinations (Cardiovascular & Respiratory, Abdominal), A-E assessment and imaging (Thorax imaging & Histology, AXR & CT). Tutees completed a post-tutorial feedback form; the primary outcome was confidence improvement on the subject content. Likert Scales were used to measure the primary aim, with 1 corresponding to the worst outcome, and 4 corresponding to the best outcome.Results152 tutee feedback responses were analysed, a 60.0% response rate. Response numbers were lowest in the examinations tutorials. Mean tutee confidence improved markedly, from 1.954(SD 0.7918) to 3.414(SD 0.5572, p < 0.0001). This was highest in imaging tutorials (p < 0.05). Mean scores for effectiveness of delivery and effect of technical issues were 3.868(SD 0.3762) and 3.908(SD 0.3327) respectively. From tutors’ feedback, 100% preferred teaching small-group over large-group sessions. However, only 33.3% prefer to teach online over face-to-face. Mean student engagement was rated at 3.417(SD 0.5149).ConclusionsSmall-group teaching improves students’ confidence in practical skills. Conducting this online is more effective for skills with little physical examination components and is something that can be expanded to a bigger cohort to maximise use of the online platforms.

Italian adaptation of the Düsseldorf Orthorexia Scale (I-DOS): psychometric properties and prevalence of orthorexia nervosa among an Italian sample

PurposeOrthorexia Nervosa (ON) is described as an extreme level of preoccupation around healthy eating, accompanied by restrictive eating behaviors. During the years, different assessment instruments have been developed. The aim of the study is to adapt into Italian the Düsseldorf Orthorexia Scale (I-DOS) and to test its psychometric properties.MethodA total sample of 422 volunteer university students (mean age = 20.70 ± 3.44, women 71.8%) completed a group of self-report questionnaires in large group sessions during their lecture time. The scales assessed ON (the I-DOS and the Orhto-15), disordered eating (Disordered Eating Questionnaire, DEQ), depressive symptoms (Beck Depression Inventory-II, BDI-II), obsessive and compulsive symptoms (Obsessive Compulsive Inventory-Revised, OCI-R), and self-reported height and weight.ResultsThe fit of the unidimensional structure and reliability of the I-DOS was tested trough Confirmatory Factor Analysis (CFA) as well as its criterion validity computing correlation coefficients among Ortho-15, DEQ, BDI-II, OCI-R, BMI. Analyses confirmed the unidimensional structure of the I-DOS with acceptable or great fit indices (CFI = 0.984; TLI = 0.978; SRMR = 0.043; RMSEA = 0.076) and the strong internal consistency (α = 0.888). The correlations path supported the criterion validity of the scale. The estimated total prevalence of both ON and ON risk was 8.1%.ConclusionsThis 10-item scale appears to be a valid and reliable measure to assess orthorexic behaviors and attitudes.Level of evidenceLevel V, descriptive cross-sectional study.

Key Insights From the Development and Implementation of a Novel Virtual Interview Process for Medical School Admissions During the COVID-19 Pandemic.

During the COVID-19 pandemic, medical schools have offered a virtual application process. Minimal literature is available to guide best practices. The Icahn School of Medicine at Mount Sinai (ISMMS) implemented a completely virtual interview (VI) process in April/May 2020. Large-group sessions for applicants, interviews with applicants, and ISMMS Admissions Committee meetings occurred via Zoom (Zoom Video Communications, Inc., San Jose, California). Large-group sessions and committee meetings occurred via communal conference calls, while one-on-one, semistructured interviews occurred in individual breakout rooms. ISMMS offered live, virtual question-and-answer sessions with students and faculty, plus digital resources describing program features. After the interview day, applicants and interviewers were invited to complete anonymous surveys regarding their experiences with and perspectives of VI. Of 125 applicants and 20 interviewers, 99 (79%) and 18 (90%), respectively, completed at least part of the survey. Of the applicants, 85/95 (89%) agreed VI met or exceeded expectations, with many praising the day's organization and convenience, and 71/95 (75%) agreed they received a sufficient sense of the student body. A minority (n = 39/95 [41%]) felt limited in their ability to learn about the institution (commonly related to their inability to tour campus), and a majority (n =74/91 [81%]) would have preferred an in-person interview. Most interviewers felt comfortable assessing applicants' verbal communication skills (n = 13/16 [81%]), and most (n = 12/17 [71%]) felt VI should be an option for future applicants. VI, likely to be a temporary-but-universal fixture of upcoming application cycles, may benefit applicants and interviewers alike by saving resources and diversifying those involved. Next steps are developing programming that will permit applicants to virtually explore the institution and connect more with current students. Future research should evaluate potential bias in VI to ensure an equitable application process for all.

Online Learning and Engagement in the Foundational Sciences During the COVID‐19 Era: Perceptions and Experiences of Graduate Students

Colleges and universities across the globe were challenged by the necessity of abruptly transitioning their courses to online or hybrid models to adhere to COVID‐19 social distancing guidelines. Second year, Doctor of Physical Therapy (DPT) students were surveyed regarding their learning experiences during an online Foundational Sciences course that included a mix of anatomy, physiology, pathology and pharmacology instruction. The purpose was to gain perceptions into best strategies for online instruction for those content areas that promoted course objective competency with an emphasis on learner engagement.Fifty‐four DPT students were surveyed following the completion of an 8‐week summer semester Foundational Sciences course at the University of the Incarnate Word, School of Physical Therapy, DPT program. The 7‐question anonymous survey addressed content delivered both synchronously (live) and asynchronously (prerecorded or self‐regulated) with regard to time, synchronous class size and format (large group vs. breakout room), use of asynchronous voiceovers and video tutorials, and rating of specific activities promoting engagement. Open feedback questions addressed virtual course elements that students identified as most and least supportive of content mastery.Fifty responses were collected (93% response rate). Findings from the survey indicated a preference for synchronous sessions of 1.5 hr (94%) in length with the combination of both large and small group (breakout room) sessions (90%). Sixty percent of respondents preferred having a mix of synchronous classes with the entire cohort of 54 learners and smaller synchronous sessions with half the cohort. While 50% indicated a preference for more asynchronous PowerPoint voiceovers, 46% indicated that they preferred not having asynchronous voiceovers that aligned with every synchronous class. Activities promoting engagement received mixed ratings overall using a 5‐point Likert scale ranging from poor to excellent. Activities that received majority satisfactory ratings included Poll Everywhere (44%), Zoom annotation tool (40%), Zoom breakout room activities (44%) and StudyMate flashcards (56%). Activities with roughly equivalent ratings for satisfactory, very good and excellent included asynchronous voiceovers (28‐36%) and Kahoot quizzes (26‐38%). The inclusion of guest speakers was least favorable (32% combined poor and fair responses) out of all the activities utilized to enhance engagement. Respondent open feedback indicated that accessibility to recorded synchronous sessions and asynchronous voiceovers were most valuable to their learning. Question interruptions during synchronous sessions and discussion‐based breakout room sessions with less structure was least helpful to their learning.Respondents consistently identified optimal duration and format of online instructional delivery but varied in their responses related to activities promoting learner engagement. This finding could be attributed to variations in learning styles and merits further study. Knowledge derived from educators’ experience during the rapidly evolving and adaptive teaching environment of 2020 can be utilized to transform educational approaches in a post COVID‐19 era.

Interactive Annotation Is an Effective Tool for Delivering Virtual Pharmacology Large Group Sessions

Introduction COVID-19 has had a tremendous impact on medical education. Following the New York State guidelines for schools, Zucker School of Medicine (ZSOM) made a quick transition from in-person classes to virtual sessions to minimize the disruption of teaching and assessment. This has challenged both learners’ and educationists’ ability to adapt to the critical situation that has arisen. Pharmacology is a crucial component of undergraduate medical education. The foundational principles of Pharmacology, including Pharmacodynamics (PD) and Pharmacokinetics (PK) are among the most challenging subjects for students. These contents were delivered entirely online this year. It is therefore important to evaluate the effectiveness of online teaching strategies and their adequacy for medical students. Method The current study was conducted in the present first-year medical students (class 2024) at ZSOM. Pharmacology contents of PK, PD and drugs used in the autonomic nervous system were delivered online via Zoom. Students were assigned pre-read work before the classes. Annotation features of Zoom were used throughout the classes to promote students’ interaction and engagement. For example, a dose-response curve of a full agonist was shown on the faculty's shared screen, and then the students were asked to draw on the screen how the curve would change if the system was pretreated with a fixed dose of an antagonist, a partial agonist, or an inverse agonist. The students could also answer questions using annotation. All students could respond at the same time. Upon collecting enough responses, the faculty facilitated a class discussion on the topics. At the end of the course, we conducted a virtual learning survey to explore the effectiveness of these virtual teaching strategies. Furthermore, we compared the final exam results of the current class (2024) with that of the previous class (2023) which was taught in-person by the same faculty. Results Eighty-eight out of 103 students completed and submitted the end of course virtual learning survey. Seventy-eight percent of the students agreed/strongly agreed that the virtual large group learning environment was engaging and promoted learning, and 75% of students also agreed/strongly agreed that the virtual large group learning environment provided opportunities to interact with the professor. Only 53% of students agreed/strongly agreed that the virtual large group learning was an equivalent learning experience to in-person large group learning. The majority of the students commented positively on the utilization of annotation features during the classes in terms of promoting students’ interaction, engagement, and learning. Furthermore, analysis of the final exam results shows no significant difference between the two classes in the understanding of the pharmacology content and the final exam grades (Figure 1). Conclusion This study reveals a positive attitude from the first-year students at ZSOM toward virtual pharmacology large group sessions. Although online teaching/learning is not the same as in-person, it is a sufficient alternative platform to deliver pharmacology education to medical students when necessary. Annotation features of Zoom are effective in engaging and interacting with students, as well as promoting learning.

Layperson Views about the Design and Evaluation of Decision Aids: A Public Deliberation.

PurposeWe carried out the first public deliberation to elicit lay input regarding guidelines for the design and evaluation of decision aids, focusing on the example of colorectal (“colon”) cancer screening.MethodsA random, demographically stratified sample of 28 laypeople convened for 4 days, during which they were informed about key issues regarding colon cancer, screening tests, risk communication, and decision aids. Participants then deliberated in small and large group sessions about the following: 1) What information should be included in all decision aids for colon screening? 2) What risk information should be in a decision aid and how should risk information be presented? 3) What makes a screening decision a good one (reasonable or legitimate)? 4) What makes a decision aid and the advice it provides trustworthy? With the help of a trained facilitator, the deliberants formulated recommendations, and a vote was held on each to identify support and alternative views.ResultsTwenty-one recommendations (“deliberative conclusions”) were strongly supported. Some conclusions matched current recommendations, such as that decision aids should be available for use with and without providers present (conclusions 1–4) and should support informed choice (conclusion 9). Some conclusions differed from current recommendations, at least in emphasis—for example, that decision aids should disclose cost of screening (conclusion 11) and should be kept simple and understandable (conclusion 14). Deliberants recommended that decision aids should disclose the baseline risk of getting colon cancer (conclusions 15, 17).LimitationsSingle location and medical decision.ConclusionsGuidelines for design of decision aids should consider putting a greater focus on disclosing cost and keeping decision aids simple, and they possibly should recommend disclosing less extensive amounts of quantitative information than currently recommended.

Teaching Pathology in an Integrated Preclinical Medical School Curriculum and Adaptations to COVID-19 Restrictions

The coronavirus disease 2019 (COVID-19) pandemic has had a major impact on education at all age levels, including professional schools and health professions programs. We describe the experience of adapting preclinical medical school courses within an integrated curriculum to virtual instruction. A major feature of two of the courses were pathology small groups adapted from pathology courses in the previous medical school curriculum. These small groups were designed to use facilitated groups of 8 to 10 students. With a sudden change to virtual learning, these small groups were shifted to large group virtual sessions. In general, the conversion went well, with ongoing optimization of the format of the large group sessions mainly occurring over the first several sessions. End-of-course student evaluations were generally positive, but with a preference toward returning to live sessions in the future. Scores on 5 multiple choice examinations in the spring 2020 course were essentially identical in mean, standard deviation, and distribution to examinations in the previous 2 years of the course that had similar layout and topic organization. We discuss the challenges and successes of the switch to virtual instruction and of teaching pathology content within an integrated medical school curriculum.

Development and Implementation of a Synchronous Online TBL Using Microsoft Forms.

After transitioning to a virtual flipped classroom due to COVID-19, pre-clinical content application session facilitators noted decreased engagement in large group sessions. Thus, we developed a synchronous virtual team-based learning session using Microsoft Forms. Students identified increased engagement, deeper learning, and ease of technology use as benefits to online team-based learning.

Current Activities to Implement Integrated Teaching Learning in Undergraduate Medical Education in Bangladesh: Students’ View

The present study was conducted amongst students of all phases in eight medical colleges (4 govt. &amp; 4 non-govt.) of Bangladesh to assess views of students about the current activities to implement integrated teaching learning in undergraduate medical education in Bangladesh. Among 956 students, 387(40.5%) were male and 569(59.5%) were female. This study revealed that 605(63.3%) students had participated in integrated teaching learning session, 328(54.3%) students disagreed that the subjects of different phases are arranged sequentially in curriculum and 265(43.8%) students responded that integrated sessions were conducted in large group sessions. More than half of the students (53.7%) stated that integrated teaching helped them to get better understanding of the topic and integrated teaching also helped them to improve application of knowledge. Insufficiency of infrastructure, allocated time, teachers’ training have been identified by respondents as barriers for implementing integrated teaching learning. Study recommended more awareness and training of teachers and students regarding integrated teaching learning. Study also recommended to choose contents which have much clinical importance for integrated teaching and which have been taught repeatedly in different departments.&#x0D; Bangladesh Journal of Medical Education Vol.11(1) 2020: 26-31

Western University Schulich School of Medicine & Dentistry.

Western University Schulich School of Medicine & Dentistry.

A Mixed Method Investigation to Determine Priorities for Improving Information, Interaction, and Individualization of Care Among Individuals on In-center Hemodialysis: The Triple I Study.

Background:Current health systems do not effectively address all aspects of chronic care. For better self-management of disease, kidney patients have identified the need for improved health care information, interaction with health care providers, and individualization of care.Objective:The Triple I study examined challenges to exchange of information, interaction between patients and health care providers and individualization of care in in-center hemodialysis with the aim of identifying the top 10 challenges that individuals on in-center hemodialysis face in these 3 areas.Design:We employed a sequential mixed methods approach with 3 phases:1. A qualitative study with focus groups and interviews (Apr 2017 to Aug 2018);2. A cross-sectional national ranking survey (Jan 2019 to May 2019);3. A prioritization workshop using a modified James Lind Alliance process (June 2019)Setting:In-center hemodialysis units in 7 academic centers across Canada: Vancouver, Calgary, Edmonton, Winnipeg, Ottawa, Montreal, and Halifax.Participants:Individuals receiving in-center hemodialysis, their caregivers, and health care providers working in in-center hemodialysis participated in each of the 3 phases.Methods:In Phase 1, we collected qualitative data through (1) focus groups and interviews with hemodialysis patients and their caregivers and (2) individual interviews with health care providers and decision makers. Participants identified challenges to in-center hemodialysis care and potential solutions to these challenges. In Phase 2, we administered a pan-Canadian cross-sectional ranking survey. The survey asked respondents to prioritize the challenges to in-center hemodialysis care identified in Phase 1 by ranking their top 5 topics/challenges in each of the 3 “I” categories. In Phase 3, we undertook a face-to-face priority setting workshop which followed a modified version of the James Lind Alliance priority setting workshop process. The workshop employed an iterative process incorporating small and large group sessions during which participants identified, ranked, and voted on the top challenges and innovations to hemodialysis care. Four patient partners contributed to study design, implementation, analysis, and interpretation.Results:Across the 5 participating centers, we conducted 8 focus groups and 44 interviews, in which 113 participants identified 45 distinct challenges to in-center hemodialysis care. Subsequently, completion of a national ranking survey (n = 323) of these challenges resulted in a short-list of the top 30 challenges. Finally, using small and large group sessions to develop consensus during the prioritizing workshop, 38 stakeholders used this short-list to identify the top 10 challenges to in-center hemodialysis care. These included individualization of dialysis-related education; improved information in specific topic areas (transplant status, dialysis modalities, dialysis-related complications, and other health risks); more flexibility in hemodialysis scheduling; better communication and continuity of care within the health care team; and increased availability of transportation, financial, and social support programs.Limitations:Participants were from urban centers and were predominately English-speaking. Survey response rate of 31.5% in Phase 2 may have led to selection bias. We collected limited information on social determinants of health, which could confound our results.Conclusion:Overall, the challenges we identified demonstrate that individualized care and information that improves interaction with health care providers is important to patients receiving in-center hemodialysis. In future stages of this project, we will aim to address these challenges by trialing innovative patient-centered solutions.Trial Registration:Not applicable.