Medical Education Outcomes Research Articles

Improving learning experience through implementing standardized team-based learning process in undergraduate medical education

IntroductionTeam-Based Learning (TBL) is a highly structured active learning methodology shown to have positive learning outcomes in undergraduate medical education (UME). While many medical schools have increasingly adopted TBL, there is considerable variation reported in the literature in the implementation of the standard sequence and key components of TBL. The extent to which this variation affects the benefits of TBL is not well understood. This study aims to assess the impact of implementing the standardized framework of the TBL process on student perception of the benefits of TBL.MethodsFaculty at our institute were surveyed to determine the frequency of implementation of TBL standards, as described in the literature. Second-year osteopathic medical students (OMS II) were surveyed for their perception of the experience of TBL at the beginning of the academic year. Curricular interventions targeting the enforcement of the standard steps and key components of TBL were implemented in a particular 6-week system course. The students were re-surveyed at the end of the course. Descriptive and thematic analyses were performed on quantitative and qualitative data.ResultsTwenty four of 31 (77.4%) faculty participated in the faculty survey, 53 of 105 OMS II students (50.4%) participated in the pre-intervention survey, and 72 of 104 OMS II students (69.2%) participated in the post-intervention survey. Faculty survey results indicated inconsistent implementation of key steps and components of the TBL process. Comparisons of student pre- and post-survey means of the perceived value of various aspects of TBL showed significant improvement in multiple aspects of the TBL process, including readiness assurance tests, immediate feedback, and application activities. Both before and after the intervention, students highly rated the value of teamwork and opportunities for practical application of concepts within TBL.ConclusionWhile medical students value teamwork in UME and professional development, their perception of TBL can be less than positive if not conducted deliberatively. Assessment of the implementation of the standard TBL steps and components and development of corresponding targeted interventions may improve the TBL experience of medical students. Our process could be generalized to help educators interested in improving TBL in their home institutes.

Self-Regulated Learning and Learning Outcomes in Undergraduate and Graduate Medical Education: A Meta-Analysis.

Self-regulated learning (SRL) plays a pivotal role in medical education. There is a pressing need for a meta-analytical review to comprehensively evaluate the effect sizes of SRL strategies across diverse learning outcomes and levels of medical trainees. A meta-analysis was executed by searching five databases and resulted in 61 studies that met our inclusion criteria. A three-level meta-analysis was performed to examine the association between SRL strategies and various levels of learning outcomes (i.e., affective, cognitive, and behavioral learning outcomes). Moderator analyses were conducted using meta-regression, considering factors such as types of learning outcomes, training levels, SRL subscales, and quality of the studies. The analysis yielded an average effect size of .212, using Pearson's correlation coefficient, demonstrating a positive and significant association between SRL strategies and overall learning outcomes. Although our moderator analyses indicated that SRL subscales and study quality did not significantly influence the relationship between SRL strategies and learning outcomes, SRL strategies had a more pronounced effect on affective outcomes than on test scores, behavioral outcomes, and mental health outcomes. In addition, the association between SRL strategies and learning outcomes were significantly higher among the clerkship phase of undergraduate medical education than the pre-clerkship phase.

Diversity, Equity, and Inclusion Efforts in Graduate Medical Education: Identifying Opportunities for Collaborative Learning.

Background Physician-patient racial and cultural concordance is essential to address health care disparities. Yet, limited literature on diversity, equity, and inclusion (DEI) outcomes in graduate medical education (GME) suggests the need for high-yield DEI resources. Objectives To describe and identify DEI efforts by US residency program director (PD) associations and areas for collaboration among the GME community. Methods Through bimonthly teleconferences and 5 iterative revisions from June to September 2022, the DEI workgroup of the US Organization of PD Associations developed a 17-question needs assessment survey to investigate DEI activities across residency PD associations, which was delivered twice electronically from September to November 2022 to 30 specialty PD association representatives. Results Survey response rate was 73% (22 of 30). Specialties track resident demographics more than PD demographics (11 of 22, 50% vs 7 of 22, 32%). Tracked demographics vary and include race, gender, and sexual orientation. Most PD associations have DEI committees (16 of 22, 73%) implementing various initiatives, the most common of which was providing resources to ensure diverse representation (11 of 16, 69%). Most specialties provide residency recruitment resources (14 of 22, 64%) and funding for visiting rotations or mentorship for underrepresented trainees (12 of 22, 54%). Resources for pipeline programs (7 of 22, 32%) and retention of diverse residents (7 of 22, 32%) were less common. Faculty development training focused more on teaching DEI to residents (14 of 22, 64%) than on teaching health disparities (7 of 22, 32%). Conclusions Our study demonstrates substantial DEI interventions among specialty PD associations. Yet, educational gaps exist in specific DEI content, faculty development, and curricular dissemination.

Locus of Control, Learning Styles, and Academic Achievement of Saudi Pre-professional Medical Students: A Cross-sectional Study.

The objective of this study was to describe medical students' learning styles and locus of control (LOC) and to determine their association with academic achievement. A cross-sectional study was performed at a health science university in Saudi Arabia. A sample of 158 medical students completed Kolb's learning style and locus of control scales. The authors measured academic achievement by grade point average (GPA) and collected demographic characteristics. Most students' learning styles were classified as convergent (51.3%), whereas the rest adopted divergent (23.4%), accommodative (18.4%), and assimilative (7%) styles. Analysis revealed that students with a lower LOC tend to have higher GPAs than those with a higher LOC. However, no association was found between Kolb's learning styles and LOC or GPA. The findings of this study provide educators with essential insights into factors that enhance students' academic achievements. We conclude that locus of control plays a crucial role in academic success. Medical educators should consider diverse student learning styles to adopt appropriate teaching methods that meet students' needs, ultimately improving educational practices and outcomes in medical education.

Gamification approach to addiction education for internal medicine residents

Background: People with a substance use disorder (SUD) outnumber the trained provider workforce. The Accreditation Council for Graduate Medical Education (ACGME) recognized this gap in 2022 and now requires addiction education for internal medicine (IM) residents. However, traditional lecture formats struggle to deliver education on this stigmatized condition with meaningful retention and changes in attitudes. Gamification is an evidence-based educational strategy with positive outcomes in graduate medical education, but to our knowledge, has not been used for an entire addiction curriculum. Intervention: This six session IM-focused, stigma-free, interactive curriculum used published physician competencies for content selection. Games were matched to topics based on complexity and need for skill practice. Each hourly session included 10 minutes on introduction, 45 minutes on gameplay, and 5 minutes on feedback. This addiction curriculum was incorporated into existing didactics for IM residents where participants’ comfort, psychological safety, and learning expectations were pre-established. Methods: Sixteen IM residents participated in the curriculum. Curriculum evaluation was conducted using Kirkpatrick’s four levels of evaluation. Resident feedback was obtained via online survey software at the conclusion of each session and behavior impact through an anonymous single question prompt. We used descriptive statistics and summative content analysis to evaluate findings, respectively. Results: All residents were highly satisfied with the curriculum design and use of gamification. Residents reported high levels of engagement and learning, despite use of various games. Findings support an increase in medication prescribing and utilization of harm reduction strategies following curriculum implementation. Conclusion: Gamification may be a preferred educational strategy for addiction curriculum for IM residents. We plan to distribute our curriculum widely for further evaluation in health professions’ programs.

Study preferences and exam outcomes in medical education: insights from renal physiology

BackgroundEfficient learning strategies and resource utilization are critical in medical education, especially for complex subjects like renal physiology. This is increasingly important given the rise in chronic renal diseases and the decline in nephrology fellowships. However, the correlations between study time, perceived utility of learning resources, and academic performance are not well-explored, which led to this study.MethodsA cross-sectional survey was conducted with second-year medical students at the University of Bergen, Norway, to assess their preferred learning resources and study time dedicated to renal physiology. Responses were correlated with end-of-term exam scores.ResultsThe study revealed no significant correlation between time spent studying and overall academic performance, highlighting the importance of study quality over quantity. Preferences for active learning resources, such as Team-Based Learning, interactive lessons and formative assignments, were positively correlated with better academic performance. A notable correlation was found between students’ valuation of teachers’ professional competence and their total academic scores. Conversely, perceived difficulty across the curriculum and reliance on self-found online resources in renal physiology correlated negatively with academic performance. ‘The Renal Pod’, a locally produced renal physiology podcast, was popular across grades. Interestingly, students who listened to all episodes once achieved higher exam scores compared to those who listened to only some episodes, reflecting a strategic approach to podcast use. Textbooks, while less popular, did not correlate with higher exam scores. Despite the specific focus on renal physiology, learning preferences are systematically correlated with broader academic outcomes, reflecting the interconnected nature of medical education.ConclusionThe study suggests that the quality and strategic approaches to learning significantly impact academic performance. Successful learners tend to be proactive, engaged, and strategic, valuing expert instruction and active participation. These findings support the integration of student-activating teaching methods and assignments that reward deep learning.

Uncovering the factors underlying collaboration outcomes in interprofessional education: A preliminary investigation involving healthcare students

BackgroundInterprofessional education (IPE) incorporates healthcare students from various disciplines to learn with, about, and from one another, aiming to foster effective collaboration. However, the factors that promote these collaboration outcomes remain elusive. Recognizing this knowledge gap, this study utilizes self-determination theory applied in a ten-day IPE programme. The study aims are twofold: to clarify the potential influence of personal factors (autonomy, competence, and relatedness) and environmental factors (clear goals and technology support) on collaboration outcomes (team goal achievement and team effectiveness) and to examine the effect of the IPE on these outcomes. MethodologyThe study utilized an IPE programme that integrated asynchronous and synchronous learning methods across two institutions in Hong Kong and the United Kingdom. This involved 147 students from diverse healthcare disciplines who were enrolled in the IPE programme. A pre- and post-test design was employed to examine programme effects. Multiple regression analysis was conducted to explore the factors influencing these outcomes, while paired samples t-tests were used to evaluate the effect of the IPE programme on collaboration outcomes. ResultsAmong the personal factors, a sense of relatedness emerged as an important predictor of team effectiveness and goal achievement. Clear goals and technology support positively influenced collaboration outcomes. A paired samples t-test indicated significant improvements in collaboration outcomes after the IPE simulation. ConclusionThese findings highlight the importance of designing a large IPE programme that meets basic psychological needs (especially the sense of relatedness) and provides clear goals and adequate technology support in the IPE context. This study is helpful to understand how personal and environmental factors promote the collaboration outcomes in medical education and provide insights for future IPE curriculum development.

The application of blended teaching in medical practical course of clinical skills training

BackgroundBlended teaching is an effective approach that combines online and offline teaching methods, leading to improved outcomes in medical education compared to traditional offline teaching. In this study, we examined the impact of blended teaching in clinical skills training, a medical practice course.MethodsThis study involved forty-eight undergraduate students studying clinical medicine in the fifth semester at Wuhan University of Science and Technology. The students were divided into two groups: the control group, which received traditional offline teaching, and the experimental group, which received hybrid teaching. Following the completion of the 4-month course, both groups underwent the Objective Structured Clinical Examination (OSCE) to evaluate their proficiency in clinical skills. Furthermore, the experimental group was given a separate questionnaire to gauge their feedback on the Blended Teaching approach.ResultsBased on the OSCE scores, the experimental group outperformed the control group significantly (P<0.05). The questionnaire results indicated that a majority of students (54.2%, 3.71 ± 1.06) believed that blended teaching is superior to traditional offline teaching, and a significant number of students (58.3%, 3.79 ± 1.15) expressed their willingness to adopt blended teaching in other courses. Furthermore, students in the experimental group displayed varying levels of interest in different teaching contents, with emergency medicine (79.2%), internal medicine (70.8%), and surgery (66.7%) being the most popular among them.ConclusionsThis research demonstrates for the first time that blended teaching can achieve a good pedagogical effectiveness in the medical practice course, clinical skills training and practice. Moreover, in different teaching contents, the teaching effects are different. In the content of Emergency Medicine and Surgery, which is more attractive to students, the application of blended teaching could result in a better pedagogical outcome than other contents.

Developing an entrustable professional activity for providing health education and consultation in occupational therapy and examining its validity

BackgroundEntrustable Professional Activities (EPA)-based assessment is easily and intuitively used in evaluating the learning outcomes of competency-based medical education (CBME). This study aimed to develop an EPA for occupational therapy focused on providing health education and consultation (TP-EPA3) and examine its validity.MethodsNineteen occupational therapists who had completed online training on the EQual rubric evaluation participated in this study. An expert committee identified six core EPAs for pediatric occupational therapy. TP-EPA3 was developed following the EPA template and refined through consensus meetings. The EQual rubric, a 14-item, five-point criterion-based anchor system, encompassing discrete units of work (DU), entrustable, essential, and important tasks of the profession (EEIT), and curricular role (CR), was used to evaluate the quality of TP-EPA3. Overall scores below 4.07, or scores for DU, EEIT, and CR domains below 4.17. 4.00, and 4.00, respectively, indicate the need for modifications.ResultsThe TP-EPA3 demonstrated good validity, surpassing the required cut-off score with an average overall EQual score of 4.21 (SD = 0.41). Specific domain scores for DU, EEIT, and CR were 3.90 (SD = 0.69), 4.46 (SD = 0.44), and 4.42 (SD = 0.45), respectively. Subsequent revisions clarified observation contexts, enhancing specificity and focus. Further validation of the revised TP-EPA3 and a thorough examination of its reliability and validity are needed.ConclusionThe successful validation of TP-EPA3 suggests its potential as a valid assessment tool in occupational therapy education, offering a structured approach for developing competency in providing health education and consultation. This process model for EPA development and validation can guide occupational therapists in creating tailored EPAs for diverse specialties and settings.

Is the National Medical Commission aligning with discontinuity and transitory in times of uncertainty by making the science and art of family medicine redundant?

Policy decisions shape strategies which in turn influence the outcome. The expected outcome of medical education in India is to produce an MBBS graduate of first contact. Are we able to do so or are we failing in that and what are the reasons behind our failure Is it a failure on part of the regulatory body to align with the expected outcome using a continuity of approach or a willingness to accept transitory as the process to achieve the objective?

A scoping review of Fit in medical education: a guaranteed success, or a threat to inclusivity?

Background: Finding applicants that fit in with educational environments is a goal of many educators in hopes that it will lead to successful training. “Fit” is used colloquially to describe a general feeling, however the field of study has grown to include specific terms describing the compatibility between people and their environments, organizations, and jobs. Despite common use, the term is used often but non-specifically in medical education. This review aims to examine the current literature of fit in medical education, how fit is defined, measured and whether it correlates to educational outcomes. Methods: A systematic database search was conducted in 2024 with Medline, Embase, APA PsychINFO, ERIC and Education Source from 1970 to April 23, 2024. Key search terms included fit, student, medicine, clinical, education. Relevant data included definitions of fit, measurement tools, and correlation with educational outcomes. The standard six-step scoping review framework and PRISMA-ScR reporting guidelines were used. Results: The search identified 1960 non-duplicate articles, 11 of which were included in the review after screening. Fit was specifically defined in only threearticles and was measured primarily through personality and value testing with interviews and surveys. Educational outcomes correlated positively with fit, however were studied in just three articles. Conclusions: Person-organization fit may correlate positively with medical education outcomes however there is limited research in this field. Further research should explore methods in evaluating for fit in trainee selection while focusing on the risk of discrimination based on intrinsic biases.

Enhancing Medical Education through the "Distribute, Discuss, and Develop" Method: A Comparative Study of Small-Group Discussions.

Background Small-group discussions (SGDs) are pivotal in medical education, facilitating the development of critical thinking, communication skills, and teamwork. However, traditional SGDs face challenges such as scalability and maintaining student engagement. This study aims to evaluate the "Distribute, Discuss, and Develop" (3D) method for enhancing learning outcomes in medical education. Methods A single-blinded interventional study was conducted with 125 first-year Bachelor of Medicine and Bachelor of Surgery students, who were divided into intervention and control groups through random assignment. The intervention group employed the 3D method across two thematic units: hematology and muscle nerve physiology. The study assessed learning outcomes using pre- and posttests, class-average normalized gain ("g"), and feedback questionnaires to capture student perceptions of interaction, communication enhancement, and session summarization. Results The intervention group showed significantly improved learning outcomes in both thematic units, with larger effect sizes (hematology: 1.55; muscle nerve physiology: 1.4) compared to the control group. The normalized gain "g" indicated a medium effectiveness level for the intervention group in both themes, suggesting enhanced learning. Feedback questionnaires revealed higher satisfaction levels within the intervention group regarding interaction, communication skills, and session summarization. Conclusions The 3D method addresses the challenges faced by traditional SGDs, providing a scalable and engaging approach to medical education. By fostering more effective student-centered learning, the method enhances the comprehension of complex physiological concepts and improves communication skills. The 3Dmethod significantly improves learning outcomes, interaction, and communication skills in medical education. This innovative approach to SGDs offers a promising strategy for enhancing the educational experience in medical schools, supporting the development of more articulate and professionally competent medical graduates.

Ambulatory Long Block: A Model of Precision Education and Assessment for Internal Medicine Residents.

High-quality precision education (PE) aims to enhance outcomes for learners and society by incorporating longitudinal data and analytics to shape personalized learning strategies. However, existing educational data collection methods often suffer from fragmentation, leading to gaps in understanding learner and program performance. In this article, the authors present a novel approach to PE at the University of Cincinnati, focusing on the Ambulatory Long Block, a year-long continuous ambulatory group-practice experience. Over the last 17 years, the Ambulatory Long Block has evolved into a sophisticated data collection and analysis system that integrates feedback from various stakeholders, as well as learner self-assessment, electronic health record utilization information, and clinical throughput metrics. The authors detail their approach to data prioritization, collection, analysis, visualization, and feedback, providing a practical example of PE in action. This model has been associated with improvements in both learner performance and patient care outcomes. The authors also highlight the potential for real-time data review through automation and emphasize the importance of collaboration in advancing PE. Generalizable principles include designing learning environments with continuity as a central feature, gathering both quantitative and qualitative performance data from interprofessional assessors, using this information to supplement traditional workplace-based assessments, and pairing it with self-assessments. The authors advocate for criterion referencing over normative comparisons, using user-friendly data visualizations, and employing tailored coaching strategies for individual learners. The Ambulatory Long Block model underscores the potential of PE to drive improvements in medical education and health care outcomes.

Implementation of novel team-based and flipped classroom technique to promote self-directed learning in the first MBBS students: A mixed-method approach

Background: Globalization has significantly impacted the field of medical education. Medical students need to be more competent to adapt to diverse patient populations and medical practices, understanding the cultural differences, and overcoming the language barriers. While the cognitive domain is important, it cannot fulfill the other domains of learning (affective, psychomotor). Therefore, medical education has to be enhanced to produce well-rounded health-care professionals. Integrating traditional teaching with interactive learning methods can bridge the gap between theoretical knowledge and practical application. Flipping the classroom is one such interactive teaching method that prioritizes the needs, interests, and autonomy of students. By organizing the students into small teams to solve problems and discuss cases, it additionally encourages accountability within the team, which further enhances enthusiasm and commitment to their studies. Aim and Objective: This team-based learning (TBL) in the settings of the flipped classroom (FCR) model can promote self-directed learning (SDL), critical thinking, and pursuing lifelong learning, which was the objective of the present study. Materials and Methods: The study was conducted on 200 undergraduate 1st-year MBBS students, 100 each in the study and control groups. The study group was subjected to flipped classroom (FCR) and the control group to traditional large group teaching. A pre-class assessment (pre-test) using Google Forms, including MCQ, open-ended questions, and case-based physiology, was administered to both the study and control groups of students. In the study group, the team test was conducted in the class. Both groups were subjected to a post-test to evaluate the efficacy of the flipped classroom over the traditional lecture. Qualitative feedback and a focus group interview were taken from the study groups to get the insight of the students regarding the flipped classroom. The incorporation of seminars in the study group further enriched the contents with lucidity of concepts. Results: In the comparison of the pre-test and post-test assessment scores, there was a weighty improvement after the post-FCR session among the study group. Furthermore, the comparison of the pre-test and team-test scores revealed the effectiveness of TBL among the study group students. Thus, the amalgamated approach of FCR with TBL enhances student engagement and comprehension of course material. It also boosts SDL, empowering the students to take ownership of their learning journey. Conclusion: Thus, employing a combination of teaching and learning techniques can be more promising than didactic teaching for cultivating medical students with SDL abilities, and certainly flipped classroom and TBL can improve learning outcomes in medical education, creating a more engaging and stimulating learning environment.

Development and applications of graduate outcome-based curriculum for basic medical education.

Outcome-based education (OBE) leads to revolutionary change in medical education, but each medical school is acknowledged to develop suited framework based on specific positioning, educational philosophy and expected outcomes. Based on the graduate outcomes of basic medical education in China released by Working Committee for the Accreditation of Medical Education (WCAME) which officially recognized by World Federation for Medical Education (WFME), Taizhou University re-documented the overall organization of the curriculum and classified the courses as "Crucial, Supporting and Associated (CSA)" categories to connect the graduate outcomes and course objectives. We redefined the standard for graduates in Taizhou University Medical School including 34 items in four domains and redesigned the curriculum with 76 courses classified as CSA. Empirical data reveals a substantial improvement in students' performance on Standardized Competence Test for Clinical Medicine Undergraduates in China (SCTCMU) by implementing the CSA system between 2022 and 2023. Notably, in 2023, Taizhou University's students achieved pass rates more than 20 percentage points higher than the national average, demonstrating a profound and unprecedented impact. The CSA classification system provides a notably clear and structured framework for categorizing courses based on their direct or indirect relevance to educational objectives, which provides clarity to educators and empowers students with a more purposeful approach to their studies.

How a Team Effectiveness Approach to Health Systems Science Can Illuminate Undergraduate Medical Education Outcomes.

Health care delivery requires physicians to operate in teams to successfully navigate complexity in caring for patients and communities. The importance of training physicians early in core concepts of working in teams (i.e., "teaming") has long been established. Over the past decade, however, little evidence of team effectiveness training for medical students has been available. The recent introduction of health systems science as a third pillar of medical education provides an opportunity to teach and prepare students to work in teams and achieve related core competencies across the medical education continuum and health care delivery settings. Although educators and health care system leaders have emphasized the teaching and learning of team-based care, conceptual models and evidence that inform effective teaming within all aspects of undergraduate medical education (including classroom, clinical, and community settings) are needed to advance the science regarding learning and working in teams. Anchoring teaming through the core foundational theory of team effectiveness and its operational components could catalyze the empirical study of medical student teams, uncover modifiable factors that lead to the evidence for improved student learning, and improve the link among competency-based assessments between undergraduate medical education to graduate medical education. In this article, authors articulate several implications for medical schools through 5 conceptual areas: admissions, the design and teaching of team effectiveness in health systems science curricula, the related competency-based assessments and course and program evaluations. The authors then discuss the relevance of the measurable components and intended outcomes to team effectiveness in undergraduate medical education as critical to successfully prepare students for teaming in clerkships and eventually residency and clinical practice.

Determination of the priority competencies of general practitioners (family doctors) in the Russian Federation: rationale and research protocol

The outcomes of competency-based medical education (CBME), is becoming increasingly important, especially for general practitioners (GPs). The research team of the National Medical Research Center for Therapy and Preventive Medicine, with the support of the Russian Society for the Prevention of Noncommunicable Diseases, initiated a study "Management of the quality of training of general practitioners (family doctors)", the aim of which is to determine the priority competencies of GPs (family doctors) of the Russian Federation. As the main research approach in the ascertaining experiment, the Delphi method is proposed to use. The respondents are GPs with experience in practical healthcare, general practice residents, teachers of departments of general practice.Conclusion. The planned research is of high significance for the theory and practice of professional education, in particular the training of GPs. Scientific rationale of GP qualification characteristics, which are the target component of the educational system for training GPs, will make it possible to determine the patterns of the educational process and the principles for selecting the content of educational programs, as well as methodological systems and conditions for training GPs. Ranking competencies according to their importance in professional activities by GPs (family doctors) of the Russian Federation will help determine key competencies and will make it possible to see the position of doctors in the priority of GP activities, which is directly related to assessing the healthcare quality

Assessment of professional identity formation: a transcultural validation of the professional identity essay for brazilian portuguese

IntroductionProfessional identity formation (PIF) is recognized worldwide as an outcome of medical education grounded in the psychology of adult development and the literature on medical professionalism. However, instruments to assess and support PIF are scarce. The Professional Identity Essay (PIE) is an open-ended question assessment of PIF that elicits short narrative responses from learners and that can be analyzed to provide formative feedback and an overall stage of development. In this study, our aim was to translate and adapt the PIE to Brazilian Portuguese.MethodsWe followed a systematic procedure for the translation and cross-cultural adaptation of the instrument. A pilot study was conducted with medical students from the University of São Paulo. After providing individual formative feedback, we administered an online questionnaire to the Brazilian students to better understand the consequences of using the PIE. Content analyses of qualitative data were performed, we employ manifest content analysis, and the categories of analysis emerged from the participants’ speeches.ResultsStudents found the instrument’s questions easy to interpret and self-reflective. It also gave students the opportunity to consider their PIF. The PIE was perceived as reliable and brought more awareness of the students’ own processes in addition to a sense of capability to foster their own development. In the same way, the students emphasized the importance of being helped in this process.ConclusionWe found sufficient evidence of the validity of the PIE in terms of content, face validity, and consequences of use. The PIE enhances self-assurance in PIF through formative assessment and is sensitive to different cultures, making it a potential tool for educators.

A successful intervention to improve conceptual knowledge of medical students who rely on memorization of disclosed items.

Background: The mere memorization of isolated facts without the claim of integrating them is detrimental to the desired learning outcomes in medical education. The current study was conducted within an environment where items from summative assessments are regularly disclosed by the university and consequently collected into an item bank that is shared between students. Within this environment, we aimed to quantify 1) to which extent students use disclosed items for their preparation for the summative exam, 2) a putative mismatch between (isolated factual) knowledge regarding distinct questions from the item bank and conceptual knowledge, and 3) to which extent this mismatch can be ameliorated by a project aiming to steer student learning away from the memorization of isolated facts toward the acquisition of conceptual knowledge. Methods: This steering project in the midst of the first semester consisted of the implementation of an oral exam based on selected learning objectives, preceded by two seminars. After their summative exam at the end of semester, 135 students performed a voluntary exam for study purposes. Here, authentic (i.e., presumably preknown) physiology questions taken from the item bank were used to assess students' ability to 1) recognize the correct answer in a multiple choice (MC) question, 2) recall the answer (short answer), or 3) display conceptual knowledge closely corresponding to the question presented in the other formats. Additionally, students received a questionnaire addressing their learning habits and attitudes. Results: The median reported percentage of learning time for the summative exam exclusively spent with this item bank was 80%. The results of the voluntary exam indicate that students frequently recognize and recall correct answers of included items without displaying knowledge of the underlying concept. Compared to recall of the correct answer, the probability of giving a correct answer regarding the corresponding basal physiologic concept was lower by 47 percentage points (p <0.001) for topics not included in the steering project. Regarding topics included in the steering project, this discrepancy was reduced to 25.5% (p <0.001). Conclusion: The results of this study demonstrate the influence of disclosed items on student learning and learning outcomes and suggest that a carefully implemented assessment is able to improve conceptual knowledge in physiology.

The Flipped Classroom Approach in a Pediatric Anesthesiology Fellowship Curriculum.

Background The flipped classroom approach is well documented to enhance medical education outcomes. Additionally, both the need for online learning materials and the increased demand for medical professionals during the COVID-19 pandemic has made this approach more relevant. The pediatric anesthesiology fellowship curriculum at one institution transitioned from a traditional classroom model to a flipped classroom approach to optimize the educational experience and support learner well-being. Approach Utilizing the American Board of Anesthesiology(ABA)and Accreditation Council for Graduate Medical Education(ACGME) content outlines, a novel, comprehensive curriculum was developed focusing on core clinical material and board review with the goal of providing structured learning while alleviating the burden of completing board review independently to improve work-life balance and reduce the potential for burnout. Evaluation Graduates of the program from 2017 to 2021 evaluated the flipped classroom structure and its perceived impact on their educational outcomes, wellness, and career development via a one-time, voluntary survey. Results indicated improved participation rates and educational benefits with the flipped classroom structure compared to the traditional structure. Fellowspreferred the flipped classroom approach to the traditional lecture approach (72.2% vs. 27%), and they preferred custom-made prework material to traditional textbooks and articles. Fellows benefited from having more time for personal activities and other scholarly work, as evidenced by open-ended responses. Implications The flipped classroom structure was perceived as beneficial by pediatric anesthesiology fellows because of increased educational engagement, alleviation of academic burden, and improved wellness due to more time for non-academic activities. Further study is needed to optimize and correlate the new curriculum with objective educational outcomes.