Performance In Medical Education Research Articles

Medical Educator Perceptions of Faculty Effort and Intent to Stay in Academic Medicine.

Core roles of medical school faculty are increasingly diverse, substantial, and evolving. In alignment with this dynamic nature of medical education, faculty effort should be accurately appraised, constantly evaluated, and rewarded to ensure faculty satisfaction and promote a culture of belonging. The study goal was to examine the imbalance in official assignments and perceptions of medical school faculty effort in various educator domains. An 80-item survey was designed to collect quantitative and qualitative measures of faculty perceptions of effort. Survey questions collected data on faculty demographics, intent to stay, and perceptions of effort in the following educator domains: teaching, educational leadership and administration, research and scholarship, and service. A mixed methods approach was utilized in data analysis. Eighty-eight complete survey responses were collected between February and May of 2022 from respondents from 27 states. There was a significant disparity between assigned and perceived effort in the educator domains of teaching, research, and service (P < 0.01). Faculty satisfaction with percent effort dedicated to teaching significantly correlated with intent to stay (P < 0.05). Satisfaction with workload assignments was higher with advanced academic rank and male gender. Qualitative analysis identified many key themes in the categories of promotion, workload, resources, and retention. Our study revealed that satisfaction with workload directly correlates with intent to stay, and principles of equitable workload distribution are violated from the perspective of the medical educator. This data provides critical information that can be used to assist medical schools in developing metrics to evaluate faculty performance in medical education and improve retention in academic medicine.

IJCM_164A: Association between Sleep Quality and Short-Term memory among medical students in mangalore

Background: Sleep plays a crucial role in maintaining cognitive functions, including memory, which is essential for academic performance. However, there is limited research exploring the relationship between sleep quality and short-term memory among medical students. Methodology: Fourth-semester MBBS students from Kasturba Medical College, Mangalore, were selected using non- random convenience sampling. A total of 195 students participated, completing a standardized sleep quality assessment (Pittsburgh Sleep Quality Index) and a semi-structured self-administered questionnaire-based short-term memory test. Data were analyzed using SPSS version 16, with correlation tested using Karl Pearson’s Coefficient of Correlation Test. Results: The majority (56.4%) of participants exhibited good sleep quality, with 69.1% of these achieving high scores in short-term memory assessment tasks. A negative correlation (r = -0.450, p &lt; 0.001) was found between sleep quality and short-term memory scores. Students with good sleep quality were more likely to have higher short-term memory scores compared to those with poor sleep quality. Conclusion: The study suggests that good sleep quality is associated with better short-term memory performance among medical students. These findings underscore the importance of promoting good sleep habits to enhance cognitive function and academic performance in medical education.

TYPES OF ITEM WRITING FLAWS IN MULTIPLE CHOICE QUESTIONS IN MEDICAL EDUCATION AND THEIR EFFECT ON PASSING RATE OF STUDENTS

Background: The most popular written exam in health professions education is the multiple-choice style question (MCQ). This study sought to understand the effects of multiple-choice writing errors on students' academic performance in medical education. Methods: This descriptive study was done from December 2017 to June 2019 in Azad Jammu Kashmir (AJK) Medical College, Muzaffarabad. Ten block examinations were included. The item review committee reviewed all MCQs for flaws. Two tests from each class of MBBS were taken. The original tests containing all items were labeled as flawed tests and the result of each flawed test was evaluated. The students were graded into high, moderate and low achievement groups with scores of more than 79.9, between 50–79.9 and less than 50 percent respectively. Flawed items were then removed from the tests by the review committee and the scores of each test (standard test) were determined and compared with flawed tests and its effects were assessed in three achieving groups of students. Optical mark reading (OMR) classic-4 software was used for post-exam analysis and data were analyzed by using SPSS-25. Results: The passing rate ranged from 68.18% to 90.82% in flawed and 75.54% to 93.69% in standard tests. Most standard tests (7) had higher passing rates than flawed tests. Conclusion: Tests containing in-house developed MCQs have frequent item writing flaws and their inclusion in assessment did affect the passing rates of students but were not statistically significant. Pak J Physiol 2023;19(4):49–52

An Explorative Review of the Constructs, Metrics, Models, and Methods for Evaluating e-Learning Performance in Medical Education

The performance evaluation of e-learning in medical education has been the subject of much research lately. Researchers are yet to achieve a consensus on the definition of performance or the suitable constructs, metrics, models, and methods to help understand student performance. Through a systematic review, this study put forward a working definition of what constitutes performance evaluation to reduce the ambiguity, arbitrariness, and multiplicity surrounding performance evaluation of e-learning in medical education. A systematic review of published articles on performance evaluation of e-learning in medical education was performed on the SCOPUS, Web of Science, PubMed, and EBSCOHost databases using search terms deduced from the PICOS model. Following the PRISMA guidelines relevant published papers were searched and exported to Endnote. Screening and quality appraisal were done on Rayyan. Three thousand four hundred and thirty-nine published studies were retrieved and screened using predetermined inclusion and exclusion criteria. One hundred and three studies passed all the criteria and were reviewed. The reviewed literature used 30 constructs to operationalize performance. The leading constructs are knowledge and effectiveness. Both constructs were used by 60% of the authors of the reviewed literature to define student performance. Knowledge gain, satisfaction, and learning outcome are the most common metrics used by 81%, 26%, and 15% of the reviewed literature to measure student performance. The study discovered that most researchers forget to evaluate the “e” or electronic component of e-learning when evaluating performance. The constructs operationalized and metrics measured were primarily focused on learning outcomes with minimal focus on technology-related metrics or the influence of the electronic mode of delivery on the learning process or evaluation outcome. Only 6% of the reviewed literature applied evaluation models to guide their evaluation process - mostly the Kirkpatrick evaluation model. Also, most of the included studies used randomization as an experimental control method, mainly using pre-and post-test surveys. Modern evaluation methods were rarely used. Only 1% of the reviewed literature used Google Analytics, and 2% used data from a learning management system. This study increments the existing body of knowledge in performance evaluation of e-learning in medical education by providing a convergence of constructs, metrics, models, and methods and proposing a roadmap to guide students’ performance evaluation process from the synthesis of findings and the gaps identified through the systematic review of existing literature in the domain. This roadmap will assist in informing researchers of grey areas to consider when evaluating performance to ensure more quality research outputs in the domain.

Understanding Academic Self-Concept and Performance in Medical Education.

Medical students' academic self-concept (ASC) is an important factor in better understanding noncognitive mediators of performance in medical school. However, research is limited on ASC in medical students across multiple phases of undergraduate medical education curriculum. This pilot study explored the relationship between ASC and academic performance across different phases of a U.S. medical school curriculum, specifically at the end of the second (preclinical) and third (clinical) years. Medical students across 2 cohorts at Virginia Commonwealth University School of Medicine, Richmond, Virginia, were surveyed using an ASC confidence subscale in 2019. Multiple linear regression analysis was conducted using medical student ASC scores in preclinical (n = 190) and clinical (n = 149) phases and performance data. Clinical performance was calculated through a weighted mean of clerkship grades based on the number of weeks for each clerkship. Preclinical performance was related to ASC, gender, and performance after year 1. ASC scores varied significantly by gender in the preclinical cohort ( P < .01), with men reporting higher ASC than women (mean [SD], 2.94 [0.41] vs 2.78 [0.38]). Significant gender differences in performance were found at the end of year 3 ( P < .01), with women performing more favorably compared with men (mean [SD], 94.1 [59.04] vs 124.24 [64.54]). The relationship between ASC and performance at the end of year 2 suggested students with higher ASC perform better during their preclinical phase. This pilot study supports future scholarship in 2 areas: (1) identification and assessment of additional factors that influence the relationship between ASC and academic performance across the entire undergraduate medical education curriculum and (2) development and implementation of evidence-based interventions to support student ASC and performance and enhance the learning environment. Analyzing longitudinal trends across multiple cohorts will drive evidence-based interventions at learner and programmatic levels.

Relationship between selection criteria and trainee performance in medical specialty training: A retrospective longitudinal study

Investigation of tools used for candidate selection as predictors of future performance in medical education has been primarily undertaken within the undergraduate setting, but little is known about the selection to medical specialist programs. This retrospective longitudinal study aims to explore correlations between selection tools and the performance of trainees enrolled in the Australasian College of Dermatologists (ACD), the accredited specialist medical college for training in dermatology in Australia. Data were collected from consecutive cohorts of ACD trainees commencing from 2007 to 2015. Predictive variables were trainee demographics and selection tools (prior academic qualification; research experience; clinical experience; curriculum vitae [CV] rating; interview scores). The outcome variables were exam performance. First Year ([Pharmacology and Clinical Sciences] and Fellowship Exam [Written, Clinical, and Overall Score]). Statistical analyses included: descriptive statistics summaries; bivariate correlation of selection criteria and demographic data with exam performance; and linear regression analysis to identify predictors of exam performance. Demographic analysis (N= 172) showed that 64% of trainees were female, the average age was 30.5 years (± 3.47) and trainees living in high socioeconomic status (SES) areas were over-represented. Using Pearson correlation analysis, interview scores were significantly positively correlated with First Year Pharmacology results (p= 0.018), Fellowship Written results (p= 0.002), and Fellowship Overall Scores (p= 0.006). First Year Pharmacology Exam performance was most highly correlated with Fellowship Exam performance (p= 0.000). No association was identified between exam performance and gender, SES, prior academic qualification, research experience or CV rating. Linear regression analysis showed that interview score (p= 0.012), entry age (p= 0.026) and First Year Pharmacology score (p= 0.002) were predictors of Fellowship exam performance. These results suggest that the comprehensive selection tools used by ACD are effective, with interviews being a highly valid tool linked to exam performance. These findings have important practical implications for assessing the selection process in specialist dermatology training.

Academic Performance in Medical Education During the COVID-19 Pandemic: A Scoping Review.

Several academic performance studies during the COVID-19 pandemic on education outside medicine showed varying results. This scoping review aims to identify research trends in medical education that focus on the academic performance of medical students during the COVID-19 pandemic to enable available research to be mapped and summarized, and gaps in research results can be identified. The authors applied the Arksey and O'Malley framework to conduct the scoping review. This review was conducted from January to 30 May 2022. Comprehensive article searches were conducted on six databases (PubMed, ProQuest, EBSCOhost, ERIC, Science Direct, Google Scholar) using keywords of COVID-19, academic performance, academic achievement, medical education, and medical students. A literature search identified 24 publications eligible for analysis. The cohort is the most chosen research design. The publications were only taken from three continents; those were from Asia, America, and Europe. Most of the publications came from the Asian continent, and most of the participants involved in the studies were undergraduates. Eleven out of 24 publications reported on the impact of research before and during the COVID-19 pandemic on academic performance. Six out of 11 studies showed differences in results. Three studies indicated that students achieved lower grades during the COVID-19 pandemic. In contrast, three other studies reported that students got higher grades during the COVID-19 pandemic. Twenty studies reported the influencing factors of the academic performance. The literatures reported differences in medical students' academic performance before and during the COVID-19 pandemic. Twelve variables affected medical students' academic performance during the COVID-19 pandemic.

A Response to "The Impact of Educational Resources and Perceived Preparedness on Medical Education Performance" - a Medical Student Perspective.

A Response to "The Impact of Educational Resources and Perceived Preparedness on Medical Education Performance" - a Medical Student Perspective.

The Impact of Educational Resources and Perceived Preparedness on Medical Education Performance

IntroductionUndergraduate medical education has evolved necessarily with the increasing utilization of technology and the availability of ancillary resources developed for medical students. However, medical educational resources are expensive and there have been few studies validating these resources for their ability to significantly modify student exam performance.MethodsA post-exam survey was devised to evaluate medical students for resource usage, student-perceived preparedness, and exam performance.ResultsStudents who felt more prepared for exams performed better than students who felt less prepared (p = .017). Students who watched didactic lectures online and those who utilized peer-to-peer tutoring outperformed students who did not use these resources (p = .035, p = .008). Analyses of the data show that none of the purchased resources utilized significantly improved student exam performance. The majority of students used between six and eight resources for exam preparation. There may be a slightly negative association with the quantity of resources used and exam scores (p = .18).DiscussionContrary to traditional confidence studies that correlate overconfidence with underperformance, medical students who reported feeling more prepared for exams performed better than students who felt less prepared.ConclusionMedical students may have a more complete grasp of their knowledge base and deficits, which may enable a more accurate match between exam expectations and academic performance. This post-exam survey method can be customized and applied to evaluate resource utility as it pertains to specific undergraduate medical education curricula at individual institutions.

The Use of Personality Assessment in Mentoring and to Aid in Self-reflection in Orthopaedic Surgery Residency Programs.

Personality plays an important role in performance in medical education and mentorship. Personality assessment can aid in the ability to identify strengths and areas for development by understanding how one's personality influences their learning and interpersonal relationships. We sought to evaluate personality assessment as an effective tool in mentoring during orthopaedic residency in this prospective, cross-sectional study from two orthopaedic surgery residency programs using the Hogan Personality Inventory (HPI). Participants completed a survey regarding their experience with the assessment. Descriptive statistics were calculated, and two-sample t-tests were used to examine differences between groups. In total, thirty-four individuals completed the survey. Our results showed 82.4% reported that the HPI very accurately represented them and 58.8% reported better understanding potentially perceived strengths and weaknesses. In total, 75.7% and 72.7% were satisfied with their mentorship about development as a clinician and researcher, respectively. Significant differences were seen between participants who did and did not re-review their results, and participants who did and did-not believe their results profile was accurate. We conclude that personality assessments can be valuable in promoting introspection and strengthening relationships within orthopaedic surgery, particularly when they are valued and emphasized by the user. Our results suggest that use of the HPI provided participants with a better understanding of their perceived strengths and weaknesses as they progress through their orthopaedic residency training.

Analyzing the attitude of medical students toward class absenteeism

Background: Class attendance is very important to improve academic performance in medical education. National Medical Commission has made it mandatory to have 75% attendance to appear in the university examination. Classroom teaching is necessary to develop competence in cognitive, affective, and psychomotor domains. The purpose of the present study was to analyze the causes of absenteeism in medical education. Methodology: This descriptive, cross-sectional study was conducted from phase 1 to phase III MBBS students of Government Medical College Srinagar, J and K, India. The response was collected through a structured, pretested, and prevalidated questionnaire. The attitude of medical students towards class absenteeism was obtained using the Likert scale. The response was analyzed using SPSS 22 software. Results: The results showed that major reasons for student absenteeism were poor teaching skills of teachers (mean 3.85), students studying through Self directed learning (SDL) (mean 3.75), unfavorable learning environment (mean 3.43), lack of sleep (mean 3.28), distraction due to concentration problems (mean 3.26) not interested with that subject (mean 3.09), ill-health (mean 2.57), traffic jams (mean 2.53), social media (mean 2.45), climatic conditions (mean 2.37), availability of online resources (mean 2.84), too much self-confidence (mean 2.61), lectures, not enough informative (mean 2.49), family issues (mean 2.01). Conclusion: The causes of student absenteeism are varied. Teachers have to be friendly and cooperative so that students can overcome their inhibitions and weaknesses. Constructive feedback and mentoring programs should be part of the curriculum.

Medical Education's Wicked Problem: Achieving Equity in Assessment for Medical Learners.

Despite a lack of intent to discriminate, physicians educated in U.S. medical schools and residency programs often take actions that systematically disadvantage minority patients. The approach to assessment of learner performance in medical education can similarly disadvantage minority learners. The adoption of holistic admissions strategies to increase the diversity of medical training programs has not been accompanied by increases in diversity in honor societies, selective residency programs, medical specialties, and medical school faculty. These observations prompt justified concerns about structural and interpersonal bias in assessment. This manuscript characterizes equity in assessment as a "wicked problem" with inherent conflicts, uncertainty, dynamic tensions, and susceptibility to contextual influences. The authors review the underlying individual and structural causes of inequity in assessment. Using an organizational model, they propose strategies to achieve equity in assessment and drive institutional and systemic improvement based on clearly articulated principles. This model addresses the culture, systems, and assessment tools necessary to achieve equitable results that reflect stated principles. Three components of equity in assessment that can be measured and evaluated to confirm success include intrinsic equity (selection and design of assessment tools), contextual equity (the learning environment in which assessment occurs), and instrumental equity (uses of assessment data for learner advancement and selection and program evaluation). A research agenda to address these challenges and controversies and demonstrate reduction in bias and discrimination in medical education is presented.

Supporting the balance between well-being and performance in medical education.

The author reflects on how clinician teachers can support the balance between well‐being and performance for trainees as stress‐related threats to performance can hamper patient care quality.

Association between class attendance and internal assessment marks in anatomy

Association between class attendance and internal assessment marks in anatomy - IJCAP- Print ISSN No: - 2394-2118 Online ISSN No:- 2394-2126 Article DOI No:- 10.18231/2394-2126.2019.0009, Indian Journal of Clinical Anatomy and Physiology-Indian J Clin Anat Physiol

Pedagogical mediation using the virtual learning environment and the new generation: A search for improved performance in medical education.

Medical schools face increasing challenges to accommodate new health care needs. However, little has changed regarding the students' education. In addition, educators face the challenge of improving their teaching approach, making it suitable and effective for the new generation. The purpose of this work was to describe and contextualize the application of active pedagogical methodologies using the virtual learning environment (VLE) as a tool to improve the students' performance. This research is a quantitative and qualitative case study, carried out in one faculty of medicine in the state of Amazonas. Given a total population of senior students in this faculty, the number of participants corresponds to a proportion of 75% in the period of two years. This work required a paradigm shift, by focusing on interactive and technological teaching, professionalism, mentoring, communication, and feedback. Courses using virtual learning environment (VLE) should be prone to interaction, dialogue, collaboration and, asynchronously, autonomy. One of the key aspects of VLE content production is to select appropriate subject matters and texts to be discussed. It is through the VLE contents that the mediation of knowledge construction process and the participants' interaction takes place. The improvement over the pre-test evaluation was evident, ranging between 12.59 and 50.9%, depending on the subject matter, to 81.31% in the final evaluation. In addition, the students expressed consistently positive opinions regarding the use of VLE. The use of VLE as a pedagogical tool, in an interactive format and appropriate to the transmission of information and knowledge construction, was adequate for an evident improvement in the cognitive performance of the senior students of medicine. In addition, the positive evaluation of the students regarding the pedagogical methodology used constitutes an added value of this approach.

Does the Flipped Classroom improve exam performance in medical education? A systematic review.

This article was migrated. The article was marked as recommended. Background: The 'flipped classroom' (FC) is a blended learning model in which educational material is delivered on-line prior to class, students then apply this knowledge through discussion and problem solving activities in class. Its effectiveness in medical education is debated. The aim of this systematic review is to assess the outcomes of studies which have compared the exam performance of traditional didactic teaching (DT) to the FC in medical education. Methods: A broad based literature search was performed in accordance with PRISMA protocol. MESH terms were 'flipped classroom', 'flipped teaching', 'blended learning' and 'medical education'. The outcomes of interest were test score results following FC compared to DT methods. Results: Eleven studies with a total of 2052 study participants were included in the review. Four studies demonstrated a significant improvement in test scores using FC compared to DT; four showed no significant difference and three demonstrated mixed results. Discussion and Conclusions: The results of this review are equivocal. Study heterogeneity in design, participants and subject covered may account for some of this disparity. Two studies provide evidence that the FC results in improved performance on higher cognitive tasks however further robust, in depth studies are required to demonstrate this conclusively.

Self-regulated learning and academic performance in medical education

Content: Medical schools aim to graduate medical doctors who are able to self-regulate their learning. It is therefore important to investigate whether medical students’ self-regulated learning skills change during medical school. In addition, since these skills are expected to be helpful to learn more effectively, it is of interest to investigate whether these skills are related to academic performance.Methods: In a cross-sectional design, the Self-Regulation of Learning Self-Report Scale (SRL-SRS) was used to investigate the change in students’ self-regulated learning skills. First and third-year students (N = 949, 81.7%) SRL-SRS scores were compared with ANOVA. The relation with academic performance was investigated with multinomial regression analysis.Results: Only one of the six skills, reflection, significantly, but positively, changed during medical school. In addition, a small, but positive relation of monitoring, reflection, and effort with first-year GPA was found, while only effort was related to third-year GPA.Conclusions: The change in self-regulated learning skills is minor as only the level of reflection differs between the first and third year. In addition, the relation between self-regulated learning skills and academic performance is limited. Medical schools are therefore encouraged to re-examine the curriculum and methods they use to enhance their students’ self-regulated learning skills. Future research is required to understand the limited impact on performance.

Comprehensive Assessment of Teaching Performance in Medical Education

Assessing teaching performance is important for students’ learning. ObjectiveAssess teaching performance in a medical school, using three strategies. Method288 Teachers were studied. The three assessment strategies were: students’ academic achievement measured with validated exams, teachers’ evaluation by students’ opinion (2,656 students) with a validated instrument, and a self-assessment tool. ResultsThere were significant differences (p≤0.001, ANOVA) among the three assessment strategies. Four different teacher categories were obtained using students’ opinion. ConclusionWe identified high- performance teachers, those requiring faculty development and those who do not fulfill appropriately their teaching responsibilities.

Narrative descriptions should replace grades and numerical ratings for clinical performance in medical education in the United States

Background: In medical education, evaluation of clinical performance is based almost universally on rating scales for defined aspects of performance and scores on examinations and checklists. Unfortunately, scores and grades do not capture progress and competence among learners in the complex tasks and roles required to practice medicine. While the literature suggests serious problems with the validity and reliability of ratings of clinical performance based on numerical scores, the critical issue is not that judgments about what is observed vary from rater to rater but that these judgments are lost when translated into numbers on a scale. As the Next Accreditation System of the Accreditation Council on Graduate Medical Education (ACGME) takes effect, medical educators have an opportunity to create new processes of evaluation to document and facilitate progress of medical learners in the required areas of competence.Proposal and initial experience: Narrative descriptions of learner performance in the clinical environment, gathered using a framework for observation that builds a shared understanding of competence among the faculty, promise to provide meaningful qualitative data closely linked to the work of physicians. With descriptions grouped in categories and matched to milestones, core faculty can place each learner along the milestones' continua of progress. This provides the foundation for meaningful feedback to facilitate the progress of each learner as well as documentation of progress toward competence.Implications: This narrative evaluation system addresses educational needs as well as the goals of the Next Accreditation System for explicitly documented progress. Educators at other levels of education and in other professions experience similar needs for authentic assessment and, with meaningful frameworks that describe roles and tasks, may also find useful a system built on descriptions of learner performance in actual work settings.Conclusions: We must place medical learning and assessment in the contexts and domains in which learners do clinical work. The approach proposed here for gathering qualitative performance data in different contexts and domains is one step along the road to moving learners toward competence and mastery.

The use of mind maps as support in medical education

During their undergraduate years, medical students are exposed to a large amount of information. In this context, students often become passive recipients of information. In recent years there have been a growing number of publications on learning strategies used in medical education, which can help students to learn and integrate information. This situation requires a change in the role of teachers and their methods: they will be less responsible for the content and will be increasingly involved in the guidance of research and knowledge discovery processes. In this scenario, the possibility arises of using a graphical technique called Mind Maps, systematized by Tony Buzan, in the process of knowledge representation. It is a visual technique where information and knowledge are converted to a hierarchical, formatted and illustrated diagram, with structural key terms associated with a subject. This paper aims to describe the main characteristics of mind maps and show how students and teachers can use it in teaching and learning processes, contributing to better quality and performance in medical education.