Автор неизвестен - Mededworld and amee 2013 conference connect - страница 34

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Mohammed Saqr (Qassim University - College of Medicine, Medicine, Melida, Saudi Arabia) Habiba Kamal (Qassim University - College of Medicine, Clinical Skills, Melida, Saudi Arabia)

Background: Learning analytics is a new and emerging area of research that aims at measurement and analysis of data about learners and their contexts, for purposes of understanding and optimizing the learning and the environments in which it occurs. Summary of work: We used data of 143 students in Principles of Disease course, Qassim College of Medicine. Data recoded were page hits; forum posts and reads, logins, session times, and online formative assessments. Daily, weekly and total students' data were monitored and analyzed. An algorithm for every parameter was proposed and calculated and a collective algorithm. The efficacy of individual e-learning components on positive students' outcome was statistically analyzed by correlation coefficient and multiple regression analysis.

Summary of results: There was a positive correlation between e-learning usage and students' final outcome. Online formative assessment algorithm, logins algorithm, time algorithm and total hits were also positively correlated with students' outcome. There was

a positive correlation between final assessments components OSPE, MCQs, SEQ, MEQs with the logins, online assessments, and time algorithm, but not with the forums. Using regression analysis; Outcome was positively associated with the e-learning algorithm however, the association was weak. Conclusions: Our data show clearly that e-learning has a positive impact on students' final outcome. The important parameters are the students' frequency of using online course and time he spends online. The correlation was not strong because in blended learning there are other factors contributing to the students' final outcome.

Take-home messages: Learning analytics should be used for understanding course usage and optimizing delivery.

3DD/11

16 years later... still 'trying not to teach'? Follow-up interviews with tutors about facilitating medical students' active learning

Gillian Maudsley (The University of Liverpool, Department of Public Health & Policy, Whelan Building (Quadrangle), Liverpool L69 3GB, United Kingdom)

Background: The Tomorrow's Doctors (2009) learning outcomes for 'the doctor as a professional' continued to encourage better ways for learning, tolerating uncertainty, and reflective practice. Following the problem-based transformation of the Liverpool MBChB curriculum in 1996, interviews with the first-ever cohort of problem-based learning facilitators (n=34) revealed their generally positive approach to that major change in educational philosophy. They were concerned though at their own fallibility about intervening without 'teaching'. Facilitating active learning (focused on: clinically relevant, integrated knowledge and tolerating uncertainty) has remained a worthy yet formidable goal, but how do the remaining tutors from that original cohort view this now?

Summary of work: Aim: To follow up and explore staff reflections about their long-term role in facilitating medical students' active learning. Setting: Liverpool MBChB curriculum. Participants: The 10 first-ever problem-based learning facilitators remaining actively involved to-date. Method: Inductive analysis (within the pragmatism paradigm) for themes from semi-structured interviews (a 16-year follow-up). Summary of results: The facilitators reveal how their own personal epistemology developed and met challenges (reflecting on their own descriptions and concerns from their original interviews). Conclusions: Long-term commitment to 'trying not to teach' raises crucial issues about facilitators' own personal epistemology.

Take-home messages: Reflective follow-up gives valuable insights about the vicissitudes of 'trying not to teach'.

ABSTRACT BOOK: SESSION 3 MONDAY 26 AUGUST: 1045-1230

3DD/12

The development of a quantifiable PBL model and its comparison to traditional PBL and didactic lecture

Xun Yao (West China School of Medicine, Sichuan University, Department of Academic Affairs, 37 Guo Xuexiang Chengdu 610041, People's Republic of China) Hai Hu (West China Hospital, Sichuan University, Department of Emergency Medicine, Chengdu, People's Republic of China)

Ping Qing (West China School of Medicine, Sichuan University, Department of Academic Affairs, Chengdu, People's Republic of China)

Background: Group-Problem-Solving-Simulation series developed by HumanSynergistics are often used and highly regarded for team-building and business-skill development in business schools. Such simulations require participants to rank a list of items or activities according to some objective (eg. surviving) and compare quantitatively their individual and team solutions to an expert one, which gives students an opportunity to learn about their personal influence style and their effectiveness as a team member. We used their survival series for PBL team-building since 2008 and got overwhelmingly positive responses from students. But because of its non-medical nature, limited amount of cases and without learning step, it can't improve medical knowledge and skills and students are losing interests because they can easily get answers from seniors.

Summary of work: We developed some medical cases in similar style and formed a new PBL model with some modifications. 87 undergraduate students (11 groups) were enrolled to experience didactic lectures, traditional PBL and the new PBL in the same semester. A Likert scale with 9 aspects was used to collect the students' perceptions towards the three models. Multivariate-dependent-variable analysis and Student-Newman-Keuls (SNK) test was used to determine the differences among and between the models and groups. Summary of results: The new model was ranked more effective than the traditional PBL and lecture in Knowledge-Retention, Knowledge-Applying and Learning-Interests. There're no differences between the new and traditional PBL in Learning-Difficulty, Motivation in searching and information management, Understanding Teamwork, Clinical Reasoning, Communicating and Educating, but both of which were ranked better than that of lecture except Learning-Difficulty. Post-hoc tests of homogeneous subsets showed less variability among PBL groups. Conclusions: The New PBL Model seems great but more samples are needed to confirm the findings.

3DD/13

The correct diagnosis and diagnostic reasoning strategies of PBL students and its change with time

Kuo-Inn Tsou (Kuo-Inn Tsou, (1)Fu Jen Catholic University, (2)Catholic Tien Hospital, (1)College of Medicine, (2)Department of Pediatrics, 510 Chung Cheng Rd., No 708-16, 13 Fl, Chung Cheng Rd., New Taipei City, Hsin-Chuang District 24205, Taiwan) Kuo-Cheng Lu ((1)Fu Jen Catholic University, (2)Catholic Tien Hospital, (1)College of Medicine, (2)Department of Internal Medicine, New Taipei City, Taiwan) Lai-King Young (Catholic Tien Hospital, Department of Internal Medicine, New Taipei City, Taiwan) Bing-Si Lin (Shin Kong Wu Ho-Su Memorial Hospital, Department of Nephrology, New Taipei City, Taiwan) Yu-Wei Fang (Shin Kong Wu Ho-Su Memorial Hospital, Department of Nephrology, New Taipei City, Taiwan) Pei Dee ((1)Fu Jen Catholic University, (2)Catholic Tien Hospital, (1)College of Medicine, (2)Department of Internal Medicine, New Taipei City, Taiwan)

Background: Problem-solving strategies are highly dependent on the availability of organized, interrelated, relevant knowledge. Different curriculum design may influence students' diagnostic accuracy and diagnostic reasoning strategy (DRS).

Summary of work: 8 nephrology clinical vignettes (CV) of different complexity and difficulty from 4 clinical presentations (CPs) were developed. 14 3rd-year and 13 5th-year medical students, from a 7-year program and taught through a near-full PBL curriculum in the third and fourth years, joined this study. Participants were asked to solve the problem in each CV before, right after and 6 weeks after they finished the nephrology block (3rd year) or the nephrology clinical rotation (5th year). They were instructed to speak out his or her thinking as much as possible after reading each case. Summary of results: Overall correct diagnosis for the 3rd year increased right after the course and then declined 6 weeks later, this change was less obvious for the 5th year student. For both cohorts, the diagnostic accuracy was related to CP and degree of case difficulty. Hypothetical-deductive reasoning was not the predominant DRS used. Those PBL students tended to use basic science knowledge to explain patient's problem or abnormal laboratory data and could reason out the underlying etiology or diagnosis sometimes. They also tended to jump into a diagnosis just based on several clinical cues.

Conclusions: PBL students tend to use physiologic knowledge to explain patient's problems, to grasp part of the cues to intuitively make a single diagnosis, and backward-directed hypothetico-deductive mode of reasoning is not the predominant one. Take-home messages: Need to strengthen the way of learning concepts to improve students' diagnostic accuracy and the strategy used to solve patients' problems.

3DD/14

Using the "New" PBL to Introduce Students to Evidence-Based Medicine

Megan McNamara (Case Western Reserve University, Medicine, 10900 Euclid Avenue, Cleveland 44106, United

States)

James Bruzik (Case Western Reserve University,

Genetics, Cleveland, United States)

Theresa Wolpaw (Penn State College of Medicine,

Medicine, Hershey, United States)

Amy Wilson-Delfosse (Case Western Reserve University,

Cleveland, United States)

Background: Practitioners of Evidence-Based Medicine (EBM) use current best evidence to inform their patient care decisions. Journal clubs or structured lectures, focusing solely on teaching critical appraisal skills in the absence of a clinical context, may be less effective for teaching students principles of EBM. Summary of work: The "5 A's" of EBM practice (Assess, Ask, Aquire, Appraise, Apply) were introduced to our first year medical students for use in their Case Inquiry Program (the "new" PBL). Each week, a student EBM leader was designated and assigned the task of developing a question related to the case, searching the literature for an article of interest, critically appraising the identified article, and briefly presenting findings to the group. The presentations occurred during "resolution" of the case, with the discussant specifically stating how the evidence should influence decisions about the "paper" patient's care. Summary of results: EBM was successfully integrated into the Case Inquiry Program. Fifty percent of students reported that incorporation of the EBM program did a "good" or "excellent" job of improving their critical appraisal skills and the majority indicated that it enhanced their understanding of the patient within the case.

Conclusions: We have developed a novel and successful approach to teaching EBM to medical students using a small-group patient-focused format. Take-home messages: Early integration of EBM skills into a PBL curriculum is well-received by students and enhances the small group experience.

3DD/15

The Use of PBL to underpin veterinary basic sciences training - the Adelaide Experience

Gail I Anderson (Ross University, School of Veterinary Medicine, West Farm, Basseterre, Saint Kitts and Nevis) Samantha Franklin (University of Adelaide, School of Animal and Veterinary Sciences, Physiology, Roseworthy, Adelaide, Australia)

Frederick Chew (Australian National University, College of Music, Canberra, Australia) Natasha Speight (University of Adelaide, School of Animal and Veterinary Sciences - Anatomy, Roseworthy, Adelaide, Australia)

Background: The recently established University of Adelaide Veterinary School adopted a blended curriculum after community consultation to decide the model of curriculum delivery. The aim was to enhance student engagement with basic science content in the BSc component of the combined BSc/DVM degree program by underpinning this content with clinical cases presented in PBL format. The School also wanted to engender team-based learning, promote independent study and enhance earlier confidence with clinical terminology use.

Summary of work: Initially, there was one facilitator per PBL group of eight students. However over the first four years of the program, faculty availability dictated a shift to one facilitator per three groups of eight students each and three weekly sessions to complete the case. PBL sessions used paper-based cases to underpin the systems-based integrated anatomy and physiology subjects. In year three of the BSc, infectious disease case material was introduced along with the systems-based anatomy and physiology. Both individual testing and group MCQ assessments were performed at the end of each case and student evaluations (SELTS) each semester.

Summary of results: Non-traditional PBL use was successful in engaging students in their basic science content (high SELTS), illustrated the value of teams (higher team MCQ scores relative to individual scores) and encouraged team learning and confidence in the use of clinical terminology by preclinical students. Take-home messages: Non-traditional use of PBL was successful in engaging students in their basic science content, encouraging confidence in the use of clinical terminology prior to students entering their clinical years and highlighting the value of teams.

3DD/16

Training of Scientific Methods for First Year Medical Students: First Experiences with a Problem-based Curriculum at the Freiburg University Medical Center

Martin Boeker (University Medical Center Freiburg, Institute of Medical Biometry and Medical Informatics, Stefan-Meier-Str. 26, Freiburg 79104, Germany) Silke Biller (University of Freiburg, Center for Evaluation of Teaching in Medicine Baden-Wurttemberg, Freiburg, Germany)

Marianne Giesler (University of Freiburg, Center for Evaluation of Teaching in Medicine Baden-Wurttemberg, Freiburg, Germany)

Werner Vach (University Medical Center Freiburg, Institute of Medical Biometry and Medical Informatics, Freiburg, Germany)

Ariane Zeuner (University Medical Center Freiburg, Department of Medical Psychology, Freiburg, Germany) Gotz Fabry (University Medical Center Freiburg, Department of Medical Psychology, Freiburg, Germany)

Background: Topics with a focus on theoretical content are perceived as tedious by many medical students and are often marginalized. This view clashes with a

ABSTRACT BOOK: SESSION 3 MONDAY 26 AUGUST: 1045-1230

competency oriented view of health professionals who need considerable scientific and methodological knowledge and skills. Early introduction and longitudinal anchoring of training in the medical curriculum can induce higher motivation and better understanding of the professional relevance in medical students. Summary of work: Learning objectives for first year medical students were developed by experts from different medical and theoretical disciplines. Authentic cases based on exemplary scientific studies were constructed accordingly and aligned in a Problem-based curriculum. Performance on cognitive learning was measured with a written test. Self-assessment of competencies and attitudes of students were collected. Summary of results: The curriculum was implemented for the first time with 340 students, 32 student research assistants and 18 expert trainers in the summer semester 2012. Test results revealed that students had reached the learning objectives. Students stated that their competence had increased with regard to each of the learning objectives. Despite these achievements a number of students complained that they had not learned enough and overall students were only moderately satisfied with the educational intervention. Conclusions: A problem-based curriculum on scientific methods for first year medical students was established successfully. Many issues for improvements remain. Take-home messages: We established a problem-based curriculum on basic scientific methods for first year medical students in which students can actively acquire foundational knowledge on evidence-based medicine, literature retrieval and biometry.

3DD/17

Can concept mapping support discussion in tutorials? A case study

Danielle Verstegen (Maastricht University, FHML, Dept.

of Educational Research and Development, P.O. Box 616,

Maastricht 6200 MD, Netherlands)

Herma Roebertsen (Maastricht University, FHML, Dept.

of Educational Research and Development, Maastricht,

Netherlands)

Angel Schols (Maastricht University, FHML, Maastricht, Netherlands)

Background: Mind mapping and concept mapping are established techniques to visualize and structure knowledge. There are numerous software packages. Our aim is to explore if and how these techniques can support Problem Based Learning, focusing on the function the stakeholders' perceptions. We report results of the first case study.

Summary of work: During the first course of the Health Sciences bachelor tutors were stimulated to ask one or two students to make concept maps during self-study time and to use these during the report phases in group tutorials. Students and tutors filled in a brief questionnaire (with 6 closed and 5 open questions) during their last meeting. Participants were 238 students divided over 26 tutor groups and 15 tutors.

Summary of results: About half of the students and tutors reported that concept mapping has been used regularly to often in the PBL report phases. Almost two thirds of the students think that concept mapping was fairly to very useful. A third of the students intends to use it in future and another 41% thinks they may do so. The majority of tutors valued the use of concept mapping recommends it to students. Conclusions: The comments show that some students think that concept mapping is useful, provides an overview and structures discussions. Others do not see additional value, or report that there was not enough time. Tutors stress that the value of concept mapping depends on the topic or problem that is studied and the preferences or learning styles of individual students. Take-home messages: Concept mapping can support PBL groups especially within problems aiming at integration of concepts. It may not fit all domains. Students should practise using concept mapping in order to decide whether the technique is valuable to them.

3FF ePosters: eLearning 2

Location: North Hall, PCC

3FF/1

Students' perception of an interactive multimedia application as a support for teaching of breast semiology

Helio Angotti Carrara (Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Gynecology and Obstetrics, Av. Bandeirantes 3900, Rua Marcondes Salgado 1058/63 Cep: 14010150, Ribeirao Preto 14049900, Brazil)

Geraldo Henrique Neto (Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Gynecology and Obstetrics, Ribeirao Preto, Brazil) Antonio Nogueira (Faculty of Medicine of Ribeirao Preto, University of Sao Paulo, Gynecology and Obstetrics, Ribeirao Preto, Brazil)

Francisco Candido dos Reis (Faculty of Medicine of

Ribeirao Preto, University of Sao Paulo, Gynecology and

Obstetrics, Ribeirao Preto, Brazil)

Juan Yazlle Rocha (Faculty of Medicine of Ribeirao Preto,

University of Sao Paulo, Social Medicine, Ribeirao Preto,

Brazil)

Background: Medical education based on informatics technology promotes significant innovations that complement the traditional education. Summary of work: This work aimed to evaluate the acceptance of a didactic application in teaching mammary semiology using computational resources. After the students have interacted with the application, they should answer six questions on a Likert scale with five levels of appreciation, ranging from "totally disagree" to "totally agree".

Summary of results: Seventy seven students filled the Likert scale. As for ease of application usage, 98.4% agreed or totally agreed with the statement. In relation to the application being enjoyable to use, 94.7% fully agreed or agreed. When it was stated that the application provides immediate feedback, 71.3% of the students agreed or totally agreed. Regarding the assertion that the application was didactic, 92.7% of the students agreed or totally agreed with the statement. Asked if applications with other similar topics should be created, 90.8% partially or totally agreed. When asked if this type of application is enough to replace teachers, 69.5% of the students disagreed partially or totally disagreed.

Conclusions: The application was well evaluated by the students. However in the students' opinion, the presence of the professor is still important in the teaching of mammary semiology. Take-home messages: Multimedia applications are important tools in learning and are well accepted by the students, but the teacher is still essential.

ABSTRACT BOOK: SESSION 3 MONDAY 26 AUGUST: 1045-1230

3FF/2

Enthusiasm vs. study requirements: motivation of students to take part on contributing to a wiki-based textbook and quality of result

Martin Vejrazka (Charles University in Prague, 1st Faculty of Medicine, Katerinska 32, Praha 2 CZ-121 08, Czech Republic)

Cestmir Stuka (Charles University in Prague, 1st Faculty of Medicine, Prague, Czech Republic) Stanislav Stipek (Charles University in Prague, 1st Faculty of Medicine, Prague)

Background: WikiSkripta (www.wikiskripta.eu) is a wiki-based textbook for medical students running in Czech and Slovak language. It is available to all medical schools in the Czech and Slovak Republics. Today, it is the most used educational web for undergraduate medical study in both countries. It is completely opened both for reading and writing new articles. Summary of work: WikiSkripta are still more used by medical teachers to stimulate students for active learning. Some teachers ask students to write an article for WikiSkripta as a requirement for obtaining a credit. However, the quality of articles created in this way seems to be lower than quality of similar articles written by students spontaneously. We compared references listed in student articles that were written spontaneously and in articles that were written as a seminary work required for credit. Summary of results: Articles written by students spontaneously cite more relevant sources. Most references are textbooks, monographs and papers from peer-reviewed journals. In contrary, articles written on demand of a teacher contain most frequently only one relevant source. Potentially inaccurate sources prevail in this case: web presentations of commercial companies, non-reviewed web pages and Wikipedia. Conclusions: It seems always controversial to allow students to write study materials for them. We demonstrated that enthusiasm as motivation leads to more reliable results than requiring a text for awarding a credit. Checking the article by teacher does not seem to improve it. Therefore, WikiSkripta are going to introduce a peer-review process.

Take-home messages: Students can significantly contribute in writing educational materials when they do it spontaneously. Forcing them for similar contribution leads to texts of inferior quality.

3FF/3

E-learning about using interpreters in medical interview: improvement of students' knowledge and self-efficacy

Jeanine Suurmond (Academic Medical Centre / University of Amsterdam, Public Health, Meibergdreef 9, PO Box 22660, Amsterdam 1100DD, Netherlands) Umar Ikram (Academic Medical Centre / University of Amsterdam, Public Health, Amsterdam, Netherlands)

Marie-Louise Essink-Bot (Academic Medical Centre / University of Amsterdam, Public Health, Amsterdam, Netherlands)

Background: Though studies have found that professional interpreters improve clinical care for patients with limited English language proficiency, healthcare providers still make little use of such interpreters. We evaluated a self-developed e-learning for medical students, which aimed to increase their knowledge and self-efficacy in working with interpreters.

Summary of work: 128 fourth-year medical students took this e-learning in 2012-2013 during their clinical rotations, as part of training in cross-linguistic consultations. In the e-learning they answered questions relating to three patient-physician-interpreter video vignettes, and compared their answers with responses from experts. Before and after the e-learning, they completed a questionnaire which tested relevant knowledge and self-efficacy (e.g. 'how prepared do you feel to care for patients who do not speak Dutch'), with in both cases scores ranged from 1 (lowest) to 10 (highest).

Summary of results: Our results indicate that the median score of knowledge increased after the e-learning (median 9.00, IQR 2.00 vs. before the e-learning: median 6.00, IQR 4.00; p<0.001). A similar pattern was observed for self-efficacy. Before the e-learning the median score was 4.00 (IQR 2.00) whereas after the median score was 7.00 (IQR 2.00), with a statistically significant difference (p<0.001). Conclusions: Our e-learning resulted in improved knowledge and self-efficacy in arranging and using professional interpretation services among fourth-year medical students. Such interactive educational formats (ideally in a form of blended learning) may lower the barriers for current and future healthcare providers to use professional interpreters in clinical practice, improving quality of services for a multi-ethnic patient population.

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