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Conclusions: Trainees gained a broader knowledge of the accreditation process, a better understanding of accreditation standards and created buy-in in the overall accreditation experience.
Take-home messages: Involvement of trainees as co-reviewers contributes positively on the accreditation process however logistical and financial challenges exist which may prevent this experience from being duplicated in the future.
New approaches to defining and measuring outcomes of learning: The AMA accelerating change in medical education initiative
Mark Quirk (American Medical Association, Medical Education, 515 N State Street, Chicago, IL 60654, United
Susan Skochelak (American Medical Association, Medical Education, Chicago, IL, United States) Richard Hawkins (American Medical Association, Medical Education, Chicago, IL, United States)
Background: The American Medical Association's "Accelerating Change in Medical Education" Initiative is a $10,000,000 grant program designed to alter medical education through bold, rigorously evaluated innovations that align student training with the evolving needs of patients, communities and the rapidly changing health care environment.
Summary of work: The RFP process began with a 5-page Letter of Intent submitted by each medical school. Letters were rigorously evaluated and a select group of schools were invited to submit full proposals. This paper explores the learning outcomes and measurement strategies defined by these medical schools. Summary of results: One hundred and seventeen (83%) of the 141 US allopathic medical schools submitted Letters of Intent. Thirty-one were invited to submit full proposals. Ten schools were awarded grants. Schools are planning to use new technologies to measure competencies at the behavior level including simulation and virtual patient panels. A surprisingly large number of schools plan to focus on learning outcomes at the 'results' level such patient health status and satisfaction,
health care delivery quality indicators and system functioning. To measure these outcomes, they will use patient data in real and virtual EHRs, actual clinical system performance indicators (including cost and safety) and interprofessional team measures such as 360-degree evaluations. Most schools will focus on aligning UME with GME competencies and milestones to promote 'readiness for residency.' Conclusions: US medical schools define and measure achievement of competency-based outcomes as the cornerstone for progression along the educational pathway. There is a trend toward defining outcomes at the 'behavioral' and at the 'results' levels (viz., Kirkpatrick).
Take-home messages: Medical educators are developing cutting edge technologies to measure learner behaviors and defining new 'results' outcomes of learning related to patient care and system functioning.
How can Kotter's (1995) model of organisational change support faculty development in Eastern Europe? The Georgian Experience
Anne-Marie Reid (University of Leeds, School of Medicine, Worsley Building, Clarendon Road, Leeds LS2 9NL, United Kingdom)
Gaiane Simonia (Tbilisi State Medical University, Internal Medicine, Tbilisi, Georgia)
Background: A medical schools partnership, funded through TEMPUS, aimed to establish faculty development units In Eastern European countries to support modernisation of undergraduate medical curricula. The lead medical university in Georgia undertook initial needs analysis, highlighting a comparatively hierarchical management culture, despite democratic change in the post-Soviet era. Previous curricular reform attempts had floundered. Summary of work: Adopting a model of organisational change management (Kotter's, 1995), the project team worked with Georgian faculty to foster conditions conducive to successful reform. This model and philosophical underpinnings were presented to senior management, regulators, faculty, administrators and students representatives. A Faculty Development strategy was jointly developed and communicated widely with stakeholders, encompassing the 'shared vision' described by Kotter (1995). Summary of results: Organisational barriers to change included bureaucratic processes at Academic Council level which created delays in approving reforms and acceptance of the faculty development strategy. 'Quick wins' were achieved in the creation of a faculty development unit through refurbishment of existing space. The strategy has now been accepted and a programme of faculty development training incorporating new teaching methodologies has been implemented.
Conclusions: Sustainable faculty development must take account of organisational culture within wider
political structures, aiming to empower those at the centre. Funded projects often gain advantage through short-term reform which is lost when the funding runs out. Initial investment in developing a shared vision and sensitivity to local context and culture allows 'quick wins' which brings collaborative advantage for further gains.
Take-home messages: Utilisation of the Kotter (1995) model provides a framework for stimulating organisational change which supports sustainable faculty development.
2L Short Communications: The Lecture Location: Club C, PCC
An innovative method to obtain immediate feedback from students during class with no cost
Mona Al Shaikh (University of Dammam, Physiology, Medical Education Unit, King Fahd University Hospital, Administration Building, 2nd floor, AlKhobar, P.O. Box 2208 31952, Saudi Arabia)
Background: Audience response systems or clickers have been used in class for the past 15 years. Instructors may use clickers in class to: assess prior knowledge of students, detect misconceptions, assess students' grasp of a new concept or its application, perform instructor or course evaluations, and/or record attendance. Clickers have been shown to improve attendance and increase participation. The problem with clickers is that they are expensive and not available in all classes. Assessing prior knowledge and linking new information to previously learnt material, early detection of misconceptions and treating them, and assessing grasp and perceptions of students during class are good practices. This is made possible by an immediate feedback system that links the instructor to a large audience. This paper describes an innovative method which replaces clickers and is as effective with no cost. Summary of work: Application of the use of Survey monkey software during class to obtain immediate feedback is described. It proved to be an efficient method which only requires one laptop for the instructor, students' mobile phones, and preferably wireless internet coverage. Perceptions of students of this method were measured by an online survey. Summary of results: Acceptability of this method was high and it increased enjoyment, engagement, student pre-class preparation, academic self-awareness and motivation to attend and participate in class. Conclusions: Use of Survey Monkey Questionnaire software can replace clickers with the same effectiveness at no cost.
Take-home messages: A new way of using technology in class is described. It allows for immediate feedback similar to clickers or audience response systems at no additional cost. It proved to be highly acceptable and increased enjoyment of class and motivation to attend classes.
The fate of pre-lecture reading materials - in the brain or in the bin?
Chee-Kiat Tan (Singapore General Hospital, Gastroenterology and Hepatology, Outram Road, Singapore 169608, Singapore) Pik-Eu Jason Chang (Singapore General Hospital, Gastroenterology and Hepatology, Singapore, Singapore)
ABSTRACT BOOK: SESSION 2 MONDAY 26 AUGUST: 0830-1015
Background: Pre-reading before didactic lectures has been shown to improve learning outcome. However, provision of pre-reading material does not equate with actual pre-reading being done. We evaluated the compliance of Internal Medicine residents and nonresidents with pre-reading before a lecture. Summary of work: A PDF journal article was e-mailed to all learners as pre-reading material two weeks before the scheduled lecture. Reminders were sent via e-mail and SMS one day before the lecture. To evaluate (1) if learners opened the document, a conspicuous picture was inserted on the front page and (2) if learners read through the document, two separate blank pages were inserted. Before the lecture started, attendees answered a questionnaire to identify the picture and number of blank pages. A subsequent follow-up survey was done to elicit the reasons for non-compliance with pre-reading.
Summary of results: We had 87 residents and 51 nonresidents. Overall attendance rate was 60/138 (43.5%). Only 14/60 (23.3%) and 6/60 (10%) attendees opened and read the document respectively. There were no significant differences between residents and nonresidents. Thus, there was very low compliance with pre-reading or even opening attached pre-reading material. The main reasons for not pre-reading were lack of time and forgetfulness. Conclusions: Compliance with pre-reading in Internal Medicine residents and non-residents is low due to lack of time and forgetfulness. We need to address our learners' lack of time and also implement an effective reminder system.
Take-home messages: Most learners do not read assigned material prior to attending a scheduled lecture.
Dwindling attendance at lectures: students' perception of its aetiology
Colin Block (Hadassah-Hebrew University Medical Centre, Department of Clinical Microbiology and Infectious Diseases, PO Box 12000, Jerusalem 91120, Israel
Robert Cohen (Hebrew University-Hadassah Medical School, Jerusalem, Israel)
Background: Decreased attendance has been observed in pre-clinical course lectures as the courses progress. This has been explained by what faculty perceived as changes in student attitudes, problems in intergenerational communication and work load pressures. We examined students' perception of the reasons for non-attendance.
Summary of work: Setting: Six-year programme with three year preclinical and clinical components, consisting of approximately 150-160 students per year. An end of year self-administered survey was completed by students in the three pre-clinical years using SurveyMonkey.
Summary of results: Overall, 425 responses were received. Individual learning preferences were varied: a minority (29%) preferred frontal lectures; a majority
used student prepared summaries (95.5%) and/or web based presentations (84%). Almost half (48.7%) of the students preferred learning independently. Options regarding reasons for decreasing attendance were: reliance on student summaries (82.4% agreed), uploaded materials (57.1% agreed), competition for time by different courses (60.2%), heavy workload (54.2%), non-compulsory attendance (47.4%), level of interest not maintained in frontal lectures (63.4%) and factors related to earning a living (76.7%). More than 140 free text responses are being analysed. Conclusions: Student responses suggested that frontal lectures may be unnecessary for most students. They also revealed a worrying reliance on colleagues' summaries as being sufficient for their basic sciences education. Many Israeli medical students need to supplement their incomes by working during their studies. Curriculum planners and course directors would be well advised to take these factors into account. Take-home messages: These findings should stimulate faculty at our medical school to adopt fresh approaches to engaging their students in the learning process.
Do Variations in Classroom Delivery of Lectures Affect Student Video Viewing Patterns?
Mary Anne Baker (Weill Cornell Medical College in Qatar, Assessment and Academic Achhievement, atar Foundation Education City, P. O. Box 24144, Doha., Qatar)
Thurayya Arayssi (Weill Cornell Medical College in Qatar, Medicine, Doha, Qatar)
Marcellina Mian (Weill Medical College in Qatar, Pediatrics, Doha, Qatar)
Amal Khidir (Weill Cornell Medical College in Qatar, Pediatrics, Doha, Qatar)
Ali Sultan (Weill Cornell Medical College in Qatar, Microbiology and Immunology, Doha, Qatar)
Background: A growing body of research confirms that medical students in many countries view video recordings of lectures as an important component of their learning and preparation for exams. Summary of work: This presentation examines the effect of in-classroom lecture presentation format on student use of all video recorded lectures. Students experienced three types of delivery of in-class lectures: professor presenting live in the classroom, live presentations from faculty at remote site, and prerecorded lectures presented in the classroom. The research question is how do these variations in lecture delivery affect student use of videos? Summary of results: The types of classroom delivery are associated with differences in class attendance as well as number video log-ons and when video lectures are viewed.
Conclusions: The mode of lecture delivery affects the student use of video recordings.
Take-home messages: As we move away from teaching via live classroom lectures and increased access to video lecture recordings, we need to know more about how
ABSTRACT BOOK: SESSION 2 MONDAY 26 AUGUST: 0830-1015
the diversity of current teaching modes affect student learning.
Flipped or flopped? - Pre-class interactive, synchronous online formative activities in Pathology positively correlate with end of year performance
Catriona A McLean (Alfred Hospital, Pathology, Commercial Rd, Melbourne 3181, Australia) Huw RH Llewellyn (Monash, Medicine, Melbourne, Australia)
George Kotsanas (Monash, Medicine, Melbourne, Australia)
Julianne Bayliss (Monash, Medicine, Melbourne, Australia)
Ben Canny (Monash, Medicine, Melbourne, Australia)
Background: Much effort is put into online pre-class activity but little is known about whether it correlates with end of year (EOY) summative performance. Year 3 Monash University medicine teaches ~500 students across multiple campuses in Australia (school-leaver (~280), graduate-entry (~90)) and Malaysia (school-leaver ~120). Pathology pre-class online activities have set objectives and use authentic clinical cases. Graded interactive synchronous prompts aimed at determining the level of understanding occur within each case with immediate individual formative feedback and model answers. Weekly class tutorials and post class online forums and self-paced online case-related multi-media, further support learning. Summary of work: A significant positive linear correlation was found in both Australia (r2 = 0.14, n = 373, p< 0.0001) and Malaysia (r2 = 0.11, n = 123, p< 0.002) between online and EOY summative scores. Analysis of online scores across the three groups revealed a significantly lower mean in Malaysia (p<0.001), largely because there were significantly (p<0.0001) more unanswered questions among the Malaysian cohort. The differences in online scores were also seen in the EOY summative scores. Of interest, of those who failed the EOY summative score, irrespective of campus, 40% were found to have copied their answers from the model answers supplied to other students.
Summary of results: Online pre-class scores positively correlate with EOY summative performance, and other measures of engagement (attempts at questions, copying) also predict performance in summative assessment.
Conclusions: Pre-class interactive and graded online
formative activities in Pathology positively correlate
with end of year performance.
Take-home messages: Pre-class online formative
activities positively correlate with end of year
2M Short Communications: Student
Location: Club D, PCC
Relationship Between Motivational Orientations, Metacognitive Adaptations And Academic Successes Of Doctorate Students
Albena Gayef (Marmara University Vocational School of Health Services, Department of Anesthesia, Tibbiye Cad. No:49 Uskudar, Istanbul 34668, Turkey) Mehmet Ali Gulpinar (Marmara University School of Medicine, Department of Medical Education, Istanbul, Turkey)
Background: Motivational orientations and metacognitive adaptations displayed in difficult situations are among two factors which affect the academic success of students. The aim of this study was to examine relationship between motivational orientations, metacognitive adaptations and academic successes of doctorate students attending to health sciences institute.
Summary of work: In this study conducted with 139 students, The Modified Archer's Health Professions Motivation Survey, The Positive Metacognitions and Positive Meta-Emotions Questionnaire, performance evaluation forms were used.
Summary of results: In the study where metacognitive adaptation levels of doctorate students are found high, their self confidence levels in extinguishing perseverative thoughts and emotions were found to be significantly different in comparison to their levels of goal orientations towards performance, academic alienation and use of superficial learning strategies; their self confidence levels in interpreting own emotions as cues, restraining from immediate reaction and mind setting for problem solving, establishing flexible and feasible hierarchy of goals were found to be significantly different in comparison to their levels of academic alienation, use of metacognitive learning strategies, internal control (p<0.05). It was observed that academic success of the students at course and thesis stages were found to be significantly different compared to their level of metacognitive learning strategies, self confidence levels for setting flexible, feasible hierarchy of goals (p<0.05).
Conclusions: It is determined that metacognitive learning strategies are related with academic success. In this study also determined that determination of flexible, feasible hierarchy of goals was standing out factor on academic success.
Measuring medical students' intention of applying clinical training: The planned behavior model
Chia-Der Lin (China Medical University Hospital, Department of Education, China Medical University
ABSTRACT BOOK: SESSION 2 MONDAY 26 AUGUST: 0830-1015
Hospital. #2, Yu-de Rd. North District, Taichung 40447, Taiwan)
Fremen Chih-Chen Chou (China Medical University Hospital, Department of Education, Taichung, Taiwan) Ming-May Lai (China Medical University Hospital, Department of Family Medicine, Taichung, Taiwan)
Background: Factors influencing medical students' intention to apply for internship and residency training program are important to medical educators in terms of its implications toward clinical training design and clinical education administration. Summary of work: The Questionnaire was developed based on the theory of planned behavior (TPB). The conceptual framework included 4 pre-proposed factors. They are "intention of applying clinical training" (Intention), "perceived usefulness" (U), "social norm" (SN), and "education environmental support" (ES). The relationships between the factors are that U, SN and ES are inter-correlated, and they can predict intention. Two surveys were conducted in sequence with two different cohorts of students (160 and 231). Exploratory factor analysis (EFA) and structural equation modeling (SEM) were executed with identical items and factors using the two cohorts' data respectively. Summary of results: The results of EFA revealed 4 factors with 71.28% total variance explained. The overall Cronbach's alpha was 0.87. The results of SEM indicated good model fit with the data of the second cohort (CMIN/d.f.=1.52, CFI=0.97, RMSEA=0.05). Regarding the predictive power, 31% of intention's total variance was explained by the model. Intention can be predicted by U (0.08, p>.05), SN (0.06, P>.05) and ES (0.51, p<.05). The correlation of U-SN, U-ES and SN-ES are 0.41, 0.36 and 0.18 respectively.
Conclusions: Medical students' intention of applying for clinical training program is dominantly predicted by the "education environmental support" rather than the "perceived usefulness" that is dominant factor in most researches applying TPB.
Take-home messages: Investments in clinical teachers, equipment related to training and training activities may attract the medical students to your program.
Online study diary - a new designed tool for the quantification of learning habits
Christina Roligoderer (University of Munich - LMU, Chair of Didactics, Hochackerstr. 61, Riemerling 85521, Germany)
Volker Brand (Medical Clinic of Munich, Munich, Germany)
Mathias Woidy (University of Munich - LMU, Munich, Germany)
Stefan Alig (University of Munich - LMU, Munich, Germany)
Ludwig Weckbach (University of Munich - LMU, Munich, Germany)
Martin Fischer (University of Munich - LMU, Chair of Didactics, Munich, Germany)
Background: A recent study revealed that the subjective study time as sensed by students does greatly differ from objectively measured study hours. Hence, retrospectively assessed study habits by surveys do not seem to be a valid method to analyze study behavior. As it is important for curriculums to take the workload of students into account, a tool to assess study habits is needed.
Summary of work: Our group developed an online tool to assess study habits with regard to medical education. Medical students keep a 24 hour diary on study time, scientific research, part-time jobs, leisure time and sleep for 2 weeks. Focus of the diary lies on study activities for privacy reasons. Additionally, exam performance and learning styles can be assessed by online questionnaires. Summary of results: The acceptance of the online diary was evaluated among medical students of the University of Munich. Users considered the tool to be time efficient (expenditure of time ~5 min/day), easy to use, and interesting in terms of self-reflection on objective study activity. However, when tested on a group of 440 students, only few participated in the study despite a lottery as incentive.
Conclusions: The newly-developed online diary is a valuable tool to assess study activities of medical students. It might not only lead to new insights into study behavior, but might also generate new ideas on how to improve medical curriculum. However, it is necessary to identify ways to encourage a broad majority of students to participate in diary studies. Take-home messages: The online diary developed by our group is a valuable tool to assess study activities of medical students. Validation of curricular improvements or the establishment of e-learning tools could be possible applications.