Project description:ObjectivesTo compare patients' enablement and satisfaction after teaching and non-teaching consultations. To explore patients' views about the possible impact that increased community based teaching of student doctors in their practice may have on the delivery of service and their attitudes towards direct involvement with students.DesignObservational study using validated survey instruments (patient enablement index--PEI, and consultation satisfaction questionnaire--CSQ) administered after teaching consultations and non-teaching consultations. Ten focus groups (two from each practice), comprising five with patients participating in prearranged teaching sessions and five with patients not participating in these.SettingFive general practices in west Suffolk and southern Norfolk, England, that teach student doctors on the Cambridge graduate medical course.Participants240 patients attending teaching consultations (response rate 82%, 196 patients) and 409 patients attending non-teaching consultations (response rate 72%, 294 patients) received survey instruments. Ten focus groups with a total of 34 patients participating in prearranged teaching sessions and 20 patients not participating in these.Main outcome measuresScores on the patient enablement index and consultation satisfaction questionnaire, analysed at the level of all patients, allowing for age, sex, general practitioner, and practice, and at the level of the individual general practitioner teacher. Qualitative analysis of focus group data.ResultsPatients' enablement or satisfaction was not reduced after teaching consultations compared with non-teaching consultations (mean difference in scores on the patient enablement index and consultation satisfaction questionnaire with adjustment for confounders 2.24% and 1.70%, respectively). This held true for analysis by all patients and by general practitioner teacher. Qualitative data showed that patients generally supported the teaching of student doctors in their practice. However, this support was conditional on receiving sufficient information about reasons for doctors' absence, the characteristics of students, and the nature of teaching planned. Many patients viewed their general practice as different from hospital and expected greater control over students' presence during their consultations.ConclusionsPatients' enablement and satisfaction are not impaired by students' participation in consultations. Patients generally support the teaching of student doctors in their general practice but expect to be provided with sufficient information and to have a choice about participation, so they can give informed consent. Recognising this when organising general practice based teaching is important.
Project description:Background Acute otitis media (AOM) is the most frequent indication for antibiotic treatment of children in the United States. Its diagnosis relies on visualization of the tympanic membrane, a clinical skill acquired through a deliberate approach. Instruction in pediatric otoscopy begins in medical school. Medical students receive their primary experience with pediatric otoscopy during the required pediatric clerkship, traditionally relying on an immersion, apprentice-type learning model. A better understanding of their preceptors’ clinical and teaching practices could lead to improved skill acquisition. This study investigates how pediatric preceptors (PP) and members of the Council on Medical Student Education in Pediatrics (COMSEP) perceive teaching otoscopy. Methods A 30-item online survey was administered to a purposeful sample of PP at six institutions in 2017. A comparable 23-item survey was administered to members through the 2018 COMSEP Annual Survey. Only COMSEP members who identified themselves as teaching otoscopy to medical students were asked to complete the otoscopy-related questions on the survey. Results Survey respondents included 58% of PP (180/310) and 44% (152/348) of COMSEP members. Forty-one percent (62/152) of COMSEP member respondents identified themselves as teaching otoscopy and completed the otoscopy-related questions. The majority agreed that standardized curricula are needed (PP 78%, COMSEP members 97%) and that all graduating medical students should be able to perform pediatric otoscopy (PP 95%, COMSEP members 79%). Most respondents reported usefulness of the American Academy of Pediatrics (AAP) AOM guidelines (PP 95%, COMSEP members 100%). More COMSEP members than PP adhered to the AAP’s diagnostic criteria (pediatric preceptors 42%, COMSEP members 93%). The most common barriers to teaching otoscopy were a lack of assistive technology (PP 77%, COMSEP members 56%), presence of cerumen (PP 58%, COMSEP members 60%), time to teach in direct patient care (PP 46%, COMSEP members 48%), and parent anxiety (PP 62%, COMSEP members 54%). Conclusions Our study identified systemic and individual practice patterns and barriers to teaching pediatric otoscopy. These results can inform education leaders in supporting and enabling preceptors in their clinical teaching. This approach can be adapted to ensure graduating medical students obtain intended core clinical skills.
Project description:IntroductionCommunication training with simulated patients (SPs) is widely accepted as a valuable and effective means of teaching communication skills. However, it is unclear which elements within SP-student encounters make these learning experiences meaningful. This study focuses on the SP's role during meaningful learning of the student by giving an in-depth understanding of the contribution of the SP from a student perspective.MethodsFifteen bachelor Technical Medicine students were interviewed. Technical medicine students become technical physicians who optimize individual patient care through the use of personalized technology. Their perceptions of meaningful learning experiences during SP-student encounters were explored through in-depth, semi-structured interviews, and analyzed using thematic analysis.ResultsThree main themes were identified that described what students considered to be important for meaningful learning experiences. First, SPs provide implicit feedback-in-action. Through this, students received an impression of their communication during the encounter. Implicit feedback-in-action was perceived as an authentic reaction of the SPs. Second, implicit feedback-in-action could lead to a process of reflection-in-action, meaning that students reflect on their own actions during the consultation. Third, interactions with SPs contributed to students' identity development, enabling them to know themselves on a professional and personal level.DiscussionDuring SP encounters, students learn more than just communication skills; the interaction with SPs contributes to their professional and personal identity development. Primarily, the authentic response of an SP during the interaction provides students an understanding of how well they communicate. This raises issues whether standardizing SPs might limit opportunities for meaningful learning.
Project description:In the United States, the onset of COVID-19 triggered a nationwide lockdown, which forced many universities to move their primary assessments from invigilated in-person exams to unproctored online exams. This abrupt change occurred midway through the Spring 2020 semester, providing an unprecedented opportunity to investigate whether online exams can provide meaningful assessments of learning relative to in-person exams on a per-student basis. Here, we present data from nearly 2,000 students across 18 courses at a large Midwestern University. Using a meta-analytic approach in which we treated each course as a separate study, we showed that online exams produced scores that highly resembled those from in-person exams at an individual level despite the online exams being unproctored-as demonstrated by a robust correlation between online and in-person exam scores. Moreover, our data showed that cheating was either not widespread or ineffective at boosting scores, and the strong assessment value of online exams was observed regardless of the type of questions asked on the exam, the course level, academic discipline, or class size. We conclude that online exams, even when unproctored, are a viable assessment tool.
Project description:Anonymous student evaluations of teaching (SETs) are used by colleges and universities to measure teaching effectiveness and to make decisions about faculty hiring, firing, re-appointment, promotion, tenure, and merit pay. Although numerous studies have found that SETs correlate with various teaching effectiveness irrelevant factors (TEIFs) such as subject, class size, and grading standards, it has been argued that such correlations are small and do not undermine the validity of SETs as measures of professors' teaching effectiveness. However, previous research has generally used inappropriate parametric statistics and effect sizes to examine and to evaluate the significance of TEIFs on personnel decisions. Accordingly, we examined the influence of quantitative vs. non-quantitative courses on SET ratings and SET based personnel decisions using 14,872 publicly posted class evaluations where each evaluation represents a summary of SET ratings provided by individual students responding in each class. In total, 325,538 individual student evaluations from a US mid-size university contributed to theses class evaluations. The results demonstrate that class subject (math vs. English) is strongly associated with SET ratings, has a substantial impact on professors being labeled satisfactory vs. unsatisfactory and excellent vs. non-excellent, and the impact varies substantially depending on the criteria used to classify professors as satisfactory vs. unsatisfactory. Professors teaching quantitative courses are far more likely not to receive tenure, promotion, and/or merit pay when their performance is evaluated against common standards.
Project description:An important aim of teaching philosophy in Dutch secondary schools is to learn about philosophy (i.e., the great philosophers) by doing philosophy. We examined doing philosophy and focused specifically on the relationship between student learning activities and teacher behavior; in doing so, a qualitative cross-case analysis of eight philosophy lessons was performed. The effectiveness of doing philosophy was operationalized into five learning activities comprising rationalizing, analyzing, testing, producing criticism, and reflecting, and scored by means of qualitative graphical time registration. Using CA we find a quantitative one-dimensional scale for the lessons that contrasts lessons that are more and less effective in terms of learning and teaching. A relationship was found between teaching by teachers and doing philosophy by students. In particular we found students to produce a higher level of doing philosophy with teachers who chose to organize a philosophical discussion with shared guidance by the teacher together with the students.
Project description:Student evaluations of teaching are widely believed to contain gender bias. In this study, we conduct a randomized experiment with the student evaluations of teaching in four classes with large enrollments, two taught by male instructors and two taught by female instructors. In each of the courses, students were randomly assigned to either receive the standard evaluation instrument or the same instrument with language intended to reduce gender bias. Students in the anti-bias language condition had significantly higher rankings of female instructors than students in the standard treatment. There were no differences between treatment groups for male instructors. These results indicate that a relatively simple intervention in language can potentially mitigate gender bias in student evaluation of teaching.
Project description:Human communication is remarkably versatile, enabling teachers to share highly abstracted and novel information with their students. What neural processes enable such transfer of information across brains during naturalistic teaching and learning? Here, a teacher was scanned in functional magnetic resonance imaging while giving an oral lecture with slides on a scientific topic followed by a review lecture. Students were then scanned while watching either the intact Lecture and Review (N = 20) or a temporally scrambled version of the lecture (N = 20). Using intersubject correlation, we observed widespread Teacher-Student neural coupling spanning sensory cortex and language regions along the superior temporal sulcus as well as higher-level regions including posterior medial cortex (PMC), superior parietal lobule, and dorsolateral and dorsomedial prefrontal cortex. Teacher-student alignment in higher-level areas was not observed when learning was disrupted by temporally scrambling the lecture. Moreover, teacher-student coupling in PMC was significantly correlated with learning: the more closely the student's brain mirrored the teacher's brain, the more the student improved their learning score. Together, these results suggest that the alignment of neural responses between teacher and students may reflect effective communication of complex information across brains in classroom settings.
Project description:The acceptance of students to a medical school places a considerable emphasis on performance in standardized tests and undergraduate grade point average (uGPA). Traditionally, applicants may be judged as a homogeneous population according to simple quantitative thresholds that implicitly assume a linear relationship between scores and academic success. This 'one-size-fits-all' approach ignores the notion that individuals may show distinct patterns of achievement and follow diverse paths to success. In this study, we examined a dataset composed of 53 variables extracted from the admissions application records of 1,088 students matriculating to NYU School of Medicine between the years 2006-2014. We defined training and test groups and applied K-means clustering to search for distinct groups of applicants. Building an optimized logistic regression model, we then tested the predictive value of this clustering for estimating the success of applicants in medical school, aggregating eight performance measures during the subsequent medical school training as a success factor. We found evidence for four distinct clusters of students-we termed 'signatures'-which differ most substantially according to the absolute level of the applicant's uGPA and its trajectory over the course of undergraduate education. The 'risers' signature showed a relatively higher uGPA and also steeper trajectory; the other signatures showed each remaining combination of these two main factors: 'improvers' relatively lower uGPA, steeper trajectory; 'solids' higher uGPA, flatter trajectory; 'statics' both lower uGPA and flatter trajectory. Examining the success index across signatures, we found that the risers and the statics have significantly higher and lower likelihood of quantifiable success in medical school, respectively. We also found that each signature has a unique set of features that correlate with its success in medical school. The big data approach presented here can more sensitively uncover success potential since it takes into account the inherent heterogeneity within the student population.
Project description:ObjectiveThis study aimed to determine whether a combination of case-based learning (CBL) and problem-based learning (PBL) methods in teaching can improve the academic performance and recruitment of medical students for neurosurgery.MethodsFour classes of fourth-year medical students were randomly divided into two groups. The traditional model group received the traditional teaching method, and the CBL-PBL group received the combined teaching methods of CBL and PBL. After the courses, the differences between the two groups in self-perceived competence, satisfaction with the course, post-class test scores, and clinical practice abilities were compared, and the proportions of neurosurgery major selection in pre- and post-curriculum between the two groups were also analyzed.ResultsSelf-perceived competence, post-class test scores, and clinical practice abilities in the CBL-PBL group were better than those in the traditional model group. The students in the CBL-PBL group showed a higher degree of satisfaction with the course than those in the traditional model group (χ2 = 12.03, P = 0.007). At the end of the semester, the proportion of students who chose neurosurgery majors in the CBL-PBL group was 13.3%, more than the 3.4% in the traditional model group (χ2 = 3.93, P = 0.048).ConclusionCompared with the traditional teaching method, the CBL and PBL integrated method is more effective for improving the performance of medical students and enhancing their clinical capabilities in neurosurgery teaching. The CBL-PBL method effectively improved students' interests in neurosurgery, potentially contributing to increasing medical student recruitment into neurosurgery.