The potential of neuroscience for health sciences education: towards convergence of evidence and resisting seductive allureSpringer Science and Business Media LLC - Tập 21 - Trang 983-990 - 2016
Anique B. H. de Bruin
Since emergence of the field ‘Educational Neuroscience’ (EN) in the late nineties of the previous century, a debate has emerged about the potential this field holds to influence teaching and learning in the classroom. By now, most agree that the original claims promising direct translations to teaching and learning were too strong. I argue here that research questions in (health professions) education require multi-methodological approaches, including neuroscience, while carefully weighing what (combination of) approaches are most suitable given a research question. Only through a multi-methodological approach will convergence of evidence emerge, which is so desperately needed for improving teaching and learning in the classroom. However, both researchers and teachers should become aware of the so-called ‘seductive allure’ of EN; that is, the demonstrable physical location and apparent objectivity of the measurements can be interpreted as yielding more powerful evidence and warranting stronger conclusions than, e.g., behavioral experiments, where in fact oftentimes the reverse is the case. I conclude that our tendency as researchers to commit ourselves to one methodological approach and to addressing educational research questions from a single methodological perspective is limiting progress in educational science and in translation to education.
Impact of a university teaching of integrative medicine on the social representations of undergraduate medical studentsSpringer Science and Business Media LLC - - 2024
Julien Poimboeuf, Éric Mener, Laure Fiquet, Pierric Renaut
Integrative medicine, need to be inoffensive, effective, and of quality (World Health Organization). In 2010, the American Society of Teachers of Family Medicine approved 19 competencies for teaching integrative medicine to residents. In 2018, the University of Rennes created a course: “Integrative Medicine and Complementary Therapies”. Up until then, the only feedback from the courses was the students’ opinions. We investigated the impact on medical students’ social representation. We performed a sociological analysis of students’ social representations before and after the course. The social representation is based on the way an individual creates his or her universe of beliefs and ideas. After hearing, “What word or group of words comes to mind when you hear people speak of integrative medicine and complementary therapies?”, students were asked to provide 5 words/phrases, rank their importance, and show their attitude towards these words/phrases. The frequency and importance of these words/phrases were used to construct social representations (with central cores, and primary and secondary peripheries) before and after the course. Among the 101 students registered, 59 provided complete responses before and 63 after the course. Before, the central core comprised “hypnosis” and “alternative medicine”, while after: “complementary care” and “global care”. We only identified first periphery before the course: “acupuncture” and “homeopathy”. 4 new contrasting elements: “integration with conventional treatment”, “patient’s choice”, “personalisation of care”, and “caring relationship of trust”. This teaching course positively affected students’ social representation of integrative medicine, and might promote their use during future practices.
Persistence as a mediator between motivation and performance accomplishment among medical students: a mixed method approachSpringer Science and Business Media LLC - - 2024
Eman Faisal
This study examined the relationship between motivation, performance accomplishment, and persistence as a mediator among medical students. Quantitative and qualitative data were collected through a two-stage sequential design to investigate the hypothesised model. A sample of 645 medical undergraduates participated in the quantitative stage, responding to an electronically structured questionnaire. Confirmatory factor analysis and structural equation modelling were utilised to analyse the data and assess the fit of the conceptual model. In the qualitative stage, semi-structured interviews were conducted with a purposeful sample of twelve medical students, and thematic analysis was employed to explore the qualitative findings. The results indicated a well-fitting model, with significant positive relationships observed among motivation, persistence, and performance accomplishment. Notably, including persistence as a mediator reinforced the relationship between motivation and performance achievement. The qualitative data supported and further emphasised the importance of persistence in the medical student population. The findings have practical implications for medical students, educators, and universities, highlighting the significance of promoting and enhancing learners’ persistence. Suggestions for future research include developing additional statistical models, conducting experimental studies, and undertaking longitudinal investigations. By expanding the understanding of the relationships between motivation, persistence, and performance accomplishment, future studies can contribute to developing effective interventions and strategies to support medical students in their educational journey.
Feedback sandwiches affect perceptions but not performanceSpringer Science and Business Media LLC - Tập 18 - Trang 397-407 - 2012
Jay Parkes, Sara Abercrombie, Teresita McCarty
The feedback sandwich technique—make positive comments; provide critique; end with positive comments—is commonly recommended to feedback givers despite scant evidence of its efficacy. These two studies (N = 20; N = 350) of written peer feedback with third-year medical students on clinical patient note-writing assignments indicate that students think feedback sandwiches positively impact subsequent performance when there is no evidence that they do. The effort necessary to produce feedback sandwiches and students’ unwarranted confidence in their performance impact have implications for teaching about how to give feedback.
Optimization of answer keys for script concordance testing: should we exclude deviant panelists, deviant responses, or neither?Springer Science and Business Media LLC - Tập 16 - Trang 601-608 - 2011
Robert Gagnon, Stuart Lubarsky, Carole Lambert, Bernard Charlin
The Script Concordance Test (SCT) uses a panel-based, aggregate scoring method that aims to capture the variability of responses of experienced practitioners to particular clinical situations. The use of this type of scoring method is a key determinant of the tool’s discriminatory power, but deviant answers could potentially diminish the reliability of scores by introducing measurement error. (1) to investigate the effects on SCT psychometrics of excluding from the test’s scoring key either deviant panelists or deviant answers; (2) to propose a method for excluding either deviant panelists or deviant answers. Using an SCT in radiation oncology, we examined three methods for reducing panel response variability. One method (‘outliers’) entailed removing from the panel members with very low total scores. Two other methods (‘distance-from-mode’ and ‘judgment-by-experts’) excluded widely deviant responses to individual questions from the test’s scoring key. We compared the effects of these methods on score reliability, correlations between original and adjusted scores, and between-group effect sizes (panel-residents; panel-students; and residents-students). With a large panel (n = 45), optimization methods have no effect on reliability of scores, correlation and effect size. With a smaller panel (n = 15) no significant effect of optimization methods were observed on reliability and correlation, but significant variation on effect size was observed across samples. Measurement error resulting from deviant panelist responses on SCTs is negligible, provided the panel size is sufficiently large (>15). However, if removal of deviant answers is judged necessary, the distance-from-mode strategy is recommended.
Measuring what Medical Students Think about Complementary and Alternative Medicine (CAM): A Pilot Study of the Complementary and Alternative Medicine SurveySpringer Science and Business Media LLC - - 2006
Ann W. Frye, Victor S. Sierpina, Eugene V. Boisaubin, Robert J. Bulik
With increasing national and international support for the development of Complementary and Alternative Medicine (CAM) curricula in American medical schools, it is essential to measure what learners know and believe about CAM in order to assess outcomes of new teaching efforts. This paper describes the development and initial results of a survey designed for those purposes. The survey is constructed so that earlier single-institution studies of students’ attitudes toward CAM topics, preferred ways of learning about CAM, and students’ use of CAM therapies for self-care might be replicated and extended. A pilot test of the Complementary and Alternative Medicine ( CAM) Survey was conducted with third-year medical students at the University of Texas Medical Branch. Validity and reliability studies of the survey were conducted. Findings were compared to those of previously published studies. Interpretable subscales were constructed from survey questions. Students’ attitudes toward CAM-related topics were generally favorable. More students were familiar with biological-based therapies than with other CAM therapies. The majority of respondents listed lectures as their preferred way to learn about CAM. Respondents’ own CAM use varied; minority and economically-disadvantaged students were more likely to use CAM therapies than other students. The survey is a promising assessment of student attitudes toward and knowledge of CAM therapies.
Clinical supervision in general practice training: the interweaving of supervisor, trainee and patient entrustment with clinical oversight, patient safety and trainee learningSpringer Science and Business Media LLC - Tập 26 - Trang 297-311 - 2020
Nancy Sturman, Malcolm Parker, Christine Jorm
Australian general practice trainees typically consult with patients from their first week of training, seeking in-consultation supervisory assistance only when not sufficiently confident to complete patient consultations independently. Trainee help-seeking plays a key role in supervisor oversight of trainee consultations. This study used focus groups and interviews with general practice supervisors to explore their approaches to trainee help-seeking and in-consultation supervision. Supervisor approaches are discussed under three themes: establishing a help-seeking culture; perceptions of in-consultation assistance required; and scripts for help provision. Within these themes, three interwoven entrustment processes were identified: supervisor entrustment; trainee self-entrustment; and ‘patient entrustment’ (patient confidence in the trainee’s clinical management). Entrustment appears to develop rapidly, holistically and informally in general practice training, partly in response to workflow pressure and time constraints. Typical supervisor scripts and etiquette for help-provision involve indirect, soft correction strategies to build trainee self-entrustment. These scripts appear to be difficult to adapt appropriately to under-performing trainees. Importantly, supervisor scripts also promote patient entrustment, increasing the likelihood of patients returning to the trainee and training practice for subsequent review, which is a major mechanism for ensuring patient safety in general practice. Theories of entrustment in general practice training must account for the interplay between supervisor, trainee and patient entrustment processes, and work-related constraints. Gaps between entrustment as espoused in theory, and entrustment as enacted, may suggest limitations of entrustment theory when extended to the general practice context, and/or room for improvement in the oversight of trainee consultations in general practice training.
Smoothing Out Transitions: How Pedagogy Influences Medical Students’ Achievement of Self-regulated Learning GoalsSpringer Science and Business Media LLC - Tập 12 - Trang 279-297 - 2006
Casey B. White
Medical school is an academic and developmental path toward a professional life demanding self-regulation and self-education. Thus, many medical schools include in their goals for medical student education their graduates' ability to self-assess and self-regulate their education upon graduation and throughout their professional lives. This study explores links between medical students' use of self-regulated learning as it relates to motivation, autonomy, and control, and how these influenced their experiences in medical school. Subjects were medical students in two distinct medical school environments, “Problem-based learning” and “Traditional.” PBL students described a rough transition into medical school, but once they felt comfortable with the autonomy and control PBL gave them, they embraced the independence and responsibility. They found themselves motivated to learning for learning's sake, and able to channel their motivation into effective transitions from the classrooms into the clerkships. Traditional students had a rougher transition from the classrooms to the clerkships. In the first two years they relied on faculty to direct and control learning, and they channeled their motivation toward achieving the highest grade. In the clerkships, they found faculty expected them to be more independent and self-directed than they felt prepared to be, and they struggled to assume responsibility for their learning. Self-regulated learning can help smooth out the transitions through medical school by preparing first and second year students for expectations in the third and fourth years, which can then maximize learning in the clinical milieu, and prepare medical students for a lifetime of learning.
Clinician educators’ conceptions of assessment in medical educationSpringer Science and Business Media LLC - - 2023
Danica Sims, François Cilliers
AbstractIn pursuing assessment excellence, clinician-educators who design and implement assessment are pivotal. The influence of their assessment practice in university-run licensure exams on student learning has direct implications for future patient care. While teaching practice has been shown to parallel conceptions of teaching, we know too little about conceptions of assessment in medical education to know if this is the case for assessment practice and conceptions of assessment. To explore clinician-educators’ conceptions of assessment, a phenomenographic study was undertaken. Phenomenography explores conceptions, the qualitatively different ways of understanding a phenomenon. Data analysis identifies a range of hierarchically inclusive categories of understanding, from simple to more complex, and the dimensions that distinguish each category or conception. Thirty-one clerkship convenors in three diverse Southern settings were interviewed in three cycles of iterative data collection and analysis. Four conceptions of assessment were identified: passive operator, awakening enquirer, active owner and scholarly assessor. Six dimensions were elucidated to describe and distinguish each conception: purpose of assessment; temporal perspective; role and responsibility; accountability; reflexivity and emotional valence. Additionally, three characteristics that appeared to track the progressive nature of the conceptions were identified: professional identity, assessment literacy and self-efficacy. These conceptions encompass and extend previously described conceptions across different educational levels, disciplines and contexts, suggesting applicability to other settings. There is some evidence of a relationship between conceptions and practice, suggesting, together with the hierarchical nature of these conceptions, that targeting conceptions during faculty development may be an effective approach to enhance assessment practice.