Online teaching. Are you learning comfortably?

Source: BMC Medical Education

Date of Publication: July 2014

In a nutshell: More and more medical education is happening online now. But how comfortable are students learning this way? Researchers from the Mayo Clinic College of Medicine in Rochester, Minnesota survey students every year about how comfortable they are using computers and their previous experiences of online learning. The researchers studied answers to the surveys filled out between 2003 and 2011 from 371 students. They found that the students’ ratings of their comfort with and previous experience of online learning hardly changed over the period between 2003 and 2011. How comfortable the students were with online learning had no influence on their test scores but the better their perceptions about their previous experiences were the higher were their test scores. You can find the full text of this article here.

What do students think about collaboration?

Source: Educational Gerontology, Dec2014, Vol. 40 Issue 12, p894-908

Date of Publication: December 2014

In a nutshell: Healthcare students are educated separately yet are expected to work together once they finish their courses. Lecturers are trying to include some inter-professional elements in courses now but how do students feel about working with their peers from other disciplines? Researchers from Florida Atlantic University studied 156 students who had taken part in an inter-professional education development session and a senior aging and geriatrics educator mentoring program where they had worked with students from other disciplines. They found that medical students had the most positive change in attitude towards working with other professions after the courses. Social-work students were the least positive about the working relationship between social workers and doctors while nurses were the least positive about the relationship between nurses and doctors.

Say hello to the GOSCE

Source: Patient Education & Counseling, Jul2014, Vol. 96 Issue 1, p79-85

Date of Publication: July 2014

In a nutshell: Objective Structured Clinical Examinations (OSCEs) involve junior doctors treating people pretending to be patients and are a mainstay of most medicine courses. However, they don’t teach communication between doctors so lecturers at Weill Cornell Medical College in New York and New York Presbyterian Hospital tried using a Group Objective Structured Clinical Examination or GOSCE. They found that discussing the pretend patients in groups had a positive impact on the students’ attitudes to learning communication skills and their self-confidence about communicating with other doctors.

Junior doctors – not quite as empathetic as they think they are?

Source: Patient Education & Counseling, Jul2014, Vol. 96 Issue 1, p22-28

Date of Publication: July 2014

In a nutshell: Empathy is increasingly being recognised as a vital skill for doctors and nurses. Doctors are assessed for their empathy and expertise during Objective Structured Clinical Examinations (OSCEs) where they treat people pretending to be patients. But how accurate are the pretend patients, and the junior doctors themselves, at assessing their empathy? A team of researchers led by Suely Grosseman from the Federal University of Santa Catarina in Brazil studied 214 junior doctors in their first year after university. They got them to fill out a standard questionnaire to measure empathy – the Jefferson Scale of Empathy (JSE) – asked them to rate their own empathy themselves and got the people pretending to be patients to rate their empathy. They found that the junior doctors’ own ratings of their empathy matched their ratings from the empathy questionnaire but that the pretend patients’ ratings for their empathy did not match either. So either the pretend patients’ ratings for the doctors’ empathy were wrong or the doctors’ own ratings – and the ones from the questionnaire – were. Either way the study raises some interesting questions about the effectiveness of OSCEs in assessing the empathy of junior doctors.

Asynchronous learning – students get there in their own sweet time

Source: Journal of Dental Education Jun2014, Vol. 78 Issue 6, p856-866

Date of Publication: June 2014

In a nutshell: Asynchronous education involves putting a load of educational material, including exercises and tests, online and letting students work through it at their own pace. Researchers from the Department of Dental Medicine at Lutheran Medical Centre in New York developed an asynchronous online curriculum made up of PowerPoint presentations with audio explanations. 169 dental students took part in a study into the effectiveness of the asynchronous learning package. The students preferred face-to-face and asynchronous learning to a time-limited online curriculum in terms of the effectiveness and clarity of presentation. However, they rated face-to-face learning as more conducive to student-instructor and student-student interaction. So while asynchronous learning was as effective at teaching students about the subject they did miss the social sides of traditional classroom teaching.

Four habits model helps nurses communicate with parents

Source: Patient Education & Counseling, Jul2014, Vol. 96 Issue 1, p72-78

Date of Publication: July 2014

In a nutshell: Communicating with parents whose children are in hospital is a task that needs a lot of skill so its important that the nurses who are doing it are well trained. Researchers from the University of Oklahoma and Indiana University studied the effectiveness of the Four Habits Model in teaching newly-qualified paediatric nurses. The four habits are: invest in the beginning by creating rapport quickly; elicit the patient’s perspective; demonstrate empathy and invest in the end by delivering clear information and involving the patient in making decisions. In the study one group of nurses took part in a simulation education session based on the Four Habits Model while the other group saw a one-hour video. The group who took part in the Four Habits training improved significantly in preparation, communication skills, relationships and confidence compared to the other group, regardless of their experience.

Junior doctors spread the word on nutrition

Source: BMC Medical Education

Date of Publication: June 2014

In a nutshell: One in four adults who come into hospital are at risk of malnutrition – something which can delay people’s recovery, increase the length of their stay in hospital, worsen their prognosis and increase their risk of complications. The Need for Nutrition Education Programme was developed in 2007 to tackle this issue and in this study three junior doctors who had attended some of its training were chosen to lead a new scheme to raise awareness about nutrition in hospitals. The programme – Nutrition Education and Leadership for Improved Clinical Outcomes (NELICO) – involved each of the junior doctors recruiting three additional people to go to an intensive training weekend which included nutrition, change management and leadership. The junior doctors – plus the additional people they had recruited – then went back to their own hospitals and ran Nutrition Awareness Weeks. The researchers tested the hospital staff’s knowledge of nutrition issues before the awareness weeks and four months after them finding a ‘significant increase in the overall score.’ Interviews with, and feedback from, staff who had attended educational sessions showed that all three junior-doctor led teams had conducted an effective nutrition awareness week.

You can find out more about this article here

Training to train – what motivates medical educators?

Medical students and junior doctors all need people to train them yet there is little research into career choices in medical education or the impact of specific training posts. Researchers from the University of Queensland interviewed 12 registrars who had all decided to specialise in medical education. They analysed their responses and found six main themes emerged from them:

Motivation for career choice and wanting to provide better education

  • Personal goals, expectations and the need for self-direction
  • The influence of role models
  • Defining one’s identity
  • Support networks
  • The need for research as a potential barrier to pursuing a career in/with education

The researchers found that there was a growing interest from junior doctors in going into medical education with junior doctors wanting to improve teaching and become specialists with an interest in education. Beyond teaching, however, the junior doctors wanting to go into education had no particular interest in going into research or academia.

You can see the full text of this article here.

Pretending to be a patient. Do all OSCEs deserve an Oscar?

Source: BMC Medical Education

Date of Publication: May 2014

In a nutshell: Many medical schools rely on Objective Structured Clinical Examinations – or OSCEs – to assess medical students. People pretend to be patients suffering from a particular complaint and medical students are given marks on how they communicate, diagnose and treat them. Because this test involves human beings it’s open to all sorts of personal factors – one of which is the accuracy of the portrayal of the illness by the person pretending to be the patient. Researchers from Jinnah Sindh Medical University in Karachi and the University of Calgary in Canada videoed sixteen people pretending to be patients during a ‘high-stakes,’ medical exam. Two doctors were asked to rate the actors’ performance with a third doctor arbitrating if the first two disagreed. The researchers found that ‘variation of trained SP (actor) portrayal of the same station across different tracks and at different times in OSCE may contribute substantial error to OSCE assessments.’ They concluded that ‘the training of SPs should be strengthened and constantly monitored … to ensure that the examinees’ scores are a true reflection of their competency and devoid of exam errors.’

 You can find the full text of this article here.

Sub-Saharan electives. Cause for pride or elephants’ graveyard?

Source: Medical Education Jun2014, Vol. 48 Issue 6, p593-603

Date of Publication: June 2014

In a nutshell: Medical students from the UK often go to far-flung countries to do an elective as part of their medical training. This study looked into the experiences of 29 students on their electives at seven host sites in sub-Saharan Africa. The researchers found that the students were highly positive about their experiences and were aware of their clinical limitations – what they should and should not be doing. The training they had received before they left was seen as having little clinical relevance. Language barriers were the main challenges faced by the students even in places where English was the second language. Students who stayed longer, were closer to qualifying and who were based in rural units (rather than teaching centres) felt that they had contributed the most to patient care.