Exploring the feasibility and acceptability of using tactical decision games to develop final year medical students’ non-technical skills

Introduction: Clinical decision-making, situation awareness, task management, and teamwork are key non-technical skills (NTS) required by junior doctors. Tactical decision games (TDGs) are low-fidelity classroom-based activities designed to develop proficiency in NTS. This study aimed to explore the feasibility and acceptability of using TDGs as a novel teaching method for final year medical students.

Methods: Final year medical students at the University of Edinburgh participated in a single TDG session. Focus groups were then used to explore students’ perceptions of participating in the TDG session and transcribed data from the focus groups was thematically analyzed.

Results: Six key themes emerged from the data: “the value of non-medical games”; “giving and receiving feedback”; “observing and reflecting”; “recognizing and understanding NTS”; “dealing with uncertainty and ambiguity”, and “introducing TDGs into the curriculum”.

Conclusions: TDGs are an easy-to-use, low-fidelity method of teaching medical students about the importance of NTS. Medical students view TDGs as a valuable learning activity that appears to increase awareness and understanding of the importance of NTS.     

Can communication skills training improve empathy? A six-year longitudinal study of medical students in Japan

Background: Empathy is an important component of overall clinical competence; thus, enhancing empathy in medical education is essential for quality patient care.

Aim: This longitudinal study was designed to address the following questions: 1. Can a targeted educational program in communication skills training enhance empathy in medical students? and 2. Can such a program have a sustained effect?

Methods: Study participants included 116 students who entered Okayama University Medical School in 2011. Students participated in a communication skills training program aimed to enhance their empathy, and completed the Jefferson Scale of Empathy (JSE) five times: at the beginning of medical school, prior to participation in the program, immediately after the program, and in last years of medical school. A total of 69 students, representing 59% of the cohort, completed the JSE in all five test administrations.

Results: Students’ total scores on the JSE and its two factors (Perspective Taking and Compassionate Care) increased significantly (p?Conclusions: Targeted educational programs to enhance empathy in medical students can have a significant effect; however, additional reinforcements may be needed for a sustained effect.     

Undergraduate medical students’ perspectives of skills,uses and preferences of information technology in medical education: A cross-sectional study in a Saudi Medical College

Abstract

Background: Information technology (IT) is widely used in medical education. However, there are not enough studies about IT uses and preferences among traditional and problem-based learning (PBL) medical students.

Aim: To compare IT skills, uses and preferences for education between traditional and PBL medical students’.

Method: A cross-sectional study; a modified Educause Center for Analysis and Research online survey was sent to traditional curriculum 5th and PBL 4th year medical students of King Saud University.

Results: Most of the responding 176 students prefer mobile devices and moderate amount of IT in education. Fourth and fifth year students perceived high academic value of Google (94.2 vs. 86.7%, p?=?0.34), YouTube (90.7 vs. 92.2%, p?=?0.83) and PubMed (83.7 vs. 86.7%, p?=?0.06). More 4th year than 5th year students rated themselves as skilled in learning management system (54.7 vs. 21.1%, p?=?0.0001) and Smartboard use (40.7 vs. 23.3%, p?=?0.04). Most students rated faculty IT skills as effective. Students agreed that technology helps working faster (95.5%) and make learning creative (85.9%).

Conclusions: More integration of information literacy and IT training in medical curricula is needed to enhance better utilization of full features of IT resources available for learning and problem solving. National multi-institutional studies are recommended.     

How characteristic routines of clinical departments influence students’ self-regulated learning: A grounded theory study

Background: In clerkships, students are expected to self-regulate their learning. How clinical departments and their routine approach on clerkships influences students’ self-regulated learning (SRL) is unknown.

Aim: This study explores how characteristic routines of clinical departments influence medical students’ SRL.

Methods: Six focus groups including 39 purposively sampled participants from one Dutch university were organized to study how characteristic routines of clinical departments influenced medical students’ SRL from a constructivist paradigm, using grounded theory methodology. The focus groups were audio recorded, transcribed verbatim and were analyzed iteratively using constant comparison and open, axial and interpretive coding.

Results: Students described that clinical departments influenced their SRL through routines which affected the professional relationships they could engage in and affected their perception of a department’s invested effort in them. Students’ SRL in a clerkship can be supported by enabling them to engage others in their SRL and by having them feel that effort is invested in their learning.

Conclusions: Our study gives a practical insight in how clinical departments influenced students’ SRL. Clinical departments can affect students’ motivation to engage in SRL, influence the variety of SRL strategies that students can use and how meaningful students perceive their SRL experiences to be.     

Does a socially-accountable curriculum transform health professional students into competent,work-ready graduates? A cross-sectional study of three medical schools across three countries

Abstract

Background: Socially-accountable health professional education (SAHPE) is committed to achieving health equity through training health-workers to meet local health needs and serve disadvantaged populations. This research assesses the biomedical and socially-accountable competencies and work-readiness of first year graduates from socially-accountable medical schools in Australia, the United States and Sudan.

Method: A self-administered survey to hospital and community health facility staff closely associated with the training and/or supervision of first year medical graduates from three SAHPE medical schools.

Main outcome measure: Likert scale ratings of key competencies of SAHPE graduates (as a group) employed as first-year doctors, compared to first year doctors from other medical schools in that country (as a group).

Findings: Supervisors rated medical graduates from the 3 SAHPE schools highly for socially-accountable competencies (‘communication skills’, ‘teamwork’, ‘professionalism’, ‘work-readiness’, ‘commitment to practise in rural communities’, ‘commitment to practise with underserved ethnic and cultural populations’), as well as ‘overall performance’ and ‘overall clinical skills’.

Interpretation: These findings suggest SAHPE medical graduates are well regarded by their immediate hospital supervisors, and SAHPE can produce a medical workforce as competent as from more traditional medical schools, but with greater commitment to health equity, working with underserved populations, and addressing local health needs.     

A qualitative study of medical educators’ perspectives on remediation: Adopting a holistic approach to struggling residents

Introduction: During residency, some trainees require the identification and remediation of deficiencies to achieve the knowledge, skills and attitudes necessary for independent practice. Given the limited published frameworks for remediation, we characterize remediation from the perspective of educators and propose a holistic framework to guide the approach to remediation.

Methods: We conducted semistructured focus groups to: explore methods for identifying struggling residents; categorize common domains of struggle; describe personal factors that contribute to difficulties; define remediation interventions and understand what constitutes successful completion. Data were analyzed through conventional content analysis.

Results: Nineteen physicians across multiple specialties and institutions participated in seven focus groups. Thirteen categories emerged around remediation. Some themes addressed practical components of remediation, while others reflected barriers to the process and the impact of remediation on the resident and program. The themes were used to inform development of a novel holistic framework for remediation.

Conclusions: The approach to remediation requires comprehensive identification of individual factors impacting performance. The intervention should not only include a tailored learning plan but also address confounders that impact likelihood of remediation success. Our holistic framework intends to guide educators creating remediation plans to ensure all domains are addressed.     

Medical teachers’ perception of professional roles in the framework of the German National Competence-Based Learning Objectives for Undergraduate Medical Education (NKLM)—A multicenter study

Background: Based on CanMEDS and others, the German National Competence-Based Learning Objectives for Undergraduate Medical Education (NKLM) were recently consented. International studies recommend integrating national and cultural context when transferring a professional roles framework in different countries. Teachers’ misconceptions may establish barriers in role understanding and implementation.

Objectives: The aim is to analyze medical teachers’ rating and perception of NKLM roles in order to reveal differences to official definitions.

Methods: A two-step sequential mixed methods design was used including a survey and focus groups with N?=?80 medical teachers from four German universities.

Results: Most of the teachers highly valued the importance of the role “Medical Expert” and understood comprehensively. The Communicator and the Collaborator were rated fairly and perceived to a large extent. Other intrinsic roles like Health Advocate and Scholar showed more deficits in perception and less importance by the participants. This was seen generally problematic and should be considered carefully. Manager and professional showed one-sided weaknesses either in importance or perception.

Conclusion: Medical teachers considered NKLM roles relevant for medical practice, although their role perception differed considerably. The value and risk matrix visualizes the specific role profile and offers strategic implications for NKLM communication and handling, thus supporting change management.