La evaluación clínica objetiva estructurada (ECOE): aspectos principales y papel de la radiología

The objective structured clinical examination (OSCE) is a format of examination that enables students to be evaluated in a uniform, standardized, reliable, and objective way. It is carried out in different clinical stations that simulate real clinical situations and scenarios. Numerous universities in Spain and other countries employ this approach for the final examination for medical school students. This update describes the organization, design, and fundamentals for the OSCE, proposing that radiology should form part of multidisciplinary OSCEs to the extent that it forms part of clinical practice. Moreover, it is interesting and opportune to introduce the OSCE in undergraduate and postgraduate training in radiology. Online platforms enable bidimensional OSCEs that are cost-effective in terms of staff, resources, and physical space, although this approach has certain limitations. Virtual world technologies make it possible to reproduce OSCE stations in three-dimensional scenarios; recent experiences in radiology have shown that this approach interests and motivates students and is widely accepted by them.     

Evaluation of different teaching methods in the radiographic diagnosis of proximal carious lesions

Objectives:To evaluate four different teaching methodologies in the radiographic diagnosis of proximal carious lesions and in the students’ perception of these methodologies.Methods:71 undergraduate dental students were subdivided into 4 groups according to the teaching methodologies used (traditional, hybrid, e-learning and problem-based learning). All methods were applied by two properly trained researchers. Initially, students completed a pre-methodology test (index test). After applying the teaching methodologies, the students were submitted to a post-methodology test containing periapical radiographs for evaluation of proximal carious lesions. Then, the students answered a questionnaire to verify their perception of the different teaching methodologies. Statistical analysis was done.Results:There were no relationship between the results of pre- and post-methodologies tests, irrespective of the teaching methodology employed (p > 0.05). No differences between the teaching methodologies studied (p > 0.05) were found regarding the amount of correct answers. However, the students who participated in the active (e-learning and problem-based learning) and hybrid teaching methodology reported a positive impact in relation to their diagnostic skills at the questionnaire.Conclusions:All the tested methodologies had a similar performance; however, the traditional methodology showed less acceptance by the students when analyzed subjectively and comparatively. The results of the present study increase comprehension about teaching methodologies for radiographic diagnosis of proximal carious lesions, and there is a potential to build on the knowledge base and provide practical support for students and educators.     

Forensic undergraduate cohort; job readiness curricula

ABSTRACT

A self- and peer-assessment strategy was implemented to support learning, teaching and assessment of undergraduate forensic science students’ capacity to work in a team. This strategy aimed to fill the gap observed in teamwork assessment, which historically focuses on the project outcome rather than an individual’s performance within a team. The online assessment tool, SPARKPLUS, was chosen as the platform to provide students with the teamwork skills criteria and levels of achievement they were required to self and peer assess against, during forensic investigation assessment team tasks. This work-integrated learning involved three components: (1) processing a mock crime scene; (2) laboratory analysis of the evidence collected; and (3) development and presentation of a police brief of evidence. A comparison of the distribution of the self- and peer-assessment ratings from students in second- and third-year cohorts shows that this approach improves assessment of teamwork.     

Diagnostic radiography students' perceptions of formative peer assessment within a radiographic technique module

IntroductionAssessment is a central part of student learning. Student involvement in peer assessment leads to significant improvement in students' performance, supports students' learning, promotes the development of evaluation skills and encourages reflection.AimThe aim of this study is to assess perceptions of the Formative Peer Assessment (FPA) initiative within a higher education setting for undergraduate radiography students.MethodsQualitative action research was conducted. Students were allowed to anonymously assess each other's assignments using a standardized evaluation sheet that they had been trained to use. Participants' perceptions were assessed through focus group discussion.ResultsThe findings showed that students' experiences with peer assessment were positive. Students acknowledged that they received valuable feedback and learned from assessing their peers. Students recommended the need for training and suggested using more than one evaluator.ConclusionThe FPA initiative in the study institution believed to be succeed as the students had a positive experience with the FPA. Students learnt from PA and from self-assessment. Implementation of PA will promote reflection and critical thinking and problem solving skills, that are important traits in radiography graduate profile as in radiography clinical practice the professional require to modify imaging techniques and critique images to ensure the quality of care.     

The Virtual Homeroom: Utility and Benefits of Small Group Online Learning in the COVID-19 Era

ObjectiveDuring COVID-19, Harvard Medical School pivoted to online learning. A large student cohort took a completely virtual Radiology clerkship with daily programming including virtual small group teaching sessions or “homerooms.”Materials and methodsOne hundred and eleven medical students were divided into 12 virtual small group sessions which emphasized foundational concepts. Uniform teaching materials were used across all homerooms in order to deepen understanding and allow insight into the working methods of radiologists. Students evaluated the homeroom learning and teachers for utility and benefit to their educational experience.ResultsMost students (93%) felt the homerooms provided an educational benefit and reinforced topics studied (77%). Most students (84%) felt the leaders created an environment conducive to learning. Despite being virtual, students were able to form interpersonal connections with the homeroom leaders.ConclusionsIncorporating virtual small group learning can be a valuable component of a virtual or hybrid Radiology clerkship, solidifying foundational concepts with the homeroom leaders playing a major role. While developed by necessity due to COVID-19, virtual small group learning with engaged leaders is an educational strategy whose benefit can continue even as there is return to in-person learning.     

Interprofessional Education and the Diagnostic Radiography curriculum: Students’ perceived value of a case-based,whole day activity

IntroductionThis study aimed to examine Diagnostic Radiography (DR) students’ perceptions and attitudes towards the Health Collaboration Challenge (HCC), as an interprofessional learning opportunity.MethodsDR students participated in the HCC, an annual intensive interprofessional collaboration and assessment activity involving case-based learning. Students' attitudes towards Interprofessional Education (IPE) were measured using a modified version of the Interprofessional Socialisation and Valuing Scale (ISVS-21) and a bespoke questionnaire with items relating to the HCC. Subsequent focus groups explored students’ experience of IPE within the HCC context.ResultsSurvey results (n = 30) suggested a mostly positive attitude towards IPE alongside other health care students, acknowledging the value of interprofessional teams in patient health care. Qualitative themes from focus group participants (n = 8) revealed that DR students, while appreciating the value of shared-decision making, found the HCC assessment distracting. Challenges included the intensive nature of the HCC, roles that DR students undertook in addressing assessment criteria, case complexity and opportunities for DR students to showcase their knowledge.ConclusionResults suggest that the intensive and assessable nature of the HCC can overshadow the value of IPE for DR students, and immersive or staggered approaches to IPE could better align with DR professionals’ unique role within the patient care spectrum.Implications for practiceRevised IPE models for DR students could include a more immersive environment, conducted over a longer period of time, with meetings at semi-regular intervals to promote an interprofessional-focus over a task-focus approach.     

The impact of teaching experimental research on-line: Research-informed teaching and COVID-19

IntroductionAs part of the BSc (Hons) Diagnostic Radiography programme students learn and undertake research relevant to their development as first post radiographers (dose optimisation and image quality) within the Research-Informed Teaching experience (RiTe). Due to the COVID-19 pandemic, the delivery of RiTe to our year 2 students was moved to an online format using Microsoft Teams and Blackboard Collaborate and focused on a key area of current practice - COVID-19 and chest X-ray imaging. Within RiTe students are placed into collaborative enquiry-based learning (CEBL) groups to share tasks, but to also support and learn from one another.MethodsAn online survey was used to explore the year 2 student cohort task value and self-efficacy of this online version of RiTe.ResultsA 73% (32/44) response rate was achieved. Students found the online version of RiTe to be a positive learning and development experience. There was strong agreement that they not only found it relevant to their area of practice (task-value), but also strongly agreed that they understood and could master the skills taught (self-efficacy).ConclusionThis online version of RiTe was effectively structured to help scaffold student learning and development of research data analysis skills despite the lack of face-to-face teaching. The students also valued the topic area (COVID-19 and chest X-ray imaging). A blended learning approach with RiTe will be used next year with a combination of collaborative online teaching and physical data collection and analysis in the university-based X-ray imaging laboratory. Further evaluation and data collection will also be undertaken.Implications for practiceUniversity-based empirical work in groups to learn about research can be replaced by an online mechanism whilst still maintaining task-value and acceptable self-efficacy.     

How do the attitudes of therapeutic radiographers affect students’ learning during practice placement?

IntroductionPractice placements are essential for radiotherapy students to learn and embed the necessary skills for practice; thus, each placement should afford an optimum learning experience. A key finding from the Phase 3 student arm of recent doctoral research suggests that for some students an optimum learning experience is not guaranteed. Using students' own words, this paper seeks to increase radiographers' awareness of how their behaviours can affect students’ placement learning, and aims to help improve the placement learning experience for both.MethodA three-phase, U.K.-wide, mixed methods study was conducted. In the Phase 3 student arm, qualitative data were gathered via focus groups/interviews from volunteer student radiographers. Data were transcribed, manually coded, and analysed thematically by the Researcher using the applied research methodology Framework Analysis.ResultsThe analysed data were complimentary to radiographers, overall, but common themes were identified criticising certain of their attitudes and behaviours. Students exhibited fragility in response to perceived negative attitudes and behaviours, and failed to develop resilience in response to further similar experiences. This had a negative effect on their placement learning. Positive attitudes from radiographers enhanced students’ placement learning. The placement experiences of radiotherapy students are consistent with those of other AHP and nursing students identified in the literature.ConclusionIncreasing radiographers' awareness of the negative and positive effects of their behaviours and attitudes will help improve students' placement learning experience. Students’ resilience may be improved by teaching them coping strategies to use on placement.Implications for practiceThe retention of radiotherapy students is an urgent concern for the radiotherapy profession therefore it is important to take steps to improve it. Enhancing students’ placement experience may contribute to increased retention.     

Radiography students’ perceptions of Peer assisted learning

IntroductionPeer Assisted Learning (PAL) is collaborative learning in which students from the same or different academic levels learn from each other. It is meant to support the regular teaching and learning process. Learning in PAL can be explained by constructive social learning theories and has many advantages such as, students' perception of it and the ease of discussion between peers. This study aims to measure students’ perception of PAL in the context of radiography education.MethodsA PAL programme was implemented in one module taught to second year radiography students. A questionnaire was then distributed to the participating students (n = 28) to measure their perception of PAL; the questionnaire consisted of 13 questions with a Likert scale of 5 (1 = strongly disagree to 5 = strongly agree). The results were analysed using SPSS to calculate the percentages, means, standard deviations, and factorial analysis.ResultsTwenty-six students responded to the questionnaire (92.8%). The range of agreement in all questionnaire items ranged from 79.9% to 92.3%. The factor analysis revealed two main factors affecting students' acceptability. PAL enriched students’ learning experience and helped them in preparation for exams.ConclusionThe use of PAL is highly acceptable by students in context of radiography education.Implications for practiceMore studies are necessary to confirm the best methods of using PAL. These may involve both students and educators, and pre- and post-methods.     

Partnerships for clinical learning: A collaborative initiative to support medical imaging technology students and their supervisors

IntroductionThe involvement of practitioners in the teaching and supervision of medical imaging technology students is central to students' learning. This article presents an overview of a learning partnership initiative, reinforced by an online platform to support students' learning and their medical imaging technologist supervisors' (MITs) teaching within a clinical learning environment in a New Zealand context.MethodologyData were generated through a series of fourteen collaborative action research focus group meetings with MITs and student MITs.ResultsThe findings revealed that a robust relationship between a student and their MIT partner gave students an ‘anchor’ for learning and a sense of belonging. The online platform supported the relationship and provided an effective means for communication between students and their MIT partners. The relationship was not one-directional as it also supported the enhancement of MITs' practice.ConclusionsThe recommendations from the study suggest learning partnerships between MITs and student MITs will be valuable in supporting teaching and learning respectively. MITs need to be better supported in their teaching role to enable them to make a greater investment in students' learning. A redistribution of funding for clinical education needs to be considered to support the MITs' central role in teaching medical imaging students.     

Problem based learning in radiography education: A narrative review

ObjectivesRadiography practice is fast developing with new imaging updates and challenging scenarios to deal with on a frequent basis. There is a need to equip students with the skill to be independent learners and develop critical thinking skills, so they can change their practice as the profession evolves. Problem Based Learning (PBL) has widely been adopted in medical and nursing training worldwide as a result of its desirable benefits. In order to ascertain the efficacy of the technique, this paper presents a review of the essential aspects of PBL, such as the theories, process, key roles and implication for radiography education and practice.Key findingsThe use of a defined model provides a useful structure to the PBL exercise with the addition of reflection, which is a pertinent inclusion within the process. The role of the facilitator in PBL is significant to students' learning as they help guide the students to the learning outcomes and provide support to the group; however, their skills development is an important factor to consider in PBL.ConclusionThis teaching approach has key benefits in radiography education and training in particular, its impact on preparing students for autonomous clinical practice.Implications for practiceThe application of PBL in developing students' critical thinking and decision-making abilities support the narrowing of the spoon-feeding expectation of students and render it a useful pedagogical implementation within radiography programmes.     

Towards a research informed teaching experience within a diagnostic radiography curriculum: The level 4 (year 1) student holistic experience

AimThis article discusses the level 4 (year 1) diagnostic radiography student holistic experience of the Research-informed Teaching experience (RiTe) at the University of Salford, UK. The purpose of RiTe is to expose undergraduate radiography students to more formal research, as part of their normal teaching and learning experience.MethodA grounded theory approach was adopted and a focus group with eight level 4 students was used to explore and evaluate the student experience and perception of RiTe.ResultsOpen coding defined categories and sub-categories, with axial and selective coding used to interrogate and explore the relationships between the focus group data. A number of insights were gained into the student holistic experience of RiTe. The issue of leadership for level 4 students was also identified.DiscussionThe focus group participants found RiTe to be an extremely positive learning experience. RiTe also facilitated their translation of learnt theory into clinical skills knowledge alongside their understanding of and desire to participate in more research as undergraduates. The article also highlights areas for future research.     

Clinical competence assessment in radiology: introduction of an objective structured clinical examination in the medical school curriculum

RATIONALE AND OBJECTIVES: Traditional oral and written examinations can be limited in predicting future clinical performance. Therefore Objective Structured Clinical Examinations (OSCEs) have been introduced in other specialties. The authors assessed their value in radiology. MATERIALS AND METHODS: The study includes 122 Harvard medical students who undertook 1-month compulsory clerkships at one of three hospitals (A, B, or C) in their 3rd and 4th year and a compulsory OSCE in their 4th year. The OSCE was constructed from five cases. Each had eight or nine standardized questions designed to test, within a set time, the perception of essential findings, their interpretation, and clinical judgment (maximum possible score, 100). Clerkship grades were high honors (score of 3), honors (score of 2), satisfactory (score of 1), and fail (score of 0). Predictors of OSCE scores-clerkship grade and affiliated hospital-were modeled as linear functions. Time elapsed between clerkship and OSCE was modeled as a nonlinear function. RESULTS: Although there was a positive relation between clerkship grade and OSCE grade, it accounted for an increase of only 5.7% in OSCE score per clerkship grade and did not predict performance of individual students. Students who trained in hospital B showed significantly higher OSCE grades. OSCE scores were highest when the examination was taken 8 months after the clerkship. CONCLUSION: The OSCE may be useful to uncover deficits in individuals and groups beyond the ones detected with traditional clerkship evaluations and provide guidance for remediation. The improved performance after additional clinical exposure suggests that the OSCE may be well suited to test the integration of radiologic and clinical knowledge.     

First-Year Radiology Residents Teaching Anatomy to First-Year Medical Students: A Symbiotic Relationship

ObjectivesOur institution has developed an educational program in which first-year radiology residents teach first-year medical students during gross anatomy laboratory sessions. The purpose of this study is to assess the impact of this program on medical student knowledge and perceptions of radiology, and on resident attitudes toward teaching.Materials and MethodsFirst-year resident pairs taught small groups of medical students during weekly 15-minute interactive sessions, and were evaluated on teaching skills by senior residents. A survey about attitudes toward radiology and a knowledge quiz were sent to the medical students, and a survey about attitudes toward teaching was sent to the first-year radiology residents, both pre-course and post-course.ResultsStudents’ radiology knowledge significantly increased between the pre-course and post-course survey across all categories tested (P < 0.001). Additionally, there were significant improvements in terms of students’ confidence in radiologic anatomy skills, perceived importance of radiology for medical training, familiarity with the field of radiology, and perception that radiologists are friendly (P < 0.001). Radiology residents felt more confident in their teaching proficiency (P < 0.001) by the conclusion of the course.ConclusionsResident-led small-group teaching sessions during anatomy laboratory are mutually beneficial for medical students and radiology residents. The program also allows radiology residents to be exposed early on in residency to teaching and academic medicine.     

Assessment of the critical thinking skills of student radiographers

PurposeEnabling students to develop critical thinking skills is one of the key aims of higher education and in preparing student radiographers for the future, there are increasing demands on educators to teach critical thinking skills to facilitate reflective, evidence-based practice and inter-professional working. The aim of the paper is to attempt to compare students' self-perception of their critical thinking skills to their actual written assessment performance.MethodsStudents were asked to self-report how they thought the course had developed their critical thinking skills and the outcomes of this exercise were compared to the scores of previous assessments that required the demonstration of these skills.ResultsThe results suggest that whilst students report having developed critical thinking skills during the course, the results of their written assessments requiring the demonstration of these skills all had a mean score of less than 60% which indicates (in terms of the university's grade criteria guidelines) “little attempt to use critical discussion in their work.”DiscussionThirteen components of critical thinking are proposed, together with ways in which they could be incorporated into a radiographic curriculum.ConclusionsIt is suggested that educators may need to review the constructive alignment of their curricula and re-assess their teaching and assessment strategies in order to effectively develop students' critical thinking skills.     

Utilisation of a peer assisted learning scheme in an undergraduate diagnostic radiography module

BackgroundPeer to peer support programmes involve students supporting each other in either an educational, social and/or pastoral way. This is now common place in higher education institutes and has been proven to decrease student attrition and improve grades.AimTo evaluate a peer assisted learning scheme (PALS) within the University of Exeter undergraduate programme, where final year (stage 3) students held extra-curricular teaching sessions in an on-campus X-ray room throughout the academic term to support a first year (stage 1) module introducing basic projectional radiographic examinations, radiation safety, patient care and radiographic equipment. PALS sessions were unstructured and as such could involve roleplaying radiographic examinations, revisiting lecture material and/or discussing hospital placement or pastoral issues.MethodsBrookfield's four lenses of critical reflection were used. 16 of 63 stage 1 students and 9 of 29 stage 3 students were electronically surveyed upon completion of the PALS sessions. Relevant colleagues and educational specialists were also informally interviewed. These were put in context with autobiographical reflections and the existing literature base on PALS.ResultsAll agreed that the sessions provided a good environment for stage 1 students to improve their practical skills, revise lecture content, and gain confidence for upcoming clinical placements. Stage 3 students gained experience teaching students, an essential role of a graduate radiographer's job. Improvements around recruiting stage 3 peer leaders, sustainability, timetabling and session structure were explored.ConclusionThe PALS proved to be a successful initiative within the undergraduate programme and will be continued into the future.