Is there a need for a specific educational scholarship for using e-learning in medical education?

We propose the need for a specific educational scholarship when using e-learning in medical education. Effective e-learning has additional factors that require specific critical attention, including the design and delivery of e-learning. An important aspect is the recognition that e-learning is a complex intervention, with several interconnecting components that have to be aligned. This alignment requires an essential iterative development process with usability testing. Effectiveness of e-learning in one context may not be fully realized in another context unless there is further consideration of applicability and scalability. We recommend a participatory approach for an educational scholarship for using e-learning in medical education, such as by action research or design-based research.     

Is there a place for medical students in research laboratories? A student's perspective

Based on personal experience gained in two medical schools, one from a developed and one from a developing European country, I present a short discourse on the introduction of undergraduate medical students to research. The potential benefit of research for professional profile and overall competency building is emphasized and the possibility of counterbalancing the present crisis in academic medicine through undergraduate research is discussed.     

What influences the quality of educational encounters between trainer and trainee in vocational training for general practice?

This study of educational encounters between a trainer and a trainee in vocational training for general practice investigates the quality of the encounter. The study focuses on the relation between the quality of the encounter and elements such as presence of feedback, duration, use of media, etc. A quality measure based on the Gagné and Briggs model for the design of instructional events was developed. The quality score was correlated with other elements of the encounter as reported in a log diary completed by trainees. In the log diary 45 trainees registered 314 encounters. Quality predictors included duration of the encounter, the number of media (files of patients, professional guidelines) used, the number of follow-up activities and feedback by the trainer on the performance of the trainee. Several elements were identified as contributing to the educational quality of the encounter, such as presence of media, follow-up activities and positive feedback. The trainer can easily control these elements.     

Is there a place for music in medical school?

Music permeates the medical literature regarding disease therapy. However, there are only few articles concerning music as a tool for development of cultural competency and interpersonal relations. We share our experience of forming a musical act of students and faculty at a medical school. We believe that this group has encouraged medical humanism and enhanced communication in the learning environment.     

Preparation for practice: how can medical schools better prepare PRHOs?

There is growing evidence that new PRHOs feel unprepared for their first post. This study compared three cohorts of graduates, the first from a traditional systems-based curriculum, the second from the same systems-based curriculum, who had also taken an intercalated degree, and the third from a PBL curriculum who had not intercalated. Subjective reports of confidence in clinical skills, anxiety and feelings of preparedness for practice were assessed using a previously published instrument. Graduates from the PBL curriculum who had not intercalated felt significantly better prepared, less anxious and more confident than equivalent graduates from the systems-based curriculum. Systems-based curriculum graduates who had taken an additional intercalated degree scored as highly in these criteria as the PBL graduates who had not intercalated. Despite these improvements, absolute levels of anxiety remained high and feelings of preparedness and confidence in clinical skills remained poor.     

Ward round simulation in final year medical students: Does it promote students learning?

Introduction: Ward round skills are essential for doctors in hospital settings. Literature shows medical students’ deficiencies in these skills. Simulation has been used to train these skills. However, exposing learners to simulation at an early stage may be associated with a high cognitive load and limited learning. This study aims to determine how students experience this load and its interplay with performance and which factors promote and impair learning.

Methods: Fifty-six final year medical students participated in a simulated ward round training exercise. Both students’ performance and cognitive load were measured to determine if there was any correlation and interviews were carried out to understand which factors support and impair learning.

Results: Performance scores revealed deficiencies in ward round skills. Students experienced a cognitive load that weakly correlated with performance. Qualitative findings provided important insights into simulated ward-based learning. It is clear that well-designed clinical scenarios, prioritization tasks, teamwork and feedback support students’ learning process whereas distractions impair learning.

Conclusions: WRS proved to be a good teaching method to improve clinical skills at this stage as the cognitive load is not too high to impair learning. Hence, including tasks in the simulation design can enhance the learning process.     

A transitional course from high school to medical school in a new medical curriculum in Asia: how do the students see it?

The objective of this study was to examine the students' views on a transitional course for Asian freshers in a revised medical curriculum. Data were collected through the year-end questionnaire distributed to all first-year students over three academic years from 1997 to 2000. The students considered the transitional course had encouraged them to become more active and self-directed although there were different views about its overall effectiveness. Students appeared uncertain as to the depth in which they were expected to master the subjects, thus leading them to call for more clearly stated learning objectives to help relieve the anxiety they had towards the examinations. Lectures and self-assessment exercises were seen to be providing the general guides for that.     

It takes only 100 true-false items to test medical students: true or false?

Multiple true/false (MTF) questions are often used to test medical students. Statistical methods can give an indication of how many of these questions are needed for a reliable test, but it would be useful in addition to have a graphical indication of reliability. Therefore, in an attempt to estimate the smallest number of items needed for reliable testing, the marks of students were plotted throughout an examination. A total of 211 medical students were given 60 pathology questions comprising 300 true/false items. The cumulative percentage mark throughout the 300 items was calculated and graphed for five students each from the top, middle and bottom total scores. For the other 196 students, percentage marks were calculated at 100 and 300 items. The reduction in reliability induced by the 300 to 100 item reduction was calculated by the Spearman-Brown formula. The cumulative percentage graphs showed that, after early fluctuations in each student's mark, the total mark stabilized after 100 items. The mark fluctuated slightly either up or down after 100 marks, but in 96.7% of students it differed by fewer than 10 percentage points between 100 and 300 items. The reliability coefficient was reduced from 0.94 in the 300-item test to 0.85 in the 100-item test. In conclusion, student marks appear to stabilize after 100 true/false items. If the level of difficulty of an examination remains constant, and items are of high discriminatory value, 100 true/false items appear to be sufficient to assess medical students in the MTF format.