Programmed Instruction: New Bottle for Rediscovered Wine

Programmed instruction is attracting attention at all educational levels. While this approach is new, the educational principles it incorporates are well established: instructional goals are defined in advance, the content is meticulously organized, active student participation is demanded, immediate feedback is provided to students, and each instructional unit is subjected to testing and revision. With its established effectiveness as a vehicle for introducing new topics, and for providing remedial and supplementary instruction, it can free the medical teacher to devote his time to matters which are more deserving of his attention, such as identifying and responding to individual student needs, exploring complex concepts, and working directly with students to provide a model and critical supervision. A more important potential contribution of programming may be that it has reminded us of sound educational precepts which deserve our attention in all forms of instruction.     

Investigating Users' Requirements: Computer-based Anatomy Learning Modules for Multiple User Test Beds

Objective: User data and information about anatomy education were used to guide development of a learning environment that is efficient and effective. The research question focused on how to design instructional software suitable for the educational goals of different groups of users of the Visible Human data set. The ultimate goal of the study was to provide options for students and teachers to use different anatomy learning modules corresponding to key topics, for course work and professional training. Design: The research used both qualitative and quantitative methods. It was driven by the belief that good instructional design must address learning context information and pedagogic content information. The data collection emphasized measurement of users'' perspectives, experience, and demands in anatomy learning. Measurement: Users'' requirements elicited from 12 focus groups were combined and rated by 11 researchers. Collective data were sorted and analyzed by use of multidimensional scaling and cluster analysis. Results: A set of functions and features in high demand across all groups of users was suggested by the results. However, several subgroups of users shared distinct demands. The design of the learning modules will encompass both unified core components and user-specific applications. The design templates will allow sufficient flexibility for dynamic insertion of different learning applications for different users. Conclusion: This study describes how users'' requirements, associated with users'' learning experiences, were systematically collected and analyzed and then transformed into guidelines informing the iterative design of multiple learning modules. Information about learning challenges and processes was gathered to define essential anatomy teaching strategies. A prototype instrument to design and polish the Visible Human user interface system is currently being developed using ideas and feedback from users.     

Distance learning on the Internet: web-based archived curriculum

Web-based education through archived educational modules offers a significant opportunity to provide didactic education. By archiving lectures and teaching materials, it reduces the educators' time of preparation, especially when many students will need to take the same curriculum over a long period of time. The site can package educational material in multiple formats including audio, video, and readable text, allowing the student to tailor the educational experience to his/her learning preferences. This can be a stand-alone program, or integrated into a program combining distance and in-person education. Assessment through on-line tests can also be conducted, but these must be considered open-book assessments where collaboration cannot be prevented. As such, this vehicle can be utilized effectively for continuing education programs in health care, where open book is permitted and credits are generally awarded on the honor system. However, tests for certificate courses should only be given with a proctor in attendance. In this instance, on-line tests can be used as pre-tests for the student, while being structured to enhance further learning.     

Learning and evaluation in medical education

An educational experience is a complex event, which involves four distinct common places: learner, curriculum, milieu and teacher. Medical education is a unique form of educational experience. The learner is almost always an adult. The teacher is not necessarily trained to teach. Because of rapid changes in knowledge it is very dynamic. Life-long learning and evaluation are mandatory, for the student as well as the medical practitioner. This communication highlights some issues concerning learning and evaluation, as applicable to medical education, including the concept of learning by objectives, learning approaches, study strategies, learning methods; the purposes of evaluation, self-evaluation and common assessment methods. This is intended to create some awareness, in the medical student, resident or medical teacher of the need to begin to learn how to learn and demystify evaluation.     

医学微生物学个性化作业的初探

根据素质教育发展的要求,医学微生物学有必要改革传统作业布置方式,以提高学生创新能力。本研究尝试针对临床医学专业本科生开展医学微生物学个性化作业改革,教师在完善自身专业知识的基础上制定个性化作业的培养目标,学生根据实验验证方面、理论认知方面及社会调查方面的作业培养要求,结合自身特点设计作业并完成。结果显示,多形式、多层次、探究性的个性化作业有助于学生更好掌握专业知识,提高学习兴趣。     

A student-centred, problem-based curriculum: 5 years' experience.

In 1987, the University of Sherbrooke's school of medicine implemented a student-centred, problem-based learning (PBL) curriculum. The experience of the first 5 years is reviewed; program goals, the schedule of learning activities, the instructional format and assessment of student learning are described. The new program is more demanding of teachers and requires better faculty training in pedagogy. No new financial resources have been available. The preclinical reform has led to revision of the clerkship, where sessions on clinical reasoning are now based on the PBL philosophy. Student reactions to the program are reported. The Sherbrooke experience has demonstrated that it is both possible and feasible to shift from a traditional to a problem-based curriculum.     

临床医学八年制PBL课程教务运行模式与质量评价体系的构建与应用

西安交通大学临床医学专业八年制正在进行人才培养方案和课程体系改革,其主要特色为按照人体器官系统将传统生物医学和临床医学课程进行有机整合,推行PBL教学。由于PBL教学法与传统教学法有很大不同,传统的教务运行管理模式及质量评价体系已不能满足需要。为解决这一问题,我们积极探索,创建符合临床医学八年制培养思路及PBL教学特色的"以学生为中心"的教务管理运行模式,并建立与之配套的学生成绩考核评价体系以及教师授课质量评价体系,使之能更加全面、科学、公平的考核学生、评价教师,经过近三年的实践已初见成效。     

Students' perceptions of values emphasized in three medical schools

The purpose of the study presented here was to assess medical students' perceptions of the weight given to scientific and humanistic values in their learning environment and to determine whether students' perceptions in a given school vary according to their level of medical training and personal characteristics. The study was conducted in 1979 via a mail questionnaire sent to a sample of 713 freshmen, juniors, and graduates from three U.S. medical schools; 82.2 percent responded. The results indicated that the students' perceptions of school values varied little according to the students' personal characteristics, such as sociodemographic and educational background, interests before medical training, and expected specialty choice. However, important differences were observed in students' perceptions of values emphasized to them at different schools. Preclinical and clinical students' perceptions of the importance given to scientific values were similar. As for humanistic values, significantly lower ratings were given by clinical students than preclinical students in two of the schools.     

Thoughts on Learning and Teaching in the First Two Years of the Medical Curriculum

Suggestions for improvement of the educational program in the first two years of the medical curriculum are made in the light of simultaneous experiences as teacher and student. The learning needs of the student should be given more consideration. Many of the present learning-teaching problems could be solved by closer communication and collaboration between instructors teaching the same students coupled to an official recognition of the value of good teaching. In spite of a multiplicity of courses and basic science departments, the student is a single person with a rather limited goal. He is required to learn and remember a vast amount of detailed factual information during his first two years of the medical curriculum. The medical student should be reinstated as an integral human component of the structure and functioning of each department. This is a difficult task because the dual functions of research in a specialized discipline and undergraduate medical teaching frequently pull an individual's or department's activities in opposite directions and lead to administrative problems.     

Role of standardized patients in medical education

Standardized patients are volunteers from the community who participate actively in the teaching and evaluation of our future physicians. The SP program augments medical student learning in both clinical and basic sciences by providing opportunities to practice on patients who are available and willing to be examined. SPs allow "teachable moments" to be created, rather than waited for. SP-based examinations are the most reliable and standardized methods for performance-based assessment of bedside clinical skills. The problem-based-learning (PBL) approach to medical education at JABSOM is designed to foster self-directed learning, interpersonal skills and early hands-on clinical experiences. JABSOM SP experiences are integrated within the PBL curriculum. The CCS and SPs are now vital components of the JABSOM educational model.     

教育教学理论在《中药炮制学》绪论部分教学设计中的运用体会

如何提高课堂教学的效率始终是教师、教务工作者思考的问题。以《中药炮制学》绪论部分教学设计为例, 从教学目标确定、学情分析、教学策略与方法选择、以及加强学生自主学习能力等方面探讨了教育教学理论在教学设计中的运用, 说明教学设计在促进课堂教学效率提高方面发挥了积极作用。     

Optimal Training Sets for Bayesian Prediction of MeSH? Assignment

Objectives

The aim of this study was to improve naïve Bayes prediction of Medical Subject Headings (MeSH) assignment to documents using optimal training sets found by an active learning inspired method.

Design

The authors selected 20 MeSH terms whose occurrences cover a range of frequencies. For each MeSH term, they found an optimal training set, a subset of the whole training set. An optimal training set consists of all documents including a given MeSH term (C ₁ class) and those documents not including a given MeSH term (C ₋₁ class) that are closest to the C ₁ class. These small sets were used to predict MeSH assignments in the MEDLINE^® database.

Measurements

Average precision was used to compare MeSH assignment using the naïve Bayes learner trained on the whole training set, optimal sets, and random sets. The authors compared 95% lower confidence limits of average precisions of naïve Bayes with upper bounds for average precisions of a K-nearest neighbor (KNN) classifier.

Results

For all 20 MeSH assignments, the optimal training sets produced nearly 200% improvement over use of the whole training sets. In 17 of those MeSH assignments, naïve Bayes using optimal training sets was statistically better than a KNN. In 15 of those, optimal training sets performed better than optimized feature selection. Overall naïve Bayes averaged 14% better than a KNN for all 20 MeSH assignments. Using these optimal sets with another classifier, C-modified least squares (CMLS), produced an additional 6% improvement over naïve Bayes.

Conclusion

Using a smaller optimal training set greatly improved learning with naïve Bayes. The performance is superior to a KNN. The small training set can be used with other sophisticated learning methods, such as CMLS, where using the whole training set would not be feasible.     

高等医学院校医学生灾难医学教育课程的设计开发

目的 为本教研室的医学生提供结构化的教育指导和资源,开发和设计灾难医学课程。方法 采用医学教育课程开发六步法作为组织流程,急诊及灾难医学专家的专业知识、文献检索灾害医师培训计划、科学证据,作为内容开发的基础。结果 最后课程由14个模块组成,每个模块教学事件2 小时。介绍灾难医学概念,包括灾难的响应、医疗救助、法律条款、指挥、协调、沟通和大规模灾难的管理。综述全球灾难援助的医院预案和经验。讨论灾难发生条件下挽救生命的急诊治疗与有限的个人治疗。介绍爆炸、战争、辐射/核事件、化学和生物事件尤其是传染病和恐怖袭击初始处理的特殊性。灾难疏散的演习,大规模灾难分诊分流与当地救灾机构合作的模拟。当地消防部门合作演练个人去污与净化。人体模型复苏练习,个人防护设备应用练习。职业道德、应激疾病、社会心理干预措施和质量改进的培训。结论 该课程设计提供了合理的时间框架、多学科、多实践的灾难医学教育模式,可以作为医学生灾难医学教育的基本模板。因其具有全面灵活的组织结构,其进一步深化,也有利于急救或灾难专业医疗学生的灾难医学教育课程     

The impact of microcomputers on program excellence

The following criteria were used to document program enhancement after the implementation of a microcomputer laboratory: faculty and student attitudes toward computer-assisted instruction (CAI); student anxiety scores toward state board examinations; increased visibility of the college (number of authored CAI modules, CAI grants, computer committee memberships, faculty attendance at computer courses); and relationship involving learning style, attitude, and student learning. Ninety-two of 112 students and 39 of 55 faculty responded to the request for data collection. Postimplementation, both faculty and students showed mean increases in their attitude toward CAI, although not statistically significant. Senior students had significantly decreased anxiety scores toward the state RN licensure examination after using Mosby's NURSESTAR for review (p<.001). Increased visibility was also documented, but data collection continues regarding the relationship involving learning style, attitude, and student learning. It was concluded that the innovation of computers in an established nursing curriculum served to enhance program excellence.     

某医学院学生生活满意度及其影响因素分析

目的：探讨医学院校学生生活满意度及其影响因素。方法：采用大学生生活满意度评定量表对346名医学院校学生进行问卷调查。结果：不同性别、籍贯、家庭经济状况、父母文化程度,以及是否独生子女、党员、学生干部与医学院校大学生生活满意度部分维度存在显著差异。性别对学习成绩满意度有显著的预测作用,是否学生干部和家庭经济状况对朋友关系和客观满意度有显著的预测作用,籍贯和家庭经济状况对健康和个人经济状况的满意度有显著的预测作用,家庭经济状况对个人生活满意度有显著的预测作用。学习成绩、朋友关系、健康状况和客观满意度均低于常模。结论：医学院校学生生活满意度的影响因素是多方面的,应切合实际来提高其生活满意度。     

医学免疫学整体教学设计的探索与实践

以免疫应答作为主线，进行整体免疫学教学设计，其内容包括：用现代化的教学设计理念建立学生为本位的教学观，促学为本实现教学目标的优化，选择并确定恰当的教学起点，创设促进学生学习的方法、条件、经验、情景、资源，注重学生的心理反应，建立促进学生全面发展的评价机制，适时打开师生交流通道，进一步完善免疫学整体教学设计。如此，可以有效地激发学生对免疫学的学习兴趣，提高和发展学生的发散思维、综合分析能力，增强学生的创新、记忆能力，并将为免疫学教学提供一种全新的教学思路和方式，有助于进一步提高教学质量。     

中德合作举办医学研究生暑期学校的实践与思考

中外合作办学是提升高校办学实力的有效途径之一,也是实施研究生教育创新计划的重大举措。中德医学研究生合作办学是华中科技大学在研究生教育领域的探索,通过引入国外优秀的教育资源,学习和积累教学经验,积极有效地探索医学研究生培养国际化的途径和方法,获得了大多数学生的认可。合作办学在传授国际前沿知识、促进文化交流的同时,也极大地激发了学生的学习兴趣和动力,培养了学生的创新能力,并为我国研究生教育提供了宝贵经验。     

The effectiveness of self-directed learning (SDL) for teaching physiology to first-year medical students

Background

Self-directed learning (SDL) has become popular in medical curricula and has been advocated as an effective learning strategy for medical students to develop competence in knowledge acquisition.

Aims

The primary aim was to find out if there was any benefit of supplementing self-directed learning activity with a traditional lecture on two different topics in physiology for first-year medical students.

Method

Two batches of first-year Bachelor of Medicine and Bachelor of Surgery (MBBS) (Batch A and Batch B) comprising 125 students each, received an SDL session on Morphological classification of anaemia. The students belonging to Batch A received a one-hour lecture on the same topic three days prior to the SDL session. The students were given a 10 multiple choice questions (MCQ) test for a maximum of 10 marks immediately following the SDL session. The next topic, Conducting system of the heart, disorders and conduction blocks was taught to both batches in traditional lecture format. This was followed by an SDL session on the same topic for Batch A only. The students were evaluated with a MCQ test for a maximum of 10 marks.

Results

The mean test scores on the first topic were 4.38±2.06 (n=119) and 4.17±1.71 (n=118) for Batch A and Batch B, respectively. The mean test scores on the second topic were 5.4± 1.54 (n=112) and 5.15±1.37 (n=107) for Batch A and Batch B, respectively. There was no significant difference between the groups.

Conclusion

For first-year medical students, SDL is an effective teaching strategy for learning physiology. However, no additional benefit is gained by supplementing SDL with a lecture to facilitate learning physiology.     

中医院校"有意义学习经历"教学设计探析

本文从"以学生为中心"和"促进学生终身发展"的理念出发,介绍了体现该理念的"有意义学习经历"的概念和创设"有意义学习经历"时应当遵循的原则,并从有意义学习经历的角度举例分析了2008年中医院校课程教学改革的基本情况.同时,从明确教学目标、创设学习经历、重视学习评价等方面,提出了中医院校课程实现"有意义学习经历"的教学设计的建议.