Short-term outcomes and long-term impact of a programme in medical education for medical students

Objectives  There is growing appreciation of the value of early preparation of future medical educators. Staff development programmes, conferences and workshops pertaining to the training of educators may be crucial to the pursuit of a school's larger educational mission to educate students, doctors and scholars and to provide comprehensive knowledge, research, patient care and service. This study examined the efficacy of a 1-week educational intervention aimed at preparing medical students to become effective doctor educators by building skills early in their careers. The study asked whether participation in a 5-day teacher training programme led to increased knowledge of instructional methods, more favourable attitudes towards teaching, and the integration of structured instructional design methods in a student-developed teaching project.
Methods  A mixed methods research design was employed with quantitative data captured through pre- and post-test inventories, qualitative components captured through written comments, and a 2-year post-intervention survey. Quantitative analyses included pre-/post-intervention repeated measures with calculated effect sizes. Qualitative analysis was conducted using constant comparative methods.
Results  Subjects demonstrated improved content knowledge and more positive attitudes towards motivation, teaching confidence, teacher roles, varied pedagogy, and use of assessment, instructional planning, and evaluation. Subjects were able to incorporate the programme's teaching theory and methods into their teaching projects and assessment of peers' and others' teaching in their own institutions 2 years post-training.
Conclusions  This study demonstrates that a well-designed programme for teacher preparation can be pedagogically effective for training medical students to become better educators and that this learning can be incorporated into long-term practice.     

The long term effectiveness of workshops in curriculum planning and design for teaching staff in Indonesian medical schools

A programme of basic curriculum change was concurrently introduced into ten Indonesian faculties of medicine which constitute an established system of medical schools with 260 separate academic departments. The programme was based on a 2-week workshop in curriculum planning and a series of follow-up activities. Within a 3-year period almost three quarters of the academic departments involved have defined a more selective curriculum based on sets of instructional (i.e. behavioural) objectives, and are involved in its implementation. This paper describes the methods used to bring about these developments and the attempts which were made to develop a structure within each medical school which would localize and ensure continuity of the changes set in motion. Because of the context from which conclusions have been drawn they have direct significance for large scale educational change in systems of medical schools in developing countries. The conclusions are however also applicable to changes in medical education in developed countries.     

Systematic curriculum development in an Indonesian post-graduate Faculty of Public Health

This paper describes a programme of curriculum development in an Indonesian post-graduate Faculty of Public Health. This faculty redefined all its curricula within a 2-year period, and these curricula are now stated in terms of sets of instructional objectives which are skill-based and learner-centred. These curricula are now being implemented in ways which are consistent with contemporary educational thinking. It is contended that the rapidity with which these changes occurred can be accounted for in terms of: (a) the strong support of the faculty's leadership; (b) the methods used to bring about these changes; and (c) the sustained efforts made by many of the teaching staff.     

How Excellent Teachers Are Made: Reflecting on Success to Improve Teaching

The authors surveyed forty-eight distinguished teachers from clinical departments regarding the role of instructional successes in learning to teach. Using qualitative content analysis of comments, the authors identified nine common successes in clinical teaching associated with planning, teaching, and reflection. In anticipatory reflection used for planning, common successes occurred by involving learners, continuously innovating, creating a positive atmosphere for learning, considering the learners, engaging the learners, preparing adequately, and limiting content. When reflecting-in-action, the success experience most commonly mentioned was maintaining flexibility in action. Reflecting-on-action after a successful teaching event, they commented on the importance of thoughtful analysis and choosing an appropriate strategy. These teachers incorporated reflective practice into their teaching as an essential component of professional development and incrementally improved their teaching based upon successful instructional experiences. This revised version was published online in July 2006 with corrections to the Cover Date.     

Guidelines for competency-based instruction in psychiatry

This paper presents guidelines for teachers who wish to design competency-based instructional activities in psychiatry. Developed over a 3 year period, these guidelines outline the methods used by teachers to construct competency-based seminars and clinical rotations.
The guidelines describe the process of stating knowledge objectives, performance objectives and experiential objectives for psychiatric trainees to attain prior to completion of training in a given area. Selection of appropriate teaching strategies as well as criteria and conditions for assessment of the residents' abilities are also reviewed.
Comments regarding the authors' experience using these guidelines with teachers are offered.     

What do we mean by web‐based learning? A systematic review of the variability of interventions

Medical Education 2010: 44 : 765–774 Objectives Educators often speak of web‐based learning (WBL) as a single entity or a cluster of similar activities with homogeneous effects. Yet a recent systematic review demonstrated large heterogeneity among results from individual studies. Our purpose is to describe the variation in configurations, instructional methods and presentation formats in WBL. Methods We systematically searched MEDLINE, EMBASE, ERIC, CINAHL and other databases (last search November 2008) for studies comparing a WBL intervention with no intervention or another educational activity. From eligible studies we abstracted information on course participants, topic, configuration and instructional methods. We summarised this information and then purposively selected and described several WBL interventions that illustrate specific technologies and design features. Results We identified 266 eligible studies. Nearly all courses (89%) used written text and most (55%) used multimedia. A total of 32% used online communication via e‐mail, threaded discussion, chat or videoconferencing, and 9% implemented synchronous components. Overall, 24% blended web‐based and non‐computer‐based instruction. Most web‐based courses (77%) employed specific instructional methods, other than text alone, to enhance the learning process. The most common instructional methods (each used in nearly 50% of courses) were patient cases, self‐assessment questions and feedback. We describe several studies to illustrate the range of instructional designs. Conclusions Educators and researchers cannot treat WBL as a single entity. Many different configurations and instructional methods are available for WBL instructors. Researchers should study when to use specific WBL designs and how to use them effectively.     

An instrument to evaluate clinical instructional skills

A questionnaire, which consisted of 10 statements dealing with the attributes of effective clinical instruction, was designed for use by medical students. Three groups of trainees who followed consecutive clinical rotations in paediatrics assessed the instructional skills of their tutors using the instrument. Summary reports on students' perceptions were made available to the teachers soon after each rotation. The results showed that although individual instructors exhibited varying degrees of the desired skills, they maintained a consistent pattern through the assessments. When considered on an overall basis, teacher behaviours such as allowing the students to ask questions and giving satisfactory answers, and helping in students' learning problems with relevant feedback, received a higher percentage of positive ratings than emphasizing problem-solving, demonstrating and supervising physical examinations and procedures, and stimulating the students' interest in the subject. It appears that the instrument developed is suitable for obtaining feedback from the students to identify the strengths and weaknesses of the instructional skills of their clinical teachers. Such feedback would become useful when modifying programme presentation and in planning and conducting faculty development activities.     

Professional Power Through Education: Universal Course Design Initiatives in Occupational Therapy Curriculum

ABSTRACT

The American Occupational Therapy Association (AOTA) has put forth a Centennial Vision that requires academic settings to explore and evaluate modes of instruction for future occupational therapy practitioners. The authors of the Centennial Vision call for occupational therapy to be recognized as a powerful profession that contributes to the health and wellness of society. They further state that education is a key factor to achieving this power aspect of the vision, and this will require innovative instructional methods that produce positive educational outcomes. This study explored the effectiveness of Universal Course Design (UCD) in occupational therapy curriculum. UCD ensures the best learning environment and instructional methods for all learners prior to instruction, as opposed to altering the learning environment or instructional methods for a select few after instruction has begun. The findings indicate that those students participating in UCD methods demonstrated higher educational outcomes in occupational therapy curriculum (t == 3.885, p ==.000). Therefore, this instructional method appears to be a beneficial process to realizing some of the key goals set forth in the AOTA Centennial Vision.     

A comparison of distance education instructional methods in occupational therapy

The progression of technology is rapidly bringing new opportunities to students and academic institutions, resulting in a need for additional information to determine the most effective strategies for teaching distance learners. The purpose of this study was to compare the effectiveness of three instructional strategies (two-way interactive video and audio, chat rooms, and independent learning) and student preferences regarding instructional methods in a mental health programming distance learning course. Precourse and postcourse surveys were completed by 22 occupational therapy students enrolled in the course. Effectiveness of the teaching methods was determined based on the results of students' examinations. The findings indicated that there were no statistically significant differences in student performance on multiple-choice examinations using the three instructional methods. Of students, 77% indicated a preference for two-way interactive video and audio instruction. To provide effective education via distance learning methods, faculty members need to structure assignments that facilitate interaction and communication among learners. As distance education becomes more commonplace, it is important to identify the methods of instruction that are the most effective in delivering essential course content and the methods that provide the atmosphere most conducive to learning.     

基于智能模拟人的医学模拟教学效果评价

目的 研究某三级医院医学生对基于高端智能模拟人的医学模拟教学效果评价,进一步推动教学改革,创新医学教育方式.方法 采用学习成效量表和教学设计量表,以某医院临床内科学36名研究生为研究对象,采用美国国家护理联盟的学习成效量表和中文版Jeffries模拟教学设计量表在模拟教学前后各进行一次问卷调查,分析学生对教学效果和课程...     

HIV Education Practices and Training Needs of Middle School and High School Teachers

ABSTRACT: A statewide, cross-sectional survey was conducted among Texas secondary school teachers to determine the scope of HIV education provided and training needs. Among 269 participants, 199 (75%) taught HIV education. Investigator developed scales measured instructional emphasis, preparation adequacy, desire for future training, comfort, instructional effectiveness, social support, and instructional barriers. Alpha levels indicated high levels of internal consistency on all scales. Considerable variations were noted in instructional emphasis among 18 content areas related to HIV education. Lessons were predominantly self-developed. Most teachers were self-taught with no formal training, relied primarily on traditional teacher-centered instructional methods, felt uncomfortable and ineffective using peer leaders and role plays, wanted additional training in all subject areas, and perceived others to be supportive. Comparisons between groups indicated middle school teachers spent less instructional time on HIV education, reported more instructional barriers, less support from district personnel, a poorer fit (coordination) of HIV education with other subjects, less adequate preparation, and less responsibility and effectiveness. High school teachers were more prone to want additional training. Differences in responses to individual scale items, major instructional barriers, and recommendations for teacher training are provided.     

An evaluation of a workshop on educational methods for health science teachers in Lagos, Nigeria

A workshop on educational methods held at the College of Medicine, University of Lagos in 1980 was evaluated by means of questionnaires. The workshop was favourably received and enhanced the teaching practices of participants. As a result of the workshop, most participants wrote instructional objectives, used more audiovisual aids and adopted new methods of teaching and assessment of clinical skills. Although the session on the production of self-instructional packages (SIPs) was rated highly at the workshop, relatively few participants had completed a programmed text at time of follow-up. Similarly, most participants had set MCQs but few had calculated either the facility or discrimination index.
The participants themselves suggested that future workshops should be tailored to the particular educational needs of different disciplines. The authors suggest that intensive short-term workshops may be useful for content areas which require more time than an extensive workshop permits.     

A curriculum on medical ignorance

The information and technology explosions in medicine have exposed the vast realm of ignorance in human biology as well as the transiency of accepted knowledge and shortcomings of instructional methods which foster rote memorization, excessive reliance on conflicting data bases, and short-answer testing. To circumvent this serious deficiency in medical education, we have initiated a multifaceted Curriculum on Medical Ignorance consisting of 'questioning' seminars and hands-on clinical and laboratory experiences. This teaching programme not only emphasizes medicine's current deficiencies and limited insight into disease processes (i.e. ignorance) but also assists students in developing attitudes and behaviours to investigate basic biologic and clinical unknowns while rendering sound everyday clinical decisions in the face of fragmentary understanding. Based on evaluative feedback over the past 3 years, participants have made substantial progress towards recognizing and dealing constructively with medical ignorance and the limitations of 'knowledge of the day', thereby preparing them for the certain uncertainty of future medical practice.     

医药分家后医院内部运行工作的思考

为贯彻《关于城镇医药卫生体制改革的指导意见》(简称《指导意见》);阐述了贯彻《指导意见》的措施：截断药品生产、销售与医疗机构的直接利益联系能否从根本上解决药费过快增长的问题;药品统一招标采购问题;非盈利性医疗机构门诊药房改为药品零售企业问题。     

An approach to mathematical literacy for medical students

Mathematical literacy is defined as the ability to read and interpret information of a mathematical nature. Based on the empirically determined needs of medical students in this area, a set of instructional materials (tests, text, and technical manual) were produced and successfully used. These results are described here as are considerations bearing on the generalizability of the described approach.     

Promoting diagnostic problem representation

PURPOSE: Problem representation, as mediated by semantic qualifiers (SQs), has been associated with better diagnostic outcomes. The purpose of this study was to assess the effect of training medical students to use semantic abstractions as a means of building problem representations. METHODS: Sixty second-year medical students were assigned to either an intervention group (n = 20) or a control group (n = 40) during 8 months of an Essentials in Clinical Medicine course which used standardized patient-based workshops. Students were trained to transform findings into SQs and to use abstractions to compare and contrast diagnostic hypotheses. Students were assessed using a standardized patient data collection checklist, a post-encounter patient finding questionnaire (PFQ), and case summaries and write-ups. RESULTS: Experimental subjects used over twice as many SQs in their summaries as control group members (1.40 versus 0.63, P = 0.006). The correlation between checklist and PFQ scores was higher for the experimental group than for the control group (r = 0.70 versus r = 0.58, P 0.56). CONCLUSION: A short instructional intervention was successful in promoting the use of SQs and enabled students to recall elicited findings better. This intervention did not enhance data interpretation and diagnostic accuracy. Use of SQs may therefore be a necessary tool for efficient problem representation but one that is insufficient when used in isolation. The naturalistic setting used in this study imposed a number of limitations, implying that further research should test whether instructional efforts should also emphasize recognition of key patient findings and knowledge representation.     

农村居民艾滋病健康教育方式探讨

[目的]了解广西农村居民目前艾滋病知识知晓状况、提高这些地区居民艾滋病知识知晓率,探讨农村开展预防艾滋病宣传教育的方式。[方法]对广西某县的4个乡镇成年居民进行艾滋病宣传教育,实施两种健康教育方式后进行教育前后的效果评估。[结果]农村群众艾滋病相关知识缺乏,经过健康教育后对艾滋病知识的知晓率明显提高,不同教育方式效果有别。[结论]应重视和加强农村艾滋病教育,并注重健康教育形式的多样化。     

Evaluation of instructional skills of medical teachers: the participant observer in the Medical School

A model for the evaluation and development of instructional skills utilizing a participant observer is presented. Examples from a medical school context are provided. Other sources of evaluative information on performance of teachers including student based surveys are reviewed.