Journal of Advances in Medical Education & Professionalism

The impact of tutor expertise on the students’ scores in active learning methods: a meta-analysis

MONA MLIKA; MOHAMED MAJDI ZORGATI; FAOUZI MEZNI

Volume 10, Issue 4 , October 2022, , Pages 235-245

http://dx.doi.org/10.30476/jamp.2022.94450.1589

Abstract

Introduction: The tutor’s role has been changing in the active learning methods in comparison to the traditional ones. Tutors are encouraged to become facilitators and to guide ... Read More Introduction: The tutor’s role has been changing in the active learning methods in comparison to the traditional ones. Tutors are encouraged to become facilitators and to guide the students to construct a new knowledge by making bridges with the old one. Tutor’s expertise in the active methods has been discussed with different results. The aim of this study was to assess the impact of tutor expertise on the students’ scores in active learning methods.Methods: The authors conducted this meta-analysis under the guidelines of a critical tool for systematic reviews (AMSTAR2). PubMed, Embase, Cochrane library, Scopus and Science Direct were the databases used for searching. The articles included compared students’ learning scores according to tutor expertise between 2 groups of students with an active method of learning. The Review Manager software 5.3 was used to conduct this metaanalysis. We considered the mean difference as the effect size.Results: 3169 students and 222 learning groups of 5 to 10 students were included in this study. The combined mean difference reached 0.84 with 95% CI [0.22, 1.46]. A significant difference between the two groups was observed in favour of the non-expert group (P=0.008). The heterogeneity I-square was evaluated to 98%. The Funnel plot reflected no publication bias (P=0.21). A sub-group analysis was performed taking into account the studies dealing with medical curriculum and the assessment methods used. It showed a significant difference between the two groups in favour of non-expert tutors (P<0.05).Conclusion: Even if the results of this meta-analysis couldn’t be conclusive and can’t induce recommendations, they highlighted the tendency of non-expert tutors to be more student-centred. The heterogeneity observed can be decreased by establishing consensual definitions of expertise and assessment tools in further research studies in order to reflect the validity and efficiency of different tutoring styles in active learning methods.

Psychometric Properties of Clinical Learning Environment Comparison Survey Questionnaire in Nursing Students

SHIRIN RIAHI; MINA ABOLFAZLIE; MOHSEN ARABI

Volume 10, Issue 4 , October 2022, , Pages 267-273

http://dx.doi.org/10.30476/jamp.2022.95206.1630

Abstract

Introduction: Continuous evaluations of clinical education and learning in nursing require the use of valid and reliableinstruments. The present study aimed to evaluate the validity ... Read More

Introducing a mobile learning model in medical education during COVID-19; a critical review

MASOMEH KALANTARION; MOHAMMAD-MEHDI SADOUGHI; SOLEIMAN AHMADY; PER KALLESTRUP; MARZIEH KATIBEH; NASRIN - KHAJEALI

Volume 10, Issue 3 , July 2022, , Pages 145-155

http://dx.doi.org/10.30476/jamp.2022.93494.1534

Abstract

Introduction: Mobile learning is one of the innovative teaching techniques that help medical students gain knowledge and skills. One of the factors that expanded the use of this strategy ... Read More

Concept maps in immunology: A metacognitive tool to promote collaborative and meaningful learning among undergraduate medical students

MOHAN B SANNATHIMMAPPA; VINOD NAMBIAR; RAJEEV ARAVINDAKSHAN

Volume 10, Issue 3 , July 2022, , Pages 172-178

http://dx.doi.org/10.30476/jamp.2022.94275.1576

Abstract

Introduction: Concept maps are graphical representations of knowledge that connect concepts, ideas, and relationships. The present study aims at assessing the perception of medical ... Read More Introduction: Concept maps are graphical representations of knowledge that connect concepts, ideas, and relationships. The present study aims at assessing the perception of medical students in utilization of concept maps as a tool to foster their lifelong learning skills in immunology.Methods: The current study was approved by Institutional Ethics and Review Committee. Third-year undergraduate (MD3) medical students of the academic year 2021-22 were sensitized about the concept map study and included after obtaining their informed consent. The students worked in teams to find answers and link the different words or phrases of the concept maps. At the end of the immunology course, students’ perception on concept map-based learning strategy was assessed. A pre-designed, selfadministered questionnaire, pre-validated by subject experts for relevance and feasibility, was used for the study. The questionnaire included some quantitative questions assessed by using 3-pointLikert Scale and an open-ended question to receive students’ comments on concept map-based learning strategy. The responses were collected and analyzed using SPSS version 22. Descriptive statistics was used for the quantitative variables, tabulated as numbers and percentages while the qualitative data was analyzed by thematic analysis. The quantitative data results were prioritized but supported by students’ comments on open ended question.Results: Out of 133 eligible participants, 109 students who volunteered and completed the study were included. Majority of our participants (>80%) welcomed the concept map-based learning strategy. Almost 4 out of 5 expressed that concept maps are interesting and enjoyable, encourage active participation, peer discussion, and enhance critical thinking and problem-solving skills. More than 80% of the students agreed that concept maps promoted deep understanding of the topic and lifelong learning. Nearly 3 out of 4 students suggested including concept maps in many immunology topics in future. Majority of students penned down positive comments indicating concept map tool facilitates metacognitive skills.Conclusion: From the study, it can be concluded that concept maps are effective active learning strategies to improve themetacognitive domain of medical students in immunology course, thus assisting them to become better lifelong learners.

Perceptions of Medical Undergraduate Students on Curricular Changes in Anatomy: An Embedded Design Mixed Method Study

APARNA MURALEEDHARAN; SARANYA RAGAVAN; NUTAN NALINI BAGE; REMA DEVI

Volume 10, Issue 1 , January 2022, , Pages 22-29

http://dx.doi.org/10.30476/jamp.2021.92149.1472

Abstract

Introduction: Implementation of competency-based medical education (CBME) offers challenges to the faculty and students. As a part of the new curriculum by the National Medical Council ... Read More Introduction: Implementation of competency-based medical education (CBME) offers challenges to the faculty and students. As a part of the new curriculum by the National Medical Council of India, we introduced certain teaching and assessment modifications in anatomy. There are few studies on the actual implementation of CBME. The current study aimed to assess the perceived usefulness of the teaching, learning, and assessment methodology (TLAM) based on written feedback from students.Methods: All the 147 first MBBS students of the batch who had undergone the new teaching learning methodology answered the questionnaire on usefulness of the various TLAMs on a 3-point Likert scale which was taken as quantitative data. They were also asked to pen down their opinions and suggestions about the TLAM which was thematically analysed and considered as qualitative data. Face and content validity was assessed prior to administration of the questionnaire. Descriptive statistics were used for quantitative variables. Qualitative data were analysed bythematic analysis. Results: 100% of the students found vertical integration and small group teaching as useful. Seminars and quizzes were reported as useful to extremely useful by 75.5% of the students. Self-directed learning and near-peer teaching was also appreciated well by 78% of students. In Embryology and Neuroanatomy, these active learning methods were not found to be useful as these topics were difficult to understand. Overall, the new TLAM introduced as per the new medical curriculum was found useful for the majority of students.Conclusion: This study provides valuable insights on the teaching, learning, and assessment methods as formulated by the competency-based medical curriculum. Though active learning methods are the integral principles of andragogy, the concepts which are difficult to understand need to be taught using the traditional teaching methodology.

Design and Evaluation of DentAll Mobile Software for Dental Education

PARISA JALALI; ZEINALABEDIN GHOLIZADEH; MINOU KOUH SOLTANI; MARYAM KOUHSOLTANI

Volume 9, Issue 4 , October 2021, , Pages 221-229

http://dx.doi.org/10.30476/jamp.2021.90771.1423

Abstract

Introduction: The use of new learning methods to improve the educational processes is inevitable in the field of dentistry. Due to the positive effects of mobile learning ... Read More Introduction: The use of new learning methods to improve the educational processes is inevitable in the field of dentistry. Due to the positive effects of mobile learning on the students’ learning and skills, we decided to design a software in the required areas. Considerations of systemic diseases, medications, emergencies, prophylaxis, tests interpretation, lesions diagnosis, cephalometric,and cast analysis were the topics required.Methods: This semi-experimental study was carried out in Faculty of Dentistry, Tabriz University of Medical Sciences during 2020. DentAll software was developed using Android Studio software. It is an educational and decision-making support system. The satisfaction and perceptions of 10 professors, 5 post-graduate students, and 30 senior dental students about the designed software were assessed using a questionnaire based on a 5-part Likert scale. The senior students were invited and the pre-test was taken to assess the students’ knowledge; then, the designed software was provided by the administrator. At the end of the process, the post-test was taken. Paired samples t-test was used to compare the results of the pre-test and post-test. The data were analyzed using the Statistical Package for Social Sciences (SPSS) 17.0. The significance level was established at a p <0.05.Results: The mean scores of the pre-test and post-test were 16.5±1.49 and 18.2±0.99, respectively. The statistical analysis showed that the difference between the mean scores of the pretest and post-test was statistically significant (p <0.001). 46.7% of the professors and post-graduate students expressed their overall satisfaction as very high, 46.7% as high, and 6.7% as average. Furthermore, 50% of the students expressed their overall satisfaction as very high, 36.7% as high, and 13.3% as moderate. Conclusion: The designed comprehensive software satisfied the students and the professors who used it and the students’ scores increased after use. This software had capabilities such as easy access to the resources, learning anytime and anywhere, increasing the students’ interest and motivation, etc. from the point of view of the commentators. To the best of our knowledge, thiscomprehensive educational aid has not been designed previously and it was effective in improving the students’ learning, scientific knowledge and treatment planning.

Multiple facets of learning a skill – Amalgamation of learning theories in cadaveric surgical skill lab

DINESH KUMAR. V; S.S.S.N RAJASEKHAR

Volume 9, Issue 3 , July 2021, , Pages 183-184

http://dx.doi.org/10.30476/jamp.2020.84959.1155

Abstract

Psychomotor skills training includes three stages of learning. In the cognitive stage, there is a creation of awareness regarding the items to be learned; in the associative ... Read More Psychomotor skills training includes three stages of learning. In the cognitive stage, there is a creation of awareness regarding the items to be learned; in the associative stage, the refining of skills takes place, and in the autonomous stage, the proficiency in the skills is developed (1). One of the ways by which novice surgeons acquire mastery standards, before proceeding to perform surgical skills independently, is by practicing in cadavers. In contrast to the conventional pattern of learning,i.e. apprenticeship model whereby the trainees learn by ‘see one, do one and teach one’ adage,cadaveric skill lab ascertains the transformation/change of individual abilities in a structuredenvironment in pursuit of a task goal. The above statement could be substantiated by the study conducted by Zendejas et al. (2), where residents trained under simulated settings were able to complete the task goal, i.e. total extraperitoneal repair in lesser time and with reduced intra-operative and post-operative complications compared to the traditional training group.When we mean acquiring mastery standards, it means that all learners should attain the prescribedcompetency standards required for deliberate practice without much variation in the definedoutcomes. Nevertheless, it is well known that each individual does not necessarily have the samemotor learning dynamics, and they need not learn the same pattern even in similar task conditions(3). Notably, the surgical skill can be deciphered as a sequential motor skill learning, involving acombination of explicit and implicit processes, operating in a schema in order to accomplish thetask (4). Besides, this should be complemented by proprioceptive feedback, which harnessesthe motor accuracy and enables making quick adjustments in the authentic environment. In thiscontext, we wish to throw light upon two pertinent learning theories which medical educators shallreconcile while planning surgical skill programs.Let us consider the sequence of learning taking place while learning a surgical skill, for example, arthrocentesis in the cadaveric knee model. Comparing the Kovacs’ steps for procedural skill training (5), we could envisage that skill acquisition passes through four distinct stages. In the first step, the novice gains the cognitive knowledge required for the procedure (‘learn’ step). Secondly, he/she visualizes and contextualizes the procedure by observing while being performed by an expert (‘see’ step).Thirdly, the step of imitation begins where the participant performs the movements required for the skill with a certain degree of confidence, and this could be considered as trial and error (‘practice’ step). Finally, upon multiple cycles of practice, the trainee would master the movement patterns, tailor it according to tricky situations, and, if needed, create a new pattern of movements(‘do’ step). Subsequently, we shall reiterate upon two theories, which could be attributed to motor learning in the cadaveric skill lab.Schmidt’s schema theory is an open-loop controlled method of motor learning which does not involve feedback mechanism (6). It postulates the mechanism by which a novice learns a specific motor task which he or she has not performed previously. During the ‘learn’ and ‘see’ phase, a trainee observes a lot of co-ordinated movement patterns that get stored as schemas in a short memory system. When they practice, they learn by committing multiple errors, which also gets coded as schemas. For example, while performing laparoscopic procedures in cadavers, a surgeon needs to learn how to anticipate where and how far the instrument will pass through employing perceptual decisions made on the moment-moment basis. From short term memory, the information goes to a recall schema, where the specific response is selected, and then the recognition schema, where the response willbe evaluated, errors are realized, and followed by the generation of information on the correctresponse. This process helps in deciding a critical move or use a certain degree of force in specific situations for a co-ordinated motor pattern. This can be analogized to a cricketer who recalls the mistakes after the innings, interprets the sequence of movements, and corrects his future performances. Besides, schema theory emphasizes the value of variability in practice conditions for honing the learned skills in simulated settings. Thus, schema theory could still be considered to have a significant role in skill learning despite the criticism placed on it.Another major theory that has been posited for motor skill acquisition is Adam’s theory of learning, which is essentially a closed-loop method relying upon the sensory/perceptual feedback on the ongoing sequence of skilled movements (7).It involves a stimulus (input) that generates a perception of input resulting in a memory trace todecide as to which movement should be initiated. This will be followed by a perception trace, whichis an amalgamation of sensory consequences of previous similar movements and, finally, a motoraction (output). This can be compared with gaining experience of driving a car in crowded placeswhere the driver learns negotiation and adjustment abilities in stimulus-response reacting manner.The crux of this theory that supports the need for formative feedback in ‘practice’ sessions wherebymaking the learners know about the results is that it facilitates the identification/rectification of errors. To exemplify, a workshop where the placement of the endotracheal tube in cadaver bythe novice is confirmed by visualizing using the ultrasound transducer, the learners could assess theend-point by themselves and rectify accordingly.Performing the prescribed movement repetitively enables the learners to gain the correct perceptualtrace over time with the actual accomplishment of end-point, similar to hitting the bull’s eye duringshooting practice. Nevertheless, this motor theory of learning does not take into consideration thesalience of variability in practice while mastering a procedure.With the advent of soft embalming techniques, cadavers are increasingly used for teachingprocedural skills owing to their relatively higher fidelity, haptic parameters, and life-likesimulation compared to mannequins and virtual reality simulator. On the flip side, many cadaverbased workshops suffer a lack of structuring and sophisticated feedback. Feedback from cadaveric skill workshops should be structured to provide feedback regarding the knowledge of results and knowledge of performance to aid the mastery of standards. In this context, we emphasize the importance of knowledge about the theories involved in motor learning, which ideally shouldbe incorporated while designing surgical skill cadaveric workshops and in the absence of whichprocedural skill training might not effectively translate to the clinical environment. Supplementingthe established framework with learning theories will suffice the long-term outcomes of the skilltraining sessions, which is reaching mastery standards in performing that particular procedure.

An evidence of group discussion and problem-solving skills in MBBS freshers: Implications and applications

SANTOSH KUMAR; ZAYABALARADJANE ZAYAPRAGASSARAZAN; DHARANIPRAGADA KADAMBARI

Volume 9, Issue 1 , January 2021, , Pages 50-53

http://dx.doi.org/10.30476/jamp.2019.81219.0

Abstract

Teachers need to follow adult learning principles and students need to have discussion and problem-solving skills for the use of active learning methods in classroom. We aimed ... Read More

The impact of a high fidelity simulation-based debriefing course on the Debriefing Assessment for Simulation in Healthcare (DASH)© score of novice instructors

ISSAM TANOUBI; IHEB LABBEN; SALMA GUÉDIRA; PIERRE DROLET; ROGER PERRON; ARNAUD ROBITAILLE; MIHAI GÉORGESCU

Volume 7, Issue 4 , October 2019, , Pages 159-164

http://dx.doi.org/10.30476/jamp.2019.74583.0

Abstract

Introduction: Experiential learning, followed by debriefing, is at the heart of Simulation-Based Medical Education (SBME) and has been proven effective to help master several ... Read More Introduction: Experiential learning, followed by debriefing, is at the heart of Simulation-Based Medical Education (SBME) and has been proven effective to help master several medical skills.We investigated the impact of an educational intervention, based on high-fidelity SBME, on the debriefing competence of novice simulation instructors.Methods: This is a prospective, randomized, quasi-experimental, pre- and post-test study. Sixty physicians without prior formal debriefing expertise attended a 5-day SBME seminar targeted ondebriefing. Prior to the start of the seminar, 15 randomly chosen participants had to debrief a spaghetti and tape team exercise. Thereafter, the members of each team assessed their debriefer’sperformance using the Debriefing Assessment for Simulation in Healthcare (DASH)© score. The debriefing seminar that followed (intervention) consisted of 5 days of teaching that included theoretical and simulation training. Each scenario was followed by a Debriefing of the Debriefing (DOD) session conducted by the expert instructor. At the end of the course, 15 randomly chosen debriefers had to debrief a second tower building exercise and were re-evaluated with the DASH score by their respective team members. The Wilcoxon signed-rank test was used to compare pre- and post-test scores. Statistical tests were performed using GraphPad Prism 6.0c for Mac.Results: A significant improvement in all items of the DASH score was noted following the seminar. The debriefers significantly improved their performance with regard to “maintaining an engaging learning environment” (Median [IQR]) (4[3-5] after the pre-test vs. 5.5[5-6] after the post-test, P<0.001); “structuring the debriefing in an organized way” (5[4-5] after the pre-test vs. 5[5-6] after the post-test, p=0.002); “provoking engaging discussion” (4[3-5.75] after the pre-test vs. 6[5-6]after the post-test, P<0.001); “identifying and exploring performance gaps” (5[4-6] after the pre-test vs. 6[5-6] after the post-test, P=0.014); and “helping trainees to achieve and sustain good future performance” (4[3-5] after the pre-test vs. 6[5-6] after the post-test, P<0.001).Conclusion: A simulation-based debriefing course, based mainly on DOD sessions, allowed novice simulation instructors to improve their overall debriefing skills including, more specifically, the abilityto foster engagement in discussions and maintain an engaging learning environment.

Exploring undergraduate medical students’ perception of learning procedural skills and its outcomes in clinical settings

MOHAMMAD REZA MANSOORIAN; MOHAMMAD JALILI; SHAHLA KHOSRAVAN; MOHAMMAD SHARIATI

Volume 7, Issue 4 , October 2019, , Pages 175-182

http://dx.doi.org/10.30476/jamp.2019.74866.0

Abstract

Introduction: Learning procedural skills is one of the essential aspects of undergraduate medical education. However, learning procedural skills in clinical settings is less ... Read More

The hybrid model of clinical skills teaching and the learning theories behind it.

SATEESH BABU ARJA; SIREESHA BALA ARJA; SAMIR FATTEH

Volume 7, Issue 3 , July 2019, , Pages 111-117

http://dx.doi.org/10.30476/jamp.2019.74838

Abstract

Introduction: There are two popular methods of clinical skills teaching. One is Peyton’s method, and the other one is Robert Gagne’s method. A hybrid model which ... Read More Introduction: There are two popular methods of clinical skills teaching. One is Peyton’s method, and the other one is Robert Gagne’s method. A hybrid model which is a combination of both teaching methods is developed and implemented at Avalon University School of Medicine in Clinical Skills. The aim of the study was to evaluate the hybrid model of clinical skills teaching.Methods: This is a quasi-experimental study where a control group with a sample size of 26 was compared with two study groups; one group included 24 participants, and as the other one consisting of 16 subjects selected without randomization. All students in the class were included in the study, except for those withdrew voluntarily. The quantitative data were gathered in the form of a questionnaire on the Likert scale which was collected as the end of course evaluations. The quantitative data for the responses on the Likert scale was analyzed for descriptive statistics: Mean, Median, and Mode. The quantitative data also included the students’ performance on assessments of clinical skills which was analyzed using ANOVA test. The qualitative data were gathered in the form of open-ended questions in the end of course evaluations. The qualitative data were also collected from the faculty members who were the examiners for the clinical skills course as the feedback taken from them. Results: There was a significant improvement in the feedback of students (end of course evaluations) after implementing the hybrid model of clinical skills teaching which was shown by increased Mean, Median, Mode for the most pointers on the Likert scale. Also, there was a notable improvement in the performance of students with a significant p-value (p<0.05) on ANOVA test.Conclusion: The hybrid model is very effective in teaching clinical skills. This teaching method can be evaluated by replicating this study at larger institutions with more number of students.

The effect of test-enhanced spaced learning on the otolaryngology board and annual examination results: A quasi-experimental study

SASAN DABIRI; AEEN MOHAMMADI; RITA MOJTAHEDZADEH

Volume 7, Issue 3 , July 2019, , Pages 131-137

http://dx.doi.org/10.30476/jamp.2019.74696

Abstract

Introduction: In the test-enhanced spaced learning, educational contents are presented in small packages of well-developed test questions with a defined frequency to the learners. ... Read More

Impact of immediate feedback on the learning of medical students in pharmacology

DINESH K BADYAL; SUMAN BALA; TEJINDER SINGH; GAURAV GULREZ

Volume 7, Issue 1 , January 2019, , Pages 1-6

http://dx.doi.org/10.30476/jamp.2019.41036

Abstract

Introduction: Providing feedback to students is an essentialcomponent in medical education and has been shown to improvethe students’ learning. The purpose of this study is to ... Read More Introduction: Providing feedback to students is an essentialcomponent in medical education and has been shown to improvethe students’ learning. The purpose of this study is to evaluatethe effect of computer-based immediate feedback on the medicalstudents’ learning in a pharmacology course. Methods: In this prospective intervention study some feedbackmodules in pharmacology (FMP) were prepared in two topics:the cardiovascular system (CVS) and chemotherapy, using blanktemplates on “Hot Potatoes” software. The FMP included MCbasedquestions and two versions were developed: one withfeedback (FMP-1) and the other without feedback (FMP-2). TheFMP-1 module provided immediate feedback for each option thestudent chose. The students (n=48) were randomized by computergenerated random number table to two groups A and B to receivethe module in CVS, i.e., FMP-1 and FMP-2, respectively. A crossoverdesign was adopted to expose all students to immediatefeedback modules. The test scores were compared and feedbackwas obtained from students and faculty using a validatedquestionnaire. A focus group discussion was conducted to clarifythe issues raised by the students. Results: The module with immediate feedback was much better appreciated by the students than the module without feedback. The students spent more time on FMP-1 (42±7.00 minutes vs 27±12.36 minutes; p<0.001 in chemotherapy and 40±12.11 minutes vs 24±6.01 minutes; p<0.001 in CVS). However, there was no statistically significant difference in mean test scores. The qualitative data collected provided important information on the value of immediate feedback. The students believed that immediate feedback was an excellent way for self-assessment and improved their deeper understanding of content areas. They also felt that it supplemented their traditional learning habitsand stimulated them to read more. The students enjoyed its nonthreatening nature.Conclusion: Immediate feedback improved the deeper understanding of pharmacology and its relevance to medicine for the two topics although immediate feedback did not improve test scores. Overall, immediate feedback had a positive impact on the students’ self-directed learning.

Exploration of faculty members’ perceptions about virtual education challenges in medical sciences: a qualitative study

MOHAMMAD HASAN KESHAVARZI; SEYED KAMRAN SOLTANI ARABSHAHI; BANAFSHEH GHARRAHEE; ZOHREH SOHRABI; MARJAN MARDANI HAMOOLEH

Volume 7, Issue 1 , January 2019, , Pages 27-34

http://dx.doi.org/10.30476/jamp.2019.41042

Abstract

Introduction: Virtual education is among the important factorsimproving the learning of medical students. This study aimed toexplain the perceptions of faculty members towards the challengesof ... Read More

Volume 10 (2022)

Volume 9 (2021)

Volume 8 (2020)

Volume 7 (2019)

Volume 6 (2018)

Volume 5 (2017)

Volume 4 (2016)

Volume 3 (2015)

Volume 2 (2014)

Volume 1 (2013)

Keywords = Learning

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