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Insights into undergraduate medical student selection tools: a systematic review and meta-analysis
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Pin-Hsiang Huang, Arash Arianpoor, Silas Taylor, Jenzel Gonzales, Boaz Shulruf
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J Educ Eval Health Prof. 2024;21:22. Published online September 12, 2024
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DOI: https://doi.org/10.3352/jeehp.2024.21.22
[Epub ahead of print]
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Abstract
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Evaluating medical school selection tools is vital for evidence-based student selection. With previous reviews revealing knowledge gaps, this meta-analysis offers insights into the effectiveness of these selection tools.
Methods A systematic review and meta-analysis were conducted applying the following criteria: peer-reviewed articles available in English, published from 2010 and which include empirical data linking performance in selection tools with assessment and dropout outcomes of undergraduate entry medical programs. Systematic reviews, meta-analyses, general opinion pieces, or commentaries were excluded. Effect sizes (ESs) of the predictability of academic and clinical performance within and by the end of the medicine program were extracted, and the pooled ESs were presented.
Results Sixty-seven out of 2,212 articles were included, which yielded 236 ESs. Previous academic achievement predicted medical program academic performance (Cohen’s d=0.697 in early program; 0.619 in end of program) and clinical exams (0.545 in end of program). Within aptitude tests, verbal reasoning and quantitative reasoning predicted academic achievement in the early program and in the last years (0.704 & 0.643, respectively). Overall aptitude tests predicted academic achievement in both the early and last years (0.550 & 0.371, respectively). Neither panel interviews, multiple mini-interviews, nor situational judgement tests (SJT) yielded statistically significant pooled ES.
Conclusion Current evidence suggests that learning outcomes are predicted by previous academic achievement and aptitude tests. The predictive value of SJT and topics such as selection algorithms, features of interview (e.g., content of the questions) and the way the interviewers’ reports are used, warrant further research.
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What impacts students’ satisfaction the most from Medicine Student Experience Questionnaire in Australia: a validity study
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Pin-Hsiang Huang, Gary Velan, Greg Smith, Melanie Fentoullis, Sean Edward Kennedy, Karen Jane Gibson, Kerry Uebel, Boaz Shulruf
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J Educ Eval Health Prof. 2023;20:2. Published online January 18, 2023
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DOI: https://doi.org/10.3352/jeehp.2023.20.2
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This study evaluated the validity of student feedback derived from Medicine Student Experience Questionnaire (MedSEQ), as well as the predictors of students’ satisfaction in the Medicine program.
Methods Data from MedSEQ applying to the University of New South Wales Medicine program in 2017, 2019, and 2021 were analyzed. Confirmatory factor analysis (CFA) and Cronbach’s α were used to assess the construct validity and reliability of MedSEQ respectively. Hierarchical multiple linear regressions were used to identify the factors that most impact students’ overall satisfaction with the program.
Results A total of 1,719 students (34.50%) responded to MedSEQ. CFA showed good fit indices (root mean square error of approximation=0.051; comparative fit index=0.939; chi-square/degrees of freedom=6.429). All factors yielded good (α>0.7) or very good (α>0.8) levels of reliability, except the “online resources” factor, which had acceptable reliability (α=0.687). A multiple linear regression model with only demographic characteristics explained 3.8% of the variance in students’ overall satisfaction, whereas the model adding 8 domains from MedSEQ explained 40%, indicating that 36.2% of the variance was attributable to students’ experience across the 8 domains. Three domains had the strongest impact on overall satisfaction: “being cared for,” “satisfaction with teaching,” and “satisfaction with assessment” (β=0.327, 0.148, 0.148, respectively; all with P<0.001).
Conclusion MedSEQ has good construct validity and high reliability, reflecting students’ satisfaction with the Medicine program. Key factors impacting students’ satisfaction are the perception of being cared for, quality teaching irrespective of the mode of delivery and fair assessment tasks which enhance learning.
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- Mental health and quality of life across 6 years of medical training: A year-by-year analysis
Natalia de Castro Pecci Maddalena, Alessandra Lamas Granero Lucchetti, Ivana Lucia Damasio Moutinho, Oscarina da Silva Ezequiel, Giancarlo Lucchetti International Journal of Social Psychiatry.2024; 70(2): 298. CrossRef
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Development and validation of the student ratings in clinical teaching scale in Australia: a methodological study
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Pin-Hsiang Huang, Anthony John O’Sullivan, Boaz Shulruf
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J Educ Eval Health Prof. 2023;20:26. Published online September 5, 2023
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DOI: https://doi.org/10.3352/jeehp.2023.20.26
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This study aimed to devise a valid measurement for assessing clinical students’ perceptions of teaching practices.
Methods A new tool was developed based on a meta-analysis encompassing effective clinical teaching-learning factors. Seventy-nine items were generated using a frequency (never to always) scale. The tool was applied to the University of New South Wales year 2, 3, and 6 medical students. Exploratory and confirmatory factor analysis (exploratory factor analysis [EFA] and confirmatory factor analysis [CFA], respectively) were conducted to establish the tool’s construct validity and goodness of fit, and Cronbach’s α was used for reliability.
Results In total, 352 students (44.2%) completed the questionnaire. The EFA identified student-centered learning, problem-solving learning, self-directed learning, and visual technology (reliability, 0.77 to 0.89). CFA showed acceptable goodness of fit (chi-square P<0.01, comparative fit index=0.930 and Tucker-Lewis index=0.917, root mean square error of approximation=0.069, standardized root mean square residual=0.06).
Conclusion The established tool—Student Ratings in Clinical Teaching (STRICT)—is a valid and reliable tool that demonstrates how students perceive clinical teaching efficacy. STRICT measures the frequency of teaching practices to mitigate the biases of acquiescence and social desirability. Clinical teachers may use the tool to adapt their teaching practices with more active learning activities and to utilize visual technology to facilitate clinical learning efficacy. Clinical educators may apply STRICT to assess how these teaching practices are implemented in current clinical settings.
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Equal Z standard-setting method to estimate the minimum number of panelists for a medical school’s objective structured clinical examination in Taiwan: a simulation study
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Ying-Ying Yang, Pin-Hsiang Huang, Ling-Yu Yang, Chia-Chang Huang, Chih-Wei Liu, Shiau-Shian Huang, Chen-Huan Chen, Fa-Yauh Lee, Shou-Yen Kao, Boaz Shulruf
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J Educ Eval Health Prof. 2022;19:27. Published online October 17, 2022
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DOI: https://doi.org/10.3352/jeehp.2022.19.27
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Undertaking a standard-setting exercise is a common method for setting pass/fail cut scores for high-stakes examinations. The recently introduced equal Z standard-setting method (EZ method) has been found to be a valid and effective alternative for the commonly used Angoff and Hofstee methods and their variants. The current study aims to estimate the minimum number of panelists required for obtaining acceptable and reliable cut scores using the EZ method.
Methods The primary data were extracted from 31 panelists who used the EZ method for setting cut scores for a 12-station of medical school’s final objective structured clinical examination (OSCE) in Taiwan. For this study, a new data set composed of 1,000 random samples of different panel sizes, ranging from 5 to 25 panelists, was established and analyzed. Analysis of variance was performed to measure the differences in the cut scores set by the sampled groups, across all sizes within each station.
Results On average, a panel of 10 experts or more yielded cut scores with confidence more than or equal to 90% and 15 experts yielded cut scores with confidence more than or equal to 95%. No significant differences in cut scores associated with panel size were identified for panels of 5 or more experts.
Conclusion The EZ method was found to be valid and feasible. Less than an hour was required for 12 panelists to assess 12 OSCE stations. Calculating the cut scores required only basic statistical skills.
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Medical student selection process enhanced by improving selection algorithms and changing the focus of interviews in Australia: a descriptive study
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Boaz Shulruf, Gary Mayer Velan, Sean Edward Kennedy
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J Educ Eval Health Prof. 2022;19:31. Published online November 28, 2022
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DOI: https://doi.org/10.3352/jeehp.2022.19.31
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Abstract
PDFSupplementary Material
- Purpose
The study investigates the efficacy of new features introduced to the selection process for medical school at the University of New South Wales, Australia: (1) considering the relative ranks rather than scores of the Undergraduate Medicine and Health Sciences Admission Test and Australian Tertiary Admission Rank; (2) structured interview focusing on interpersonal interaction and concerns should the applicants become students; and (3) embracing interviewers’ diverse perspectives.
Methods Data from 5 cohorts of students were analyzed, comparing outcomes of the second year in the medicine program of 4 cohorts of the old selection process and 1 of the new process. The main analysis comprised multiple linear regression models for predicting academic, clinical, and professional outcomes, by section tools and demographic variables.
Results Selection interview marks from the new interview (512 applicants, 2 interviewers each) were analyzed for inter-rater reliability, which identified a high level of agreement (kappa=0.639). No such analysis was possible for the old interview since it required interviewers to reach a consensus. Multivariate linear regression models utilizing outcomes for 5 cohorts (N=905) revealed that the new selection process was much more effective in predicting academic and clinical achievement in the program (R2=9.4%–17.8% vs. R2=1.5%–8.4%).
Conclusion The results suggest that the medical student selection process can be significantly enhanced by employing a non-compensatory selection algorithm; and using a structured interview focusing on interpersonal interaction and concerns should the applicants become students; as well as embracing interviewers’ diverse perspectives.
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- Insights into undergraduate medical student selection tools: a systematic review and meta-analysis
Pin-Hsiang Huang, Arash Arianpoor, Silas Taylor, Jenzel Gonzales, Boaz Shulruf Journal of Educational Evaluation for Health Professions.2024; 21: 22. CrossRef
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Assessment methods and the validity and reliability of measurement tools in online objective structured clinical examinations: a systematic scoping review
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Jonathan Zachary Felthun, Silas Taylor, Boaz Shulruf, Digby Wigram Allen
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J Educ Eval Health Prof. 2021;18:11. Published online June 1, 2021
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DOI: https://doi.org/10.3352/jeehp.2021.18.11
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PDFSupplementary Material
- The coronavirus disease 2019 (COVID-19) pandemic has required educators to adapt the in-person objective structured clinical examination (OSCE) to online settings in order for it to remain a critical component of the multifaceted assessment of a student’s competency. This systematic scoping review aimed to summarize the assessment methods and validity and reliability of the measurement tools used in current online OSCE (hereafter, referred to as teleOSCE) approaches. A comprehensive literature review was undertaken following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews guidelines. Articles were eligible if they reported any form of performance assessment, in any field of healthcare, delivered in an online format. Two reviewers independently screened the results and analyzed relevant studies. Eleven articles were included in the analysis. Pre-recorded videos were used in 3 studies, while observations by remote examiners through an online platform were used in 7 studies. Acceptability as perceived by students was reported in 2 studies. This systematic scoping review identified several insights garnered from implementing teleOSCEs, the components transferable from telemedicine, and the need for systemic research to establish the ideal teleOSCE framework. TeleOSCEs may be able to improve the accessibility and reproducibility of clinical assessments and equip students with the requisite skills to effectively practice telemedicine in the future.
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- Feasibility and reliability of the pandemic-adapted online-onsite hybrid graduation OSCE in Japan
Satoshi Hara, Kunio Ohta, Daisuke Aono, Toshikatsu Tamai, Makoto Kurachi, Kimikazu Sugimori, Hiroshi Mihara, Hiroshi Ichimura, Yasuhiko Yamamoto, Hideki Nomura Advances in Health Sciences Education.2024; 29(3): 949. CrossRef - A level playing field? Evaluation of the virtual Objective Structured Clinical Examination in Psychiatry and Addiction Medicine: A mixed methods study
Rebecca E Reay, Paul A Maguire, Jeffrey CL Looi Australasian Psychiatry.2024; 32(4): 359. CrossRef - Conducting an objective structured clinical examination under COVID-restricted conditions
Andrea Gotzmann, John Boulet, Yichi Zhang, Judy McCormick, Mathieu Wojcik, Ilona Bartman, Debra Pugh BMC Medical Education.2024;[Epub] CrossRef - The virtual Clinical Assessment of Skills and Competence: the impact and challenges of a digitised final examination
Kenny Chu, Shivanthi Sathanandan BJPsych Bulletin.2023; 47(2): 110. CrossRef - Virtual Learning and Assessment in Rheumatology Fellowship Training: Objective Structured Clinical Examination Revisited
Rachel M. Wolfe, Faye N. Hant, Rumey C. Ishizawar, Lisa G. Criscione‐Schreiber, Beth L. Jonas, Kenneth S. O'Rourke, Marcy B. Bolster Arthritis Care & Research.2023; 75(12): 2435. CrossRef - Innovations in assessment in health professions education during the COVID‐19 pandemic: A scoping review
Jamal Giri, Claire Stewart The Clinical Teacher.2023;[Epub] CrossRef - Evaluation of the Utility of Online Objective Structured Clinical Examination Conducted During the COVID-19 Pandemic
Mona Arekat, Mohamed Hany Shehata, Abdelhalim Deifalla, Ahmed Al-Ansari, Archana Kumar, Mohamed Alsenbesy, Hamdi Alshenawi, Amgad El-Agroudy, Mariwan Husni, Diaa Rizk, Abdelaziz Elamin, Afif Ben Salah, Hani Atwa Advances in Medical Education and Practice.2022; Volume 13: 407. CrossRef - Comparison of student pharmacists' performance on in-person vs. virtual OSCEs in a pre-APPE capstone course
Justine S. Gortney, Joseph P. Fava, Andrew D. Berti, Brittany Stewart Currents in Pharmacy Teaching and Learning.2022; 14(9): 1116. CrossRef - Is online objective structured clinical examination teaching an acceptable replacement in post-COVID-19 medical education in the United Kingdom?: a descriptive study
Vashist Motkur, Aniket Bharadwaj, Nimalesh Yogarajah Journal of Educational Evaluation for Health Professions.2022; 19: 30. CrossRef - Equal Z standard-setting method to estimate the minimum number of panelists for a medical school’s objective structured clinical examination in Taiwan: a simulation study
Ying-Ying Yang, Pin-Hsiang Huang, Ling-Yu Yang, Chia-Chang Huang, Chih-Wei Liu, Shiau-Shian Huang, Chen-Huan Chen, Fa-Yauh Lee, Shou-Yen Kao, Boaz Shulruf Journal of Educational Evaluation for Health Professions.2022; 19: 27. CrossRef - Applying the Student Response System in the Online Dermatologic Video Curriculum on Medical Students' Interaction and Learning Outcomes during the COVID-19 Pandemic
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Jonathan Zachary Felthun, Silas Taylor, Boaz Shulruf, Digby Wigram Allen Journal of Educational Evaluation for Health Professions.2021; 18: 23. CrossRef
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Empirical analysis comparing the tele-objective structured clinical examination and the in-person assessment in Australia
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Jonathan Zachary Felthun, Silas Taylor, Boaz Shulruf, Digby Wigram Allen
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J Educ Eval Health Prof. 2021;18:23. Published online September 23, 2021
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DOI: https://doi.org/10.3352/jeehp.2021.18.23
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Abstract
PDFSupplementary Material
- Purpose
It aimed to compare the use of the tele-objective structured clinical examination (teleOSCE) with in-person assessment in high-stakes clinical examination so as to determine the impact of the teleOSCE on the assessment undertaken. Discussion follows regarding what skills and domains can effectively be assessed in a teleOSCE.
Methods This study is a retrospective observational analysis. It compares the results achieved by final year medical students in their clinical examination, assessed using the teleOSCE in 2020 (n=285), with those who were examined using the traditional in-person format in 2019 (n=280). The study was undertaken at the University of New South Wales, Australia.
Results In the domain of physical examination, students in 2020 scored 0.277 points higher than those in 2019 (mean difference=–0.277, P<0.001, effect size=0.332). Across all other domains, there was no significant difference in mean scores between 2019 and 2020.
Conclusion The teleOSCE does not negatively impact assessment in clinical examination in all domains except physical examination. If the teleOSCE is the future of clinical skills examination, assessment of physical examination will require concomitant workplace-based assessment.
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- Feasibility and reliability of the pandemic-adapted online-onsite hybrid graduation OSCE in Japan
Satoshi Hara, Kunio Ohta, Daisuke Aono, Toshikatsu Tamai, Makoto Kurachi, Kimikazu Sugimori, Hiroshi Mihara, Hiroshi Ichimura, Yasuhiko Yamamoto, Hideki Nomura Advances in Health Sciences Education.2024; 29(3): 949. CrossRef - Feasibility of an online clinical assessment of competence in physiotherapy students
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Effects of virtual reality training on decreasing the rates of needlestick or sharp injury in new-coming medical and nursing interns in Taiwan
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Szu-Hsien Wu, Chia-Chang Huang, Shiau-Shian Huang, Ying-Ying Yang, Chih-Wei Liu, Boaz Shulruf, Chen-Huan Chen
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J Educ Eval Health Prof. 2020;17:1. Published online January 20, 2020
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DOI: https://doi.org/10.3352/jeehp.2020.17.1
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Abstract
PDFSupplementary Material
- Purpose
Senior nursing and medical interns’ lack of familiarity and confidence with respect to practicing universal precaution for the prevention of occupational needlestick or sharp injuries may harm themselves. Trainees’ self-reported needlestick or sharp injury rate was known to be especially high during the first 2 months of internship in Taiwan. This prospective cohort study aimed to assess the effect of newly developed virtual reality (VR) game, which uses Gagne’s learning model to improve universal precaution for needlestick or sharp injury prevention and decrease the rates of needle stick or sharp injuries in new-coming medical and nursing interns in Taiwan.
Methods From 2017 to 2019, the VR system was developed and applied in training of 59 new-coming nursing and 50 medical interns. Occupational needlestick or sharp injury prevention was sought to be achieved through a game of right and wrong choices for safe or unsafe universal precaution behaviors.
Results In comparison with medical interns, a higher proportion of nursing interns had past experiences of deep occupational needlestick or sharp injury. Before VR training, the familiarity and confidence for needlestick or sharp injury prevention were higher among nursing interns than medical interns. Trainees with past experiences of deep needlestick or sharp injury exhibited better performance on the accuracy rate and time needed to complete 20 decisions than those without past experiences in VR practice. All trainees showed an improved performance after VR training. A high proportion of trainees reported that the VR-based training significantly decreased their anxiety about needlestick or sharp injury prevention.
Conclusion This self-developed VR game system using Gagne’s flow improved universal precaution for needlestick or sharp injury prevention and reduced the needlestick or sharp injury rates in the first 2 months of nursing and medical internship.
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Comparison of the effects of simulated patient clinical skill training and student roleplay on objective structured clinical examination performance among medical students in Australia
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Silas Taylor, Matthew Haywood, Boaz Shulruf
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J Educ Eval Health Prof. 2019;16:3. Published online January 11, 2019
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DOI: https://doi.org/10.3352/jeehp.2019.16.3
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Abstract
PDFSupplementary Material
- Purpose
Optimal methods for communication skills training (CST) are an active research area, but the effects of CST on communication performance in objective structured clinical examinations (OSCEs) has not been closely studied. Student roleplay (RP) for CST is common, although volunteer simulated patient (SP) CST is cost-effective and provides authentic interactions. We assessed whether our volunteer SP CST program improved OSCE performance compared to our previous RP strategy.
Methods We performed a retrospective, quasi-experimental study of 2 second-year medical student cohorts’ OSCE data in Australia. The 2014 cohort received RP-only CST (N=182) while the 2016 cohort received SP-only CST (N=148). The t-test and analysis of variance were used to compare the total scores in 3 assessment domains: generic communication, clinical communication, and physical examination/procedural skills.
Results The baseline characteristics of groups (scores on the Australian Tertiary Admission Rank, Undergraduate Medicine and Health Sciences Admission Test, and medicine program interviews) showed no significant differences between groups. For each domain, the SP-only CST group demonstrated superior OSCE outcomes, and the difference between cohorts was significant (P<0.01). The superiority of volunteer SP CST over student RP CST in terms of OSCE performance outcomes was found for generic communication, clinical communication, and physical examination/procedural skills.
Conclusion The better performance of the SP cohort in physical examination/procedural skills might be explained by the requirement for patient compliance and cooperation, facilitated by good generic communication skills. We recommend a volunteer SP program as an effective and efficient way to improve CST among junior medical students.
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An expert-led and artificial intelligence system-assisted tutoring course to improve the confidence of Chinese medical interns in suturing and ligature skills: a prospective pilot study
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Ying-Ying Yang, Boaz Shulruf
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J Educ Eval Health Prof. 2019;16:7. Published online April 10, 2019
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DOI: https://doi.org/10.3352/jeehp.2019.16.7
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Abstract
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- Purpose
Lack of confidence in suturing/ligature skills due to insufficient practice and assessments is common among novice Chinese medical interns. This study aimed to improve the skill acquisition of medical interns through a new intervention program.
Methods In addition to regular clinical training, expert-led or expert-led plus artificial intelligence (AI) system tutoring courses were implemented during the first 2 weeks of the surgical block. Interns could voluntarily join the regular (no additional tutoring), expert-led tutoring, or expert-led+AI tutoring groups freely. In the regular group, interns (n=25) did not receive additional tutoring. The expert-led group received 3-hour expert-led tutoring and in-training formative assessments after 2 practice sessions. After a similar expert-led course, the expert-led+AI group (n=23) practiced and assessed their skills on an AI system. Through a comparison with the internal standard, the system automatically recorded and evaluated every intern’s suturing/ligature skills. In the expert-led+AI group, performance and confidence were compared between interns who participated in 1, 2, or 3 AI practice sessions.
Results The end-of-surgical block objective structured clinical examination (OSCE) performance and self-assessed confidence in suturing/ligature skills were highest in the expert-led+AI group. In comparison with the expert-led group, the expert-led+AI group showed similar performance in the in-training assessment and greater improvement in the end-of-surgical block OSCE. In the expert-led+AI group, the best performance and highest post-OSCE confidence were noted in those who engaged in 3 AI practice sessions.
Conclusion This pilot study demonstrated the potential value of incorporating an additional expert-led+AI system–assisted tutoring course into the regular surgical curriculum.
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Definition of professionalism and tools for assessing professionalism in pharmacy practice: a systematic review
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Huda Dubbai, Barbara-Ann Adelstein, Silas Taylor, Boaz Shulruf
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J Educ Eval Health Prof. 2019;16:22. Published online August 21, 2019
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DOI: https://doi.org/10.3352/jeehp.2019.16.22
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Abstract
PDFSupplementary Material
- Purpose
In contemporary pharmacy, the role of pharmacists has become more multifaceted, as they now handle a wider range of tasks and take more responsibility for providing patient care than 20 years ago. This evolution in pharmacists’ responsibilities has been accompanied by the need for pharmacists to display high-quality patient-centred care and counselling, and to demonstrate professionalism, which now needs to be taught and assessed as part of pharmacy education and practice. This study aimed at identifying definitions of professionalism in pharmacy practice and critically evaluating published instruments for assessing professionalism in pharmacy practice.
Methods We searched the medical literature listed in Scopus, MEDLINE, and PsycINFO databases from 1 January 2000 to 31 December 2018. All papers meeting our selection criteria were reviewed and summarised into a clear review of professionalism requirements in pharmacy practice. Details of the instruments measuring professionalism were reviewed in detail.
Results There is no accepted simple definition of professionalism, although we identified several theoretical and policy frameworks required for professional pharmaceutical practice. We identified 4 instruments (the Behavioural Professionalism Assessment Instrument, Lerkiatbundit’s instrument, the Pharmacy Professionalism Instrument, and the Professionalism Assessment Tool that build on these frameworks and measure professional practice in pharmacy students. These were found to be reliable and valid, but had only been used and tested in student populations.
Conclusion Given the increasingly broad role of community pharmacists, there is a need for assessments of professionalism in practice. Professionalism is a complex concept that is challenging to measure because it has no standardised definition and the existing literature related to the topic is limited. Currently available instruments focus on measuring the development of the elements of professionalism among pharmacy students, rather than pharmacists.
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Dreyfus scale-based feedback increased medical students’ satisfaction with the complex cluster part of a interviewing and physical examination course and improved skills readiness in Taiwan
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Shiau-Shian Huang, Chia-Chang Huang, Ying-Ying Yang, Shuu-Jiun Wang, Boaz Shulruf, Chen-Huan Chen
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J Educ Eval Health Prof. 2019;16:30. Published online October 11, 2019
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DOI: https://doi.org/10.3352/jeehp.2019.16.30
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Abstract
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- Purpose
In contrast to the core part of the clinical interviewing and physical examination (PE) skills course, corresponding to the basic, head-to-toe, and thoracic systems, learners need structured feedback in the cluster part of the course, which includes the abdominal, neuromuscular, and musculoskeletal systems. This study evaluated the effects of using Dreyfus scale-based feedback, which has elements of continuous professional development, instead of Likert scale-based feedback in the cluster part of training in Taiwan.
Methods Instructors and final-year medical students in the 2015–2016 classes of National Yang-Ming University, Taiwan comprised the regular cohort, whereas those in the 2017–2018 classes formed the intervention cohort. In the intervention cohort, Dreyfus scale-based feedback, rather than Likert scale-based feedback, was used in the cluster part of the course.
Results In the cluster part of the course in the regular cohort, pre-trained standardized patients rated the class climate as poor, and students expressed low satisfaction with the instructors and course and low self-assessed readiness. In comparison with the regular cohort, improved end-of-course group objective structured clinical examination scores after the cluster part were noted in the intervention cohort. In other words, the implementation of Dreyfus scale-based feedback in the intervention cohort for the cluster part improved the deficit in this section of the course.
Conclusion The implementation of Dreyfus scale-based feedback helped instructors to create a good class climate in the cluster part of the clinical interviewing and PE skills course. Simultaneously, this new intervention achieved the goal of promoting medical students’ readiness for interviewing, PE, and self-directed learning.
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Examiner seniority and experience are associated with bias when scoring communication, but not examination, skills in objective structured clinical examinations in Australia
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Lauren Chong, Silas Taylor, Matthew Haywood, Barbara-Ann Adelstein, Boaz Shulruf
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J Educ Eval Health Prof. 2018;15:17.
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DOI: https://doi.org/10.3352/jeehp.2018.15.17
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Abstract
PDFSupplementary Material
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The biases that may influence objective structured clinical examination (OSCE) scoring are well understood, and recent research has attempted to establish the magnitude of their impact. However, the influence of examiner experience, clinical seniority, and occupation on communication and physical examination scores in OSCEs has not yet been clearly established.
Methods We compared the mean scores awarded for generic and clinical communication and physical examination skills in 2 undergraduate medicine OSCEs in relation to examiner characteristics (gender, examining experience, occupation, seniority, and speciality). The statistical significance of the differences was calculated using the 2-tailed independent t-test and analysis of variance.
Results Five hundred and seventeen students were examined by 237 examiners at the University of New South Wales in 2014 and 2016. Examiner gender, occupation (academic, clinician, or clinical tutor), and job type (specialist or generalist) did not significantly impact scores. Junior doctors gave consistently higher scores than senior doctors in all domains, and this difference was statistically significant for generic and clinical communication scores. Examiner experience was significantly inversely correlated with generic communication scores.
Conclusion We suggest that the assessment of examination skills may be less susceptible to bias because this process is fairly prescriptive, affording greater scoring objectivity. We recommend training to define the marking criteria, teaching curriculum, and expected level of performance in communication skills to reduce bias in OSCE assessment.
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The sights and insights of examiners in objective structured clinical examinations
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Lauren Chong, Silas Taylor, Matthew Haywood, Barbara-Ann Adelstein, Boaz Shulruf
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J Educ Eval Health Prof. 2017;14:34. Published online December 27, 2017
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DOI: https://doi.org/10.3352/jeehp.2017.14.34
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Abstract
PDFSupplementary Material
- Purpose
The objective structured clinical examination (OSCE) is considered to be one of the most robust methods of clinical assessment. One of its strengths lies in its ability to minimise the effects of examiner bias due to the standardisation of items and tasks for each candidate. However, OSCE examiners’ assessment scores are influenced by several factors that may jeopardise the assumed objectivity of OSCEs. To better understand this phenomenon, the current review aims to determine and describe important sources of examiner bias and the factors affecting examiners’ assessments.
Methods We performed a narrative review of the medical literature using Medline. All articles meeting the selection criteria were reviewed, with salient points extracted and synthesised into a clear and comprehensive summary of the knowledge in this area.
Results OSCE examiners’ assessment scores are influenced by factors belonging to 4 different domains: examination context, examinee characteristics, examinee-examiner interactions, and examiner characteristics. These domains are composed of several factors including halo, hawk/dove and OSCE contrast effects; the examiner’s gender and ethnicity; training; lifetime experience in assessing; leadership and familiarity with students; station type; and site effects.
Conclusion Several factors may influence the presumed objectivity of examiners’ assessments, and these factors need to be addressed to ensure the objectivity of OSCEs. We offer insights into directions for future research to better understand and address the phenomenon of examiner bias.
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Australian medical students have fewer opportunities to do physical examination of peers of the opposite gender
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Silas Taylor, Boaz Shulruf
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J Educ Eval Health Prof. 2016;13:42. Published online November 23, 2016
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DOI: https://doi.org/10.3352/jeehp.2016.13.42
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25,821
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- Purpose
Peer physical examination (PPE), by which junior medical students learn physical examination skills before practicing on patients, is a widely implemented and accepted part of medical curricula. However, the ethical implications of PPE have been debated, since issues including student gender impact on its acceptability. Research has previously demonstrated the phenomenon of ‘attitude-behavior inconsistency’ showing that students’ predictions about their participation in PPE differ from what they actually do in practice. This study asks whether gender and student self-ratings of outlook affect engagement in PPE. Methods: This study gathered data from students who had completed PPE with the objective of determining what factors have the greatest impact on the actual practice of PPE by students. Data were used to derive the number of opportunities students had to examine a peer, for various body parts. Respondent gender and self-ratings of outlook were recorded. Results: Responses from 130 students were analysed: 74 female (57%) and 56 male (43%). Students have fewer opportunities to examine peers of the opposite gender; this is statistically significant for all body parts when male students examine female peers. Conclusion: Gender is the factor of overriding importance on whether these peer interactions actually occur, such that students have fewer opportunities to examine peers of the opposite gender, particularly male students examining female peers. Student outlook has little impact. We speculate that the more acceptable PPE is to participants, paradoxically, the more complicated these interactions become, possibly with implications for future practice.
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Citations
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Breadth of knowledge vs. grades: What best predicts achievement in the first year of health sciences programmes?
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Boaz Shulruf, Meisong Li, Judy McKimm, Melinda Smith
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J Educ Eval Health Prof. 2012;9:7. Published online May 16, 2012
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DOI: https://doi.org/10.3352/jeehp.2012.9.7
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35,522
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- This study aimed to identify those features within secondary school curricula and assessment, particularly science subjects that best predict academic achievement in the first year of three different three-year undergraduate health professional programmes (nursing, pharmacy, and health sciences) at a large New Zealand university. In particular, this study compared the contribution of breadth of knowledge (number of credits acquired) versus grade level (grade point average) and explored the impact of demographic variables on achievement. The findings indicated that grades are the most important factor predicting student success in the first year of university. Although taking biology and physics at secondary school has some impact on university first year achievement, the effect is relatively minor.
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Dalal Hammoudi Halat, Abdel-Salam G. Abdel-Salam, Ahmed Bensaid, Abderrezzaq Soltani, Lama Alsarraj, Roua Dalli, Ahmed Malki BMC Medical Education.2023;[Epub] CrossRef - Predictive validity of multiple mini interview scores for future academic and clinical placement performance in physiotherapy, occupational therapy and speech and language therapy programmes
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