Purpose This study aimed to determine how the general course experiences of dental students in Chile and the satisfaction or frustration of their basic psychological needs influenced their passion for studying, and how passion influenced students’ study strategies.
Methods A correlational cross-sectional study was conducted at 3 Chilean dental schools between April and June 2018, in which 935 undergraduate students participated. Students responded to Spanish-language versions of 4 psychological scale tools: the Course Experience Questionnaire, the Basic Psychological Needs Satisfac¬tion and Frustration Scale, the Passion Scale, and the Revised Study Process Questionnaire. Data were analysed with bivariate correlations and structural equation modelling, controlling for age, gender, year of study, and type of university.
Results Students’ general course experiences (i.e., good teaching, clear goals and standards, appropriate assessment, and appropriate workload) positively predicted basic need satisfaction and negatively predicted need frustration. Need satisfaction positively predicted passion in students, with stronger scores for harmonious passion. Basic need frustration positively predicted obsessive passion and negatively predicted harmonious passion. Harmonious passion positively predicted deep study strategies and negatively predicted surface study strategies, while obsessive passion positively predicted both deep and surface study strategies.
Conclusion Dental students’ optimal course experiences positively influenced the satisfaction of their basic psychological needs, which favoured harmonious over obsessive passion. In turn, harmonious over obsessive passion positively influenced deep study strategies. Therefore, efforts should be made to provide course experiences that support students’ basic needs and harmonious passion for studying, both in classroom and chair-side teaching.
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Purpose Students’ satisfaction is an essential element in higher education. This study aimed to identify paths and predictive power of students’ satisfaction during team-based learning (TBL) activities in the faculty of life sciences using partial least squares structural equation modelling (PLS-SEM).
Methods In 2018–2019, at the University of Sussex (Falmer, UK), 180 life science students exposed to TBL were invited to participate in the study. Team-Based-Learning-Student-Assessment-Instrument was used. A conceptual model was developed for testing six hypotheses. H1: What was the effect of TBL on student satisfaction? H2: What was the effect of lectures on student satisfaction? H3: What was the effect of TBL on accountability? H4: What was the effect of lectures on accountability? H5: What was the effect of accountability on student satisfaction? H6: What were the in-sample and out-of-sample predictive power of the model? The analysis was conducted using the PLS-SEM approach.
Results Ninety-nine students participated in the study giving a 55% response rate. Confirmatory tetrad analysis suggested a reflective model. Construct reliability, validity, average extracted variance, and discriminant validity were confirmed. All path coefficients were positive, and 5 were statistically significant (H1: β=0.587, P<0:001; H2: β=0.262, P<0.001; H3: β=0.532, P<0.001; H4: β=0.063, P=0.546; H5: β=0.200, P=0.002). The in-sample predictive power was weak for Accountability, (R2=0.303; 95% confidence interval [CI], 0.117–0.428; P<0.001) and substantial for Student Satisfaction (R2=0.678; 95% CI, 0.498–0.777; P<0.001). The out-of-sample predictive power was moderate.
Conclusion The results have demonstrated the possibility of developing and testing a TBL conceptual model using PLS-SEM for the evaluation of path coefficients and predictive power relative to students’ satisfaction.
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Purpose This study investigated changes in students’ attitudes using 2 validated interprofessional survey instruments—the Collaborative Healthcare Interdisciplinary Relationship Planning (CHIRP) instrument and the Interprofessional Attitudes Scale (IPAS)—before and after didactic and clinical cohorts.
Methods Students from 7 colleges/schools participated in didactic and clinical cohorts during the 2017–2018 year. Didactic cohorts experienced 2 interactive sessions 6 months apart, while clinical cohorts experienced 4 outpatient clinical sessions once monthly. For the baseline and post-cohort assessments, 865 students were randomly assigned to complete either the 14-item CHIRP or the 27-item IPAS. The Pittman test using permutations of linear ranks was used to determine differences in the score distribution between the baseline and post-cohort assessments. Pooled results were compared for the CHIRP total score and the IPAS total and subdomain scores. For each score, 3 comparisons were made simultaneously: overall baseline versus post-didactic cohort, overall baseline versus post-clinical cohort, and post-didactic cohort versus post-clinical cohort. Alpha was adjusted to 0.0167 to account for simultaneous comparisons.
Results The baseline and post-cohort survey response rates were 62.4% and 65.9% for CHIRP and 58.7% and 58.1% for IPAS, respectively. The post-clinical cohort scores for the IPAS subdomain of teamwork, roles, and responsibilities were significantly higher than the baseline and post-didactic cohort scores. No differences were seen for the remaining IPAS subdomain scores or the CHIRP instrument total score.
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Methods This expert panel study was conducted from 2018 to 2019 at Isfahan University of Medical Sciences, Iran. It included 2 phases: developing a framework in 2 steps and forming an expert panel to validate the framework in 3 rounds. We adapted a 3-stage narrative medicine model with 9 training activities from Gagne’s theory, developed a framework, and then produced a checklist to validate the framework in a multidisciplinary expert panel that consisted of 7 experts. The RAND/UCLA appropriateness method was used to assess the experts’ agreement. The first-round opinions were received by email. Consensus was achieved in the second and third rounds through face-to-face meetings to facilitate interactions and discussion among the experts.
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Results The search yielded 870 total articles. After screening, 7 articles remained for review. All studies reported a positive impact of IPE on the education of students of the health professions.
Conclusion Evidence showed that IPE activities were an effective tool for improving attitudes toward interdisciplinary teamwork, communication, shared problem-solving, and knowledge and skills in preparation for collaboration within interdisciplinary teams.
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Purpose Summative evaluation forms assessing a student’s clinical performance are often completed by a faculty preceptor at the end of a clinical training experience. At our institution, despite the use of an electronic system, timeliness of completion has been suboptimal, potentially limiting our ability to monitor students’ progress. The aim of the present study was to determine whether a student-directed approach to summative evaluation form collection at the end of a pediatrics clerkship would enhance timeliness of completion for third-year medical students.
Methods This was a pre- and post-intervention educational quality improvement project focused on 156 (82 pre-intervention, 74 post-intervention) third-year medical students at Penn State College of Medicine completing their 4-week pediatric clerkship. Utilizing REDCap (Research Electronic Data Capture) informatics support, student-directed evaluation form solicitation was encouraged. The Wilcoxon rank-sum test was applied to compare the pre-intervention (May 1, 2017 to March 2, 2018) and post-intervention (April 2, 2018 to December 21, 2018) percentages of forms completed before the rotation midpoint.
Results In total, 740 evaluation forms were submitted during the pre-intervention phase and 517 during the post-intervention phase. The percentage of forms completed before the rotation midpoint increased after implementing student-directed solicitation (9.6% vs. 39.7%, P<0.05).
Conclusion Our clerkship relies on subjective summative evaluations to track students’ progress, deploy improvement strategies, and determine criteria for advancement; however, our preceptors struggled with timely submission. Allowing students to direct the solicitation of evaluation forms enhanced the timeliness of completion and should be considered in clerkships facing similar challenges.
Purpose This study was conducted to determine whether an objective structured clinical examination (OSCE) could be used to evaluate and monitor hand hygiene and personal protective equipment (PPE) proficiency among medical interns in the United States.
Methods Interns in July 2015 (N=123, cohort 1) with no experience of OSCE-based contact precaution evaluation and teaching were evaluated in early 2016 using an OSCE for hand hygiene and PPE proficiency. They performed poorly. Therefore, the new interns entering in July 2016 (N=151, cohort 2) were immediately tested at the same OSCE stations as cohort 1, and were provided with feedback and teaching. Cohort 2 was then retested at the OSCE station in early 2017. The Mann-Whitney U-test was used to compare the performance of cohort 1 and cohort 2 on checklist items. In cohort 2, performance differences between the beginning and end of the intern year were compared using the McNemar chi-square test for paired nominal data.
Results Checklist items were scored, summed, and reported as percent correct. In cohort 2, the mean percent correct was higher on the posttest than on the pretest (92% vs. 77%, P<0.0001), and the passing rate (100% correct) was also significantly higher on the posttest (55% vs. 16%). At the end of intern year, the mean percent correct was higher in cohort 2 than in cohort 1 (95% vs. 90%, P<0.0001), and 55% of cohort 2 passed (a perfect score) compared to 24% in cohort 1 (P<0.0001).
Conclusion An OSCE can be utilized to evaluate and monitor hand hygiene and PPE proficiency among interns in the United States.
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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.
Purpose Peer-assisted learning (PAL) promotes the development of communication, facilitates improvements in clinical skills, and is a way to provide feedback to learners. We utilized PAL as a conceptual framework to explore the feasibility of peer-assisted feedback (PAF) to improve note-writing skills without requiring faculty time. The aim was to assess whether PAL was a successful method to provide feedback on the United States Medical Licensing Exams (USMLE)-style clinical skills exam notes by using student feedback on a survey in the United States.
Methods The University of Florida College of Medicine administers clinical skills examination (CSEs) that include USMLE-like note-writing. PAL, in which students support the learning of their peers, was utilized as an alternative to faculty feedback. Second-year (MS2) and third-year (MS3) medical students taking CSEs participated in faculty-run note-grading sessions immediately after testing, which included explanations of grading rubrics and the feedback process. Students graded an anonymized peer’s notes. The graded material was then forwarded anonymously to its student author to review. Students were surveyed on their perceived ability to provide feedback and the benefits derived from PAF using a Likert scale (1–6) and open-ended comments during the 2017–2018 academic year.
Results Students felt generally positively about the activity, with mean scores for items related to educational value of 4.49 for MS2s and 5.11 for MS3s (out of 6). MS3s perceived peer feedback as constructive, felt that evaluating each other’s notes was beneficial, and felt that the exercise would improve their future notes. While still positive, MS2 students gave lower scores than the MS3 students.
Conclusion PAF was a successful method of providing feedback on student CSE notes, especially for MS3s. MS2s commented that although they learned during the process, they might be more invested in improving their note-writing as they approach their own USMLE exam.
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Purpose Since 2004, the Korea Institute of Medical Education and Evaluation has been responsible for the evaluation and accreditation of medical schools in Korea. The 2nd cycle of evaluations was conducted from 2007 to 2011. The present study aimed at testing the goodness of fit of the items used in the 2nd cycle of evaluation and accreditation based on the Rasch model.
Methods Dichotomous data on 40 medical schools were analyzed using Winsteps, a tool based on the Rasch model that includes goodness-of-fit testing.
Results Two of the 109 items had an outfit mean square exceeding 2.0. The other 107 items showed a goodness of fit in the acceptable range for the outfit mean square. All items were in the acceptable range in terms of the infit mean square. Furthermore, 1 school had an outfit mean square exceeding 2.0, while all schools were in the acceptable range for the infit mean square. An outfit mean square value over 2.0 means that an item is a outlier. Therefore, 2 items showed an extreme response relative to the overall response. Meanwhile, the finding of an outfit mean square over 2.0 for 1 school means that it showed extraordinary responses to specific items, despite its excellent overall competency.
Conclusion The goodness of fit of the items used for evaluation and accreditation by the Korea Institute of Medical Education and Evaluation should be checked so that they can be revised appropriately. Furthermore, the outlier school should be investigated to determine why it showed such an inappropriate goodness of fit.
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Volunteering at a free clinic may influence career choice among health profession students. The purpose of this study was to explore knowledge, skills, attitudes, self-efficacy, interest in future work with the underserved, and interest in primary care among physician assistant (PA) students through an analysis of demographic characteristics of PA students at a student-run free clinic in the United States. Data were collected from 56 PA students through a quantitative survey in October 2018 after their participation at a student-run free clinic in Salt Lake City, Utah, in the intermountain west region of the USA. Out of the 3 sub-scales (attitudes, effect, and readiness), students responded most positively to items exploring the effect of their experiences of volunteering at the free clinic. Students who spoke Spanish showed higher levels of self-efficacy and readiness for a future career than non-Spanish speakers.
Purpose We aimed to review and provide a quality improvement for the document utilized by the relevant Korean government body to verify and evaluate foreign university/college graduates’ eligibility for nursing and qualification to take the Korean nursing licensing examination.
Methods This was a descriptive study. We analyzed the current Korean qualification system for foreign graduates to Korean nursing licensing examination and the same system utilized in some other countries. Then, we created a draft of the reviewed qualification standards document based on the 2 prior analyses and their comparisons, and applied a questionnaire in an open hearing with 5 experts to enhance the draft’s quality. Finally, we presented and discussed the final draft.
Results The reviewed criteria of the qualification standards included confirming whether the foreign graduate’s university has an accreditation provided by its relevant government body, the exclusion of foreign graduates’ provision of several documents previously required, a minimum number of credits (1,000 hours) for their original course, a 3-year minimum enrollment period for their original course, and a mandatory reassessment of the foreign graduates’ university recognition in a 5-year cycle.
Conclusion We believe that by creating a review draft that addresses the flaws of the current document utilized to determine the qualification for foreign graduates to take the Korean nursing licensing examination, we have simplified it for a better understanding of the application process. We hope that this draft will contribute to a more objective and equitable qualification process for foreign university nurse graduates in Korea.
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Purpose To evaluate ophthalmic educational training and confidence in caring for patients with ophthalmic complaints among internal, emergency, and family medicine residents in the United States.
Methods A 41-item cross-sectional survey was sent to the directors of 529 internal medicine, 237 emergency medicine, and 629 family medicine residency programs, who distributed it to residents in those programs. The survey included the number of ophthalmic education hours residents received. Respondents were asked to rate their confidence in performing an ophthalmic exam and treating patients with ocular conditions using a 5-point Likert scale ranging from “not confident” to “very confident.”
Results In total, 92.5% of internal medicine, 66.8% of emergency medicine, and 74.5% of family medicine residents received less than 10 hours of ophthalmic education during residency. Most respondents (internal medicine, 59.1%; emergency medicine, 76.0%; family medicine, 65.7%) reported that patients with ocular complaints constituted 1%–5% of visits. Mean±standard deviation confidence levels in performing an eye exam and treating patients with ophthalmic conditions were highest in emergency medicine residency programs (2.9±0.7), followed by family medicine (2.3±0.6) and internal medicine (2.2±0.6). A higher reported number of ophthalmic education hours in residency was associated with greater confidence among emergency (P<0.001), family (P<0.001), and internal (P=0.005) medicine residents.
Conclusion Internal, emergency, and family medicine residents receive limited ophthalmic education, as reflected by their overall low confidence levels in performing an ophthalmic exam and treating patients with ocular complaints. An increase in ophthalmic educational hours during their residencies is recommended to improve upon this knowledge gap.
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Purpose The Graduate Record Examination (GRE) is a general examination predictive of success in US-based graduate programs. Used to assess students’ written, mathematical, and critical thinking (CT) skills, the GRE is utilized for admission to approximately 85% of US physical therapist education (PTE) programs. The purpose of this study was to assess whether the CT skills measured by the GRE match those deemed by an expert panel as the most important to assess for PTE program acceptance.
Methods Using a modified E-Delphi approach, a 3-phase survey was distributed over 8 weeks to a panel consisting of licensed US physical therapists with expertise on CT and PTE program directors. The CT skills isolated by the expert panel, based on Facione’s Delphi report, were compared to the CT skills assessed by the GRE.
Results The CT skills supported by the Delphi report and chosen by the expert panel for assessment prior to acceptance into US PTE programs included clarifying meaning, categorization, and analyzing arguments. Only clarifying meaning matched the CT skills from the GRE.
Conclusion The GRE is a test for general admission to graduate programs, lacking context related to healthcare or physical therapy. The current study fails to support the GRE as an assessment tool of CT for admission to PTE programs. A context-based admission test evaluating the CT skills identified in this study should be developed for use in the admission process to predict which students will complete US PTE programs and pass the licensure exam.
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Purpose This study aimed to evaluate students’ perception of team-based learning (TBL) amongst a cohort exposed to this methodology for the first time at a university in the United Kingdom.
Methods Between November and December 2018, 26 first-year Master of Pharmacy and 90 second-year Biomedical Science students of the School of Life Sciences, University of Sussex, United Kingdom were invited to participate and requested to complete a questionnaire that contained quantitative and qualitative questions. The quantitative component was based on the Team-Based Learning Student Assessment Instrument (TBL-SAI). It additionally contained questions about key student characteristics.
Results The response rate was 60% (70 of 116); of the participants, 74% (n=52) were females and 26% (n=18) males. The percentage of agreement in the TBL-SAI suggested a favourable response to TBL. The overall mean score for the TBL-SAI was 115.6 (standard deviation, 5.6; maximum score, 140), which was above the threshold of 102, thus suggesting a preference for TBL. Statistically significant differences were not found according to demographic characteristics. Students who predicted a final grade of ≥70% strongly agreed that TBL helped improve their grades. Some students highlighted issues with working in teams, and only 56% of students agreed that they could learn better in a team setting.
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