Medical Teacher最新文献

Aim: This study aimed to investigate the perceptions of dental students and teachers about introducing metacognition pedagogy within an established clinical professional curriculum to provide primary data informing its feasibility.

Methodology and method: A qualitative study using phenomenography methodology was undertaken as part of a master's dissertation. Semi-structured interviews were conducted on 16 participants which included 9 clinical teachers and 7 dental students.

Findings: Metacognition pedagogy was positively perceived by most of the participants as being beneficial to students' learning in oral health education. A few reported some negativity. All participants identified some challenges to be addressed if a metacognition pedagogy was to be implemented in the undergraduate curriculum.

Conclusion: According to the perceptions of most participants in the study, metacognition emerged as a potential factor in improving student learning and exam performance, and facilitating the development of critical thinking, professionalism, and clinical skills. In the context of rigorous, demanding, and challenging courses, and recognising the complexities and uncertainties inherent in health professional working environments, metacognition emerges as a valuable tool, fostering self-awareness, regulation, and adaptability. Ultimately, metacognition has the capability to shape more adept learners and clinicians, yielding benefits for students, teachers, and patients alike.

Attention-Deficit/Hyperactivity Disorder (ADHD) is a neurodevelopmental disorder that affects a significant number of medical students worldwide. It is poorly recognised by educators, and therefore inadequately accommodated for in educational strategies. In order to investigate this further, a literature review and pilot survey were conducted. Health educators employed by The University of Newcastle, Australia, completed a short online survey, which focused on their understanding of, and ability to recognise and adapt teaching strategies for students with ADHD. The results of the survey informed the development of a resource that provided evidence-based strategies for supporting the learning of tertiary students with ADHD. In addition, the results of this pilot study may form the basis for further research in this domain. Given the prevalence and potential impact of ADHD on higher education, it is important to gain deeper insight into how medical educators can best engage and support students with ADHD. This knowledge may potentially reduce the negative impacts of this neurodiversity on students and support their learning and well-being throughout their medical career. Ultimately this may help doctors to achieve their full potential, especially in clinical decision-making.

Purpose of article: This paper explores issues pertinent to teaching and assessment of clinical skills at the early stages of medical training, aimed at preventing academic integrity breaches. The drivers for change, the changes themselves, and student perceptions of those changes are described.

Methods: Iterative changes to a summative high stakes Objective Structured Clinical Examination (OSCE) assessment in an undergraduate medical degree were undertaken in response to perceived/known breaches of assessment security. Initial strategies focused on implementing best practice teaching and assessment design principles, in association with increased examination security.

Results: These changes failed to prevent alleged sharing of examination content between students. A subsequent iteration saw a more radical deviation from classic OSCE assessment design, with students being assessed on equivalent competencies, not identical items (OSCE stations). This more recent approach was broadly acceptable to students, and did not result in breaches of academic integrity that were detectable.

Conclusions: Ever increasing degrees of assessment security need not be the response to breaches of academic integrity. Use of non-identical OSCE items across a cohort, underpinned by constructive alignment of teaching and assessment may mitigate the incentives to breach academic integrity, though face validity is not universal.

Purpose: In Thailand, Lesbian, Gay, Bisexual, Transgender, and Queer (LGBTQ) individuals face significant health disparities and discrimination in healthcare. A primary cause is the lack of knowledge among doctors and their negative attitudes towards LGBTQ people. The purpose of this study was to explore the current undergraduate medical curricula of medical schools in Thailand concerning learning outcomes, contents, teaching and learning methods, and assessment methods in the field of LGBTQ health. It also sought to gather opinions from principal stakeholders in curriculum development.

Methods: The authors employed a mixed-methods approach with a convergent design to conduct the research. Quantitative data were collected from 23 deputy deans of educational affairs using a standardized interview form, and qualitative data were obtained through in-depth interviews with key stakeholders including 16 LGBTQ healthcare receivers, 22 medical students, and three medical teachers. Both datasets were analyzed simultaneously to ensure consistency.

Results: The findings indicate that none of the medical schools had established learning objectives related to LGBTQ healthcare within their curricula. Of the institutions surveyed, 8 out of 15 (53.3%) offered some form of teaching on this topic, aligning with the qualitative data which showed 7 out of 17 institutions (41.2%) provided such education. The most frequently covered topics were gender identity and sexual orientation. Lectures were the predominant teaching method, while multiple-choice questions were the most common assessment format. There was a unanimous agreement among all principal stakeholders on the necessity of integrating LGBTQ healthcare into the M.D. program and the professional standards governed by the Thai Medical Council.

Conclusions: Although some Thai medical schools have begun to incorporate LGBTQ health into their curricula, the approach does not fully address the actual health issues faced by LGBTQ individuals. Future teaching should emphasize fostering positive attitudes towards LGBTQ people and enhancing communication skills, rather than focusing solely on the cognitive aspects of terminology. Importantly, medical educators should serve as role models in providing competent and compassionate care for LGBTQ patients.

Introduction: Multiple-choice questions (MCQs) are frequently used for formative assessment in medical school but often lack sufficient answer explanations given time-restraints of faculty. Chat Generated Pre-trained Transformer (ChatGPT) has emerged as a potential student learning aid and faculty teaching tool. This study aims to evaluate ChatGPT's performance in answering and providing explanations for MCQs.

Method: Ninety-four faculty-generated MCQs were collected from the pre-clerkship curriculum at a US medical school. ChatGPT's accuracy in answering MCQ's were tracked on first attempt without an answer prompt (Pass 1) and after being given a prompt for the correct answer (Pass 2). Explanations provided by ChatGPT were compared with faculty-generated explanations, and a 3-point evaluation scale was used to assess accuracy and thoroughness compared to faculty-generated answers.

Results: On first attempt, ChatGPT demonstrated a 75% accuracy in correctly answering faculty-generated MCQs. Among correctly answered questions, 66.4% of ChatGPT's explanations matched faculty explanations, and 89.1% captured some key aspects without providing inaccurate information. The amount of inaccurately generated explanations increases significantly if the questions was not answered correctly on the first pass (2.7% if correct on first pass vs. 34.6% if incorrect on first pass, p < 0.001).

Conclusion: ChatGPT shows promise in assisting faculty and students with explanations for practice MCQ's but should be used with caution. Faculty should review explanations and supplement to ensure coverage of learning objectives. Students can benefit from ChatGPT for immediate feedback through explanations if ChatGPT answers the question correctly on the first try. If the question is answered incorrectly students should remain cautious of the explanation and seek clarification from instructors.

Student engagement is a key contributor to educational programme quality. It is a complex construct often defined with the focus on student behaviors. However, a broader, more organizational approach takes into account the institutional context and how this can be structured to encourage and support students' willingness and ability to become engaged. This paper includes suggestions for a student engagement system using key elements recognized in the literature and concrete examples from medical schools that achieved recognition in the ASPIRE-to-Excellence student engagement initiative. The examples from the ASPIRE participants demonstrate that the presence of certain key features creates a mutually beneficial collaborative approach between students and their institutions. This includes opportunities for students to formally engage in four domains touching on the breadth of student life, including institutional governance and policy-making, educational programme development and evaluation, participation in activities in the academic community, and participation in local community and international outreach. Based on an in-depth review of the information from three medical schools that recently received an ASPIRE-to-Excellence award in student engagement, it was possible to identify certain specific practices that individually and taken together allow an institution to demonstrate excellence in this complex construct. As an overarching concept, it was clear that student participation in each of these domain areas benefitted from a supportive institutional culture characterized by specific formal attributes and activities. Examples included codifying student involvement in governance through institutional policies; maximizing communication routes among students and between students and school administrators and faculty; and formalizing a participatory environment through missions statements or strategic plans. For programme planning, a helpful conceptualization is that a successful student engagement programme occurs when change is championed by all stakeholders within an institution and the organization supports a collaborative culture that includes students as active participants and partners.

Educational challenge: As technological advancements challenge the current roles healthcare workers fill, curiosity and lifelong learning are becoming increasingly important. However, descriptions of specific curricular interventions that successfully develop these attitudes and skills remain limited.

Proposed solution: We aimed to promote curiosity and advance practical application of evidenced-based medicine through a longitudinal, gamified learning activity within a longitudinal integrated clerkship (LIC). Thirty-seven students across two inquiry-themed LICs based at a university hospital and a community-based integrated healthcare delivery system used BINGO cards containing various assignments designed to develop the skill of asking and answering clinical questions. Assignments included: engaging experts, using evidence-based medical resources, attending education events, utilizing medical library resources, and Phone-a-Scientist. Students shared their experiences in a group setting and wrote a reflection for each assignment that was qualitatively analyzed to determine the perceived educational outcomes according to the Kirkpatrick Evaluation Model.

Lessons learned: Results suggest that Inquiry BINGO fosters curiosity and builds skill in applied evidenced-based medicine early in clinical training. Most assignments prompted students to engage in opportunities they might not have otherwise explored. All but three students reported a change in behavior as a result of the assignment and 57% reported positive clinical or research results.

Next steps: Future iterations of this activity should be evaluated by obtaining patient and/or preceptor feedback as well as longitudinal evaluations of student behavior to ensure higher level educational outcomes are being met.

Purpose: The purpose of this study is to report on the design, implementation, use and evaluation of TELLme, an online platform with annotated multiple-choice questions (MCQs) for formative assessment of knowledge acquisition covering an entire undergraduate medical curriculum.

Materials and methods: We used the Educational Design Research (EDR) framework to develop TELLme as an online platform with 24/7 access for students in a co-creation process between educators, faculty and students. EDR cycle 1 focused on prototyping, while EDR cycle 2 focused on upscaling, usage analysis and evaluation. Database entries were analysed for TELLme usage. Online surveys evaluated platform usability and support for student learning.

Results: At the end of EDR cycle 2, TELLme contained 6,713 fully annotated MCQs aligned with the cognitive learning objectives of the curriculum. Up to 600 students per day used TELLme to self-assess their knowledge, answering 3,168,622 MCQs in two semesters. Surveys indicated good usability of TELLme, 75% of students indicated that TELLme helped them to identify knowledge gaps, and 72% agreed that TELLme supported their learning.

Conclusions: Medical students use TELLme extensively to formatively assess their learning in a self-directed manner across the entire curriculum. TELLme aligns with the existing summative and formative system of assessment of the study programme.