really good stuff cal); Second MBBS (1.5 years, para-clinical and clinical); Third MBBS (2 years, clinical), and Internship (1 year). However, this curriculum includes neither a mandatory module nor the provision of an elective module in research methodology and thus medical students do not learn research methodology.1 As a result, the curriculum has produced a generation of primary care physicians who are weak in health care research and thus fail to improve either community health or the health care system. What was tried? A programme entitled ‘ABC of Research’ was designed and implemented for the First MBBS 2013–14 academic year with the objective of teaching the basic concepts of research methodology to First MBBS students. An 8-hour programme was delivered to all 100 First MBBS students by a single faculty member over a period of 4 weeks during practical classes in physiology. The programme involved four individual sessions, each of 2 hours in duration. One session of 2 hours per week was delivered to each of the three physiology practical classes, which comprised 33, 33 and 34 students, respectively, so that all 100 students were exposed to 2 hours of the programme per week. The teaching–learning method included didactic and interactive lectures and student group exercises. A student research workbook consisting of scientific information as per the learning objectives of the programme, as well as student exercises, was developed. The students were introduced to the following concepts of research methodology: nature of the research; research topic; literature review; research hypothesis; research question; study design; research ethics; research funding; data collection; data analysis; research conclusion; scientific writing, and best research practices. The programme was evaluated by student assessment (using a pre-test and post-test with measurements of effect size and normalised gain), as well as by student and faculty feedback. What lessons were learned? The programme was successful in terms of student learning as indicated by the effect size (0.57) and normalised gain (28.3% [36.6% after ignoring negative absolute gain]) derived from pre-test and post-test scores. Students reported that they had enjoyed participating in the programme (73%), that they had learned about research-related concepts (81%), that the programme had inspired their interest in research (64%), and that they had found the programme to be worth attending (73%), well designed (79%) and well delivered (88%). A total of 54% of students reported that they believed First MBBS to be an appropriate juncture in the undergraduate medical curriculum at which to introduce the concept of
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research methodology. Faculty feedback suggested that the programme outcome could be improved by incorporating the subject of research methodology in formative assessment. The study indicates that the concept of research methodology can be introduced effectively to medical undergraduates studying in India as early as the First MBBS phase of the undergraduate medical curriculum. REFERENCE 1 Reddy MVR. Need to integrate student research with the medical course curriculum in India. Health Agenda 2013;1:45–8. Correspondence: Wasim Shaikh, Department of Physiology, Pramukhswami Medical College, Gokalnagar, Karamsad, Gujarat 388325, India. Tel: 00 91 9328 204923; E-mail: [email protected] doi: 10.1111/medu.12714
Medical students reintroduce basic science to residents Eileen Hennrikus & Jason Ferderber What problems were addressed? In attempts to develop higher-order, lifelong cognitive skills, medical schools are identifying educational methods that are active, self-directed and collaborative.1 Curriculum design teams are looking for methods that are contextual, experiential and motivational and that vertically integrate basic science with clinical medicine. What was tried? Year 1 medical students learn basic science through weekly problem-based learning (PBL) sessions in their Scientific Principles of Medicine course. We asked for student volunteers to present the basic science learned in PBL sessions to residents during the internal medicine morning report. The number of volunteers was more than twice that of available slots. We selected four students for each of five morning reports. After completing the PBL at the end of selected weeks of the 13-week course, the four students met briefly with a resident who would be presenting a case similar to that of the PBL. The students were then instructed to develop a 5–10-minute presentation on the basic science concepts. At morning report, in 20–25 minutes, the resident presented the case as unknown material that medical students in Years 3 and 4 and residents were required to explore, generating a differential diagnosis and management
ª 2015 John Wiley & Sons Ltd. MEDICAL EDUCATION 2015; 49: 513–541
really good stuff plan. The Year 1 students then presented the basic science underlying the clinical presentation. Following these sessions, the students and residents completed a survey and each student group participated in a focus group. What lessons were learned? Using a 5-point Likert scale, a total of 20 Year 1 students (100% response rate) ranked the sessions at 4.4 for enhancing the relevance of basic science principles and 4.3 for improving their retention of basic science concepts. Thirty residents (75% response rate) ranked the sessions at 3.8 for basic science enhancement of clinical understanding, and 4.1 for the applicability of basic science knowledge to clinical practice. Year 1 students stated that they found the morning report process insightful and that it put their learning in perspective, gave their learning purpose, gave their knowledge context, and was motivating. Instead of viewing their learning for the short-term purpose of passing a test, they saw long-term relevance useful to patient care. Tasked to teach residents within a time constraint, they collaborated, learned the material in depth and consolidated the information, distilling it down to the key elements. The residents and clerkship students wanted more sessions and asked for one or two per month. Selected comments included: ‘. . .all things medicine can be broken down into basic science. . .’; ‘. . .basic science is the foundation of evidence-based medicine. . .’; ‘. . .we reviewed pathways learned in the first 2 years that are now clinically applicable. . .’; ‘. . .understanding the mechanism ultimately helps me understand what I’m treating and why. . .’; ‘. . .I have a better understanding of the disease process. . .’; ‘. . .it’s an opportunity to review information not often discussed on wards. . .’, and ‘. . .it’s great to involve the first years in case presentations’. In light of the overwhelmingly positive responses from both medical students and residents, we would like to expand this format so that all students have the opportunity to participate in similar experiences. REFERENCE 1 White C, Bradley E, Martindale J, Roy P, Patel K, Yoon M, Worden MK. Why are medical students ‘checking out’ of active learning in a new curriculum? Med Educ 2014;48:315–24. Correspondence: Eileen Hennrikus, Department of Internal Medicine, Pennsylvania State University College of Medicine and Milton S Hershey Medical Center, 500 University Drive, MC H034, PO Box 850, Hershey, Pennsylvania 17033, USA. Tel: 00 1 717 531 8161; E-mail: [email protected]
Using incident reporting to design authentic interprofessional education Hannah Beckwith, Rachel Gill, Megan Hall-Jackson, Tom Smith & Gomathy Kandasamy What problems were addressed? High-fidelity interprofessional simulation training is well established within medical education. Learning outcomes for interprofessional education (IPE) in undergraduates are often mapped to curriculum objectives, but in IPE in the postgraduate setting, establishing relevant learning outcomes is more challenging. Constructivist learning theory emphasises the importance of creating meaning from learning1 and we were keen to develop an effective simulation programme that postgraduate interprofessional learners would find relevant to their practice. What was tried? A retrospective review of incident report forms submitted to the local online database identified 21 episodes in which missed clinical deterioration contributed to patient harm. These events were examined using thematic analysis to identify potential learning needs and interventions. Results indicated that problems referred to difficulties in communicating clinical concerns to colleagues, the mode and timing of escalation, the ability to anticipate and delegate, and the management of distracting patients. Three half-day courses, constructed around four ‘real-life’ patient cases, were prepared. Participation was voluntary. Local funding was secured to provide the course without charge in order to enable unrestricted recruitment from all disciplines. Participants included doctors, nurses, health care assistants and clinical site practitioners (n = 30). Post-course Likert scale-based feedback questionnaires were used to generate qualitative and quantitative feedback. Overall, 100% of participants found the programme beneficial and relevant to their clinical practice. In addition, all participants felt it served as a catalyst for reflection. The scenarios were realistic (mean score: 4.64/5.00), interesting (mean score: 4.55/5.00) and increased participants’ confidence in their ability to manage the situations addressed (mean score: 4.27/5.00). What lessons were learned? By using ‘real-life’ clinical events, we were able to design high-fidelity simulation scenarios that represented authentic clinical situations and addressed local education needs. Participants commented on the ‘realistic nature’ of the training and therefore the ability to ‘translate it’ to their practice (regardless of their profession),
doi: 10.1111/medu.12712
ª 2015 John Wiley & Sons Ltd. MEDICAL EDUCATION 2015; 49: 513–541
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research methodology. Faculty feedback suggested that the programme outcome could be improved by incorporating the subject of research methodology in formative assessment. The study indicates that the concept of research methodology can be introduced effectively to medical undergraduates studying in India as early as the First MBBS phase of the undergraduate medical curriculum. REFERENCE 1 Reddy MVR. Need to integrate student research with the medical course curriculum in India. Health Agenda 2013;1:45–8. Correspondence: Wasim Shaikh, Department of Physiology, Pramukhswami Medical College, Gokalnagar, Karamsad, Gujarat 388325, India. Tel: 00 91 9328 204923; E-mail: [email protected] doi: 10.1111/medu.12714
Medical students reintroduce basic science to residents Eileen Hennrikus & Jason Ferderber What problems were addressed? In attempts to develop higher-order, lifelong cognitive skills, medical schools are identifying educational methods that are active, self-directed and collaborative.1 Curriculum design teams are looking for methods that are contextual, experiential and motivational and that vertically integrate basic science with clinical medicine. What was tried? Year 1 medical students learn basic science through weekly problem-based learning (PBL) sessions in their Scientific Principles of Medicine course. We asked for student volunteers to present the basic science learned in PBL sessions to residents during the internal medicine morning report. The number of volunteers was more than twice that of available slots. We selected four students for each of five morning reports. After completing the PBL at the end of selected weeks of the 13-week course, the four students met briefly with a resident who would be presenting a case similar to that of the PBL. The students were then instructed to develop a 5–10-minute presentation on the basic science concepts. At morning report, in 20–25 minutes, the resident presented the case as unknown material that medical students in Years 3 and 4 and residents were required to explore, generating a differential diagnosis and management
ª 2015 John Wiley & Sons Ltd. MEDICAL EDUCATION 2015; 49: 513–541
really good stuff plan. The Year 1 students then presented the basic science underlying the clinical presentation. Following these sessions, the students and residents completed a survey and each student group participated in a focus group. What lessons were learned? Using a 5-point Likert scale, a total of 20 Year 1 students (100% response rate) ranked the sessions at 4.4 for enhancing the relevance of basic science principles and 4.3 for improving their retention of basic science concepts. Thirty residents (75% response rate) ranked the sessions at 3.8 for basic science enhancement of clinical understanding, and 4.1 for the applicability of basic science knowledge to clinical practice. Year 1 students stated that they found the morning report process insightful and that it put their learning in perspective, gave their learning purpose, gave their knowledge context, and was motivating. Instead of viewing their learning for the short-term purpose of passing a test, they saw long-term relevance useful to patient care. Tasked to teach residents within a time constraint, they collaborated, learned the material in depth and consolidated the information, distilling it down to the key elements. The residents and clerkship students wanted more sessions and asked for one or two per month. Selected comments included: ‘. . .all things medicine can be broken down into basic science. . .’; ‘. . .basic science is the foundation of evidence-based medicine. . .’; ‘. . .we reviewed pathways learned in the first 2 years that are now clinically applicable. . .’; ‘. . .understanding the mechanism ultimately helps me understand what I’m treating and why. . .’; ‘. . .I have a better understanding of the disease process. . .’; ‘. . .it’s an opportunity to review information not often discussed on wards. . .’, and ‘. . .it’s great to involve the first years in case presentations’. In light of the overwhelmingly positive responses from both medical students and residents, we would like to expand this format so that all students have the opportunity to participate in similar experiences. REFERENCE 1 White C, Bradley E, Martindale J, Roy P, Patel K, Yoon M, Worden MK. Why are medical students ‘checking out’ of active learning in a new curriculum? Med Educ 2014;48:315–24. Correspondence: Eileen Hennrikus, Department of Internal Medicine, Pennsylvania State University College of Medicine and Milton S Hershey Medical Center, 500 University Drive, MC H034, PO Box 850, Hershey, Pennsylvania 17033, USA. Tel: 00 1 717 531 8161; E-mail: [email protected]
Using incident reporting to design authentic interprofessional education Hannah Beckwith, Rachel Gill, Megan Hall-Jackson, Tom Smith & Gomathy Kandasamy What problems were addressed? High-fidelity interprofessional simulation training is well established within medical education. Learning outcomes for interprofessional education (IPE) in undergraduates are often mapped to curriculum objectives, but in IPE in the postgraduate setting, establishing relevant learning outcomes is more challenging. Constructivist learning theory emphasises the importance of creating meaning from learning1 and we were keen to develop an effective simulation programme that postgraduate interprofessional learners would find relevant to their practice. What was tried? A retrospective review of incident report forms submitted to the local online database identified 21 episodes in which missed clinical deterioration contributed to patient harm. These events were examined using thematic analysis to identify potential learning needs and interventions. Results indicated that problems referred to difficulties in communicating clinical concerns to colleagues, the mode and timing of escalation, the ability to anticipate and delegate, and the management of distracting patients. Three half-day courses, constructed around four ‘real-life’ patient cases, were prepared. Participation was voluntary. Local funding was secured to provide the course without charge in order to enable unrestricted recruitment from all disciplines. Participants included doctors, nurses, health care assistants and clinical site practitioners (n = 30). Post-course Likert scale-based feedback questionnaires were used to generate qualitative and quantitative feedback. Overall, 100% of participants found the programme beneficial and relevant to their clinical practice. In addition, all participants felt it served as a catalyst for reflection. The scenarios were realistic (mean score: 4.64/5.00), interesting (mean score: 4.55/5.00) and increased participants’ confidence in their ability to manage the situations addressed (mean score: 4.27/5.00). What lessons were learned? By using ‘real-life’ clinical events, we were able to design high-fidelity simulation scenarios that represented authentic clinical situations and addressed local education needs. Participants commented on the ‘realistic nature’ of the training and therefore the ability to ‘translate it’ to their practice (regardless of their profession),
doi: 10.1111/medu.12712
ª 2015 John Wiley & Sons Ltd. MEDICAL EDUCATION 2015; 49: 513–541
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