scholarly journals How supervision and educational supports impact medical students’ preparation for future learning of endotracheal intubation skills: a non-inferiority experimental trial

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Julian C. Manzone ◽  
Maria Mylopoulos ◽  
Charlotte Ringsted ◽  
Ryan Brydges
Keyword(s):  
Medical Students ◽  
Endotracheal Intubation ◽  
Professional Education ◽  
Transfer Test ◽  
Rating Scale ◽  
Global Rating Scale ◽  
Global Rating ◽  
Near Transfer ◽  
Preparation For Future Learning ◽  
Future Learning

Abstract Background Professional education cannot keep pace with the rapid advancements of knowledge in today’s society. But it can develop professionals who can. ‘Preparation for future learning’ (PFL) has been conceptualized as a form of transfer whereby learners use their previous knowledge to learn about and adaptively solve new problems. Improved PFL outcomes have been linked to instructional approaches targeting learning mechanisms similar to those associated with successful self-regulated learning (SRL). We expected training that includes evidence-based SRL-supports would be non-inferior to training with direct supervision using the outcomes of a ‘near transfer’ test, and a PFL assessment of simulated endotracheal intubation skills. Method This study took place at the University of Toronto from October 2014 to August 2015. We randomized medical students and residents (n = 54) into three groups: Unsupervised, Supported; Supervised, Supported; and Unsupervised, Unsupported. Two raters scored participants’ test performances using a Global Rating Scale with strong validity evidence. We analyzed participants’ near transfer and PFL outcomes using two separate mixed effects ANCOVAs. Results For the Unsupervised, Supported group versus the Supervised, Supported group, we found that the difference in mean scores was 0.20, with a 95% Confidence Interval (CI) of − 0.17 to 0.57, on the near transfer test, and was 0.09, with a 95% CI of − 0.28 to 0.46, on the PFL assessment. Neither mean score nor their 95% CIs exceeded the non-inferiority margin of 0.60 units. Compared to the two Supported groups, the Unsupervised, Unsupported group was non-inferior on the near transfer test (differences in mean scores were 0.02 and − 0.22). On the PFL assessment, however, the differences in mean scores were 0.38 and 0.29, and both 95% CIs crossed the non-inferiority margin. Conclusions Training with SRL-supports was non-inferior to training with a supervisor. Both interventions appeared to impact PFL assessment outcomes positively, yet inconclusively when compared to the Unsupervised and Unsupported group, By contrast, the Unsupervised, Supported group did not score well on the near transfer test. Based on the observed sensitivity of the PFL assessment, we recommend researchers continue to study how such assessments may measure learners’ SRL outcomes  during structured learning experiences.

1005 Acquisition of Surgical Skills in Medical Students Via Telementoring: A Randomised Control Trial

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
A Feeley ◽  
I Feeley ◽  
D Hehir
Keyword(s):  
Medical Students ◽  
Rating Scale ◽  
Significant Degree ◽  
Randomised Control Trial ◽  
Global Rating Scale ◽  
Control Group ◽  
Live Streaming ◽  
Global Rating ◽  
Post Test ◽  
Suturing Skills

Abstract Aim To evaluate the use of telementoring in acquisition of basic suturing skills in medical students. Method This was a single blinded two- armed randomised control trial. Medical students undergoing clinical rotations in their penultimate and final years were invited to participate in this study. Informed consent was obtained. The control group underwent conventional suturing training, with the interventional group undergoing the tutorial in a remote learning setting via live streaming. Pre- and post-test assessment was carried out using validated Global Rating Scale tool. Results Eleven students were enrolled in this study. Participants were comparable at baseline (p=.18) and following the tutorial (p=.29). Participants improved to a statistically significant degree in both the virtual group (p=.02) and the in-person group (p=.001). Conclusions Telementoring is an effective tool in the provision of teaching basic suturing skills in medical students. Research on its use in more complex practical skills is warranted.

scholarly journals Aprendizagem Assistida por Pares: Uma Alternativa Pedagógica no Ensino de Competências a Estudantes de Medicina

2020 ◽  
Vol 33 (11) ◽  
pp. 742
Author(s):  
Joana Fernandes Ribeiro ◽  
Manuel Rosete ◽  
Andreia Teixeira ◽  
Hugo Conceição ◽  
Lèlita Santos
Keyword(s):  
Medical Students ◽  
Rating Scale ◽  
Technical Skills ◽  
Surgical Skills ◽  
Global Rating Scale ◽  
Control Group ◽  
P Value ◽  
Global Rating ◽  
Learning Program ◽  
Peer Assisted Learning

Introduction: Technical skills training is fundamental for clinical practice although poorly emphasised in undergraduate medical curricula. In these circumstances, Peer Assisted Learning methodology has emerged as a valid alternative to overcome this insufficiency. The purpose of this study is to evaluate the impact on students of a Peer Assisted Learning program in basic surgical skills, regarding technical competences and knowledge improvement.Material and Methods: A total of 104 randomly selected third year medical students participated in a workshop delivered by fifth year students. From that total, 34 students were assessed before and after the workshop, using the Objective Structured Assessment of Technical Skills instrument, that consists of a global rating scale and a procedure-specific checklist. Sixth year students (control group) were also assessed in their performance without participating in the workshop. Before workshop versus after workshop Objective Structured Assessment of Technical Skills results were compared using Wilcoxon and McNemar tests. After workshop versus control group Objective Structured Assessment of Technical Skills results were compared using Mann-Whitney, qui-squared test and Fisher’s exact test.Results: For the global rating scale, students obtained an after the workshop score (29.5) that was significantly higher than the before the workshop score (15.5; p-value < 0.001), but no significant differences were found between after the workshop and control group scores (p-value = 0.167). For the procedure-specific checklist, 3rd year students had a substantial positive evolution in all parameters and obtained higher rates of correct achievements compared to the control group.Discussion: The final outcomes demonstrated a significant qualitative and quantitative improvement of knowledge and technical skills, which is in accordance with other literature.Conclusion: This Peer Assisted Learning program revealed promising results concerning improvement of surgical skills in medical students, with little staff faculty contribution and extension to a much broader number of students.

scholarly journals Training on synthetic ethylene-vinyl acetate bench model allows novice medical students to acquire suture skills

2012 ◽  
Vol 27 (3) ◽  
pp. 271-278 ◽  
Author(s):  
Rafael Denadai ◽  
Rogério Saad-Hossne ◽  
Marie Oshiiwa ◽  
Érika Malheiros Bastos
Keyword(s):  
Medical Students ◽  
Vinyl Acetate ◽  
Rating Scale ◽  
Ethylene Vinyl Acetate ◽  
Global Rating Scale ◽  
Global Rating ◽  
Post Test ◽  
Group A ◽  
Group B ◽  
Bench Model

PURPOSE: To assess the acquisition of suture skills by training on ethylene-vinyl acetate bench model in novice medical students. METHODS: Sixteen medical students without previous surgery experience (novices) were randomly divided into two groups. During one hour group A trained sutures on ethylene-vinyl acetate (EVA) bench model with feedback of instructors, while group B (control) received a faculty-directed training based on books and instructional videos. All students underwent a both pre-and post-tests to perform two-and three-dimensional sutures on ox tongue. All recorded performances were evaluated by two blinded evaluators, using the Global Rating Scale. RESULTS: Although both groups have had a better performance (p<0.05) in the post-test when compared with the pre-test, the analysis of post-test showed that group A (EVA) had a better performance (p<0.05) when compared with group B (control). CONCLUSION: The ethylene vinyl acetate bench model allowed the novice students to acquire suture skills faster when compared to the traditional model of teaching.

Making sense of self-reported practice impacts after online dementia education: the example of Bedtime to Breakfast and Beyond

2020 ◽  
Vol 21 (3) ◽  
pp. 299-313
Author(s):  
Belinda Goodenough ◽  
Jacqueline Watts ◽  
Sarah Bartlett ◽  
Keyword(s):  
Professional Education ◽  
Large Scale ◽  
Rating Scales ◽  
Rating Scale ◽  
Practice Change ◽  
Global Rating Scale ◽  
Global Rating ◽  
National Scale ◽  
People With Dementia ◽  
Guidelines Development

AbstractObjectives:To satisfy requirements for continuing professional education, workforce demand for access to large-scale continuous professional education and micro-credential-style online courses is increasing. This study examined the Knowledge Translation (KT) outcomes for a short (2 h) online course about support at night for people living with dementia (Bedtime to Breakfast), delivered at a national scale by the Dementia Training Australia (DTA).Methods:A sample of the first cohort of course completers was re-contacted after 3 months to complete a KT follow-up feedback survey (n = 161). In addition to potential practice impacts in three domains (Conceptual, Instrumental, Persuasive), respondents rated the level of Perceived Improvement in Quality of Care (PIQOC), using a positively packed global rating scale.Results:Overall, 93.8% of the respondents agreed that the course had made a difference to the support they had provided for people with dementia since the completion of the course. In addition to anticipated Conceptual impacts (e.g., change in knowledge), a range of Instrumental and Persuasive impacts were also reported, including workplace guidelines development and knowledge transfer to other staff. Tally counts for discrete KT outcomes were high (median 7/10) and explained 23% of the variance in PIQOC ratings.Conclusions:Online short courses delivered at a national scale are capable of supporting a range of translation-to-practice impacts, within the constraints of retrospective insight into personal practice change. Topics around self-assessed knowledge-to-practice and the value of positively packed rating scales for increasing variance in respondent feedback are discussed.

scholarly journals Assessing communication skills during OSCE: need for integrated psychometric approaches

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Giovanni Piumatti ◽  
Bernard Cerutti ◽  
Noëlle Junod Perron
Keyword(s):  
Factor Analysis ◽  
Medical Students ◽  
Measurement Invariance ◽  
Communication Skills ◽  
Rating Scale ◽  
Skills Training ◽  
Global Rating Scale ◽  
Global Rating ◽  
Measurement Instruments ◽  
Current Form

Abstract Background Physicians’ communication skills (CS) are known to significantly affect the quality of health care. Communication skills training programs are part of most undergraduate medical curricula and are usually assessed in Objective Structured Clinical Examinations (OSCE) throughout the curriculum. The adoption of reliable measurement instruments is thus essential to evaluate such skills. Methods Using Exploratory Factor Analysis (EFA), Multi-Group Confirmatory Factor Analysis (MGCFA) and Item Response Theory analysis (IRT) the current retrospective study tested the factorial validity and reliability of a four-item global rating scale developed by Hodges and McIlroy to measure CS among 296 third- and fourth-year medical students at the Faculty of Medicine in Geneva, Switzerland, during OSCEs. Results EFA results at each station showed good reliability scores. However, measurement invariance assessments through MGCFA across different stations (i.e., same students undergoing six or three stations) and across different groups of stations (i.e., different students undergoing groups of six or three stations) were not satisfactory, failing to meet the minimum requirements to establish measurement invariance and thus possibly affecting reliable comparisons between students’ communication scores across stations. IRT revealed that the four communication items provided overlapping information focusing especially on high levels of the communication spectrum. Conclusions Using this four-item set in its current form it may be difficult to adequately differentiate between students who are poor in CS from those who perform better. Future directions in best-practices to assess CS among medical students in the context of OSCE may thus focus on (1) training examiners so to obtain scores that are more coherent across stations; and (2) evaluating items in terms of their ability to cover a wider spectrum of medical students’ CS. In this respect, IRT can prove to be very useful for the continuous evaluation of CS measurement instruments in performance-based assessments.

scholarly journals Non-technical skills of medical students in the course of pediatric emergency simulations are associated with their mindfulness: an observational cohort study

2019 ◽  
Author(s):  
Jacek Chmielewski ◽  
Włodzimierz Łuczyński ◽  
Jakub Dobroch ◽  
Grzegorz Cebula ◽  
Tomasz Bielecki ◽  
...  
Keyword(s):  
Medical Students ◽  
Rating Scale ◽  
Technical Skills ◽  
Pediatric Emergency ◽  
Global Rating Scale ◽  
Attention And Memory ◽  
High Fidelity ◽  
Global Rating ◽  
Extreme Stress ◽  
Fixation Error

Abstract Background High fidelity medical simulations allow for teaching medical skills in safe and realistic conditions. Pediatric teams of emergency departments work under extreme stress, which affects high-level cognitive functions, specifically attention and memory, and increases the already high stakes for young doctors. Lapses in attention increase the risk of serious consequences such as medical errors, failure to recognize life-threatening signs and symptoms, and other essential patient safety issues. Mindfulness as a process of intentionally paying attention to each moment with curiosity, openness and acceptance of each experience without judgment can potentially contribute to improving the performance of medical teams in conditions of pediatric emergency. The aim of the study was to determine whether the actions of medical students in the course of pediatric high fidelity simulations are related to their mindfulness. Participants and methods A total of 166 standardized simulations were conducted among students of medicine in three simulation centers of medical universities, assessing: stress sensation, technical skills (checklists), non-technical skills (Ottawa Crisis Resource Management Global Rating Scale) and mindfulness using Five Facet Mindfulness Questionnaire. Results The perception of stress among students was lower and more motivating if they were more mindful. Mindfulness of students correlated positively with avoiding fixation error, but negatively with listening to and managing the team. The lowest scores among non-technical skills were noted in the area of ​​situational awareness (fixation error). In subsequent simulations of the same team, students' non-technical skills improved, although no change was noted in their technical skills. Conclusions The results of our research indicate the relationship between the mindfulness of medical students and their non-technical skills and the perception of stress in pediatric emergency simulations. Further research is needed to show whether mindfulness training leads to any changes in this field. Trial registration ClinicalTrials.gov, NCT03761355).

scholarly journals The effect of microsurgical training on novice medical students’ basic surgical skills—a randomized controlled trial

2019 ◽  
Vol 43 (4) ◽  
pp. 459-466
Author(s):  
Stian Kreken Almeland ◽  
Andrew Lindford ◽  
Henriette Pisani Sundhagen ◽  
Karl Ove Hufthammer ◽  
Eivind Strandenes ◽  
...  
Keyword(s):  
Medical Students ◽  
Plastic Surgery ◽  
Rating Scale ◽  
Assessment Tool ◽  
Intervention Group ◽  
Global Rating Scale ◽  
Control Group ◽  
Diagnostic Study ◽  
Global Rating ◽  
Suturing Skills

Abstract Background It has been demonstrated that medical students are capable of learning microsurgical techniques. We hypothesize that microsurgical training might give insight into the importance of delicate tissue handling and correct knot tying that could have a positive influence on macrosurgical skills. The primary aim of this study was to evaluate the effect of microsurgical training on macrosurgical suturing skills in novice medical students. Subjects and methods In 2018, 46 novice medical students were enrolled and randomized into two groups. The intervention group received both macro- and microsurgical training and the control group received only microsurgical training. Both groups underwent an assessment test that consisted of macrosurgical tasks of three simple interrupted sutures with a square knot and continuous three-stitch long over-and-over sutures. These tests were individually filmed and assessed using the University of Bergen suturing skills assessment tool (UBAT) and the Objective Structured Assessment of Technical Skill global rating scale (OSATS). Questionnaires regarding future career ambitions and attitudes towards plastic surgery were also completed both prior to and following the tests. Results The intervention group needed a longer time to complete the tasks than the control group (12.2 min vs. 9.6 min, p > 0.001), and scored lower on both the UBAT (5.6 vs. 9.0, p > 0.001) and the OSATS (11.1 vs. 13.1, p > 0.001) assessments. The microsurgery course tended to positively influence the students’ attitudes towards a career in plastic surgery (p = 0.002). This study demonstrates poorer macrosurgical skills in the medical students group exposed to microsurgical training. The true effect of microsurgical training warrants further investigation. Level of evidence: Level I, diagnostic study.

scholarly journals Otoskills training during covid-19 pandemic: a before-after study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Maxime Fieux ◽  
Antoine Gavoille ◽  
Fabien Subtil ◽  
Sophie Bartier ◽  
Stéphane Tringali
Keyword(s):  
Surgical Training ◽  
Rating Scale ◽  
Surgical Simulation ◽  
Global Rating Scale ◽  
Middle Ear Surgery ◽  
Global Rating ◽  
Training Requirements ◽  
Significant Difference ◽  
Before And After ◽  
Total Performance

Abstract Background The ongoing COVID-19 pandemic has disrupted the surgical training of residents. There is a real concern that trainees will not be able to meet their training requirements. Low-fidelity surgical simulation appears to be an alternative for surgical training. The educational benefits of repeating ossiculoplasty simulations under a microscope have never been evaluated. With this study we aimed to evaluate the differences in performance scores and on a global rating scale before and after training on an ossiculoplasty simulator. Methods In this quasi-experimental, prospective, single-centre, before-after study with blinded rater evaluation, residents performed five microscopic ossiculoplasty tasks with a difficulty gradient (sliding beads onto rods, the insertion of a partial prosthesis, the insertion of a total prosthesis, and the insertion of a stapedotomy piston under microscopic or endoscopic surgery) before and after training on the same simulator. Performance scores were defined for each task, and total performance scores (score/min) were calculated. All data were collected prospectively. Results Six out of seven intermediate residents and 8/9 novices strongly agreed that the simulator was an effective training device and should be included in the ENT residency program. The mean effect of training was a significant increase in the total performance score (+ 0.52 points/min, [95 % CI, 0.40–0.64], p < 0.001), without a significant difference between novice and intermediate residents. Conclusions This preliminary study shows that techniques for middle-ear surgery can be acquired using a simulator, avoiding any risk for patients, even under lockdown measures.

Objective structured assessment of technical skill in temporal bone dissection: validation of a novel tool

2021 ◽  
pp. 1-11
Author(s):  
M Stavrakas ◽  
G Menexes ◽  
S Triaridis ◽  
P Bamidis ◽  
J Constantinidis ◽  
...  
Keyword(s):  
Temporal Bone ◽  
Rating Scale ◽  
Assessment Tool ◽  
Three Dimensional ◽  
Technical Skills ◽  
Technical Skill ◽  
Global Rating Scale ◽  
Global Rating ◽  
Validity And Reliability ◽  
Cortical Mastoidectomy

Abstract Objective This study developed an assessment tool that was based on the objective structured assessment for technical skills principles, to be used for evaluation of surgical skills in cortical mastoidectomy. The objective structured assessment of technical skill is a well-established tool for evaluation of surgical ability. This study also aimed to identify the best material and printing method to make a three-dimensional printed temporal bone model. Methods Twenty-four otolaryngologists in training were asked to perform a cortical mastoidectomy on a three-dimensional printed temporal bone (selective laser sintering resin). They were scored according to the objective structured assessment of technical skill in temporal bone dissection tool developed in this study and an already validated global rating scale. Results Two external assessors scored the candidates, and it was concluded that the objective structured assessment of technical skill in temporal bone dissection tool demonstrated some main aspects of validity and reliability that can be used in training and performance evaluation of technical skills in mastoid surgery. Conclusion Apart from validating the new tool for temporal bone dissection training, the study showed that evolving three-dimensional printing technologies is of high value in simulation training with several advantages over traditional teaching methods.

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