scholarly journals Evaluation of a digitally enhanced cardiac auscultation learning method: a controlled study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Fred-Cyrille Goethe Doualla ◽  
Georges Bediang ◽  
Chris Nganou-Gnindjio

Abstract Background Cardiac auscultation remains an efficient and accessible diagnostic tool, especially in resource-limited countries where modern diagnostic devices like cardiac ultrasound are expensive and difficult to access. However, cardiac auscultation skills of medical students and physicians are declining, mainly because of an ineffective teaching method for this technique. The objective of this study is to evaluate the effect of a digitally enhanced cardiac auscultation learning method on participants’ theoretical knowledge and auscultation skills. Methods This will be a controlled study with two parallel arms (1:1). Participants (fourth-year medical students) will be divided into two groups: an intervention group (receiving additional lectures, clinical internship and audio listening sessions) and a control group (receiving additional lectures and clinical internship). At the beginning of the study, all participants will undergo a pre-test that consist of two parts: a knowledge assessment based on multiple-choice questions and a skills assessment based on recognition of cardiac sounds from audio files. Thereafter, three specific additional lectures on cardiac auscultation will be delivered and all participants will take part in their official clinical internship. During these clinical internships (eight weeks), participants of the intervention group will be invited to two listening sessions based on five digital recordings of heart sounds. At the end of the clinical internship, all participants will be invited to a post-test to evaluate their knowledge, skills and satisfaction according to their learning method. The main outcome will be the participants’ knowledge progression. The other outcomes will be the participants’ skills progression, participants’ total progression and satisfaction. Data will be collected and analyzed in per protocol. Discussion This study could contribute to the development of a learning method that takes into account the advantages of the conventional method and the contribution of digital technology. Positive results could lead to improved cardiac auscultation skills among health professionals, especially in developing countries. Trial registration The trial is registered on the Pan-African Clinical Trials Registry (http://www.pactr.org) under unique identification number: PACTR202001504666847, registered the 29 November 2019.

Author(s):  
Leila Naeimi ◽  
Fariba Asghari ◽  
Saharnaz Nedjat ◽  
Azim Mirzazadeh ◽  
Mahsa Abbaszadeh ◽  
...  

Many medical schools around the world have included professionalism training in their formal curriculum. However, these efforts may not be adequate; given the exposure of students to unprofessional behaviors in the clinical settings. In the present study, we aimed to design, implement, and evaluate a longitudinal program to improve professionalism among medical students upon their transition to clinical settings. A total of 75 medical students were enrolled in the study and randomly assigned to two groups. The control group did not receive any training, while for the intervention group; a 10-hour program through 16 weeks was organized based on the Holmes' reflection approach. The effectiveness of the program was evaluated by measuring three outcomes in both groups. Data analysis was performed using paired t-test and Multiple Linear Regression. Scores of judgment of professionalism increased in the intervention group (from 7.56 to 10.17; P< 0.001), while there was no significant improvement in the control group’s scores. Students' attitudes towards professionalism and their professional behaviors did not change significantly. Based on our findings, the Holmes reflection approach helps students improve their cognitive base of professionalism. Long-term follow-up and further qualitative studies will help us better understand the effects of this approach on other desirable outcomes.


Author(s):  
SG Mortazavi Moghadam ◽  
E. Allahyari ◽  
F Vahedi ◽  
M. Zare-Bidaki

Introduction: Student-centered educational models, such as Flipped classrooms, seem to provide more educational opportunities for learners, especially when combined with web technology. This study aimed to evaluate the effectiveness and satisfaction of medical students with the web-based Flipped classroom method in comparison with the lecture-based teaching method. Method: This is a quasi-experimental case-control study that evaluates 51 people in each of the two intervention and control groups. In the intervention group, pulmonary physiopathology e-contents were delivered to the students one week before the presence-based class in the form of digital files such as video, text, image, audio and interactive applications through Navid learning management system. Students were required to read the content before the class. Then the face-to-face classroom time was completed with group discussion, question and answer and problem-based learning. In the control group, teaching was carried out by the traditional lecture method in the classroom. Data were analyzed using SPSS, 18. Result: In terms of age, sex and, mean pre-test scores, there were no significant differences between the groups. The mean scores in the final exam turned out to be 14.66 (10.16-66) in the intervention group but 12 (9.14-3.66) in the controls (P < 0.001) to make a significant difference. In addition to gaining higher final exam scores as for the flipped classroom group, they were also more satisfied with the procedure (P < 0.001). Conclusion: The flipped classroom approach not only improves learning but also leads to greater students’ satisfaction.


2020 ◽  
Vol 75 (5) ◽  
pp. 490-499
Author(s):  
Yuri Y. Kiryachkov ◽  
Marina V. Petrova ◽  
Bagautdin G. Muslimov ◽  
Sergey A. Bosenko ◽  
Mikhail M. Gorlachev

Background.At the same time, the main effect of the use of this drug is the elimination of the autonomic nervous system dysfunction and sympatholysis. It seems important to search for a method of indications and selection of a dose of dexmedetomidine in intensive care.Aims to improve the clinical effectiveness of the electrophysiological navigation of the prolonged use of dexmedetomidine in patients with brain pathology of various origins.Methods.The study included 83 patients 2050 days after the traumatic brain injury, anoxic damage; consequences of acute disorders of cerebral. 37 patients comprised the 1st intervention group with a clinical course of dexmedetomidine (male 28; female 9; average age 49.62.3 years) and 46 patients comprised the 2nd control group without pharmacological correction with dexmedetomidine (male 23; female 23, average age 512.5 years). Criteria for the inclusion of prolonged infusion of the drug dexmedetomidine (Orion Pharma, Finland) are based on heart rate variability (HRV) indicators characteristic of sympathetic hyperactivity, the target task of titration of doses of dexmedetomidine served as the parameters for achieving normal HRV indicators, the appearance of parasympathetic hyperactivity served as the basis for reducing the dosage of the drug or stopping it of application. HRV parameters were recorded before dexmetomedine infusion-initially, on 13; 45; 910; 1520 days of drug administration.Results.The starting dose of dexmedetomidine with sympathetic hyperactivity in patients was 0.12 to 0.24 g.kg1.hr1(average dose 0.160.01; total 200 mg/day). According to digital data from HRV, the effective dose of dexmedetomidine ED50 was 0.260.03 g.kg1.hr1(total daily 353.835.1 g) and was achieved on day 910 using dexmedetomidine.Conclusions.The protective role of dexmedetomidine with correction of sympathetic hyperactivity based on electrophysiological navigation according to the HRV is reliable in the following indicators: The improvement of consciousness; a significant decrease in the incidence of distress lung syndrome; septic shock; mortality.


2020 ◽  
Author(s):  
Tay Siew Cheng Sarah ◽  
Lim Jit Fan Christina ◽  
Tan Soo Chieng Daphne ◽  
Tan Seok Yee Maureen ◽  
Chen Jieying Cordelia ◽  
...  

BACKGROUND Diabetes is one of the most common medical conditions referred to medication review service run by pharmacists, OBJECTIVE This study aims to determine whether pharmacist-run MRS can be an effective intervention tool to improve patients’ participation in self-care of diabetes. METHODS This randomised controlled study was conducted in five public primary healthcare centres from December 2014 to October 2016. Participants were 40 to 80 years of age and had been diagnosed with type 2 diabetes. These participants were prescribed with five or more chronic medications, of which at least one was an antidiabetic medication, by the primary healthcare centres’ doctors. The participants were randomly recruited into the intervention or control arm. A self-developed questionnaire which incorporated the validated Diabetes Self-Management Questionnaire (DSMQ) was administered face-to-face by the study team to the participants prior to and after MRS. MRS was not administered to participants in the control group. RESULTS A total of 221 participants completed the follow up. There were 105 participants in the control arm and 116 in the intervention arm. The DSMQ Sum Scale score of the control group improved by 0.16 ± 1.11 (p= 0.136) while the intervention group improved by 0.40 ± 0.99 (p=0.000). Participants in the intervention group reported a better improvement in their self-care of diabetes, specifically in glucose management (0.38± 1.35, p=0.003), dietary control (0.26±1.66, p=0.096) and physical activity (0.67±2.36, p=0.003). CONCLUSIONS Pharmacist-run MRS is an effective intervention tool to improve participants’ self-care of diabetes, particularly in glucose management, dietary control and physical activity.


2021 ◽  
Vol 0 (0) ◽  
Author(s):  
Enkhtsogt Sainbayar ◽  
Nathan Holt ◽  
Amber Jacobson ◽  
Shalini Bhatia ◽  
Christina Weaver

Abstract Context Some medical schools integrate STOP THE BLEED® training into their curricula to teach students how to identify and stop life threatening bleeds; these classes that are taught as single day didactic and hands-on training sessions without posttraining reviews. To improve retention and confidence in hemorrhage control, additional review opportunities are necessary. Objectives To investigate whether intermittent STOP THE BLEED® reviews were effective for long term retention of hemorrhage control skills and improving perceived confidence. Methods First year osteopathic medical students were asked to complete an eight item survey (five Likert scale and three quiz format questions) before (pretraining) and after (posttraining) completing a STOP THE BLEED® training session. After the surveys were collected, students were randomly assigned to one of two study groups. Over a 12 week intervention period, each group watched a 4 min STOP THE BLEED® review video (intervention group) or a “distractor” video (control group) at 4 week intervals. After the 12 weeks, the students were asked to complete an 11 item survey. Results Scores on the posttraining survey were higher than the pretraining survey. The median score on the five Likert scale items was 23 points for the posttraining survey and 14 points for the pretraining survey. Two of the three knowledge based quiz format questions significantly improved from pretraining to posttraining (both p<0.001). On the 11 item postintervention survey, both groups performed similarly on the three quiz questions (all p>0.18), but the intervention group had much higher scores on the Likert scale items than the control group regarding their confidence in their ability to identify and control bleeding (intervention group median = 21.4 points vs. control group median = 16.8 points). Conclusions Intermittent review videos for STOP THE BLEED® training improved medical students’ confidence in their hemorrhage control skills, but the videos did not improve their ability to correctly answer quiz-format questions compared with the control group.


2021 ◽  
pp. 1-4
Author(s):  
Xian-Rong Yu ◽  
Yu-Qing Lei ◽  
Jian-Feng Liu ◽  
Zeng-Chun Wang ◽  
Hua Cao ◽  
...  

Abstract Objective: This study explored the clinical effect of employing breast milk oral care for infants who underwent surgical correction of ventricular septal defect. Methods: A prospective randomised controlled study was conducted in a provincial hospital between January, 2020 and July, 2020 in China. Patients were randomly divided into an intervention group (breast milk oral care, n = 28) and a control group (physiological saline oral care, n = 28). The intervention group was given oral nursing using breast milk for infants in the early post-operative period, and the control group was given oral nursing using physiological saline. Related clinical data were recorded and analysed. Results: There were no significant differences in age, gender, weight, operation time, cardiopulmonary bypass time, or aortic cross-clamping time between the two groups. Compared with the physiological saline oral care group, the mechanical ventilation duration, the length of ICU stay in the breast milk oral care group were significantly shorter. The time of start feeding and total enteral nutrition were significantly earlier in the intervention group than those in the control group. The incidence of post-operative pneumonia in the breast milk oral care group was 3.6%, which was significantly lower than that of the physiological saline oral care group. Conclusion: The use of breast milk for oral care in infants who underwent surgical correction of VSD can reduce the incidence of post-operative pneumonia and promote the recovery of gastrointestinal function.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Nadia Younes ◽  
Anne Laure Delaunay ◽  
M. Roger ◽  
Pierre Serra ◽  
France Hirot ◽  
...  

Abstract Background Training in psychiatry requires specific knowledge, attitudes, and skills that are obtainable by simulation, of which the use is only recent and still needs further development. Evidence is accumulating on its effectiveness but requires further validation for medical students. We aimed to evaluate the effectiveness of a single-day optional teaching program in psychiatry by simulation for medical students and validate a scale measuring Confidence in Psychiatric Clinical Skills (CPCQ), as part of the assessment. Methods This was a controlled study in a French University that compared (using paired-sample Student t-tests) knowledge and attitudes (university grades and CPCQ scores) before, just after teaching with simulated patients, and 2 months later. Satisfaction with the program (including the quality of the debriefing) was also investigated. The CPCQ scale was validated by assessing the factor structure, internal consistency, and test-retest reliability. Finally, a comparison was run with a control group who received the usual psychiatric instruction using covariance analyses. Results Twenty-four medical students were included in the simulation group and 76 in the control group. Just after the simulation, knowledge and attitudes increased significantly in the simulation group. Satisfaction with the training and debriefing was very high. The CPCQ scale showed good psychometric properties: a single-factor structure, acceptable internal consistency (α = 0.73 [0.65–0.85]), and good test-retest reliability (ICC = 0.71 [0.35–0.88]). Two months after the simulation, knowledge and attitudes were significantly higher in the simulation group than the control group, despite a lack of difference in knowledge before the simulation. Conclusions Adding a simulation program in psychiatry to the usual teaching improved the knowledge and confidence of medical students. The CPCQ scale could be used for the evaluation of educational programs.


2021 ◽  
Vol 10 (2) ◽  
pp. e001385
Author(s):  
Ali Elbeddini ◽  
Yasamin Tayefehchamani

ObjectiveTo design, implement and assess an online learning module for third-year and fourth-year medical students addressing medication safety.DesignThis study was a prospective, parallel, open-label, randomised controlled trial with two arms: (1) a control arm in which students were given five articles to read about medication safety, and (2) an intervention arm in which students were given access to an interactive web-based learning module on medication safety. Pretesting and post-testing were done online to evaluate change in medication safety knowledge.ResultsTen students completed the study in the intervention group (online module) and six students completed the study in the control group. The increase in score obtained on the post-test, relative to the pretest, was 15.4% in the group who completed the online module and 2.0% in the control group (difference=13.4%, 95% CI 0.5% to 26.2%, p=0.04).ConclusionStudents who completed an online educational tool about medication safety demonstrated a significantly greater increase in knowledge than those who completed a few readings. Online learning modules can be a convenient and effective means of teaching safe prescribing concepts to medical trainees.


2017 ◽  
Vol 5 (1) ◽  
Author(s):  
Sahara Sahara ◽  
Dedeh Kurniasih ◽  
Rizmahardian Azhari Kurniawan

ABSTRACT The process of learning chemistry which only focused on teacher as informant caused the students’ memory lower. This could make the students’ learning outcomes lower, thus, it was needed STAD type of Cooperative Learning Method which had the process of interaction between student and teacher, and could help the students comprehend the material. Therefore, it was necessary to make a research which had the purpose to know the difference between students’ learning outcomes and memory which used STAD type ofCooperative Learning Method and lectures teaching method as well as how large the effect of STAD type of Cooperative Learning Method on salt hydrolysis material was. This research was Quasi Experimental Nonequivalent Control Group Design. The sample of the research was choosen by using saturated sampling which XI IPA 1 as experimental class and XI IPA 2 as control class. The techniques of data collection used measurement technique, observation, and interview while the tools of data collection used tests such as essayquestion, observation sheet, and interview guide. The statistical analysis of posttest result using U-man whitney test obtained significant value 0.000. This value was smaller than α (0.005) which meant that there was difference in learning outcome between experimental and control class. The statistical analysis result of U-man whitney delayed test obtained significant value 0.006, this value was smaller than α (0.005) which meant that there was difference between students’ memory in experimental and control class. The calculation of effect size showed value 1.64 with high criteria which gave high effect on students’ learning outcomes which was 44.95%, while the calculation of students’ memory effect size showed value 0.69 with moderate criteria which gave effect on students’ memory which was 26,42%. Keywords : Memory, Learning Outcomes, Salt Hydrolysis, STAD type of Cooperative Learning Method


2016 ◽  
Vol 55 (6) ◽  
pp. 339 ◽  
Author(s):  
Hartono Gunadi ◽  
Rini Sekartini ◽  
Retno Asti Werdhani ◽  
Ardi Findyartini ◽  
Muhammad Arvianda Kevin Kurnia

Background Immunization is recognized as one of the strategiesto reduce vaccine preventable diseases. Competency related toimmunization are consequently important for medical students andthe medical school needs to assure the competence acquisition.Objective To assess competence related to immunization andits retention following lectures with simulations compared tolectures only.Methods A quasi-experimental study was conducted to the 5th yearstudents of University of Indonesia Medical School during the ChildAdolescent Health Module in 2012-2013. The intervention grouphad lectures with simulations and the control group had lecturesonly. Immunization knowledge was assessed with a 30 multiplechoice question (MCA) items performed before and after themodule. Competence retention was assessed by MCQ (knowledge)and OSCE (skills) 2-6 months afterwards.Results Sixty eight subjects for each group with similarcharacteristics were analyzed. There was significant differenceafter module MCQ score between two groups. Competenceretention in 2-6 months after module completion was betterin intervention group, both for the knowledge (median MCQscore of 70.00 (range 37-93) vs. mean score of 58.01 (SD 12.22),respectively; P<0.001) and skill (OSCE mean scores of 75.21 (SD10.74) vs. 62.62 (SD 11.89), respectively; P < 0.001). Proportionof subjects in the intervention group who passed both the MCQand OSCE were also significantly greater.Conclusion Lectures with simulations are proved to bemore effective in improving medical students’ immunizationcompetence as well as its retention compared to lectures onlyapproach.


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