Teaching Medical Students to Choose Wisely Through Simulation

Abstract The Choosing Wisely (CW) campaign aims to encourage dialog among physicians and patients about the costs and benefits of medical care. The purpose of the present study was to describe the implementation of the CW campaign among medical students in the pediatrics clerkship using different teaching strategies and to evaluate the students’ perception and performance. A prospective, interventionist, open study with a control group was conducted. All sixth-year undergraduate medical students that were on their pediatric clerkship at the Emergency Department during the study period were invited to participate. The study consisted of two strategies: a remote video class about the CW initiative and in situ simulation training. By the end of the rotation, all participants were evaluated through an Objective Structured Clinical Examination (OSCE). A total of 50 students were included, of which 24 watched only the online video (control group) and 26 were exposed to both the online video and the simulation scenarios (intervention group). Students in the intervention group had a statistically significant higher total score in the OSCE compared to students in the control group (median 90 vs 90; range 78-100 vs 50-100; p: 0.047). Median scores of behavioral items of the OSCE grouped together were statistically significant higher in the intervention group compared to the control group (median 60 vs 50; range 40-60 vs 20-60; p: 0.002).Conclusion: Simulation training about principles of the CW campaign had a greater impact on behavioral aspects of undergraduate students. This learning strategy was well accepted by participants.

Download Full-text

Learning clinical skills through audiovisual aids embedded in electronic-PBL sessions in undergraduate medical curriculum: perception and performance

AJP Advances in Physiology Education ◽

10.1152/advan.00075.2019 ◽

2019 ◽

Vol 43 (3) ◽

pp. 378-382

Author(s):

Shoukat Ali Arain ◽

Nasir Ali Afsar ◽

Dileep Kumar Rohra ◽

Muhammad Zafar

Keyword(s):

Classroom Environment ◽

Medical Curriculum ◽

Clinical Skills ◽

Intervention Group ◽

Clinical Signs ◽

Innovative Technology ◽

Control Group ◽

Undergraduate Medical Students ◽

Audiovisual Aids ◽

And Performance

Learning clinical skills in a large group of undergraduate medical students is challenging. Innovative technology-based modalities are being evaluated to complement limited hospital rotations. We determined the effectiveness of clinical skills-related audiovisual (AV) aids embedded in electronic-problem-based learning (PBL) sessions, in terms of students’ feedback and formative Objective Structured Clinical Examinations (OSCE) grades. This mixed-method study was conducted during the Cardiovascular System module in year 3 of the Bachelor of Medicine, Bachelor of Surgery program. The AV aids, mainly consisting of abnormal chest auscultation sounds, were linked to the cases for the intervention group. The control group received only a description of clinical signs. Sessions were conducted using an intranet platform. At the end of the module, feedback was obtained from intervention group students and faculty using a self-administered questionnaire. The learning was compared between intervention and control groups through an OSCE. Finally, focus group interviews were conducted to explore factors underlying deviation from the expected results. Out of 110 intervention group students, 86 (78%) responded. The students appreciated the inclusion of AV aids, as suggested by a high average satisfaction score of 4.2 (SD 0.8). They agreed that, apart from being appropriate and relevant, the aids improved the learning environment and engagement in the process. The tutors also gave a similar feedback. However, no difference in the OSCE scores was found between control and intervention groups. The study indicates that inclusion of AV aids improved students’ engagement and classroom environment in electronic-PBL sessions, but did not improve diagnostic abilities based on the learned clinical skills.

Download Full-text

Exploring Effects of Interprofessional Education on Undergraduate Students Behaviour: A Randomized Controlled Trial

Journal of Research in Interprofessional Practice and Education ◽

10.22230/jripe.2010v1n3a41 ◽

2010 ◽

Vol 1 (3) ◽

Cited By ~ 5

Author(s):

Johannes Maximilian Just ◽

Martin W Schnell ◽

Maren Bongartz ◽

Christian Schulz

Keyword(s):

Randomized Controlled Trial ◽

Medical Students ◽

Undergraduate Students ◽

Interprofessional Education ◽

Nursing Student ◽

Controlled Trial ◽

Intervention Group ◽

Control Group ◽

Team Approach ◽

Randomized Controlled

Background: One way to improve the quality of palliative care for elderly patients is to use an interprofessional team approach, which may be encouraged through interprofessional education (IPE). However, the effectiveness of IPE interventions has yet to be proven. We therefore designed a randomized controlled trial using a simulated practice setting to measure the effects of an IPE intervention on medical students’ clinical behaviour.Methods: Undergraduate nursing (N = 20) and medical (N = 20) students were evenly assigned to either an intervention or a control group. Students in the intervention group received interprofessional curriculum (12 teaching units), and the control group was given written material containing the content of the IPE curriculum. Using a pre-post design, clinical behaviour of matched pairs of nursing and medical students was analyzed for qualitative (care objectives) and quantitative aspects of communication (initiation, interruptions, speaking time, and exchanged information items). Statistical analyses included chi-square, Fisher’s exact, and t-tests, where appropriate.Results: Care objective scores improved in both groups (categories N = 6, p-range = intervention group: .001–.630; control group: .001–.888). Interruptions and speaking time showed no change between or within groups, while the number of nursing student-initiated contacts increased (p = .0007). The number of information items exchanged increased significantly in both the intervention group (Pre: M = 9.65, SD = 1.79; Post: M = 12.35, SD = 1.87; p = .001) and the control group (Pre: M = 8.75, SD = 2.59; Post: M = 11.75, SD = 2.22; p = .001).Conclusions:We found a moderate effect of IPE on a change in interprofessionalcommunication style.

Download Full-text

Efficacy of implementing intermittent STOP THE BLEED® reviews on long term retention of hemorrhage control skills of first year medical students

Journal of Osteopathic Medicine ◽

10.1515/jom-2020-0231 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Enkhtsogt Sainbayar ◽

Nathan Holt ◽

Amber Jacobson ◽

Shalini Bhatia ◽

Christina Weaver

Keyword(s):

Medical Students ◽

Intervention Group ◽

Training Session ◽

Likert Scale ◽

Control Group ◽

First Year ◽

Hemorrhage Control ◽

Term Retention ◽

Long Term Retention

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.

Download Full-text

Effect of Engaging Trainees by Assessing Peer Performance: A Randomised Controlled Trial Using Simulated Patient Scenarios

BioMed Research International ◽

10.1155/2014/610591 ◽

2014 ◽

Vol 2014 ◽

pp. 1-7 ◽

Cited By ~ 5

Author(s):

Charlotte Loumann Krogh ◽

Charlotte Ringsted ◽

Charles B. Kromann ◽

Maria Birkvad Rasmussen ◽

Tobias Todsen ◽

...

Keyword(s):

Controlled Trial ◽

Intervention Group ◽

Control Group ◽

Global Rating ◽

Training Performance ◽

Significant Difference ◽

Training Format ◽

Peer Performance ◽

And Performance ◽

Randomised Controlled

Introduction. The aim of this study was to explore the learning effect of engaging trainees by assessing peer performance during simulation-based training.Methods. Eighty-four final year medical students participated in the study. The intervention involved trainees assessing peer performance during training. Outcome measures were in-training performance and performance, both of which were measured two weeks after the course. Trainees’ performances were videotaped and assessed by two expert raters using a checklist that included a global rating. Trainees’ satisfaction with the training was also evaluated.Results. The intervention group obtained a significantly higher overall in-training performance score than the control group: mean checklist score 20.87 (SD 2.51) versus 19.14 (SD 2.65)P=0.003and mean global rating 3.25 SD (0.99) versus 2.95 (SD 1.09)P=0.014. Postcourse performance did not show any significant difference between the two groups. Trainees who assessed peer performance were more satisfied with the training than those who did not: mean 6.36 (SD 1.00) versus 5.74 (SD 1.33)P=0.025.Conclusion. Engaging trainees in the assessment of peer performance had an immediate effect on in-training performance, but not on the learning outcome measured two weeks later. Trainees had a positive attitude towards the training format.

Download Full-text

Searching for the erosion of empathy in medical undergraduate students: a longitudinal study

BMJ Open ◽

10.1136/bmjopen-2020-041810 ◽

2020 ◽

Vol 10 (12) ◽

pp. e041810

Author(s):

José Manuel Blanco ◽

Fernando Caballero ◽

Santiago Álvarez ◽

Mercedes Plans ◽

Diana Monge

Keyword(s):

Medical Students ◽

Undergraduate Students ◽

Cognitive Empathy ◽

Primary Outcome Measure ◽

Undergraduate Medical Students ◽

School Settings ◽

School Year ◽

School Of Medicine ◽

Medical Undergraduate ◽

Sociocultural Differences

ObjectiveTo analyse the trajectory of empathy throughout the degree programme of medicine in a Spanish school of medicine.DesignLongitudinal, prospective 5-year study, between October 2014 and June 2019.SettingStudents from a Spanish university of medicine.ParticipantsTwo voluntary cohorts of undergraduate medical students from two different school years were invited to participate (n=135 (cohort 1, C1) and 106 (cohort 2, C2) per school year). Finally, a total number of 174 students (102 (C1, 71.6% women) and 72 (C2, 70.8% women) students, respectively) were monitored for 5 years. Each cohort was divided in two subcohorts of paired and unpaired students that were analysed to check possible social desirability bias.Primary outcome measureThe Jefferson Scale of Empathy (JSE).ResultsThe cohort of 102 students (C1) monitored between their first and fifth years of study (71.6% women) showed an improvement among paired women of 2.15 points in total JSE score (p=0.01) and 2.39 points in cognitive empathy (p=0.01); in the unpaired female cohort the increase was of 2.32 points (cognitive empathy) (p=0.02). The cohort of 72 students (C2) monitored between their second and sixth years of study (70.8% women) displayed a cognitive empathy increase of 2.32 points (p=0.04) in the paired group of women. There were no significant differences between paired and unpaired results for either cohort. Empathy scores among men did not decrease.ConclusionsThe empathy of medical students at our school did not decline along grade years. In fact, it improved slightly, particularly cognitive empathy, among women. This paper contributes to enlarge data from Europe, where longitudinal studies are scarce. It supports the idea that there may be global geo-sociocultural differences; however, more studies comparing different school settings are needed.

Download Full-text

Development and evaluation of an online medication safety module for medical students at a rural teaching hospital: the Winchester District Memorial Hospital

BMJ Open Quality ◽

10.1136/bmjoq-2021-001385 ◽

2021 ◽

Vol 10 (2) ◽

pp. e001385

Author(s):

Ali Elbeddini ◽

Yasamin Tayefehchamani

Keyword(s):

Online Learning ◽

Medical Students ◽

Medication Safety ◽

Controlled Trial ◽

Effective Means ◽

Intervention Group ◽

Control Group ◽

Open Label ◽

Online Module ◽

Learning Module

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.

Download Full-text

Effect of health education on awareness and practices of breast self-examination among females attending a charitable hospital at North Karachi

Journal of the Pakistan Medical Association ◽

10.47391/jpma.04-564 ◽

2021 ◽

Vol 71 (9) ◽

Author(s):

Zohra Jabeen ◽

Nighat Shah ◽

Zaeema Ahmer ◽

Sulhera Khan ◽

Amir Hussain Khan ◽

...

Keyword(s):

Health Education ◽

Intervention Group ◽

Positive Association ◽

Control Group ◽

Low Resource ◽

Resource Setting ◽

Low Resource Setting ◽

Study Results ◽

Quasi Experimental ◽

And Performance

Abstract Objective: The objective of this study was to compare the effectiveness of health education as an intervention to promote BSE among intervention and non-intervention group presenting in a low resource setting at North Karachi Methodology: This Quasi-experimental study was conducted from January-August 2018 in a charitable hospital in Karachi after taking ethical approval by the Institutional Review Board of Jinnah Sindh Medical University and relevant approvals from the hospital authorities. This study recruited 172 eligible women by dividing them into intervention (n=86) and control (n=86) groups from a low resource setting in Karachi. Demographic variables were collected through pretested questionnaire by interview. Intervention group then received health education regarding carcinoma of breast, importance of BSE and monthly motivation to perform BSE through cell phone. The questionnaire was again filled after 6 months of intervention. Control group was also given health education sessions upon completion of study. Results: Results revealed that both groups were similar initially. After 6 months females in intervention group showed significant (p=<0.001) improvement in knowledge and performance of BSE from 44.2% to 88.4% but there was no change in control group. Being in intervention group (RR=2.714, 95% CI= 1.760 - 4.186, p=0.001) and education (RR=0.573, 95% CI= 0.361 - 0.910, p=0.018) showed positive association with BSE performance. Upon adjusting with age, marital status, family history and education, intervention group (RR=2.570, 95% CI= 1.654 - 3.992, p= 0.001) remained significant while education (RR=1.466, 95% CI =0.910 - 2.363, p=0.116) became insignificant. Continuous...

Download Full-text

Immunization competence retention in medical students: a comparation between conventional lectures and lectures with simulations method

Paediatrica Indonesiana ◽

10.14238/pi55.6.2015.339-44 ◽

2016 ◽

Vol 55 (6) ◽

pp. 339 ◽

Cited By ~ 1

Author(s):

Hartono Gunadi ◽

Rini Sekartini ◽

Retno Asti Werdhani ◽

Ardi Findyartini ◽

Muhammad Arvianda Kevin Kurnia

Keyword(s):

Experimental Study ◽

Medical Students ◽

Medical School ◽

Intervention Group ◽

Control Group ◽

Vaccine Preventable Diseases ◽

Before And After ◽

Quasi Experimental

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.

Download Full-text

Effect of epidemiology batch posting in improving attitude towards research among medical students

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20200984 ◽

2020 ◽

Vol 7 (3) ◽

pp. 1158

Author(s):

Aparnavi P. ◽

Venkatesh U. ◽

Priyanka S. ◽

Shalini S.

Keyword(s):

Medical Students ◽

Undergraduate Students ◽

Medical Curriculum ◽

Statistical Significance ◽

Sampling Technique ◽

Rank Test ◽

New Delhi ◽

Undergraduate Medical Students ◽

Indian Medical ◽

Wilcoxon Sign Rank

Background: Epidemiology batch posting (EBP) is conducted only in a few Indian medical colleges for undergraduate students to orient them with research methodologies. EBP is designed to overcome the lacuna in knowledge on attitude towards scientific research amongst medical students. The objective of the study was to study the effect of EBP in improving attitude towards research among medical students.Methods: A pre-post study was conducted on a batch of 40 students (consecutive sampling technique) posted for EBP in Department of Community Medicine, at VMMC and Safdarjung Hospital, New Delhi during October-November 2017. This was well above the required sample size of 16 calculated using G Power 3.1. Data was collected using R-ATR (revised attitude towards research) Data was found to be non-parametric by applying tests of normality. Hence Wilcoxon sign rank test was used to find the statistical significance in change of attitude between pre and post-tests.Results: Participants mean age was 20.50±1.58 yrs and 75% of them were males. The median attitude towards research usefulness increased from 5.25 to 6.75 following EBP. In the domain of positive predisposition towards research, there was an overall positive change in attitude from a median of 4.00 to 5.25. A negative change was shown in ‘research anxiety’ domain, from a median score of 5.00 to 3.00.Conclusions: Authors recommend that Indian medical curriculum should mandate a small group learning model such as EBP for all undergraduate medical students to bring about a positive attitude towards research and to reduce their anxiety levels.

Download Full-text

Using Gamification and Social Incentives to Increase Physical Activity and Related Social Cognition among Undergraduate Students in Shanghai, China

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph16050858 ◽

2019 ◽

Vol 16 (5) ◽

pp. 858 ◽

Cited By ~ 3

Author(s):

Dandan Mo ◽

Mi Xiang ◽

Mengyun Luo ◽

Yuanyuan Dong ◽

Yue Fang ◽

...

Keyword(s):

Physical Activity ◽

Social Cognition ◽

Undergraduate Students ◽

Vigorous Physical Activity ◽

Intervention Group ◽

Daily Physical Activity ◽

Control Group ◽

Activity Duration ◽

Social Incentives ◽

Physical Activity Duration

Gamification and social incentives are promising strategies to increase the effectiveness of web-based physical activity (PA) interventions by improving engagement. In this study, we designed a PA intervention integrating gamification and social incentives based on the most popular social networking service in China, WeChat. A controlled trial involving 52 Chinese undergraduate students was implemented to evaluate the effectiveness of the intervention. Subjects in the intervention group received a 7-week intervention. PA behavior and related social cognitive variables according to the theory of planned behavior were measured at the baseline and after the intervention. Daily physical activity duration was measured during the intervention. The results showed that PA-related subjective norms, perceived behavior control, and intention, as well as self-reported vigorous physical activity and moderate physical activity in the intervention group, were increased after the intervention, compared with the control group (p <0.05). During the intervention, perceived daily physical activity duration in the intervention group was on the rise, while it declined in the control group (p <0.001). The findings indicate that WeChat-based intervention integrating gamification and social incentives could effectively increase subjectively measured PA and related social cognition among Chinese undergraduate students and that it is a promising way to ameliorate the problem of insufficient PA among youths.

Download Full-text