Evaluation of a Quality Improvement Experience for Family Medicine Clerkship Students

Background and Objectives: There is emphasis on systems-based practice competencies and quality improvement (QI) training in postgraduate medical education. However, we lack effective approaches to provide experiences in these areas during undergraduate medical education. To address this, we developed a novel approach to providing didactic and experiential learning experiences in QI during a third-year family medicine clerkship. Methods: We implemented and evaluated a QI curriculum combining self-directed learning with real-world experience to increase knowledge and confidence in the plan-do-study-act (PDSA) process for family medicine clerkship students. Students collaborated and presented their change ideas in a “Shark Tank” format for practice leaders at the end of their rotation. We used pre- and postcurriculum surveys to assess knowledge of and comfort with completing QI projects. Results: Three hundred eighty-nine students completed precurriculum surveys and 242 completed postcurriculum surveys. Pre- and postlearning evaluations revealed an increase in agreement or strong agreement with self-reported understanding of specific QI topic areas of 50%. Almost all (91.3%) reported feeling confident or reasonably confident in their ability to create change in health care after exposure to the curriculum, compared with 66.3% in the precurriculum survey. One-third of students (34%) reported intent to complete the Institute for Healthcare Improvement Open School curriculum in QI. Conclusions: Self-directed learning about QI, combined with practice observation, small-group discussion and presentation in a Shark Tank format was effective and engaging for learners. Students had limited preexisting knowledge of QI principles, suggesting a need for preclinical exposure to this topic. The family medicine clerkship provides an ideal environment for teaching QI.

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Because Life Is Open Book: An Open Internet Family Medicine Clerkship Exam

PRiMER ◽

10.22454/primer.2017.626578 ◽

2017 ◽

Vol 1 ◽

Cited By ~ 1

Author(s):

Deborah Erlich

Keyword(s):

Family Medicine ◽

Student Performance ◽

Clinical Performance ◽

Resource Assessment ◽

Evidence Based ◽

Self Directed Learning ◽

Final Exam ◽

Medicine Clerkship ◽

Novel Approach ◽

Competency Based

Introduction: A core principle of family medicine is information mastery, or application of principles of evidence-based medicine in clinical practice. While information mastery teaching and assessment are beginning to permeate postgraduate family medicine training programs, and while exciting literature on new open resource assessment methods is emerging, there are no prior descriptions of examinations that specifically assess medical students’ information mastery competency. Methods: To test information mastery competency, a novel final exam for the family medicine clerkship was developed, implemented, and evaluated. During the timed exam, the competency-based information mastery assessment (IMA) requires students to look up evidence-based information using web resources to answer case-based questions. Exam feasibility was tested with pilot examinees whose reactions were gauged. Student performance on the traditional closed book knowledge assessment (KA) was compared with performance on the open internet IMA. Exam performance was compared with preceptor ratings of students’ clinical performance. Low performers were further analyzed for preceptors’ ratings of specific student skills in information mastery and self-directed learning. Results: An open internet IMA testing knowledge application and information mastery skills is not only feasible but can also be educational. Student performance scores on the open internet IMA do not differ from scores on the closed book KA. Students describe many positive features of this open internet IMA. Student performance on the competency-based IMA correlates with clinical ratings by preceptors and with preceptors’ judgment of information mastery skills. Conclusions: A novel approach to assessment in family medicine clerkships may be used to assess student competency in information mastery. Further research is needed for enhanced exam validation.

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‘Flipped Learning’ in Disaster Triage – Polarising Medical Student Attainment?

Disaster Medicine and Public Health Preparedness ◽

10.1017/dmp.2020.423 ◽

2020 ◽

pp. 1-3

Author(s):

Anthony Mark Monaghan ◽

Jake Hudson ◽

Arion Romanos Alexopoulos

Keyword(s):

Medical Education ◽

Medical Student ◽

Flipped Classroom ◽

Independent Learning ◽

Flipped Learning ◽

Potential Utility ◽

Self Directed Learning ◽

Learning Skills ◽

Directed Learning

Abstract ‘Flipped learning’ has become increasingly popular in medical education as a means of developing independent learning skills in students. The article by Zheng at al. (2020) highlights the potential utility of this approach in disaster triage training. However, the article also highlights to us some concerns regarding how ‘flipped learning’ may favour certain learners over others in the provision of disaster triage education. Specifically, the article demonstrates the necessity for increased pre-classroom preparation when a ‘flipped classroom’ model is employed which inevitably privileges those with a higher ability to engage with self-directed learning. Whilst such a skill is important to develop in medical education, we fear it may lead to polarised student attainment rather than ensuring a maximum number of students achieve the requisite standard required. More research is consequently needed to inform the most efficacious means of facilitating disaster triage training that supports all students sufficiently whilst also helping to nurture their independent learning skills.

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Assessment of students’ satisfaction with a student-led team-based learning course

Journal of Educational Evaluation for Health Professions ◽

10.3352/jeehp.2015.12.23 ◽

2015 ◽

Vol 12 ◽

pp. 23 ◽

Cited By ~ 4

Author(s):

Justin W. Bouw ◽

Vasudha Gupta ◽

Ana L. Hincapie

Keyword(s):

Focus Group ◽

Student Perceptions ◽

Group Discussion ◽

Barriers To Success ◽

Self Directed Learning ◽

Group Data ◽

Team Based Learning ◽

Focus Group Data ◽

Directed Learning ◽

Students Satisfaction

Purpose: To date, no studies in the literature have examined student delivery of team-based learning (TBL) modules in the classroom. We aimed to assess student perceptions of a student-led TBL elective. Methods: Third-year pharmacy students were assigned topics in teams and developed learning objectives, a 15-minute mini-lecture, and a TBL application exercise and presented them to student colleagues. Students completed a survey upon completion of the course and participated in a focus group discussion to share their views on learning. Results: The majority of students (n=23/30) agreed that creating TBL modules enhanced their understanding of concepts, improved their self-directed learning skills (n=26/30), and improved their comprehension of TBL pedagogy (n=27/30). However, 60% disagreed with incorporating student-generated TBL modules into core curricular classes. Focus group data identified student-perceived barriers to success in the elective, in particular the development of TBL application exercises. Conclusion: This study provides evidence that students positively perceived student-led TBL as encouraging proactive learning from peer-to-peer teaching.

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Experiences from tsunami relief activity: implications for medical training

Canadian Medical Education Journal ◽

10.36834/cmej.36588 ◽

2012 ◽

Vol 3 (2) ◽

pp. e138-e140

Author(s):

Sudharsanam Manni Balasubramaniam ◽

Gautam Roy ◽

Yogesh Mohan

Keyword(s):

Medical Education ◽

Disaster Preparedness ◽

Medical Training ◽

Postgraduate Medical Education ◽

Group Discussion ◽

Leadership Skills ◽

Psychological Impact ◽

Vital Role ◽

Medical Relief ◽

Jawaharlal Institute

A tsunami struck the coast of Tamilnadu and Pondicherry on 26 December 2004. Jawaharlal Institute of Postgraduate Medical Education & Research, (JIPMER) in Pondicherry played a vital role in providing medical relief. The experiences from the relief activities revealed areas of deficiency in medical education in regards to disaster preparedness. A qualitative study using focus group discussion was employed to find the lacunae in skills in managing medical relief measures. Many skills were identified; the most important of which was addressing the psychological impact of the tsunami on the victims. Limited coordination and leadership skills were also identified. It is recommended that activity-based learning can be included in the curriculum to improve these skills.

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Introduction of Problem Based Learning (PBL) as a Supplementary Tool to Enhance Active Learning in Physiology – A Study in a Medical College of Southern Kolkata

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/631 ◽

2021 ◽

Vol 8 (40) ◽

pp. 3483-3488

Author(s):

Pandurang Narhare ◽

Padmakar Sasane ◽

Revathi Mohanan ◽

Mriganka Baruah

Keyword(s):

Medical Education ◽

Active Learning ◽

Subjective Evaluation ◽

Problem Based Learning ◽

Basic Knowledge ◽

Control Group ◽

Study Group ◽

Self Directed Learning ◽

Clinical Scenarios ◽

Directed Learning

BACKGROUND The motivation to learn begins with a problem. The ideology of problem-based learning (PBL) is to encourage the students to think beyond the books and apply the basic knowledge to various clinical scenarios. Problem based learning has been a concept in existence for decades, yet its implementation in medical education is limited. So the study on PBL was taken up to know analytical skills, comprehensive understanding of disease process and inculcate the practice of self-directed learning in physiology. METHODS This was an educational interventional study carried out on 60 first MBBS students chosen by simple random sampling. Students were further randomly divided into two groups containing 30 students in the control group and 30 students in the study group. Control group was taught by didactic lectures. 10 clinical scenarios were given to study group and discussions were conducted under the moderation of faculties. Objective evaluation was performed using pre-test and post-test examination for both groups. Subjective evaluation of attitude in study group towards PBL was recorded using self-developed questionnaire using Likert’s scale. Data was analysed by using paired students t test. RESULTS The mean pre-PBL (9.83±4.88) and post-PBL scores (15.61 ± 2.99) in study group were significant (p < 0.00001). The comparison of mean scores of postdidactic lectures (12.88 ± 3.13) in control group and post-PBL (15.61 ± 2.99) in study group were significant (p < 0.001). Subjective evaluation using Likert’s scale revealed increased interest in active learning, better confidence, communication, comprehension, and motivation amongst the PBL group. CONCLUSIONS From the results of this study, it can be concluded that problem-based learning is a good supplementary tool in teaching physiology, and it can be included in the regular medical teaching programmes so that the students have a better understanding of the various challenges in the field of medical education and research so that newer strategies for better health care provision can be planned. KEYWORDS Active Learning, Medical Education, Problem Solving, Self-Directed Learning

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Introduction of Group Discussion as a Teaching—Learning Method in Dissection Hall for the First MBBS Students

National Journal of Clinical Anatomy ◽

10.1055/s-0039-1692301 ◽

2019 ◽

Vol 08 (02) ◽

pp. 066-070 ◽

Cited By ~ 1

Author(s):

Mehul Tandel ◽

Daxa Kanjiya ◽

Neeraj Vedi ◽

Deepak Sharma ◽

Praveen Singh ◽

...

Keyword(s):

Group Discussion ◽

Active Participation ◽

Cooperative Interaction ◽

Learning Method ◽

Self Directed Learning ◽

Medical College ◽

Feedback Questionnaire ◽

Directed Learning ◽

Teaching Learning ◽

Academic Year

Abstract Background Human cadaveric dissection is considered as a core teaching tool and plays a major role in active learning process of students. However, students’ active participation and self-directed learning in dissection hall has declined over the period of time. Group discussion in dissection hall allows students to participate actively, engage in cooperative interaction, communicate effectively, and utilize self-directed learning. Therefore, group discussion has been introduced and assessed as a teaching-learning method in dissection with the aim of improving participation, learning, and communication skill of students in dissection hall. Methods This study was conducted on 100 students of Pramukhswami Medical College, Karamsad, Anand, Gujarat, India, during the 2018–2019 academic year. Students were divided in 10 groups for dissection. Group discussion was introduced as a teaching-learning method and assessed during dissection. Data were collected through anonymous feedback and then statistically analyzed. Result There was significant increase in active participation of most students during dissection: 79% students rated this method as good or excellent; 51 to 74% students agreed that this method helped them in better understanding of subject, improving dissection skills and communication; and 68% students agreed that working in group is better as compared with traditional method of dissection. The Cronbach's alpha of feedback questionnaire was 0.816. Conclusion Students perceived that the group discussion during dissection not only helped in creating active participation and better understanding of subject but also helped improve learning, communication, and dissection skills.

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LO093: A national needs assessment survey for the development of a quality improvement and patient safety curriculum for Canadian emergency medicine residents

CJEM ◽

10.1017/cem.2016.130 ◽

2016 ◽

Vol 18 (S1) ◽

pp. S62-S62 ◽

Cited By ~ 1

Author(s):

L.B. Chartier ◽

S. Vaillancourt ◽

M. McGowan ◽

K. Dainty ◽

A.H. Cheng

Keyword(s):

Emergency Medicine ◽

Medical Education ◽

Patient Safety ◽

Quality Improvement ◽

Needs Assessment ◽

Residency Training ◽

Royal College ◽

Assessment Tool ◽

Postgraduate Medical Education ◽

Clinical Scenarios

Introduction: The Canadian Medical Education Directives for Specialists (CanMEDS) framework defines the competencies that postgraduate medical education programs must cover for resident physicians. The 2015 iteration of the CanMEDS framework emphasizes Quality Improvement and Patient Safety (QIPS), given their role in the provision of high value and cost-effective care. However, the opinion of Emergency Medicine (EM) program directors (PDs) regarding the need for QIPS curricula is unknown, as is the current level of knowledge of EM residents in QIPS principles. We therefore sought to determine the need for a QIPS curriculum for EM residents in a Canadian Royal College EM program. Methods: We developed a national multi-modal needs assessment. This included a survey of all Royal College EM residency PDs across Canada, as well as an evaluative assessment of baseline QIPS knowledge of 30 EM residents at the University of Toronto (UT). The resident evaluation was done using the validated Revised QI Knowledge Application Tool (QIKAT-R), which evaluates an individual’s ability to decipher a systematic quality problem from short clinical scenarios and to propose change initiatives for improvement. Results: Eight of the 13 (62%) PDs responded to the survey, unanimously agreeing that QIPS should be a formal part of residency training. However, challenges identified included the lack of qualified and available faculty to develop and teach QIPS material. 30 of 30 (100%) residents spanning three cohorts completed the QIKAT-R. Median overall score was 11 out of 27 points (IQR 9-14), demonstrating the lack of poor baseline QIPS knowledge amongst residents. Conclusion: QIPS is felt to be a necessary part of residency training, but the lack of available and qualified faculty makes developing and implementing such curriculum challenging. Residents at UT consistently performed poorly on a validated QIPS assessment tool, confirming the need for a formal QIPS curriculum. We are now developing a longitudinal, evidence-based QIPS curriculum that trains both residents and faculty to contribute to QI projects at the institution level.

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