Factors influencing first-year medical students' perceptions of stress

This preliminary report from an ongoing longitudinal study of students at both Tufts and Harvard medical schools examined the relationship between premedical school demographic and stress variables and the numbers and types of stresses reported by students in open-ended interviews conducted during their first year of medical school. Analyses showed that the general categories of "medical school stresses" and "social stresses related to medical school" accounted for about two-thirds of the total number of stresses mentioned. The overall distributions of stresses across general categories were remarkably similar in all student groups studied, although significant differences were found between students from different background groups on a number of the specific types of stress. No significant differences were found between groups as to those reporting a high total number of stresses. There did appear to be differences in the degree to which students felt affected by the stresses they reported, suggesting the need for additional data on the meanings of different stresses for different students and the ways in which they cope with them.     

Effect of problem-based,self-directed undergraduate education on life-long learning.

OBJECTIVE: To compare how well graduates of a self-directed, problem-based undergraduate curriculum (at McMaster University [MU], Hamilton, Ont.) and those of a traditional curriculum (at the University of Toronto [UT]) who go on to primary care careers keep up to date with current clinical practice guidelines. DESIGN: Analytic survey. Management of hypertension was chosen as an appropriate topic to assess guideline adherence. An updated version of a previously validated questionnaire was mailed to the participants for self-completion. SETTING: Private primary care practices in southern Ontario. PARTICIPANTS: A random sample of 48 MU graduates and 48 UT graduates, stratified for year of graduation (1974 to 1985) and sex, who were in family or general practice in Ontario; 87% of the eligible subjects in each group responded. MAIN OUTCOME MEASURES: Overall and component-specific scores; analysis was blind to study group. RESULTS: The overall mean scores were 56 (68%) of a possible 82 for the MU graduates and 51 (62%) for the UT graduates (difference between the means 5, 95% confidence interval 1.9 to 8.2; p < 0.01). Multivariate linear regression analysis of seven factors that might affect questionnaire scores revealed that only the medical school was statistically significant (p < 0.01). The MU graduates had significantly higher mean scores than the UT graduates for two components of the questionnaire: knowledge of recommended blood pressures for treatment (p < 0.05) and successful approaches to enhance compliance (p < 0.005). The trends were similar for the other components but but were not significant. CONCLUSIONS: The graduates of a problem-based, self-directed undergraduate curriculum are more up to date in knowledge of the management of hypertension than graduates of a traditional curriculum.     

Gender differences in learning style preferences among undergraduate physiology students

Students have individual learning style preferences including visual (V; learning from graphs, charts, and flow diagrams), auditory (A; learning from speech), read-write (R; learning from reading and writing), and kinesthetic (K; learning from touch, hearing, smell, taste, and sight). These preferences can be assessed using the VARK questionnaire. We administered the VARK questionnaire to undergraduate physiology majors enrolled in a capstone physiology laboratory at Michigan State University; 48 of the 86 students (55.8%) who returned the completed questionnaire voluntarily offered gender information. The responses were tallied and assessed for gender difference in learning style preference; 54.2% of females and only 12.5% of males preferred a single mode of information presentation. Among the female students, 4.2% of the students preferred V, 0% of the students preferred A, 16.7% of the students preferred printed words (R), and 33.3% of the students preferred using all their senses (K). In contrast, male students were evenly distributed in preference, with 4.2% of the students preferring A, R, or K, respectively, while 0% of the students preferred V. Furthermore, 45.8% of female and 87.5% of male respondents preferred multiple modes [female: 2 modes (12.5%), 3 modes (12.5%), and 4 modes (20.8%); males: 2 modes (16.7%), 3 modes (12.5%), and 4 modes (58.3%)] of presentation. In summary, a majority of male students preferred multimodal instruction, specifically, four modes (VARK), whereas a majority of female students preferred single-mode instruction with a preference toward K. Thus, male and female students have significantly different learning styles. It is the responsibility of the instructor to address this diversity of learning styles and develop appropriate learning approaches.     

Learning approaches of undergraduate medical students to physiology in a non-PBL- and partially PBL-oriented curriculum

Melaka Manipal Medical College (Manipal Campus; Manipal, Karnataka, India) conducts the Bachelor of Medicine and Bachelor of Surgery program, for which the admission intakes are during the months of March and September. The present study was undertaken to study the differences in learning approaches to physiology of undergraduate medical students in a partially problem-based learning (PBL)- and non-PBL-oriented curriculum. PBL was introduced as a curricular reform for the September 2006 batch of students (partially PBL group), whereas it was not incorporated for the March 2006 batch of students (non-PBL group). Learning approaches to physiology of both groups of students were compared using the short inventory of approaches to learning. Mean scores for deep and strategic approaches were found to be significantly higher for the partially PBL group compared with the non-PBL group. The results of the present study support the earlier observation that PBL promotes a deep approach to learning.     

Using a high-fidelity patient simulator with first-year medical students to facilitate learning of cardiovascular function curves

Students are relying on technology for learning more than ever, and educators need to adapt to facilitate student learning. High-fidelity patient simulators (HFPS) are usually reserved for the clinical years of medical education and are geared to improve clinical decision skills, teamwork, and patient safety. Finding ways to incorporate HFPS into preclinical medical education represents more of a challenge, and there is limited literature regarding its implementation. The main objective of this study was to implement a HFPS activity into a problem-based curriculum to enhance the learning of basic sciences. More specifically, the focus was to aid in student learning of cardiovascular function curves and help students develop heart failure treatment strategies based on basic cardiovascular physiology concepts. Pretests and posttests, along with student surveys, were used to determine student knowledge and perception of learning in two first-year medical school classes. There was an increase of 21% and 22% in the percentage of students achieving correct answers on a posttest compared with their pretest score. The median number of correct questions increased from pretest scores of 2 and 2.5 to posttest scores of 4 and 5 of a possible total of 6 in each respective year. Student survey data showed agreement that the activity aided in learning. This study suggests that a HFPS activity can be implemented during the preclinical years of medical education to address basic science concepts. Additionally, it suggests that student learning of cardiovascular function curves and heart failure strategies are facilitated.     

Clinically oriented physiology teaching: strategy for developing critical-thinking skills in undergraduate medical students

Medicine is an applied science, interpreting evidence and applying it to real life by using clinical reasoning skills and experience. COPT (clinically oriented physiology teaching) was incorporated in physiology instruction aiming to relate the study of physiology to real-life problems, to generate enthusiasm and motivation for learning, and to demonstrate the vocational relevance of physiology among students by integrating clinical experience with teaching. COPT consisted of two elements: 1) critical-thinking questions (CTQ) and 2) clinical case studies. After a few topics were taught, CTQ and case studies were given as an assignment. Answers were discussed in the next class. Two exams, each of which contained CTQ and recall questions, were conducted, one before (exam 1) and one after (exam 2) the implementation of COPT. Analysis of student performance in the examinations revealed that the students did better in exam 2 (P < 0.0001). Feedback from students indicated that this method was useful and challenging.     

Morningness-eveningness preferences,learning approach and academic achievement of undergraduate medical students

ABSTRACT

Several studies have focused on determining the effect of chronotype and learning approach on academic achievement separately indicating that morning types have an academic advantage over the evening types and so have the deep learners over the surface learners. But, surprisingly none have assessed the possible relationship between chronotype and learning approach. So, the current study aimed to evaluate this association and their individual influence on academic performance as indicated by the Cumulative Grade Point Average (CGPA) as well as the effect of their interaction on academic performance. The study included 345 undergraduate medical students who responded to reduced Morningness-Eveningness Questionnaire and Biggs Revised Two-Factor Study Process Questionnaire. Morning types indulged in deep learning while evening types in surface learning. Morning and evening types did not differ on academic performance but deep learners had better academic outcomes than their counterparts. The interaction between chronotype and learning approach was significant on determining academic achievement. Our findings gave the impression that chronotype could have an impact on academic performance not directly but indirectly through learning approaches.     

Effects of different forms of physiology instruction on the development of students' conceptions of and approaches to science learning

The purpose of this study was to investigate students' conceptions of and approaches to learning science in two different forms: internet-assisted instruction and traditional (face-to-face only) instruction. The participants who took part in the study were 79 college students enrolled in a physiology class in north Taiwan. In all, 46 of the participants were from one class and 33 were from another class. Using a quasi-experimental research approach, the class of 46 students was assigned to be the "internet-assisted instruction group," whereas the class of 33 students was assigned to be the "traditional instruction group." The treatment consisted of a series of online inquiry activities. To explore the effects of different forms of instruction on students' conceptions of and approaches to learning science, two questionnaires were administered before and after the instruction: the Conceptions of Learning Science Questionnaire and the Approaches to Learning Science Questionnaire. Analysis of covariance results revealed that the students in the internet-assisted instruction group showed less agreement than the traditional instruction group in the less advanced conceptions of learning science (such as learning as memorizing and testing). In addition, the internet-assisted instruction group displayed significantly more agreement than the traditional instruction group in more sophisticated conceptions (such as learning as seeing in a new way). Moreover, the internet-assisted instruction group expressed more orientation toward the approaches of deep motive and deep strategy than the traditional instruction group. However, the students in the internet-assisted instruction group also showed more surface motive than the traditional instruction group did.     

Using a learning log to support students' learning in biology lessons

Providing copies of an instructor's lecture notes before lectures is enthusiastically approved of by university students in introductory biology classes. Surprisingly, students who use the notes tend to perform less well onexams than students who avoid using the notes. However, there is no evidence that using the notes is harmful to learning; rather, those students who choose not to use the notes enter the course with better preparation or knowledge than the class as a whole. Pre-circulated notes may improve the clarity of lectures and encourage advance preparation by students — a learning discipline possibly as valuable as organising and reviewing one's own notes.     

精心设计教学活动,激发学生的学习兴趣

在生物学教学中通过设疑引起学生对知识的好奇;通过增加学生的认知冲突引起学生对知识的关注;以形象、生动的手段展示知识的魅力,让学生感受到知识的趣味：使学生在积极的情绪体验中产生兴趣。