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.     

Teaching Medical Ethics to Meet the Realities of a Changing Health Care System

The changing context of medical practice—bureaucratic, political, or economic—demands that doctors have the knowledge and skills to face these new realities. Such changes impose obstacles on doctors delivering ethical care to vulnerable patient populations. Modern medical ethics education requires a focus upon the knowledge and skills necessary to close the gap between the theory and practice of ethical care. Physicians and doctors-in-training must learn to be morally sensitive to ethical dilemmas on the wards, learn how to make professionally grounded decisions with their patients and other medical providers, and develop the leadership, dedication, and courage to fulfill ethical values in the face of disincentives and bureaucratic challenges. A new core focus of medical ethics education must turn to learning how to put ethics into practice by teaching physicians to realistically negotiate the new institutional maze of 21st-century medicine.     

Developing a contextualised blended learning framework to enhance medical physics student learning and engagement

As a specialist field of study, medical physicists require a broad range of knowledge and skills to operate competently in their workplace. In Australia, these competencies are accredited by the Australasian College of Physical Scientists and Engineers in Medicine (ACPSEM). Education and training for medical physicists therefore consists of an exhaustive range of knowledge areas. This is made even more challenging due to the extremely diverse backgrounds of students in these specialist courses of study. These factors frequently lead to a disengagement by students with learning activities.To address some of these challenges, the Radiotherapy Physics unit in a Masters level Medical Physics course of study was re-designed to increase active learning that included scaffolded in-class and online tasks and supported by virtual reality simulations. These re-design initiatives were informed by a diverse team including academic and clinical medical physicists as well as education experts.A survey, conducted over two consecutive years was used to gain students perceptions about the re-design. The questions were designed to see if the students felt engaged with the various learning activities.Analysis of the survey data indicates that there was an overall improvement in students’ engagement with the learning activities and the learning content.The paper further discusses nuanced understanding about the ways in which students engaged with the various learning activities including online, in-class, practicals and industry attachments. The paper discusses the appropriately informed learning activities that can be used to improve student engagement for highly specialised, content heavy areas of study.     

医学生早期教育阶段综合能力培养之探索

现代医学模式要求医务工作者必须是高素质的人才。基础医学教育阶段是医学生培养过程中的基础环节和重要阶段,与临床教学阶段相比,基础教育阶段更有利于学生综合能力培养和开展素质教育。医学生综合能力的培养在医学教育中具有重要的地位,它的实现要靠教育者在教育教学的各个环节中主动施行,积极探讨医学生综合能力培养的有效实施途径和方法。我们课题组根据多年从事医学生人才培养的教育教学经验,针对医学生早期教育阶段的心理、生理、环境、知识结构特点,围绕综合能力培养这个核心课题,强化创新性人才培养,系统有序地按学生学习时间和课程进行各种能力的逐一培养,从学习能力,思维能力,观察能力,动手能力,合作能力,分析问题和解决问题能力,判断是非能力,语言表达能力,写作能力,创新开拓能力等,探索医学生早期教育阶段综合能力培养模式。     

The Need for Continuing Medical Education

Continuing medical education is an essential feature of the practice of modern medicine since it furnishes the means to maintain the doctor''s ability to provide quality patient care.To ensure that continuing medical education is provided efficiently and in the best quality, and utilized fully, it is necessary that: (1) the medical faculty inculcate in the student the concept of lifelong learning; (2) the practitioner adopt less time-consuming patterns of practice, to free more of his time for learning; (3) community hospital-based clinical teaching be provided universally; and (4) research be conducted to determine the best of current teaching methods and develop better ones. Conflicting efforts to meet these needs by practitioners (whose primary responsibility it is) and by organized medicine, specialty societies, voluntary health agencies and others have led to inefficient use of medical faculty teachers. The key parties in continuing medical education—practitioner and teacher—can learn best in medical school-administered programs, which need be supported by all other interested organizations.     

Improving Education in Medical Statistics: Implementing a Blended Learning Model in the Existing Curriculum

Background

Although recent studies report on the benefits of blended learning in improving medical student education, there is still no empirical evidence on the relative effectiveness of blended over traditional learning approaches in medical statistics. We implemented blended along with on-site (i.e. face-to-face) learning to further assess the potential value of web-based learning in medical statistics.

Methods

This was a prospective study conducted with third year medical undergraduate students attending the Faculty of Medicine, University of Belgrade, who passed (440 of 545) the final exam of the obligatory introductory statistics course during 2013–14. Student statistics achievements were stratified based on the two methods of education delivery: blended learning and on-site learning. Blended learning included a combination of face-to-face and distance learning methodologies integrated into a single course.

Results

Mean exam scores for the blended learning student group were higher than for the on-site student group for both final statistics score (89.36±6.60 vs. 86.06±8.48; p = 0.001) and knowledge test score (7.88±1.30 vs. 7.51±1.36; p = 0.023) with a medium effect size. There were no differences in sex or study duration between the groups. Current grade point average (GPA) was higher in the blended group. In a multivariable regression model, current GPA and knowledge test scores were associated with the final statistics score after adjusting for study duration and learning modality (p<0.001).

Conclusion

This study provides empirical evidence to support educator decisions to implement different learning environments for teaching medical statistics to undergraduate medical students. Blended and on-site training formats led to similar knowledge acquisition; however, students with higher GPA preferred the technology assisted learning format. Implementation of blended learning approaches can be considered an attractive, cost-effective, and efficient alternative to traditional classroom training in medical statistics.     

“小组学习”模式在基础医学课程中的实践应用：以医学免疫学为例

将"小组学习"模式应用于基础医学课程"医学免疫学"的教学,在理论课堂采用案例导学、问题导学、角色转换导学和专题讨论导学,实践教学过程针对课堂实验、实验选修课和大学生创新创业项目进行层次化导学。综合运用思维导图、问卷星、成长袋等多元化教学方法和手段,编写思政案例库进行专业课课程思政,结合小组过程性考核进行多元化考核评价。该模式通过培养学生自主学习能力、小组合作能力、实践能力、创新能力和人文素质,为培养高素质、高能力的应用型医学人才奠定基础。该教学模式得到了绝大多数学生的认同,可为基础医学及其他相关课程的开展及高校人才培养提供思路和参考。     

以问题为中心的学习方法在高职社区问诊技能教学中的应用

目的:探讨以问题为中心的教学方法(problem-based learning,PBL)在高职社区问诊教学中的效果,寻求更有效的现代医学教育方法。方法:在高职社区问诊技能学习中开展以问题为中心的教学方法(PBL),分析问诊中存在的问题,以提高知识应用与沟通能力。结果:通过对62名高职医学生进行问诊技能和见习报告评分显示,成绩优良比率为89%,满意度调查显示83.87%的高职医学生对PBL教学方法满意。PBL教学可以让高职医学生灵活的利用自已的时间,进行比较主动的学习,可以更好的发现高职医学生在问诊见习中存在的问题,有利于提高高职医学生的问诊技能及医患沟通能力,但实施中所需时间较长,占用课时多。结论:PBL教学对高职医学生的主动学习能力、问诊技能及医患沟通能力的提高有利,医学生对PBL教学方法满意度高。在医学教育中可以将PBL教学和传统教学方法结合起来,以在有效的时间里达到更好的教学效果。     

Effective field trips in nature: the interplay between novelty and learning

Educational field trips are common practice in environmental education and education for sustainable development, well recognised by researchers for their potential to achieve cognitive and affective educational outcomes. One of the factors that influences learning during field trips is their novelty. The current study focuses on the interplay between novelty, preparation and environmental learning outcomes of 5th and 6th grade students during a typical field trip in Flanders. Our dependent variables are Inclusion of Nature in the Self, the two major ecological values Preservation and Utilisation and ecosystem knowledge. The sample includes 484 students (10–12 years old) and their 24 teachers. Key questions addressed are: (1) What is learned during the field trip? (2) What is the level of novelty for students during a field trip? (3) How does the novelty effect relate to learning? Results show that participation in the field trip leads to a substantial increase in ecosystem knowledge, but fails in reaching the affective goals set out by the field trip organisers. Our results furthermore provide support for the hypothesised non-linear relationship between novelty and knowledge gain, showing that while a little novelty is positive, too much novelty can stand in the way of learning.     

提高临床实习教学质量的实践与体会

临床实习是医学生大学教育阶段的重要组成部分,是医学生向临床医生转型的过渡时期。临床实习质量的高低直接关系到医学生的培养质量。在实习期间培养出扎实的临床基本功、科学的临床思维和高尚的医德医风对于医学生而言是非常重要的。同时,临床实习教学也是医学院校及教学医院的工作重心。作为教学医院,我院多年来积极推进教学改革,不断探索提升临床实习质量的方法,部分科室率先开展了PBL等新的教学模式,并取得了卓越的成效。我院领导阶层也通过抓好教学准备、提升带教质量、严格实习考核等方面的工作,全面提升了临床实习教学质量,从而提高了医学生的综合素质,也为提高执业医师考试通过率打下了坚实的基础。     

Biology student teachers’ dialogic talk in inquiry-based instruction

ABSTRACT

Inquiry-based learning has generally accepted by scholars as a most effective teaching approach in biology education. The talk during inquiry-based teaching needs to be practiced. There is less evidence how student teachers talk with students during their inquiry-based biology instruction. This knowledge is needed in supporting student teachers to develop their teachership in biology education. In this qualitative case study, the dialogic talk of biology student teachers (N = 6) was studied in the context of inquiry-based lessons in lower secondary school. The student teachers’ lessons were video and audio recorded and the data was analyzed using content analysis. The student teachers used dialogic talk in their inquiry-based instruction only occasionally, mainly in the examination and the conclusion stages. During the introduction stage, dialogic talk was less used and it was mainly explaining and instructing the content. In the examination stage, student teachers also guided students and stated facts. During the conclusion stage, student teachers mainly explained and also evaluated students’ statements. The lesson’s topics and methods used in inquiry-based learning may enable the dialogic talk of student teacher to some extent. However, teacher education should focus more on scaffolding student teachers’ talk with their students in all kinds of inquiry approaches.     

Biomechanics - Review of approaches for performance training in spinal manipulation

Motor skills development is an inherent part of clinical training in health disciplines. The conscious use of educational theory to ground learning is receiving increasing attention across health care education. There are three distinct, yet overlapping, stages of motor skill learning; the cognitive, the integrative or associative, and the autonomous; in which a contextual framework for learning content may be structured. The learning is associated with a mapping of changes within the central nervous system by the interactive mechanisms of adaptation, use-dependent plasticity and operant reinforcement. Successful skill learning requires a sufficient amount of practice and the implementation of relevant feedback strategies in the form of knowledge of performance (KP) or knowledge of results (KR). There is a natural maturation of skills that may be accelerated by feedback. Several factors contribute to stronger skills development. "Mixture-of-experts" models systematically sequence tasks into logical blocks of theory, practice and student reflection on performance. Feedback should involve both KP and KR that compares performance to a tangible standard. Rehearsals should balance use of simulators and volunteer simulated patients to provide the full range of safe and effective learning opportunities prior to students accepting a role as care givers to the public in any clinical setting.     

“因材施教”与“循序渐进”——微生物学教学中的“以人为本”教育观浅析

通过分析提出"因材施教"和"循序渐进"是"以人为本"教育观在高校人才培养过程中的具体贯彻和体现;结合微生物学教学实践,从"教"与"学"两个方面阐述了:课堂教学要以学生为中心因材施教,实施基于学生需求和认知能力的教学内容和方法;学生学习要循序渐进,发挥教师主导作用,建立实验与课堂协调促进机制,实现阶段性提高等具体措施,从而进一步阐明了全面落实"以人为本"教育观于微生物学教学的重要性和现实意义。     

On-line integration of computer controlled diagnostic devices and medical information systems in undergraduate medical physics education for physicians

We designed and evaluated an innovative computer-aided-learning environment based on the on-line integration of computer controlled medical diagnostic devices and a medical information system for use in the preclinical medical physics education of medical students. Our learning system simulates the actual clinical environment in a hospital or primary care unit. It uses a commercial medical information system for on-line storage and processing of clinical type data acquired during physics laboratory classes. Every student adopts two roles, the role of ‘patient’ and the role of ‘physician’. As a ‘physician’ the student operates the medical devices to clinically assess ‘patient’ colleagues and records all results in an electronic ‘patient’ record. We also introduced an innovative approach to the use of supportive education materials, based on the methods of adaptive e-learning. A survey of student feedback is included and statistically evaluated.The results from the student feedback confirm the positive response of the latter to this novel implementation of medical physics and informatics in preclinical education. This approach not only significantly improves learning of medical physics and informatics skills but has the added advantage that it facilitates students’ transition from preclinical to clinical subjects.     

对医学研究生教育的实践与思考

医学研究生教育作为我国高等教育的重要组成部分,为国家培养了大批高素质医学人才。本文就我们医学研究生教育的实践,探讨医学研究生教育存在的问题。医学研究生教育应首先应加强医学专业知识的全面学习,做到博学而精深。同时,应注重科研素质和人文素质的培养。最后,医学研究生的教育国际化也是非常重要的一个问题。总之,医学院校研究生教育应更加注重创新性、科研素质、人文素质和国际视野的培养,培养具有国际竞争力的高素质专业医学人才。     

病原生物学专业研究生综合素质培养的探讨

病原生物学是基础医学中一门重要学科,高素质病原生物学人才培养,是适应社会发展、满足社会需求、促进创新型人才建设的关键.作者在实际工作中,注重引导学生学习态度和思维模式的转变,开展多种形式的教学,从学习态度、科研能力、协作能力等方面对病原生物学专业研究生综合素质的培养进行了初步的探讨,把研究生带到知识前沿、形成研究问题、引导批判和创新,使研究生掌握一定的科研思路与科研方法;注重动手能力的训练,严格施教,加强学术道德教育,探索高素质病原生物学研究生培养的新模式.     

Digital gestützte Biodiversitätsexkursionen

Digitally supported excursions focusing on biodiversity The current study was conceived in order to constructively counteract the lack of essential experiences of nature and biodiversity knowledge of students. It combines the three fields “biodiversity”, “education” and “biology instruction“ outside the classroom in a context of environmental education in the Thuringian nature reserve Schiefergebirge/Obere Saale with regard to education as a necessary condition for any planned protection of biodiversity worldwide. The pedagogical proceeding focusing the concept of biodiversity was developed for biology instruction outside the classroom by integrating digital media into the learning process in a constructive way. On the basis of a ten-step procedure, biologically based GPS tours (“biotracks”) were created and tested in practice. For this purpose, two student excursions were designed: the first for grade 7 students in the vicinity of Heberndorf, the second for grade 9 students in the Bleilochstausee region. The results of the knowledge tests and records of the excursion journals from both groups indicate positive effects on studentś biodiversity knowledge. The pre-post questionnaires of the grade 7 students reveal the positive effects of biotracks on studentś attitudes and intentional behavior with respect to biodiversity.     

医学专业学生确立自主学习观的必要性和重要性

目前,高等医学教育的主要任务是培养学生的综合能力,对于医学院校的学生来说,掌握扎实的医学基础知识至关重要。然而,大多医学专业的学生习惯于被动接受老师传授的知识,而严重缺乏主观能动性。医学知识涉及的内容广、难度大,初学者很难迅速掌握其精髓之处,因此确立一种高效的学习模式帮助医学生更好的理解并掌握专业理论是医学院校教育改革的重点。自主学习能力是现代教育学所提倡的相对于传统学习模式的一种现代化学习理念。自主学习的主体是学生,自主学习的过程要求主体发挥其主观能动性,自我督促、自我激励,以独立自主的方式完成高效的学习,帮助学生牢固地掌握专业理论,同时又可以灵活的运用在临床实践中。本文通过对自主学习的含义进行阐述,分析医学生确立自主学习观的必要性和重要性,并对如何确立自主学习观提出相应的建议,以推进我校教育体制改革的进度,进一步完善医学教育教学的质量。     

Introduction and evaluation of case-based learning in the first foundational course of an undergraduate medical curriculum

Case-based learning (CBL) has been proposed as an effective method to promote student knowledge and motivation. The timing and methods for implementation have varied among schools, and data regarding the effectiveness of this pedagogy compared to other learning modalities are inconclusive. We introduced five different cases in the first course of our medical school as part of small-group CBL, and monitored student satisfaction and performance in summative evaluations. We observed that (1) students were very satisfied with the CBL sessions; (2) performance in essay examinations was significantly higher in CBL topics, compared to non-CBL topics, as evaluated at the end of the course, and three months after course conclusion; and (3) there was a trend of higher performance in multiple-choice questions about CBL topics, but this was not statistically significant. Our results indicate that CBL is an acceptable pedagogy to be incorporated from the beginning of undergraduate medical education to promote acquisition and retention of knowledge, students’ interest in foundational sciences, and integration of basic science disciplines and clinical medicine. When evaluating knowledge acquired using the CBL method, integrative essays represent a valuable tool to assess the depth of comprehension and application of information.