An evaluation of case-based teaching: evidence for continuing benefit and realization of aims

A cross-sectional evaluation of case-based teaching (CBT), a novel physiology learning environment for medical undergraduates, revealed that second, third, and fourth year students, together with their tutors, valued CBT as an experience that met its three major aims. The initiative not only integrated physiology with related basic sciences and clinical medicine but importantly linked students' developing knowledge of theory to practice. CBT was also valued by students as their first introduction to clinical skills, with most tutors believing that it was the nonthreatening environment that helped students gain confidence for their first "real patient" encounters. The greatest support for CBT came from third year medical students, at the crossroads between their preclinical and clinical environments. Fourth year students, now encountering real patients, had moved on to developing their skills in the hospital environment.     

A review of bioinformatics education in the UK

If the completion of the first draft of the human genome represents the coming of age of bioinformatics, then the emergence of bioinformatics as a university degree subject represents its establishment. In this paper bioinformatics as a subject for formal study is discussed, rather than as a subject for research, and a selection of the taught, mainly graduate, courses currently available in the UK are reviewed. Throughout, the author tries to draw parallels between the integration of bioinformatics into biomedical research and teaching today, and that of molecular biology, two decades ago. Others have made this analogy between these two relatively young disciplines. Although research sources are referenced, the author makes no pretence of objectivity. This article contains his opinions, and those of a number of current bioinformatics course organisers whose comments on the subject were solicited in advance specifically for this paper. The course organisers kindly advised how they planned their curricula, and described the special strengths of their programmes. Comments from present and former students of several bioinformatics degree programmes were also solicited. Except where individuals are directly quoted, any opinions expressed herein should be considered the author's. Compared with its sister piece [Marion Zatz, in previous issue of Briefings in Bioinformatics pp. 353], this paper is less about funding policy--which, in the UK, has lately (if belatedly) been more generous towards bioinformatics teaching--than it is about practice and content; the requirements of the bioinformatics research communities, the corresponding emphases of bioinformatics courses, and the general market for holders of bioinformatics degrees. Individual courses are cited throughout as examples, but the final section contains a full annotated listing with URL addresses. Based on the author's own experience of practising and teaching bioinformatics, he describes the skills he believes will be most useful to bioinformaticians in the near future and suggests ways to prepare students of bioinformatics for a fall in demand for those abilities.     

Preparing physicians to utilize the emerging genetic toolbox: an approach for medical biochemistry

New genetic information is accumulating so rapidly that even the most current material given to first or second year medical students about any specific genetic disease may be incomplete if not obsolete before they obtain the M.D. degree. Therefore, medical education must emphasize the principles of molecular biology and genetics while providing students with the skills to independently obtain up-to-date genetic information following graduation. An assignment that requires students to acquire details about a particular genetic disease from various on-line resources is one method being used to accomplish the latter goal.     

Students online: learning medical genetics.

It is possible to focus medical genetics education by using a model that integrates the skills of end-user searching of the medical literature into the traditional course content. Since 1988, 313 first-year medical students were studied as they accessed MEDLINE to retrieve information about biochemical genetic disorders. Their search behavior was studied by analyzing data from the National Library of Medicine's traffic files. The skills that they initially learned were reinforced as they searched clinical genetics problem cases in the second-year pathology course, and these skills were consolidated in the third year when the students addressed specific patient-care questions in pediatrics. The students' perception of the value of this model was studied by analyzing questionnaires completed during the exercise. It was demonstrated that when students were taught the skills of accessing MEDLINE by computer, they could formulate a question, retrieve current information, critically review relevant articles, communicate effectively, and use these skills to contribute to patient care.     

Use of Learning Media by Undergraduate Medical Students in Pharmacology: A Prospective Cohort Study

The ubiquity of the internet and computer-based technologies has an increasing impact on higher education and the way students access information for learning. Moreover, there is a paucity of information about the quantitative and qualitative use of learning media by the current student generation. In this study we systematically analyzed the use of digital and non-digital learning resources by undergraduate medical students. Daily online surveys and semi-structured interviews were conducted with a cohort of 338 third year medical students enrolled in a general pharmacology course. Our data demonstrate a predominant use of digital over non-digital learning resources (69 ± 7% vs. 31 ± 7%; p < 0.01) by students. Most used media for learning were lecture slides (26.8 ± 3.0%), apps (22.0 ± 3.7%) and personal notes (15.5 ± 2.7%), followed by textbooks (> 300 pages) (10.6 ± 3.3%), internet search (7.9 ± 1.6%) and e-learning cases (7.6 ± 3.0%). When comparing learning media use of teaching vs. pre-exam self-study periods, textbooks were used significantly less during self-study (-55%; p < 0.01), while exam questions (+334%; p < 0.01) and e-learning cases (+176%; p < 0.01) were utilized more. Taken together, our study revealed a high prevalence and acceptance of digital learning resources by undergraduate medical students, in particular mobile applications.     

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。     

Variability Is Not the Villain: Finding Patterns in Complex Natural Images

Everyone needs strong observational skills to solve challenging problems and make informed decisions. However, many students expect to find exact answers to their questions by using the internet and do not understand the role of uncertainty, especially in decision making and scientific research. Humans and other animals choose among many options by using information about their environment. During this activity, students use their observational skills to analyze data from images of grass shrimp and a highly variable salt-marsh habitat as case studies for prioritizing different pieces of information. They gain an increased appreciation of natural variability and learn to build a consensus in a scenario that has no correct answer.     

Can students learn clinical method in general practice? A randomised crossover trial based on objective structured clinical examinations.

OBJECTIVE: To determine whether students acquired clinical skills as well in general practice as in hospital and whether there was any difference in the acquisition of specific skills in the two environments. DESIGN: Randomised crossover trial. SUBJECTS AND SETTING: Annual intake of first year clinical students at one medical school. INTERVENTION: A 10 week block of general internal medicine, one half taught in general practice, the other in hospital. Students started at random in one location and crossed over after five weeks. OUTCOME MEASURES: Students'' performance in two equivalent nine station objective structured clinical examinations administered at the mid and end points of the block: a direct comparison of the two groups'' performance at five weeks; analysis of covariance, using their first examination scores as a covariate, to determine students'' relative improvement over the second five weeks of their attachment. RESULTS: 225 students rotated through the block; all took at least one examination and 208 (92%) took both. For the first half of the year there was no significant difference in the students'' acquisition of clinical skills in the two environments; later, however, students taught in general practice improved slightly more than those taught in hospital (P = 0.007). CONCLUSIONS: Students can learn clinical skills as well in general practice as in hospital; more work is needed to clarify where specific skills, knowledge, and attitudes are best learnt to allow rational planning of the undergraduate curriculum.     

PBL教学法在医学寄生虫学教学中的几点体会

目前全国高等医学院校医学寄生虫学学时大大减少,有的院校列为考查课,有的列为选修课。在此情况下,医学寄生虫学实验所占学时更是少之又少,如何利用好有限课时,使学生最大限度地吸收、掌握教学内容,已成为摆在高校师生面前的一道难题。传统的教学方法以讲授为主,容易忽视学生学习的主动性和积极性。而应用了PBL(problem based learning)教学法,其基本要点是以学生为中心、基于问题、综合地、相互合作和交互式地学习,有助于培养和提高学生在自学、实验技术、团队合作、分析问题和解决问题等方面的能力,激发学生学习的积极性和主动性。     

Digital game design-based STEM activity: Biodiversity example

Abstract

The purpose of this study is to design a digital game design-based STEM activity for fifth-grade students learning about endangered organisms and significance of biodiversity for living. This activity was carried out with twenty students in a public school in Eastern Black Sea Region of Turkey during academic year of 2018–2019 spring term. This study planned as eight-lesson time (8?×?40?minutes) and completed at this lesson time. The students were given the digital game design challenge in real-life problem context that has been created based on design-based science learning and for which they shall use their knowledge and skills in each of the STEM disciplines. During this design challenge, students worked like a scientist and an engineer. They carried out scientific research and inquiry process in the science discipline, understood the engineering design process in the engineering discipline, established mathematical relations in the mathematics discipline, learned how to make coding in the technology discipline, and used this knowledge and skills thus acquired in their suggested solutions for the design challenge. They designed a digital game by coding and presented science knowledge and skills that acquired from inquiry process.     

浅谈对医学生临床思维与临床技能提高的培养

为适应目前医学事业发展的需要,医学生的临床思维与临床技能的培养至关重要。在教学中,应不断提高教师自身的业务水平和自身素质,给予学生适当引导和启发,采取灵活多样的教学方式,并鼓励学生学会独立思考能力,激发学生的主动性和创造性,同时理论与实践相结合,推出模拟教学,由此激发学生的学习兴趣;并通过病例的采集归纳和整理,加强基本功的训练。从而提高学生临床思维能力与标准实践技能。     

Medical decision making and medical education: challenges and opportunities

The Flexner Report highlighted the importance of teaching medical students to reason about uncertainty. The science of medical decision making seeks to explain how medical judgments and decisions ought ideally to be made, how they are actually made in practice, and how they can be improved, given the constraints of medical practice. The field considers both clinical decisions by or for individual patients and societal decisions designed to benefit the public. Despite the relevance of decision making to medical practice, it currently receives little formal attention in the U.S. medical school curriculum. This article suggests three roles for medical decision making in medical education. First, basic decision science would be a valuable prerequisite to medical training. Second, several decision-related competencies would be important outcomes of medical education; these include the physician's own decision skills, the ability to guide patients in shared decisions, and knowledge of health policy decisions at the societal level. Finally, decision making could serve as a unifying principle in the design of the medical curriculum, integrating other curricular content around the need to create physicians who are competent and caring decision makers.     

A fitness screening model for increasing fitness assessment and research experiences in undergraduate exercise science students

When students analyze and present original data they have collected, and hence have a cultivated sense of curiosity about the data, student learning is enhanced. It is often difficult to provide students an opportunity to practice their skills, use their knowledge, and gain research experiences during a typical course laboratory. This article describes a model of an out-of-classroom experience during which undergraduate exercise science students provide a free health and fitness screening to the campus community. Although some evidence of the effectiveness of this experience is presented, this is not a detailed evaluation of either the service or learning benefits of the fitness screening. Working in small learning groups in the classroom, students develop hypotheses about the health and fitness of the population to be screened. Then, as part of the health and fitness screening, participants are evaluated for muscular strength, aerobic fitness, body composition, blood pressure, physical activity, and blood cholesterol levels. Students then analyze the data collected during the screening, accept or reject their hypotheses based on statistical analyses of the data, and make in-class presentations of their findings. This learning experience has been used successfully to illustrate the levels of obesity, hypercholesterolemia, and lack of physical fitness in the campus community as well as provide an opportunity for students to use statistical procedures to analyze data. It has also provided students with an opportunity to practice fitness assessment and interpersonal skills that will enhance their future careers.     

Linking cardiovascular theory to practice in an undergraduate medical curriculum

Case-based teaching (CBT) tutorials were introduced by the Physiology Department at Adelaide University to bridge the gap between theory and practice in the early years of undergraduate medical education. With the use of a clinical case-based environment, CBT aimed to achieve integration of structure-function relationships and an increase in students' capacity to apply a physiological understanding to clinical observations/symptoms and data. With peer-peer interactions in small groups, students could trial history taking and examination skills, interpret common investigations, and relate their findings to an understanding of structure and function. Here, the cardiovascular tutorials highlight the centrality of an understanding of structure and function in the evaluation of a case of syncope. An independent evaluation of the students' learning experience demonstrated that CBT tutorials were successful in their aims. The "hands-on" experience was highly rated, with students reporting that the CBT approach gave relevance to structure and function. Whatever the curriculum learning style, underpinning practice with an understanding of theory remains a desirable feature of medical education.     

EvoS: A Prescription for What Ails Pre-Medical Education?

Pre-medical students are certainly a widely varied group, with different motivations and experiences, different skills sets and interests. However, they often tend to approach their undergraduate education as a necessary evil that they must endure in order to achieve their ultimate goals. This article summarizes recent literature addressing some of the questions that have been raised regarding pre-medical education programs. Are students prepared for the intellectual, emotional, and even physical challenges of medical training? What deficiencies are commonly seen in entering medical students? What are students’ perceptions of how well their pre-medical studies helped them? Many of these studies have resulted in a call for more science training, while some have advocated for less, but with an enhanced focus on humanistic studies. We supply a brief outline of our Evolutionary Studies (EvoS) program and reflect upon how participation in this program can enhance pre-medical students’ education. Importantly, we argue that EvoS can expand students’ depth of understanding of science, as well as nurture their ability to think about the needs of their patients and the context of their medical practice.