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Fulltext Attitude towards problem-based learning and its relationship with locus of control and academic self-concept among medical students

Abdalla MMI, Abdelal MS, Soon SC

Korean J Med Educ, 2019 Mar;31(1):11-18.
PMID: 30852857 DOI: 10.3946/kjme.2019.114

PURPOSE: This study aimed to assess the degree of acceptance of problem-based learning (PBL) among phase one medical students and its association with academic self-concept (ASC) and internal locus of control (ILOC).
METHODS: A 5-point Likert scale valid and reliable questionnaire assessing the attitude towards PBL, ASC, and ILOC was given to phase one medical students at MAHSA University. Data were analysed using IBM SPSS ver. 22.0 (IBM Corp., Armonk, USA).
RESULTS: Out of 255 participants, there were 84 males and 171 females, 175 Malaysians and 80 non-Malaysians. The results showed an overall acceptance of PBL with a mean of 3.7±0.07, ASC of 3.5±0.05 and ILOC of 2.9±0.05. Females showed a higher significant acceptance of PBL, ASC, and ILOC as compared with males. There was no difference between Malaysians and non-Malaysians in any of the variables measured. Simple regression analysis revealed a significant predictive effect of acceptance of PBL on ASC and ILOC (r=0.44 and r=0.88, respectively).
CONCLUSION: The higher the acceptance of PBL among students, the higher is the ASC and ILOC. This reflects the importance of PBL as a teaching method as well as the importance of increasing the level of appreciation of PBL amongst students.

Matched MeSH terms: Education, Medical, Undergraduate/methods*
Clinically oriented physiology teaching: strategy for developing critical-thinking skills in undergraduate medical students

Abraham RR, Upadhya S, Torke S, Ramnarayan K

Adv Physiol Educ, 2004 Dec;28(1-4):102-4.
PMID: 15319191

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.

Matched MeSH terms: Education, Medical, Undergraduate/methods*
Self-directed learning

Abraham RR, Upadhya S, Ramnarayan K

Adv Physiol Educ, 2005 Jun;29(2):135-6.
PMID: 15905163
Matched MeSH terms: Education, Medical, Undergraduate/methods*
A global perspective on the challenges and opportunities in learning about rheumatic and musculoskeletal diseases in undergraduate medical education : White paper by the World Forum on Rheumatic and Musculoskeletal Diseases (WFRMD)

Al Maini M, Al Weshahi Y, Foster HE, Chehade MJ, Gabriel SE, Saleh JA, et al.

Clin Rheumatol, 2020 Mar;39(3):627-642.
PMID: 31127461 DOI: 10.1007/s10067-019-04544-y

Rheumatic and musculoskeletal diseases (RMDs) encompass a spectrum of degenerative, inflammatory conditions predominantly affecting the joints. They are a leading cause of disability worldwide and an enormous socioeconomic burden. However, worldwide deficiencies in adult and paediatric RMD knowledge among medical school graduates and primary care physicians (PCPs) persist. In October 2017, the World Forum on Rheumatic and Musculoskeletal Diseases (WFRMD), an international think tank of RMD and related experts, met to discuss key challenges and opportunities in undergraduate RMD education. Topics included needs analysis, curriculum content, interprofessional education, teaching and learning methods, implementation, assessment and course evaluation and professional formation/career development, which formed a framework for this white paper. We highlight a need for all medical graduates to attain a basic level of RMD knowledge and competency to enable them to confidently diagnose, treat/manage or refer patients. The importance of attracting more medical students to a career in rheumatology, and the indisputable value of integrated, multidisciplinary and multiprofessional care are also discussed. We conclude that RMD teaching for the future will need to address what is being taught, but also where, why and to whom, to ensure that healthcare providers deliver the best patient care possible in their local setting.

Matched MeSH terms: Education, Medical, Undergraduate/methods*
Fulltext Medical students' epistemological beliefs: Implications for curriculum

Assenheimer D, Knox K, Nadarajah VD, Zimitat C

Educ Health (Abingdon), 2016 May-Aug;29(2):107-12.
PMID: 27549647 DOI: 10.4103/1357-6283.188748

BACKGROUND: Epistemological beliefs have a pervasive influence on learning and practice. Understanding these beliefs and how they develop, could play an important role in medical student training and shape later clinical practice.

METHODS: The epistemological beliefs of first-year medical students from an Australian and Malaysian university were explored using a domain-specific instrument.

RESULTS: There were significant differences between the disciplinary epistemological beliefs of Australian and Malaysian medical students across many items, and two specific factors (Certainty of Knowledge and Justification for Knowing).

DISCUSSION: These findings have potential implications for teaching in biomedical disciplines and adaptation of Western curriculum innovations in Eastern educational contexts. Further work is needed to confirm and understand any epistemological differences and subsequent implications for learning and teaching in medicine.

Matched MeSH terms: Education, Medical, Undergraduate/methods*
Training students to learn in a problem-based learning programme

Azer SA

Med Educ, 2011 May;45(5):510.
PMID: 21486331 DOI: 10.1111/j.1365-2923.2011.03952.x
Matched MeSH terms: Education, Medical, Undergraduate/methods*
Training surgeons to teach anatomy: an innovative approach

Azer SA

Med Educ, 2010 Nov;44(11):1128-9.
PMID: 20946493 DOI: 10.1111/j.1365-2923.2010.03836.x
Matched MeSH terms: Education, Medical, Undergraduate/methods*
Model construction by students within an integrated medical curriculum

Barling PM, Ramasamy P

Clin Teach, 2011 Mar;8(1):37-42.
PMID: 21324071 DOI: 10.1111/j.1743-498X.2010.00419.x

This paper presents our experience of running a special study module (SSM) in the second semester of the first year of our 5-year medical programme, worth 10 per cent of that semester's assessment, in which each student constructs an individually selected model illustrating a specific aspect of the teaching course.

Matched MeSH terms: Education, Medical, Undergraduate/methods*
An approach to enrich online medical Problem-Based Learning with tacit healthcare knowledge

Cheah YN, Rashid FA, Abidi SS

Stud Health Technol Inform, 2003;95:744-9.
PMID: 14664077

Existing Problem-Based Learning (PBL) problems, though suitable in their own right for teaching purposes, are limited in their potential to evolve by themselves and to create new knowledge. Presently, they are based on textbook examples of past cases and/or cases that have been transcribed by a clinician. In this paper, we present (a) a tacit healthcare knowledge representation formalism called Healthcare Scenarios, (b) the relevance of healthcare scenarios in PBL in healthcare and medicine, (c) a novel PBL-Scenario-based tacit knowledge explication strategy and (d) an online PBL Problem Composer and Presenter (PBL-Online) to facilitate the acquisition and utilisation of expert-quality tacit healthcare knowledge to enrich online PBL. We employ a confluence of healthcare knowledge management tools and Internet technologies to bring tacit healthcare knowledge-enriched PBL to a global and yet more accessible level.

Matched MeSH terms: Education, Medical, Undergraduate/methods*
Fulltext Stimulating student interest in physiology: the intermedical school physiology quiz

Cheng HM

Adv Physiol Educ, 2010 Mar;34(1):20-1.
PMID: 20237230 DOI: 10.1152/advan.00096.2009
Matched MeSH terms: Education, Medical, Undergraduate/methods*
Design, Implementation, and Evaluation of a Simulation-Based Clinical Correlation Curriculum as an Adjunctive Pedagogy in an Anatomy Course

Coombs CM, Shields RY, Hunt EA, Lum YW, Sosnay PR, Perretta JS, et al.

Acad Med, 2017 04;92(4):494-500.
PMID: 27680320 DOI: 10.1097/ACM.0000000000001387

PROBLEM: Because reported use of simulation in preclinical basic science courses is limited, the authors describe the design, implementation, and preliminary evaluation of a simulation-based clinical correlation curriculum in an anatomy course for first-year medical students at Perdana University Graduate School of Medicine (in collaboration with Johns Hopkins University School of Medicine).
APPROACH: The simulation curriculum, with five weekly modules, was a component of a noncadaveric human anatomy course for three classes (n = 81 students) from September 2011 to November 2013. The modules were designed around major anatomical regions (thorax; abdomen and pelvis; lower extremities and back; upper extremities; and head and neck) and used various types of simulation (standardized patients, high-fidelity simulators, and task trainers). Several methods were used to evaluate the curriculum's efficacy, including comparing pre- versus posttest scores and comparing posttest scores against the score on 15 clinical correlation final exam questions.
OUTCOMES: A total of 81 students (response rate: 100%) completed all pre- and posttests and consented to participate. Posttest scores suggest significant knowledge acquisition and better consistency of performance after participation in the curriculum. The comparison of performance on the posttests and final exam suggests that using simulation as an adjunctive pedagogy can lead to excellent short-term knowledge retention.
NEXT STEPS: Simulation-based medical education may prove useful in preclinical basic science curricula. Next steps should be to validate the use of this approach, demonstrate cost-efficacy or the "return on investment" for educational and institutional leadership, and examine longer-term knowledge retention.

Matched MeSH terms: Education, Medical, Undergraduate/methods*
The role of student surgical interest groups and surgical Olympiads in anatomical and surgical undergraduate training in Russia

Dydykin S, Kapitonova M

Anat Sci Educ, 2015 Sep-Oct;8(5):471-7.
PMID: 25688979 DOI: 10.1002/ase.1523

Traditional department-based surgical interest groups in Russian medical schools are useful tools for student-based selection of specialty training. They also form a nucleus for initiating research activities among undergraduate students. In Russia, the Departments of Topographical Anatomy and Operative Surgery play an important role in initiating student-led research and providing learners with advanced, practical surgical skills. In tandem with department-led activities, student surgical interest groups prepare learners through surgical competitions, known as "Surgical Olympiads," which have been conducted in many Russian centers on a regular basis since 1988. Surgical Olympiads stimulate student interest in the development of surgical skills before graduation and encourage students to choose surgery as their postgraduate specialty. Many of the participants in these surgical Olympiads have become highly qualified specialists in general surgery, orthopedic surgery, neurosurgery, urology, gynecology, and emergency medicine. The present article emphasizes the role of student interest groups and surgical Olympiads in clinical anatomical and surgical undergraduate training in Russia.

Matched MeSH terms: Education, Medical, Undergraduate/methods*
Effects of brief psychoeducational program on stigma in Malaysian pre-clinical medical students: a randomized controlled trial

Fernandez A, Tan KA, Knaak S, Chew BH, Ghazali SS

Acad Psychiatry, 2016 Dec;40(6):905-911.
PMID: 27527730

OBJECTIVE:
If presented with serious mental illness (SMI), individuals' low help-seeking behaviors and poor adherence to treatment are associated with negative stereotypes and attitudes of healthcare providers. In this study, we examined the effects of a brief psychoeducational program on reducing stigma in pre-clinical medical students.

METHODS: One hundred and two pre-clinical medical students (20-23 years old) were randomly assigned to face-to-face contact + educational lecture (n = 51) condition or video-based contact + educational lecture (n = 51) condition. Measures of pre-clinical medical students' mental illness-related stigma using the Opening Minds Stigma Scale for Health Care Providers (OMS-HC) were administered at pre-, post-treatment, and 1-month follow-up.
RESULTS: A 2 (condition: face-to-face contact + educational lecture, video-based contact + educational lecture) by 3 (time: pre-treatment, post-treatment, and 1-month follow-up) mixed model MANOVA was conducted on the Attitudes, Disclosure and Help-Seeking, and Social Distance OMS-HC subscales. Participants' scores on all subscales changed significantly across time, regardless of conditions. To determine how participants' scores changed significantly over time on each subscale, Bonferroni follow-up comparisons were performed to access pairwise differences for the main effect of time. Specifically, pairwise comparisons produced a significant reduction in Social Distance subscale between pre-treatment and post-treatment and between pre-treatment and 1-month follow-up, and a significant increase between post-treatment and 1-month follow-up, regardless of conditions. With respect to the Attitudes and Disclosure and Help-Seeking subscales, pairwise comparisons produced a significant reduction in scores between pre-treatment and post-treatment and a significant increase between post-treatment and 1-month follow-up.
CONCLUSIONS: Our findings provide additional evidence that educational lecture on mental illness, coupled with either face-to-face contact or video-based contact, is predictive of positive outcomes in anti-stigma programs targeting future healthcare providers.
KEYWORDS: Face-to-face contact; Stigma; Video-based contact

Matched MeSH terms: Education, Medical, Undergraduate/methods*
The missing link: introducing travel medicine into the undergraduate medical curriculum

Flaherty G, Thong Zi Yi C, Browne R

J Travel Med, 2016 May;23(5).
PMID: 27378364 DOI: 10.1093/jtm/taw038
Matched MeSH terms: Education, Medical, Undergraduate/methods*
Dance, drama and laughter: the best medicine

Foong CC, Tong WT, Daniel EG, Vadivelu J

Med Educ, 2013 May;47(5):516-7.
PMID: 23574067 DOI: 10.1111/medu.12155

Study site: Universiti Malaya, Phase 2 clinical students.

Matched MeSH terms: Education, Medical, Undergraduate/methods*
Fulltext Answering questions in a co-created formative exam question bank improves summative exam performance, while students perceive benefits from answering, authoring, and peer discussion: A mixed methods analysis of PeerWise

Guilding C, Pye RE, Butler S, Atkinson M, Field E

Pharmacol Res Perspect, 2021 Aug;9(4):e00833.
PMID: 34309243 DOI: 10.1002/prp2.833

Multiple choice questions (MCQs) are a common form of assessment in medical schools and students seek opportunities to engage with formative assessment that reflects their summative exams. Formative assessment with feedback and active learning strategies improve student learning outcomes, but a challenge for educators, particularly those with large class sizes, is how to provide students with such opportunities without overburdening faculty. To address this, we enrolled medical students in the online learning platform PeerWise, which enables students to author and answer MCQs, rate the quality of other students' contributions as well as discuss content. A quasi-experimental mixed methods research design was used to explore PeerWise use and its impact on the learning experience and exam results of fourth year medical students who were studying courses in clinical sciences and pharmacology. Most students chose to engage with PeerWise following its introduction as a noncompulsory learning opportunity. While students perceived benefits in authoring and peer discussion, students engaged most highly with answering questions, noting that this helped them identify gaps in knowledge, test their learning and improve exam technique. Detailed analysis of the 2015 cohort (n = 444) with hierarchical regression models revealed a significant positive predictive relationship between answering PeerWise questions and exam results, even after controlling for previous academic performance, which was further confirmed with a follow-up multi-year analysis (2015-2018, n = 1693). These 4 years of quantitative data corroborated students' belief in the benefit of answering peer-authored questions for learning.

Matched MeSH terms: Education, Medical, Undergraduate/methods*
Anatomy education environment measurement inventory: A valid tool to measure the anatomy learning environment

Hadie SNH, Hassan A, Ismail ZIM, Asari MA, Khan AA, Kasim F, et al.

Anat Sci Educ, 2017 Sep;10(5):423-432.
PMID: 28135037 DOI: 10.1002/ase.1683

Students' perceptions of the education environment influence their learning. Ever since the major medical curriculum reform, anatomy education has undergone several changes in terms of its curriculum, teaching modalities, learning resources, and assessment methods. By measuring students' perceptions concerning anatomy education environment, valuable information can be obtained to facilitate improvements in teaching and learning. Hence, it is important to use a valid inventory that specifically measures attributes of the anatomy education environment. In this study, a new 11-factor, 132-items Anatomy Education Environment Measurement Inventory (AEEMI) was developed using Delphi technique and was validated in a Malaysian public medical school. The inventory was found to have satisfactory content evidence (scale-level content validity index [total] = 0.646); good response process evidence (scale-level face validity index [total] = 0.867); and acceptable to high internal consistency, with the Raykov composite reliability estimates of the six factors are in the range of 0.604-0.876. The best fit model of the AEEMI is achieved with six domains and 25 items (X2 = 415.67, P

Matched MeSH terms: Education, Medical, Undergraduate/methods*
Fulltext Pathology crossword competition: an active and easy way of learning pathology in undergraduate medical education

Htwe TT, Sabaridah I, Rajyaguru KM, Mazidah AM

Singapore Med J, 2012 Feb;53(2):121-3.
PMID: 22337187

INTRODUCTION:
In line with the trend to engage students in active learning, it is imperative to introduce new strategies that make learning more interesting, especially in undergraduate curricula. This study aimed to determine students' performance and perception in pathology crosswords as an active way of learning and to assess their ability to memorise difficult terms in pathology.

METHODS:
A crossword competition in pathology was conducted for two batches (year 2009 and 2010) of Phase 2 medical students in Malaysia. Crossword puzzles were prepared using an online application. Two sets of puzzles were prepared, with 20 questions for the assessment of general pathology and 20 for systemic pathology. The purpose was to compare the students' recent and remote memorising abilities, as general pathology was taught a year before proceeding to systemic pathology teaching. There were 12 groups per batch, with 8-10 students in a group. Survey questionnaires were used to assess the students' perception of the competition. Descriptive analysis was performed for comparison of performance.

RESULTS:
The mean score of correctly answered questions in general pathology was 12.75 and 11.50 in batch 2009 and 2010, respectively. The mean score for systemic pathology was 14.50 in 2009 and 13.83 in 2010. Students in the 2009 batch performed better, but this was not statistically significant (p-value > 0.05). A positive response was observed from the questionnaires.

CONCLUSION:
Applying crossword puzzles as a new strategy is a useful and easy way for undergraduate medical students to learn pathology.

Matched MeSH terms: Education, Medical, Undergraduate/methods*
Fulltext Comparative assessment of students' performance and perceptions on objective structured practical models in undergraduate pathology teaching

Htwe TT, Ismail SB, Low GK

Singapore Med J, 2014 Sep;55(9):502-5.
PMID: 25273936

INTRODUCTION: Assessment is an important factor that drives student learning, as students tend to mainly focus on the material to be assessed. The current practice in teaching pathology extensively applies objective-structured practical examination for the assessment of students. As students will have to deal with real patients during clinical years, it is preferred that students learn and practise via potted specimens and slides instead of picture plates. This study aimed to assess the preferred assesment method of pathology practical exercises.

METHODS: This was a cross-sectional survey carried out in two consecutive batches of Phase 2 medical students. Student competency was assessed using both the traditional (TD) (i.e. use of potted specimens and slides) and picture plate (PP) methods. To compare the two assessment methods, we compared the mean scores obtained by the students and examined student perception of the two methods.

RESULTS: The mean scores obtained via the PP method were significantly higher than those obtained via the TD method for almost all the components tested.

CONCLUSION: We found that students performed significantly better (p < 0.05) when assessed using the PP method instead of the TD method. PP preparations might provide better visuals, thus aiding understanding, than the TD method. The findings of this study are valuable in identifying and improving our current teaching and assessment methods of medical students, in line with advancements in information technology.

Matched MeSH terms: Education, Medical, Undergraduate/methods*
Fulltext A randomised controlled trial of a blended learning education intervention for teaching evidence-based medicine

Ilic D, Nordin RB, Glasziou P, Tilson JK, Villanueva E

BMC Med Educ, 2015;15:39.
PMID: 25884717 DOI: 10.1186/s12909-015-0321-6

BACKGROUND: Few studies have been performed to inform how best to teach evidence-based medicine (EBM) to medical trainees. Current evidence can only conclude that any form of teaching increases EBM competency, but cannot distinguish which form of teaching is most effective at increasing student competency in EBM. This study compared the effectiveness of a blended learning (BL) versus didactic learning (DL) approach of teaching EBM to medical students with respect to competency, self-efficacy, attitudes and behaviour toward EBM.
METHODS: A mixed methods study consisting of a randomised controlled trial (RCT) and qualitative case study was performed with medical students undertaking their first clinical year of training in EBM. Students were randomly assigned to receive EBM teaching via either a BL approach or the incumbent DL approach. Competency in EBM was assessed using the Berlin questionnaire and the 'Assessing Competency in EBM' (ACE) tool. Students' self-efficacy, attitudes and behaviour was also assessed. A series of focus groups was also performed to contextualise the quantitative results.
RESULTS: A total of 147 students completed the RCT, and a further 29 students participated in six focus group discussions. Students who received the BL approach to teaching EBM had significantly higher scores in 5 out of 6 behaviour domains, 3 out of 4 attitude domains and 10 out of 14 self-efficacy domains. Competency in EBM did not differ significantly between students receiving the BL approach versus those receiving the DL approach [Mean Difference (MD)=-0.68, (95% CI-1.71, 0.34), p=0.19]. No significant difference was observed between sites (p=0.89) or by student type (p=0.58). Focus group discussions suggested a strong student preference for teaching using a BL approach, which integrates lectures, online learning and small group activities.
CONCLUSIONS: BL is no more effective than DL at increasing medical students' knowledge and skills in EBM, but was significantly more effective at increasing student attitudes toward EBM and self-reported use of EBM in clinical practice. Given the various learning styles preferred by students, a multifaceted approach (incorporating BL) may be best suited when teaching EBM to medical students. Further research on the cost-effectiveness of EBM teaching modalities is required.

Matched MeSH terms: Education, Medical, Undergraduate/methods*

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