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Adopting programmatic feedback to enhance the learning of complex skills

Yusoff MS, Hadie SN, Abdul Rahim AF

Med Educ, 2014 Feb;48(2):108-10.
PMID: 24528391 DOI: 10.1111/medu.12403
Matched MeSH terms: Education, Medical, Undergraduate/methods*
The BigSib students' peer group mentoring programme

Yusoff MS, Rahim AF, Noor AR, Yaacob NA, Hussin ZA

Med Educ, 2009 Nov;43(11):1106.
PMID: 19874517 DOI: 10.1111/j.1365-2923.2009.03459.x
Matched MeSH terms: Education, Medical, Undergraduate/methods*
Community Residency Programme (CRP)--a tool for research and rural health training for medical students

Yadav H

Med J Malaysia, 2002 Dec;57 Suppl E:94-8.
PMID: 12733201

Rural health training is an important element in the training of medical students in the University of Malaya. There is a need for the undergraduates to be familiar with the rural health infrastructure and to understand the social and economic aspects of the rural poor. The objective of the training is to make the students understand the problems faced by the poor in the rural areas so that when they practice in rural health areas, after graduation, they will understand the problems of the rural poor. They will have the knowledge of the diseases in the rural areas and also understand the community and the environmental factors that contribute to the disease. The training lasts' for 4 weeks, one week for lectures on health survey, two weeks for the field trip and one week of data analysis and presentation of their findings to an expert panel. During the field trip the students are divided into groups and they go to different parts of the country. Each group will do a field survey to find out the socio-demography, environmental, economic, nutritional and health problems in the village. In addition to the survey they also do a research project on any topic. The students also do social work, visit places of public health interest like the water treatment plant, sewage disposal, factory visits and others. Apart from technical skills in statistics and epidemiology, various other managerial skills like leadership, teamwork, communications and public relations are also learnt during the training. In conclusion this rural health training is an important aspect of the medical students training as it imparts several skills to them that are needed as a doctor.

Matched MeSH terms: Education, Medical, Undergraduate/methods*
Fulltext Using an integrated teaching approach to facilitate student achievement of the learning outcomes in a preclinical medical curriculum in India

Vashe A, Devi V, Rao R, Abraham RR, Pallath V, Umakanth S

Adv Physiol Educ, 2019 Dec 01;43(4):522-528.
PMID: 31642706 DOI: 10.1152/advan.00067.2019

Today most education institutions around the world have adopted the philosophy of outcome-based education. The emphasis in outcome-based education is achievement of outcomes; hence the curriculum should be designed in a way that it includes the components targeted specifically at achieving these outcomes. A discipline-based approach results in fragmentation of learning and lack of clinical applicability. Integrated teaching could be a solution to achieve required outcomes in a holistic way. Hence, the aim of this study was to develop, implement, and evaluate an integrated teaching module. Temporal coordination of the basic sciences, along with correlation of learned topics to clinical settings, was done in the first year of the undergraduate medical program. The module was evaluated by obtaining qualitative and quantitative feedback from students. Student assessment was conducted with a test that had case vignettes and multiple-choice questions. In addition, students' change in learning approaches and self-directed learning readiness were collected. Students' perception regarding the educational environment was also obtained. Analysis of the data showed positive feedback from the students regarding the integrated teaching. Students' average score in the test was 86%. There was a significant increase in the scores for the deep approach and self-directed learning readiness in the posttest compared with the pretest. Moreover, students were found to be satisfied with the educational environment. Evaluation of integrated teaching revealed that it was well accepted by the students. Moreover, it facilitated the achievement of the students' outcomes.

Matched MeSH terms: Education, Medical, Undergraduate/methods*
Discovering potential, transforming life

Van Rostenberghe H, Yusoff MS, Jie TY, Shamsuddin S, Ibrahim WP

Med Educ, 2010 May;44(5):504-5.
PMID: 20518994 DOI: 10.1111/j.1365-2923.2010.03647.x
Matched MeSH terms: Education, Medical, Undergraduate/methods*
Evaluation of basic science knowledge retention in clinical teaching

Vadivelu J

Med Educ, 2008 May;42(5):520-1.
PMID: 18412895 DOI: 10.1111/j.1365-2923.2008.03047.x
Matched MeSH terms: Education, Medical, Undergraduate/methods*
Peer-guided cooperative learning enhances the performance of refresher students

Torke S, Abraham RR, Ramnarayan K, Upadhya S

Adv Physiol Educ, 2007 Mar;31(1):118.
PMID: 17327594
Matched MeSH terms: Education, Medical, Undergraduate/methods*
Fulltext Should clinical normality be examined in medical course?

Tiong TS

Singapore Med J, 2008 Apr;49(4):328-32.
PMID: 18418526

INTRODUCTION: In medical practice, some patients consult doctors for reassurance of normality, e.g. patients with throat discomfort. Therefore, medical graduates should be competent in diagnosing clinical normality. One way to assess clinical competence is by the objective structured clinical examination (OSCE).
METHODS: In 2002-2006, five batches of medical students who completed their otorhinolaryngology posting in Universiti Malaysia Sarawak were examined with the same OSCE question on clinically normal vocal cords. There were five subquestions concerning structures, clinical features, diagnosis and management. All students had prior slide show sessions regarding normal and abnormal laryngeal conditions.
RESULTS: The total number of students in 2002, 2003, 2004, 2005 and 2006 was 25, 41, 20, 30 and 16, respectively, and 100 percent responded. The average percentage of students with correct answers was 19.4, 2.4, 2.2, 21.2, and 2.4, in the subquestions 0.1 to 0.5, respectively, leaving the remaining relatively larger percentages with incorrect answers of various clinical abnormalities. A reason for these findings is examination fever by the students, who also assumed that all the stations had clinical abnormalities and required differentiating abnormalities from abnormalities, and not from normality. Without clinical normality OSCE questions, the assessment of the undergraduates' clinical competence in real life would seem incomplete.
CONCLUSION: This study showed that a significantly large percentage of students answered incorrectly in the clinical normality OSCE. This may mean that more clinical normality OSCE questions should be included in the undergraduate medical examination to help undergraduates practise the need to look for, and become competent in, clinical normality in real life.

Matched MeSH terms: Education, Medical, Undergraduate/methods*
Teaching of pharmacology in Universiti Malaya and the other medical schools in Malaysia -- a historical perspective

Sim SM

Acta Pharmacol Sin, 2004 Sep;25(9):1209-19.
PMID: 15339399

Traditional pharmacology teaching has focused more on drug instead of therapeutics, such that although pharmacological knowledge is acquired, practical skills in prescribing remain weak. In Malaysia many new medical schools (both public and private) have been set up in the last 12 years due to a change in government policy, resulting in a wide spectrum of medical curricula. Universiti Malaya (UM) being the oldest medical school in Malaysia was deep set in its traditional way of teaching-learning, since its inception in 1962, until a visit from the General Medical Council of the United Kingdom in 1984 triggered off a change of tide. Since then the medical curriculum in UM has undergone two major revisions. The first revised curriculum (1988) aimed to inject more clinical relevance into basic science teaching, through introducing clinical lectures and skills in the paraclinical year. Professional behaviour was also addressed. The second revised curriculum (1998) sought to improve further the integration of knowledge as well as to produce a holistic doctor, viewing the patient as a person instead of a clinical entity. The teaching-learning of pharmacology has gradually moved from factual regurgitation to more clinical reasoning, from lab-based to more patient-oriented approach. As more new medical schools are being set up in Malaysia, exchange of experience in this area of learning will hopefully help us find a happy medium between "the old is best" and "the new is better" type approach so that a pedagogically sound and yet logistically practical curriculum can be found in our local setting, to help produce doctors with good prescribing practice.

Matched MeSH terms: Education, Medical, Undergraduate/methods*
Fulltext Integrating an open-source course management system (Moodle) into the teaching of a first-year medical physiology course: a case study

Seluakumaran K, Jusof FF, Ismail R, Husain R

Adv Physiol Educ, 2011 Dec;35(4):369-77.
PMID: 22139773 DOI: 10.1152/advan.00008.2011

Educators in medical schools around the world are presently experimenting with innovative ways of using web-based learning to supplement the existing teaching and learning process. We have recently used a popular open-source course management system (CMS) called the modular object-oriented dynamic learning environment (Moodle) to construct an online site (DPhysiol) to facilitate our face-to-face teaching of physiology to a group of first-year students in the Bachelor of Medicine and Bachelor of Surgery program. The integration of the Moodle site into our teaching was assessed using online log activity, student examination marks, and feedback from students. The freely available Moodle platform was simple to use, helped to effectively deliver course materials, and has features that allowed cooperative learning. Students who used the CMS throughout their academic year and commented favorably regarding its use as a complement to the face-to-face classroom sessions. The group of students used the CMS obtained significantly higher scores in the final examination compared with the previous class that did not use the CMS. In addition, there was a significant correlation between student participation and performance in online quizzes and their final examination marks. However, students' overall online usage of the CMS did not correlate with their examination marks. We recommend Moodle as a useful tool for physiology educators who are interested in integrating web-based learning into their existing teaching curriculum.

Matched MeSH terms: Education, Medical, Undergraduate/methods*
Fulltext Professionalism development of undergraduate medical students: Effect of time and transition

Sattar K, Akram A, Ahmad T, Bashir U

Medicine (Baltimore), 2021 Mar 05;100(9):e23580.
PMID: 33655905 DOI: 10.1097/MD.0000000000023580

Changeover phases are essential and inevitable times in professional life, which let the learners adapt and grasp emerging opportunities for learning based on the past experiences with the catering of novel creativity as required in the present as well as emerging time. This study was carried out to examine the effectiveness of a professionalism course, during the transition from a non-clinical to clinical setting, within the context of undergraduate medical education.This observational study was conducted during 2019 to 2020, with pre- and post-professionalism course evaluation. We used the Dundee Poly-professionalism inventory-1: Academic Integrity, among the undergraduate medical students.Our results are based on the medical student's professional progress with the transition from 2nd year to 3rd year. During the 1st phase of the study, the participants at their Pre-Professionalism Course (PrPC) level in their 2nd medical year (only attended the introductory lectures for professionalism), showed a good understanding of professionalism. For the 2nd phase, when the same students, at their Post-Professionalism Course (PoPC) level, in their 3rd year (completed professionalism course) filled the same survey and it was found that there was no decline in their understanding of the topic, even after more than a year. They were even more aware of the significance of professionalism in their clinical settings.Despite a year gap, the understanding of professionalism among students was stable. Results helped us infer that time laps did not affect the professionalism concept learned earlier; rather during clinical settings, students become more aware of professionalism.

Matched MeSH terms: Education, Medical, Undergraduate/methods*
Fulltext Perceptions toward a pilot project on blended learning in Malaysian family medicine postgraduate training: a qualitative study

Salim H, Lee PY, Ghazali SS, Ching SM, Ali H, Shamsuddin NH, et al.

BMC Med Educ, 2018 Aug 29;18(1):206.
PMID: 30157829 DOI: 10.1186/s12909-018-1315-y

BACKGROUND: Blended learning (BL) is a learning innovation that applies the concept of face-to-face learning and online learning. However, examples of these innovations are still limited in the teaching of postgraduate education within the field of family medicine. Malaysian postgraduate clinical training, is an in-service training experience and face-to-face teaching with the faculty members can be challenging. Given this, we took the opportunity to apply BL in their training. This study provides an exploration of the perceptions of the educators and students toward the implementation of BL.
METHODS: A qualitative approach was employed using focus group discussions (FGD) and in-depth interviews (IDI) at an academic centre that trains family physicians. Twelve trainees, all of whom were in their hospital specialty's rotations and five faculty members were purposively selected. Three FGDs among the trainees, one FGD and two IDIs among the faculty members were conducted using a semi-structured topic guide. Data were collected through audio-recorded interviews, transcribed verbatim and checked for accuracy. A thematic approach was used to analyse the data.
RESULTS: There were four main themes that emerged from the analysis. Both educators and trainees bill the perspective that BL encouraged continuity in learning. They agreed that BL bridges the gap in student-teacher interactions. Although educators perceived that BL is in concordance with trainees learning style, trainees felt differently about this. Some educators and trainees perceived BL to be an extra burden in teaching and learning.
CONCLUSION: This study highlights a mix positive and negative perceptions of BL by educators and trainees. BL were perceived positively for continuity in learning and student-teacher interaction. However, educator and learner have mismatched perception of learning style. BL was also perceived to cause extra burden to both educators and learners. Integrating BL to a traditional learning curriculum is still a challenge. By knowing the strengths of BL in this setting, family medicine trainees in Malaysia can use it to enhance their current learning experience. Future study can investigate different pedagogical designs that suit family medicine trainees and educators in promoting independent learning in postgraduate training.

Matched MeSH terms: Education, Medical, Undergraduate/methods*
Problem-based learning: an educational strategy for interactive learning: experience from Universiti Sains Malaysia

Salam A

Med Teach, 2004 May;26(3):279.
PMID: 15203509
Matched MeSH terms: Education, Medical, Undergraduate/methods*
Fulltext Peer-Assisted Learning Activities During Undergraduate Ophthalmology Training: How the Medical Students of Asia Pacific Region Perceive

Sahoo S, Venkatesan P, Myint KT, Moe S

Asia Pac J Ophthalmol (Phila), 2015;4(2):76-9.
PMID: 26065348 DOI: 10.1097/APO.0000000000000094

OBJECTIVES: The aims of this study were to identify the attitude of peer tutors (PTs) toward peer-assisted learning (PAL) and to explore the perceived benefits of PAL by PTs and peer learners (PLs).
DESIGN: A qualitative and quantitative research study.
METHODS: This study involved fourth-year medical undergraduates during their clinical posting in ophthalmology. One PAL session was conducted in each of the 4-week clinical postings. Peer tutors were selected during the first week and were briefed on PAL. Premultiple and postmultiple choice questions were distributed to PLs before and after each PAL session. One focus group discussion was conducted with PLs to explore their perception. Peer tutors were requested to give feedback in the form of structured Likert scale statements with 2 open-ended questions.
RESULTS: A total of 104 students, 6 PTs and 98 PLs, participated in this study. Both tutor and learner groups expressed positive attitudes toward PAL. Peer learners preferred having PAL in a clinical setting. There were some issues related with PAL that emerged from both groups. Success in PAL depends on the teaching ability of PTs.
CONCLUSIONS: Students have positive perceptions toward PAL. Most of the students believed PAL was beneficial to them.

Matched MeSH terms: Education, Medical, Undergraduate/methods*
Fulltext Ten maxims of formative assessment

Prashanti E, Ramnarayan K

Adv Physiol Educ, 2019 Jun 01;43(2):99-102.
PMID: 30835147 DOI: 10.1152/advan.00173.2018

In an era that is seemingly saturated with standardized tests of all hues and stripes, it is easy to forget that assessments not only measure the performance of students, but also consolidate and enhance their learning. Assessment for learning is best elucidated as a process by which the assessment information can be used by teachers to modify their teaching strategies while students adjust and alter their learning approaches. Effectively implemented, formative assessments can convert classroom culture to one that resonates with the triumph of learning. In this paper, we present 10 maxims that show ways that formative assessments can be better understood, appreciated, and implemented.

Matched MeSH terms: Education, Medical, Undergraduate/methods*
Fulltext Student perceptions regarding the usefulness of explicit discussion of "Structure of the Observed Learning Outcome" taxonomy

Prakash ES, Narayan KA, Sethuraman KR

Adv Physiol Educ, 2010 Sep;34(3):145-9.
PMID: 20826769 DOI: 10.1152/advan.00026.2010

One method of grading responses of the descriptive type is by using Structure of Observed Learning Outcomes (SOLO) taxonomy. The basis of this study was the expectation that if students were oriented to SOLO taxonomy, it would provide them an opportunity to understand some of the factors that teachers consider while grading descriptive responses and possibly develop strategies to improve scores. We first sampled the perceptions of 68 second-year undergraduate medical students doing the Respiratory System course regarding the usefulness of explicit discussion of SOLO taxonomy. Subsequently, in a distinct cohort of 20 second-year medical students doing the Central Nervous System course, we sought to determine whether explicit illustration of SOLO taxonomy combined with some advice on better answering descriptive test questions (to an experimental group) resulted in better student scores in a continuous assessment test compared with providing advice for better answering test questions but without any reference to SOLO taxonomy (the control group). Student ratings of the clarity of the presentation on SOLO taxonomy appeared satisfactory to the authors, as was student understanding of our presentation. The majority of participants indicated that knowledge of SOLO taxonomy would help them study and prepare better answers for questions of the descriptive type. Although scores in the experimental and control group were comparable, this experience nonetheless provided us with the motivation to orient students to SOLO taxonomy early on in the medical program and further research factors that affect students' development of strategies based on knowledge of SOLO taxonomy.

Matched MeSH terms: Education, Medical, Undergraduate/methods
Fulltext Explicit constructivism: a missing link in ineffective lectures?

Prakash ES

Adv Physiol Educ, 2010 Jun;34(2):93-6.
PMID: 20522904 DOI: 10.1152/advan.00025.2010

This study tested the possibility that interactive lectures explicitly based on activating learners' prior knowledge and driven by a series of logical questions might enhance the effectiveness of lectures. A class of 54 students doing the respiratory system course in the second year of the Bachelor of Medicine and Bachelor of Surgery program in my university was randomized to two groups to receive one of two types of lectures, "typical" lectures (n = 28, 18 women and 10 men) or "constructivist" lectures (n = 26, 19 women and 7 men), on the same topic: the regulation of respiration. Student pretest scores in the two groups were comparable (P > 0.1). Students that received the constructivist lectures did much better in the posttest conducted immediately after the lectures (6.8 +/- 3.4 for constructivist lectures vs. 4.2 +/- 2.3 for typical lectures, means +/- SD, P = 0.004). Although both types of lectures were well received, students that received the constructivist lectures appeared to have been more satisfied with their learning experience. However, on a posttest conducted 4 mo later, scores obtained by students in the two groups were not any different (6.9 +/- 3 for constructivist lectures vs. 6.9 +/- 3.7 for typical lectures, P = 0.94). This study adds to the increasing body of evidence that there is a case for the use of interactive lectures that make the construction of knowledge and understanding explicit, easy, and enjoyable to learners.

Matched MeSH terms: Education, Medical, Undergraduate/methods*
The use of objective structured self-assessment and peer-feedback (OSSP) for learning communication skills: evaluation using a controlled trial

Perera J, Mohamadou G, Kaur S

Adv Health Sci Educ Theory Pract, 2010 May;15(2):185-93.
PMID: 19757129 DOI: 10.1007/s10459-009-9191-1

Feedback is essential to guide students towards expected performance goals. The usefulness of teacher feedback on improving communication skills (CS) has been well documented. It has been proposed that self-assessment and peer-feedback has an equally important role to play in enhancing learning. This is the focus of this study. Objectively structured self-assessment and peer feedback (OSSP) was incorporated into small group CS teaching sessions of a group of semester one medical students who were learning CS for the first time, to minimise the influence of previous educational interventions. A control group matched for academic performance, gender and age was used to enable parallel evaluation of the innovation. A reflective log containing closed and open ended questions was used for OSSP. Facilitators and simulated patients provided feedback to students in both groups during CS learning as per routine practice. Student perceptions on OSSP and acceptability as a learning method were explored using a questionnaire. CS were assessed in both groups using objective structured clinical examination (OSCE) as per routine practice and assessors were blinded as to which group the student belonged. Mean total score and scores for specific areas of interview skills were significantly higher in the experimental group. Analysis of the questionnaire data showed that students gained fresh insights into specific areas such as empathy, addressing patients' concerns and interview style during OSSP which clearly corroborated the specific differences in scores. The free text comments were highly encouraging as to acceptability of OSSP, in spite of 67% being never exposed to formal self- and peer-assessment during pre-university studies. OSSP promotes effective CS learning and learner acceptability is high.

Matched MeSH terms: Education, Medical, Undergraduate/methods*
Distant peer-tutoring of clinical skills, using tablets with instructional videos and Skype: A pilot study in the UK and Malaysia

O'Donovan J, Maruthappu M

Med Teach, 2015 May;37(5):463-9.
PMID: 25182187 DOI: 10.3109/0142159X.2014.956063

To assess the feasibility and impact of using low-cost Android tablets to deliver video tutorials and remote online peer-tutoring for clinical skills between two countries.

Matched MeSH terms: Education, Medical, Undergraduate/methods*
Fulltext Teaching medical students how to take a sexual history and discuss sexual health issues

Ng CJ, McCarthy SA

Med J Malaysia, 2002 Dec;57 Suppl E:44-51.
PMID: 12733193

BACKGROUND: Taking a sexual history and discussing sexual health issues with patients form an important part of a medical consultation. These specific communication skills can be acquired through various teaching methods.
OBJECTIVE: This paper describes the communication skill workshops conducted for undergraduate medical students on how to talk to patients about sex.
METHODOLOGY: 198 medical students participated in a series of workshops conducted in the University of Malaya in 2001-2002. Pre- and post-workshop evaluations of the programme were carried out to find out the students' difficulties and to assess the usefulness of the workshop. The workshop consisted of a short lecture, role-plays and discussion.
RESULTS: Only 34% of the participants had received some informal training during their clinical years. The main barriers encountered were gender and age differences, language and choice of words, patients and doctors feeling shy, and cultural differences. The workshop was felt to be useful (mean score 4.38, maximum 5.0), most students felt comfortable during the workshop (mean score 4.10, maximum 5.0) and there was significant improvement in the "comfort level" when talking to patients about sex after attending the workshop (P < 0.001).
CONCLUSION: Gender, language and cultural differences were the main barriers in taking a sexual history and discussing sexual health issues among the medical students. Communication workshop was felt to be a useful and comfortable method of learning these specific.

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

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