Purpose Debriefing after simulation-based healthcare education (SBHE) is challenging. Educators’ debriefing skills are essential to the success of learning. For debriefing skill training, we designed a simulation course with the standardized learner (SL) through video conference. The purpose of this study was to describe the implementation process of the SL simulation course and evaluate its effectiveness on educators’ self-confidence and debriefing skills.
Methods This simulation course involved six trainees and two trainers. After watching a 5-minute sample video of SBHE, each trainee conducted their role as a debriefer in this video and the trainer acted as a learner (SL) in this video. Following each simulation, individual feedback by the trainer was immediately implemented. To evaluate the course’s effectiveness, trainees’ self-confidence questionnaire was collected, and objective structured assessment of debriefing (OSAD) scores were evaluated.
Results After completing five SL simulation sessions in 2 weeks, the trainees’ self-confidence level and OSAD scores improved significantly (estimate=0.114, standard error=0.020, p<0.001, and p=0.006).
Conclusion This debriefer training course using SL simulation via video conference could improve self-confidence and debriefing skills of trainees. This SL simulation can be used as a new and flexible method for training debriefers.
Purpose The practice of feedback is influenced by the characteristics of students, teachers, and the clinical environment. Most studies on feedback have been conducted in Western settings with different sociocultural backgrounds to Indonesia. This study explores feedback in Indonesian clinical clerkship using a sociocultural lens and aims to provide an exemplar of adaptive practice relevant to non-Western settings.
Methods This qualitative study was conducted using an interpretive phenomenology approach. Data were collected through focus groups with students and teachers and interviews with program coordinators. Data were transcribed verbatim and grouped according to data sources, coded, and analyzed thematically.
Results Themes identified from the focus group discussions and interviews were categorized as student, teacher, and environmental factors. Student factors include dependence on feedback, tendencies to use a group approach, difficulties recognizing social rules, a perceived lack of resilience, and tendencies to doubt praise. Factors related to teachers include a high level of expertise, being extremely busy, having a strong commitment, and being unsure of students’ acceptance of feedback. Clinical environment factors influence interactions between teachers and learners and include high power distance and collectivistic values. A safe environment is needed to ensure effective feedback interactions.
Conclusion High power distance, collectivism, and generational characteristics of students likely impact feedback practice in clinical settings. Designing a safe environment is essential for effective feedback practice.
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Purpose Longitudinal integrated clerkships (LICs) have been introduced in medical schools, as learning relationships with clinical faculty or peers are important components of medical education. The purpose of this study was to investigate the characteristics of student-faculty and student-student interactions in the LIC and to identify other factors related to whether students understood and acquired the program’s main outcomes.
Methods The study was conducted among the 149 third-year students who participated in the LIC in 2019. We divided the students into groups of eight. These groups were organized into corresponding discussion classes, during which students had discussions with clinical faculty members and peers and received feedback. Clinical faculty members and students were matched through an e-portfolio, where records were approved and feedback was given. A course evaluation questionnaire was completed and analysed.
Results A total of 144 valid questionnaires were returned. Logistic regression analysis showed that relevant feedback in discussion classes (adjusted odds ratio [AOR], 5.071; p<0.001), frequency of e-portfolio feedback (AOR, 1.813; p=0.012), and motivation by e-portfolio feedback (AOR, 1.790; p=0.026) predicted a greater likelihood of understanding the continuity of the patient’s medical experience. Relevant feedback from faculty members in discussion classes (AOR, 3.455; p<0.001) and frequency of e-portfolio feedback (AOR, 2.232; p<0.001) also predicted a greater likelihood of understanding the concept of patient-centered care.
Conclusion Student-faculty interactions, including relevant feedback in discusstion classes, frequency of e-portfolio feedback, and motivation by e-portfolio feedback were found to be important factors in the LIC program.
Purpose Constructive feedback is key to successful teaching and learning. The unique characteristics of problem-based learning (PBL) tutorials require a unique feedback intervention. Based on the review of existing literature, we developed a feedback model for PBL tutorials, as an extension of the feedback facilitator guide of Mubuuke and his colleagues. This study was aimed to examine the perceptions of students and tutors on the feedback model that was piloted in PBL tutorials.
Methods This study employed a qualitative research design. The model was tested in nine online PBL sessions, selected using the maximum variation sampling strategy based on tutors’ characteristics. All sessions were observed by the researcher. Afterwards, tutors and students in the PBL sessions were interviewed to explore their perceptions of the model.
Results Three themes were identified based on the perceptions of the tutors and students: cognitive changes, behavioral changes, and challenges of the use of the feedback model. Both tutors and students benefited from improved cognition and behavior. However, the use of the feedback model still encountered some challenges, such as limited sources of feedback data, flexibility and adaptability of the model, content of feedback delivered, students’ characteristics and performance, tutors’ characteristics and self-perceptions, and supportive infrastructure.
Conclusion The model can be used as a reference for tutors to deliver constructive feedback during PBL tutorials. The challenges identified in using the constructive feedback model include the need for synchronized guidelines, ample time to adapt to the model, and skills training for tutors.
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Purpose Active involvement of students in their learning process is a recommended andragogical approach to increase student engagement. Many new teaching-learning strategies based on active learning have been implemented, but their efficacies to achieve the proposed benefits of attaining knowledge, skills, and attitude have not been evaluated, especially in the field of medical education. We substituted passive learning in the conventional tutorial classes with an active-learning strategy of Student-Led Seminar Series (SLSS) in the subject of physiology over 4 months and performed program evaluation for the SLSS.
Methods Sixty-four first-year medical undergraduate students volunteered to participate, who were divided into groups to present seminars on the allocated topics under the guidance of a mentor. At the end of 4 months, program evaluation was done using Kirkpatrick’s model of evaluation—levels 1 and 2, which correspond to reaction and learning, respectively.
Results Statistically significant improvement was observed in students’ satisfaction, and the self-perceived increase was observed in knowledge, skills, and attitude.
Conclusion Program evaluation of SLSS not only established the significant impact of SLSS as an andragogical approach but also helped us in the improvisation of the program for the next cycle.
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Purpose Nonverbal communication (NVC) is important in the patient-physician relationship, but the effect of NVC education is not well kown. In this study, we try to identify if students’ NVC abilities are improved through communication training.
Methods First-year medical students conducted medical interviews, which were performed with standardized patients (SPs) before and after communication skill education, and recorded in video. Fifty-one students were enrolled for this study. Two researchers used the NVC checklist, which consists of 12 nonverbal behaviors, to analyze and compare the students’ nonverbal expressions in the interviews recorded before and after the education.
Results After the students participated in communication training, open body position and adequate facial expression were increased while unnecessary silence, un-purposive movements, and giggling were decreased. These results can be interpreted as positive effects of the education. However, hand gesture was increased as a negative effect of the education. The total NVC score of the 12 nonverbal behaviors in the NVC checklist improved significantly, rising from 8.56 to 10.03.
Conclusion Communication skill education using SPs can improve nonverbal behaviors of medical students, especially facial expression, un-purposive movement, body position, unnecessary silence, and giggle, but not hand gesture. Further research is needed on a variety of teaching methods to improve NVCs.
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Purpose Feedback in medical education is as important as developing the curriculum and choosing the right method of instruction. This study measured three overarching areas: student satisfaction rates with academic feedback, the type and helpfulness of the feedback, and the types of feedback that students want.
Methods In December 2013, 166 students answered a student survey that consisted of 26 items. The survey asked questions on their experiences with the overall feedback that was given the previous semester, the satisfaction rate, the type of feedback that was received, the helpfulness of the feedback, and the types of feedback that were desired after examinations and learning tasks.
Results Overall, 35% of the students were satisfied with the feedback that they received in the previous semester. Students wanted more systematic (61.4%) and timely feedback (30.1%). The types of feedback that were most desired were “written comment feedback from the teacher” (51.8%) for learning tasks and “item difficulty, percentile ranks feedback” for examinations (62.0%).
Conclusion Students found the current feedback to be helpful, but the lack of feedback that students desired indicates that we must provide more systematic feedback in a more timely manner.
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PURPOSE This study was conducted to investigate the effect of direct verbal feedback from an expert during endotracheal intubation skills training using a mannequin compared to practice alone without feedback.
METHODS 154 fourth-year medical students at the Pusan National University were divided into control or feedback groups. Both groups were taught by experts using a mannequin at a clinical skills learning center. The feedback group (n=66) received verbal feedback from the expert throughout training. Skills acquisition was tested during a Clinical Performance Examination.
RESULTS There were no differences between the control and feedback groups in terms of prior experiences with endotracheal intubation, confidence level to perform the skill, and grades received from previous clinical clerkships. The average score of the feedback group was significantly higher than that of the control group (14.06 versus 11.98, p<0.05). When the students were divided into 'exceeds expectations', 'meets expectations' and 'needs development' groups according to a global rating, more students from the feedback group were in the 'exceeds expectations' group and less were in the 'needs development' group compared to the control group (p<0.05). The results showed no significant relation with training date.
CONCLUSION This study demonstrated that direct verbal feedback from an expert during training significantly improves the performance of endotracheal intubation skill.
Feedback acts as an essential component of clinical education; and its effect is prominent, especially in students who require further development.
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PURPOSE This study aimed to inquire into the educational implication of peer evaluation in PBL in relation to the evaluation system. METHODS: 89 third and fourth-year medical students in PBL courses participated in this study.
Descriptive statistics analysis and correlation analysis were performed. RESULTS: Based on the results of the interviews with all the forth-year students, the feedback method of peer evaluation was modified and the peer evaluation sheet was revised. On the new peer evaluation system, the percentages of indiscriminant scores were significantly lower than those on the previous system. Peer evaluation on the new evaluation system was positively related to tutor evaluation, written examination, and quizzes. Correlations between the peer evaluation scores each units were higher than those of the tutor evaluation scores. All third-year students within the bottom ten percent on the peer evaluation score failed to successfully complete that year. CONCLUSION: The peer evaluation with feedback based on faculty counseling and a user-friendly evaluation sheet can be used as an effective method for assessing student performance in PBL and to screen for maladjusted students.
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BACKGROUND Progression note is a critical source in patient care. It is used to evaluate physician performance as well as the quality of clinical care. However, the majority of medical schools do not formally teach how to write progression notes. Therefore, the purpose of this research was to determine the impact of feedback education on the quality of the students' progression notes.
METHODS A static group-comparison design was used to determine the quality of progression notes written by 64 students. 31 students received feedback, but the other 33 students did not. 219 patients' progression notes were selected for this study. Progression notes were blindly reviewed by the 3 faculty members.
RESULTS Progression notes from students who received feedback showed significantly higher scores than those students who did not received feedback(p<0.05).
CONCLUSIONS Our findings suggest that feedback education in writing progression notes needs to be integrated to improve quality of the notes.
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The Effect of Direct Feedback in Teaching Endotracheal Intubation Sun Ju Im, So Jung Yune, Shin Young Kang, Sang Yeoup Lee, Hae Kyu Kim, Hae Jin Jeong Korean Journal of Medical Education.2007; 19(4): 325. CrossRef
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