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Objective To determine the differential effects of a paper-based versus a web-based portfolio in terms of portfolio quality, user-friendliness and student motivation. Methods An experimental design was used to compare Year 1 medical students' reflective portfolios. The portfolios differed in presentation medium only (i.e. web-based versus paper-based). Content analysis, a student questionnaire and mentor interviews were used to evaluate portfolio quality, user-friendliness and student motivation. A total of 92 portfolios were scored independently by 2 raters using a portfolio quality-rating instrument. Results Portfolio structure, quality of reflection and quality of evidence showed no significant effects of presentation medium. Multi-level analysis showed a significant effect for student motivation: web-based portfolios scored 0.39 more than paper-based portfolios ( P < 0.05; effect size 0.76). The mentors reported no differences in portfolio quality, except that there were more visuals in web-based portfolios. Students spent significantly more time preparing the web-based than the paper-based portfolios (15.4 hours versus 12.2 hours; t = 2.1, P < 0.05; effect size 0.46). The 2 student groups did not differ significantly in terms of their satisfaction with the portfolio. The mentors perceived the web-based portfolios as more user-friendly. Conclusions The web-based portfolios were found to enhance students' motivation, were more user-friendly for mentors, and delivered the same content quality compared with paper-based portfolios. This suggests that web-based presentation may promote acceptance of portfolios by students and teachers alike. [ABSTRACT FROM AUTHOR]

There are few publications summarising the main issues concerning pathology teaching and learning within undergraduate medical degrees. This article examines the themes that have emerged from the literature over the last 2 decades. A literature search was performed using PubMed, which identified 86 relevant papers in the English language. The themes discussed in the literature included the timing and duration of pathology courses, the appropriate pathology teacher for medical students, the teaching strategies used for pathology, and the methods used to assess learning. With the gradual increase of integrated medical curricula, it is important for pathology teachers to engage in the change process and help to shape the new-style courses. One of the positive aspects of change is that it can provide an opportunity to rethink current practice. It is hoped that this paper might stimulate discussion about how pathology is taught and learnt, leading to further developments in this area. [ABSTRACT FROM AUTHOR]

It is important to establish the predictive validity of medical school grades. The strength of predictive validity and the ability to identify at-risk students in medical schools depends upon assessment systems such as number grades, pass/fail (P/F) or honours/pass/fail (H/P/F) systems. This study was designed to examine the predictive validity of number grades in medical school, and to determine whether any important information is lost in a shift from number to P/F and H/P/F grading systems. The participants in this prospective, longitudinal study were 6656 medical students who studied at Jefferson Medical College over 3 decades. They were grouped into 10 deciles based on their number grades in Year 1 of medical school. Participants were compared on academic accomplishments in Years 2 and 3 of medical school, medical school class rank, delayed graduation and attrition, performance on medical licensing examinations and clinical competence ratings in the first postgraduate year. Results supported the short- and longterm predictive validity of the number grades. Ratings of clinical competence beyond medical school were predicted by number grades in medical school. We demonstrated that small differences in number grades are statistically meaningful, and that important information for identifying students in need of remedial education is lost when students who narrowly meet faculty's expectations are included with the rest of the class in a broad ‘pass’ category. The findings refute the argument that knowledge of sciences basic to medicine is not critical to subsequent performance in medical school and beyond if an appropriate evaluation system is used. Furthermore, the results of this study raise questions about abandoning number grades in favour of a pass/fail system. Consideration of these findings in policy decisions regarding assessment systems of medical students is recommended. [ABSTRACT FROM AUTHOR]

Portfolios are increasingly advocated in medical education. Qualitative studies have suggested their value in stimulating experiential learning, promoting deep learning and encouraging reflection. This study explored the use of educational portfolios in reflective learning by general practice (GP) registrars in Yorkshire, England. A postal questionnaire was sent to the 92 registrars of a deanery in November 2001, after a pilot study with registrars in a single district had been carried out. The questionnaire explored the registrars' use of the portfolio to collect information and for reflection, as well as registrars' attitudes towards the portfolio. It was returned by 71 registrars, representing a 77% response rate. Structured in-depth interviews were used to support the results obtained. Of the registrars who responded, 65% recorded information on a regular basis and 42% used the portfolio in reflective learning. Experienced registrars used the portfolio least. Those with supportive trainers used the portfolio more in reflection. The study suggests that the role of the trainer/supervisor is vital in portfolio-based learning. It raises questions about the acceptability of portfolio learning. It adds weight to the suggestion that careful introduction of portfolios and training of supervisors is vital. Further work to establish the role of portfolios in reflective learning is recommended. [ABSTRACT FROM AUTHOR]

To explore the relationship between teaching scientific methodology in Year 2 of the medical curriculum and student attitudes towards and knowledge about science and scientific methodology. Anonymous questionnaire survey developed for this purpose. Zagreb University School of Medicine, Croatia. A total of 932 students (response rate 58%) from all 6 years were invited to participate. Score on attitude scale with 45 Likert-type statements and score on knowledge test consisting of 8 multiple choice questions. The average attitude score for all students was 166 ± 22 out of a maximum of 225, indicating a positive attitude towards science and scientific research. The students' average score on the knowledge test was 3.2 ± 1.7 on 8 questions. Students who had finished Year 2 had the highest mean attitude (173 ± 24) and knowledge (4.7 ± 1.7) scores compared with other year groups ( P < 0.001, anova and Tukey posthoc test). For students who had attended a mandatory Year 2 course on the principles of scientific research in medicine (Years 3 to 6), multiple linear regression analysis showed that knowledge test score (B = 3.4; SE = 0.4; 95% confidence interval 2.5–4.2; P < 0.001) and average grades (B = 7.6; SE = 1.5; 95% CI 4.6–10.6; P < 0.001) were significant predictors of attitude towards science, but not sex or failure to pass a year (B = − 0.6; SE = 1.7; 95% CI − 3.9–2.6; P = 0.707; and B = − 3.1; SE = 1.9; 95% CI − 6.8–5.7; P = 0.097, respectively). Medical students have generally positive attitudes towards science and scientific research in medicine. Attendance of a course on research methodology is related to a positive attitude towards science. [ABSTRACT FROM AUTHOR]

To evaluate potential learning outcomes for pre-registration house officer (PRHO) training and develop an evidence base for informed decision making. A 2-stage Delphi process was employed to establish the opinions of Scottish stakeholders with regard to learning outcomes for the PRHO year. Doctors involved in the provision of PRHO training, including deans, postgraduate tutors and general practitioners (GPs) with trainees, were invited to participate in the study. Respondents rated a range of outcomes according to which they believed should be included or excluded from the PRHO training year. Learning outcomes identified for PRHOs were grouped under the 12-domain framework of the 3-circle model: ‘What the doctor can do’, ‘How they approach their practice’ and ‘Their professionalism’. Based on the consensus opinions gained in the Delphi study, the ratings were classified into priority groupings. Priority 1 contained 45 of the original 81 learning outcomes, representing each area of the 3-circle model, with emphasis on the domains of clinical skills, patient investigation/management, communication, appropriate attitudes and personal development. Health promotion and disease prevention was the only domain not represented at priority 1. Priority 2 contained 24 outcomes with emphasis on the understanding of clinical skills, patient management and personal development. Priority 3 contained 12 outcomes indicating a lack of emphasis for some outcomes, particularly the role of the doctor and health promotion. Consensus on the learning outcomes for PRHO training has been achieved, providing an evidence base for curriculum planning. The relative priority assigned to these outcomes can facilitate the use of the evidence. This evidence base should be referred to when reviewing any PRHO training programme. [ABSTRACT FROM AUTHOR]

To consider Medical Education' s claim to international status in terms of the extent of international authorship within published articles, the degree to which authors draw on the international literature to support their work, and its self-citation rates and publication decisions. We examined 6 journals' citation rates for the period 1997–2001 to see if there was evidence of national publication bias; we calculated their self-citation rates to see if this had any influence on impact factor, and we examined Medical Education's management files for trends which might indicate publication bias due to country of origin of authors. All 6 journals exhibited a bias in favour of citing journals from their own countries. The US journals were more likely to cite journals from their own country. Medical Education was most likely to cite journals from non-UK countries. Self-citation rates did not appear to affect impact factors. The ratio of UK to non-UK papers published in Medical Education has not changed significantly over the period studied although non-UK submissions increased sharply in 2002 and the number of North American submissions has doubled since 1998. Medical Education is justified in calling itself an international journal to the extent that the majority of papers it publishes are from countries other than the UK, and it is more likely than other journals in the field to publish papers which cite work in journals published outside the UK. Nevertheless, there is some evidence of publication bias in the journal and more work is needed to discover why this is the case. Various strategies to address the issue of national bias in Medical Education are discussed. [ABSTRACT FROM AUTHOR]

To evaluate the effect of a compulsory evidence-based medicine (EBM) seminar in critical appraisal skills and the overall acceptance of compulsory EBM seminars for Year 3 medical undergraduate students. Small group seminars by peer teaching were conducted for up to 23 undergraduates. Knowledge and skills in EBM before and after the compulsory seminars were evaluated by 2 different sets of 20 questions. To apply knowledge, each undergraduate had to analyse an individual paper case using the principles of EBM. Undergraduates gave anonymous feedback using separate evaluation sheets at the end of the seminar. Main outcome variables were changes in knowledge and skills. A total of 132 Year 3 undergraduates at the University of Frankfurt participated in a compulsory EBM seminar during the academic half-year 2003/04 as part of their regular curriculum. Complete datasets were available for evaluation from 124 undergraduates (94%). The seminars led to an overall increase in knowledge (question paper score increase from 2.37 to 7.48, 99% CI 6.61–8.36, or 216%). Transfer of knowledge into a paper case scenario was generally good, with a mean score of 49.5 (SD 5.24) out of 55 points. Feedback indicated good overall acceptance of the seminars, with a median of 2 (score range from 1 = excellent to 6 = failed). Trained medical students are effective and well accepted EBM trainers in compulsory undergraduate seminars. [ABSTRACT FROM AUTHOR]

The article presents abstracts on topics related to medical education including "Virtual Continuity in Learning Programme — 'On-The-Job' Learning for Foundation Doctors," by E. Wood and S. H. Y. Tso, "Lack of Junior Doctors Knowledge of Iron Deficiency Anaemia and Blood Transfusion: A Risk to Patient Safety?," by A. E. Coates and colleagues, and "Learning to Listen: A Patient Led Innovation to Improve Student's Communication with Patient Feedback," by E. S. Anderson and J. S. Ford.

Presents guidelines for authors of the periodical "Medical Education" in 2004. Mission in education and research; Submission of manuscripts.

The article presents information about submission of papers for the November and May issue of the journal Medical Education. Authors who wish to consider their papers for the next section, to appear in May 2005, should submit manuscripts electronically using http://medicaleducation.manuscriptcentral.com before November 1, 2004. Those who would like to submit to the November 2005 section should submit their papers by May 1, 2005. Common reasons for papers not being published include lack of originality, ideas that are still at development stage and have not been tested in practice and descriptions of ideas where no evaluation has been carried out.

Focuses on the editorial policy of the periodical "Medical Education." Mission statement of the journal; Ethical standards; Outright rejection.

Context The administration of an objective structured clinical examination (OSCE) using paper checklists presents problems such as illegible handwriting, missing student names and/or numbers and lost checklists. Calculating and entering results is not only time-consuming, but is subject to human errors, and feedback to students is rarely available. To rectify these problems, personal digital assistants (PDAs) and HaPerT software were acquired to replace paper checklists and provide automated results and feedback. This study sought to determine the usability of the PDA assessment system. Methods The usability of the PDA system was evaluated according to effectiveness, efficiency and user satisfaction. Effectiveness was judged by comparing the results of an OSCE conducted in 2003 (paper-based method) and repeated in 2004 and 2005 (PDA method). Efficiency was determined by calculating the amount of time required to organise the logistics for 2 consecutive PDA OSCEs and deliver results and grades, compared with the time required for the paper-based OSCE. User satisfaction was established by using questionnaires to obtain feedback on the assessors' experiences during their first assessments. Results An independent groups t-test used to compare the means of scores achieved by students in the PDA and paper-based OSCEs, respectively, showed that the difference in effectiveness was not significant. In terms of efficiency, 77% less time was used for the PDA OSCE in 2004 and 93% less in 2005. Assessor feedback on PDA assessment was overwhelmingly positive. Assessment by PDA was found to be just as effective as and more efficient than paper-based assessment in practical examinations, and was highly rated by assessors. [ABSTRACT FROM AUTHOR]

To explore the review process from the reviewers' perspective, including perceptions of the time taken to carry out a review, barriers to and facilitators of the review process, benefits of reviewing, opinions about blinded versus transparent reviews, how the process of reviewing might be made easier, and to assess reviewers' experience of, and training in, the peer review process.Reviewers forMedical Educationinvited to review over a 5-month period between 1st June and 31st October 2002 (n = 221).Postal questionnaire accompanying a request to review a manuscript.The overall response rate was 64.7% (the response rate of those completing and returning a manuscript review and a questionnaire was 87%); 30% were first-time reviewers forMedical Education, although the majority (87%) reviewed for other journals. The average time spent on the current review was just over 3 hours (184.3 minutes, median 162 minutes, range 30–810 minutes), which was stated to be about the same time as usual for the majority. Only 14% of respondents had received formal training in reviewing, although 66% said they would like such training. A total of 79.5% said they would have liked to seek a colleague's opinion, and 90% wished to receive other reviewers' comments. A wide range of problems with the review process were encountered, and the main way in which it was felt it could be made easier was to make the process electronic. Nearly three quarters of respondents said they would be happy to sign their reviews. Acting as a reviewer was seen as a professional responsibility and as an opportunity for learning.This study provides useful insights into the process of review from the reviewer's perspective. Reviewers spend a substantial amount of time on each paper. Many referees feel their reviews would benefit if they had formal training in the review process, received feedback on their reviews, or were able to ask colleagues for opinions on the paper being reviewed. Most reviewers would be willing to sign their reviews and feel that the process should be transparent. These results may help inform discussions about how to better prepare peer reviewers for their job. [ABSTRACT FROM AUTHOR]

Focuses on issues related to medical education journals. Description of ideas in curriculum design; Evaluation of the survey results; Introduction of technological innovations in the field of medicine.

The article offers a list of forthcoming papers for the next issue of "Medical Education," which includes current perspectives of medical education in China, medical student risk-taking and self-perceived influence in medical practice, and the effect of practice on standardized learning outcomes in simulation-based medical education.

Purpose The development of self-regulated learning is a major focus of our problem-based learning (PBL) medical programme. Students who are unsuccessful in assessments often seem to lack insight into the standard of their own performance, yet the ability to self-assess accurately is essential for the effective self-management of learning. The aim of this project was to evaluate the accuracy of self- and peer-assessment according to academic performance. Method In 2004, 175 3rd-year students undertook an integrated, case-based, short-essay, formative assessment. After the assessment they were provided with model answers and marking criteria. Students marked their own assessment paper and the paper of one of their peers. Assessment papers were subsequently marked by faculty members. The following data was available for each student: self-mark, faculty-mark, score awarded by a peer and the score that they awarded to their peer. Self-assessment and peer-assessment ability was compared to overall academic performance. Results Low-achieving students score themselves and their peers generously. High-achieving students score themselves more harshly than faculty. However, they score their peers accurately. Conclusion In the 3rd year of the programme low-achieving students are unable to assess accurately the quality of their own work or the work of their peers in a formative written assessment. The PBL curriculum does not guarantee the appropriate development of self-assessment skills. [ABSTRACT FROM AUTHOR]

Context The development of clinical reasoning ( CR) in students has traditionally been left to clinical rotations, which, however, often offer limited practice and suboptimal supervision. Medical schools begin to address these limitations by organising pre-clinical CR courses. The purpose of this paper is to review the variety of approaches employed in the teaching of CR and to present a proposal to improve these practices. Methods We conducted a narrative review of the literature on teaching CR. To that end, we searched PubMed and Web of Science for papers published until June 2014. Additional publications were identified in the references cited in the initial papers. We used theoretical considerations to characterise approaches and noted empirical findings, when available. Results Of the 48 reviewed papers, only 24 reported empirical findings. The approaches to teaching CR were shown to vary on two dimensions. The first pertains to the way the case information is presented. The case is either unfolded to students gradually - the 'serial-cue' approach - or is presented in a 'whole-case' format. The second dimension concerns the purpose of the exercise: is its aim to help students acquire or apply knowledge, or is its purpose to teach students a way of thinking? The most prevalent approach is the serial-cue approach, perhaps because it tries to directly simulate the diagnostic activities of doctors. Evidence supporting its effectiveness is, however, lacking. There is some empirical evidence that whole-case, knowledge-oriented approaches contribute to the improvement of students' CR. However, thinking process-oriented approaches were shown to be largely ineffective. Conclusions Based on research on how expertise develops in medicine, we argue that students in different phases of their training may benefit from different approaches to the teaching of CR. [ABSTRACT FROM AUTHOR]

Focuses on the changes in the periodical "Medical Education" for 2004. Changes in guidelines; Guidelines for reviewers.

Context The inclusion of interprofessional education opportunities in clinical placements for pre-registration learners has recently been proposed as a strategy to enhance graduates' skills in collaborative practice. Objectives A realist review was undertaken to ascertain the contexts, mechanisms and outcomes of formal interprofessional clinical workplace learning. Methods Initial scoping was carried out, after which Ovid MEDLINE, CINAHL and EMBASE were searched from 2005 to April 2016 to identify formal interprofessional workplace educational interventions involving pre-registration learners. Papers reporting studies conducted in dedicated training wards were excluded, leaving a total of 30 papers to be included in the review. Results Several educational formats that combined students from medicine, nursing, pharmacy and allied health professions were identified. These included: the use of engagement by student teams with a real patient through interview as the basis for discussion and reflection; the use of case studies through which student teams work to promote discussion; structured workshops; ward rounds, and shadowing. Meaningful interprofessional student discussion and reflection comprised the mechanism by which the outcome of learners acquiring knowledge of the roles of other professions and teamwork skills was achieved. The mechanism of dialogue during an interaction with a real patient allowed the patient to provide his or her perspective and contributed to an awareness of the patient's perspective in health care practice. Medication- or safety-focused interprofessional tasks contributed to improved safety awareness. In the absence of trained facilitators or in the context of negative role-modelling, programmes were less successful. Conclusions In the design of workplace education initiatives, curriculum decisions should take into consideration the contexts of the initiatives and the mechanisms for achieving the education-related outcomes of interest. [ABSTRACT FROM AUTHOR]