Search

Context Over nearly two decades, a wealth of literature describing the various capabilities, uses and adaptations of virtual microscopy ( VM) has been published. Many studies have investigated the effects on and benefits to student learning of VM compared with optical microscopy ( OM). Objectives This study statistically aggregated the findings of multiple comparative studies through a meta-analysis in order to summarise and substantiate the pedagogical efficacy of teaching with VM. Methods Using predefined eligibility criteria, teams of paired researchers screened the titles and abstracts of VM studies retrieved from seven different databases. After two rounds of screening, numerical and thematic data were extracted from the eligible studies for analysis. A summary effect size and estimate of heterogeneity were calculated to determine the effects of VM on learner performance and the amount of variance between studies, respectively. Trends in student perceptions were also analysed and reported. Results Of the 725 records screened, 72 studies underwent full-text review. In total, 12 studies were viable for meta-analysis and additional studies were reviewed to extract themes relating to learners' perceptions of VM. The meta-analysis detected a small yet significant positive effect on learner performance (standardised mean difference 0.28, 95% confidence interval 0.09-0.47; p = 0.003), indicating that learners experience marked knowledge gains when exposed to VM over OM. Variation among studies was evident as high heterogeneity was reported. An analysis of trends in learner perceptions noted that respondents favoured VM over OM by a large margin. Conclusions Although many individual studies have reported non-significant findings in comparisons of VM and OM, the enhanced power afforded by meta-analysis revealed that the pedagogical approach of VM is modestly superior to that of OM and is preferred by learners. [ABSTRACT FROM AUTHOR]

Background:When ratings of student performance within the clerkship consist of a variable number of ratings per clinical teacher (rater), an important measurement question arises regarding how to combine such ratings to accurately summarize performance. As previous G studies have not estimated the independent influence of occasion and rater facets in observational ratings within the clinic, this study was designed to provide estimates of these two sources of error. Method: During 2 years of an emergency medicine clerkship at a large midwestern university, 592 students were evaluated an average of 15.9 times. Ratings were performed at the end of clinical shifts, and students often received multiple ratings from the same rater. A completely nested G study model (occasion: rater: person) was used to analyze sampled rating data. Results: The variance component (VC) related to occasion was small relative to the VC associated with rater. The D study clearly demonstrates that having a preceptor rate a student on multiple occasions does not substantially enhance the reliability of a clerkship performance summary score. Conclusions: Although further research is needed, it is clear that case-specific factors do not explain the low correlation between ratings and that having one or two raters repeatedly rate a student on different occasions/ cases is unlikely to yield a reliable mean score. This research suggests that it may be more efficient to have a preceptor rate a student just once. However, when multiple ratings from a single preceptor are available for a student, it is recommended that a mean of the preceptor's ratings be used to calculate the student's overall mean performance score. [ABSTRACT FROM AUTHOR]

Background: A battery of various psychometric assessments has been conducted on script concordance tests (SCTs) that are purported to measure data interpretation, an essential component of clinical reasoning. Although the breadth of published SCT research is broad, best practice controversies and evidentiary gaps remain.Purposes: In this study, SCT data were used to test the psychometric properties of 6 scoring methods. In addition, this study explored whether SCT items clustered by difficulty and type were able to discriminate between medical training levels.Methods: SCT scores from a problem-solving SCT (SCT-PS;n= 522) and emergency medicine SCT (SCT-EM;n= 1,040) were collected at a large institution of medicine. Item analyses were performed to optimize each dataset. Items were categorized into difficulty levels and organized into types. Correlational analyses, one-way multivariate analysis of variance (MANOVA), repeated measures analysis of variance (ANOVA), and one-way ANOVA were conducted to explore study aims.Results: All 6 scoring methods differentiated between training levels. Longitudinal analysis of SCT-PS data reported that MS4s significantly (p< .001) outperformed their scores as MS2s in all difficulty categories. Cross-sectional analysis of SCT-EM data reported significant differences (p< .001) between experienced EM physicians, EM residents, and MS4s at each level of difficulty. Items categorized by type were also able to detect training level disparities.Conclusions: Of the 6 scoring methods, 5-point scoring solutions generated more reliable measures of data interpretation than 3-point scoring methods. Data interpretation abilities were a function of experience at every level of item difficulty. Items categorized by type exhibited discriminatory power providing modest evidence toward the construct validity of SCTs. [ABSTRACT FROM AUTHOR]

This article discusses a U.S. study which aims to compare the effectiveness of emergency medicine (EM) residents with that of EM faculty in facilitating postcase debriefing during a mannequin-based stimulation, and mentions how the study was conducted, its results and conclusions.

Background: Reduction in contact hours has led to the use of more efficient teaching approaches in medical education, yet the efficacy of such approaches is often not fully investigated. Purpose: This work provides a detailed analysis of alternating group dissections with peer-teaching in Medical Anatomy (MA). Methods: MA I and II percentages of the alternating (ALT) and nonalternating (NALT) groups were compared, scores of ALT subgroups (A and B) were compared, and subgroup performance on practical exam questions was compared. Results: MA I and MA II percentages indicated no significant difference in median scores (pMAI= 0.581, pMAII= 0.223) between ALT and NALT. Subgroup analysis and assessment of question types showed that student performance and ability to identify a structure were not dependent on dissection group assignment. Conclusion: Alternating dissections offered students more unscheduled time for independent learning activities, such as studying or shadowing preceptors, and reduced student-to-cadaver and student-to-faculty ratios by 50%. Alternating dissections with peer teaching were not detrimental to student performance. [ABSTRACT FROM AUTHOR]

Objectives One of the goals of medical education is to bridge the gap between basic science and clinical practice. Students acquire basic science knowledge during their pre-clinical years, yet have limited opportunities to apply this knowledge clinically. This hands-on laboratory exercise was designed to facilitate a review of anatomy in the context of select clinical procedures, highlighting the application of anatomical concepts in clinical practice. Methods In 2008, Year 2 medical students participated in a clinical procedures laboratory taught by senior residents and attending physicians. Before participating, all students completed anatomy and clinical pre-tests and received syllabi detailing the select procedures and the anatomy pertinent to each. Students were organised into experimental (EG, n = 48) and control (CG, n = 17) groups. The EG observed and practised five procedures on cadavers and the CG participated in a traditional anatomy review laboratory with no procedural demonstrations or practice. Anatomy and clinical post-tests were administered to both groups following the 3-hour interventions. Surveys and focus sessions were used to assess student opinions. Results Scores on the anatomy pre- and post-tests were compared and were found to have significantly increased ( P ≤ 0.015) in each group, with the EG performing better than the CG ( P = 0.001). The EG also showed significant improvement in clinical post-test scores ( P < 0.001). Clinical test scores in the CG did not improve ( P = 0.393). Conclusions Review of anatomy coupled with the teaching of clinical procedures results in an anatomical review superior to that of traditional methods, enhances knowledge of clinical procedures, and heightens students’ awareness of the relationships between basic science and clinical practice. [ABSTRACT FROM AUTHOR]

Purpose: Uncertainty tolerance (UT) is increasingly valued as a medical graduate attribute and broadly measured among medical student populations. However, the validity evidence underpinning UT scale implementation has not been summarised across studies. The present work evaluates UT scale validity evidence to better inform when, why and how UT scales ought to be used and to identify remaining validity evidence gaps. Methods: A literature search for psychometric studies of UT scales was completed in 2022. Records were included if they implemented one of the four most cited UT scales (i.e. Physicians' Reactions to Uncertainty scale 1990 [PRU1990] or 1995 [PRU1995], Tolerance for Ambiguity [TFA] scale or Tolerance of Ambiguity in Medical Students and Doctors scale [TAMSAD]) in a population of physicians and/or medial students and presented validity evidence according to the Standards for Educational and Psychological Testing framework. Included studies were rated and analysed according to evidence for test content, response processes, internal structure, relations to other variables and consequences of testing. Results: Among the investigated scales, 'relations to other variables' and 'internal structure' were the most commonly reported forms of validity evidence. No evidence of 'response processes' or 'consequences of testing' was identified. Overall, the PRU1990 and PRU1995 demonstrated the strongest validity evidence, although evidence primarily related to physician populations. Conclusions: None of the studied scales demonstrated evidence for all five sources of validity. Future research would benefit from assessing validity evidence for 'response processes' and 'consequences of testing' among physicians and medical students at different training/career stages to better understand UT construct conceptualisation in these populations. Until further and stronger validity evidence for UT scales is established, we caution against implementing UT scales outside of research settings (e.g. for higher stakes decision making). Stephens et al. review the validity evidence for uncertainty tolerance scales, identifying gaps in evidence for response processes and testing consequences. Thus, scale score interpretation is, ironically, uncertain. [ABSTRACT FROM AUTHOR]

Phenomenon: Given the growing number of medical science educators, an examination of institutions' promotion criteria related to educational excellence and scholarship is timely. This study investigates the extent to which medical schools' promotion criteria align with published standards for documenting and evaluating educational activities. Approach: This document analysis systematically analyzed promotion and tenure (P&T) guidelines from U.S. medical schools. Criteria and promotion expectations (related to context, quantity, quality, and engagement) were explored across five educational domains including: (i) teaching, (ii) curriculum/program development, (iii) mentoring/advising, (iv) educational leadership/administration, and (v) educational measurement and evaluation, in addition to research/scholarship and service. After independent review and data extraction, paired researchers compared findings and reached consensus on all discrepancies prior to final data submission. Descriptive statistics assessed the frequency of referenced promotion criteria. Findings: Promotion-related documents were retrieved from 120 (of 185) allopathic and osteopathic U.S. medical schools. Less than half of schools (43%; 52 of 120) documented a well-defined education-related pathway for advancement in academic rank. Across five education-specific domains, only 24% (12 of 50) of the investigated criteria were referenced by at least half of the schools. The least represented domain within P&T documents was "Educational Measurement and Evaluation." P&T documents for 47% of schools were rated as "below average" or "very vague" in their clarity/specificity. Insights: Less than 10% of U.S. medical schools have thoroughly embraced published recommendations for documenting and evaluating educational excellence. This raises concern for medical educators who may be evaluated for promotion based on vague or incomplete promotion criteria. With greater awareness of how educational excellence is currently documented and how promotion criteria can be improved, education-focused faculty can better recognize gaps in their own documentation practices, and more schools may be encouraged to embrace change and align with published recommendations. [ABSTRACT FROM AUTHOR]