Comparison of blunder lecture with tutorial for small-group discussion among Phase I M.B.B.S. students in a medical college in North India

Background: Small-group discussion (SGD) plays an essential role in physiology to foster active learning by the students. Blunder lecture has been used to stimulate inquiry, reflection, and promote collaborative learning by cognitive conflict strategy. Aims and Objectives: The objectives of the study were as follows: (i) To compare the effectiveness of blunder lecture with tutorial for SGD and (ii) to assess the perception of students toward blunder lecture and tutorial. Material and Methods: An educational interventional study was conducted in the department of physiology among 116 Phase I MBBS students using tutorial and blunder lecture for SGD on two core topics of physiology which were already covered in didactic lectures. Blunder lecture included deliberate mistakes spread over the different levels of Bloom’s taxonomy. Blunders were identified and discussed during the group activity. The evaluation was done by validated pre-post tests and questionnaires. Results: There was a statistically significant gain in the mean score of the students who attended blunder lecture session in comparison to tutorial. Out of 116 students who participated in the study, 89% perceived blunder lecture as a challenging way to recollect prior knowledge. Conclusion: Blunder lecture is an effective reinforcement tool that can be used in SGD to facilitate the learning of the undergraduates.

Investigating the effects of interprofessional communication education for medical students / 한국의학교육

PURPOSE: Interprofessional communication skills are an essential competency for medical students training to be physicians. Nevertheless, interprofessional education (IPE) is relatively rare in Korean medical schools compared with those overseas. We attempted to evaluate the effectiveness of the first IPE program in our school. METHODS: In the first semester of the school year 2018, third-grade medical students (N=149) at the Seoul National University College of Medicine participated in ‘communication between healthcare professionals in the clinical field’ training, which consisted of small group discussions and role-play. To evaluate the effectiveness of this training, we conducted pre- and post-training questionnaire surveys. Comparing paired t-tests, we evaluated the students' competency in interpersonal communication and their attitude towards the importance of IPE before and after the training. The Global Interpersonal Communication Competence Scale (GICC-15) was used to evaluate competency in interpersonal communication. RESULTS: Out of 149 students, 144 completed the pre- and post-training questionnaires. The total GICC-15 scores before and after training were 55.60±6.94 (mean±standard deviation) and 58.89±7.34, respectively (p=0.000). All subcategory scores of GICC-15 after training were higher after training and were statistically significant (p<0.05), except for two subcategories. The importance of IPE score also improved after training but was not significant (p=0.159). The appropriateness of content and training method scores were 3.99±0.92 and 3.94±1.00, respectively. CONCLUSION: From the results, our school's IPE program demonstrated a positive overall educational effect. Deployment of systematic and varied IPE courses is expected in the future, with more longitudinal evaluation of educational effect.

An Experience with a Novel Scenario-Based Workshop for Residents to Learn Professionalism / 医学教育

Optimal strategies for learning professionalism have not been established to date. For the purpose of resolving this problem, the author developed a novel workshop activity in which scenarios describing unprofessional behavior were represented. In the scenarios, participants performed role play followed by small group discussions. Key words chosen during discussion were pooled and reconstructed into an association chart using KJ method.　From 2014 through 2017, a total of forty-four junior residents participated in the activity. To estimate the effectiveness of the workshop, participants completed a post-activity questionnaires composed of a ten-point rating scale (higher value denotes a positive evaluation) and free commentary.　Most residents indicated interest in this workshop (mean rating, 8.5±1.25, median, 9). Similarly, a considerable number of residents reported that the activity allowed them an opportunity to reflect on their behavior (mean, 8.05±1.43;, median 8). Qualitative analyses of free commentary was performed using Steps for Coding and Theorization (SCAT). Consequently, 6 themes were extracted: interest in learning professionalism, exchange of diverse values, importance of reflection, recognition of objectives, difficulty in understanding professionalism, and proposals for the workshop. On association charts, key words were sorted into four to six categories; these were further arranged in such a way as to converge toward the concepts of patient-centered care.　We consider that our scenario-based workshop may be an effective strategy to facilitate learning professionalism for residents.

An Experience with a Novel Scenario-Based Workshop for Residents to Learn Professionalism / 医学教育

Optimal strategies for learning professionalism have not been established to date. For the purpose of resolving this problem, the author developed a novel workshop activity in which scenarios describing unprofessional behavior were represented. In the scenarios, participants performed role play followed by small group discussions. Key words chosen during discussion were pooled and reconstructed into an association chart using KJ method.　From 2014 through 2017, a total of forty-four junior residents participated in the activity. To estimate the effectiveness of the workshop, participants completed a post-activity questionnaires composed of a ten-point rating scale (higher value denotes a positive evaluation) and free commentary.　Most residents indicated interest in this workshop (mean rating, 8.5±1.25, median, 9). Similarly, a considerable number of residents reported that the activity allowed them an opportunity to reflect on their behavior (mean, 8.05±1.43;, median 8). Qualitative analyses of free commentary was performed using Steps for Coding and Theorization (SCAT). Consequently, 6 themes were extracted: interest in learning professionalism, exchange of diverse values, importance of reflection, recognition of objectives, difficulty in understanding professionalism, and proposals for the workshop. On association charts, key words were sorted into four to six categories; these were further arranged in such a way as to converge toward the concepts of patient-centered care.　We consider that our scenario-based workshop may be an effective strategy to facilitate learning professionalism for residents.

Ayurveda education: Evaluating the integrative approaches of teaching Kriya Sharira (Ayurveda physiology)

Background: ‘What is the ideal way of teaching Ayurveda?’ – has been a debated question since long. The present graduate level curriculum lists out the topics from ‘contemporary medical science’ and ‘Ayurveda’ discretely, placing no emphasis on integration. Most of the textbooks, too, follow the same pattern. This makes learning not only diffi cult, but also leads to cognitive dissonance. Objectives: To develop and evaluate the effectiveness of a few integrative teaching methods. Materials and Methods: We introduced three different interventions in the subject Kriya Sharira with special reference to ‘cardiovascular physiology’. The instructional methods that we evaluated were: 1. Integrative module on cardiovascular physiology (IMCP), 2. case-stimulated learning (CSL), and 3. classroom small group discussion (CSGD). In the fi rst two experiments, we subjected the experimental group of graduate students to the integrative instructional methods. The control group of students received the instructions in a conventional, didactic, teacher-centric way. After the experiments were over, the learning outcome was assessed and compared on the basis of the test scores. The groups were crossed over thereafter and the instructional methods were interchanged. Finally, feedback was obtained on different questionnaires. In the third experiment, only student feedback was taken as we could not have a control group. Results: The test results in the fi rst experiment showed that the integrative method is comparable with the conventional method. In the second experiment, the test results showed that the integrative method is better than the conventional method. The student feedback showed that all the three methods were perceived to be more interesting than the conventional one. Conclusion: The study shows that the development of testable integrative teaching methods is possible in the context of Ayurveda education. It also shows that students fi nd integrative approaches more interesting than the conventional method.

Student Satisfaction and Self-Assessment after Small Group Discussion in a Medical Ethics Education Program / 한국의학교육

PURPOSE: Small group discussions are useful tools in medical ethics education. We aimed to assess student satisfaction with specific components of a small group discussion and to evaluate student self-assessment of the objectives of education. METHODS: A structured questionnaire was developed after a literature review and a focus group interview. Components of the small group discussion were categorized by discussion case (self, other), individual activities (self-study, making materials, presentation experience), and group activities (preclass/in-class/postclass/plenary discussion, instructor's comments). The items for student self-assessment were: "To specify ethical issue in actual practice", "To get new knowledge", "To consider doctor's entity", "Empathy to others", "To get multidimensional viewpoint", "Viewpoint change", "To deliver my thought clearly", and "Ability to confront the medical ethics dilemma in the future". After the survey, an in-depth interview was performed to determine the reason behind the students' answers. RESULTS: A total of 121 students responded, for whom overall satisfaction and self-assessment were high. Students reported greater satisfaction with self-case, presentation experience, in-class discussion, and instructor's comments but less satisfaction with self-study before class and postclass discussion. Student self-assessment was highest in the ability to specify an ethical issue and lowest for viewpoint change and self-confidence. After multivariate analysis, higher student self-assessment was associated with greater satisfaction with the small group discussion. CONCLUSION: To improve the quality of medical ethics education, close investigation and monitoring of each component of the small group discussion and student achievement are essential, as is continuous feedback.

Student Satisfaction and Self-Assessment after Small Group Discussion in a Medical Ethics Education Program / 한국의학교육

PURPOSE: Small group discussions are useful tools in medical ethics education. We aimed to assess student satisfaction with specific components of a small group discussion and to evaluate student self-assessment of the objectives of education. METHODS: A structured questionnaire was developed after a literature review and a focus group interview. Components of the small group discussion were categorized by discussion case (self, other), individual activities (self-study, making materials, presentation experience), and group activities (preclass/in-class/postclass/plenary discussion, instructor's comments). The items for student self-assessment were: "To specify ethical issue in actual practice", "To get new knowledge", "To consider doctor's entity", "Empathy to others", "To get multidimensional viewpoint", "Viewpoint change", "To deliver my thought clearly", and "Ability to confront the medical ethics dilemma in the future". After the survey, an in-depth interview was performed to determine the reason behind the students' answers. RESULTS: A total of 121 students responded, for whom overall satisfaction and self-assessment were high. Students reported greater satisfaction with self-case, presentation experience, in-class discussion, and instructor's comments but less satisfaction with self-study before class and postclass discussion. Student self-assessment was highest in the ability to specify an ethical issue and lowest for viewpoint change and self-confidence. After multivariate analysis, higher student self-assessment was associated with greater satisfaction with the small group discussion. CONCLUSION: To improve the quality of medical ethics education, close investigation and monitoring of each component of the small group discussion and student achievement are essential, as is continuous feedback.

Introduction of Active Educational Methods in Medical Ethics Education and Evaluations of Their Effect on Medical Students / 医学教育

We introduced active educational methods in medical ethics education and evaluated their effect on medical students. Three methods were used: 1) small-group discussion to clarify the clinical ethical issues, 2) self-study to analyze examples of doctors' explanations to patients, and 3) self-study with videotapes to recognize informed consent. We asked students to write a report on each subject of the three studies. Before grading their reports, we determined a standard answer for each subject and marked their reports according to an absolute standard. We found the mean value and standard error of the students' scores in study 1 were significantly higher than those in study 2 or 3. These results suggest that small-group discussion is an effective educational method and useful in the analysis of clinical ethical issues.