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Objective:To explore the application effect of modified direct observation of procedural skills (DOPS) as a formative assessment tool in clinical skills training of professional graduate students.Methods:A total of 130 professional graduate students of Batch 2019 were selected as the experimental group, and 127 graduate students of Batch 2018 were selected as the control group. Two groups of students received clinical general skills training after enrollment, the control group adopted the traditional skills teaching method, and the experimental group added DOPS as formative assessment on the basis of traditional teaching. The teaching effect of DOPS was evaluated by means of scores analysis and student self-assessment. SPSS 23.0 was used for t-test. Results:The score of the experimental group (84.35±3.41) was higher than that of the control group (77.58±2.68), which showed a statistically significant difference ( t=2.63, P<0.05). The scores of "skill operation ability" and "communication ability" were the lowest single indexes in the assessment of DOPS. The results of self-assessment showed that the scores of autonomous learning ability, clinical thinking ability, clinical practice ability and professional accomplishment of students in the experimental group were all higher than those in the control group ( P<0.05). Conclusion:Modified DOPS is helpful to improve clinical core ability, which is worth promoting for application.
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Introducción: Las habilidades procedimentales invariantes en las peritonitis posoperatorias, les permite a los cirujanos el diagnóstico temprano y la reoperación abdominal urgente. Objetivo: Diseñar las habilidades procedimentales invariantes de atención diagnóstica y terapéutica a la peritonitis posoperatoria dirigida a los cirujanos. Método: Se realizó una investigación cualitativa en el Hospital Clínico Quirúrgico "Ambrosio Grillo" de Santiago de Cuba en el trimestre mayo-julio de 2022. La población de estudio estuvo constituida por 33 profesionales tratantes de la peritonitis posoperatoria: 22 médicos (12 cirujanos y 10 intensivistas) y 11 licenciadas en Enfermería. Se utilizó la sistematización como método teórico y como método empírico la revisión documental con la revisión de las historias clínicas y la observación con la práctica atencional-docente de la autora principal. Resultados: Se diseñaron las habilidades procedimentales invariantes para el diagnóstico temprano y la terapéutica de la peritonitis posoperatoria dirigida a los cirujanos con especial importancia en el método clínico. La autopreparación del tema en cuestión posibilita la complementación de conocimientos y habilidades aprendidas, así como la actualización de saberes que garantiza la atención clínica quirúrgica a este complejo enfermo. Conclusiones: El diseño de las habilidades procedimentales invariantes para el diagnóstico temprano y la terapéutica de la peritonitis posoperatoria en la necesaria superación permanente y continuada de los cirujanos representa una herramienta asistencial-docente que contribuye al mejoramiento del desempeño profesional ante este tipo de enfermo.
Introduction: Invariant procedural skills in postoperative peritonitis allow surgeons an early diagnosis and the performance of urgent abdominal resurgery. Objective: To design invariant procedural skills to be implemented for surgeons on the diagnostic and therapeutic care of postoperative peritonitis. Method: A qualitative research was conducted at the Hospital Clínico Quirúrgico "Ambrosio Grillo" of Santiago de Cuba in the quarter period of May-July 2022. The study population consisted of 33 specialists on postoperative peritonitis: 22 physicians (12 surgeons and 10 intensivists) and 11 graduated bachelor in nursing. Systematization was used as the theoretical method and the empirical methods used were the document analysis supported with the review of clinical histories and the observation with the main author's attentional-teaching practice. Results: It was designed an invariant procedural skills for the early diagnosis and therapy of postoperative peritonitis with special emphasis on the clinical method. The self-preparation on the subject makes possible the complementation of both knowledge and skills learned, as well as an update of knowledge that guarantees the surgical clinical care of these complex patients. Conclusions: The design of invariant procedural skills for the early diagnosis and therapy of postoperative peritonitis in the necessary permanent and continuous knowledge improvement of surgeons represents a care-teaching tool that contributes to improve the professional performance at the time to attend to this type of patient.
Introdução: As habilidades processuais invariantes na peritonite pós-operatória permitem aos cirurgiões o diagnóstico precoce e a reoperação abdominal urgente. Objetivo: Projetar as habilidades processuais invariantes de atenção diagnóstica e terapêutica para peritonite pós-operatória destinadas a cirurgiões. Método: Uma pesquisa qualitativa foi realizada no Hospital Clínico Cirúrgico "Ambrosio Grillo" em Santiago de Cuba no trimestre maio-julho de 2022. A população do estudo consistiu em 33 profissionais que tratam de peritonite pós-operatória: 22 médicos (12 cirurgiões e 10 intensivistas) e 11 graduados em enfermagem. Utilizou-se como método teórico a sistematização e como métodos empíricos a revição documental com revisão de histórias clínicas e a observação com a prática docente-atencional da autora principal. Resultados: Desenharam-se competências processuais invariantes para o diagnóstico precoce e terapêutica da peritonite pós-operatória dirigidas a cirurgiões com especial importância no método clínico. O autopreparo do sujeito em questão possibilita a complementação dos conhecimentos e habilidades aprendidas, bem como a atualização de conhecimentos que garantem o cuidado clínico cirúrgico desta complexa doença. Conclusões: O desenho de habilidades processuais invariantes para o diagnóstico precoce e tratamento da peritonite pós-operatória no necessário aperfeiçoamento permanente e contínuo dos cirurgiões representa uma ferramenta cuidado-ensino que contribui para o aperfeiçoamento da atuação profissional frente a este tipo de paciente.
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Background: During MBBS course, the students’ study about cardiovascular system (CVS) in physiology, pathology, pharmacology, preventive medicine, pediatrics, and medicine for the management and diagnosis of cardiovascular disorders. Blood pressure measurement is a common and a beneficial tool for the diagnosis of cardiovascular disorders (hypertension, hypotension, etc.) along with their treatment and management. Thus, knowing the proper technique of measuring blood pressure becomes an essential part of learning the course and management of cardiovascular disease. This study is designed to teach and train the first phase undergraduate students to measure blood pressure in a proper way so that they do not stumble on the first step of examination of CVS. Competency-based training is an outcome-based approach that involves identifying the skills acquired by Indian medical graduate. Competency-based teaching involves teaching of undergraduate students to support their achievement and assessment of the communication and technical skills and to develop their ability to interpret the results of blood pressure measurement for apt patient management. Aim and Objectives: This study aims to assess and compare the effect of competency-based teaching and traditional teaching in learning the skill of blood pressure measurement. Materials and Methods: Two hundred students were taken from Phase I undergraduate medical students which were randomly divided in two Groups A and B. Competency-based teaching of blood pressure measurement was done in Group A in by teaching method of demonstrate, observe, assist, and perform and Group B was taught by traditional demonstration. Pre-test questionnaire was given to both the groups before beginning of the practical session. The students learning of skill to measure blood pressure was assessed by directly observed procedural skills (DOPS) checklist after which student feedback was provided along with filling up of the post-test questionnaire. Furthermore, feedback from both student and teacher was collected. Results: Highly significant difference was found between pre-test and post-test of both Group A and Group B. Significant difference was found between Group A and Group B post-test scores. It was found that Group A in which competency-based teaching was done scored higher post-test scores then Group B. Furthermore, highly significant difference was seen among the scores of DOPS checklist between Group A and Group B. Conclusion: In the present research study, it was found that the students who underwent competency-based training of the skill of blood pressure measurement showed significantly higher scores in learning and performing the skill. Furthermore, on feedback provided by the students, 96% of the students strongly agree that the competency-based teaching and learning is better than traditional teaching.
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AIM: To explore the effect of flipped classroom combined with team-based learning(TBL)in ophthalmology practice teaching by applying directly observed procedural skills(DOPS). METHODS: A total of 54 students of clinical medicine “5+3” integration and clinical medicine for five years, interned at the department of ophthalmology from June 15th to November 14th, 2021 were divided into traditional teaching group(group A)and flipped classroom combined with TBL group(group B). The teaching effects of slit lamp microscopy and direct ophthalmoscopy in group A and group B were compared by DOPS score, and Mann-Whitney U test was used for statistical analysis.RESULTS: Total DOPS score for slit-lamp microscopy in group A was 59(58.00, 60.00)points,which was significantly lower than that of group B 63(61.00,65.00)points(P<0.001). The DOPS score for direct ophthalmoscopy in group A was 63(61.00, 63.75)points, which was significantly lower than that of group B, 66(63.75,66.25)points(P<0.001). In the two operations and especially in the aspects of “understanding of complications,relevant anatomical structure and proficiency in operation”“preparatory work” and “technical ability of operation”, the scores of group B was significantly higher than those of group A(P<0.05).CONCLUSION: Flipped classroom combined with TBL has significant advantages in clinical practice teaching for interns in ophthalmology, which is worthy of promotion and application compared with traditional teaching.
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Background: In view of changing requirements in healthcare systems and planned reforms of medical education curricula, effective teaching and assessment of clinical skills in the undergraduate setting has become more and more important. There is a need for implementation of newer methods of evaluation keeping in mind the principles of adult learning and self-directed learning. DOPS (directly observed procedural skills) is a highly structured assessment tool for assessment of the practical work performed by a trainee on a real patient under supervision of experienced faculty. This study aimed to make use of DOPS as a method of workplace based assessment for interns in otorhinolaryngology posting.Methods: 15 interns posted in department of otorhinolaryngology participated in the study. Three clinical procedural skills included were anterior rhinoscopy, otoscopy and indirect laryngoscopy. Three DOPS were undertaken for each skill. The performance was noted as DOPS ratings. The results were tabulated and statistically analysed.Results: A total of 135 DOPS were undertaken for 15 interns. Mean overall DOPS rating improved from DOPS 1 to DOPS 3. The difference in value between DOPS 1 and 3 for anterior rhinoscopy was statistically significant. For otoscopy and indirect laryngology, the difference between DOPS 1 and 2, DOPS 1 and 3 was statistically significant. Both faculty and interns found DOPS to be an efficient tool for assessment.Conclusions: DOPS is a cost effective assessment tool. It has an effective role in facilitating students’ learning and skill development as it is based on the direct observation of trainees’ procedural skills in real clinical environment.
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Point-of-care ultrasound (POCUS) has become increasingly employed in recent years. POCUS is the concept of quickly assessing for conditions using ultrasound based on the patient history and physical examinations to make a clinical decision in a timely manner. This concept has been developed and widely used in emergency medicine and other specialties, and has spread to primary care over the past several years. In Japan, POCUS is not well-known in primary care, but the importance of primary care physicians using ultrasound has been reported since the 1990s. However, many physicians depend on higher imaging modalities, such as computed tomography (CT) and magnetic resonance imaging (MRI), instead of ultrasound. Although the benefits of integrating POCUS into primary care have been documented, the barriers of POCUS being employed by primary care physicians include a shortage of educational resources and time during busy practice. As primary care settings in Japan vary, such as clinics, hospitals and patient homes, the indications and required skills for POCUS differ. A standardized training curriculum for POCUS needs to be developed according to the primary care setting.
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En la etapa pre-escolar los niños adquieren competencias motrices, procedimentales, sociales, cognitivas, comunicativas; todas ellas básicas para el desempeño del escolar y dependientes de la autonomía, el contexto, las tareas. El estudio se propuso describir la adquisición de hábitos en un grupo de niños en edad pre-escolar y valorar la enseñanza de acciones procedimentales que fomentan la realización de actividades secuenciales en la participación y el desempeño de los niños. Se realizó una investigación descriptiva secuencial en donde se realizaron registros observacionales cuantitativos de habilidades procedimentales de los niños. Así mismo se identificaron conocimientos, percepciones, prácticas y necesidades en la enseñanza de acciones procedimentales, mediante grupos focales con los docentes. Finalmente se desarrollaron talleres de actividades secuenciales para la adquisición de hábitos necesarios en actividades cotidianas. Los resultados muestran que hay necesidad de formar a cuidadores y do entes en el proceso de adquisición de hábitos en niños preescolares por su importancia en el desarrollo posterior. Los talleres apoyaron a niños y docentes en el proceso de aprendizaje y enseñanza de actividades secuenciales. Se concluye que el aprendizaje de la estructuración de hábitos mediante la realización de actividades secuenciales es necesario para el desempeño de actividades cotidianas. La deficiencia presenta riesgo para el posterior desarrollo y desempeño en la ejecución de tareas. Los talleres interdisciplinares para establecer habilidades procedimentales, promueven la identificación y disminución del riesgo.
ching of procedural actions that promote sequential activities in the children's participation and performance. Methodology: A descriptive, sequential research was held. The procedural skills of the children were recorded through non-participant quantitative observation. Focal groups with teachers were made to identify their knowledge, per- ceptions, practices and needs in procedural actions teaching. Finally, workshops were developed for promoting sequential activities to allow children to acquire habits that are necessary for daily activities. Results: Caregivers and teachers need to be trained on the preschool children's process of acquiring habits because of their vital importance in their future development. The workshops supported children and teachers in the process of learning / teaching sequential activities. Conclu- sions: Learning how to structure hab ts through the execution of sequential activities is necessary to perform of daily activities. Deficiency in this area risks the subsequent task's development and performance. Interdisciplinary workshops to establish procedural skills promote the identification and reduction of this risk.
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Humanos , Autonomía Personal , Actividades Cotidianas , Hábitos , Terapia OcupacionalRESUMEN
Objective To explore the application of direct observation of procedural skills (DOPS) in anesthesia-related effects skills teaching. Methods Anesthesia students in the Department of Anesthe-siology, Clinical Medical College, Yangzhou University between June 2013 and June 2015, received an anesthesia-related DOPS examination at the mid-internship and pre-delivery. Through the DOPS assessment results, the analysis of teachers' and students' satisfaction degree on the evaluation results, the teaching effect of DOPS was evaluated. At the same time, the students were surveyed to find out the satisfaction degree of DOPS. SPSS 18.0 was applied to processing the date. Measurement data were expressed as mean plus or minus standard deviation, and t test was used in the comparison between groups. Results Interim assessment indicators for each individual average of more than four points , the individual departmental rotation examination scores were higher than the overall average score interim assessment results. Compared with interim assessment, satisfaction of teachers has made great progress in the end of assessment [(8.46 ± 0.32) vs. (8.14 ±0.60)], satisfaction of students was [(8.57 ±0.59) vs. (8.20 ±0.45)], satisfaction of the students was higher than the teachers [(8.57±0.59) vs. (8.46±0.32)], and the differences were statistically significant. Conclusion DOPS as an effective anesthesia-related skill of teaching and assessment method, can improve the level of anesthesia anesthesia-related skills of college students.
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This interventional study was done in the Dept of OBGY of Bharati Vidyapeeth medical college, Pune, during Sept to Dec 2013. Context of the study: This educational research project was planned to introduce a formative structured assessment method for residents in OBGY and assess its impact on student learning. Primary Objectives:1) To design and conduct DOPS in Dept of OBGY, for second year postgraduate students.2) To assess impact on learning after 1 week of practice. Methodology: All participants were sensitized about the new assessment method: DOPS. Standard Operative Procedure for the core skill ‘Female Genital Tract Examination’ was prepared. A 5 point scale for DOPS Evaluation was designed, peer reviewed and piloted. DOPS was conducted by senior faculty members over 2 week’s time frame. Students were reassessed using same checklist by same observer after one week. Feedback about the entire experience was taken from all participants. Evaluation: 1) Student DOPS scores before and after feedback and practice 2) Analysis of feedback from all participants. Results and Conclusion: All participating students and faculty members felt that DOPS is 100% relevant to the curriculum and feasible to accept as a regular formative assessment and learning tool for PG students in OBGY. Higher Patient satisfaction expressed during second session suggests that such an intervention will result in better clinical care in long run.
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Objective To explore the effect of direct observation of procedural skills (DOPS) in teaching acupuncture manipulation skills. Methods Sophomores of acupuncture and Tuina spe-ciality were divided into two groups based on their classes, 36 students in experimental group and 31 in control group. In experimental group, DOPS on filiform needling was done twice in the middle and at the end of the semester respectively. In control group, DOPS was done once at the end of semester. The final exam's DOPS score and satisfaction degree of teachers and students concerning the results of the assessment in two groups were compared by independent samples t-test. P<0.05 indicates signifi-cant differences. The teaching effect of DOPS was also evaluated by questionnaire survey of students in experimental group. Results The total score of DOPS (4.26 ±0.24), scores of needle insertion (4.18±0.42), and scores of reinforcing and reducing method (4.03±0.28) in experimental group were higher than those in control group ((4.14±0.25), (4.00±0.29) and (3.87±0.37), P<0.05). The teachers' satisfaction (8.38±0.51) and students' satisfaction (8.47±1.03) concerning the results of the assessment in experimental group were higher than those in control group ((8.05±0.78) and (7.94±1.15), P<0.05). More than 80% of students in experimental group supported the saying of‘DOPS promoting students' skills training and enhancing the ability of handwork ’ . Conclusions DOPS can be used as an effective teaching and examination method and can improve students' skills of acupuncture manipulation.
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Objective To evaluate the efficacy of short-term training of direct observation procedural skills (DOPS) for community general practitioner (GP) trainers.Methods Thirty six GP trainers participated in one-day workshop of DOPS.The participants were interviewed with questionnaire before and after the training program and the training video was scored.Results 47.2％ (17/36) of GP trainers knew and briefly understood DOPS before the training.41.7％ (15/36)of them had a rough idea of how to use it and only 2.8％ (1/36) had used it before.All of these trainers wanted to learn how to perform DOPS.The vast majority of GP trainers completely or basically understood the standards for evaluation of 11 items of DOPS after the training.The accuracy rates of 4 items were close to or more than 50.0％ in 9-point scale and 7 items exceeded 50.0％ in 3-rank system.There was significant difference in accuracy rates of 6 items between the two scoring system(all P ＜ 0.01).Conclusions Community GP trainers recognize the advantages of DOPS in assessment of clinical skills and have strong intention of application.The efficacy of short-term workshop is satisfactory,but the evaluators need more training and practice.
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Objective To explore the effective evaluation methods of case-based learning (CBL) in critical disease teaching.Methods Totally 53 undergraduate students in department of clinical medicine of Shanghai Jiao Tong University,who practiced in our hospital from 2010 to 2012,were divided into the traditional teaching group and CBL teaching group.We used traditional teaching combining with CBL teaching in CBL group.Common cases of critical illness(severe acute pancreatitis and multiple trauma)in intensive care unit (ICU) were selected for CBL cases.The evaluation of theoretical knowledge,mini-clinical evaluation exercise(Mini-CEX)and direct observation of procedural skills (DOPS) were continued after teaching and practice.Results These was no significant difference in the theoretical knowledge examination between the two groups. In Mini-CEX,the students in CBL group were better concerning the medical interview capacity (P=0.000),humanistic care (P=0.013),clinical diagnosis(P=0.035),counseling(P=0.009) and the overall clinical competence (P=0.008) than those in traditional teaching group.The DOPS scores of endotracheal intubation (P=0.016)and central venous catheterization (P=0.001)discussed in CBL teaching were significantly higher in CBL group.Conclusion Traditional theoretical knowledge examination has little significance in the assessment of CBL teaching,but Mini-CEX and DOPS can reflect the advantages of CBL teaching better in the assessment of clinical abilities and skills.
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PURPOSE: To evaluate the educational effectiveness of practice-based program for procedural skills at Kangwon National University College of Medicine. METHODS: In 2005, we conducted the training program composed of 19 procedural skills for third-year medical students during their first semester clerkship. The 14-week training used simulation models and was held for 3 hours per week, one hour for didactic session and 2 hours for practical exercise. A lecture was given only for wound dressing. OSCE, consisting of four 5-minute stations, was administered to analyze the students' achievement. 53 third-year students were given a survey following skills training and OSCE. RESULTS: Most students reported that the practice-based program was interesting and helpful in learning procedural skills. Students preferred practice to didactic medium. Students were satisfied with the faculty's instruction, but suggested that the training should be providedprior to clerkship. OSCE had an overall reliability coefficient (Cronbach's alpha) of 0.78. The mean score in the dressing case was lower than those in other cases. CONCLUSION: The practice-based program for procedural skills was effective in motivating students' learning as well as improving theirtechnical skills. Self-directed exercises and appropriate feedback are more effective training tools than lectures.