Does a learner-centered approach using teleconference improve medical students' psychological safety and self-explanation in clinical reasoning conferences? a crossover study.

During clinical reasoning case conferences, a learner-centered approach using teleconferencing can create a psychologically safe environment and help learners speak up. This study aims to measure the psychological safety of students who are supposed to self-explain their clinical reasoning to conference participants. This crossover study compared the effects of two clinical reasoning case conference methods on medical students' psychological safety. The study population comprised 4th-5th year medical students participating in a two-week general medicine clinical clerkship rotation, from September 2019 to February 2020. They participated in both a learner-centered approach teleconference and a traditional, live-style conference. Teleconferences were conducted in a separate room, with only a group of students and one facilitator. Participants in group 1 received a learner-centered teleconference in the first week and a traditional, live-style conference in the second week. Participants assigned to group 2 received a traditional, live-style conference in the first week and a learner-centered approach teleconference in the second week. After each conference, Edmondson's Psychological Safety Scale was used to assess the students' psychological safety. We also counted the number of students who self-explained their clinical reasoning processes during each conference. Of the 38 students, 34 completed the study. Six out of the seven psychological safety items were significantly higher in the learner-centered approach teleconferences (p<0.01). Twenty-nine (85.3%) students performed self-explanation in the teleconference compared to ten (29.4%) in the live conference (p<0.01). A learner-centered approach teleconference could improve psychological safety in novice learners and increase the frequency of their self-explanation, helping educators better assess their understanding. Based on these results, a learner-centered teleconference approach has the potential to be a method for teaching clinical reasoning to medical students.

e-Learning for enhancement of medical student performance at the Objective Structured Clinical Examination (OSCE).

This study aimed to investigate the impact of student e-learning on the development of clinical competencies. The study participants were 3rd year students (n = 43) at a private mid-sized medical school located in a South Korean suburb on a four-year medical program. Educational intervention was implemented to enhance student clinical performance. Students engaged in learning activities that intended to promote their self-directed learning abilities and clinical performances using e-learning resources. Intervention was conducted for the duration of six months during the 3rd year and its effectiveness was investigated by comparing student performances in OSCEs in a pre- and post- comparison format and also by comparing them with national scores. In addition, student perceptions of the impact of e-learning on their OSCE performances were assessed using a questionnaire, which included 36 items that elicited student perceptions of their experiences of e-learning and readiness for e-learning. Student OSCE scores improved significantly after educational intervention in all domains of clinical competencies assessed and for total scores (p < 0.001). Furthermore, students achieved higher OSCE scores than national average scores in the post-test, whereas they had performed lower than national average scores in the pre-test. Students showed neutral or slightly positive responses to the effectiveness of e-learning, and their perceptions of e-learning were not associated with their e-learning readiness scores. The study shows student OSCE performance improved significantly after educational intervention, which indicate the effectiveness of e-learning to support student learning of clinical performance. Despite significant improvements in student OSCE scores after e-learning, their perceptions of its effectiveness were neutral. Furthermore, student perceptions of e-learning were not associated with their readiness for it. Suggestions are made to help students use e-learning more effectively to enhance their clinical competencies.

Student Survey Results of a Virtual Medical Student Course Developed as a Platform for Neurosurgical Education During the Coronavirus Disease 2019 Pandemic.

BACKGROUND: Before the coronavirus disease 2019 (COVID-19) pandemic, medical students training in neurosurgery relied on external subinternships at institutions nationwide for immersive educational experiences and to increase their odds of matching. However, external rotations for the 2020-2021 cycle were suspended given concerns of spreading COVID-19. Our objective was to provide foundational neurosurgical knowledge expected of interns, bootcamp-style instruction in basic procedures, and preinterview networking opportunities for students in an accessible, virtual format. METHODS: The virtual neurosurgery course consisted of 16 biweekly 1-hour seminars over a 2-month period. Participants completed comprehensive precourse and postcourse surveys assessing their backgrounds, confidence in diverse neurosurgical concepts, and opinions of the qualities of the seminars. Responses from students completing both precourse and postcourse surveys were included. RESULTS: An average of 82 students participated live in each weekly lecture (range, 41-150). Thirty-two participants completed both surveys. On a 1-10 scale self-assessing baseline confidence in neurosurgical concepts, participants were most confident in neuroendocrinology (6.79 ± 0.31) and least confident in spine oncology (4.24 ± 0.44), with an average of 5.05 ± 0.32 across all topics. Quality ratings for all seminars were favorable. The mean postcourse confidence was 7.79 ± 0.19, representing an improvement of 3.13 ± 0.38 (P < 0.0001). CONCLUSIONS: Feedback on seminar quality and improvements in confidence in neurosurgical topics suggest that an interactive virtual course may be an effective means of improving students' foundational neurosurgical knowledge and providing networking opportunities before application cycles. Comparison with in-person rotations when these are reestablished may help define roles for these tools.

Anatomy education of medical and dental students during COVID-19 pandemic: a reality check.

PURPOSE: During this forced down-time of COVID-19 pandemic, shift to virtual anatomy education is the solitary solution to support the learning of students. The purpose of this study was to understand the visible and invisible potential challenges being faced by the 1st year medical and dental students while attending digital anatomy classes. METHODS: The present study was conducted on 81st year medical and dental students who were admitted to their respective college in August 2019 and were willing to participate in the study. A multiple choice close-ended questionnaire regarding their opinion on virtual classes was designed and feedback was taken from the students. RESULTS: Majority (65%) of the students agreed that they missed their traditional anatomy learning i.e., dissection courses, face to face lectures and interaction with mentors. The students strongly felt the lack of confidence and difficulty in the topics completed without dissections, models, microscopic slides and other modalities. 83% felt lack of proper gadgets, high-band width and strong internet connections, a potential barrier in their digital learning. Lack of self-motivation was felt by 69% students. CONCLUSIONS: The current situation of anatomy education is not intentional, and is not the long term silver bullet solution for a visual subject like anatomy. Though learners face a lot of challenges, however, a shift to online must be supported at this time of health crisis. As the digital learning may go for indefinite period, the feedback of students may be helpful for relevant and timely modifications in digital anatomy education.

Implementation and evaluation of eight virtual surgical electives for medical students during the COVID-19 pandemic.

BACKGROUND: Eight novel virtual surgery electives (VSEs) were developed and implemented in April-May 2020 for medical students forced to continue their education remotely due to COVID-19. METHODS: Each VSE was 1-2 weeks long, contained specialty-specific course objectives, and included a variety of teaching modalities. Students completed a post-course survey to assess changes in their interest and understanding of the specialty. Quantitative methods were employed to analyze the results. RESULTS: Eighty-three students participated in the electives and 67 (80.7%) completed the post-course survey. Forty-six (68.7%) respondents reported "increased" or "greatly increased" interest in the course specialty completed. Survey respondents' post-course understanding of each specialty increased by a statistically significant amount (p-value = <0.0001). CONCLUSION: This initial effort demonstrated that VSEs can be an effective tool for increasing medical students' interest in and understanding of surgical specialties. They should be studied further with more rigorous methods in a larger population.

The Effectiveness of a Serious Game Versus Online Lectures for Improving Medical Students' Coronavirus Disease 2019 Knowledge.

Objective: The sudden disruption of university teaching caused by the coronavirus disease 2019 (COVID-19) pandemic has forced universities to switch to online teaching. It is vital for graduating medical students to learn about COVID-19 because they are likely to treat COVID-19 patients after graduation. We developed a COVID-19 lesson for medical students that used either an online lecture or a serious game that we designed. The aim of this study is to explore the effectiveness of a serious game versus online lectures for improving medical students' COVID-19 knowledge. Materials and Methods: From our university's database of knowledge scores, we collected the prelesson, postlesson, and final test knowledge scores of the students who participated in the lesson and conducted a retrospective comparative analysis. Results: An analysis of scores concerning knowledge of COVID-19 from prelesson and postlesson tests shows that both teaching methods produce significant increases in short-term knowledge, with no statistical difference between the two methods (P > 0.05). The final test scores, however, show that the group of students who used the game-based computer application scored significantly higher in knowledge retention than did the online lecture group (P = 0.001). Conclusion: In the context of the disruption of traditional university teaching caused by the COVID-19 pandemic, the serious game we designed is potentially an effective option for online medical education about COVID-19, particularly in terms of its capacity for improved knowledge retention.

Evaluation of undergraduate medical students' preference to human anatomy practical assessment methodology: a comparison between online and traditional methods.

PURPOSE: COVID 19 pandemic has brought crucial changes in the field of medical education. Ad mist university examinations in India medical schools have switched to online assessment methods to avoid student gatherings. In this context, we conducted online anatomy practical evaluation and we have aimed at quantifying the students' experience on virtual assessment. METHODS: A total of 250 first year MBBS students appeared for online anatomy practical examinations. Immediately after the completion of exams electronic feedback about their experience, in questionnaire format was obtained after getting informed consent. Their feedback was analysed and quantified. RESULTS: Completed feedback forms were submitted by 228 students. More than 50% of students favoured online anatomy spotter examinations. Only 32.8% of students were comfortable with soft parts discussion using images. For image based viva voce 61.4%, 80% & 82% of students responded that the features and orientation of osteology, radiology and embryology images, respectively, were good. For surface marking 55% of the participants preferred online verbal evaluation. Finally, more than 60% of the students preferred the conventional over online assessment methods. CONCLUSIONS: The inclination of students' preference for traditional anatomy examination methods mandates adequate training of both students and teachers for virtual examination. The superiority of conventional anatomy practical examination methods is unbiased but pandemic situations warrant adequate preparedness. In the future the anatomy teaching and evaluation methodology in Indian medical schools have to be drastically reviewed in equivalence with global digitalization.

Gross Anatomy Education in China during the Covid-19 Pandemic: A National Survey.

The Covid-19 pandemic launched the use of online courses in Chinese medical schools during February 2020. To evaluate the state of gross anatomy education in China during the pandemic, a nationwide survey was conducted through convenience sampling by email or respondent invitations on social media. A total of 359 questionnaires were received from the respondents. The first response from a given school was included in the study to represent that school, thus, 77 questionnaires were used for analyses. Schools represented were from all provinces in mainland China as well as Hong Kong and Macao. The survey found that before the pandemic, 74.0% and 33.8% of the 77 schools conducted online theoretical and practical sessions, respectively, on gross anatomy, and 36 (46.8% of 77) had temporarily suspended practical sessions at the time the survey was conducted. Body donation programs were also affected with 26.0% and 27.3% of the 77 schools having suspended donation programs or saw a decreased number of donations. During the pandemic, 40.3% of the 77 schools kept or initiated the implementation of active learning, and online assessment was continued in 49.4% of the 77 medical schools. Another 26 (33.8%) schools initiated online assessment during the pandemic. A total of 359 answers were included for the analysis of the "teachers' perception of the online teaching experience." Over half (51.0%) of the 359 responded teachers were very statisfied or satisfied with the effectiveness of online teaching during the pandemic. A total of 36.2% of these respondents preferred to implement online teaching of theoretical sessions after the pandemic, and 89 (24.8%) teachers were keen to return to traditional face-to-face anatomy education.

Evaluation of academic integrity of online open book assessments implemented in an undergraduate medical radiation science course during COVID-19 pandemic.

INTRODUCTION: Online open book assessment has been a common alternative to a traditional invigilated test or examination during the COVID-19 pandemic. However, its unsupervised nature increases ease of cheating, which is an academic integrity concern. This study's purpose was to evaluate the integrity of two online open book assessments with different formats (1. Tightly time restricted - 50 min for mid-semester and 2. Take home - any 4 h within a 24-h window for end of semester) implemented in a radiologic pathology unit of a Bachelor of Science (Medical Radiation Science) course during the pandemic. METHODS: This was a retrospective study involving a review and analysis of existing information related to the integrity of the two radiologic pathology assessments. Three integrity evaluation approaches were employed. The first approach was to review all the Turnitin plagiarism detection software reports with use of 'seven-words-in-a-row' criterion to identify any potential collusion. The second approach was to search for highly irrelevant assessment answers during marking for detection of other cheating types. Examples of highly irrelevant answers included those not addressing question requirements and stating patients' clinical information not from given patient histories. The third approach was an assessment score statistical analysis through descriptive and inferential statistics to identify any abnormal patterns that might suggest cheating occurred. An abnormal pattern example was high assessment scores. The descriptive statistics used were minimum, maximum, range, first quartile, median, third quartile, interquartile range, mean, standard deviation, fail and full mark rates. T-test was employed to compare mean scores between the two assessments in this year (2020), between the two assessments in the last year (2019), between the two mid-semester assessments in 2019 and 2020, and between this and last years' end of semester assessments. A p-value of less than 0.05 was considered statistically significant. RESULTS: No cheating evidence was found in all Turnitin reports and assessment answers. The mean scores of the end of semester assessments in 2019 (88.2%) and 2020 (90.9%) were similar (p = 0.098). However, the mean score of the online open book mid-semester assessment in 2020 (62.8%) was statistically significantly lower than that of the traditional invigilated mid-semester assessment in 2019 (71.8%) with p < 0.0001. CONCLUSION: This study shows the use of the online open book assessments with tight time restrictions and the take home formats in the radiologic pathology unit did not have any academic integrity issues. Apparently, the strict assessment time limit played an important role in maintaining their integrity.

The impact of the COVID-19 pandemic on final year medical students in the United Kingdom: a national survey.

BACKGROUND: The coronavirus disease (COVID-19) global pandemic has resulted in unprecedented public health measures. This has impacted the UK education sector with many universities halting campus-based teaching and examinations. The aim of this study is to identify the impact of COVID-19 on final year medical students' examinations and placements in the United Kingdom (UK) and how it might impact their confidence and preparedness going into their first year of foundation training. METHODS: A 10-item online survey was distributed to final year medical students across 33 UK medical schools. The survey was designed by combining dichotomous, multiple choice and likert response scale questions. Participants were asked about the effect that the COVID-19 global pandemic had on final year medical written exams, electives, assistantships and objective structured clinical examinations (OSCEs). The survey also explored the student's confidence and preparedness going into their first year of training under these new unprecedented circumstances. RESULTS: Four hundred forty students from 32 UK medical schools responded. 38.4% (n = 169) of respondents had their final OSCEs cancelled while 43.0% (n = 189) had already completed their final OSCEs before restrictions. 43.0% (n = 189) of assistantship placements were postponed while 77.3% (n = 340) had electives cancelled. The impact of COVID-19 on OSCEs, written examinations and student assistantships significantly affected students' preparedness (respectively p = 0.025, 0.008, 0.0005). In contrast, when measuring confidence, only changes to student assistantships had a significant effect (p = 0.0005). The majority of students feel that measures taken during this pandemic to amend their curricula was necessary. Respondents also agree that assisting in hospitals during the outbreak would be a valuable learning opportunity. CONCLUSIONS: The impact on medical student education has been significant, particularly affecting the transition from student to doctor. This study showed the disruptions to student assistantships had the biggest effect on students' confidence and preparedness. For those willing to assist in hospitals to join the front-line workforce, it is crucial to maintain their wellbeing with safeguards such as proper inductions, support and supervision.