A novel Medical Achievement Self-efficacy Scale (MASS): a valid and reliable tool.

In search for an instrument to measure overall curriculum impact, we developed a Medical Achievement Self-efficacy Scale (MASS) and presented it to medical students enrolled in the different years of the integrated Ghent curriculum. The research aim was to study the validity and reliability of this new scale. MASS items were constructed based on the end terms of the Ghent curriculum, as it is related to the general competency frameworks of CanMEDs and the Five-star Doctor. The scale includes at least two items for each CanMEDS competency domain. Items were examined by seven experts in view of content and face validity. This resulted in an MASS version, containing 18 items, to be rated on a five-point Likert scale. This version was piloted on 94 undergraduate medical students enrolled at the Catholic University of Leuven. The final version was presented to 1066 undergraduate medical students enrolled at Ghent University. Reliability of the MASS scale was high (α=0.89). As expected, self-efficacy scores increased significantly over the years (F=39.11, p<0.001). In view of determining predictive validity, regression analysis was carried out to predict students' academic achievement from self-efficacy scores. As expected, MASS scores significantly predicted Maastricht Progress Test scores (F=108.18, p<0.001).

Twelve tips for successful e-tutoring using electronic portfolios.

BACKGROUND: E-tutoring by means of a digital portfolio offers personal guidance in a context in which regular face-to-face contact between supervisor and student is difficult. However, implementing e-tutoring in practice is not always straightforward. AIMS: This article investigates the conditions for successful e-tutoring of electronic portfolios. METHOD: A combination of three methods is used: our own experience with e-tutoring, interviews with 14 tutors using an e-portfolio and the answers on questionnaires by 107 students. RESULTS: We present 12 tips to increase the chances of successful e-tutoring when using electronic portfolios. CONCLUSION: E-tutoring by means of electronic portfolios can be a feasible alternative in contexts in which face-to-face tutoring is difficult.

Electronic discussion forums in medical ethics education: the impact of didactic guidelines and netiquette.

OBJECTIVES: The quality of computer-mediated asynchronous group discussion in educational settings often has potential for improvement. To this end, 2 categories of recommendations can be found in the literature. Some authors advise providing didactic guidelines to students. Others recommend informing students about the basics of (formal) network etiquette (netiquette). This paper investigates whether the type of guideline provided has an effect on either or both the quality of asynchronous group discussion and the appraisal of participants in the context of a course in medical ethics. METHODS: A total of 112 students graduating in the biomedical sciences were randomly assigned to electronic discussion groups of 18-19 participants each. Three treatment groups were created by varying the guidelines presented to participants upon entering the discussion forum. Guidelines contained trivial information, netiquette advice, or a combination of didactic guidelines and netiquette advice. RESULTS: Both the quality of discussion and the participants' appraisal of the discussion were highest in the third group. However, contrary to what is widely suggested, it was observed that exclusively supplying netiquette guidelines had no impact on discussion quality. CONCLUSIONS: To improve the quality of asynchronous group discussion, it is advisable to provide not only netiquette rules, but also didactic guidelines. Future research should focus on the effects of netiquette guidelines on students of different levels and skills and should allow for disentangling the effects of netiquette and didactic guidelines. It might also seek to establish methods of disseminating guidelines that enhance their effect.

Making more of it! Medical students' motives for voluntarily keeping an extended portfolio.

BACKGROUND: Although medical students' use of portfolios has been studied from many angles, little is known about their motivations. AIM: This article explores medical students' motives for voluntarily compiling a learning portfolio that widely exceeded the assignments. METHODS: Content analysis was performed on 22 (8%; n = 22/269) extensive portfolios, followed by a semi-structured interview with 11 medical students. Building on the theoretical work of Simons et al. (2004), interpretative analysis was used to reconstruct and understand the medical students' motives for the effort they put into the portfolios. RESULTS: Compiling an elaborate portfolio is mainly instigated by a personal instrumentality (internally regulated instrumental motivation). These medical students reflected on what they considered important and useful. The portfolio was a tool to achieve self-set goals, yet the specific goals turned out to be very different among the students, reflecting their particular needs and experiences during clerkship. CONCLUSION: Motivation theory shows that students who are internally regulated use more deep-level learning strategies and perform better. Internally regulated motivation mainly occurs when students use the portfolio to achieve their self-set goals. The formal portfolio assignments, enforced by the medical school, were more related with externally regulated motivation.

Disentangling clinical learning experiences: an exploratory study on the dynamic tensions in internship.

Clinical practice is an essential component of medical training, but not all internships yield the appropriate and expected learning results. We report on an exploratory study of the learning process during internship in undergraduate medical education. We hypothesised that learning experiences in clinical practice are determined by characteristics of the interns, characteristics of the training setting and the meaningful interactions between them. As the study focused on the perceptions and interpretations of both interns and their supervisors of interns' experiences in practical training, qualitative research methods were used for data collection and analysis. This consisted of student shadowing, complemented by informal and semistructured interviews with both interns and supervisors. Analysis revealed 5 components that constitute learning experiences in clinical internship. These components represent dynamics in the clinical environment that constantly require students to (re-)define and (re-)position themselves: the agenda of the internship (working versus learning); the attitude of the supervisor (evaluator versus coach); the culture of the training setting (work-orientated versus training-orientated); the intern's learning attitude (passive versus proactive), and the nature of the learning process (informal versus formal). The model of components and tensions offers a conceptual framework to analyse and understand students' learning during internship. It not only contributes to a grounded theoretical conceptualisation of clinical learning, but may also be used in efforts to improve the quality of learning during internship, as well as the level of support and supervision.