Use of the Online Discussion Board in Health Professions Education: Contributions, Challenges, and Considerations.

Online discussion boards offer opportunities for individualized and interactive learning in higher education and are frequently used in health professions education. This article investigates the ways in which discussion board activities foster cognitive and affective domain learning among health professions students and contribute to the professional competencies that are required of emerging clinicians. In addition, pedagogical challenges, including the need to develop sophisticated interpersonal affective domain skills, promote problem-based learning, and prepare students for standardized examinations, are addressed. Considerations for practice, which include the importance of specific teaching strategies such as the shaping of student and instructor roles, scaffolding, and online debates and role-playing, are discussed.

Usability and Efficacy of Neurologic Digital Case Studies to Promote Clinical Decision-Making Skills Among Physical Therapist Students.

Clinical decision-making (CDM) is essential to professional competency but remains a difficult concept to teach and learn. The purpose of this study was to assess usability and efficacy of digital case studies for development of CDM skills within the neurologic physical therapy curriculum. METHOD: A two-part pilot study was designed to: 1) examine the usability and perceived efficacy of digital case studies; and 2) examine the efficacy of case studies upon student CDM skill development. Twenty-one students participated in the initial pilot study and were given a 5-question survey and open-response questions that were analyzed quantitatively and qualitatively. The second phase of the study consisted of two groups (n=48): one completed digital case studies, and another completed paper cases. Both groups completed pre- and post-tests, and data were analyzed using independent sample t-test for comparing mean difference. ASSESSMENT: Students reported digital case studies as user-friendly, but there was no statistically significant difference found in CDM between groups. CONCLUSION: While the use of digital case studies generated student satisfaction, they do not appear to eclipse low-tech options in terms of efficacy. Various pedagogies can yield similar results, and thus faculty resources should be considered when developing educational methodologies.

Developing Affective Domain Learning in Health Professions Education.

The delivery of effective 21st-century multidisciplinary healthcare requires that clinicians focus on patient needs and concerns and are able to communicate compassionately and appropriately so that patient-practitioner trust is engendered. To develop interpersonal skills among healthcare providers, health professions education programs must build student competencies in the affective domain of learning. This paper seeks to investigate the efficacy of some of the contemporary strategies used to present and assess affective domain learning in health professions education, including the think-pair-share technique, reflective journaling, simulation and role play, motivational interviewing, and structured controversy. Additionally, the role of contemporary technology-based learning platforms as barriers or facilitators of affective learning is discussed. Finally, the utilization of various teaching methodologies in conjunction with pedagogical factors such as instructor approach, student feedback, and judicious course design is considered. Evidence suggests that affective learning competencies are best achieved when teaching practices are designed to improve self-awareness, expose multiple points of view, shape perspective transformation, and emphasize the interpersonal skills needed to master person-centered care.

A Pivotal Study of Optoacoustic Imaging to Diagnose Benign and Malignant Breast Masses: A New Evaluation Tool for Radiologists.

Purpose To compare the diagnostic utility of an investigational optoacoustic imaging device that fuses laser optical imaging (OA) with grayscale ultrasonography (US) to grayscale US alone in differentiating benign and malignant breast masses. Materials and Methods This prospective, 16-site study of 2105 women (study period: 12/21/2012 to 9/9/2015) compared Breast Imaging Reporting and Data System (BI-RADS) categories assigned by seven blinded independent readers to benign and malignant breast masses using OA/US versus US alone. BI-RADS 3, 4, or 5 masses assessed at diagnostic US with biopsy-proven histologic findings and BI-RADS 3 masses stable at 12 months were eligible. Independent readers reviewed US images obtained with the OA/US device, assigned a probability of malignancy (POM) and BI-RADS category, and locked results. The same independent readers then reviewed OA/US images, scored OA features, and assigned OA/US POM and a BI-RADS category. Specificity and sensitivity were calculated for US and OA/US. Benign and malignant mass upgrade and downgrade rates, positive and negative predictive values, and positive and negative likelihood ratios were compared. Results Of 2105 consented subjects with 2191 masses, 100 subjects (103 masses) were analyzed separately as a training population and excluded. An additional 202 subjects (210 masses) were excluded due to technical failures or incomplete imaging, 72 subjects (78 masses) due to protocol deviations, and 41 subjects (43 masses) due to high-risk histologic results. Of 1690 subjects with 1757 masses (1079 [61.4%] benign and 678 [38.6%] malignant masses), OA/US downgraded 40.8% (3078/7535) of benign mass reads, with a specificity of 43.0% (3242/7538, 99% confidence interval [CI]: 40.4%, 45.7%) for OA/US versus 28.1% (2120/7543, 99% CI: 25.8%, 30.5%) for the internal US of the OA/US device. OA/US exceeded US in specificity by 14.9% (P < .0001; 99% CI: 12.9, 16.9%). Sensitivity for biopsied malignant masses was 96.0% (4553/4745, 99% CI: 94.5%, 97.0%) for OA/US and 98.6% (4680/4746, 99% CI: 97.8%, 99.1%) for US (P < .0001). The negative likelihood ratio of 0.094 for OA/US indicates a negative examination can reduce a maximum US-assigned pretest probability of 17.8% (low BI-RADS 4B) to a posttest probability of 2% (BI-RADS 3). Conclusion OA/US increases the specificity of breast mass assessment compared with the device internal grayscale US alone. Online supplemental material is available for this article. © RSNA, 2017.