Exploring medical students' perceptions of individual and group-based clinical reasoning with virtual patients: a qualitative study.

BACKGROUND: Virtual Patients are computer-based simulations used to teach and evaluate patient interviews, medical diagnoses, and treatment of medical conditions. It helps develop clinical reasoning skills, especially in undergraduate medical education. This study aimed to and investigate the medical students' perceptions of individual and group-based clinical reasoning and decision-making processes by using Virtual Patients. METHODS: The study group comprised 24 third-year medical students. Body Interact® software was utilized as a VP tool. The students' readiness and the courses' learning goals were considered when choosing the scenarios. Semi-structured interview forms were employed for data collection. MAXQDA 2020 qualitative analysis software was used to analyze the data. The students' written answers were analyzed using content analysis. RESULTS: The participants perceived individual applications as beneficial when making clinical decisions with Virtual Patients, but they suggested that group-based applications used with the same cases immediately following individual applications were a more appropriate decision-making method. The results indicated that students learn to make decisions through trial and error, based on software scoring priorities, or using clinical reasoning protocols. CONCLUSION: In group-based reasoning, the discussion-conciliation technique is utilized. The students stated that the individual decision-making was advantageous because it provided students with the freedom to make choices and the opportunity for self-evaluation. On the other hand, they stated that the group based decision-making process activated their prior knowledge, assisted in understanding misconceptions, and promoted information retention. Medical educators need to determine the most appropriate method when using Virtual Patients, which can be structured as individual and/or group applications depending on the competency sought.

A study on the standard setting, validity, and reliability of a standardized patient performance rating scale - student version.

INTRODUCTION: The quality of the performances of standardized patients plays a significant role in the effectiveness of clinical skills education. Therefore, providing standardized patients with constant feedback is essential. It is especially important to get students' perspectives immediately following their encounters with standardized patients. In the literature, there is no scale for use by students to evaluate the performance of standardized patients. Thus, the three main goals of this study were to: (1) develop a scale for use by students to evaluate the performance of standardized patients, (2) examine the psychometric properties of the scale, and (3) determine a cut-off score for the scale in a standard-setting. MATERIALS AND METHODS: Seven hundred and two medical students participated in the scale- development process, the pilot test, and the validation process, and seven educators took part in the standard-setting process. After the evaluation of content validity, construct validity was assessed via exploratory and confirmatory factor analyses. For the standard-setting study, the extended Angoff method was used. RESULTS: The exploratory factor analysis revealed that the scale had a single-factor structure, which was confirmed by confirmatory factor analysis. The Cronbach's alpha internal consistency coefficient was 0.91. The scale consists of nine items. The cut-off score was determined to be 24.11/45, which represents the minimum acceptable standard for standardized patient performance. CONCLUSIONS: Our study outlined the critical steps in developing a measurement tool and produced a valid and reliable scale that allows medical students to assess the performance of standardized patients immediately following their interaction with the standardized patient. This scale constitutes an important contribution to the literature as it provides a tool for standardized patient trainers to assess standardized patients' weaknesses and help them improve their performance.KEY MESSAGESEvaluation of SP performance is essential to ensure the educational quality of clinical skills training programs.Students are the most relevant stakeholders to give feedback about SP performance immediately after encounters.The 'Standardized Patient Performance Rating Scale - Student Version' is a valid, reliable scale that can be used by students for the evaluation of standardized patients' strengths and weaknesses at individual-performance levels quickly.

Profiling students via clustering in a flipped clinical skills course using learning analytics.

Flipped classrooms have become popular as a student-centered approach in medical education because they allow students to improve higher-order thinking skills and problem-solving applications during in-class activities. However, students are expected to study videos and other class materials before class begins. Learning analytics and unsupervised machine learning algorithms (clustering) can be used to examine the pre-class activities of these students to identify inadequate student preparation before the in-class stage and make appropriate interventions. Furthermore, the students' profiles, which provide their interaction strategies towards online materials, can be used to design appropriate interventions. This study investigates student profiles in a flipped classroom. The learning management system interactions of 375 medical students are collected and preprocessed. The k-means clustering algorithms examined in this study show a two-cluster structure: 'high interaction' and 'low-interaction.' These results can be used to help identify low-engaged students and give appropriate feedback.

Adaptation of a short and universal learning self-efficacy scale for clinical skills in Turkish.

BACKGROUND: The performance of a clinical task depends on an individual's skills, knowledge, and beliefs. However, there is no reliable and valid tool for measuring self-efficacy beliefs toward clinical skills in the Turkish language. This research work aims to study the linguistic equivalence, validity, and reliability of a Self-Efficacy Scale for Clinical Skills (L-SES). MATERIALS AND METHODS: After reaching the original item pool of the scale, applying both forward and backward translation processes, and collecting responses of 11 experts from health professional sciences and educational sciences, the translation and adoption processes were completed. We randomly divided 651 medical students' responses to a 15-item questionnaire into two datasets and conducted exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) analyses. RESULTS: CFA validated the three-factor model, and the model fit indexes were found to have acceptable values. The item factor loads ranged from .34 to .84, and items in the scale explained 47% of the total variance. Cronbach's alpha (.91), Spearman-Brown (.88), and Guttman Split-Half (.88) coefficients obtained within the scope of internal consistency reliability demonstrated that the scale had the desired internal consistency. CONCLUSION: The Turkish version of the short and universal learning self-efficacy scale for clinical skills questionnaire is a valid and reliable scale for measuring medical students' self-efficacy for clinical skills. Adopted questionnaires may have different factor structures when applied to two different cultures. We also discussed this issue as a hidden pattern in our study.

Assessment preferences of nursing and medical students: A correlational research.

AIM: The study aims to determine nursing and medical students' preferences for assessment in education and factors affecting their preferences for assessment. BACKGROUND: It is crucial to design the evaluation and evaluation processes in education to develop desired behaviours in education and to determine whether the intended goals in education have been achieved. In earlier studies on assessment practices affecting student learning and academic achievement, it has been emphasized that students' preferences for assessment and different practices in assessment have a significant effect on their academic performance. DESIGN: This research was designed as nonexperimental and quantitative research of correlational design with linear regression statistical analyses approach. METHODS: The participants consisted of 641 students (including 169 medical students with 472 nursing students), who were volunteered to participate in the study and reached with the method of convenience sampling. The 'Assessment Preferences Inventory' adapted to Turkish by Gulbahar and Buyukozturk (2008) was used as a data collection tool. To analyze the data, descriptive statistics, the Mann-Whitney-U test, the Kruskal-Wallis test and logistic regression with Bonferroni correction to control the type I error were applied. RESULTS: In the study, it was found that male students preferred alternative assessment methods and complex/constructive assessment more than female students and male students expected more questions assessing cognitive processes while female students needed more preparations for assessment. In addition, it was determined that medical students preferred complex/constructive assessment more; on the other hand, nursing students preferred simple-multiple choice assessment more and had the need for pre-assessment preparations more. Besides, it was detected that the variables of the students' grade level had an impact on their assessment preferences and that there was a minimal relationship between the students' age and academic achievement with their assessment preferences. CONCLUSIONS: This study showed that the department, gender and grade level were effective on assessment preferences.

Attachment Style Predicts Cortical Activity in Temporoparietal Junction (TPJ): An fNIRS Study Using a Theory of Mind (ToM) Task in Healthy University Students.

Results of the behavioral studies suggest that attachment styles may have an enduring effect upon theory of mind (ToM). However biological underpinnings of this relationship are unclear. Here, we compared securely and insecurely attached first grade university students (N = 56) in terms of cortical activity measured by 52 channel Functional Near Infrared Spectroscopy (fNIRS) during the Reading the Mind from the Eyes Test (RMET). The control condition involved gender identification via the same stimuli. We found that the ToM condition evoked higher activity than the control condition particularly in the right hemisphere. We observed higher activity during the ToM condition relative to the control condition in the secure group (SG), whereas the overall cortical activity evoked by the two conditions was indistinguishable in the insecure group (ISG). Higher activity was observed in channels corresponding to right superior temporal and adjacent parietal cortices in the SG relative to the ISG during the ToM condition. Dismissive attachment scores were negatively correlated with activity in channels that correspond to right superior temporal cortex. These results suggest that attachment styles do have an effect on representation of ToM in terms of cortical activity in late adolescence. Particularly, dismissive attachment is represented by lower activity in the right superior temporal cortex during ToM, which might be related to weaker social need and habitual unwillingness for closeness among this group of adolescents.

Exploring the Role of Social Anhedonia in the Positive and Negative Dimensions of Schizotypy in a Non-Clinical Sample.

INTRODUCTION: The present study aimed to investigate the role of social anhedonia, defined as the lack of ability to feel pleasure from interpersonal relationship, in a multidimensional model of schizotypy and to determine the psychometric properties of the Turkish version of Chapman's Revised Social Anhedonia Scale (SAS) in a non-clinical sample. METHODS: Second-grade students of Ankara University Medical Faculty were recruited (n=266, Mage=20.28). Confirmatory factor analysis was performed to test schizotypy dimensions. The Cronbach's alpha internal consistency value, test-retest reliability and congruent validity of SAS were calculated. RESULTS: The model in which social anhedonia was allowed to load on both schizotypy dimensions fit the data set better than the model in which social anhedonia was allowed to load on negative dimension alone. The internal consistency assessed with Cronbach's alpha was .84, test-retest reliability was r=.76 and the congruent validity of SAS was r=.55. CONCLUSION: The results of current study were consistent with those of earlier studies showing that social anhedonia was related to both schizotypy dimensions. Furthermore, the psychometric properties of the Turkish Version of SAS revealed that it is a reliable and valid measurement to assess social anhedonia in a non-clinical population.

Fighting against cigarette smoking among medical students: a success story.

A survey in the year 2007 among medical students of Ankara University Medical School to assess the smoking rates showed that 25.1 % of them were smoking. Moreover, the smoking rate was 35 % at sixth grade students and 60 % of the smokers specified that they started smoking at medical school. This report provides a successful approach to decrease smoking among medical students by measures against starting smoking. An "Antismoking Group" composed of voluntary academic staff, nurses, students, psychologists, and a social worker of the medical school was established to engage in lowering the smoking rate and eliminating it eventually among our students. Several methods including regular monthly meetings, annual "Smoking or Health" symposiums, and lectures to first, second, and third grade students to increase their awareness related to harms of smoking and their role in the fight against smoking were carried out. Our surveys in the years 2009 (641 students) and 2012 (975 students) showed that total smoking rates dropped to 15.0 and 11.0 %, respectively (p < 0.0002). Moreover, the smoking rate for the sixth grade students dropped from 35.0 % in 2007 to 21.8 and 8.8 % in the years 2009 and 2012, respectively (p < 0.0002). In 2012, the smoking rates of first year and sixth year students were 7.8 and 9.0 %, respectively. These close rates of smoking at the first and last years of medical school training and the significant drop in smoking rates in 5 years confirm that our group pursued a realistic and successful strategy against smoking.

Self-reported prevalence of hypersensitivity reactions against drugs among medical students: does awareness cause any difference?

PURPOSE: True epidemiologic data on hypersensitivity reactions to drugs are scarce. More accurate data may be obtained in more specific clinical settings. Considering their educational background, medical students may be an appropriate target audience for evaluating prevalence of drug hypersensitivity. This study is designed to determine the prevalence of self-reported drug hypersensitivity alongside related factors among young adults. METHODS: A structured questionnaire was administered to the students. RESULTS: A total of 1267 students (mean age: 21.71+1.90 years, F/M: 648/619) from all grades responded to the survey. The mean prevalence of self-reported drug hypersensitivity was 4.7% (60/1267). The most frequently involved drugs were beta-lactam antibiotics (55%) followed by non-steroidal anti-inflammatory drugs (28%). The most commonly reported clinical presentations were cutaneous (43.3%), followed by systemic (36.8%), cardiovascular (8.3%) and respiratory (8.3%) symptoms. Factors related with reported reactions were higher grades (p=0.015, OR: 2.09), female gender (p=0.006, OR: 2.13), personal history of allergic diseases (p=0.001, OR: 2.64), and family history of drug hypersensitivity (p<0.001, OR: 5.78). Half of the students sought medical help during the acute stage of their reaction. Only 3.2% of the cases have been referred to an allergist for further evaluation. CONCLUSION: This study, the first of its kind in Turkey, with medical students showed that self-reported hypersensitivity reactions to drugs is highly prevalent and its prevalence seems to be affected by awareness of the individuals in addition to previously reported risk factors. The education of both patients and physicians on the management of drug hypersensitivity seems to be necessary.