Classifying simulation-based studies using the description, justification and clarification framework: a review of simulation conference abstracts.

Introduction: Simulation-based medical education (SBME) is an accepted learning methodology with an ever-expanding evidence base. Concerns have been expressed that research output in SBME lacks explicit links to educational theory. Using the 'Description, Justification and Clarification' framework we have investigated the extent to which SBME conference abstracts declare the educational theory underpinning their studies. Methods: Abstracts from four major international SBME conferences (for 2014 and 2015) were reviewed. Abstracts were classified using the framework offered by Cook et al who classified studies published in major educational journals. Clarification studies are those which specifically declare and test their underpinning educational approach. Results: We reviewed 1398 conference abstracts which we classified as Description 54.4%, Justification 36.3% and Clarification 9.3%. The two most frequently declared educational theories were Cognitive Theories and Experiential Learning. Conclusion: The low proportion of Clarification studies found in the SBME conference abstracts reflects previous findings highlighting the lack of medical education studies that establish how and why SBME works. Researchers should be encouraged to declare their underpinning educational theories when presenting their work. Conference organisers play an important role in facilitating this through allowing sufficient word count in their submission criteria.

Formal appraisal of undergraduate medical students: is it worth the effort?

Medical student stress is most often related to difficulties of adjusting to university academic standards, and work-social life balance. Faculty systems identify academically failing students for counselling, whilst the majority of students do not have opportunities for individual discussion about progress. This study reports a pilot formal appraisal process for first-year undergraduates. Preparatory material required students to reflect on their academic performance, factors contributing to their university life and satisfaction with career choice. Individual appraisal sessions were held with trained, experienced senior faculty staff, with completion of an appraisal record to document agreed outcomes. Individualized study skills advice was the commonest documented outcome on appraisal records. Students were overwhelmingly positive about the experience, reporting both enhanced perceptions of faculty and reduced anxiety about academic performance. Medical schools have responsibilities to consider ways to optimize students' performance; attainment can be related more to personal and motivational factors than academic ability.

Lifelong learning skills: how experienced are students when they enter medical school?

Widening participation initiatives together with changes in school curricula in England may broaden the range of lifelong learning skills experience of new undergraduates. This project examines the experience levels of current students, as a comparative baseline. First-year medical students completed a questionnaire on arrival, investigating their practice of 31 skills during the previous two years. Responses show that most students have regularly practised transferable skills. However, significant numbers report little experience, particularly in IT skills such as email, using the Internet, spreadsheets and databases. Some remain unfamiliar with word processing. Library research, essay writing and oral presentation are also rarely practised by substantial numbers. One-third of students lack experience of evaluating their own strengths and weaknesses. Current students already show diversity of experience in skills on arrival at medical school. Changes in the near future may increase this range of experience further, and necessitate changes to undergraduate courses.

Student-selected projects: can they enhance lifelong learning skills?

Student-selected projects with clearly identified transferable skill objectives have been introduced in Year 1, to help students focus on developing their lifelong learning skills. This study aimed to assess the impact of this innovation on students' perceptions of their skills, and to compare these views with those of students from the previous course. Students' views of their skill abilities were assessed by questionnaire at the beginning and end of the first year, and at the end of each project. Students report improvements, particularly in their IT and presentation skills, but an overall decrease in confidence in their transferable skills at the end of the year compared with the previous cohort. Students appear to recognize development of new skills, but seem less able to identify improvement in existing skills. Increased emphasis on skills development, together with practice of self-evaluation, has reduced students' self-confidence, probably to a more realistic level.

Alternative learning environments: what do they contribute to professional development of medical students?

Special study modules provide opportunities for students to develop lifelong learning skills and develop areas of interest. The GMC also recommends opportunities to study topics not included in the core medical curriculum. This paper reports the evaluation of modules based within alternative learning environments developed to provide students with experiences outside traditional medical, scientific or academic cultures. The attachment was highly rated as contributing to professional development, provided novel learning experiences, and was stimulating for both students and supervisors. All students achieved new skills that they felt were pertinent to their personal development. Assessment was by standardized pro forma, including generic transferable skills and module specific outcomes. Whilst overall assessment grades were comparable to similar course components, unease amongst both students and supervisors was expressed reflecting anxieties in the diversity of workloads and assessment. Attempts to standardize assessment across the diversity of modules did not reduce anxieties and potentially detracted from the learning experiences.