Students' and Instructors' Perspectives on Learning and Professional Development in the Context of Interprofessional Simulation.

Phenomenon: Simulation-enhanced interprofessional education is a potentially valuable pedagogical approach in health professional education. Simulation-enhanced interprofessional education merits more empirical exploration particularly in terms of experiences from different perspectives. Approach: The study aims to provide a multi-perspective in-depth understanding of students' engagement in a simulation-based interprofessional learning environment. Ninety students and thirteen facilitators participated. We analyzed data from examination sheets of medical and nursing students in a simulation-enhanced interprofessional education course and from a facilitator survey, using manifest inductive content analysis. The analysis was informed by actor network theory and Schön's reflection on action model. Findings: Students reflected on their performance in relation to (1) personal attributes, such as systemization skills; (2) other team members, such as communication skills; and (3) the surrounding environment, such as efficient employment of resources. They also reflected on the consequences of their actions and future professional growth. We observed group differences in conceptualizations of performance and knowledge enactment. Facilitators' and students' perceptions of performance were mostly aligned. Leadership enactment in the learning environment was problematic for students as well as facilitators. Insights: Students' engagement in the learning environment helped them develop a prototype of their professional identity and explore potential domains or tools for further learning and professional growth. Features of the learning environment fostered teamwork skills and allowed students to learn from each other, thus improving performance. Our findings have several implications for education, and professional practice, including the need for meticulous planning of learning environments and the importance of more intensive pedagogical efforts for soon-to-be health professionals regarding workplace dynamics and potential conflicts. It is also important to consider that an interactive learning environment can invoke reflection on action not only among students but also among facilitators and that this can contribute to the development of clinical praxis.

How prior experience, cognitive skills and practice are related with eye-hand span and performance in video gaming.

Research has shown that performance in visual domains depends on domain-specific cognitive and perceptual adaptations that result from extensive practice. However, less is known about processes and factors that underpin the acquisition of such adaptations. The present study investigated how prior experience, cognitive skills, task difficulty and practice effect eye-hand span (EHS) and performance in video gaming. Thirty-three participants played a platformer video game in a pre-test/practice/post-test experiment. Eye movements and keypresses were recorded. The results show that a short practice period improved performance but did not increase EHS. Instead, EHS was related to task difficulty. Furthermore, while EHS correlated with initial performance, this effect seemed to diminish after practice. Cognitive skills (concentration endurance, working memory, mental flexibility and executive functioning) predicted performance in some parts of the experiment. The study offers insights into the early development of visual adaptations and performance.

Histological knowledge as a predictor of medical students' performance in diagnostic pathology.

Over the years, the role and extent of the basic sciences in medical curricula have been challenged by research on clinical expertise, clinical teachers, and medical students, as well as by the development and diversification of the medical curricula themselves. The aim of this study was to examine how prior knowledge of basic histology and histopathology among students predicts early learning of diagnostic pathology. Participants (N=118, representing 91% of the full student cohort) were medical students at the University of Turku, Finland. Data were collected during two preclinical courses that students attended in their first and second years of medical school. The measurements included tests on biomedical and clinical knowledge and a performance test in diagnostic pathology. Second-year performance on the diagnostic pathology examinations was predicted by the students' prior knowledge of histology, but not by the students' prior knowledge of histopathology. Although earlier research has demonstrated similar results in studies with shorter longitudinal designs, the present study demonstrates that the effect remains even if there is a considerably long time delay (a year) between the measurements, thus confirming the long-term value of basic science studies in the preclinical phase.

More technology, better learning resources, better learning? Lessons from adopting virtual microscopy in undergraduate medical education.

The adoption of virtual microscopy at the University of Turku, Finland, created a unique real-world laboratory for exploring ways of reforming the learning environment. The purpose of this study was to evaluate the students' reactions and the impact of a set of measures designed to boost an experimental group's understanding of abnormal histology through an emphasis on knowledge of normal cells and tissues. The set of measures included (1) digital resources to review normal structures and an entrance examination for enforcement, (2) digital course slides highlighting normal and abnormal tissues, and (3) self-diagnostic quizzes. The performance of historical controls was used as a baseline, as previous students had never been exposed to the above-mentioned measures. The students' understanding of normal histology was assessed in the beginning of the module to determine the impact of the first set of measures, whereas that of abnormal histology was assessed at the end of the module to determine the impact of the whole set of measures. The students' reactions to the instructional measures were assessed by course evaluation data. Additionally, four students were interviewed. Results confirmed that the experimental group significantly outperformed the historical controls in understanding normal histology. The students held favorable opinions on the idea of emphasizing normal structures. However, with regards to abnormal histology, the historical controls outperformed the experimental group. In conclusion, allowing students access to high-quality digitized materials and boosting prerequisite skills are clearly not sufficient to boost final competence. Instead, the solution may lie in making students externally accountable for their learning throughout their training.

Traditional microscopy instruction versus process-oriented virtual microscopy instruction: a naturalistic experiment with control group.

BACKGROUND: Virtual microscopy is being introduced in medical education as an approach for learning how to interpret information in microscopic specimens. It is, however, far from evident how to incorporate its use into existing teaching practice. The aim of the study was to explore the consequences of introducing virtual microscopy tasks into an undergraduate pathology course in an attempt to render the instruction more process-oriented. The research questions were: 1) How is virtual microscopy perceived by students? 2) Does work on virtual microscopy tasks contribute to improvement in performance in microscopic pathology in comparison with attending assistant-led demonstrations only? METHOD: During a one-week period, an experimental group completed three sets of virtual microscopy homework assignments in addition to attending demonstrations. A control group attended the demonstrations only. Performance in microscopic pathology was measured by a pre-test and a post-test. Student perceptions of regular instruction and virtual microscopy were collected one month later by administering the Inventory of Intrinsic Motivation and open-ended questions. RESULTS: The students voiced an appreciation for virtual microscopy for the purposes of the course and for self-study. As for learning gains, the results indicated that learning was speeded up in a subgroup of students consisting of conscientious high achievers. CONCLUSIONS: The enriched instruction model may be suited as such for elective courses following the basic course. However, the instructional model needs further development to be suited for basic courses.

Do prior knowledge, personality and visual perceptual ability predict student performance in microscopic pathology?

OBJECTIVES There has been long-standing controversy regarding aptitude testing and selection for medical education. Visual perception is considered particularly important for detecting signs of disease as part of diagnostic procedures in, for example, microscopic pathology, radiology and dermatology and as a component of perceptual motor skills in medical procedures such as surgery. In 1968 the Perceptual Ability Test (PAT) was introduced in dental education. The aim of the present pilot study was to explore possible predictors of performance in diagnostic classification based on microscopic observation in the context of an undergraduate pathology course. METHODS A pre- and post-test of diagnostic classification performance, test of visual perceptual skill (Test of Visual Perceptual Skills, 3rd edition [TVPS-3]) and a self-report instrument of personality (Big Five Personality Inventory) were administered. In addition, data on academic performance (performance in histology and cell biology, a compulsory course taken the previous year, in addition to performance on the microscopy examination and final examination) were collected. RESULTS The results indicated that one personality factor (Conscientiousness) and one element of visual perceptual ability (spatial relationship awareness) predicted performance on the pre-test. The only factor to predict performance on the post-test was performance on the pre-test. Similarly, the microscopy examination score was predicted by the pre-test score, in addition to the histology and cell biology grade. The course examination score was predicted by two personality factors (Conscientiousness and lack of Openness) and the histology and cell biology grade. CONCLUSIONS Visual spatial ability may be related to performance in the initial phase of training in microscopic pathology. However, from a practical point of view, medical students are able to learn basic microscopic pathology using worked-out examples, independently of measures of personality or visual perceptual ability. This finding should reassure students about their abilities to improve with training independently of their scores on tests on basic abilities and personality.