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1.
BMC Med Educ ; 24(1): 393, 2024 Apr 09.
Artigo em Inglês | MEDLINE | ID: mdl-38594650

RESUMO

BACKGROUND: With conference attendees having expressed preference for hybrid meeting formats (containing both in-person and virtual components), organisers are challenged to find the best combination of events for academic meetings. Better understanding what attendees prioritise in a hybrid conference should allow better planning and need fulfilment. METHODS: An online survey with closed and open-ended questions was distributed to registrants of an international virtual conference. Responses were then submitted to descriptive statistical analysis and directed content analysis. RESULTS: 823 surveys (Response Rate = 4.9%) were received. Of the 813 who expressed a preference, 56.9% (N = 463) desired hybrid conference formats in the future, 32.0% (N = 260) preferred in-person conferences and 11.1% (N = 90) preferred virtual conferences. Presuming a hybrid meeting could be adopted, 67.4% (461/684) preferred that virtual sessions take place both during the in-person conference and be spread throughout the year. To optimise in-person components of hybrid conferences, recommendations received from 503 respondents included: prioritising clinical skills sessions (26.2%, N = 132), live international expert presentations and discussions (15.7%, N = 79) and interaction between delegates (13.5%, N = 68). To optimise virtual components, recommendations received from 486 respondents included: prioritising a live streaming platform with international experts' presentations and discussions (24.3%, N = 118), clinical case discussions (19.8%, N = 96) and clinical update sessions (10.1%, N = 49). CONCLUSIONS: Attendees envision hybrid conferences in which organisers can enable the vital interaction between individuals during an in-person component (e.g., networking, viewing and improving clinical skills) while accessing virtual content at their convenience (e.g., online expert presentations with latest advancements, clinical case discussions and debates). Having accessible virtual sessions throughout the year, as well as live streaming during the in-person component of hybrid conferences, allows for opportunity to prolong learning beyond the conference days.


Assuntos
Competência Clínica , Aprendizagem , Humanos , Projetos de Pesquisa
2.
Eur Arch Otorhinolaryngol ; 281(6): 2871-2876, 2024 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-38105363

RESUMO

PURPOSE: To compare the audiological outcomes, tympanic membrane (TM) healing rates and complication rates in patients undergoing endoscopic underlay and over-under tympanoplasty type I (TTI). METHODS: The study includes 95 patients who underwent endoscopic TTI in the period between 2018 and 2023: 56% of the patients had the underlay technique and 41% had the over-under technique. Data regarding pre- and postoperative hearing, perforation characteristics, surgical procedures, graft types and complications were retrospectively analyzed. Audiometrical assessment included air conduction (AC) and bone conduction (BC) pure tone averages (PTA) and air-bone gap (ABG), pre- and postoperatively. RESULTS: Both underlay and over-under techniques significant improved AC PTA, with a mean ABG improvements of 5.9 dB and 7.2 dB, respectively. There was no significant difference in BC PTA between pre- and post-operative, indicating no inner ear damage in both techniques. The over-under technique showed a significantly higher TM closure rate (94.4%) compared to the underlay technique (80.6%). Complications were rare, with only one case of TM lateralization requiring revision surgery. CONCLUSIONS: Endoscopic TTI is an effective treatment in improving auditory function in chronic middle ear diseases. In our cohort, the detachment of the umbo does not negatively influence the postoperative hearing results and does not increase rate of complications. Moreover, the over-under technique demonstrates superior TM closure rates, making it a valuable option for specific cases. However, future prospective studies with larger sample sizes and longer term follow-up are needed to validate these findings and provide more comprehensive insights.


Assuntos
Endoscopia , Perfuração da Membrana Timpânica , Timpanoplastia , Humanos , Masculino , Feminino , Estudos Retrospectivos , Pessoa de Meia-Idade , Adulto , Timpanoplastia/métodos , Endoscopia/métodos , Perfuração da Membrana Timpânica/cirurgia , Perfuração da Membrana Timpânica/fisiopatologia , Resultado do Tratamento , Audiometria de Tons Puros , Condução Óssea , Complicações Pós-Operatórias/epidemiologia , Idoso , Adulto Jovem , Audição/fisiologia
3.
Adv Health Sci Educ Theory Pract ; 28(5): 1485-1508, 2023 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-37120683

RESUMO

Conferences enable rapid information sharing and networking that are vital to career development within academic communities. Addressing diverse attendee needs is challenging and getting it wrong wastes resources and dampens enthusiasm for the field. This study explores whether, and how, motivations for attendance can be grouped in relation to preferences to offer guidance to organizers and attendees. A pragmatic constructivist case study approach using mixed methods was adopted. Semi-structured interviews completed with key informants underwent thematic analysis. Survey results outlining attendees' perspectives underwent cluster and factor analysis. Stakeholder interviews (n = 13) suggested attendees could be grouped by motivations predictable from level of specialisation in a field and past engagement with conferences. From n = 1229 returned questionnaires, motivations were clustered into three factors: learning, personal and social. Three groups of attendees were identified. Group 1 (n = 500; 40.7%) was motivated by all factors. Group 2 (n = 345; 28.1%) was mainly motivated by the learning factor. Group 3 (n = 188; 15.3%) scored the social factor highest for in-person conferences and the learning factor highest for virtual meetings. All three groups expressed a preference for hybrid conferences in the future. This study indicates that medical conference attendees can be clustered based on their learning, personal and social motivations for attendance. The taxonomy enables organizers to tailor conference formats with guidance on how to utilize hybrid conferences, thereby enabling better catering to attendees' desires for knowledge gain relative to networking.


Assuntos
Aprendizagem , Motivação , Humanos , Inquéritos e Questionários
4.
Med Teach ; 45(8): 885-892, 2023 08.
Artigo em Inglês | MEDLINE | ID: mdl-36919450

RESUMO

BACKGROUND: Although entrustment scales are increasingly applied in workplace-based assessments, their role in OSCEs remains unclear. We investigated raters' perceptions using an entrustment scale and psychometric analyses. METHOD: A mixed-methods design was used. OSCE raters' (n = 162) perceptions were explored via questionnaire and four focus groups (n = 14). Psychometric OSCE properties were analyzed statistically. RESULTS: Raters (n = 53, response rate = 41%) considered the entrustment scale comprehensible (89%) and applicable (60%). A total of 43% preferred the entrustment scale, 21% preferred the global performance scale, and 36% were undecided. Raters' written comments indicated that while they appreciated the authenticity of entrustment levels, they considered them subjective. The focus groups highlighted three main themes: (1) recollections of the clinical workplace as a cognitive reference triggered by entrustment scales; (2) factors influencing entrustment decisions; and (3) cognitive load is reduced at the perceived cost of objectivity. Psychometric analyses (n = 480 students) revealed improvements in some OSCE metrics when entrustment and global performance scales were combined. CONCLUSION: Entrustment scales are beneficial for high-stakes OSCEs and have greater clinical relevance from the raters' perspective. Our findings support the use of entrustment and global performance scales in combination.


Assuntos
Competência Clínica , Estudantes de Medicina , Humanos , Psicometria , Avaliação Educacional/métodos , Estudantes de Medicina/psicologia
5.
Praxis (Bern 1994) ; 111(10): 539-548, 2022 Aug.
Artigo em Alemão | MEDLINE | ID: mdl-35920014

RESUMO

Interprofessional Training for Discharge Planning: Effects of Self-Efficacy in Nursing and Medical Students Abstract. Concordant and methodical briefing about a patient's disposition for discharge from hospital within the interprofessional ward round can facilitate a timely discharge. However, interprofessional ward rounds require not only professional skills but also knowledge of interprofessional cooperation between all the occupational groups involved. The question arose whether students of the various professions could learn the necessary competencies during their studies. To this end, a training course on interprofessional discharge planning was developed for nursing and medical students. The training includes four phases consisting of flipped classroom and interprofessional skills training. After each phase, a questionnaire was distributed to assess the self-efficacy of participating nursing and medical students regarding their interprofessional collaboration skills. The results showed that self-efficacy increased steadily with increasing study duration from phase 1 to 4. The study also shows that despite the differences between nursing and medical school curricula, students' self-efficacy regarding interprofessional collaboration skills increased during the IAVI training, which strongly suggests that they benefited from the training.


Assuntos
Estudantes de Medicina , Competência Clínica , Currículo , Humanos , Alta do Paciente , Autoeficácia
6.
Swiss Med Wkly ; 152: w30118, 2022 02 28.
Artigo em Inglês | MEDLINE | ID: mdl-35429236

RESUMO

BACKGROUND: Formerly, a substantial number of the 120 multiple-choice questions of the Swiss Society of General Internal Medicine (SSGIM) board examination were derived from publicly available MKSAP questions (Medical Knowledge Self-Assessment Program®). The possibility to memorise publicly available questions may unduly influence the candidates' examination performance. Therefore, the examination board raised concerns that the examination did not meet the objective of evaluating the application of knowledge. The society decided to develop new, "Helvetic" questions to improve the examination. The aim of the present study was to quantitatively assess the degree of difficulty of the Helvetic questions (HQ) compared with publicly available and unavailable MKSAP questions and to investigate whether the degree of difficulty of MKSAP questions changed over time as their status changed from publicly available to unavailable. METHODS: The November 2019 examination consisted of 40 Helvetic questions, 40 publicly available questions from MKSAP edition 17 (MKSAP-17) and 40 questions from MKSAP-15/16, which were no longer publicly available at the time of the examination. An one factorial univariate analysis of variance (ANOVA) examined question difficulty (lower values mean higher difficulty) between these three question sets. A repeated ANOVA compared the difficulty of MKSAP-15/16 questions in the November 2019 examination with the difficulty of the exact same questions from former examinations, when these questions belonged to the publicly available MKSAP edition. The publicly available MKSAP-17 and the publicly unavailable Helvetic questions served as control. RESULTS: The analysis of the November 2019 exam showed a significant difference in average item difficulty between Helvetic and MKSAP-17 questions (71% vs 86%, p <0.001) and between MKSAP-15/16 and MKSAP-17 questions (70% vs 86%, p <0.001). There was no significant difference in item difficulty between Helvetic and MKSAP-15/16 questions (71% vs 70%, p = 0.993). The repeated measures ANOVA on question use and the three question categories showed a significant interaction (p <0.001, partial eta-squared = 0.422). The change in the availability of MKSAP-15/16 questions had a strong effect on difficulty. Questions became on average 21.9% more difficult when they were no longer publicly available. In contrast, the difficulty of the MKSAP-17 and Helvetic questions did not change significantly across administrations. DISCUSSION: This study provides the quantitative evidence that the public availability of questions has a decisive influence on question difficulty and thus on SSGIM board examination performance. Reducing the number of publicly available questions in the examination by introducing confidential, high-quality Helvetic questions contributes to the validity of the board examination by addressing higher order cognitive skills and making rote-learning strategies less effective.


Assuntos
Avaliação Educacional , Medicina Interna , Humanos , Medicina Interna/educação
7.
Swiss Med Wkly ; 152: w30137, 2022 03 14.
Artigo em Inglês | MEDLINE | ID: mdl-35315268

RESUMO

AIMS OF THE STUDY: Clinical teaching is essential in preparing trainees for independent practice. To improve teaching quality, clinical teachers should be provided with meaningful and reliable feedback from trainees (bottom-up feedback) based on up-to-date educational concepts. For this purpose, we designed a web-based instrument, "Swiss System for Evaluation of Teaching Qualities" (SwissSETQ), building on a well-established tool (SETQsmart) and expanding it with current graduate medical education concepts. This study aimed to validate the new instrument in the field of anaesthesiology training. METHODS: Based on SETQsmart, we developed an online instrument (primarily including 34 items) with generic items to be used in all clinical disciplines. We integrated the recent educational frameworks of CanMEDS 2015 (Canadian Medical Educational Directives for Specialists), and of entrustable professional activities (EPAs). Newly included themes were "Interprofessionalism", "Patient centredness", "Patient safety", "Continuous professional development', and "Entrustment decisions". We ensured content validity by iterative discussion rounds between medical education specialists and clinical supervisors. Two think-aloud rounds with residents investigated the response process. Subsequently, the instrument was pilot-tested in the anaesthesia departments of four major teaching hospitals in Switzerland, involving 220 trainees and 120 faculty. We assessed the instrument's internal structure (to determine the factorial composition) using exploratory factor analysis, internal statistical consistency (by Cronbach's alpha as an estimate of reliability, regarding alpha >0.7 as acceptable, >0.8 as good, >0.9 as excellent), and inter-rater reliability (using generalisability theory in order to assess the minimum number of ratings necessary for a valid feedback to one single supervisor). RESULTS: Based on 185 complete ratings for 101 faculty, exploratory factor analysis revealed four factors explaining 72.3% of the variance (individual instruction 33.8%, evaluation of trainee performance 20.9%, teaching professionalism 12.8%; entrustment decisions 4.7%). Cronbach's alpha for the total score was 0.964. After factor analysis, we removed one item to arrive at 33 items for the final instrument. Generalisability studies yielded a minimum of five to six individual ratings to provide reliable feedback to one supervisor. DISCUSSION: The SwissSETQ possesses high content validity and an "excellent" internal structure for integrating up-to-date graduate medical education concepts. Thereby, the tool allows reliable bottom-up feedback by trainees to support clinical teachers in improving their teaching. Transfer to disciplines other than anaesthesiology needs to be further explored.


Assuntos
Docentes de Medicina , Canadá , Retroalimentação , Humanos , Reprodutibilidade dos Testes , Suíça
9.
BMJ Open ; 12(6): e057201, 2022 06 03.
Artigo em Inglês | MEDLINE | ID: mdl-36691242

RESUMO

INTRODUCTION: Intravenous cannulation is a core competence in medicine, but is considered challenging to learn. This study investigates the effectiveness of three educational strategies used to refresh the intravenous cannulation skills of first-year medical students: mental imagery, part-task trainer simulation and written instructions. MATERIALS AND METHODS: In this single-centre randomised controlled trial, first-year medical students were assigned to one of three different refresher tutorials on intravenous cannulation. Six months after their compulsory 4 hour instructor-led intravenous-cannulation course, each student was randomised to a 6 min self-learning tutorial: a mental imagery audioguide session, hands-on intravenous cannulation on a part-task trainer or reading written instructions.Immediately after the refresher tutorials, trained evaluators who were blinded to the randomised group assessed the students' performance. Each evaluator completed a 15-item standardised checklist in an Objective Structured Clinical Examination (OSCE) station for intravenous cannulation. We performed a descriptive analysis of the data and a one-way analysis of variance. Additionally, we investigated the influence of previous intravenous cannulation experience on the total OSCE score. RESULTS AND DISCUSSION: On analysing the 309 students' results, we did not find differences in the total rating of the performance (in percentage) between the three groups at the OSCE station (mental imagery group: 72.0%±17.9%; part-task trainer group: 74.4%±15.6%; written instructions group: 69.9%±16.6%, p=0.158). Multiple linear regression showed a small but statistically significant effect of students' previous intravenous cannulation experience on OSCE performance. With the same outcome, written instructions and mental imagery had a better return on effort, compared with resource-intensive hands-on training with part-task trainers. CONCLUSION: A single, short refresher seems to have a limited effect on intravenous-cannulation skills in first-year medical students. Less resource-intensive interventions, such as written instructions or mental imagery, are effective compared with hands-on part-task trainer simulation for refreshing this simple but important skill. TRIAL REGISTRATION NUMBER: AEARCTR-0008043.


Assuntos
Estudantes de Medicina , Humanos , Competência Clínica , Aprendizagem , Exame Físico , Cateterismo/métodos , Álcool de Polivinil , Povidona , Avaliação Educacional
10.
Patient Educ Couns ; 104(1): 85-91, 2021 01.
Artigo em Inglês | MEDLINE | ID: mdl-32631649

RESUMO

OBJECTIVE: Good physician communication skills increase patient satisfaction and improve healing processes. Although physicians and patients appear to value communicative competencies differently, students are often evaluated solely by physicians. This study examines whether additional assessment of students by 'standardized patients' (SPs) is useful. METHODS: During their Objective Structured Clinical Examination (OSCE) 238 medical students were additionally rated by SPs at 9 stations according to two items that defined the 'physician-patient relationship' and 'communication'. SPs were informed that their assessment was for research purposes only, with no impact on the assessment of the students. SPs also had the opportunity to comment on their rating of the students. RESULTS: The SPs rated the communicative competencies of students differently than physicians. The two parts of the SP rating are closely related. Inclusion of SP rating in the OSCE would provide higher measurement precision, with more students failing. SPs considered five factors relevant in their rating: 'human connection', 'information flow', 'professionalism', 'competence', and 'exam situation'. CONCLUSION: Our study suggests inclusion of SP rating as additional assessment of student communication skills. PRACTICE IMPLICATIONS: Addition of SP rating in assessments is worthwhile, as it appears to complete the picture of the student performance in their OSCEs.


Assuntos
Avaliação Educacional , Estudantes de Medicina , Competência Clínica , Comunicação , Humanos , Simulação de Paciente , Relações Médico-Paciente
11.
Swiss Med Wkly ; 150: w20389, 2020 Dec 14.
Artigo em Inglês | MEDLINE | ID: mdl-33382074

RESUMO

OBJECTIVE: Prior high school educational attainment and medical aptitude tests are two of the most frequently used selection procedures for admission to medical school. Both of these have been shown to correlate with future performance. However, there is a need for further analysis of the combined impact of these two admissions tools and comparison of their predictive value for future performance. At present, successful completion of high school (Matura) and an aptitude test (Eignungstest Medizinstudium Schweiz, EMS; Swiss Aptitude Test in Medicine) are used for admission to all medical schools in the German-speaking part of Switzerland. The purpose of this study was to explore the predictors that are most decisive for performance in undergraduate medical education. More precisely, we were interested in the contributions of the Matura grade and the EMS score to explanations of performance in the Bachelor program of Medicine at the University of Bern. METHODS: Matura grades, EMS score and performance in the Bachelor program of Medicine were collected for 730 students from four cohorts. Of these, 277 graduated from high school with a biology-chemistry major. Hierarchical regression analysis was conducted for each study year and type of examination to determine which predictors affected performance during undergraduate medical education. RESULTS: These data show that Matura grades are an important predictor for performance in undergraduate medical education. The EMS score had no impact when the Matura grades were part of the analysis. The biology-chemistry major grade was a predictor for performance in the first year of undergraduate study. From the second academic year onwards, past performance in the bachelor’s program was the best predictor for future performance during undergraduate medical education. CONCLUSIONS: Students’ Matura grades predicted their subsequent performance in undergraduate medical education in the bachelor’s program of the University of Bern. In contrast, EMS scores do not explain any additional variance in students’ performance throughout the entire bachelor’s program. These findings suggest a need for rethinking the admission process.


Assuntos
Educação de Graduação em Medicina , Estudantes de Medicina , Testes de Aptidão , Estudos de Coortes , Avaliação Educacional , Humanos , Critérios de Admissão Escolar , Faculdades de Medicina
12.
PLoS One ; 15(10): e0240835, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33085695

RESUMO

BACKGROUND: Interprofessional Education (IPE) aims to improve students' attitudes towards collaboration, teamwork, and leads to improved patient care upon graduation. However, the best time to introduce IPE into the undergraduate curriculum is still under debate. METHODS: We used a mixed-methods design based on a sequential explanatory model. Medical students from all six years at the University of Bern, Switzerland (n = 683) completed an online survey about attitudes towards interprofessional learning using a scale validated for German speakers (G-IPAS). Thirty-one medical students participated in nine semi-structured interviews focusing on their experience in interprofessional learning and on the possible impact it might have on their professional development. RESULTS: Women showed better attitudes in the G-IPAS across all years (p = 0,007). Pre-clinical students showed more positive attitudes towards IPE [Year 1 to Year 3 (p = 0.011)]. Students correctly defined IPE and its core dimensions. They appealed for more organized IPE interventions throughout the curriculum. Students also acknowledged the relevance of IPE for their future professional performance. CONCLUSIONS: These findings support an early introduction of IPE into the medical curriculum. Although students realise that interprofessional learning is fundamental to high-quality patient care, there are still obstacles and stereotypes to overcome. TRIAL REGISTRATION: ISRCTN 41715934.


Assuntos
Atitude do Pessoal de Saúde/etnologia , Educação Interprofissional/tendências , Estudantes de Medicina/psicologia , Adulto , Comportamento Cooperativo , Currículo/tendências , Feminino , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Educação Interprofissional/métodos , Relações Interprofissionais , Masculino , Equipe de Assistência ao Paciente , Papel Profissional , Inquéritos e Questionários , Adulto Jovem
13.
BMC Med Educ ; 20(1): 357, 2020 Oct 12.
Artigo em Inglês | MEDLINE | ID: mdl-33046060

RESUMO

BACKGROUND: In medical settings, multisource feedback (MSF) is a recognised method of formative assessment. It collects feedback on a doctor's performance from several perspectives in the form of questionnaires. Yet, no validated MSF questionnaire has been publicly available in German. Thus, we aimed to develop a German MSF questionnaire based on the CanMEDS roles and to investigate the evidence of its validity. METHODS: We developed a competency-based MSF questionnaire in German, informed by the literature and expert input. Four sources of validity evidence were investigated: (i) Content was examined based on MSF literature, blueprints of competency, and expert-team discussions. (ii) The response process was supported by analysis of a think-aloud study, narrative comments, "unable to comment" ratings and evaluation data. (iii) The internal structure was assessed by exploratory factor analysis, and inter-rater reliability by generalisability analysis. Data were collected during two runs of MSF, in which 47 residents were evaluated once (first run) or several times (second and third run) on 81 occasions of MSF. (iv) To investigate consequences, we analysed the residents' learning goals and the progress as reported via MSF. RESULTS: Our resulting MSF questionnaire (MSF-RG) consists of 15 items and one global rating, which are each rated on a scale and accompanied by a field for narrative comments and cover a construct of a physician's competence. Additionally, there are five open questions for further suggestions. Investigation of validity evidence revealed that: (i) The expert group agreed that the content comprehensively addresses clinical competence; (ii) The response processes indicated that the questions are understood as intended and supported the acceptance and usability; (iii) For the second run, factor analysis showed a one-factor solution, a Cronbach's alpha of 0.951 and an inter-rater reliability of 0.797 with 12 raters; (iv) There are indications that residents benefitted, considering their individual learning goals and based on their ratings reported via MSF itself. CONCLUSIONS: To support residency training with multisource feedback, we developed a German MSF questionnaire (MSF-RG), which is supported by four sources of validity evidence. This MSF questionnaire may be useful to implement MSF in residency training in German-speaking regions.


Assuntos
Internato e Residência , Idioma , Competência Clínica , Retroalimentação , Humanos , Reprodutibilidade dos Testes , Inquéritos e Questionários
14.
Eur J Anaesthesiol ; 37(5): 387-393, 2020 May.
Artigo em Inglês | MEDLINE | ID: mdl-31860597

RESUMO

BACKGROUND: Pre-anaesthetic assessment of patients is a complex competency that needs to be taught during anaesthesia clerkships. OBJECTIVES: We aimed to improve student teaching and investigated the effectiveness of trained 'simulated patients' (lay persons or actors trained to portray specific roles or symptoms) in the teaching of medical students to perform routine pre-anaesthetic assessments. We hypothesised that the intervention of one 30-min teaching sequence with a simulated patient will improve the performance of year 4 medical students in pre-anaesthesia assessment of elective surgical patients, compared with the control of standard apprentice-based teaching. DESIGN: Randomised controlled trial. SETTING/PARTICIPANTS: One hundred and forty-four year 4 medical students at the University of Bern. INTERVENTION: These students were randomised to either the standard clinician-supervised learning in the operating theatre (n=71; control group) or a single teaching session with a simulated patient (nonhealthcare provider, as a trained layperson) (n=73; intervention group). Both groups of students then performed pre-anaesthetic patient visits. The student performances during these visits were assessed according to the mini-Clinical Evaluation Exercise tool by trained anaesthesiologists blinded to randomisation. The 71 students in the standard clinical supervision group also underwent the simulated patient teaching session on the day following the assessments. RESULTS: The students in the intervention group of simulated patient teaching scored significantly higher in both their mini-Clinical Evaluation Exercise overall impression scores (8.8 ±â€Š0.8 vs. 8.3 ±â€Š0.9; P = 0.004) and mean domain scores (8.7 ±â€Š0.8 vs. 8.3 ±â€Š0.9; P = 0.01), compared with those of the control group with the standard clinical supervision. CONCLUSION: The current single teaching encounter with a trained layperson acting as a simulated patient improved medical student performances in their pre-anaesthetic clinical assessment of surgical patients. This might be a suitable alternative to reduce the teaching burden for busy and costly clinicians.


Assuntos
Anestesiologia/educação , Anestésicos , Estudantes de Medicina , Adulto , Competência Clínica , Feminino , Humanos , Masculino , Salas Cirúrgicas , Simulação de Paciente , Pacientes
15.
BMC Med Educ ; 19(1): 357, 2019 Sep 14.
Artigo em Inglês | MEDLINE | ID: mdl-31521153

RESUMO

BACKGROUND: Endoscopic ear surgery is gaining increasing popularity and has an important impact on teaching middle ear anatomy and basic surgical skills among residents and fellows. Due to the wide-angled views offered, the approach significantly differs from the established microscopic technique. This randomized study compares the acquisition of basic ear-surgery skills using the endoscopic and microscopic technique under standardized conditions. We aim to investigate the required surgical times, attempts and accidental damages to surrounding structures (errors) in surgeons with different training levels. METHODS: Final-year medical students (n = 9), residents (n = 14) and consultants (n = 10) from the Department of Otorhinolaryngology, Head and Neck Surgery at the University Hospital of Bern, Switzerland were enrolled in the present study. After randomization every participant had to complete a standard set of grasping and dissecting surgical tasks in a temporal bone model. After the first session the participants were crossed over to the other technique. RESULTS: Time required for completion of the surgical tasks was similar for both techniques, but highly dependent on the training status. A significant increase in the number of damages to the ossicular chain was observed with the microscopic as compared to the endoscopic technique (p < 0.001). Moreover, students beginning with the endoscopic technique showed an overall significantly lower amount of time to complete the tasks (p = 0.04). From the subjective feedback a preference towards the endoscopic technique mainly in medical students was observed. CONCLUSIONS: The endoscopic approach is useful and beneficial for teaching basic surgical skills, mainly by providing a reduction of damage to surrounding tissues with similar operating times for both techniques. Moreover, medical students performed significantly faster, when first taught in the endoscopic technique. Especially for young surgeons without previous training in ear surgery, the endoscope should be considered to improve surgical skills in the middle ear.


Assuntos
Competência Clínica/estatística & dados numéricos , Endoscopia , Internato e Residência , Microscopia , Procedimentos Cirúrgicos Otológicos/educação , Humanos , Procedimentos Cirúrgicos Otológicos/normas , Estudantes de Medicina , Suíça
16.
Anat Sci Educ ; 12(5): 507-517, 2019 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-30430760

RESUMO

Teaching methodologies for the anatomy of the middle ear have not been investigated greatly due to the middle ear's highly complex structure and hidden location inside of the temporal bone. The aim of this randomized study was to quantitatively compare the suitability of using microscope- and endoscope-based methods for teaching the anatomy of the middle ear. We hypothesize that the endoscopic approach will be more efficient compared to the microscopic approach. To answer the study questions, 33 sixth-year medical students, residents and otorhinolaryngology specialists were randomized either into the endoscopy or the microscopy group. Their anatomical knowledge was assessed using a structured anatomical knowledge test before and after each session. Each participant received tutoring on a human cadaveric specimen using one of the two methods. They then performed a hands-on dissection. After 2-4 weeks, the same educational curriculum was repeated using the other technique. The mean gains in anatomical knowledge for the specialists, residents, and medical students were +19.0%, +34.6%, and +23.4%, respectively. Multivariate analyses identified a statistically significant increase in performance for the endoscopic method compared to the microscopic technique (P < 0.001). For the recall of anatomical structures during dissection, the endoscopic method outperformed the microscopic technique independently of the randomization or the prior training level of the attendees (P < 0.001). In conclusion, the endoscopic approach to middle ear anatomy education is associated to an improved gain in knowledge as compared to the microscopic approach. The participants subjectively preferred the endoscope for educational purposes.


Assuntos
Anatomia/educação , Orelha Média/anatomia & histologia , Ensino , Adulto , Cadáver , Currículo , Dissecação , Orelha Média/diagnóstico por imagem , Educação Médica Continuada/métodos , Educação Médica Continuada/estatística & dados numéricos , Educação de Graduação em Medicina/métodos , Educação de Graduação em Medicina/estatística & dados numéricos , Avaliação Educacional/estatística & dados numéricos , Endoscopia , Feminino , Humanos , Internato e Residência/métodos , Internato e Residência/estatística & dados numéricos , Masculino , Rememoração Mental , Microscopia , Pessoa de Meia-Idade , Avaliação de Programas e Projetos de Saúde , Distribuição Aleatória , Estudantes de Medicina/estatística & dados numéricos , Cirurgiões/educação , Cirurgiões/estatística & dados numéricos , Adulto Jovem
17.
Patient Educ Couns ; 100(6): 1203-1212, 2017 06.
Artigo em Inglês | MEDLINE | ID: mdl-28179074

RESUMO

OBJECTIVE: Appropriate training strategies are required to equip undergraduate healthcare students to benefit from communication training with simulated patients. This study examines the learning effects of different formats of video-based worked examples on initial communication skills. METHODS: First-year nursing students (N=36) were randomly assigned to one of two experimental groups (correct v. erroneous examples) or to the control group (no examples). All the groups were provided an identical introduction to learning materials on breaking bad news; the experimental groups also received a set of video-based worked examples. Each example was accompanied by a self-explanation prompt (considering the example's correctness) and elaborated feedback (the true explanation). RESULTS: Participants presented with erroneous examples broke bad news to a simulated patient significantly more appropriately than students in the control group. Additionally, they tended to outperform participants who had correct examples, while participants presented with correct examples tended to outperform the control group. CONCLUSION: The worked example effect was successfully adapted for learning in the provider-patient communication domain. PRACTICE IMPLICATIONS: Implementing video-based worked examples with self-explanation prompts and feedback can be an effective strategy to prepare students for their training with simulated patients, especially when examples are erroneous.


Assuntos
Comunicação , Aprendizagem , Relações Médico-Paciente , Aprendizagem Baseada em Problemas/métodos , Estudantes/psicologia , Competência Clínica , Método Duplo-Cego , Humanos , Masculino , Simulação de Paciente , Gravação de Videoteipe
18.
GMS J Med Educ ; 33(5): Doc73, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-27990469

RESUMO

Objectives: Interprofessional collaboration is becoming increasingly important in health care for various reasons. Interprofessional Education (IPE) can provide a basis for this. The aim of our study was to find out how medical (MS) and nursing students (NS) think about their own and other professions, what they know about each other, how strong their willingness to embrace IPE is, and what forms of IPE they deem useful. Methodology: Seven IPE experts rated the two measuring instruments, Readiness for Interprofessional Learning Scale RIPLS, and Interdisciplinary Education Perception Scale IEPS in terms of relevance of the items, and the quality of translation into German. Nine RIPLS items and 13 IEPS items were considered content-valid. All MS of the University of Bern and NS of the two Bernese educational institutions for nursing were invited to the online survey in the fall of 2014 by email. Results: 498 (254 MS, 244 NS) of the 2374 invited students completely filled in the questionnaire (21%). The results of the reduced RIPLS allowed no conclusive statements. When assessing their own occupational group in the IEPS, the MS attributed "competence and autonomy" to themselves significantly more frequently, while to the NS, the same was true for the item, "actual cooperation". MS know significantly less about the training of other health professionals. NS show a significantly higher willingness to embrace IPE. Teaching ethics, communication, team training, and clinical skills are deemed suitable for IPE by both groups. From the comments it appears that in both groups a majority welcomes IPE; however, the various arguments had different prevalence in both groups. Both groups fear that IPE leads to heightened stress during the study. A subgroup of MS fears a lowering of academic level. Conclusion: The results of this survey of Bernese MS and NS concerning IPE provide important information for the planning and implementation of IPE. Important steps in the introduction of IPE will be a clear justification and the definition of its objectives. These must be explicitly communicated to all students.


Assuntos
Competência Clínica , Relações Interprofissionais , Estudantes de Enfermagem , Atitude do Pessoal de Saúde , Humanos , Estudos Interdisciplinares , Estudantes de Medicina
19.
Comput Methods Programs Biomed ; 92(1): 135-43, 2008 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-18653259

RESUMO

Powerful software for statistical analysis is expensive. Here I present BrightStat, a statistical software running on the Internet which is free of charge. BrightStat's goals, its main capabilities and functionalities are outlined. Three different sample runs, a Friedman test, a chi-square test, and a step-wise multiple regression are presented. The results obtained by BrightStat are compared with results computed by SPSS, one of the global leader in providing statistical software, and VassarStats, a collection of scripts for data analysis running on the Internet. Elementary statistics is an inherent part of academic education and BrightStat is an alternative to commercial products.


Assuntos
Interpretação Estatística de Dados , Internet , Modelos Estatísticos , Sistemas On-Line , Linguagens de Programação , Software , Simulação por Computador , Interface Usuário-Computador
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