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Confounding factors in using upward feedback to assess the quality of medical training: a systematic review.

Journal of Educational Evaluation for Health Professions.2014;11(1):17-. doi:10.3352/jeehp.2014.11.17

PURPOSE: Upward feedback is becoming more widely used in medical training as a means of quality control. Multiple biases exist, thus the accuracy of upward feedback is debatable. This study aims to identify factors that could influence upward feedback, especially in medical training. METHODS: A systematic review using a structured search strategy was performed. Thirty-five databases were searched. Results were reviewed and relevant abstracts were shortlisted. All studies in English, both medical and non-medical literature, were included. A simple pro-forma was used initially to identify the pertinent areas of upward feedback, so that a focused pro-forma could be designed for data extraction. RESULTS: A total of 204 articles were reviewed. Most studies on upward feedback bias were evaluative studies and only covered Kirkpatrick level 1-reaction. Most studies evaluated trainers or training, were used for formative purposes and presented quantitative data. Accountability and confidentiality were the most common overt biases, whereas method of feedback was the most commonly implied bias within articles. CONCLUSION: Although different types of bias do exist, upward feedback does have a role in evaluating medical training. Accountability and confidentiality were the most common biases. Further research is required to evaluate which types of bias are associated with specific survey characteristics and which are potentially modifiable.
Bias (Epidemiology) ; Confidentiality ; Quality Control ; Social Responsibility

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Is a medical humanities test needed in the National Medical Licensing Examination of Korea? Opinions of medical students and physician writers (secondary publication).

Kun HWANG

Journal of Educational Evaluation for Health Professions.2014;11(1):16-. doi:10.3352/jeehp.2014.11.16

The purpose of this study was to examine the opinions of medical students and physician writers regarding the medical humanities as a subject and its inclusion in the medical school curriculum. Furthermore, we addressed whether an assessment test should be added to the National Medical Licensing Examination of Korea (KMLE). A total of 192 medical students at Inha University and 39 physician writers registered with the Korean Association of Physician Essayists and the Korean Association of Physician Poets participated in this study. They were asked to answer a series of questionnaires. Most medical students (59%) and all physician writers (100%) answered that the medical humanities should be included in the medical school curriculum to train good physicians. They thought that the KMLE did not currently include an assessment of the medical humanities (medical students 69%, physician writers 69%). Most physician writers (87%; Likert scale, 4.38+/-0.78) felt that an assessment of the medical humanities should be included in the KMLE. Half of the medical students (51%; Likert scale, 2.51+/-1.17) were against including it in the KMLE, which they would have to pass after several years of study. For the preferred field of assessment, medical ethics was the most commonly endorsed subject (medical students 59%, physician writers 39%). The most frequently preferred evaluation method was via an interview (medical students 45%, physician writers 33%). In terms of the assessment of the medical humanities and the addition of this subject to the KMLE, an interview-based evaluation should be developed.
Curriculum ; Ethics, Medical ; Humanities* ; Humans ; Korea ; Licensure* ; Schools, Medical ; Students, Medical* ; Surveys and Questionnaires

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Would medical students enter an exclusion zone in an infected district with a high mortality rate? An analysis of book reports on 28 (secondary publication).

Kun HWANG ; Hyung Sun HONG ; Won Young HEO

Journal of Educational Evaluation for Health Professions.2014;11(1):15-. doi:10.3352/jeehp.2014.11.15

This study aimed to ascertain whether medical students would enter a closed area where there was a raging epidemic of an infectious disease with a high fatality rate, and includes reasons for the students entering or refusing to enter. Participants included 50 second-year medical students. They were assigned to read a novel entitled 28, written by Youjeong Jeong, and discuss it in groups. Using their book reports, their decisions of whether or not to enter Hwayang, the city from the novel, and the reasons for their decisions were analyzed; we furthermore investigated the factors affecting their decisions. Among the 50 respondents, 18 students (36%) answered that they would enter, and the remaining 32 students (64%) answered that they would not enter the zone. The reasons given for entering were responsibility (44%), sense of ethics (33%), social duty (17%), and sense of guilt (6%). The reasons the students provided for not entering were inefficiency (44%), worry regarding family (28%), needlessness of sacrifice (19%), and safety not ensured (9%). Students who had four or fewer family members were more likely to enter Hwayang than were students who had five or more family members (odds ratio, 1.85). Students who had completed over 100 hours of volunteer work were more likely to enter Hwayang than were students who had volunteered less than 100 hours (odds ratio, 2.04). Owing to their "responsibility" as a doctor, 36% of medical students answered that they would enter an exclusion zone in an infected district with a high fatality rate. However, 64% answered they would not enter because of "inefficiency." For the medical students it is still a question 'To enter or not to enter?'
Communicable Diseases ; Surveys and Questionnaires ; Ethics ; Guilt ; Humans ; Mortality* ; Odds Ratio ; Rage ; Students, Medical* ; Volunteers ; Writing

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Changes in flow experience among occupational therapy students: a 1-year longitudinal study.

Kazuki HIRAO

Journal of Educational Evaluation for Health Professions.2014;11(1):14-. doi:10.3352/jeehp.2014.11.14

PURPOSE: The purpose of this 1-year longitudinal study is to investigate the change in flow experience among occupational therapy students (OTS). METHODS: In December 2012, we prospectively recruited 97 OTS from the Department of Occupational Therapy, Kibi International University. To assess flow experience in daily life, we used the Flow Experience Checklist. RESULTS: The dataset included 87 OTS, of which 75 participated in the assessment at 1 year (follow-up rate, 86.2%). The mean age at baseline of 45 male and 30 female OTS was 19.59+/-1.1 years (range, 18 to 24 years). A comparison of the 'frequency of flow experience' showed significant differences between baseline values and those after 1 year (December 2013) among male OTS (P<0.05). CONCLUSION: The present results indicate that, for male OTS, the frequency of flow was significantly reduced after 1 year compared with baseline values. This finding suggests the need for further education to increase the frequency of flow among male OTS.
Checklist ; Dataset ; Education ; Female ; Follow-Up Studies ; Humans ; Japan ; Longitudinal Studies* ; Male ; Occupational Therapy* ; Prospective Studies

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Higher satisfaction with ethnographic edutainment using YouTube among medical students in Thailand.

Thira WORATANARAT

Journal of Educational Evaluation for Health Professions.2014;11(1):13-. doi:10.3352/jeehp.2014.11.13

PURPOSE: At present, transformative learning is one of the most important issues in medical education, since a conventional learning environment is prone to failure due to changing patterns among students. Ethnographic edutainment is a concept that consists of reward, competition, and motivation strategies that be used to effectively engage with learners. METHODS: A total 321 first-year medical students took part in ethnographic edutainment sessions in 2011. We defined four preset learning objectives and assigned a term group project using clouding technologies. Participatory evaluation was conducted to assess the delivery of and attitudes towards this method. RESULTS: Career lifestyles in the general population and expected real-life utilization of the final product were used as motivating factors, with competition and rewards provided through a short film contest. Nineteen out of twenty groups (95%) achieved all learning objectives. Females were more satisfied with this activity than males (P<0.001). We found statistically significant differences between lecture-based sessions and field visit sessions, as well as ethnographic edutainment activity sessions and other instructional approaches (P<0.01). The results were consistent in male and female groups. CONCLUSION: Ethnographic edutainment is well accepted, with higher satisfaction rates than other types of teaching. The concepts of health promotion and the social determinants of health can be learned through ethnographic edutainment activities, which might help train more humanized health professionals.
Education, Medical ; Female ; Health Occupations ; Health Promotion ; Humans ; Learning ; Life Style ; Male ; Motivation ; Personal Satisfaction ; Reward ; Social Determinants of Health ; Students, Medical* ; Thailand*

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Near-peer mentoring to complement faculty mentoring of first-year medical students in India.

Satendra SINGH ; Navjeevan SINGH ; Upreet DHALIWAL

Journal of Educational Evaluation for Health Professions.2014;11(1):12-. doi:10.3352/jeehp.2014.11.12

PURPOSE: The first year is stressful for new medical students who have to cope with curricular challenges, relocation issues, and separation from family. Mentoring reduces stress and facilitates adaptation. A program for faculty mentoring of first-semester students was initiated by the Medical Education Unit in 2009 at University College of Medical Sciences, Delhi. Feedback after the first year revealed that mentees were reluctant to meet their mentors, some of whom were senior faculty. In the following year, student mentors (near-peers) were recruited to see if that would improve the rate and quality of contact between mentees and mentors. METHODS: Volunteer faculty (n=52), near-peers (n=57), and new entrants (n=148) admitted in 2010 participated in the ratio of 1:1:3. The program aims were explained through an open house meeting, for reinforcement, and another meeting was conducted 5 months later. At year-end, a feedback questionnaire was administered (response rate: faculty, 28 [54%]; mentees, 74 [50%]). RESULTS: Many respondent faculty (27, 96%) and mentees (65, 88%) believed that near-peer mentoring was useful. Compared to the preceding year, the proportion of meetings between faculty mentors and mentees increased from 4.0+/-5.2 to 7.4+/-8.8; mentees who reported benefit increased from 23/78 (33%) to 34/74 (46%). Benefits resulted from mentors' and near-peers' demonstration of concern/support/interaction/counseling (35, 47.3% mentees); 23 mentees (82%) wanted to become near-peers themselves. CONCLUSION: Near-peer mentoring supplements faculty mentoring of first-year medical students by increasing system effectiveness.
Complement System Proteins* ; Counseling ; Surveys and Questionnaires ; Education, Medical ; Humans ; India* ; Mentors* ; Program Development ; Students, Medical* ; Volunteers

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Imperfect physician assistant and physical therapist admissions processes in the United States.

Phillip Eugene JONES ; Susan SIMPKINS ; Jennie Alicea HOCKING

Journal of Educational Evaluation for Health Professions.2014;11(1):11-. doi:10.3352/jeehp.2014.11.11

We compared and contrasted physician assistant and physical therapy profession admissions processes based on the similar number of accredited programs in the United States and the co-existence of many programs in the same school of health professions, because both professions conduct similar centralized application procedures administered by the same organization. Many studies are critical of the fallibility and inadequate scientific rigor of the high-stakes nature of health professions admissions decisions, yet typical admission processes remain very similar. Cognitive variables, most notably undergraduate grade point averages, have been shown to be the best predictors of academic achievement in the health professions. The variability of non-cognitive attributes assessed and the methods used to measure them have come under increasing scrutiny in the literature. The variance in health professions students' performance in the classroom and on certifying examinations remains unexplained, and cognitive considerations vary considerably between and among programs that describe them. One uncertainty resulting from this review is whether or not desired candidate attributes highly sought after by individual programs are more student-centered or graduate-centered. Based on the findings from the literature, we suggest that student success in the classroom versus the clinic is based on a different set of variables. Given the range of positions and general lack of reliability and validity in studies of non-cognitive admissions attributes, we think that health professions admissions processes remain imperfect works in progress.
Educational Measurement ; Health Occupations ; Humans ; Physical Therapists* ; Physician Assistants* ; Reproducibility of Results ; School Admission Criteria ; Uncertainty ; United States*

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Medical students' achievement on the Bachelor of Medicine, Bachelor of Surgery/Chirurgery Final Part I and II licensing examination: a comparison of students in problem-based learning, community-based education and service, and conventional curricula in G.

Victor MOGRE ; Anthony AMALBA ; Mark SAAKA ; Kwabena KYEI-ABOAGYE

Journal of Educational Evaluation for Health Professions.2014;11(1):10-. doi:10.3352/jeehp.2014.11.10

PURPOSE: Problem-based learning is an established method of teaching and learning in medical education. However, its impact on students' achievement on examinations is varied and inconsistent. We compared the levels of achievement on the Bachelor of Medicine, Bachelor of Surgery/Chirurgery (MB ChB) Part I and II licensing examination of students in problem-based learning, community-based education and service (PBL/COBES), and conventional curricula. METHODS: In 2014, we analyzed the MB ChB Final Part I and II licensing examination results of students in three classes (2004, 2005, and 2006) of the School of Medicine and Health Sciences, University for Development Studies, Tamale, Ghana. Ninety-three students in the 2004 and 2005 cohorts followed a conventional curriculum, and 82 students in the 2006 cohort followed a PBL/COBES curriculum. Using appropriate statistical tools, the analysis compared individual discipline scores and the proportions of students who received distinction/credit/pass grades among the classes. RESULTS: The PBL students had significantly higher mean and median scores than the conventional students in Obstetrics and Gynecology, Internal Medicine, Community Health and Family Medicine, Surgery, and Psychiatry, but not in Child Health and Pediatrics. Also, a significantly (P=0.0010) higher percentage, 95.1% (n=78), of the PBL students passed all the disciplines, compared to 79.6% (n=74) of the conventional students. CONCLUSION: The PBL students significantly performed better in all the disciplines except child health and pediatrics, where the conventional students scored higher. These findings demonstrate that the benefits of the PBL/COBES curriculum are tangible and should be fostered.
Child ; Child Health ; Cohort Studies ; Curriculum* ; Education* ; Education, Medical ; Educational Measurement ; Educational Status ; Ghana* ; Gynecology ; Humans ; Internal Medicine ; Learning ; Licensure* ; Obstetrics ; Pediatrics ; Problem-Based Learning*

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Students' perception of the learning environment at Xavier University School of Medicine, Aruba: a follow-up study.

P Ravi SHANKAR ; Rishi BHARTI ; Ravi RAMIREDDY ; Ramanan BALASUBRAMANIUM ; Vivek NUGURI

Journal of Educational Evaluation for Health Professions.2014;11(1):9-. doi:10.3352/jeehp.2014.11.9

Xavier University School of Medicine admits students mainly from the United States and Canada to the undergraduate medical program. A previous study conducted in June 2013 used the Dundee Ready Educational Environment Measure to measure the educational environment and impact of different teaching and learning methods in the program. The present study aims to obtain information about students' perceptions of changes in the educational environment, which underwent modifications in teaching and learning, in January 2014. Information was collected about the participants' semester of study, gender, nationality, and age. Students' perceptions of the educational environment were documented by noting their degree of agreement with a set of 50 statements grouped into five categories. Average scores were compared among different groups. The mean total and category scores were compared to those of the 2013 study. Sixty of the sixty-nine students (86.9%) who enrolled in the undergraduate medical program participated in the survey. The majority were male, aged 20-25 years, and of American nationality. The mean+/-SD total score was 151.32+/-18.3. The mean scores for students' perception in the survey categories were perception of teaching/learning (38.45), perception of teachers (33.90), academic self-perceptions (22.95), perception of atmosphere (36.32), and social self-perception (19.70). There were no significant differences in these scores among the different groups. All scores except those for academic self-perception were significantly higher in the present study compared to the previous one (P<0.05). The above results will be of particular interest to schools that plan to transition to an integrated curriculum.
Atmosphere ; Canada ; Curriculum ; Education, Medical ; Educational Measurement ; Ethnic Groups ; Follow-Up Studies* ; Humans ; Learning* ; Male ; Self Concept ; Students, Medical ; United States ; Netherlands*

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Assessing study skills among a sample of university students: an Iranian survey.

Alireza DIDARLOO ; Hamid Reza KHALKHALI

Journal of Educational Evaluation for Health Professions.2014;11(1):8-. doi:10.3352/jeehp.2014.11.8

PURPOSE: Numerous studies have revealed that study skills have a constructive role on the academic performance of students, in addition to educational quality, students' intelligence, and their affective characteristics. This study aims to examine study skills and the factors influencing them among the health sciences students of Urmia University of Medical Sciences in Iran. METHODS: This was a cross-sectional study carried out from May to November 2013. A total of 340 Urmia health sciences students were selected using a simple sampling method. Data were collected using the Study Skills Assessment Questionnaire of Counseling Center of Houston University and analyzed with descriptive and analytical statistics. RESULTS: The mean and standard deviation of the students' study skills were 172.5+/-23.2, out of a total score of 240. Around 1.2% of the study skills were weak; 86.8%, moderate; and 12%, good. Among the study skills, the scores of time management, and memory and concentration were better than the others. Also, there was a significant positive correlation between study skills scores and the students' family housing status and academic level (P<0.05). CONCLUSION: Although the majority of the participants had moderate study skills, these were not sufficient and far from good. Improving and promoting the study skills of university students require the designing and implementing of education programs for study strategies. Therefore, decision makers and planners in the educational areas of universities should consider the topic described above.
Counseling ; Cross-Sectional Studies ; Education ; Housing ; Humans ; Intelligence ; Iran ; Memory ; Test Taking Skills* ; Time Management ; Surveys and Questionnaires

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