MSE Articles

ABSTRACT

Problem-based learning (PBL) is a popular teaching method in medical schools, but is resource intensive due to the large number of faculty required to serve as small group tutors. This study 1) compares the effectiveness and student satisfaction of PBL small groups tutored by physicians with groups tutored by 4th year medical students (MSIVs) and 2) examines the effect of tutoring on learning by MSIVs. Sixteen MSIV students were recruited to tutor MSII groups. Seven MSIVs participated in a separate study to analyze the amount of learning that occurred as a result of teaching. The MSII students were given a quiz after each module to measure the amount of information learned, and a satisfaction survey regarding their tutor. Additionally, the tutors completed a pre-test and a post-test of the material they taught. All data was input into SPSS, a statistical analysis package, and analyzed using an Independent Samples t-test. Results indicated that there was no statistically significant difference in mean quiz scores of the MSII students between groups (those tutored by physicians and those tutored by MSIVs). There was also no statistically significant difference between groups on any of the questions on the satisfaction survey. Furthermore, the MSIV student tutor pre- and post-test scores showed no statistically significant difference although the post-test scores were all higher than the pre-test scores. These findings support the use of MSIV students as PBL tutors. The results also indicated that MSIV students may benefit from teaching MSII students. Additionally, the results suggest that MSIV students may be better prepared and more knowledgeable as physicians when they have been in a position to teach medical students.

ABSTRACT

An independently-developed, interactive, Web-based examination is used to assess learning in histology. The examination assesses factual information, concepts and whether the examinees recognize the organs of the body and the cells, tissues and structures that are associated with them and the other parts of the body. The method of assessment streamlines the administration and scoring of an examination and overcomes some of the inadequacies of examinations that use a microscope, video, projection slides or projected digital images. The strengths of the examination flow from the delivery of the examination to a computer workstation, the duel display of the questions and the images of the specimens on a computer monitor, and the use of an interactive computer interface. The interface allows the examinees to perform operations that improve the process of test-taking by conventional means. As a result, the examination is less cumbersome than a synchronous laboratory examination. The examinees advance by opening individual question windows. The examinees tag questions for review, view the images of specimens at more than one level of magnification, add notes to a textbox and strikethrough the options of multiple-choice questions that are judged to be erroneous. The evaluation of the computer application by the examinees shows the interactive features of the application are useful. The security of the examination during and following an examination is handled by the computer application and the actions taken by the course director. The security measures make the recycling of the images and questions on future examinations feasible.

As 2007 comes to an end, it seems appropriate to recap some of the highlights of the year for IAMSE. This past July IAMSE visited Cleveland for another successful meeting. This year the highlights, in addition to a wonderful visit to the science center, included some excellent pre-conference faculty development courses and workshops, presentations on… Read more »

The websites reviewed by the Medical Educator’s Resource Guide in this issue – one from the Medical University of South Carolina, another from the University of Iowa College of Medicine and a third from the University of Oklahoma Health Sciences Center –are used by the schools for laboratory instruction in histology.

The digital images of all three websites resemble the histological specimens that would be studied with a microscope. The websites differ substantially, however, in the way the content of the materials is presented and displayed to an online audience. The website at the University of Oklahoma is structured as an atlas and uses static labeled digital images. The other two websites utilize virtual microscopy and are structured to resemble a microscope laboratory. As Robert Ogilvie, Professor Emeritus of Cell Biology and Anatomy and Professor of Pathology and Laboratory Medicine at the Medical University of South Carolina, pointed out in his 2006 IAMSE audio seminar, virtual microscopy uses computer software to simulate the process of viewing glass microscope slides with a microscope.* He also stressed that virtual microscopy may or not use virtual slides.

At Dr. Ogilvie’s institution, the images are viewed with WebMic, a virtual microscope that scans and magnifies the snapshots of digitized histological materials. The students are guided in their study of the images by a laboratory manual that explains the relevant aspects of the morphology contained within the images and the steps that are needed to be taken if the images are to be thoroughly examined. In contrast, the website at the University of Iowa utilizes virtual slides. The difference is subtle and, according to Dr. Ogilvie, related to the digitization of the entire specimen contained on a glass microscope slide.

With virtual slides, the users can, if they wish, explore any sector of a slide and the cellular details of a specific area of the slide at higher magnifications. The technological difference is apparent when comparing the magnification features of the two virtual microscopy websites. There is also some perceivable but modest difference in the loading times for the images at higher magnifications when the field of view is moved.

If you know of a website that teachers and students working in the medical sciences would find useful, please consider submitting a review to The Medical Educator’s Resource Guide. You can do so by contacting us by e-mail (jrcotter@buffalo.edu).

ABSTRACT

From the authors’ experiences at a medical faculty where students are introduced to research early in their studies, members of the traditional pre-clinical medical science departments (Anatomy, Physiology, Biochemistry, Pharmacology and Medical Microbiology) have contributed significantly to the development of a research ethos amongst students, not only by supervising curriculum research, but also by providing extra-curricular research opportunities for students locally and abroad. Some of this work has resulted in scholarly achievements such as conference presentations and journal articles. Thus, medical scientists, through their supervision and mentorship of student research, have contributed to the preparation of young medical students for their clinical experience by developing skills that foster life-long learning. These important contributions should be duly acknowledged.

ABSTRACT

A remedial course for pathology was created and administered during the past four summers; two years as a classroom lecture course, and two years as an online course. Currently, West Virginia University School of Medicine is the only U.S. medical school that offers a summer remedial experience for a second-year medical school pathology course.

Objective: The objective of this study is to ascertain any differences in student learning between the online and the lecture-based remedial courses.

Plan of study: At the end of the summer courses, we asked students to evaluate the course and provide input about the course regarding what was done well and what could be improved. Weekly and shelf examination scores were also compared between students in the lecture-based and online remedial courses.

Results: Students in both the lecture-based and online remedial courses participated to the same extent in the learning experiences (p<0<0<0Conclusion: Overall, students had more positive comments about the online learning experience, which could be offered at a lower cost due to reduced faculty time. However, future modifications of the online learning experience will be necessary in order to maximize student performance on the standardized pathology shelf examination.

ABSTRACT

Course directors often note that medical science classes struggle with beginning medical courses when the material introduces novel concepts and terminology or requires recall of previously learned material. Pre-class quizzes induce students to review past courses and pre-read before the class is initiated, fostering easier entry into the subject matter.

ABSTRACT

Students find it difficult to see the relevance of, and have trouble integrating, some of the basic science course material when taught in isolation from the clinical courses. Integration of disparate material is perceived to be a challenge and this problem is compounded by assessments in which a single discipline is tested at a time – mostly in a multiple choice format. As such, the theory assessments in Years I and II were changed into a case-based, integrated format with extended-matching and short-answer type questions. This article describes the development of case-based theory exams involving simultaneous testing of all material taught in a module. Specific steps involving the process of building common cases across disciplines, question construction, faculty coordination and quality assurance are described.

This paper also addresses the quality of these integrated exams as experienced over the first academic year of implementation. Statistical analyses of internal consistency, such as Cronbach’s alpha of between 0.75 and 0.89, and split-half values of between 0.69 and 0.93 for the different exams were found. Correlations between modular results, as well as between Year I discipline-based results and Year II modular results, indicated some measure of construct validity. This result was supported by backward stepwise multiple linear regression analyses.

The new assessment format is resource intensive, but addresses issues of clinical relevance and integration. The fairly sound psychometric proportions of the exams support the high-stake decisions that we have to make on the basis of our examination results.

ABSTRACT

Pop quizzes have been utilized in non-medical academic settings to ensure student preparedness and improve test scores. This study is the first to examine the utility of pop quizzes in an undergraduate medical education (UME) setting. Three consecutive years of sophomore medical student data (n = 409) were used to compare performance indicators for students who were administered pop quizzes versus those who were administered scheduled quizzes and those who took no additional quizzes. Indicators examined were course test scores, semester exam scores, cumulative grades and scores on the National Board of Medical Examiner’s (NBME) Introduction to Clinical Diagnosis subject exam. Students who took pop quizzes performed the poorest on semester exams, the NBME exam and course final grades. ANOVA and post hoc test analyses showed that all three groups differed significantly on NBME scores and semester exams, with those who completed no quizzes scoring the highest, followed by those who took scheduled quizzes and then those who took pop quizzes. This study suggests that mandatory pop quizzes have questionable value in a UME clinical skills course.

ABSTRACT

Health science educators are under increasing pressure to reduce traditional lecture time and build more interactive teaching into curricula. While small group exercises such as problem based learning achieve that aim, they are highly faculty intensive and difficult to sustain for many faculties. The commercial availability of easy to use audience response systems (ARS) provides a platform for increasing instructor interaction and engagement with learners. This article details my recent experience with ARS, and suggests its uses to increase lecture interactivity, build student teamwork, provide formative feedback, and energize both faculty and students.

ABSTRACT

The Pre-Entry Program at The University of Texas Medical School at Houston is established to assist entering students who are judged to be at risk for academic difficulty. It requires a significant commitment of time on the part of faculty, staff and students. The effectiveness of this program needs to be evaluated.

This was a causal-comparative study of students invited to the Pre-Entry Program between 1999 and 2005. Students were self-selected into two groups, attendees (n = 174) and decliners (n = 81). The proportion of students with unsatisfactory performance and the rate of attrition from the first year class were compared for each group by a Pearson chi-square test. An analysis of covariance was used to compare the academic achievement as measured by the National Board of Medical Examiners (NBME) Subject Examinations in Biochemistry, Gross Anatomy and Physiology using Medical College Admission Test scores as the covariate.

There were no statistically significant differences in the incidence of unsatisfactory performance or in the rates of attrition from the first-year class between accepters and decliners or in the mean performances of the two groups on the NBME Examinations in Biochemistry and Physiology. The decliners had a statistically significant higher mean performance on the NBME Gross Anatomy Examination (p = .04), although the effect size (d = 0.29) was not educationally significant.

The effect of the Pre-Entry Program on the academic performance and attrition rate of at-risk first-year medical students is minimal. The program should remain voluntary and further studies should be performed to determine the non-academic effects of the program.