Browsing by Subject "Medical education"
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Item Open Access A comparison of the effectiveness of the team-based learning readiness assessments completed at home to those completed in class.(J Educ Eval Health Prof, 2015) Carbrey, Jennifer M; Grochowski, Colleen O'Connor; Cawley, Joseph; Engle, Deborah LPURPOSE: The readiness assurance process (RAP) of team-based learning (TBL) is an important element that ensures that students come prepared to learn. However, the RAP can use a significant amount of class time which could otherwise be used for application exercises. The authors administered the TBL-associated RAP in class or individual readiness assurance tests (iRATs) at home to compare medical student performance and learning preference for physiology content. METHODS: Using cross-over study design, the first year medical student TBL teams were divided into two groups. One group was administered iRATs and group readiness assurance tests (gRATs) consisting of physiology questions during scheduled class time. The other group was administered the same iRAT questions at home, and did not complete a gRAT. To compare effectiveness of the two administration methods, both groups completed the same 12-question physiology assessment during dedicated class time. Four weeks later, the entire process was repeated, with each group administered the RAP using the opposite method. RESULTS: The performance on the physiology assessment after at-home administration of the iRAT was equivalent to performance after traditional in-class administration of the RAP. In addition, a majority of students preferred the at-home method of administration and reported that the at-home method was more effective in helping them learn course content. CONCLUSION: The at-home administration of the iRAT proved effective. The at-home administration method is a promising alternative to conventional iRATs and gRATs with the goal of preserving valuable in-class time for TBL application exercises.Item Open Access Association Between E-learning System Usage and Medical Student Academic Performance at the Kilimanjaro Christian Medical University College in Moshi, Tanzania(2018) Murray, MargaretAbstract
Introduction: Due to Tanzania’s rising population and shortage of physicians, there has been an emphasis on the expansion of medical schools in the past two decades, both in number and class size. In order to teach a growing student body, faculty adopted e-learning (electronic learning) systems to distribute materials and educate students. At Kilimanjaro Christian Medical University College (KCMUCo) faculty adopted the e-learning system called Learning Management Content System (LCMS+) in 2011. LCMS+ allowed students to access and download course materials during the year; but the association between the downloaded course materials and final grade was unknown. This study aimed to analyze the association between the downloaded materials and final grade in a course between 2011 and 2016.
Methods: To determine the association between downloaded materials and grade, a retrospective analysis study studied first- and second-year medical students in seven courses from 2011-2016 at KCMUCo. The study initially measured the frequency of downloaded course material (i.e. powerpoints, readings, assignments, course outlines and discussion board posts) from LCMS+ per first and second-year student. The final course grades were then obtained. A linear regression was used to assess the association between (1) downloads and grade and (2) sociodemographic variables and grade.
Results: Of the 1,527 students and 5,205 student-course-years studied, there was a weak or null association between downloaded materials and grade for each year and for different types of downloaded material. The distributions of the grades were approximately normal from 2011-2014 and in 2014-2016 there was a left shift of grade distribution. Additionally the female sex and post-service history were associated with slightly lower grades in some of the student years.
Conclusion: This study demonstrated there was no strong association between the number of downloads and grade. There was also no association between the type of downloaded material and grade and the number of materials did not increase the longer the e-learning system was at KCMUCo. More research on how e-learning systems can benefit students is required and may lead to better training for future generations of health care providers.
Item Open Access Global Mental Health: Five Areas for Value-Driven Training Innovation.(Acad Psychiatry, 2016-08) Kohrt, Brandon A; Marienfeld, Carla B; Panter-Brick, Catherine; Tsai, Alexander C; Wainberg, Milton LOBJECTIVE: In the field of global mental health, there is a need for identifying core values and competencies to guide training programs in professional practice as well as in academia. This paper presents the results of interdisciplinary discussions fostered during an annual meeting of the Society for the Study of Psychiatry and Culture to develop recommendations for value-driven innovation in global mental health training. METHODS: Participants (n = 48), who registered for a dedicated workshop on global mental health training advertised in conference proceedings, included both established faculty and current students engaged in learning, practice, and research. They proffered recommendations in five areas of training curriculum: values, competencies, training experiences, resources, and evaluation. RESULTS: Priority values included humility, ethical awareness of power differentials, collaborative action, and "deep accountability" when working in low-resource settings in low- and middle-income countries and high-income countries. Competencies included flexibility and tolerating ambiguity when working across diverse settings, the ability to systematically evaluate personal biases, historical and linguistic proficiency, and evaluation skills across a range of stakeholders. Training experiences included didactics, language training, self-awareness, and supervision in immersive activities related to professional or academic work. Resources included connections with diverse faculty such as social scientists and mentors in addition to medical practitioners, institutional commitment through protected time and funding, and sustainable collaborations with partners in low resource settings. Finally, evaluation skills built upon community-based participatory methods, 360-degree feedback from partners in low-resource settings, and observed structured clinical evaluations (OSCEs) with people of different cultural backgrounds. CONCLUSIONS: Global mental health training, as envisioned in this workshop, exemplifies an ethos of working through power differentials across clinical, professional, and social contexts in order to form longstanding collaborations. If incorporated into the ACGME/ABPN Psychiatry Milestone Project, such recommendations will improve training gained through international experiences as well as the everyday training of mental health professionals, global health practitioners, and social scientists.Item Open Access Identification of barriers at the primary care provider level to improve inflammatory breast cancer diagnosis and management.(Preventive medicine reports, 2023-12) Devi, Gayathri R; Fish, Laura J; Bennion, Alexandra; Sawin, Gregory E; Weaver, Sarah M; Reddy, Katherine; Saincher, Rashmi; Tran, Anh NThe purpose of this study, based in the United States, was to evaluate knowledge gaps and barriers related to diagnosis and care of inflammatory breast cancer (IBC), a rare but lethal breast cancer subtype, amongst Primary Care Providers (PCP) as they are often the first point of contact when patients notice initial symptoms. PCP participants in the Duke University Health System, federally qualified health center, corporate employee health and community practices, nearby academic medical center, Duke physician assistant and advanced practice nurse leadership program alumni were first selected in a convenience sample and for semi-structured interviews (n = 11). Based on these data, an online survey tool was developed and disseminated (n = 78) to assess salient measures of IBC diagnosis, health disparity factors, referral and care coordination practices, COVID-19 impact, and continuing medical education (CME). PCP reported access to care and knowledge gaps in symptom recognition (mean = 3.3, range 1-7) as major barriers. Only 31 % reported ever suspecting IBC in a patient. PCP (n = 49) responded being challenged with referral delays in diagnostic imaging. Additionally, since the COVID-19 pandemic started, 63 % reported breast cancer referral delays, and 33 % reported diagnosing less breast cancer. PCP stated interest in CME in their practice for improved diagnosis and patient care, which included online (53 %), lunch time or other in-service training (33 %), patient and provider-facing websites (32 %). Challenges communicating rare cancer information, gaps in confidence in diagnosing IBC, and timely follow-up with patients and specialists underscores the need for developing PCP educational modules to improve guideline-concordant care.Item Open Access Implicit and Explicit Attitudes of Medical Students Towards Mental Illness: A Randomized Controlled Pilot Trial of Service User Videos to Reduce Stigma in Nepal(2018) Tergesen, CoriBackground: Many health providers worldwide stigmatize people living with mental illness, creating a barrier to providing quality mental health services. Interventions aiming to reduce stigma during medical school have utilized education and contact-based methods to improve student attitudes towards mental illness. However, the effectiveness of these methods has never before been compared in medical schools in low-income countries. The aim of this study was to evaluate a video featuring a mental health service user with depression in a randomized controlled pilot trial among medical students in Nepal. Methods: In a three-armed randomized controlled pilot trial, participants were randomized to one of three conditions: a didactic video lecture based on the mental health Gap Action Programme Implementation Guide (mhGAP-IG) depression module, a service user testimonial video about living with depression, and a condition with no video presentation. Participants were 94 second and third year medical students in Nepal. All of the measures were collected post-intervention. The primary outcome was explicit attitudes measured on the Social Distance Scale (SDS). Additional outcomes were implicit attitudes on two Implicit Association Tests (IAT), diagnostic accuracy, treatment knowledge, and symptom knowledge. Results: Both the didactic lesson (SDS mean score, M = 33.32; standard deviation, SD = 9.57) and the service user videos (M= 30.13; SD= 9.16) had lower explicit stigma after the video presentations compared to the control (M= 39.10; SD= 11.14) (F2,91= 6.37, p= 0.003, R2= 0.12), but there was no difference between the two intervention conditions (F1,61= 1.55, p= 0.23, R2= 0.02). There were no significant differences on implicit associations (IAT d score), depression diagnosis, treatment knowledge, and symptom knowledge. Conclusions: Prerecorded videos (whether didactic or service user testimonials) are scalable learning tools that have potential to reduce explicit stigma among medical students in low resources settings. Additional research is necessary to explore the differences between both didactic education and service user testimonial interventions, as well as the potential outcomes when the videos are combined. A full scale randomized controlled trial will be conducted based on these findings.
Clinical Trials Registration: CTRN NCT03231761
Item Open Access Mental Well-Being in Students at University of Ruhuna Faculty of Medicine: A Cross-Sectional Study(2019) Wimberly, Courtney EliseObjective: Though the role of negative mental health has been investigated, positive mental health in medical students remains an under-investigated topic. This study sought to describe and explore mental well-being in a population of medical students in Sri Lanka, by investigating the range and level of both positive and negative mental health and covariates and by comparing the results with those of US studies. Methods: Students at University of Ruhuna Faculty of Medicine completed paper-based, cross-sectional questionnaires that included demographic items, the Mental Health Continuum-Short Form (MHC-SF), the Kessler 10 Psychological Distress Scale (K10), and the Oldenburg Burnout Inventory (OLBI). Analysis took place in Stata and RStudio. Results: Most students were categorized with moderate positive mental health (64.8%) and severe psychological distress (40.4%). Negative and positive mental health outcomes were moderately associated. None of the demographic factors was a significant predictor of positive mental health nor academic performance, and none of the mental health outcomes predicted academic performance. Females reported significantly higher levels of burnout. Conclusions: Medical students in Sri Lanka may experience different levels of positive and negative mental health by year in school. In the current study, final year students reported significantly higher levels of psychological distress and burnout than first year students. Males and older students were significantly more likely to have poor academic performance. Institutions should monitor medical student well-being and direct resources toward evidence-based activities, allowing students to continue along the upward spiral of well-being and flourish into successful medical practitioners.