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Objectives: This study aimed to evaluate the effects, and timing of, a video educational intervention on medical student performance in manikin-based simulation patient encounters. Methods: This prospective mixed-methods study was conducted as part of the University of Toledo College of Medicine and Life Sciences undergraduate medical curriculum. One hundred sixty-six students second-year students participated in two simulations on a single day in September 2021. A 7-minute video intervention outlining the clinical diagnostic approach to pulmonary complaints was implemented. Students were randomized into 32 groups which were divided into two cohorts. One received the video prior to simulation-1 (n=83) and the other between simulation-1 and simulation-2 (n=83). Each simulation was recorded and assessed using a 44-point standardized checklist. Comparative analysis to determine differences in performance scores was performed using independent t-tests and paired t-tests. Results: Independent t-tests revealed the video-prior cohort performed better in simulation-1 (t(30)= 2.27, p= .03), however in simulation-2 no significant difference was observed between the cohorts. Paired t-test analysis revealed the videobetween cohort had significant improvement from simulation-1 to simulation-2 (t(15)= 3.06, p = .01); no significant difference was found for the video-prior cohort. Less prompting was seen in simulation-2 among both the video-prior (t(15)= -2.83, p= .01) and video-between cohorts (t(15)= -2.18, p= .04). Conclusions: Simulation training, and targeted educational interventions, facilitate medical students to become clinically competent practitioners. Our findings indicate that guided video instruction advances students' clinical performance greater than learning through simulation alone. To confirm these findings, similar investigations in other clinical training exercises should be considered.
Introduction: Self-directed learning (SDL) is a process in which learners diagnose their learning needs, formulate learning goals, and identify appropriate resources to close the knowledge gap. While there has been a growing emphasis on medical schools incorporating SDL into their curriculum, implementation can bring challenges. The objective of this study was to assess student satisfaction as well as content mastery after implementing two novel models of SDL into our pre-clinical curriculum. Methods In the first model instructors provided a detailed clinical vignette (topic: anticoagulants; Cardio-Renal system) to the students, who were then instructed to identify a learning objective, identify appropriate resources, and submit their findings on the learning management software. Instructors provided individual narrative feedback to the students based on a well-defined rubric. In the second model, the faculty designed a series of questions/learning objectives based on a chosen topic (COVID-19). The students were divided into small groups of 5–6. Each group chose a clinical question, found original research papers that addressed their learning objective, and then presented the findings to their peers. The faculty provided narrative feedback based on their presentation guided by a rubric. The authors conducted a cross-sectional survey of the second-year students who participated in the program (n = 158/175; 90%). Survey items measured students' approach towards SDL, thoughts on the role of SDL in their learning process, and factors influencing their engagement and satisfaction. Finally, we analyzed students’ content mastery on the topic covered by SDL in the internal assessments using a cognitively diagnostic assessment called the Deterministic Input, Noisy “And” Gate (DINA) model. Results Students reacted positively in the survey with 69% percent of the respondents reporting that SDL reinforced their learning and 66% agreeing that it helped their development as lifelong learners. DINA model analysis showed that 91% of the students attained the skills necessary to answer questions on “COVID-19”. Conclusions Other medical schools can easily adapt the two innovative approaches described here. In the next phase, the methods will be further refined and elaborated into other systems based on student feedback.
Purpose: In our institution, we initiated integrated learning in the format of Learning Modules (LM), interactive audio/visual modules developed by the faculty in alignment with session learning objectives, as pre-work for in-class sessions.?This pilot study examined students’ perceptions of this new learning method and effectiveness in helping them achieve content mastery. Methods: The instructor provided the LMs in advance, allowing a self-paced introduction of critical concepts that were subsequently discussed in detail during the in-class learning (ICL) session. A cognitive diagnostic assessment was used to analyze the student's performance on the exams. This involved identifying six skills, one or more of which were marked to be necessary for answering each exam question correctly. A question-by-skill Q-matrix was constructed, followed by analysis using a Deterministic Input, Noisy "And" Gate (DINA) model. Results: 70% of the students rated the new approach as "Excellent or Good." 63% of the students attained skills necessary to answer questions that involved integrating information gained separately from LM and ICL sessions. However, only 23% of the students achieved mastery in all the 6 skills. Conclusion: This integrative learning system allowed for time optimization since ICL sessions could focus on more interactive aspects of the content.
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