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Background: Developing an appropriate attitude and sensibility of professional values and behaviour is a consistent goal of medical education. There is comparatively little understanding of how medical students' attitudes and values of professionalism develop during the course of their medical education. Summary of work: A study was carried out to analyse the changes in Japanese medical students' perception of a good doctor as they progressed through medical school. Year 1, 4 and 5 students participated in this study. The relative importance of each of seven attributes of a good doctor: 'excellence', 'accountability', 'basic medical knowledge', 'clinical competences in therapy', those in 'diagnosis', 'morals and ethics', and 'communication skills' was estimated by a statistical method, Conjoint analysis. Summary of results: Year 1 students most emphasised 'clinical competences in therapy', followed by 'communication skills'. Unlike the results of the previous studies, 'morals and ethics' was the fifth importance of them. Gradually from Year 1 to 5, the relative importance of 'communication skills' declined, and in contrast, those of 'clinical competences in therapy' and 'diagnosis' increased. Year 5 students emphasised less on 'morals and ethics' and 'excellence' than Year 4 and 1 students did.
Conclusions: The students appeared to change their attitudes and values of professionalism as they progressed through medical school. The preferences of Year 5, who had experienced clinical clerkship, seemed to become more realistic than those of Year 1. Take-home messages: The students' development was influenced by informal and hidden curricula in clinical
settings. This seemed to reflect social demands for doctors and not necessarily be negative as generally believed.
Yellow Card - Professional Attitudes and Behaviour
P Bjelogrlic (University of St Andrews, School of Medicine, Medical and Biological Sciences Building, St Andrews KY16 9TF, United Kingdom) E Sinclair (University of St Andrews, School of Medicine, St Andrews, United Kingdom)
A Laidlaw (University of St Andrews, School of Medicine, St Andrews, United Kingdom)
Background: Forming attitudes, cultivating desired behaviour and ultimately promoting professionalism is an important aspect of medical education from day one. To encourage students to adopt the GMC's (General Medical Council) guidance "Medical Students: Professional behaviour and fitness to practise", the School of Medicine, University of St Andrews, introduced a yellow card warning system. Summary of work: For one cohort of medical students (n151), year of entry 2010, yellow card data was recorded for three years. The data was entered into an Excel spread sheet and included date of card issue and the reason for issue. We have reviewed and identified trends in delivery of yellow card warnings. The results will be presented.
Summary of results: The number of warnings issued varied for each semester. Distribution was not uniform throughout the semesters. We have reviewed and identified trends in delivery of yellow card warnings. We reflected on these trends and propose how the yellow card system influenced and improved students' understanding of professional behaviour. Conclusions: The yellow card scheme is an effective tool to influence attitudes and behaviour and make students more aware of the GMC's guidance: "Medical Students: Professional behaviour and fitness to practise" Take-home messages: Raising awareness of professionalism using a yellow card system from day one at medical school influences students' attitudes and behaviour.
3DD Posters: Problem Based Learning Location: South Hall, PCC
PBL - What next?
Nicholas Latcham (Hull York Medical School, Medical Education, 47 Main Avenue, York YO31 0RR, United Kingdom)
Elizabeth Hughes (Hull York Medical School, Medical Education, Hull, United Kingdom)
John Lewis (Hull York Medical School, Medical Education, York, United Kingdom)
Background: Problem Based Learning (PBL) was introduced into medical education in 1969 and has become an internationally accepted educational tool. It has, however, shown little evolution in over 40 years. Summary of work: Junior doctors in academic posts in medical education at Hull York Medical School (HYMS) are investigating the potential development of PBL within HYMS. A preliminary review of published literature suggested there was no universally accepted definition of PBL. To explore its development, it is important to clarify what PBL is perceived to be. Summary of results: A literature review confirmed that there was no universal definition of PBL, although recurrent themes were highlighted. There is little published literature on how PBL should be developed. In comparison to traditional courses, PBL seems to be effective in social and cognitive domains. Its relative effectiveness in the acquisition of knowledge remains contentious. This may in part be due to the complexity of variable implementations of PBL. Conclusions: Research should be conducted into defining what PBL is and how it should be developed. Qualitative research methods are being used to answer these questions.
Take-home messages: We should avoid complacency in our use of PBL. Educational research can be used to develop junior academics and to inform educational development and policy.
10 years' experience of PBL in Kyungpook National University School of Medicine
Sang Hee Yeo (Kyungpook National University School of Medicine, Department of Medical Education, 101 Dongin-dong, Jung-gu, Daegu 700422, Korea, Republic of (South Korea))
Bong Hyung Chang (Kyungpook National University School of Medicine, Department of Medical Education, Daegu, Korea, Republic of (South Korea)) Jong Myung Lee (Kyungpook National University School of Medicine, Office of Medical Education, Daegu, Korea, Republic of (South Korea))
Jang Soo Suh (Kyungpook National University School of Medicine, Department of Laboratory, Daegu, Korea, Republic of (South Korea))
ABSTRACT BOOK: SESSION 3 MONDAY 26 AUGUST: 1045-1230
Chang Ho Youn (Kyungpook National University School of Medicine, Department of Medical Education, Daegu, Korea, Republic of (South Korea))
Background: The purpose of this study is to investigate the students' satisfaction in PBL, the students' preference for the number of PBL sessions per week and per case, the sequence of PBL and related lecture, and the preference for the presence of a tutor in the group. Summary of work: The target period in our study is from 1999 to 2009, and target students are from second year. Satisfaction with PBL was investigated in 2002, 2005, and 2009. The rest of the study topics as mentioned above were investigated in 2009. Surveys were conducted during PBL class. We had a focused interview with group leaders and some students after class. Summary of results: The scores of PBL satisfaction based on a 7-point scale were 4.95 points in 2002, 5.62 points in 2005, and 5.00 points in 2009. 69 respondents (70.5%) among 97 students preferred to study throughout the semester to the short term. Among 109 students, 92 respondents (84.4%) preferred to meet once a week and to study a case every two weeks. 59 respondents (54.1%) preferred attendances of tutor to absences in the group. It was investigated that 94 respondents (95.9%) in 2004 and 57 respondents (52.3%) in 2009 preferred to learn PBL case related to lecture contents. 85 respondents (78%) in 2009 preferred to take a PBL session after lecture. Conclusions: As a result, in order to increase students' satisfaction with PBL, it is necessary to arrange the date and the time of PBL session so that students can concentrate on PBL. Secondly, we should select PBL case to develop the ability of students' problem solving by arranging PBL case not to be synchronized with ongoing lecture contents.
Take-home messages: Finally, we should help make an atmosphere where students feel free to talk during PBL session.
Teaching Neurosciences in an Integrated Problem-Based Learning Program in an Undergraduate Medical Curriculum: Students' and Tutors' Perceptions
Ahmed Al Rumayyan (King Saud bin Abdulaziz University for Health Science, College of Medicine, P.O. Box 3660, MC3130, Riyadh 11481, Saudi Arabia)
Background: This paper aimed to briefly explore students' and tutors' perspectives regarding relevance, stimulation and amount learned from ten problems presented as triggers of learning in the Neurosciences, Vision and Behaviour Block in a problem-based curriculum at the College of Medicine, King Saud bin Abdulaziz University for Health Sciences. It is well known that the nature of student learning in PBL is largely dependent on the quality of the cases presented to them.
Summary of work: To describe teaching of the Neuroscience, Vision and Behaviour block in an
integrated PBL undergraduate medical curriculum and to discuss students' and tutors' perceptions of relevance, stimulation and amount learned from the problems used as triggers for learning. Summary of results: Students and tutors had favorable, congruent perceptions of amount learned, stimulation and relevance of neuroscience problems in a Saudi Arabian healthcare context. Open-ended comments from both groups were highly supportive of the block objectives, content and integrated teaching. Conclusions: It is important to evaluate amount learned, relevance and stimulation of problems as triggers of learning in a problem-based curriculum. This is particularly important where problems have been developed in a socio-cultural context that is different to that in which they are being implemented. Often students' perspectives are the only evaluation feedback elicited but tutors are also well placed to provide insights into functioning of PBL problems. Take-home messages: Exploring the congruence of students' and tutors' perspectives has been helpful when determining necessity for neurosciences block modifications, emulating a PBL collaborative knowledge-building approach in curriculum development.
PBL in Parasitology: A pilot project in a transforming medical school
Tatiana Giusti-Ehlert (Universidad Central de Venezuela, Centro de Investigacion y Desarrollo de la Educacion Medica, Escuela de Medicina "Luis Razetti", Ciudad Universitaria, Caracas 1053, Venezuela) Juan Perez-Gonzalez (Universidad Central de Venezuela, Centro de Investigacion y Desarrollo de la Educacion Medica, Caracas, Venezuela)
Background: In a transforming medical school, where a competency-based curriculum is due to replace a traditional one, there is a need for gradual implementation of student-centered, competency-developing learning strategies. This is a particular challenge in basic disciplines such as Parasitology. We describe an attempt to develop a PBL course to complement traditional teaching methods for third-year medical students.
Summary of work: The traditional Parasitology course requires students to complete 3 activities for each program topic: lectures, practical sessions and tutorials. We substituted the latter for PBL-type sessions based on cases depicting the clinical presentation of various parasite groups to promote in-context learning within traditional learning objectives. Cases were delivered to students, via the Edmodo platform, one week prior to each session in which four randomly-selected students make a 15-minute presentation of their reasoning and conclusions. A further 45-minute general discussion follows, to construct group-learning. Students are encouraged to use a structured clinical reasoning approach to problem-solving. Students' performance is assessed after each session by the tutor, with summative purposes, using Elizondo-Montemayor's
ABSTRACT BOOK: SESSION 3 MONDAY 26 AUGUST: 1045-1230
criterion-referenced system. Formative self-assessment and peer-assessment is carried out periodically. Summary of results: Students are followed up and their performance in the traditional course is compared to a control group. Self-directed learning skills are assessed before and after the course in both groups, as is student satisfaction with the learning process. Take-home messages: PBL, adapted to a traditional curriculum is a suitable method to enhance knowledge application and self-directed study in Parasitology. Furthermore, it helps to familiarize students and faculty with strategies aimed to develop significant learning.
Satisfaction of medical students towards a change from problem-solving approach to problem-based learning in a 3-week renal system block
Promjit Sriyabhaya (Srin akharin wirot University, Pathology, 114 Soi 23 Sukhumvit Rd., Wattana, Bangkok 10110, Thailand)
Nantana Choomchuay (Srinakharinwirot University, Pathology, Bangkok, Thailand)
Background: In 2012, problem-based learning (PBL) activity was initially implemented as the first session of the renal system block at Srinakharinwirot University. Some faculty members, however, disagreed to this change as they believe that undergraduate students would be more satisfied and perform better if lectures in anatomy and physiology of the renal system are provided prior to problem-solving sessions. Summary of work: The authors investigated whether a change from problem-solving to PBL affected exam performance and satisfaction of students on teaching and learning activities by comparing the data obtained from students completing the course in 2012 and the previous year.
Summary of results: A change from problem-solving to PBL did not significantly affect the performance of students on the in-house examination, with an average score of 71% in 2012 versus 73% in 2011. In addition, there was no significant difference of the satisfactory scores on an evaluation of teaching and learning activities between the year 2011 and 2012, with the average scores of 4.47/5 and 4.48/5, respectively. Importantly, most students (95%) highlighted the challenge of PBL scenario and the fulfillment of supplementary lectures as they came to the class with meaning instead of just for simply listening. Conclusions: Hence, students were satisfied with structuring PBL at the beginning of the course although it is challenging.
Take-home messages: To improve performance of students, the faculty should familiarize students with PBL rather than holding a lecture.
Problem based learning: a more rewarding learning experience?
F Mughal (University of Birmingham, School of Population and Health Sciences, Birmingham, United Kingdom)
A Ryan (University of Birmingham, School of Population and Health Sciences, Birmingham, United Kingdom) C Barton (University of Birmingham, School of Population and Health Sciences, Edgbaston, West Midlands, Birmingham B15 2TT, United Kingdom) R Stores (University of Birmingham, School of Population and Health Sciences, Birmingham, United Kingdom) H Lee (University of Birmingham, School of Population and Health Sciences, Birmingham, United Kingdom) J Clark (University of Birmingham, School of Population and Health Sciences, Birmingham, United Kingdom)
Background: There is evidence demonstrating that problem-based learning (PBL) is a more rewarding learning experience for students, and that students generally favour PBL against 'lecture-based' traditional pedagogy. There is, however, limited research that compares student satisfaction and their learning behaviours when both teaching methodologies are applied to a single cohort. This study aims to reflect on the effectiveness of current teaching techniques, endeavouring to increase student enjoyment in learning. Summary of work: A cross-sectional study of 260 undergraduate medical students at the University of Birmingham was undertaken, with questionnaires exploring students' preferred teaching methodology, learning resources and their learning behaviours. Summary of results: An overwhelming majority of students preferred traditional teaching over PBL, with a more accessible structure and greater clarity being fundamental reasons. The internet was the commonest resource used in PBL study, whereas textbooks were the most used resource in traditional learning. There is no significant difference between both teaching methodologies in the average time students engaged in library study.
Conclusions: Despite the growing integration of PBL into medical school curricula, this study demonstrates a population where the majority of students prefer traditional pedagogy. To achieve a more rewarding learning experience from PBL whilst enabling students to develop responsibility for managing their own learning needs, we recommend a phased integration of PBL into medical education with a concerted effort to establish a positive PBL ethos with clearer objectives which students can use as a foundation for lifelong learning.
Take-home messages: It is necessary to identify the positive aspects of traditional teaching and appropriately implement this into PBL methodology.
ABSTRACT BOOK: SESSION 3 MONDAY 26 AUGUST: 1045-1230
Problem-based learning assessment in school might predict the medical students' performances in pediatric clerkship training
LS Ou (Chang Gung Memorial Hospital, Department of Pediatrics, 5, Fu-Hsing St., Kwei-Shan, Taoyuan, Kwei-Shan 33305, Taiwan)
RH Fu (Chang Gung Memorial Hospital, Department of Pediatrics, Taoyuan, Taiwan)
CC Jenq (Chang Gung Memorial Hospital, Department of Nephrogy, Taoyuan, Taiwan)
JL Huang (Chang Gung Memorial Hospital, Department of Pediatrics, Taoyuan, Taiwan)
HJ Tseng (Chang Gung Memorial Hospital, Biostatistical Center for Clinical Research, Taoyuan, Taiwan) SJ Yeh (Chang Gung Memorial Hospital, Department of Cardiology, Taoyuan, Taiwan)
Background: The problem-based learning (PBL) is a strategy for medical learning between school to clinical workplace learning. We want to explore whether the assessments in PBL might predict the clinical workplace performance later.
Summary of work: Ninety-five medical students from Chang Gung University received PBL training in the fourth year at school and clerkship pediatric training in the fifth year at Chang Gung memorial hospital. Six different PBL training scores in school were compared with the five different scores in pediatric clerkship training.
Summary of results: The relationship between different PBL scores and clinical pediatric assessment scores showed moderate, low, or poor correlation. We found that PBL scores of behavior assessment from tutors is a better prediction factor than PBL written test. The students in upper 25% ranking of PBL assessment from tutors had better performances in three kinds of pediatric clerkship assessments (case-based discussion score, assessment score by resident supervisors, and on duty performance score, all p<0.05) than students in lower 25% ranking of PBL assessment from tutors. Conclusions: PBL assessment scores by tutors in school might reflect the medical students' learning and working ability in the future and might help us to predict or find students to improve their clinical learning strength. Take-home messages: PBL assessment scores by tutors might predict the medical students' learning and working ability in the future.
Students', Tutors' and Experts' perspective of the Effective PBL Problems
Savitri Shitarukmi (Faculty of Medicine Universitas Gadjah Mada, Medical Education, Jalan Farmako, Sekip Utara, Perumahan Jombor Baru Blok 2 No 12 Sleman, Yogyakarta 55285, Indonesia) Siti Rokhmah Projosasmito (Faculty of Medicine Universitas Gadjah Mada, Medical Education, Yogyakarta, Indonesia)
Herma Roebertsen (Faculty of Health, Medicine and Life Science, Maastricht University, Educational Development and Research, Maastricht, Netherlands)
Background: A PBL problem should be designed as an effective starting point for students to attain learning objectives. Thus, a continuous monitoring, evaluating, and improving the PBL problems should be done systematically. The aim of this study is to evaluate the effectiveness of PBL problem by involving students, tutors and experts of PBL principles. We do hope that the results of this evaluation could give us about the importance of maintaining the quality of PBL problems. Summary of work: A survey by using questionnaire based on six factors of an effective PBL problem was conducted to obtain students, tutors and experts perception towards the effectiveness PBL problems used in tutorial session. The perceptions were then analysed by using descriptive statistic. Four open ended questions included in the questionnaire were used to get better understanding and explanation of quantitative result. Summary of results: Some differences among students, tutors and experts in rating the overall quality on each problem were found. The strength and the weakness of each problem were also obtained. Each group of participants had their own concern regarding the most important factor for an effective PBL problem. Conclusions: The result of this evaluation could reflect the effectiveness of PBL problems in achieving students' learning objectives from different viewpoints: students, tutors and experts. This valuable information can be used by problem designers and their institutions to monitor and improve the quality of PBL problems continuously.
Take-home messages: Whenever you have a problem, always see it from different viewpoints.
Learners' success vs. learners' satisfaction: different sides of the same coin? Hints from evaluation data of a PBL-seminar on basic scientific competencies in medicine
Gotz Fabry (Albert-Ludwigs-University, Department of Medical Psychology and Sociology, Rheinstrasse 12, Freiburg 79104, Germany) Silke Biller (Albert-Ludwigs-University, Centre for Evaluation of Teaching in Medicine Baden-Wurttemberg, Freiburg, Germany)
Boeker Martin (Albert-Ludwigs-University, Institute of Medical Biometry and Medical Informatics, Freiburg, Germany)
Marianne Giesler (Albert-Ludwigs-University, Centre for Evaluation of Teaching in Medicine Baden-Wurttemberg, Freiburg, Germany)
Ariane Zeuner (Albert-Ludwigs-University, Department of Medical Psychology and Sociology, Freiburg, Germany)
Background: As the first step in a longitudinal thread on scientific competencies we developed a PBL-seminar for first year medical students. PBL-cases focused on basic issues of scientific methods and approaches. To evaluate
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the seminar we used different self-assessed variables related to students' learning success as well as to their satisfaction with the seminar.
Summary of work: 340 students evaluated the seminar at the end of their first year by means of questionnaires. Summary of results: In their self-assessment students stated that their competencies had increased with regard to the learning objectives (M=1.94 vs. M=3.38, p <.001, Cohens d = 1.98). A pre-post-assessment of their scientific competencies by means of the respective scale of the Freiburg Questionnaire to Assess Competencies in Medicine (FKM, Giesler et al. 2011) also indicated an increase in competency (M=2.82 vs. M=3.11, p<.0001, Cohen's d=0.47). Students were also positive with regard to the quality of the discussion process (Group Interaction Questionnaire, GIQ, Visschers-Pleijers et al. 2005) and the guidance of their tutors. However, when students were asked in the end-of-year evaluation to rate their learning success in the seminar and their satisfaction with the seminar overall, results were rather poor (M=3.64 and M=3.54, 6-point scale, 1=very good, 6=very poor). In addition, qualitative data also indicated that many students were rather discontent with the seminar.
Conclusions: The inconsistency of these results highlights the importance of understanding possible influences on the evaluation process (e.g. point in time, reliability and validity of items).
Using Learning Analytics to Evaluate the Efficacy of Blended Learning in PBL Based Medical Course
Abdullah Alghasham (Qassim University - College of Medicine, Pharmacology, PO Box 6655, Meldia 51452, Saudi Arabia)