Medical education
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Randomized Controlled Trial
The effect of dyad versus individual simulation-based ultrasound training on skills transfer.
Dyad practice may be as effective as individual practice during clinical skills training, improve students' confidence, and reduce costs of training. However, there is little evidence that dyad training is non-inferior to single-student practice in terms of skills transfer. ⋯ Dyad practice improves the efficiency of simulation-based training and is non-inferior to individual practice in terms of skills transfer.
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Randomized Controlled Trial
Clinical supervision and learning opportunities during simulated acute care scenarios.
Closer clinical supervision has been increasingly promoted to improve patient care. However, the continuous bedside presence of supervisors may threaten the model of progressive independence traditionally associated with effective clinical training. Studies have shown favourable effects of closer supervision on trainees' learning, but have not paid specific attention to the learning processes involved. ⋯ The shift of responsibility for patient care occurred during both direct and distant supervision, and did not necessarily translate into a lack of opportunities for trainee participation and practice.
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Randomized Controlled Trial
Dyad practice is efficient practice: a randomised bronchoscopy simulation study.
Medical simulation training requires effective and efficient training strategies. Dyad practice may be a training strategy worth pursuing because it has been proven effective and efficient in motor skills learning. In dyad practice two participants collaborate in learning a task they will eventually perform individually. In order to explore the effects of dyad practice in a medical simulation setting, this study examined the effectiveness and efficiency of dyad practice compared with individual practice in the learning of bronchoscopy through simulation-based training. ⋯ Individual practice and dyad practice did not differ in their effectiveness for the acquisition of bronchoscopy skills through supervised simulation training. However, dyad practice proved more efficient than individual practice because two participants practising in dyads learned as much as one participant practising individually but required the same instructor resources and training time as the single learner.
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Randomized Controlled Trial
Task- versus ego-oriented feedback delivered as numbers or comments during intubation training.
Learners can focus on mastery (i.e. task orientation) or on learning relative to others (i.e. ego orientation). Previous research suggests task orientations are optimal for learning, a benefit usually linked to the suggestion that qualitative comments are better for learning than quantitative comparisons (i.e. grades). Yet, it is not clear if the observed effects are attributable to the feedback orientation (i.e. task versus ego), feedback format (i.e. comments versus numerical scores), or an interaction between the two. Here, we aimed to clarify the effects of feedback orientation and feedback format during simulation-based training in endotracheal intubation. ⋯ Medical students responded to feedback in ways that challenge previous education research. Specifically, students preferred and improved more in the short term (but not at retention) when receiving Ego-oriented feedback in Numerical form. Although learning retention did not differ significantly across feedback conditions, students' perceptions of themselves and of the teacher and training environment did differ and the implications for trainees' future learning must be considered.
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Randomized Controlled Trial
The objective structured clinical examination: can physician-examiners participate from a distance?
Currently, a 'pedagogical gap' exists in distributed medical education in that distance educators teach medical students but typically do not have the opportunity to assess them in large-scale examinations such as the objective structured clinical examination (OSCE). We developed a remote examiner OSCE (reOSCE) that was integrated into a traditional OSCE to establish whether remote examination technology may be used to bridge this gap. The purpose of this study was to explore whether remote physician-examiners can replace on-site physician-examiners in an OSCE, and to determine the feasibility of this new examination method. ⋯ This preliminary study demonstrated that OSCE ratings by LEs and REs were reasonably comparable when using checklists. Remote examination may be a feasible and acceptable way of assessing students' clinical skills, but further validity evidence will be required before it can be recommended for use in high-stakes examinations.