Advances in health sciences education : theory and practice
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Adv Health Sci Educ Theory Pract · May 2019
Randomized Controlled TrialFostering medical students' clinical reasoning by learning from errors in clinical case vignettes: effects and conditions of additional prompting procedures to foster self-explanations.
The present study aims at fostering undergraduate medical students' clinical reasoning by learning from errors. By fostering the acquisition of "negative knowledge" about typical cognitive errors in the medical reasoning process, we support learners in avoiding future erroneous decisions and actions in similar situations. Since learning from errors is based on self-explanation activities, we provided additional prompting procedures to foster the effectiveness of the error-based instructional approach. ⋯ Both prompting procedures increased extraneous cognitive load. For learners with low self-efficacy, the prompting procedures interfered with effective learning from errors. Although our error-based instructional approach substantially improved clinical reasoning, additional instructional measures intended to support error-based learning processes may overtax learners in an early phase of clinical expertise development and should therefore only be used in moderation.
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Adv Health Sci Educ Theory Pract · May 2016
Randomized Controlled TrialCan student self-ratings be compared with peer ratings? A study of measurement invariance of multisource feedback.
Measurement invariance is a prerequisite for comparing measurement scores from different groups. In medical education, multi-source feedback (MSF) is utilized to assess core competencies, including the professionalism. However, little attention has been paid to the measurement invariance of assessment instruments; that is, whether an instrument holds the same meaning across different rater groups. ⋯ In addition, same factor structure and similar factor loadings and intercepts of NTU P-MSF scores between both groups indicate that NTU P-MSF scores had configural, metric, and scalar invariance. Thus, students' self-assessments and peer assessments can be compared in terms of the constructs of NTU P-MSF scores, change in NTU P-MSF scores, and its factor scores. This study demonstrates how to investigate the measurement invariance of a professionalism MSF and contributes to the discussion on self- and peer assessment in medical education.
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Adv Health Sci Educ Theory Pract · Oct 2015
Randomized Controlled TrialPart versus whole: a randomized trial of central venous catheterization education.
Central venous catheterization (CVC) is a complex but commonly performed procedure. How best to teach this complex skill has not been clearly delineated. We conducted a randomized trial of the effects of two types of teaching of CVC on skill acquisition and retention. ⋯ Participants in the part-task group outperformed the whole-task group in skill acquisition (2.2 ± 0.8 vs 1.3 ± 1.0; g = 1.01; p = 0.04) and in skill retention (1.5 ± 0.7 vs 0.5 ± 0.8; g = 1.39; p = 0.006) using the global rating scale. Scores rated by the checklist were not significantly different (52.0 ± 25.3 vs 43.5 ± 23.4; g = 0.33; p = 0.47 for skill acquisition; and 48.5 ± 34.9 vs 41.1 ± 20.4; g = 0.35; p = 0.44 for skill retention). For teaching ultrasound-guided CVC to novice learners, teaching in part is preferable than teaching in whole.
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Adv Health Sci Educ Theory Pract · Mar 2015
Randomized Controlled TrialA randomized controlled study of manikin simulator fidelity on neonatal resuscitation program learning outcomes.
The neonatal resuscitation program (NRP) has been developed to educate physicians and other health care providers about newborn resuscitation and has been shown to improve neonatal resuscitation skills. Simulation-based training is recommended as an effective modality for instructing neonatal resuscitation and both low and high-fidelity manikin simulators are used. There is limited research that has compared the effect of low and high-fidelity manikin simulators for NRP learning outcomes, and more specifically on teamwork performance and confidence. ⋯ There were no significant differences in teamwork behaviour scores, as observed by two independent raters, nor differences on mandatory integrated skills station performance items at the p < 0.05 level. Medical students' reported greater satisfaction and confidence with high-fidelity manikin simulators, but did not demonstrate overall significantly improved teamwork or integrated skills station performance. Low and high-fidelity manikin simulators facilitate similar levels of objectively measured NRP outcomes for integrated skills station and teamwork performance.
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Adv Health Sci Educ Theory Pract · Aug 2010
Randomized Controlled TrialThe testing effect on skills learning might last 6 months.
In a recent study we found that testing as a final activity in a skills course increases the learning outcome compared to spending an equal amount of time practicing. Whether this testing effect measured as skills performance can be demonstrated on long-term basis is not known. The research question was: does testing as a final activity in a cardio-pulmonary resuscitation (CPR) skills course increase learning outcome when assessed after half a year, compared to spending an equal amount of time practicing? The study was an assessor-blinded randomised controlled trial. ⋯ The difference between groups was not statistically significant, P = 0.06. This study suggests that testing as a final activity in a CPR skills course might have an effect on long-term learning outcome compared to spending an equal amount of time practicing the skills. Although this difference was not statistically significant, the identified effect size of 0.4 can have important clinical and educational implications.