Psychometric properties and calibration of the SPOREEM (Students’ Perception of the Operating Room Educational Environment Measure)

Objective: The experience in the operating room is considered as a crucial element affecting medical students’ satisfaction with workplace-based training in surgery. We developed the “Students’ Perception of the Operating Room Educational Environment Measure” (SPOREEM) and applied the approach of Item Response Theory to improve accuracy of its measurement. Design: Psychometric analysis determined the factorial structure. Using Item Response Theory, item thresholds were calculated on response option levels. Sum scores in the factors were then computed using calibrated unit weights. Setting: One hundred medical students from the University Medical Center in Goettingen, Germany, enrolled in a one-week surgery rotation completed the SPOREEM. Results: The final 19-item questionnaire resulted in 3 factors: "Learning support and inclusion" (1), "Workplace atmosphere" (2), and "Experience of emotional stress" (3). Item calibration resulted in refinement of sum scores in the factors. Male students significantly rated factor 1 more positively. Factor 2 was perceived to a similar degree in all 3 surgical disciplines involved. Factor 3 was rated lower by those students planning a surgical field of postgraduate training. Conclusions: We developed a valid, reliable, and feasible tool to assess the overall educational climate of undergraduate training in the OR. Calibration of items refined the measurement

Assessment of Health-Related Quality of Life after TBI: Comparison of a Disease-Specific (QOLIBRI) with a Generic (SF-36) Instrument

Psychosocial, emotional, and physical problems can emerge after traumatic brain njury (TBI), potentially impacting health-related quality of life (HRQoL). Until now, however, neither the discriminatory power of disease-specific (QOLIBRI) and generic (SF-36) HRQoL nor their correlates have been compared in detail. These aspects as well as some psychometric item characteristics were studied in a sample of 795 TBI survivors. The Shannon H耠 index absolute informativity, as an indicator of an instrument’s power to differentiate between individualswithin a specific group or health state,was investigated. Psychometric performance of the two instruments was predominantly good, generally higher, and more homogenous for the QOLIBRI than for the SF-36 subscales. Notably, the SF-36 “Role Physical,” “Role Emotional,” and “Social Functioning” subscales showed less satisfactory discriminatory power than all other dimensions or the sum scores of both instruments. The absolute informativity of disease-specific as well as generic HRQoL instruments concerning the different groups defined by different correlates differed significantly.When the focus is on how a certain subscale or sum score differentiates between individuals in one specific dimension/health state, the QOLIBRI can be recommended as the preferable instrument.Psychosocial, emotional, and physical problems can emerge after traumatic brain injury (TBI), potentially impacting health-related quality of life (HRQoL). Until now, however, neither the discriminatory power of disease-specific (QOLIBRI) and generic (SF-36) HRQoL nor their correlates have been compared in detail. These aspects as well as some psychometric item characteristics were studied in a sample of 795 TBI survivors. The Shannon H耠 index absolute informativity, as an indicator of an instrument’s power to differentiate between individualswithin a specific group or health state,was investigated. Psychometric performance of the two instruments was predominantly good, generally higher, and more homogenous for the QOLIBRI than for the SF-36 subscales. Notably, the SF-36 “Role Physical,” “Role Emotional,” and “Social Functioning” subscales showed less satisfactory discriminatory power than all other dimensions or the sum scores of both instruments. The absolute informativity of disease-specific as well as generic HRQoL instruments concerning the different groups defined by different correlates differed significantly.When the focus is on how a certain subscale or sum score differentiates between individuals in one specific dimension/health state, the QOLIBRI can be recommended as the preferable instrument.Peer reviewe

Learner characteristics predict performance and confidence in e-learning: an analysis of user behaviour and self-evaluation.

We examined the role of learner characteristics as predictors of four aspects of e-learning performance, including knowledge test performance, learning confidence, learning efficiency, and navigational effectiveness. We used both self-reports and log file records to compute the relevant statistics. Regression analyses showed that both need for cognition and serialist preference predicted test performance. Participants needed less time to complete the e-module when they had lower serialist and higher surface processing scores. Learners with higher deep strategy and need for cognition scores were more confident in their learning, whilst the reverse held true for learners who scored high on surface strategy use. Also, learners with higher surface strategy use showed less active navigation patterns. Age did not predict any outcome except performance efficiency. The results therefore support the importance of including self-reported learner characteristics and educational background in addition to log file information

Assessing Efficiency of Prompts Based on Learner Characteristics

Personalized prompting research has shown the significant learning benefit of prompting. The current paper outlines and examines a personalized prompting approach aimed at eliminating performance differences on the basis of a number of learner characteristics (capturing learning strategies and traits). The learner characteristics of interest were the need for cognition, work effort, computer self-efficacy, the use of surface learning, and the learner’s confidence in their learning. The approach was tested in two e-modules, using similar assessment forms (experimental n = 413; control group n = 243). Several prompts which corresponded to the learner characteristics were implemented, including an explanation prompt, a motivation prompt, a strategy prompt, and an assessment prompt. All learning characteristics were significant correlates of at least one of the outcome measures (test performance, errors, and omissions). However, only the assessment prompt increased test performance. On this basis, and drawing upon the testing effect, this prompt may be a particularly promising option to increase performance in e-learning and similar personalized systems

Quantifying teaching quality in medical education: The impact of learning gain calculation

Background Student performance is a mirror of teaching quality. The pre-/post-test design allows a pragmatic approach to comparing the effects of interventions. However, the calculation of current knowledge gain scores introduces varying degrees of distortion. Here we present a new metric employing a linear weighting coefficient to reduce skewness on outcome interpretation. Methods We compared and contrasted a number of common scores (raw and relative gain scores) with our new method on two datasets, one simulated and the other empirical from a previous intervention study (n = 180) employing a pre-/post-test design. Results The outcomes of the common scores were clearly different, demonstrating a significant dependency on pre-test scores. Only the new metric revealed a linear relationship to the knowledge baseline, was less skewed on the upper or lower extremes, and proved well suited to allow the calculation of negative learning gains. Employing the empirical dataset, the new method also confirmed the interaction effect of teaching formats with specific subgroups of learner characteristics. Conclusion This work introduces a new weighted metric enabling meaningful comparisons between interventions based on a linear transformation. This method will form the basis to intertwine the calculation of test performance closely with the outcome of learning as an important factor reflecting teaching quality and efficacy. Its regular use can improve the transparency of teaching activities and outcomes, contribute to forming rounded judgements of students' acquisition of knowledge and skills and enable valuable feedforward to develop and enhance curricular concepts

Assessing efficiency of prompts based on earner characteristics

Personalized prompting research has shown the significant learning benefit of prompting. The current paper outlines and examines a personalized prompting approach aimed at eliminating performance differences on the basis of a number of learner characteristics (capturing learning strategies and traits). The learner characteristics of interest were the need for cognition, work effort, computer self-efficacy, the use of surface learning, and the learner’s confidence in their learning. The approach was tested in two e-modules, using similar assessment forms (experimental n = 413; control group n = 243). Several prompts which corresponded to the learner characteristics were implemented, including an explanation prompt, a motivation prompt, a strategy prompt, and an assessment prompt. All learning characteristics were significant correlates of at least one of the outcome measures (test performance, errors, and omissions). However, only the assessment prompt increased test performance. On this basis, and drawing upon the testing effect, this prompt may be a particularly promising option to increase performance in e-learning and similar personalized systems

Item format statistics and readability of extended matching questions as an effective tool to assess medical students

Testing based on multiple choice questions (MCQ) is one of the most established forms of assessment, not only in the medical field. Extended matching questions (EMQ) represent a specific type of MCQ designed to require higher levels of cognition, such as problem-solving. The purpose of this evaluation was to assess the suitability and efficiency of EMQ as an assessment method. EMQ were incorporated into the end-of-semester examination in internal medicine, in which 154 students participated, and compared with three established MCQ types. Item and examination quality were investigated, as well as readability and processing time. EMQ were slightly more difficult to score; however, both item discrimination and discrimination index were higher when compared to other item types. EMQ were found to be significantly longer and required more processing time, but readability was improved. Students judged EMQ as clearly challenging, but attributed significantly higher clinical relevance when compared to established MCQ formats. Using the Spearman-Brown prediction, only ten EMQ items would be needed to reproduce the Cronbach’s alpha value of 0.75 attained for the overall examination. EMQ proved to be both efficient and suitable when assessing medical students, demonstrating powerful characteristics of reliability. Their expanded use in favor of common MCQ could save examination time without losing out on statistical quality

Students’ perception of three-dimensionally printed teeth in endodontic training

Introduction In endodontic education, there is a need for thorough training prior to students embarking on clinical treatment. The aim of this study was to use three-dimensional printing technology to create a new model and to compare its suitability for training purposes with resin blocks and extracted teeth. Materials and Methods Multi-jet-modelling (MJM) produced the 3D model replicating a common difficulty in root-canal morphology. An evaluation study comprising 88 students was run in the sixth semester (summer 2018 and winter 2018/2019). A new questionnaire assessed students’ perception of training models and educational environment. Welch's t-test analysed significant differences. Results The most pronounced differences between models were noted when rating material hardness, radiopacity, root-canal configuration and suitability for practising. Students estimated their learning outcome as greater with 3D-printed teeth compared to resin blocks. Three-dimensionally printed teeth received significantly lower ratings with regard to enthusiasm, the learning of fine motor skills and spatial awareness, when compared to human teeth (p ≤ .001). However, 3D-printed teeth were appreciated for additional benefits, such as their cleanliness, availability and standardisation of training opportunities with complex root-canal configurations. Conclusion Students preferred extracted human teeth to 3D-printed teeth with respect to their physical characteristics and training experience. However, educational advantages may compensate for the shortcomings. The new questionnaire proved both adequate and accurate to assess the models and educational environment in endodontic training. The new 3D-printed teeth enhanced the learning opportunities

Gastrointestinal Pathogens in Multi-Infected Individuals: A Cluster Analysis of Interaction

Indigenous people live in remote areas of Colombia. Multiple infections with bacteria, protozoa and/or helminths are common, as well as colonization in various forms. This study focused on the question of whether and to what extent various pathogens interact with each other. Therefore, a mathematical approach was retrospectively applied to PCR-based data of 244 stool samples, collected in two datasets. A stable cluster solution of the pathogens assessed was determined, and a unique configuration between Blastocystis hominis/Campylobacter spp./Giardia lamblia forming cluster 1 and Dientaemoeba fragilis was verified. A pathogen density-dependent interplay appeared between the B. hominis/Campylobacter spp./G. lamblia cluster, D. fragilis and Ascaris lumbricoides. The applied mathematical approach demonstrated that co-infections with parasites of questionable pathological relevance such as B. hominis and D. fragilis can be of diagnostic relevance due to their ability to promote or repress other pathogens. With the increasing availability of highly sensitive multiplexed molecular diagnostic approaches even in resource-limited settings, where multiple colonization of infection events with enteric pathogens in parallel are common, the importance of interpreting whole pathogen patterns rather than just individual pathogen detection may become more and more relevant

Tablet-based versus presentation-based seminars in radiology: Effects of student digital affinity and teacher charisma on didactic quality

Aims: Tablets are being adopted as teaching medium in medical education more frequently. Here we compared two teaching formats in a radiology seminar using a tablet-based student-centred approach guided by teachers and traditional presentation-based, teacher-centred instruction. The aim was to investigate the effects on academic performance, estimated learning gain, didactic quality, as well as how teacher charisma and student digital affinity influence these elements. Methods: Data from 366 students were collected. Student digital affinity, didactic quality of, and overall satisfaction with the seminars were rated for each teaching format over three semesters, whereby in the last semester, students additionally estimated their learning gain, took a knowledge and image interpretation test, and rated teacher charisma. Results: The tablet-based seminars yielded significantly higher ratings for didactic quality and overall satisfaction. However, the presentation-based seminars proved superior with respect to academic performance as well as estimated learning gain. When employing tablets, teacher charisma correlated with estimated learning gain, and digital affinity affected didactic quality. Additionally, good seminar organization, comprehensible learning objectives, and optimal variation of learning activities were identified as important factors.Conclusion: This study suggests a complex interplay of various factors concerning teachers, students, and didactics that can be assessed and improved to assure the successful curricular implementation of tablets. Of note, tablet integration and thereby active engagement of students with imaging analysis skills does not automatically result in greater declarative knowledge. Nevertheless, understanding the complexities of structuring and delivering tablet-based, teacher-guided instruction is essential to creating meaningful educational experiences