An understanding of (mis)understanders: exploring the underlying mechanisms of concept learning using functional magnetic resonance imaging

Obtaining adequate understanding of scientific concepts is considered challenging due to learners' misconceptions about natural phenomena. Misconceptions may coexist with scientific knowledge in the brain. Therefore, misconceptions must be cognitively inhibited in order to select the scientific knowledge. There is, however, lack of substantial neuroscientific evidence supporting this hypothesis. In this study, we sought for this evidence by investigating medical students who solved a cardiovascular conceptual problem in a magnetic resonance imaging scanner. Brain activation was compared between understanders who had the scientific knowledge, and misunderstanders who held a misconception. No significant activation was found in brain areas related to cognitive inhibition in understanders compared with misunderstanders. Therefore, we could not confirm the idea that cognitive inhibition is involved in overcoming a misconception. Instead, we found that the putamen was significantly activated in misunderstanders compared with understanders, suggesting a role for episodic memory in learners holding a misconception.Medical Education Researc

De cesuurmethode Cohen-Schotanus bij de opleiding Geneeskunde in Leiden

Teaching and Teacher Learning (ICLON

Assessing publication rates from medical students' mandatory research projects in the Netherlands: a follow-up study of 10 cohorts of medical students

Objectives The medical field is facing a clinician-scientist shortage. Medical schools could foster the clinician-scientist workforce by offering students research opportunities. Most medical schools offer elective research programmes. Subsequently, a subset of doctors graduates without any research experience. Mandatory research projects may be more sufficient to develop clinician-scientist, but take more supervision and curricular time. There is limited insight in the scientific outcomes of mandatory research experiences. This study aims to examine publication rates of a mandatory research experience, identify factors associated with publication, and includes postgraduate research engagement. Design and setting Prospective follow-up study involving 10 cohorts of medical students' mandatory research projects from Leiden University Medical Center. Participants All medical students who conducted their research project between 2008 and 2018 (n=2329) were included. Main outcome measure Publication rates were defined as peer-reviewed scientific publications, including research papers, reviews, and published meeting abstracts. Postgraduate research engagement was defined as research participation and dissemination of research at scientific conferences or in journals. Results In total, 644 (27.7%) of all mandatory research experiences resulted in publication, with students mainly as first (n=984, 42.5%) or second author (n=587, 25.3%) and above world average citation impact (mean normalised journal score 1.29, mean normalised citation score 1.23). Students who conducted their research in an academic centre (adjusted OR 2.82; 95% CI 2.10 to 3.77), extended their research (adjusted OR 1.73; 95% CI 1.35 to 2.20), were involved in an excellency track (adjusted OR 2.08; 95% CI 1.44 to 3.01), or conducted clinical (adjusted OR 2.08; 95% CI 1.15 to 3.74) or laboratory (adjusted OR 2.16; 95% CI 1.16 to 4.01) research published their research more often. Later as junior doctors, this group significantly more often disseminate their research results at scientific conferences (adjusted OR 1.89; 95% CI 1.11 to 3.23) or in journals (adjusted OR 1.98; 95% CI 1.14 to 3.43). Conclusions Our findings suggest that a significant subset of hands-on mandatory research projects with flexible learning pathways result in tangible research output with proper impact and that such successful experiences can be considered as diving board towards a research-oriented career.Clinical epidemiolog

Fostering first-year student learning through research integration into teaching: Student perceptions, beliefs about the value of research and student achievement

Research should be explicated in undergraduate teaching in a way that stimulates student learning. Previous studies in higher education have shown that student perceptions of research integrated into teaching could promote student learning, but have also indicated that it can be difficult to confront first-year undergraduates with research during courses. In this study, we describe relationships between first-year medical student perceptions of research, learning outcomes and beliefs about the value of research. The Student Perception of Research Integration Questionnaire was filled out by 261 students. Answers were related to student achievement. The findings suggest that student motivation for research is strongly related to merging current research into teaching. Students rather recognised an emphasis on research methodologies than research engagement. Particularly student beliefs about research are related to achievement. It is suggested that to foster positive beliefs about research, teachers should familiarise students with current research and create enthusiasm for research.Teaching and Teacher Learning (ICLON

What were you thinking?: Medical students' metacognition and perceptions of self-regulated learning

PhenomenonAs a component of self-regulated learning, metacognition is gaining attention in the medical education research community. Metacognition, simply put, is thinking about one's thinking. Having a metacognitive habit of mind is essential for healthcare professionals. This study identified the metacognitive competencies of medical students as they completed a conceptual learning task, and provided insight into students' perceptions of self-regulated learning in their curriculum. Approach: Eleven third-year medical students from a Dutch University were purposively sampled to participate in this qualitative study. The study design included a think-aloud assignment followed by a semi-structured interview. During the assignment, participants were instructed to think aloud while solving questions about medical physiological concepts such as blood flow, pressure, and resistance. Think-aloud data were collected through audiotaping and used to identify participants' metacognitive competencies. The assignment also served as a prompt for an interview in which participants were questioned about metacognitive knowledge, monitoring, experiences, and perceptions of self-regulated learning in their curriculum. All data were transcribed verbatim and analyzed iteratively using a template analysis. Findings: Students differed in their use of metacognitive skills, with an overall focus on monitoring and, to a lesser extent, on planning and evaluation. Additionally, differences were found in students' metacognitive knowledge and metacognitive experiences. There was apparent use of inefficient, superficial predictive cues. Regarding perceptions of self-regulated learning skills, some students felt no need to develop such skills as they perceived medical education as an exercise in memorizing facts. Others emphasized the need for more insight into their actual level of knowledge and competence. Insights: Pre-clinical medical students require explicit teaching of metacognitive skills to facilitate self-regulated learning. Educators should aim to integrate metacognition in the everyday discourse of the classroom to foster an environment in which students discuss their own learning.Supplemental data for this article is available online at .Cardiolog

Use of very short answer questions compared to multiple choice questions in undergraduate medical students: an external validation study

Multiple choice questions (MCQs) offer high reliability and easy machine-marking, but allow for cueing and stimulate recognition-based learning. Very short answer questions (VSAQs), which are open-ended questions requiring a very short answer, may circumvent these limitations. Although VSAQ use in medical assessment increases, almost all research on reliability and validity of VSAQs in medical education has been performed by a single research group with extensive experience in the development of VSAQs. Therefore, we aimed to validate previous findings about VSAQ reliability, discrimination, and acceptability in undergraduate medical students and teachers with limited experience in VSAQs development. To validate the results presented in previous studies, we partially replicated a previous study and extended results on student experiences. Dutch undergraduate medical students (n = 375) were randomized to VSAQs first and MCQs second or vice versa in a formative exam in two courses, to determine reliability, discrimination, and cueing. Acceptability for teachers (i.e., VSAQ review time) was determined in the summative exam. Reliability (Cronbach's & alpha;) was 0.74 for VSAQs and 0.57 for MCQs in one course. In the other course, Cronbach's & alpha; was 0.87 for VSAQs and 0.83 for MCQs. Discrimination (average R-ir) was 0.27 vs. 0.17 and 0.43 vs. 0.39 for VSAQs vs. MCQs, respectively. Reviewing time of one VSAQ for the entire student cohort was & PLUSMN;2 minutes on average. Positive cueing occurred more in MCQs than in VSAQs (20% vs. 4% and 20.8% vs. 8.3% of questions per person in both courses). This study validates the positive results regarding VSAQs reliability, discrimination, and acceptability in undergraduate medical students. Furthermore, we demonstrate that VSAQ use is reliable among teachers with limited experience in writing and marking VSAQs. The short learning curve for teachers, favourable marking time and applicability regardless of the topic suggest that VSAQs might also be valuable beyond medical assessment.Cellular mechanisms in basic and clinical gastroenterology and hepatolog

Glucose management for exercise using continuous glucose monitoring: should sex and prandial state be additional considerations? Reply to Yardley JE and Sigal RJ [letter]

Oral diseases are a significant global health problem across all countries and populations. With about 3.5 billion cases (2017), more people are affected than by any other disease group. The main oral diseases comprise tooth decay of permanent and deciduous teeth, severe periodontal disease, and oral and lip cancer. With a largely unchanged high global prevalence, but significantly growing population sizes, the pressure on health systems is increasing, particularly in low- and middle-income countries.Nonetheless, in many countries oral health has insufficient priority as a key health topic, including the global health policy discourse of German and international stakeholders. One of the fundamental challenges is ensuring universal and equitable access to basic oral healthcare services for all and without financial hardship (Universal Health Coverage).This paper provides an introductory overview of the global trends for the main oral diseases, which are generally characterized by stark inequalities. Opportunities for improving the situation through population-wide risk reduction and preventive approaches, access to oral healthcare, and policy options are highlighted. In addition, a range of relevant global (oral) health topics with potential for tangible change are discussed. Lastly, the reform areas of the Lancet Series on Oral Health from 2019 are presented and recommendations for the German and international global health policy discourse are provided

Foregoing intensive care treatment in newborn infants with extremely poor prognoses : a study in four neonatal intensive care units in the Netherlands

Contains fulltext : 23909___.PDF (publisher's version ) (Open Access