Knowledge and skills acquisition in medical students:exploring aspects of the curriculum

Medical curricula are aimed at supporting students in developing knowledge and skills until they are able to perform as a medical doctor. The general aim of this thesis was to gain more insight into several aspects of the curriculum by studying students’ knowledge development in different medical curricula, students’ performance on progress tests and the effect of spacing training sessions and different types of feedback on skill acquisition. Because of the complexity of studying aspects of curricula, different methodologies were used, such as retrospective, quasi-experimental, systematic review and experimental research. The findings of this thesis demonstrate that only two aspects of the curriculum seem to benefit students’ knowledge development and, interestingly, both are related to repeating the learning material over time, before students forget what they learned. Regarding skill acquisition, two important findings emerge from this thesis. First, the complexity and nature of the skill plays an important role. For example, complex skills that require a lot of medical knowledge benefit from spacing the training sessions, whereas simple skills can be trained in one session. Second, how often a skill will be performed in the future determines the focus of the training. When a skill is practiced frequently, the focus can be on skill acquisition using one single training session and when a skill is practiced rarely, the focus can be on skill retention using multiple, spaced training sessions. Future research is needed to explore the implications of the findings of this thesis

Implementing computerized adaptative test

Tradicionalmente, a avaliação de conhecimento é composta por itens dos quais os alunos respondem ao mesmo tempo e os mesmos itens, como por exemplo a prova de uma disciplina. Essa avaliação pode ser considerada muito fácil ou difícil pelo aluno. Em ambos os casos, a prova será entediante e fornecerá pouca informação sobre o nível de conhecimento do aluno. Uma forma de resolver esse problema, é criar provas customizadas para cada aluno, sendo que a próxima questão será selecionada baseada no desempenho anterior do aluno. Essa forma de avaliação é conhecida por teste adaptativo computadorizado. O teste adaptativo computadorizado apresenta tanto vantagens educacionais quanto psicométricas quando comparado às provas de formato tradicional. O teste adaptativo computadorizado requer menos itens do que o teste no formato tradicional, algo que consequentemente diminuirá a fadiga dos alunos, aumentando a aprendizagem do aluno. Ademais, o teste adaptativo computadorizado é desenhado especificamente para cada aluno, considerando a dificuldade de cada item. Isso torna o teste mais atrativo e autêntico, pois os itens sempre estarão alinhados ao conhecimento do aluno. Por ser necessária a informação sobre a dificuldade do item e a habilidade do aluno, o teste adaptativo computadorizado utiliza a Teoria de Resposta ao Item, que estabelece uma relação entre a habilidade do sujeito, a dificuldade do item e a probabilidade de acertar o item, essencial para o funcionamento do teste adaptativo computadorizado. Apesar da complexidade técnica para a implementação do teste adaptativo computadorizado, o mesmo traz um maior padrão para a avaliação tanto de um ponto de vista psicométrico como do ponto de vista do alinhamento às teorias modernas de aprendizagem. Por causa de sua alta complexidade, a implementação e a utilização do teste adaptativo computadorizado geralmente estão associadas a provas de decisão de alto impacto e em grande escala. No entanto, com o novo entendimento educacional, onde se faz necessário respeitar a individualidade e o ritmo de cada aluno, o teste adaptativo computadorizado será cada vez mais utilizado293FUNDAÇÃO DE AMPARO À PESQUISA DO ESTADO DE SÃO PAULO - FAPESP2018/15642-1Traditionally, the assessment of knowledge consists of items, who students answered the same items at the same time, such as test of a specific subject. This assessment may be considered too easy or difficulty by the student. In both cases, the test is likely to be boring by the students and it may provide little information on students’ knowledge level. One way of solving this problem is by creating tailored tests for each student, considering that the next question will be selected based on students’ performance on previous items. This type of test is known as computerized adaptative test. Computerized adaptative test provides both educational and psychometrics advantages compared to the traditional paper-pen testing. Computerized adaptative test requires less items than the traditional test, which in turns will decrease students’ fatigue, and optimizing learning. Furthermore, computerized adaptative test is designed for each student, considering the level of difficulty of each item. This makes the teste more attractive and authentic, since the items will be always aligned with the level of students’ knowledge. Since computerized adaptative test requires both the difficulty of the item and students’ ability, it requires the use of Item Response Theory, which establish a relation between difficulty of the item, students’ ability and the probability of answering a question correctly. Although the implementation of computerized adaptative test is complex, computerized adaptative test has a higher standard in both psychometric point of view and the alignment with modern theories of learning. Because of the high complexity, the implementation of computerized adaptative test is usually in high-stakes test and large scale. However, the new educational paradigm in which requires tailored-made education respecting the pace of each student, the computerized adaptative test will be more used over tim

The challenge of understanding, evaluating and providing feedback on regulation during group learning

Learning in groups is commonly used in academic and clinical health professions education (HPE). There is growing recognition that regulation during learning is essential for both the individual learner and group learning. The authors in this article propose a practical approach for understanding, evaluating and providing feedback on regulation during group learning. The approach is informed by previous studies conducted in other areas of education. Three varieties of regulation during group learning are discussed: individual, co-regulation and shared regulation. Each variety of regulation has a focus on three essential activities during group learning: task, social and motivation. Illustrative scenarios are presented to describe how the approach can be practically used in HPE. The specific and additional focus on regulation can enhance current approaches for providing feedback on group learning and the authors discuss recommendations for practical implementation and future research