Research in medical education: pratical impact on medical training and future challenges

Medical education research has changed over the years from merely descriptive studies towards justification or curriculum comparison studies and, nowadays, towards a slow introduction of more clarification studies. In clarification studies quantitative and qualitative methods are used to explain why or how educational interventions work or do not work. This shift is described in this paper. In addition, it is explained how research into workplace learning and assessment has impacted developments in educational practice. Finally, it is argued that the participation of teachers within the medical domain in conducting and disseminating research should be cherished, because they play a crucial role in ensuring that medical education research is applied in educational practice

Deep and surface learning in problem-based learning: a review of the literature

In problem-based learning (PBL), implemented worldwide, students learn by discussing professionally relevant problems enhancing application and integration of knowledge, which is assumed to encourage students towards a deep learning approach in which students are intrinsically interested and try to understand what is being studied. This review investigates: (1) the effects of PBL on students’ deep and surface approaches to learning, (2) whether and why these effects do differ across (a) the context of the learning environment (single vs. curriculum wide implementation), and (b) study quality. Studies were searched dealing with PBL and students’ approaches to learning. Twenty-one studies were included. The results indicate that PBL does enhance deep learning with a small positive average effect size of .11 and a positive effect in eleven of the 21 studies. Four studies show a decrease in deep learning and six studies show no effect. PBL does not seem to have an effect on surface learning as indicated by a very small average effect size (.08) and eleven studies showing no increase in the surface approach. Six studies demonstrate a decrease and four an increase in surface learning. It is concluded that PBL does seem to enhance deep learning and has little effect on surface learning, although more longitudinal research using high quality measurement instruments is needed to support this conclusion with stronger evidence. Differences cannot be explained by the study quality but a curriculum wide implementation of PBL has a more positive impact on the deep approach (effect size .18) compared to an implementation within a single course (effect size of −.05). PBL is assumed to enhance active learning and students’ intrinsic motivation, which enhances deep learning. A high perceived workload and assessment that is perceived as not rewarding deep learning are assumed to enhance surface learning

The effect of midterm peer feedback on student functioning in problem-based tutorials

Within Problem-Based Learning successful learning depends on the quality of cognitive, social and motivational contributions students make to the tutorial group. But at the same time, not all students in PBL automatically contribute in a high quality manner, which might impede successful group functioning. This study investigated whether peer process feedback combined with goal setting can be used to improve the quality of students' individual contributions. A mixed-methods explanatory design, in which 74 second-year Health Sciences students participated, combined a pre- and posttest with a focus group. The results indicated that the quality of the contributions only increased for students with a below average score on the pre-test. The qualitative data confirmed that the impact of the feedback could be increased by combining individual reflection by means of goal setting with face-to-face discussion. Another suggestion is to investigate whether midterm peer process feedback is more effective for first year students, because they are still developing their tutorial behavior, as opposed to second year students

Describing Ultrasound Skills Teaching by Near-Peer and Faculty Tutors Using Cognitive Apprenticeship.

Phenomenon: Ultrasound skills are becoming increasingly important in clinical practice but are resource-intensive to teach. Near-peer tutors often alleviate faculty teaching burden, but little is known about what teaching methods near-peer and faculty tutors use. Using the lens of cognitive apprenticeship, this study describes how much time faculty and near-peer tutors spend on different teaching methods during abdominal ultrasound skills training. Approach: Sixteen near-peer and 16 faculty tutors were videotaped during one 55-min practical ultrasound lesson with randomly assigned students. Videos were directly coded using Cognitive Apprenticeship teaching methods and activities. Segment durations were summed up and compared quantitatively. Findings: All 32 tutors spent most of the time on observing and helping students (Coaching, Median 29:14 minutes), followed by asking open and stimulating questions (Articulation, 12:04 minutes and demonstrating and giving explanations (Modeling, 04:50 minutes). Overall, distributions of teaching methods used were similar between faculty and near-peer tutors. However, faculty tutors spent more time on helping students manually, whereas near-peer tutors spent more time on exploring students' learning gaps and establishing a safe learning climate. Cognitive Apprenticeship was well suited as observational framework to describe ultrasound skills. Insights: Ultrasound train-the-tutor programs should particularly focus on coaching and articulation. Near-peers' similar use of teaching methods adds to the evidence that supports the use of near-peer teaching in ultrasound skills education

Assessing students in community settings: the role of peer evaluation

The assessment of students in community settings faces unique difficulties. Since students are usually posted in small groups in different community settings and since the learning (largely) takes place outside the classroom, assessing student performance becomes an intrinsically complex endeavor. In this article, the proposition is made and tested that peers may be used to accurately assess particular aspects of performance, in particular those which need extensive and close observation. Examples are: Effort displayed while working in a community, quality of the interaction with that community, display of leadership, and subject-matter contributions