Advances in health sciences education : theory and practice
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Adv Health Sci Educ Theory Pract · Dec 2009
ReviewTowards effective evaluation and reform in medical education: a cognitive and learning sciences perspective.
Health professions education is dealing with major transformations in light of the changing nature of the health care delivery system, including the use of technology for "just in time" delivery of care, evidence-based practice, personalized medical care and learning, as health professionals strive to integrate biomedical advances and clinical practice. This has forced the medical education community to reassess the current teaching and learning practices and more importantly, the evaluation of the medical education process. There have been recent advances in cognitive and learning sciences theories, some of which can inform medical educators about best teaching and learning practices and their impact on the evaluation process. ⋯ The review begins with an overview of evaluation and assessment in education, followed by an overview of major theories from the cognitive and learning sciences. Next, the role of cognitive and learning sciences theories in informing the process of medical education evaluation is discussed, including its impact on student learning, performance and professional competence, as well as recommendations for reform of medical curricula based on such theories. The paper continues with the elaboration of current trends in health sciences education, particularly medical education, and available evidence for the impact on student learning and performance as well as areas where more research is needed.
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Adv Health Sci Educ Theory Pract · Dec 2009
Comparative StudyDoes scale length matter? A comparison of nine- versus five-point rating scales for the mini-CEX.
Educators must often decide how many points to use in a rating scale. No studies have compared interrater reliability for different-length scales, and few have evaluated accuracy. This study sought to evaluate the interrater reliability and accuracy of mini-clinical evaluation exercise (mini-CEX) scores, comparing the traditional mini-CEX nine-point scale to a five-point scale. ⋯ Mini-CEX scores demonstrated modest interrater reliability and accuracy. Although interrater reliability is similar for nine- and five-point scales, nine-point scales appear to provide more accurate scores. This has implications for many educational assessments.
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Adv Health Sci Educ Theory Pract · Dec 2009
'They don't know much about us': educational reform impacts on students' learning in the clinical environment.
Placements are an integral component of the medical, nursing, and allied health curriculum. Literature on problem-based learning indicates that curriculum change can impact student experience. However, outside of the nursing literature, there is little research on the impact of education reform on students' experiences of placements. ⋯ Three themes were identified from the data: clinical educator's lack of familiarity with new curriculum, clinical educator's negative attitudes to curricular change and looking to the future. Our study advances the understanding of the implications of education reform during the clinical placement of medical, midwifery, and paramedic students. Whilst important lessons can be learned from the medical and nursing literature this study highlights that staff responsible for curriculum change need to action change management process to ensure that the clinical educators are able to deliver the revised program.
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Adv Health Sci Educ Theory Pract · Dec 2009
Blended learning positively affects students' satisfaction and the role of the tutor in the problem-based learning process: results of a mixed-method evaluation.
Problem-based learning (PBL) is an established didactic approach in medical education worldwide. The impact of PBL depends on the tutors' quality and the students' motivation. To enhance students' motivation and satisfaction and to overcome the problems with the changing quality of tutors, online learning and face-to-face classes were systematically combined resulting in a blended learning scenario (blended problem-based learning--bPBL). ⋯ The tutors' opinion and the test results showed no differences between the groups. Working with the web-based learning environment was assessed as very good by the students. According to the log-file analysis, the web-based learning module was frequently used and improved the cooperation during the self-directed learning.
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Adv Health Sci Educ Theory Pract · Dec 2009
Information-gathering patterns associated with higher rates of diagnostic error.
Diagnostic errors are an important source of medical errors. Problematic information-gathering is a common cause of diagnostic errors among physicians and medical students. The objectives of this study were to (1) determine if medical students' information-gathering patterns formed clusters of similar strategies, and if so (2) to calculate the percentage of incorrect diagnoses in each cluster. ⋯ We found a high positive correlation (Spearman Correlation = .893, P = .007). Clusters closest to the worst performing cluster had the highest percentages of incorrect diagnoses. Patterns of information-gathering were distinct and had different rates of diagnostic error.