Reflection on learning is an essential component of effective learning. Deconstructing the components of reflection on learning using a self-regulated learning (SRL) framework, allows the assessment ...of students' ability to reflect on their learning. The aim of this study was to validate an instrument to measure medical students' reflection on their learning.
A systematic search was conducted to identify the most suitable instrument to measure students' reflection on their learning based on the theoretical framework of SRL. The search identified the Motivated Strategies for Learning Questionnaire (MSLQ) which contained five subscales: internal goal orientation, self-efficacy, critical thinking, metacognitive/self-regulation, help seeking and peer learning. Using the original MSLQ as the foundation, we carried out three phases of a research program to develop a useful set of items: an expert panel's review of items, a substantial pilot study, and a factor analysis of ratings of a modified set of items by preclinical and final year medical students.
The factor analysis of the Modified MSLQ extracted four subscales with reasonable internal consistency: self-orientation, critical thinking, self-regulation and feedback-seeking. Each subscale correlates highly with the Modified MSLQ score, with modest inter-correlations between the subscales suggesting that they are measuring different components of the total score.
Medical students and their educators need to be able to monitor their learning in their complex academic and clinical environments. The Modified MSLQ provides a means of investigating and tracking individual medical students' reflections on their learning.
Clinical clerkship programme in medical schools were developed to provide students with direct interactions with patients and observe clinical teachers in practice. However, professional dilemmas are ...prone to occur due to the nature of experiential learning. Several studies across different cultures showed that medical students responded differently towards professional dilemma.
This study aims to explore how medical students respond to professional dilemmas occurred during their clinical clerkships and to what extent culture influences the responses.
A qualitative descriptive approach was used in this study. We conducted four focus group discussions with final year medical students who were selected using maximum variety sampling method. Thematic analysis was conducted following the transcription of the focus groups.
We identified the impact of dilemmas on students' emotions and concerns, students' responses towards professional dilemmas, and factors affecting responses to dilemmas in clinical clerkship, which confirmed that cultures played roles in how students responded towards professional dilemmas.
This study has identified that culture, to some extent, influenced the way students responded to professional dilemmas. Therefore, it is paramount to develop a conducive and culturally sensitive educational environment and students' ability to learn from professional dilemma experienced in the workplace for developing their professional identity.
The importance of cultivating a humanistic physician has gained attention in medical education. Humanistic values are established in early education and medical schools should provide a suitable ...environment to nurture and grow these values into professional identity. The clinical setting has a significant impact due to its direct involvement of students in real-life situations.
The present study aims to explore the hurdles in cultivating humanistic physicians in the clinical setting.
We conducted a qualitative study involving medical students in the clinical phase, as well as residents, clinical teachers, and module administrators in the clinical setting under study.
Respondents from different groups of stakeholders shared the same definition for 'humanistic physician': a physician who provides patient-centred care while demonstrating empathy, respect, compassion, integrity, knowledge, competence and a collaborative spirit. Despite changes in the healthcare system and technological advancements, humanistic physicians are still needed.
Cultivating humanistic physicians is a complex process, requiring various methods and assessments. Role models play a significant role in this process, which included not only clinical teachers but also peers. Feedback from peers was perceived as an important factor. The key hurdles identified were negative role models, and a less humanistic learning environment and the students' personal backgrounds.
Internationally, medical selection relies heavily on prior academic attainment which has an adverse impact on the diversity of selected students. Since non-academic attributes are also important, ...this study aims to evaluate the use of a Situational Judgment Test (SJT) for selection and the impact on student diversity relating to gender, ethnicity and socio-economic status. Previous SJT research has almost entirely originated from a Western context and this study focuses on new evidence in a South East Asian context with a different demographic profile.
Thirty faculty members developed 112 SJT scenarios assessing professionalism, communication and self-awareness domains. The scenarios underwent a concordance stage where stakeholder input was sought on the content appropriateness, to define the item scoring key, followed by an initial psychometric evaluation with first and second year medical students (N = 436). Based on these results, 30 scenarios, consisting of 128 nested items, were selected for pilot testing and evaluation regarding diversity issues with two cohorts of applicants in 2017 (N = 446) and 2018 (N = 508).
The SJT demonstrated good internal consistency (Cronbach's alpha of 0.80 and 0.81 respectively). There were significant differences in SJT scores based on gender in both years, where females consistently outperformed males (p = .0001). However, no significant differences were found based on high school origin, parental educational background or ethnicity.
This is the first study to evaluate the use of an SJT in Indonesia, which has a unique diversity profile compared to Western countries. Largely, the preliminary results replicate previous studies of the potential diversity benefits of using an SJT as a tool for medical student selection and has the potential to level the playing field regarding socio-economic status and ethnicity. Further studies exploring more variables representing diversity are warranted to confirm the early results in this study.
Constructive feedback is key to successful teaching and learning. The unique characteristics of problem-based learning (PBL) tutorials require a unique feedback intervention. Based on the review of ...existing literature, we developed a feedback model for PBL tutorials, as an extension of the feedback facilitator guide of Mubuuke and his colleagues. This study was aimed to examine the perceptions of students and tutors on the feedback model that was piloted in PBL tutorials.
This study employed a qualitative research design. The model was tested in nine online PBL sessions, selected using the maximum variation sampling strategy based on tutors' characteristics. All sessions were observed by the researcher. Afterwards, tutors and students in the PBL sessions were interviewed to explore their perceptions of the model.
Three themes were identified based on the perceptions of the tutors and students: cognitive changes, behavioral changes, and challenges of the use of the feedback model. Both tutors and students benefited from improved cognition and behavior. However, the use of the feedback model still encountered some challenges, such as limited sources of feedback data, flexibility and adaptability of the model, content of feedback delivered, students' characteristics and performance, tutors' characteristics and self-perceptions, and supportive infrastructure.
The model can be used as a reference for tutors to deliver constructive feedback during PBL tutorials. The challenges identified in using the constructive feedback model include the need for synchronized guidelines, ample time to adapt to the model, and skills training for tutors.
Currently there are a limited number of comprehensive studies exploring in more depth the relationship between burnout and quality of life (QoL) of medical residents during residency training. This ...study aims to examine the correlation between burnout and residents' QoL and explore the factors associated with burnout in residency training.
This was a mixed-method study. The first stage was a quantitative study using cross-sectional design to administer the Maslach Burnout Inventory Human Service Survey and World Health Organization Quality of Life-BREF instruments to 86 medical residents, followed with the qualitative study through 10 in-depth interviews.
Twenty-seven residents (31.4%) experienced severe emotional exhaustion (EE), 22 (25.6%) experienced severe depersonalization (DP), and 40 (46,5%) experienced low personal accomplishment (PA). Factors increasing the likelihood of experiencing burnout were being surgical residents for EE (2.65 times), dealing with difficult/rare cases for DP (1.14 points), and working hours for PA (1.03 points). The QoL was influenced by the three burnout domains, marital status, education level, gender, age, type of residency, night shift, difficult/rare cases, working hours, and number of emergency cases. Factors influencing burnout, both intrinsic and extrinsic, were identified and divided into causative and protective factors.
The current study has examined the relationship between burnout and QoL and identified factors affecting residents' burnout. Both intrinsic factors, such as spirituality, and extrinsic factors which include duration of shift, work facilities, and teacher-senior-junior relationships, affect burnout. Supervision and academic regulation are some of the solutions expected by the residents to minimize burnout.
Background: Agreement on the importance of teaching and assessing ethical competence as part of professionalism in medical education continues to grow. The assessments of ethical competence at the ...“does” level in preclinical students or a large group of resident candidates are considered less efficient and expensive. It is necessary to find an alternative form of ethical competence assessment instrument as a complementary test at the level “knows how” before being tested at the level “does.” This research proposed investigating the Situational Judgement Test (SJT) potential and obtaining evidence of the SJT as an instrument of ethical competence assessment.Methods: This study was a literature review of 39 journal articles relating to SJT, obtained through PubMed data-based and google scholar search engine.Results: There was evidence of the use of SJT to assess ethical competence. Ethical competence can be evaluated by ethical decisions making ability. SJT containing procedural skills in ethical decisions making. SJT having good values as deliberation in ethical dilemmas and idealistic ethical ideology (conative test) also exists. These findings support the evidence of potential SJT to assess ethical competence.Conclusion: SJT can be used to assess ethical competence at the level “knows how” before being tested at the level “does” based on the following reasons: SJT can contain content questions that are conative, SJT can assess the ability of ethical decision making based on an assessment of procedural knowledge related to ethical deliberation of ethical decision making in ethical dilemmas.
Effective and efficient health services require efforts to increase collaboration among health professionals. One of the barriers to effective collaboration is stereotypes. Stereotypes represent ...perceptions or perspectives about a person or group of people. This study aims to explore the perceptions of health professional students and practitioners regarding stereotypes.
This was a qualitative study using a phenomenology approach. A sample of health professions students from both preclinical and clinical stages, as well as health practitioners, was selected using a maximum variation sampling method. Primary data collection was conducted through focus group discussions. Data obtained were analyzed using thematic analysis. A total of nine focus group discussions were conducted.
Four themes were identified from this study, including the types of stereotypes, factors affecting stereotype formation, the implications of stereotypes, and how to overcome stereotypes. Stereotype formation was affected by the lack of understanding of other health professions' roles, hierarchical culture, personal experience in receiving healthcare, and community view. Stereotypes among health professionals created obstacles to healthcare team communication and reduced self-confidence in certain health professionals. These stereotypes may be overcome through competency development and knowledge sharing among professionals as well as through education on other health care professionals' roles and competencies so that each profession possessed similar goals for patient safety.
Both positive and negative stereotypes negatively affected collaboration. Stereotypes were greatly affected by multifactorial causes. Therefore, understanding other professions' roles and conducting interprofessional education are important to overcome stereotypes.
BackgroundGiven the various novel educational approaches and online interactions following the pandemic, it is timely to identify lessons learned for post-pandemic student and teacher relationships ...within the ‘new normal’ teaching learning processes. This study aims to explore the dynamics and to what extent the disruption influences student-teacher relationships in teaching and learning process following the COVID-19 pandemic.Materials and MethodsA qualitative descriptive approach was employed to explore individual reflections and perspectives from 28 medical teachers and 35 medical students from different institutions who participated in 10 focus groups. Data were analyzed thematically using steps for coding and theorization (SCAT) approach. The emerging themes were then further analyzed and regrouped into the relationship-centered leadership framework based on emotional intelligence.ResultsThe identified themes described three elements representing student-teacher relationships in the teaching learning processes. The self as the center of the diagram consists of the co-existing role of the self as teachers and as students, which to some extent, is related to their personal and professional development, motivation, and struggles to maintain work-life balance. The middle layer represents the dynamic of student-teacher relationship, which showed that despite the increased number of teaching opportunities, the trust among teachers and students was compromised. These changes in the self and the dynamic relationship occurred in a broader and more complex medical education system, pictured as the outer layer. Thorough curriculum improvements, contents, and new skills were emphasized.ConclusionsOur findings emphasized the need to recalibrate student-teacher relationships, taking into account the intrapersonal, interpersonal, and the system factors. The pandemic has reemphasized the aim of teachers’ roles, not only to nurture students’ competencies, but also to nurture meaningful interpersonal reciprocal relationships through responding towards both teachers’ and students’ needs as well as supporting both personal and professional development.
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