Background
This study focuses on the use of reflective teaching journals by fourth year US allopathic medical school students (MS4) during a longitudinal medical student-as-teacher (SaT) elective, ...and how MS4s self-assess their perceptions around teacher skill development and individual transitions into resident educators who teach junior learners.
Method
Between September 2020 and December 2020, twelve MS4s in a longitudinal SaT elective completed 21 hours in a clinical bedside student teaching placement with embedded structured reflective teaching journals. Sixty-nine individual reflective teaching journal entries were collected in two distinct stages and analyzed using a phenomenographical lens.
Conclusion
From these data, the author established three thematic categories where reflective teaching journals reveal (a) a framework for pedagogical skill building, (b) provided a sense-making tool to navigate the psychosocial environment, and (c) a framework for educator identity formation. Structured reflective teaching journals with educator feedback support self-reflection and awareness of growth through the SaT elective. Health professions educators can leverage the reflective teaching journal as a formative assessment process to help learners identify transitions and grapple with educator identity confidence and the formation of new teacher skill development to further advance the field of future health professions education.
Some child patients have a number of carious teeth due to individual nursing environment. Such children frequently have maladaptation behavior to dental treatment. The reasons for the maladaptation ...behavior are considered to be found in ① cases in which children cannot communicate with the dentists because of being too young or intellectual disability, ② cases in which the patients have autism spectrum disorder or attention deficit hyperactivity disorder, ③ cases in which the stereotype that dental treatment is painful and scary was instilled with the patients by their parents or adults around them, or ④ cases in which the patients experienced fear or pain through dental treatment. In either case, if the urgency of dental treatment is high as well as the patient seems to be hard to adapt dental treatment soon, dental treatment under general anesthesia is considered. On the other hand, if the urgency of dental treatment isn’t high and the patient’s intellectual level is 3-4 years old and more, pediatric dentists provide some supports to the patient based on his/her condition.When the children cannot communicate with their dentists because of being too young or intellectual disability, dental treatment under general anesthesia is selected. When the patients have autism spectrum disorder or attention- deficit disorder, structured teaching with vision assistance is provided. Structured teaching is a method for such patients to understand the operative procedure, necessary equipment, and approximate time required for the dental treatment. Behavioral therapies are also performed; respondent conditioning, systematic desensitization, operant conditioning, and applied behavior analysis for patients with autism spectrum disorder, and positive reinforcement in operant conditioning, time-out, token-economy, and response cost for patients with attention deficit hyperactivity disorder. If the patients with attention deficit hyperactivity disorder are too young to undergo behavioral therapies, dental treatment under general anesthesia is usually selected. When the patients can communicate with dentists, but have stereotype that dental treatment is painful and scary, or experienced fear or pain through dental treatment, behavioral therapies are the first choice. Behavioral therapies consist of anxiety reduction methods (respondent conditioning, relaxation, exposure), performance shaping methods (operant conditioning, applied behavior analysis, token-economy, response cost, time-out, shaping), and observation learning (modeling). When the behavioral therapies are ineffective, dental treatment under general anesthesia is considered.Since a lot of patients are referred to Pediatric Dentistry, Kyushu Dental University because of the maladaptation behavior to dental treatment, cooperation with dental anesthesists is very important.
Autism spectrum disorders (ASD) are recognized as a major public health issue. Here, we evaluated the effects of folic acid intervention on methylation cycles and oxidative stress in autistic ...children enrolled in structured teaching. Sixty-six autistic children enrolled in this open-label trial and participated in three months of structured teaching. Forty-four children were treated with 400 μg folic acid (two times/daily) for a period of three months during their structured teaching (intervention group), while the remaining 22 children were not given any supplement for the duration of the study (control group). The Autism Treatment Evaluation Checklist (ATEC) and Psychoeducational Profile-third edition (PEP-3) were measured at the beginning and end of the treatment period. Folic acid, homocysteine, and glutathione metabolism in plasma were measured before and after treatment in 29 autistic children randomly selected from the intervention group and were compared with 29 age-matched unaffected children (typical developmental group). The results illustrated folic acid intervention improved autism symptoms towards sociability, cognitive verbal/preverbal, receptive language, and affective expression and communication. Furthermore, this treatment also improved the concentrations of folic acid, homocysteine, and normalized glutathione redox metabolism. Folic acid supplementation may have a certain role in the treatment of children with autism.
Although physicians gain clinical knowledge in their specialty, it does not mean they receive adequate instruction to teach and provide feedback. Using smart glasses (SG) to provide educators with a ...first-person learner perspective has not been explored in faculty development such as Objective Structured Teaching Exercises (OSTEs).
Integrated within a 6-session continuing medical education-bearing certificate course, this descriptive study involved one session where participants provided feedback to a standardized student in an OSTE. Participants were recorded by mounted wall cameras (MWCs) and SG. They received verbal feedback on their performance based on a self-designed assessment tool. Participants reviewed the recorded content and identified areas for improvement, completed a survey about their experience with SG, and wrote a narrative reflection.
Seventeen physicians at the assistant professor level participated in the session; data were analyzed on the 14 who had both MWC and SG recordings and who also completed the survey and reflection. All were comfortable with the standardized student wearing SG and indicated it did not affect communication. Eighty-five percent of the participants felt the SG provided additional feedback not available with the MWC, with majority noting additional feedback was related to eye contact, body language, voice inflection, and tone. Eighty-six percent see value in using SG for faculty development, and 79% felt that periodically using SG in their teaching would improve quality.
Use of SG during an OSTE on giving feedback was a nondistracting and positive experience. SG provided affective feedback otherwise not perceived from a standard MWC.
We aimed to determine whether the use of a structured teaching approach, rehearsing, and training (SRT) for anesthesia induction in patients with autism spectrum disorder (ASD) could reduce the need ...for physical restraint.
Retrospective observational study
We retrospectively analyzed 63 patients (4 to 40 y old) with ASD who underwent general anesthesia for dental treatment. Patients were divided into SRT (n = 22) and non-SRT (n = 41) groups. In the SRT group, patients were presented with a visual guide based on a structured teaching approach at the pre-anesthetic consultation. The guide comprised photographs of the places, tools, and processes that the patient would experience prior to anesthesia induction. Patients then practiced these processes (rehearsal). Patients in the non-SRT group were administered anesthesia in a conventional manner without SRT.
The percentage of patients needing physical restraint was significantly lower in the SRT (3/22, 13%) than in the non-SRT group (21/41, 51%, P < .001).
The SRT method reduces the need for physical restraint in patients with ASD during anesthesia induction.
To pilot test an objective structured teaching exercise (OSTE) to determine its feasibility and acceptability as a preceptor development method.
Phase I: A comprehensive training needs analysis was ...conducted. Data from a survey of pharmacy practice preceptors as well as students’ evaluations of preceptors were analyzed using qualitative and descriptive methods. Preceptor training needs amenable to the OSTE format were identified. Phase II: Three OSTE cases were developed. A pre/post-OSTE survey measured preceptor reaction to the method and preceptor performance on each OSTE case was observed. Welch’s t-test was used to assess the differences between mean responses of preceptors on the pre/post-OSTE survey.
Phase I: Needs analysis suggested that preceptors needed more training when communicating feedback to learners in three situations: (1) a poor or failing evaluation, (2) an observed patient encounter involving an over-the-counter recommendation, and (3) an observed patient counseling session regarding metered-dose inhaler use. In all, 15 preceptors participated in the OSTE. Preceptor confidence in performing the skills practiced during the OSTE significantly improved. Preceptors reported that OSTE is an effective method to enhance feedback skills.
OSTE is an effective and well-received method for training pharmacy preceptors.
Abstract Introduction Objective structured clinical encounters (OSCEs) have become a widely-used tool to teach, provide feedback on, and evaluate clinical skills for both medical students and ...residents. They have the advantages of both providing immediate and standardized feedback (typically using competency-based checklists) and an opportunity to engage in reflective practice. The objective structured teaching encounter (OSTE) is a relatively new tool that uses a similar format to teach and/or evaluate teaching skills, rather than clinical skills. Methods Our collection of OSTE case scenarios addresses five teaching challenges: (1) precepting an intern in the continuity clinic (a case of viral gastroenteritis); (2) giving feedback to learners on the inpatient wards (professionalism); (3) observation and feedback of a physical examination skill (the dermatologic exam); (4) teaching procedures (lumbar puncture); and (5) conducting ward rounds (managing pain). For each scenario, we provide a front sheet summarizing the case, instructions for the standardized learner (SL) and for the faculty member, and a checklist of teaching skills. Some of the cases have a handout we distributed to faculty to help them develop the skills needed in the case. Results Our pediatric OSTE cases were used as a teaching tool as part of a department-wide faculty development session to allow faculty to practice skills in precepting and giving feedback. All 26 faculty (100%) who engaged in this OSTE completed the included evaluation form. We used a 5-point Likert scale (1 = below expectations; 5 = exceeding expectations). The OSTE was rated overall as 4.9. In the feedback station, participants felt that the case and SLs were realistic and that the SL (an actor) provided helpful feedback (4.7 average rating). In the precepting case, participants felt that the case was realistic (4.5) and the SL was realistic (4.4) but rated the feedback from the SL (an internal medicine intern) somewhat lower (4.0). Participants rated the brief didactics and debriefing as helpful (means 4.6 and 4.7, respectfully). Written comments included positive comments (“Great experience—good actors and cases”) and requests for both more challenging cases and for more time for the verbal feedback sessions and for the cases overall. Discussion Although we have assessed the pediatric OSTEs for feasibility and acceptability by the faculty and we have shown that OSTEs can measure some of the effects of a longitudinal faculty development program, we do not have data on short− or long-term changes in teaching effectiveness or an impact on patient care. We do plan to survey our faculty regarding the ways in which participation in OSTEs has affected their teaching effectiveness. We are particularly interested in gathering qualitative data on the ways that their teaching may have changed as a result of their participation.
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