Dejano T. Sobral

Peer tutoring and student outcomes in a problem‐based course

Summary: Summary. Does peer‐tutoring affect students’ educational outcomes in problem‐based learning? Students’ characteristics and outcomes were compared along 14 successive classes of a problem‐based learning course in the University of Brasilia medical programme. In the first stage of this time series, 26 teacher‐tutored groups were formed; in the second stage, 50 groups had both teacher‐ and peer‐tutoring. Both groups had equivalent characteristics in stages one and two as regards membership size and composition (students’ learning style, self‐confidence and motivation to learn). Results showed that scores for problem‐solving tests and self‐evaluation of skills were not significantly different between first and second stage groups. However, scores of meaningfulness of course experience and group work usefulness were significantly higher in the peer‐tutoring stage. Significant positive correlations were found between scores of meaningfulness of course experience and both self‐evaluation and group work usefulness but not between the first measure and group size or motivation to learn. The findings suggest that peer‐tutoring can facilitate group work without sustained loss of cognitive achievement in long range conditions of problem‐based learning experience.

Medical students' self-appraisal of first-year learning outcomes: use of the course valuing inventory

The aims of this paper were: to appraise how medical students perceive the meaning and value of their first-year experiences in medical studies, as measured by the Course Valuing Inventory (CVI); and to identify the relationships between the CVI responses and the learners’ attributes and expectations. The study involved 282 second-year students of a six-year medical programme over a four-year timeframe. Factor analysis identified five dimensions of CVI responses: worthiness of learning experience, emotional awareness, personal development, cognitive enhancement and task drive. Higher CVI scores related positively and significantly to female gender, stronger self-confidence as a learner, greater motivation to learn, meaning orientation and reflection in learning. The CVI score was the strongest independent predictor of intention to continue the studies as a motivational consequence of first-year learning experience. In addition, a separate test showed significant relationships between the dimensions of CVI responses and the DREEM score (Dundee Ready Education Environment Measure). In conclusion, CVI responses that are more positive are likely to be associated with a quest for meaning, reflection in learning and autonomous motivation, given the relevance of the educational environment for the proximal interests of the students.

Motivação do aprendiz de medicina: uso da escala de motivação acadêmica

251 O autor registra o apoio institucional, agradece a participacao ativa e o interesse real dos aprendizes envolvidos e expressa seu reconhecimento ao Dr. Robert J. Vallerand por fornecer o instrumento original e permitir a realizacao do estudo.2 Enderecco: Faculdade de Medicina - C.P. 04569 - 70919-970 Brasilia – DF. E-mail: dtsobral@unb.br/ dtsobral@netscape.netPsicologia: Teoria e PesquisaJan-Abr 2003, Vol. 19 n. 1, pp. 025-031

Diagnostic ability of medical students in relation to their learning characteristics and preclinical background

Is the diagnostic ability of medical students — as appraised by the Diagnostic Thinking Inventory (DTI) — influenced by the learners’ characteristics, or the way they acquired basic knowledge? This question was explored in a 4‐year consecutive sampling of clinical clerkship students. DTI inventory scores (flexibility in thinking and structure in memory), learners’ characteristics (learning style, self‐confidence as a learner, and motivation to learn), together with knowledge scores (grade‐point average and problem‐solving test) were measured and analysed for their relationships and the differences between groups. Results revealed that higher scores of the DTI measures were associated with students’ high self‐confidence, high motivation to learn, and abstract learning types. Correlation coefficients showed significant relationships between the DTI scores and both knowledge measures. In addition, t‐tests showed that students with an integrated teaching background and problem‐based learning (PBL) experience obtained significantly higher scores for structure in memory. The findings suggest that the inventory scores are sensitive to both cognitive and non‐cognitive factors. The inventory may be useful in detecting subtle influences on diagnostic ability differentiation in medical students.

Learning the educator role: a course for medical students

Summary. The design and evaluation of a revised course on educational skills for medical students is described. The overall aim of this elective was to help students develop a working concept of their educator role regarding themselves, their peers, and their patients. The programme comprised 15 2‐hour weekly meetings consisting of small‐group discussion and exercises around issues of self‐learning skills, peer teaching, and the process of patient education. Advanced preparation was promoted by readings and special assignments. Self‐assessment, peer‐assessment, and continuous assessment based on course‐work were used to help student learning and to provide a basis for final grading. During a 3‐year study period, the Course Valuing Inventory (CVI) and a goal‐oriented questionnaire were used for course evaluation.

Self-report visual scale of course appeal

A 4-item affect scale portrayed on crosswise lines was developed and tested on medical students participating in preclinical courses with a view to measuring appeal as an educational outcome. This usage was based on assumptions that end-of-course adaptation could be derived from affect responses and should reflect the appeal of a course experience. Indeed, the results demonstrated that positive affect (pleasure, satisfaction) and negative affect (anxiety, grief) responses have substantial correlations with an independent measure of appeal: course valuing section scores of the Course Valuing Inventory. Moreover, students with various adaptation modes, as signalled by affect response patterns, showed significantly different means in course valuing scores. Significant differences were also shown in adaptation mode distribution among students finishing courses with distinct integration methods, or levels of learner control. As hypothesized, it was found that end-of-course adaptation modes differentiate between learners who do and do not volunteer for a student preceptorship in the same course. Findings suggest that affect responses can be used as a scale of course appeal to measure the effects of motivational strategies.

Avaliação seriada versus exame vestibular: semelhanças e diferenças entre Coortes no Curso de Medicina da Universidade de Brasília

The purpose of this retrospective study was to appraise the impact of a new admission process (serialevaluation) on the attributes and achievement patterns of medical students in comparison to the standing onetime admission test. The subjects were 415 students (57,8% males) enrolled in the medical program of the Universit y of Brasilia, admitted through serial evaluation or admission test in the course of six years (1999-2004). The admission groups were compared as refers to demographic data, learning attitudes and academic achievement indicators. The results showed significantly higher proportions of students born in the Federal District and of a younger age-bracket in the serial evaluation group than in comparison to the admission test group. Academic achievement was also significantly higher in this group, from the second to the ninth semester. Statistical analyses indicate that besides the year and the criteria of admission the effect on academic achievement reflected other differences such as sex, age and self-appraisal of learning outcomes in the features of the students. These findings suggest that the new admission process has favored academic aptitude in terms of cognitive achievement. It also seems to have modified the demographic composition of the student body with effects on academic achievement in itself.

Autodeterminação da motivação em alunos de Medicina: relações com motivos de escolha da opção e intenção de adesão ao curso

The purpose of this study was to analyze the variability of self-determined motivation as refers to the reasons for choosing medicine and with respect to factors related to the learning process and their effect on the students’ motivation to pursue the studies. The Academic Motivation Scale (AMS) was applied to 450 students over 6 years. The reasons underlying the choice were assessed and the value attributed to the course, learning orientation, self-confidence and learning outcome were measured. The results of the analyses indicate significant and positive correlations between self-determined motivation and course valuing, meaningful orientation, self-confidence, and firstyear GPA, as well as altruism and looking for challenges as reasons for choosing medicine. Regression analysis revealed that contextual and personal variables, including choice reasons, explained 42% of the variability of self-determined motivation. Further analysis showed that self-determined motivation, the intention to learn, and course valuing explained the greater part of variability in the intention to pursue the studies. In conclusion, the findings suggest meaningful correlations between contextual and personal factors in shaping self-determination and motivation and the intention to pursue the studies after the first year of the medical course.

Indicadores da escolha de pediatria por graduandos da universidade de Brasília: estudo longitudinal em série histórica

The authors analyzed Pediatrics as career choice in a study involving 877 graduates from the University of Brasilia from 1994 to 2007. Data included demographics, learning attributes, early career preference, peer-tutoring experience, academic achievement, selective training in the last semester, and choice of residency training. Contingency and logistic regression analyses were performed with the graduates grouped according to choice of Pediatrics versus all other options. Overall, 9.7% of graduates had chosen Pediatrics, of whom 44.7% had indicated early attraction to the specialty, while another 45.9% did not express interest until their clinical training. No significant trend was shown for early attraction, but a lower proportion of graduates chose Pediatrics in the last 6 years, in parallel with fewer applications for tutoring experience and selective training. Logistic regression identified five predictors of choice in decreasing order of effect size: selective training, overall achievement, reflective learning style, ranking of early preference, and time of graduation. Independent ef fects of gender and peer tutoring were not statistically significant. In conclusion, the predictors of choice of Pediatrics comprised personal and curricular features in distinct patterns of interest and influence, within an overall context of decreasing choice of the specialty in recent years.

The New Schools : The Medical School of the University of Brasilia

The keynotes of the University of Brasilia medical education programme are the flexible system of registration, the integrated study programme, community orientation and student choice and self-pacing. While the programme is not without its problems, a measure of its effectiveness is the proportion of graduates choosing a career in general care medicine (general practice, paediatrics, internal medicine, and obstetrics/gynaecology). Among the 1978 graduates the percentage who made general care medicine their career choice (60 per cent) was double the number who had stated this preference before the medical learning experience.