Hussain Alyami

The relationship between academic assessment and psychological distress among medical students: a systematic review

A systematic review was conducted to determine the relationship between academic assessment and medical student psychological distress with the aim of informing assessment practices. A systematic literature search of six electronic databases (Medline, Medline IN PROCESS, PubMed, EMBASE, Psychinfo, ERIC) from 1991 to May 2014 was completed. Articles focusing on academic assessment and its relation to stress or anxiety of medical students were included. From 3,986 potential titles, 82 full-text articles were assessed for eligibility, and 23 studies met review inclusion criteria. Studies focused on assessment stress or anxiety, and assessment performance. Consistent among the studies was the finding that assessment invokes stress or anxiety, perhaps more so for female medical students. A relationship may exist between assessment stress or anxiety and impaired performance. Significant risks of bias were common in study methodologies. There is evidence to suggest academic assessment is associated with psychological distress among medical students. However, differences in the types of measures used by researchers limited our ability to draw conclusions about which methods of assessment invoke greater distress. More rigorous study designs and the use of standardized measures are required. Future research should consider differences in students’ perceived significance of assessments, the psychological effects of constant exposure to assessment, and the role of assessment in preparing students for clinical practice.

Social anxiety apps: a systematic review and assessment of app descriptors across mobile store platforms

Question The aim of this systematic review is twofold: (1) to characterise the purpose and description of available social anxiety apps and (2) to review the evidence on the effectiveness of social anxiety apps. Study selection and analysis A search was conducted on three major mobile platforms: Apple iTunes, Google Play and Windows Store. Apps were included if they addressed social anxiety and used an English language interface. A systematic review of the literature from MEDLINE, EMBASE, PsycINFO, Cochrane, Scopus and Web of Science to identify evidence-based evaluations of social anxiety apps was also undertaken. Findings Of the 1154 apps identified, 38 apps met the inclusion criteria: iTunes (n=18), Google Play (n=16) and Windows Store (n=4). Over 60% of apps were exclusively focused on social anxiety, while the remainder targeted social anxiety and related conditions. Most developers did not provide information on their organisational affiliations or their content source. Most apps used multimedia while 17 apps used text only. Finally, although the systematic review of the literature identified 94 articles, none of which met inclusion criteria. Conclusions Social anxiety apps have the potential to overcome barriers to accessing treatment; however, none of the apps identified have had studies on their effectiveness published. As the evidence base is lacking, it is therefore not currently possible to recommend their use.

Enhancing suicide risk assessment: a novel visual metaphor learning tool

Objective: Suicide risk assessment is variably taught and learnt by health professionals. The literature indicates that training programs of this fundamental competency need to be enhanced. To facilitate teaching and learning of this core clinical skill, we propose a novel visual metaphor in order to conceptualize suicide risk factors. The design of the proposed visual metaphor was informed by the Cognitive Load Theory to enhance deep learning of the various suicide risk factors. Conclusion: The visual metaphor depicting suicide risk factors can potentially improve memory and recall. It activates prior knowledge and is based on educational theory informed design principles.

Translating research knowledge in dementia care organisations

Objective: To evaluate dementia care organisations’ capacity to acquire, assess, adapt and apply dementia research. Methods: We used the Canadian Health Services Research Foundation’s survey, ‘Is research working for you?’ by inviting the members of the New Zealand National Dementia Cooperative to participate in the online survey. Results: A total of 146 (32%) members responded and indicated that, although the workforce had the skills to engage in research and implement evidence into practice, there was limited organisational support in terms of the time, resources and access to external support. Conclusions: We propose a number of strategies to improve knowledge translation in dementia care.

Preparing a presentation.

Giving a presentation is often a dreaded part of surgical training and ongoing academic development. It requires a set of practiced skills which are not formally addressed during training. Once presentation skills are developed, however, speakers gain confidence and may even enjoy giving future presentations. The purpose of this mini review of educational psychology and communication research is aimed to provide practical tips for optimizing presentation design, delivery and effectiveness. A useful educational theory that is helpful in understanding effective learning from presentations is cognitive load theory. This theory acknowledges the limitation of the temporary or working memory (WM) to hold only seven to nine novel items at one time. These items will be lost permanently if not rehearsed or if there is not enough WM free to process the information into the long-term memory (LTM). Therefore, reducing the cognitive load or content of our slides could facilitate enhanced learning of new material. An evidence-based method to reduce content on slides in order to increase effective learning is chunking theory. This centres around how information can be chunked in meaningful ways to facilitate recall in smaller units. For example, take the four fat soluble vitamins – A, D, E and K – which could either occupy half or more of the WM capacity or be chunked into a single unit. Chunking these into one unit frees up the other six units to process this information meaningfully into the LTM. For instance, one might recall that there used to be a department store named DEKA and this encompasses all of the fat-soluble vitamins. Grouping multiple information sources together in similar spatial proximity reduces the audience’s mental effort needed to learn. Figure 1 illustrates visuospatially scattered text, numbers and graphics that need higher mental effort by the viewers as they attempt to integrate these elements whilst listening to the presenter. This cognitive loading or split attention is minimized by grouping these elements together as demonstrated on the left side of the figure. This reduces the WM load which facilitates processing the information into the LTM. The same principle can be applied to presenting photos, illustrations and graphs. Cognitive load research demonstrates that the audience will learn better from visuals and verbal narration than from visuals, narration and text together. A good example of this is watching a subtitled movie. As we try to listen, follow the scenes and read subtitles, we are bound to concentrate less on one of them. Once we turn the subtitles off, the experience is much improved. Therefore, where possible, refrain from using redundant text to improve the audience’s attention on you as the presenter. The redundancy principle is simple to remember, less is more! This principle suggests that people learn better from animation and verbal narration than from animation and on-screen text. Therefore, you could replace on-screen text with your narrative as the animation plays. Practical tips for slide design are given in Table 1. As the purpose of presentations is to convey knowledge, avoid puzzling the audience with vague and long titles. Choose a title that is brief and to the point. Brainstorm your main ideas about the topic on a piece of paper before reaching out to your computer. Then, link these ideas aiming for an easy flow as this facilitates your speech making as well as slide design and layout. Sometimes, it is useful to summarize each idea into one sentence as if this was the ‘take home message’ from each idea. It may be useful to search the internet for other presentations on your topic to optimize your structures and ideas. Audience engagement can be enhanced by contextualization of your talk. For example, in a lecture on an obscure and potentially boring pathological topic, wrap the topic in a clinical case. Choose emotionally rich cases to maximize the audience’s attention and engagement. The software programmes available for slide design offer an increasing amount of themes templates and animations. While it may be tempting to employ exotic slide themes and animations, these are more often not distracting and may actually malfunction on the day of your presentation. As far as possible, minimize the complexity of your slides. Slide backgrounds or themes work best as a solid colour with no underlying pattern. Use a contrasting colour for your font and ensure your colour combination facilitates easy reading. Some good examples are black on white, yellow on blue and white on black. Often your institution or funding body requires you to brand your presentation with their logos. Do comply with the branding guidelines of your institution, but where possible minimize the presence of branding logos to title slides only to minimize visual cognitive loading. Font and bullet point formatting need to be carefully considered. Ensure your chosen font is easily legible. Your font size should be as large as possible to allow readability for those most far away from the projection. Bullet points should be double-spaced and kept as succinct as possible. There is no exact consensus in the literature as to how many bullet points or how many words per bullet point are ideal. Opinions range from four bullet points with four words each to seven bullets points with seven words in each. An easy rule is the ‘triple-seven’ rule by Pratt which says ‘no more than seven bullets, no more than seven words per bullet, no more than seven lines per bulleted slide’. Loading bullet points individually