Kyong-Jee Kim

Use of online clinical videos for clinical skills training for medical students: benefits and challenges

BackgroundMultimedia learning has been shown effective in clinical skills training. Yet, use of technology presents both opportunities and challenges to learners. The present study investigated student use and perceptions of online clinical videos for learning clinical skills and in preparing for OSCE (Objective Structured Clinical Examination). This study aims to inform us how to make more effective us of these resources.MethodsA mixed-methods study was conducted for this study. A 30-items questionnaire was administered to investigate student use and perceptions of OSCE videos. Year 3 and 4 students from 34 Korean medical schools who had access to OSCE videos participated in the online survey. Additionally, a semi-structured interview of a group of Year 3 medical students was conducted for an in-depth understanding of student experience with OSCE videos.Results411 students from 31 medical schools returned the questionnaires; a majority of them found OSCE videos effective for their learning of clinical skills and in preparing for OSCE. The number of OSCE videos that the students viewed was moderately associated with their self-efficacy and preparedness for OSCE (p < 0.05). One-thirds of those surveyed accessed the video clips using mobile devices; they agreed more with the statement that it was convenient to access the video clips than their peers who accessed the videos using computers (p < 0.05). Still, students reported lack of integration into the curriculum and lack of interaction as barriers to more effective use of OSCE videos.ConclusionsThe present study confirms the overall positive impact of OSCE videos on student learning of clinical skills. Having faculty integrate these learning resources into their teaching, integrating interactive tools into this e-learning environment to foster interactions, and using mobile devices for convenient access are recommended to help students make more effective use of these resources.

Digital report in an anatomy laboratory: a new method for team-based dissection, reporting, and evaluation

PurposeDigital report (DR), a new method for students’ dissection report, has been introduced to replace the traditional method in the anatomy laboratory.MethodsLaboratory tasks were assigned to groups of five students, and each group was asked to make a DR of their dissection tasks and upload it on the website for the anatomy course developed by the authors’ institution. For creating the DR, students were instructed to take photographs of their findings with digital cameras, to mark the orientation and label the structures on the photograph. Students were assessed as a group by evaluating the DR. All the photographs of the DR were saved to construct a database that can be used by the students who will take the anatomy course in the following years. A questionnaire consisting of 14 questions was administered at the end of the anatomy course to evaluate the effectiveness of the DR.ResultsThe results of the student survey showed that the DR was useful for making the students participate more actively in the teamwork for dissection, and for making dissection reports by referring to the DR made by the students from previous years. The DR was also more helpful for the anatomy teacher to assess student learning in the anatomy laboratory than conventional practical examinations and paper-based dissection reports.ConclusionsDR, a paperless report of team-based dissection, is concurrent with the ‘digital’ age and is in line with the need for a more systematic and objective evaluation of students’ dissection.

Changes in medical students' motivation and self-regulated learning: a preliminary study.

Objectives To investigate whether medical students’ motivation and Self-Regulated Learning (SRL) change over time to enhance our understanding of these constructs as dependent variables in medical education. Methods A cohort of first-year students (n=43) at a medical school in South Korea completed a self-report questionnaire on motivation and SRL - the Motivated Strategies for Learning Questionnaire (MSLQ). The same questionnaire was administered to the same cohort in the beginning of Year 2. A Wilcoxon signed-rank test was conducted to determine if changes in participants’ MSLQ scores occurred between in Years 1 and 2. Results Forty-one students completed the questionnaires in both years (95% response rate). Participants’ motivation scores significantly increased, whereas their SRL scores decreased significantly after they went through Year 1. The most notable change in participants’ MLSQ scores was in the increase in their test anxiety. There was a positive association between the participants’ test anxiety and their cognitive strategies use in Year 1, which changed to a negative one in Year 2. Meanwhile, participants’ test anxiety scores and their self-regulation scores became more negatively associated over time. Conclusions Our study shows that even as medical students become more motivated, they actually use fewer self-regulated strategies over time. Our findings highlight the need for change in the medical school’s learning environment to lessen students’ test anxiety to facilitate their use of cognitive and meta-cognitive strategies.

The utility of multiple mini-interviews: experience of a medical school

Purpose This paper aims to introduce the design of multiple mini-interviews (MMIs) as a tool to assess medical school applicants’ attributes in alignment with the school’s educational goals and to evaluate its utility. Methods In this MMI, candidates rotated through six stations (10 minutes per station), in which specific interview topics were drawn by mapping the school’s educational goals with the core competencies for entering medical students. We conducted post-MMI surveys of all of the interviewers and candidates to investigate their experiences of MMIs. The G-coefficient and interclass correlation were analyzed to investigate the reliability of this test. Additionally, the candidates’ MMI scores were compared across different backgrounds and a univariate analysis was used to estimate correlations between their MMI scores and prior academic achievements. Results A total of 164 candidates (a 98.8% response rate) and 19 interviewers (a 100% response rate) completed the surveys in the years 2014 and 2015. Both candidates and assessors showed positive responses to MMIs. The G-coefficient of MMI scores was 0.88 and the interclass correlation coefficients ranged from 0.58 to 0.75. The participants’ total MMI scores did not differ across genders or undergraduate backgrounds and were not associated with age, undergraduate graduate point averages, nor the Korean medical school admission test (Medical Education Eligibility Test) scores. Conclusion Our study illustrates the utility of MMIs that utilize the institution’s educational goals to identify attributes to be pursued in the admission interviews in alignment with the institution’s core values. Future research is warranted of the predictive validity of this MMI.

Medical student plagiarism in problem-based learning courses

Students’ academic misconduct has been an issue in medical education and is more likely with development of technology (1, 2). We investigated the occurrence of plagiarism by medical students in a problem-based learning (PBL) course. The participants were a cohort of Year 1 students in the 4-year medical program (n=53) at Dongguk University Medical School in South Korea. Of these students, 38.5% were female and 61.5% were male. Of these, 60% were graduate-entry students and 40% were undergraduate-entry students. Student ages ranged from 19 to 33 years (M=24.13, SD=3.19). The students turned in papers after self-study of topics on the PBL module. The plagiarism detection program offered by the university was used for the investigation. Thirty-three students (62%) plagiarized, mainly copying and pasting websites found using Google, a Korean search engine, or the one offered by a Korean medical center. As a result of such extensive use of limited resources and searching the Internet using similar keywords, contents of the papers were very similar. In another assignment, students wrote their reflections on ethical issues raised in the module. Seventeen students (32%) plagiarized papers written by their peers; some of them copied and pasted others’ work and in some cases they used ideas from what their peers had written. In addition, we conducted one-on-one interviews with all of the students who were found to have plagiarized to investigate their patterns and perceptions of plagiarism. We found that most of the students were not aware that copying information from the website without proper citation of sources was considered plagiarism, and they were not aware that copying reports of their peers was a serious problem. In addition, most of the students copied papers written by their peers who were neither in their social network nor in the same PBL group. Our study indicates that plagiarism in PBL is as prevalent as in other conventional courses and that its occurrence differs according to the type of assignment. In addition, all students should be monitored across PBL groups for detection of plagiarism because they likely copy papers written by peers in other PBL groups or those outside of their social networks. In conclusion, it is suggested that students should be educated on plagiarism to enhance their awareness of what it is and how to avoid it. A variety of educational interventions may be available to teach about plagiarism to medical students – from conventional lectures to online tutorials. In addition, students need to be offered various learning resources for their self-study in order to prevent student plagiarism. Offering diverse, quality learning resources is fundamental to fostering an effective learning environment for PBL (3), and this can also encourage students to use diverse resources instead of merely copying and pasting content from simple Internet search in writing up papers.

Differences in medical students' academic interest and performance across career choice motivations.

Objectives To investigate medical students’ career choice motivation and its relationship with their academic interest and performance. Methods We conducted a cross-sectional study in a sample (n=207) of medical students at a private medical school in Korea, stratified by year of medical course. Data about participant demographics, career choice motivation and academic interest were collected using a self-report questionnaire. The item on career choice motivation enquired about the respondents’ main reason for applying for medical school among 8 possible response options, which comprised two components of career choice motivation: intrinsic and extrinsic. The participants’ levels of academic interest were measured in a Likert-type question. Participants’ academic interest and Grade Point Averages (GPAs) were compared across the groups of different career motivations along with analyses of their admission scores for baseline comparisons. Results A total of 195 students completed the questionnaire (94%response rate). Seventy-four percent, (n=145; the intrinsic group) of the participants chose reasons related to intrinsic motivation, 22% (n=42; the extrinsic group) chose reasons pertaining to extrinsic motivation, and 4% (n = 8) chose other reasons for applying to medical school. The intrinsic group outperformed the extrinsic group in their GPAs, although their prior academic achievements did not differ significantly. The intrinsic group showed significantly higher levels of academic interest and also performed better in the admission interviews. Conclusions Our study illustrates differences in medical students’ academic interest and performance across career choice motivations. Further research is warranted to establish the predictive power of medical students’ career choice motivation and academic interest on their academic performance.

Factors associated with medical student test anxiety in objective structured clinical examinations: a preliminary study

Objectives To investigate attributes of medical students associated with their test anxiety on Objective Structured Clinical Examinations (OSCEs). Methods A cross-sectional study using a self-administered questionnaire was conducted of all Year 3 and 4 students at a private medical school in South Korea in 2014. This 53-item questionnaire consisted of factors pertaining to test anxiety on the OSCE identified from a review of relevant literature, which included students’ motivational beliefs and achievement emotions, perceived values of the OSCE, and attitude and orientation towards patients. Participants’ test anxiety levels were measured using the Korean Achievement Emotions Questionnaire. Participants rated their responses using a five-point Likert-type scale. Univariate analysis was performed to examine relationships between the variables. Results A total of 94 students completed the questionnaire (a 93% response rate). No differences in the participants’ test anxiety scores were observed across genders, entry-levels, or years in medical school. Participants’ test anxiety on the OSCE showed moderate association with their class-related achievement emotions (i.e., anxiety and boredom), where r = 0.46 and 0.32, p < 0.01, respectively, and weak negative associations with their patient-centeredness (r = -0.21, p < 0.05) and with their perceived values of the OSCE (r = -0.21, p < 0.05). Conclusions This study found some non-cognitive factors related to medical students’ test anxiety on the OSCE. These findings have implications for developing effective educational interventions for helping students cope with such a stress by enhancing our understanding of the various factors that influence their test anxiety in OSCEs.

Survey on the undergraduate curriculum in clinical pharmacology and interns' prescribing ability in South Korea

Appropriate prescription writing is one of the critical medical processes affecting the quality of public health care. However, this is a complex task for newly qualified intern doctors because of its complex characteristics requiring sufficient knowledge of medications and principles of clinical pharmacology, skills of diagnosis and communication, and critical judgment. This study aims to gather data on the current status of undergraduate prescribing education in South Korea. Two surveys were administered in this study: survey A to 26 medical schools in South Korea to gather information on the status of undergraduate education in clinical pharmacology; and survey B to 244 intern doctors in large hospitals to gather their opinions regarding prescribing education and ability. In survey A, half of the responding institutions provided prescribing education via various formats of classes over two curriculums including lecture, applied practice, group discussions, computer-utilized training, and workshops. In survey B, we found that intern doctors have the least confidence when prescribing drugs for special patient populations, especially pregnant women. These intern doctors believed that a case-based practical training or group discussion class would be an effective approach to supplement their prescribing education concurrently or after the clerkship in medical schools or right before starting intern training with a core drug list. The results of the present study may help instructors in charge of prescribing education when communicating and cooperating with each other to improve undergraduate prescribing education and the quality of national medical care.

Does the sequence of rotations in Multiple Mini Interview stations influence the candidates’ performance?

ABSTRACT In Multiple Mini Interviews (MMIs), the candidates start out with different stations depending on the sequence of rotation they are assigned; thus, their perceived difficulty level and nervousness with their first station may differ. We examined whether such differences influenced the candidates’ overall performance in the MMI. A 32-item questionnaire was developed and administered to candidates for admission interviews at a medical school regarding their perceptions of the MMI. Candidates’ interview scores were also obtained and were compared across groups who differed in the sequence of rotation of MMI stations. Candidates felt nervous when they encountered the first station, which did not differ regardless of which station was their first encounter. Candidates were neutral regarding whether their first station was more difficult than the others and about whether its difficulty level influenced their overall performance in the test. Although candidates’ perceived station difficulty differed across stations, there were no differences in their performance in each station between those it was their first station and those it was not. Candidates’ total interview scores also did not differ across groups of different sequence of rotations. The MMI is a fair process as it does not give disadvantage to those who encounter a more difficult station than others for their first station.

Enhancement of student perceptions of learner-centeredness and community of inquiry in flipped classrooms

BackgroundFlipped classrooms (FC) are expected to create a more student-centered, active learning environment than traditional lectures. This study assessed the effectiveness of FC in promoting a student-centered, active learning environment by examining the changes in student perceptions of the learning environment of FC in terms of student-centeredness and sense of community of inquiry (COI), which represents the elements of a successful learning environment.MethodsQuestionnaires were given to a cohort of Year 2 students in a six-year undergraduate medical education program, who had taken an introduction to medicine course in a FC format. The questionnaire included 7 items on the teaching orientation (i.e., teacher-centered vs. student-centered) and 34 items from the Community of Inquiry Survey Instrument, which consisted of three sub-scales – teaching, social, and cognitive presences. The questionnaires were administered in pre- and post-test format during the first and last week of the semester.ResultsA total of 55 students returned the questionnaires (100% response rate). The student perceptions of student-centeredness of FC increased significantly over time (p < 0.001), and their perceptions of COI in FC also increased significantly in all three presences (p < 0.001). The student perceptions of student-centeredness and sense of COI in FC increased significantly in both high-achieving and low-achieving students (p < 0.01).ConclusionsThis study indicates that the flipped classroom model is an effective approach to fostering a learner-centered learning environment and developing a community of inquiry among medical students.