Manuel João Costa

CRITERIA FOR GOOD ASSESSMENT: CONSENSUS STATEMENT AND RECOMMENDATIONS FROM THE OTTAWA 2010 CONFERENCE

In this article, we outline criteria for good assessment that include: (1) validity or coherence, (2) reproducibility or consistency, (3) equivalence, (4) feasibility, (5) educational effect, (6) catalytic effect, and (7) acceptability. Many of the criteria have been described before and we continue to support their importance here. However, we place particular emphasis on the catalytic effect of the assessment, which is whether the assessment provides results and feedback in a fashion that creates, enhances, and supports education. These criteria do not apply equally well to all situations. Consequently, we discuss how the purpose of the test (summative versus formative) and the perspectives of stakeholders (examinees, patients, teachers-educational institutions, healthcare system, and regulators) influence the importance of the criteria. Finally, we offer a series of practice points as well as next steps that should be taken with the criteria. Specifically, we recommend that the criteria be expanded or modified to take account of: (1) the perspectives of patients and the public, (2) the intimate relationship between assessment, feedback, and continued learning, (3) systems of assessment, and (4) accreditation systems.

The remediation challenge: theoretical and methodological insights from a systematic review

Objectives  Remediation is usually offered to medical students and doctors in training who underperform on written or clinical examinations. However, there is uncertainty and conflicting evidence about the effectiveness of remediation. The aim of this systematic review was to synthesise the available evidence to clarify how and why remediation interventions may have worked in order to progress knowledge on this topic.

A latent growth model suggests that empathy of medical students does not decline over time.

Empathy is a relevant attribute in the context of patient care. However, a decline in empathy throughout medical education has been reported in North-American medical schools, particularly, in the transition to clinical training. The present study aims to longitudinally model empathy during medical school at three time points: at the entrance, final of pre-clinical phase and at the beginning of clinical training. Data collected with the adaptation to Portuguese of the Jefferson Scale of Physician Empathy (student version) were analysed with latent growth modelling, conditioned by gender, openness and agreeableness. Empathy scores at all times were higher for females than for males, but only significantly at the end of the preclinical phase. The model showed a satisfactory fit level and the primary finding was that undergraduate medical student’s empathy did not decline over time. Empathy scores were significantly and positively related with Openness to Experience and Agreeableness at admission, but the empathy rate of change across time was not significant. The stability of empathy revealed by a longitudinal methodology applied for the first time to empathy studying, contradicts previous results of decline and contributes to the understanding of the empathy development of medical students.

Empathy of medical students and personality: Evidence from the Five-Factor Model

The main aim of this study was to test hypothetical associations between personality dimensions and empathy scores in medical students. The Portuguese version of NEO-FFI was administered in order to characterize participants in terms of five personality traits: Neuroticism, Extraversion, Agreeableness, Openness to Experience, and Conscientiousness. Self-reported empathy measures were obtained with the Portuguese version of the Jefferson Scale of Physician Empathy (JSPE-spv), a Likert-type questionnaire specifically developed for administration in health sciences settings that measures domains, such as compassionate care and perspective taking. Correlation analysis, multivariate analysis of covariance, and logistic regression analysis were conducted. The results confirmed positive associations between agreeableness, openness to experience and empathy, and did not support our hypothesis of negative associations between neuroticism and empathy. It is suggested that that the personality of students should be taken into account in programs to enhance empathy in undergraduate medical education.

Individual characteristics and student’s engagement in scientific research: a cross-sectional study

BackgroundIn light of the increasing recognition of the importance of physician scientists, and given the association between undergraduate research experiences with future scientific activity, it is important to identify and understand variables related to undergraduate students’ decision to engage in scientific research activities. The present study assessed the influence of individual characteristics, including personality traits and socio-demographic characteristics, on voluntary engagement in scientific research of undergraduate medical students.MethodsFor this study, all undergraduate students and alumni of the School of Health Sciences in Minho, Portugal were invited to participate in a survey about voluntary engagement in scientific research activities. Data were available on socio-demographic, personality and university admission variables, as part of an ongoing longitudinal study. A regression model was used to compare (1) engaged with (2) not engaged students. A classification and regression tree model was used to compare students engaged in (3) elective curricular research (4) and extra-curricular research.ResultsA total of 466 students (88%) answered the survey. A complete set of data was available for 435 students (83%).Higher scores in admission grade point average and the personality dimensions of “openness to experience” and “conscientiousness” increased chances of engagement. Higher “extraversion” scores had the opposite effect. Male undergraduate students were two times more likely than females to engage in curricular elective scientific research and were also more likely to engage in extra-curricular research activities.ConclusionsThis study demonstrated that student’ grade point average and individual characteristics, like gender, openness and consciousness have a unique and statistically significant contribution to students’ involvement in undergraduate scientific research activities.

NEO-FFI: Psychometric properties of a short personality inventory in Portuguese context

The aim of this study was to assess the psychometric properties (validity and reliability) of the Portuguese adaptation of the NEO Five-Factor Inventory (NEO-FFI) and to compare the obtained structure to the original North American version. The methods of analysis used for cross-validation of the factorial structure were the Principal Axis Factoring (PAF) and the Confirmatory Factor Analysis (CFA). PAF reproduced the original structure of NEO-FFI and CFA revealed a satisfactory fit of single-factor models for the five dimensions. The reliability analysis showed high values of internal consistency which are congruent with previous international adaptations of the NEO-FFI. Multidimensional analysis showed significant main effects of gender and academic qualifications on personality using age as covariant. The findings suggest that the Portuguese version of the NEO-FFI is a reliable instrument to measure the five dimensions of personality.

Bologna in Medicine Anno 2012: Experiences of European medical schools that implemented a Bologna two-cycle curriculum – An AMEE-MEDINE2 survey

Background: The 1999 Bologna Agreement implies a European harmonization of higher education using three cycles: bachelor and master before doctorate. Undergraduate medical programmes were restructured in only seven of the 47 countries. Aim: Given the debate about a two-cycle system in undergraduate medical education, providing an overview of experiences in medical schools that applied this structure was the purpose of this investigation. Methods: In 2009, an AMEE-MEDINE2 survey was carried out among all the 32 medical schools that applied the two-cycle system in medicine. At the end of 2011, a member-check validation using a draft manuscript was carried out to complete an accurate up-to-date impression. Results: All the 32 schools responded initially; 26 schools responded to the second round. All schools had implemented the two-cycle system (all but one in a 3 + 3 year model) with hardly any problems. All reported smaller or larger curriculum improvements, often triggered, but not caused, by the two-cycle system. No school reported that introducing the system interfered with any desired curriculum development, particularly horizontal or vertical integration. Conclusion: In 32 of the 442 medical schools in Bologna signatory countries, introducing a two-cycle model for basic medical education was successfully completed. However, harmonization of medical training in Europe requires further international collaboration.

A quick guide for computer-assisted instruction in computational biology and bioinformatics.

Computational Biology and Bioinformatics (CBB) are indispensable components in the training of life scientists [1]–[3]. Current curricula in the life sciences should prepare graduates who master quantitative and computer skills for increased levels of performance [4]–[6]. Equally important is that the application of the curricula is driven by an appropriate instructional paradigm and effective learning experiences. Teaching and learning with computers bring specific issues that should be considered beforehand by any instructor. The following Quick Guide for Computer-Assisted Instruction (CAI) outlines ten principles for effective teaching. The principles are aligned with current developments on human cognition and learning [7] and have been drawn from our own experience using CAI in seminars, tutorials, and distance education, in courses on Molecular Life Sciences at the undergraduate level, taught to majors in biology or in other subjects (e.g., nutrition, teaching of physics and chemistry, teaching of biology, sports). The Guide refers to the preparation, presentation, and assessment of CAI. It should be an aid for those who teach CBB with CAI in class, and it is expected to stimulate student motivation and deeper learning in CBB, thus making class time more effective and improving satisfaction of both students and instructors.

Clarifying changes in student empathy throughout medical school: a scoping review

Despite the increasing awareness of the relevance of empathy in patient care, some findings suggest that medical schools may be contributing to the deterioration of students’ empathy. Therefore, it is important to clarify the magnitude and direction of changes in empathy during medical school. We employed a scoping review to elucidate trends in students’ empathy changes/differences throughout medical school and examine potential bias associated with research design. The literature published in English, Spanish, Portuguese and French from 2009 to 2016 was searched. Two-hundred and nine potentially relevant citations were identified. Twenty articles met the inclusion criteria. Effect sizes of empathy scores variations were calculated to assess the practical significance of results. Our results demonstrate that scoped studies differed considerably in their design, measures used, sample sizes and results. Most studies (12 out of 20 studies) reported either positive or non-statistically significant changes/differences in empathy regardless of the measure used. The predominant trend in cross-sectional studies (ten out of 13 studies) was of significantly higher empathy scores in later years or of similar empathy scores across years, while most longitudinal studies presented either mixed-results or empathy declines. There was not a generalized international trend in changes in students’ empathy throughout medical school. Although statistically significant changes/differences were detected in 13 out of 20 studies, the calculated effect sizes were small in all but two studies, suggesting little practical significance. At the present moment, the literature does not offer clear conclusions relative to changes in student empathy throughout medical school.

The power of interactive teaching.

The teaching of the Molecular Life Sciences in most Universities still remains teacher-centered [1–3]. Instructors impart knowledge (terms, facts, concepts) in a didactic fashion and then complement these with ‘‘laboratories’’ or exercises to provide practice opportunities and develop skills. In such environments, students play predominantly passive roles [3, 4]. However, results from science education research show that by getting their students actively engaged, they may do more for student learning [5–9]. This suggests that, even though replacing one’s way of teaching is not easy, faculty members should move progressively toward the application of interactive educational approaches in their classrooms. Changing one’s approach to teaching requires a careful consideration of different methods. Currently there are many choices (see [10] for examples) and these keep expanding as newer methodologies are being developed. Even a cursory search by the interested teacher using the search term ‘‘based learning’’ in Google, would yield over 7 million items! In fact, many different formats have been named and described ranging from problem-based learning, project-based learning, peer led team learning, process oriented guided inquiry learning, inquiry-based learning, case-based learning, team-based learning, student-centered learning, active learning, cooperative learning to peer instruction, scientific teaching, and so forth. Each method has its own strong advocates of the virtues of their particular approach despite the blurred boundaries between any two particular methods. Taking Biochemistry and Molecular Biology for example, the July/August 2008 issue of BAMBED advances two methodological suggestions, other than the widely accepted ‘‘Problem-Based Learning’’ (the long time method alternative to traditional teaching) [11]. Choosing a method has become a problem in itself. Indeed, the issues associated with the implementation of ‘‘pure’’ methods, however modern or well studied they may be, are often far from trivial. Knowing ‘‘which will work’’ is difficult since little if any reliable empirical evidence is available for most. Providing an extensive list may in fact have the opposite impact on teachers’ willingness to change, by creating more insecurity and thus inducing greater resistance to the idea of leaving the lectern. In this discussion forum, we argue that, rather than focus excessively on choosing ONE particular method, faculty members should be concerned with providing more opportunities for interactive teaching and never to ignore the specific context in which they teach. For operational reasons, we will assume that an effective educational method is one that: 1) Motivates and inspires students; 2) Achieves cognitive engagement from the students; 3) Enhances student learning. The empirical evidence that supports of interactive teaching approaches exists and is gradually expanding. However, finding the relevant literature requires transgressing disciplinary boundaries. Educational research on instruction at the college level is mostly performed at the disciplinary level. Unfortunately, Molecular Life Science educators generally are not aware of the substantial body of literature in other disciplines, namely medical, engineering, or physics education. The most compelling evidence on the power of interactivity in teaching comes from the community of Physics Education Research [7]. Results come out of the application of concept inventories—The Force Concept Inventory and the Mechanics Baseline Test [12, 13]—to assess improvements in student conceptual understanding with different instructional approaches. A meta-analysis of results gathered in a plethora of high school, college and university classrooms, totaling 62 introductory physics courses and 6,542 students, with a multitude of teaching approaches [10], shows that ‘‘What works’’ is apparently ‘‘interactive engagement’’ approaches which are described by the author of the study as ‘‘methods as those designed at least in part to promote conceptual understanding through interactive engagement of students in heads-on (always) and hands-on (usually) activities which yield immediate feedback through discussion with peers and/or instructors, all as judged by their litera¶To whom correspondence should be addressed. E-mail: mmcosta@ecsaude.uminho.pt.