Martin G. Tolsgaard

Student teachers can be as good as associate professors in teaching clinical skills

Aim: The aim of this study is to compare student teachers and clinical associate professors regarding the quality of procedural skills teaching in terms of participants’ technical skills, knowledge and satisfaction with the teaching. Methods: This is an experimental, randomized, controlled study comparing the teaching of student teachers and associate professors regarding participants’ learning outcome and satisfaction with the teaching. Two skills are chosen for the experiment, IV-access and bladder catheterization. Learning outcome is assessed by a pre- and post testing of the participants’ knowledge and skills. Participants evaluate satisfaction with teaching on nine statements immediately after the teaching. Results: In total 59 first year medical students are included as participants in the experiment. The students taught by student teachers perform just as well as the students taught by associate professors and in one skill–catheterization–they perform even better, mean post- minus pre-test scores 65.5 (SD 12.9) vs. 35.0 (SD 23.3), One-way ANOVA, pu2009<u20090.0001, effect size 1.62. Student teachers receive significantly more positive evaluations than associate professors on several statements. Conclusion: Trained student teachers can be as good as associate professors in teaching clinical skills.

International multispecialty consensus on how to evaluate ultrasound competence: a Delphi consensus survey.

Objectives To achieve international consensus across multiple specialties on a generic ultrasound rating scale using a Delphi technique. Methods Ultrasound experts from Obstetrics-Gynaecology, Surgery, Urology, Radiology, Rheumatology, Emergency Medicine, and Gastro-Enterology representing North America, Australia, and Europe were identified. A multi-round survey was conducted to obtain consensus between these experts. Of 60 invited experts, 44 experts agreed to participate in the first Delphi round, 41 remained in the second round, and 37 completed the third Delphi round. Seven key elements of the ultrasound examination were identified from existing literature and recommendations from international ultrasound societies. All experts rated the importance of these seven elements on a five-point Likert scale in the first round and suggested potential new elements for the assessment of ultrasound skills. In the second round, the experts re-rated all elements and a third round was conducted to allow final comments. Agreement on which elements to include in the final rating scale was pre-defined as more than 80% of the experts rating an element four or five, on importance to the ultrasound examination. Results Two additional elements were suggested by more than 10% of the experts in the first Delphi round. Consensus was obtained to include these two new elements along with five of the original elements in the final assessment instrument: 1) Indication for the examination 2) Applied knowledge of ultrasound equipment 3) Image optimization 4) Systematic examination 5) Interpretation of images 6) Documentation of examination and 7) Medical decision making. Conclusion International multispecialty consensus was achieved on the content of a generic ultrasound rating scale. This is the first step to ensure valid assessment of clinicians in different medical specialties using ultrasound.

Reliable and valid assessment of ultrasound operator competence in obstetrics and gynecology

To explore the reliability and validity of a recently developed instrument for assessment of ultrasound operator competence, the Objective Structured Assessment of Ultrasound Skills (OSAUS).

Which factors are associated with trainees' confidence in performing obstetric and gynecological ultrasound examinations?

To explore the association between clinical training characteristics and trainees level of confidence in performing ultrasound scans independently.

Collecting Validity Evidence for the Assessment of Mastery Learning in Simulation-Based Ultrasound Training.

PURPOSEnTo collect validity evidence for the assessment of mastery learning on a virtual reality transabdominal ultrasound simulator.nnnMATERIALS AND METHODSnWe assessed the validity evidence using Messicks framework for validity. The study included 20 novices and 9 ultrasound experts who all completed 10 obstetric training modules on a transabdominal ultrasound simulator that provided automated measures of performance for each completed module (i.u200ae., simulator metrics). Differences in the performance of the two groups were used to identify simulator metrics with validity evidence for the assessment of mastery learning. The novices continued to practice until they had attained mastery learning level.nnnRESULTSnOne-third of the simulator metrics discriminated between the two groups. The median simulator scores from a maximum of 40 metrics were 17.5 percent (range 0u200a-u200a45.0 percent) for novices and 90.0 percent (range 85.0u200a-u200a97.5) for experts, pu200a<u200a0.001. Internal consistency was high, with a Cronbachs alpha value of 0.98. The test/retest reliability gave an intra-class correlation coefficient (ICC) of 0.62 for novices who reached the mastery learning level twice. Novices reached the mastery learning level within a median of 4 attempts (range 3u200a-u200a8) corresponding to a median of 252 minutes of simulator training (range 211u200a-u200a394 minutes).nnnCONCLUSIONnThis study found that validity evidence for the assessment of mastery learning inxa0simulation-based ultrasound training can be demonstrated and that ultrasound novices can attain mastery learning levels with less than 5 hours of training. Only one-third of the standard simulator metrics discriminated between different levels of competence.

Using equivalence designs to improve methodological rigor in medical education trials.

student, course, and instructor characteristics in evaluation of university teaching. Am Educ Res J 1980;17 :219–37. 3 Marsh HW, Roche LA. Effects of grading leniency and low workload on students’ evaluations of teaching: popular myth, bias, validity, or innocent bystanders? J Educ Psychol 2000;92:202–28. 4 Marsh HW. Students’ evaluations of university teaching: dimensionality, reliability, validity, potential biases and usefulness. In: Perry RP, Smart JC, ed. The Scholarship of Teaching and Learning in Higher Education: an Evidence-based Perspective. Dordrecht: Springer 2007;319–83. 5 Schwarz N. How the questions shape the answers. Am Psychol 1999; 54:93–105.

Medical students’ perception of dyad practice

Training in pairs (dyad practice) has been shown to improve efficiency of clinical skills training compared with single practice but little is known about students’ perception of dyad practice. The aim of this study was to explore the reactions and attitudes of medical students who were instructed to work in pairs during clinical skills training. A follow-up pilot survey consisting of four open-ended questions was administered to 24 fourth-year medical students, who completed four hours of dyad practice in managing patient encounters. The responses were analyzed using thematic analysis. The students felt dyad practice improved their self-efficacy through social interaction with peers, provided useful insight through observation, and contributed with shared memory of what to do, when they forgot essential steps of the physical examination of the patient. However, some students were concerned about decreased hands-on practice and many students preferred to continue practising alone after completing the initial training. Dyad practice is well received by students during initial skills training and is associated with several benefits to learning through peer observation, feedback and cognitive support. Whether dyad training is suited for more advanced learners is a subject for future research.

Quality of randomised controlled trials in medical education reported between 2012 and 2013: a systematic review protocol

Introduction Research in medical education has increased in volume over the past decades but concerns have been raised regarding the quality of trials conducted within this field. Randomised controlled trials (RCTs) involving educational interventions that are reported in biomedical journals have been criticised for their insufficient conceptual, theoretical framework. RCTs published in journals dedicated to medical education, on the other hand, have been questioned regarding their methodological rigour. The aim of this study is therefore to assess the quality of RCTs of educational interventions reported in 2012 and 2013 in journals dedicated to medical education compared to biomedical journals with respect to objective quality criteria. Methods and analysis RCTs published between 1 January 2012 and 31 December 2013 in English are included. The search strategy is developed with the help of experienced librarians to search online databases for key terms. All of the identified RCTs are screened based on their titles and abstracts individually by the authors and then compared in pairs to assess agreement. Data are extracted from the included RCTs by independently scoring each RCT using a data collection form. The data collection form consists of four steps. Step 1 includes confirmation of RCT eligibility; step 2 consists of the CONSORT checklist; step 3 consists of the Medical Education Research Study Quality Instrument framework; step 4 consists of a Medical Education Extension (MEdEx) to the CONSORT checklist. The MEdEx includes the following elements: Description of scientific background, explanation of rationale, quality of research questions and hypotheses, clarity in the description of the use of the intervention and control as well as interpretation of results. Ethics and dissemination This review is the first to systematically examine the quality of RCTs conducted in medical education. We plan to disseminate the results through publications and presentation at relevant conferences. Ethical approval is not sought for this review.

Use of simulators for the assessment of trainees' competence: trendy toys or valuable instruments?

Over the past decade, ultrasound simulators have been increasingly used as an adjunct to clinical training in Obstetrics and Gynaecology. Studies have shown that providing initial simulation-based ultrasound training leads to sustained improvements in clinical performances1 including improved diagnostic accuracy,2 reduced need for supervised practice, and decreased patient discomfort.3.

Validity of the ISUOG basic training test

A certain level of theoretical knowledge is required when performing basic obstetrical and gynecological ultrasound. To assess the adequacy of trainees basic theoretical knowledge, the International Society of Ultrasound in Obstetrics and Gynecology (ISUOG) has developed a theoretical test of 49 Multiple Choice Questionnaire (MCQ) items for their basic training courses.