Peter Cantillon

ABC of learning and teaching: Web based learning.

Many of us use the internet or the “web” (world wide web) as a source of information. In medical education, the web is increasingly used both as a learning tool to support formal programmes and as a means of delivering online learning programmes. What can educators do to ensure that the potential of the web is used effectively to support both their own learning and that of their students? Much of the literature on web based learning shows that one of the main barriers to the effective use of teaching materials is the technology (for example, poor access, slow downloading) rather than the design of the learning materials themselves. Some of these issues are discussed later in the article, but it is vital that teachers take on expert help with technical issues in the planning, design, and delivery of web based learning programmes. Through programming and the use of “plug-ins” (programs that can be downloaded from the internet), designers can produce interactive course materials containing online activities (such as self assessments), animations, and simulations. These can improve learning and are often more enjoyable and meaningful for learners. #### Glossary E-conferencing —Use of online presentations and discussion forums (in real time or stored as downloadable files on a website) to avoid the need for participants to travel E-learning —Learning through electronic means, such as via the web (see world wide web), an intranet, or other multimedia materials HTML (hypertext markup language) —The language used to create web pages. HTML files can also contain links to other types of files including wordprocessed files, spreadsheets, presentation slides, and other web pages Hyperlinks —Links in web pages that enable the user to access another web page (either on the same or a different site) with just one mouse click Internet— A global network of computers divided …

Giving feedback in clinical settings

Think about a clinical teaching session that you supervised recently. How much feedback did you provide? How useful do you think your feedback was?

Helping each other to learn – a process evaluation of peer assisted learning

BackgroundThe benefits of Peer Assisted Learning (PAL) are well established with positive effects on examination scores, student satisfaction and personal and professional development reported. PAL is increasingly utilised as a resource within medical education where the restrictions on resources have forced teachers to look at creating new educational environments which can be delivered at a lower cost. This study sought to evaluate the processes at work as the emphasis of PAL research to date has largely been on the consideration of student outcomes.MethodsFifth-year medical undergraduates, who had completed their communication skills modular training and attended a preparatory workshop, facilitated a role-play session for their second-year colleagues within an Early Patient Contact programme. Semi-structured interviews and focus groups were used to collect data at different time points in order to establish the views of peer learners and tutors towards this new method of teaching. The data was analysed according to the principles framework analysis using N-vivo software. Themes were shared and debated with the multidisciplinary team of authors and a concordance of views on common themes was reached after discussion and debate.ResultsAnalysis of the data resulted in the emergence of three thematic categories: Learning Environment, Educational Exchange and Communication and Modelling. The data demonstrated a concordance of the views between peer tutors and learners on barriers and levers of this approach as well as a heightened awareness of the learning environment and the educational exchange occurring therein.ConclusionThe data is significant as it not only demonstrates a high level of acceptability among tutors and learners for PAL but also indicates the reciprocity of educational exchange that appears to occur within the PAL setting. This study highlights some of the unique characteristics of PAL and we recommend the development of further qualitative studies around peer learners and tutors views of this process.

A surgical career? The views of junior women doctors

To explore female pre‐registration house officers (PRHOs) views of surgery as a possible career choice.

Using computers for assessment in medicine

Computer based testing can offer many advantages over traditional paper based methods of assessment. The authors look at what it means and its potential uses for assessment in medicine

The doctor-patient relationship: from undergraduate assumptions to pre-registration reality

To describe the ways in which the doctor–patient relationship experienced by newly qualified pre‐registration house officers (PRHOs) differed from their undergraduate expectations.

Patients' perceptions of changes in their blood pressure

Objectives: (1) To investigate patients’ experience of changes in their blood pressure (BP) in an every day setting and the accuracy of patients’ predictions; and (2) to examine what influences patients’ belief that they can tell when their BP is up. Subjects: A total of 102 hypertensive patients were recruited sequentially as they presented for routine BP checks. The setting was an inner city general practice. Design: Patients attended for BP checks on a weekly basis. Before each check they were asked whether they thought their BP was higher, lower or the same as usual. Subjects were classified as predictors if they thought they could tell when their BP was up. On completing their series of BP checks each subject completed symptom and Hospital Anxiety and Depression questionnaires. Main outcome measures: Accuracy of BP predictions, BP levels and variability, number of symptoms reported and anxiety level. Results: One hundred and two hypertensive patients entered the study of whom 51 patients were predictors. The majority (86%) of predictors could not accurately predict their BP. There were no significant differences in either BP or variability between predictors and non-predictors. Predictors were significantly more anxious and reported more symptoms than non-predictors. Conclusions: For the majority of predictors there is no significant relationship between predictions of BP and clinical measurements. Predictor status is associated with the reporting of more symptoms and higher levels of anxiety. Doctors should counsel patients against using subjective BP assessments to guide their use of antihypertensive medication.

Does responsibility drive learning? Lessons from intern rotations in general practice

Background: The intern (or pre-registration) year has been criticised in the past for its emphasis on service delivery at the expense of educational achievement. It is hoped that new approaches to early postgraduate training such as the foundation programmes in the UK, will make clinical education more structured and effective. Intern placements in non-traditional settings such as general practice have been shown in the past to improve the quality of learning. Little is known however about which features of the general practice learning environment contribute most to the perception of improved learning. Aims: This aim of this study was to examine the learning environment in general practice from the perspective of interns, (the learners), to determine the factors that contribute most to motivating effective learning in a general practice setting. Methods: This study used a qualitative case study approach to explore the effects of two different learning environments, (general practice and hospital) on learner motivation amongst a small group of interns. Results: We found that the biggest difference between the hospital and general practice learning environments was the increased individual responsibility for patient care experienced by interns in general practice. Greater responsibility was associated with greater motivation for learning. Conclusions: Increased intern responsibility for patient care does appear to motivate learning. More work needs to be done on providing interns in hospital posts with greater patient responsibility within an effective supervisory structure.

Training socially responsive health care graduates: Is service learning an effective educational approach?

Background: Health care educators strive to train graduates who are socially responsive and can act as “change agents” for communities they serve. Service learning (SL) is increasingly being used to teach the social aspects of health care and develop students’ social responsiveness. However, the effectiveness of SL as an educational intervention has not been established. Aim: To assess the evidence for the effectiveness of SL. Method: Seven electronic databases were searched up to 2012 and included all articles on SL for pre-professional health care students. Hand searching was also conducted. Results: A total of 1485 articles were identified, 53 fulfilled the search and quality appraisal criteria and were reviewed across six domains of potential SL effects: (i) personal and interpersonal development; (ii) understanding and applying knowledge; (iii) engagement, curiosity and reflective practice; (iv) critical thinking; (v) perspective transformation and (vi) citizenship. Conclusion: While SL experiences appear highly valued by educators and students the effectiveness of SL remains unclear. SL is different from other forms of experiential learning because it explicitly aims to establish reciprocity between all partners and increase students’ social responsiveness. Impact studies based on the interpretative paradigm, aligned with the principles of social accountability and including all stakeholder perspectives are necessary.

Teaching on a ward round

A deliberate and planned approach to bedside teaching will make learning more effective