Raphael Bonvin

Evaluation of an online, case-based interactive approach to teaching pathophysiology

Aim: The aim of this study was to evaluate a new pedagogical approach in teaching fluid, electrolyte and acid-base pathophysiology in undergraduate students. Methods: This approach comprises traditional lectures, the study of clinical cases on the web and a final interactive discussion of these cases in the classroom. When on the web, the students are asked to select laboratory tests that seem most appropriate to understand the pathophysiological condition underlying the clinical case. The percentage of students having chosen a given test is made available to the teacher who uses it in an interactive session to stimulate discussion with the whole class of students. The same teacher used the same case studies during 2 consecutive years during the third year of the curriculum. Results: The majority of students answered the questions on the web as requested and evaluated positively their experience with this form of teaching and learning. Conclusions: Complementing traditional lectures with online case-based studies and interactive group discussions represents, therefore, a simple means to promote the learning and the understanding of complex pathophysiological mechanisms. This simple problem-based approach to teaching and learning may be implemented to cover all fields of medicine.

Medical Students’ Skills and Needs for Training in Breaking Bad News

This study assessed medical students’ perception of individual vs. group training in breaking bad news (BBN) and explored training needs in BBN. Master-level students (N = 124) were randomised to group training (GT)—where only one or two students per group conducted a simulated patient (SP) interview, which was discussed collectively with the faculty—or individual training (IT)—where each student conducted an SP interview, which was discussed during individual supervision. Training evaluation was based on questionnaires, and the videotaped interviews were rated using the Roter Interaction Analysis System. Students were globally satisfied with the training. Still, there were noticeable differences between students performing an interview (GT/IT) and students observing interviews (GT). The analysis of the interviews showed significant differences according to scenarios and to gender. Active involvement through SP interviews seems required for students to feel able to reach training objectives. The evaluation of communication skills, revealing a baseline heterogeneity, supports individualised training.

Individual training at the undergraduate level to promote competence in breaking bad news in oncology.

Training medical students in breaking bad news (BBN) in oncology may be key to improve patient care in an area where many physicians tend to be uncomfortable. Given the lack of evidence in the literature, this study aimed to assess empirically the impact of 2 teaching strategies to prepare students for the task of BBN in oncology: one‐to‐one simulated patient (SP) training with individual feedback (intervention group) vs small‐group SP training with collective feedback (comparison group).

The use of video in standardized patient training to improve portrayal accuracy: A randomized post-test control group study.

Abstract Introduction: High-stake objective structured clinical examinations (OSCEs) with standardized patients (SPs) should offer the same conditions to all candidates throughout the exam. SP performance should therefore be as close to the original role script as possible during all encounters. In this study, we examined the impact of video in SP training on SPs’ role accuracy, investigating how the use of different types of video during SP training improves the accuracy of SP portrayal. Methods: In a randomized post-test, control group design three groups of 12 SPs each with different types of video training and one control group of 12 SPs without video use in SP training were compared. The three intervention groups used role-modeling video, performance-feedback video, or a combination of both. Each SP from each group had four students encounter. Two blinded faculty members rated the 192 video-recorded encounters, using a case-specific rating instrument to assess SPs’ role accuracy. Results: SPs trained by video showed significantly (p < 0.001) better role accuracy than SPs trained without video over the four sequential portrayals. There was no difference between the three types of video training. Discussion: Use of video during SP training enhances the accuracy of SP portrayal compared with no video, regardless of the type of video intervention used.

Cultural competence and simulated patients.

Cultural competence education is central in addressing the socio‐cultural factors that affect health care; however, there is little agreement over the best teaching approach. Although simulated patients are widely used in medical education, little is known about their application to cultural competence education.

Integrated problem-based learning versus lectures: a path analysis modelling of the relationships between educational context and learning approaches

ABSTRACT Students’ approaches to learning are central to the process of learning. Previous research has revealed that influencing students’ approaches towards deep learning is a complex process and seems much more difficult than expected, even in student-activating learning environments. There is evidence that learning approaches are impacted not only by the learning environment, but also by how students perceive it. However the nature of the links between the environment itself, the way in which it is perceived by students and students’ learning approaches is poorly understood. This study aimed at investigating the relationships between students’ perception of their educational context and learning approaches in three learning environments differing by their teaching formats (lecture or problem-based-learning PBL) and integration level of the curriculum (traditional or integrated). We tested the hypothesis that a PBL format and an integrated curriculum are associated to deeper approaches to learning and that this is mediated by student perception. The study sample was constituted of 1394 medical students trained respectively in a traditional lecture-based (n = 295), in an integrated lecture-based (n = 612) and in an integrated PBL-based (n = 487) curricula. They completed a survey including the Dundee-Ready-Educational-Environment-Measure (students’ perceptions of the educational environment) and the Revised-Study-Process-Questionnaire (learning approaches). Data were analysed by path analysis. The model showed that the learning environment was related to students’ learning approaches by two paths, one direct and one mediated via students’ perception of their educational context. In the lecture-based curricula students’ used deeper approaches when it was integrated and both paths were cumulative. In the PBL-based curriculum students’ did not use deeper approaches than with lectures, due to opposite effects of both paths. This study suggested that an integrated lecture-based curriculum was as effective as a PBL curriculum in promoting students’ deep learning approaches, reinforcing the importance of integrating the curriculum before choosing the teaching format.