Sissel Guttormsen

Affective computing--a rationale for measuring mood with mouse and keyboard.

Emotions are an increasingly important factor in Human-Computer Interaction (HCI). Up to the present, emotion recognition in HCI implies the use of explicit or intrusive methods, for example, video cameras or physiological measurements. We are developing and evaluating a method for the measurement of affective states through motor-behavioral parameters from standard input devices (mouse and keyboard).

The new licencing examination for human medicine: from concept to implementation

A new Swiss federal licencing examination for human medicine (FLE) was developed and released in 2011. This paper describes the process from concept design to the first results obtained on implementation of the new examination. The development process was based on the Federal Act on University Medical Professions and involved all national stakeholders in this venture. During this process questions relating to the assessment aims, the assessment formats, the assessment dimensions, the examination content and necessary trade-offs were clarified. The aims were to create a feasible, fair, valid and psychometrically sound examination in accordance with international standards, thereby indicating the expected knowledge and skills level at the end of undergraduate medical education. Finally, a centrally managed and locally administered examination comprising a written multiple-choice element and a practical “clinical skills” test in the objective structured clinical examination (OSCE) format was developed. The first two administrations of the new FLE show that the examination concept could be implemented as intended. The anticipated psychometric indices were achieved and the results support the validity of the examination. Possible changes to the format or content in the future are discussed.

The new final Clinical Skills examination in human medicine in Switzerland: Essential steps of exam development, implementation and evaluation, and central insights from the perspective of the national Working Group.

Objective: Since 2011, the new national final examination in human medicine has been implemented in Switzerland, with a structured clinical-practical part in the OSCE format. From the perspective of the national Working Group, the current article describes the essential steps in the development, implementation and evaluation of the Federal Licensing Examination Clinical Skills (FLE CS) as well as the applied quality assurance measures. Finally, central insights gained from the last years are presented. Methods: Based on the principles of action research, the FLE CS is in a constant state of further development. On the foundation of systematically documented experiences from previous years, in the Working Group, unresolved questions are discussed and resulting solution approaches are substantiated (planning), implemented in the examination (implementation) and subsequently evaluated (reflection). The presented results are the product of this iterative procedure. Results: The FLE CS is created by experts from all faculties and subject areas in a multistage process. The examination is administered in German and French on a decentralised basis and consists of twelve interdisciplinary stations per candidate. As important quality assurance measures, the national Review Board (content validation) and the meetings of the standardised patient trainers (standardisation) have proven worthwhile. The statistical analyses show good measurement reliability and support the construct validity of the examination. Among the central insights of the past years, it has been established that the consistent implementation of the principles of action research contributes to the successful further development of the examination. Conclusion: The centrally coordinated, collaborative-iterative process, incorporating experts from all faculties, makes a fundamental contribution to the quality of the FLE CS. The processes and insights presented here can be useful for others planning a similar undertaking.

Learning communication from erroneous video-based examples: A double-blind randomised controlled trial

OBJECTIVE Appropriate training strategies are required to equip undergraduate healthcare students to benefit from communication training with simulated patients. This study examines the learning effects of different formats of video-based worked examples on initial communication skills. METHODS First-year nursing students (N=36) were randomly assigned to one of two experimental groups (correct v. erroneous examples) or to the control group (no examples). All the groups were provided an identical introduction to learning materials on breaking bad news; the experimental groups also received a set of video-based worked examples. Each example was accompanied by a self-explanation prompt (considering the examples correctness) and elaborated feedback (the true explanation). RESULTS Participants presented with erroneous examples broke bad news to a simulated patient significantly more appropriately than students in the control group. Additionally, they tended to outperform participants who had correct examples, while participants presented with correct examples tended to outperform the control group. CONCLUSION The worked example effect was successfully adapted for learning in the provider-patient communication domain. PRACTICE IMPLICATIONS Implementing video-based worked examples with self-explanation prompts and feedback can be an effective strategy to prepare students for their training with simulated patients, especially when examples are erroneous.

Coping through blogging: A review of studies on the potential benefits of weblogs for stress reduction

This paper provides a descriptive overview of the empirical evidence for potential effects of reflective weblog writing for coping with stress. Seventeen studies meeting the inclusion criteria are summarized in a systematic synopsis. Sixteen studies focus on self-initiated blogging in informal contexts. Only one study examines mandated weblog writing for coping in an institutionalized context. Results indicate that the public nature of weblogs opens up a variety of possibilities for both problem-focused and emotion-focused coping, most importantly through social support. Although these studies show promising results, it remains unclear if and how the benefits of self-initiated blogging can be transferred to more formal settings. Thus, future research should examine how blogging can be mandated and scaffolded in order to foster coping strategies and decrease stress levels. For this purpose, experimentally controlled and longitudinal studies are needed to evaluate the effectiveness of this approach.

The learning effects of different presentations of worked examples on medical students’ breaking-bad-news skills: A randomized and blinded field trial

OBJECTIVES Effective instructional approaches are needed to enable undergraduates to optimally prepare for the limited training time they receive with simulated patients (SPs). This study examines the learning effects of different presentation formats of a worked example on student SP communication. METHODS Sixty-seven fourth-year medical students attending a mandatory communication course participated in this randomized field trial. Prior to the course, they worked through an e-learning module that introduced the SPIKES protocol for delivering bad news to patients. In this module, a single worked example was presented to one group of students in a text version, to a second group in a video version, and to a third group in a video version enriched with text hints denoting the SPIKES steps. RESULTS The video-with-hints group broke bad news to SPs significantly more appropriately than either of the other groups. Although no further condition-related effects were revealed, students who learned from the text version most frequently (although non-significantly) ignored unpleasant emotions (standardised emotional cues and concerns) expressed by the SPs. CONCLUSIONS The learning effect was strongest when the video-based worked example was accompanied by hints. PRACTICE IMPLICATIONS Video-related learning approaches that embed attention-guiding hints can effectively prepare undergraduates for SP encounters.

Cognitive load in internal medicine: What every clinical teacher should know about cognitive load theory

Internal medicine is an appropriate example of specialties in which to teach learners clinical reasoning skills, decision-making, and analytical thinking, as well as evidence-based, patient-oriented medicine. During daily clinical work, general internists always encounter a multitude of situations that lend themselves to educating medical trainees in ambulatory and inpatient settings. Application of existing learning theories to teaching has been shown to optimize teaching ability and to maximize the efficiency of teaching efforts. Cognitive Load Theory explains learning according to three important aspects: the types of memory (working and long-term memory), the learning process and the forms of cognitive load that affect our learning. The aim of this paper is to show the main perspectives and implications of the Cognitive Load Theory on clinical educational practices. It is important to give the right amount of information in the most effective way to learners, thereby making this information more useful. This article presents a concise overview of the basis of the Cognitive Load Theory in its first part, and, in its second part, it exposes the practical applications of this theory with examples. This learning theory will encourage clinical teachers to reflect on how to foster learning in medical trainees in the more effective way.

GMA Annual Conference 2016 in Bern – Conference Report

Under the motto “Innovative Together” and for the first time in 15 years, the annual meeting of the Association for Medical Education (GMA) was held in Switzerland from 14 to 17 September 2016. More than 450 participants made their way to Bern and contributed to a lively event, by presenting their projects, moderating, discussing, asking questions and providing answers. Under the patronage of the two conference presidents Sissel Guttormsen (Bern) and Christian Schirlo (Zurich), 274 scientific papers and 36 workshops tackled various projects and questions of education, further education and CPD in human, dental, veterinary medicine and academic health professions. All contributions had previously been critically reviewed by two reviewers. The abstracts for all scientific contributions were published via the German Medical Science (GMS) portal for the conference and are available at http://www.egms.de/dynamic/en/meetings/gma2016/ index.htm. Various welcome speakers from the Swiss educational landscape as well as exhibitors provided valuable contributions and together with the sponsors and our cooperation partners (Federal Office of Public Health of the Federal Department of Home Affairs and the Robert Bosch Foundation), provided a framework for the conference. The program is available online at http://box.iml. unibe.ch/gma-programm/GMA2016_Prog.pdf. Program

Die neue eidgenössische Prüfung hat einen Mehrwert

Wir danken Herrn Professor Martin Fey für die ausführliche Reaktion [1] auf unseren Artikel [2] und die Hinweise auf wichtige, nicht gelöste Problemkreise. Zwischen zwei lateinischen Redewendungen vermittelt Herr Fey seine Botschaft mit dem Tenor, dass früher alles besser war. Es ist uns ein Anliegen, die Notwendigkeit des Fortschritts in Bezug auf Inhalt, Form und Wissenschaft für die eidgenössische Prüfung (EP) darzustellen. Als Erstes einige Richtigstellungen: – Nicht die eidgenössische Prüfungskommission (PK) hat die Inhalte der EP oder den Wechsel von der alten zur neuen Ordnung beschlossen, sondern das Medizinalberufegesetz (MedBG) legt die Rahmenbedingungen für die Prüfungen der Medizinalberufe fest. Die PK setzt die EP im Einklang mit dem Gesetz um und bezieht aktiv die verschiedenen Stakeholder, insbesondere die medizinischen Fakultäten und deren Experten, ein. – Die neue EP besteht seit 5 Jahren aus zwei klinischen Prüfungen: eine schriftliche und eine praktische. Bekanntlich setzt das «Tun» eine Wissensbasis voraus. Ein duales Verständnis, wie Herr Fey den Unterschied zwischen «Wissen» und «Tun» aufstellt, liegt uns fern. Die EP erfasst klinisches Können auf zwei Arten: schriftlich und praktisch. Bei beiden Teil-Prüfungen ist Clinical Reasoning eine Voraussetzung für erfolgreiche Lösungen. Die statistischen Ana lysen zeigen, dass sich die zwei aktuellen Prüfungsformen gut ergänzen und unterschiedliche Aspekte prüfen. – Nach sechs Jahren Studium ist die EP eine letzte Qualitätssicherungsmassnahme für die Lizenzierung und damit den Eintritt in die klinische Arbeit. Selbstverständlich wird angestrebt, dass möglichst alle Kandidatinnen und Kandidaten die Prüfung bestehen. Bei jenen, die nicht bestehen, handelt es sich um eine negative Selektion einer Minderheit. Diese nach abgeschlossenem Medizinstudium zu erkennen, muss auf methodisch und wissenschaftlich stichfester Grundlage beruhen. – Rekurse kommen immer wieder vor, sie sind aber selten und sie leiten mit Sicherheit nicht unser Handeln. Im Vordergrund steht ein valides und faires Examen mit vergleichbaren Bedingungen für alle! Herr Fey vermisst die alten Zeiten, in denen der direkten Interaktion zwischen Meister und Lehrling mehr Raum gegeben wurde. Selbstverständlich ist die direkte Interaktion des erfahrenen Lehrers mit den Studierenden und realen Patienten zentral für die medizinische Ausbildung und sollte so oft wie möglich im Rahmen des sechsjährigen Medizinstudiums umgesetzt werden. Es steht jeder Fakultät frei, während der Ausbildung unterschiedliche Lehrund Assessmentformen umzusetzen, vieles in der Art ist auch bereits erfolgreich

Eidgenössische Prüfung Clinical Skills: Die neue nationale klinisch-praktische Schlussprüfung in Humanmedizin der Schweiz

Bitte zitieren als: Schurter T, König B, Vichard E, van Gessel E, Bonvin R, Maier V, Keller U, Kropf R, Beyeler C, Guttormsen S, Huwendiek S. Zentrale Erkenntnisse der Qualitätssicherung des schriftlichen Teils der Schweizer Schlussprüfung Humanmedizin nach 6 Jahren. In: Jahrestagung der Gesellschaft für Medizinische Ausbildung (GMA). Bern, 14.-17.09.2016. Düsseldorf: German Medical Science GMS Publishing House; 2016. DocV33-224. DOI: 10.3205/16gma179, URN: urn:nbn:de:0183-16gma1799 Frei verfügbar unter: http://www.egms.de/en/meetings/gma2016/16gma179.shtml