Tjaart Imbos

Evaluation Instruments for Medical Interviewing Skills

This chapter is designed for teachers who want to construct or select assessment methods for evaluating students. The first part of the chapter is devoted to the methodology of evaluating medical interviewing skills. The different types of observers are discussed and justification is given for our focus on the use of trained observers. The categories of interviewing skills and their methods of measurement are introduced. (Categories and coding are covered more extensively in chapter 42.) In the second part of this chapter, criteria are developed to select instruments for evaluation, based on models of medical interviewing, instructional purposes, reliability, and validity. A table summarizing 14 measurement methods is presented and discussed in the third part of the chapter.

Prior knowledge moderates instructional effects on conceptual understanding of statistics

This study investigated the effects of different teaching and learning methods for statistics for 2 levels of prior knowledge on cognitive load, propositional knowledge, and conceptual understanding. Teaching methods were whether or not to provide students with propositional information, and learning strategies were self-explaining the learning material and explaining in pairs. The results indicate that prior knowledge facilitates propositional knowledge development and leads to differential effects of teaching and learning methods on conceptual understanding: Only low prior knowledge students profit from additional information in the learning task and/or explaining in pairs. An implication of these findings is that low prior knowledge students should be guided into the subject matter by means of working in pairs on learning tasks that comprise additional information. Once students have developed more knowledge of the subject matter, they should be stimulated to work individually on learning tasks that do not comprise additional information.

Why should I prepare? a mixed method study exploring the motives of medical undergraduate students to prepare for clinical skills training sessions

BackgroundAlthough preparation for educational activities is considered beneficial for student learning, many students do not perform preparatory assignments. This phenomenon has received little attention in the literature although it might provide medical educators with the opportunity to enhance student learning. Therefore, we explored why students prepare or not prepare.MethodsAn explorative mixed methods study was performed. In a qualitative study, 24 short group interviews with medical undergraduate students (n=209) were conducted on why they prepared for skills training sessions. In a subsequent quantitative study the resulting themes were used to construct a questionnaire. The questionnaire was presented to all undergraduate medical students at Maastricht University and 847 students completed it. Scales were constructed by a combination of exploratory factor analysis, reliability analysis, and content analysis. Between-class differences in the scale scores were investigated using ANOVA.ResultsThe qualitative study showed that students’ opinions on preparation are influenced by both personal factors, categorized as ‘personal learning style’, ‘attitudes and beliefs’, and ‘planning and organization’, as well as external factors, including ‘preparatory advice’, ‘pressure, consequence, and checking of preparation’, ‘teacher-related motivations’, and ‘contents and schedule of the training sessions’. The quantitative study showed that ‘the objective structured clinical examination’ and ‘facilitation of both understanding and memorizing the learning material’, were the two most motivating items. The two most demotivating aspects were ‘other students saying that preparation was not useful’ and ‘indistinct preparatory advices’. Factor analyses yielded three scales: ‘urge to learn’, ‘expected difficulties’, and ‘lack of motivation‘. Between group differences were found between the three classes on the first two scales.ConclusionsStudents make an active and complex choice whether to prepare or not, based on multiple factors. Practical implications for educational practice are discussed.

The Effect of Guidance in Problem-Based Learning of Statistics

Contrary to classical problem-based learning, in guided problem-based learning, the learning goals are predetermined by the instructor—on the basis of a detailed decomposition of the subject matter to be studied—to activate prior knowledge and to structure self-study and subsequent group discussion. This study investigated the effects of classical problem-based learning and guided problem-based learning, for different prior knowledge levels, on perceived value and usefulness of the learning activity and on conceptual understanding of statistics. Participants randomly assigned 110 students to 10 problem-based learning groups, and subsequently, the 10 groups were allocated randomly to classical problem-based learning or guided problem-based learning. The results indicate that guided problem-based learning tends to enhance conceptual understanding of statistics more thanbreak; classical problem-based learning once students have some prior knowledge of the subject. Furthermore, guided problem-based learning tends to increase students’ awareness of the value and usefulness of the learning activity.

The Evaluation System at the Maastricht Medical School

In 1967, the Dutch government established its eighth medical school with the goal of providing a six-year program adapted to the changing needs of the health care system in The Netherlands. Its mandate was to develop educational approaches that reflected modern educational developments. As a result, and in contrast with the other seven Dutch medical schools, the six-year program is primarily oriented toward primary health care and community medicine and the educational approach is based on the principles of “problem-based-self-directed learning”.1

Teaching and Measuring Interviewing Skills in the Maastricht Medical Curriculum

The medical interview is the basic clinical medium in primary care.1,2 Over the last decade, studies have demonstrated the positive influence of adequate interviewing on the physician-patient relationship including patient satisfaction and compliance with medical requirements as well as other aspects of medical competence.3 In large measure, interviewing skills determine what physical and mental problems are presented during the medical consultation.4 Accurate data collecting and diagnosis are therefore closely related to the physicians’ interviewing skills.5,6