Moderated by Aviad Haramati

PRESENTATION 1 - Increasing motivation for research and scientific reasoning skills in undergraduate biomedical students using inquiry based and team based learning    
Nelleke Gruis    
Leiden University Medical Center

PURPOSE To introduce first-year students in the Biomedical Science program at Leiden University Medical Center (LUMC) to scientific reasoning, a 10-day introductory course on the topic of skin cancer is offered. In order to further enhance student initiative, curiosity, motivation and self-regulating skills, a combination of inquiry based learning (IBL) and team based learning (TBL) was introduced in 2020 and 2021. Both courses were delivered online due to covid restrictions. In this study we report on how the students perceive their abilities, motivation and performance in the research activities offered.

METHODS A validated self-efficacy questionnaire was offered to the students before and after the course. To systematically evaluate the intervention the outcomes of the LUMC course evaluations tool (GOES) over the years 2018 and 2019 (pre-intervention) and 2020 and 2021 were used.

RESULTS Outcomes of the GOES show that students in 2020/2021 had a better understanding of the course subject skin cancer. Knowledge enhancement in the workgroups and activation in learning activities scored significantly higher in 2020 and 2021, compared to previous years. The TBL format was well received and allowed for optimum interaction, peer learning and acquaintance. In 2020 and 2021 students filled out the self-efficacy questionnaire before (n=135) and after the course (n=76). Over the course students' scores significantly increased on three aspects: "research activities challenges me"; "I see multiple solutions when seeing a problem'; and "I am busy solving problems which I think should be solved".

CONCLUSION We observed that students rather quickly picked-up the skill of defining research questions and were able to deepen their eagerness for more biomedical knowledge by team based learning.  Introduction of IBL and TBL stimulated self-regulation aspects such as autonomy, sense of competence and relatedness to peers, resulting in an early authentic, undergraduate research experience with more active and motivated students. 
 

PRESENTATION 2 - Faculty and Students Agree That Team-based Learning Meets Important Goals in Medical Education  
Jade Woodcock    
Western Michigan University Homer Stryker M.D. School of Medicine

PURPOSE Team-based learning (TBL) has been shown to be an effective learning modality, yet student resistance is common. One possible source of resistance may arise when students and instructors do not think TBL is aligned with the important goals of medical education. It is also important for students and instructors to have a similar understanding of the goals of TBL. The purpose of this study was to better understand how well faculty and students perceive that TBL meets important goals of medical education in the preclinical undergraduate medical education curriculum at Western Michigan University Homer Stryker M.D. SOM (WMed).

METHODS A survey of fourteen possible goals for TBL was developed based on prior literature and thematic analysis of interviews and focus groups with students and faculty. The survey was distributed to the graduating classes of 2021, 2022, and 2023 (127/239=53% response rate), and all basic science faculty (11/11=100% response rate) in the biomedical sciences department. The survey contained three sections pertaining to the goals of TBL at WMed.

RESULTS Faculty and students are largely aligned regarding the goals of TBL at WMed. Both groups agreed TBL supports most of the fourteen goals. There were statistically significant differences (p > 0.01) between how well faculty and students felt TBL supported two of the goals. Students felt the current use of TBL at WMed did not sufficiently support the goal of introducing new content. Faculty felt more strongly than students that TBL helps to prepare students for clerkships.

CONCLUSION Although faculty and students generally agreed about the importance of the goals identified for TBL at WMed, there were some important differences. An intentional discussion of the process and goals at the start of each course may benefit both faculty and students in terms of cohesiveness and buy-in for the TBL process. 
 

PRESENTATION 3 - Establishing a Virtual Reality Temporal Bone Drilling Simulation Laboratory - Is It Useful?    
Emma Richards    
Queen Elizabeth Hospital Birmingham

PURPOSE To assess and compare the confidence, objectives and experience of junior ENT doctors before and after mastoid surgery training using the VOXEL-MAN (VM) Virtual Reality (VR) Temporal Bone (TB) Simulator.

METHODS Candidates attended a 3-hour course at the West-Midlands VR TB Laboratory (Lab) between June and September 2021, and completed pre- and post- course questionnaires asking about general demographics, sub-speciality interests, previous TB course and mastoid surgery experience, as well as learning objectives (LO) for the course (list of 16 options). Additionally, confidence with key steps of TB surgery was self-rated by participants prior to and following the course.

RESULTS Twenty-five (17 M:8 F) junior doctors attended mastoid surgery training courses in the VR TB Lab, of which 96% (24/25) completed pre- and post-course questionnaires. Candidates included Foundation Trainee Year 3 to Specialist Trainee (ST) Year 6, and included four non-training grade doctors. Eleven were classed 'junior candidates' (JCs; ST3s and below), and 14 'senior candidates' (SCs; ST4 and above). Two had previous VR TB experience, and 18/24 (75%) had TB wet lab experience. One JC (9%) had performed a cortical mastoidectomy versus 100% of the SCs. All (100%) JCs wished to make a start on learning TB anatomy and how to drill a TB. These LOs were successfully achieved by all (100%) JCs. SCs had more diverse objectives with focus on more specific skill development. Those chosen to focus on during the 3-hour course were met. Improvement in confidence was made in all six domains assessed. An appropriate level of supervision was reported by 22/24 (92%) and 23/24 (96%) rated the course as 'extremely useful'. All (100%) felt they would benefit from attending again and would recommend it to others.

CONCLUSION This suggests that junior doctors of varying previous experience can benefit from VR TB Lab Courses.
 

PRESENTATION 4 - Effectiveness of Problem-Based Learning in Undergraduate Medical Education: A Systematic Review    
Naunihal Zaveri    
Arkansas College of Osteopathic Medicine

PURPOSE: Problem-based learning (PBL) has been in use in medical education for over fifty years, and there is a need to evaluate how learning and skill development improve with PBL. The purpose of this systematic review is to summarize the available evidence on whether PBL is more effective in helping students enhance cognitive integration and/or improve life-long learning skills, compared to lectures or traditional learning. Secondarily, does PBL promote active self-directed learning skills?

METHODS: Studies were included if undergraduate medical students were taught using a PBL approach and if their performance was compared to lecture-based learning. Outcome measures included performance on national or local examinations or assessment by questionnaire or survey. Observation, quasi-experimental, and experimental studies published in English from 2007-2020 were included. PubMed, Embase, ERIC, CINAHL Plus, and PsychInfo were queried on December 31, 2020. The risk of bias was assessed for each included study. Results were qualitatively assessed.

RESULTS: From the literature search, 205 articles were screened and subjected to inclusion/exclusion criteria in the first-pass review, resulting in a total of 34 articles. After the second-pass review, a total of 8 articles which studied 3,103 subjects were used for data extraction. The observational designs of the studies led to low quality assessment scores (highest score being 8 on a scale of 12). Overall, students prefer PBL, and PBL-taught students have exam scores that are equal to or better than those from lecture-based classes. There is a strong likelihood that publication bias may have affected the patterns revealed in this study.

CONCLUSIONS: Of the studies examined, the evidence that PBL improves learning over traditional teaching modalities in undergraduate medical students is equivocal. Since PBL is learner-centered and promotes a social, collaborative, transdisciplinary approach to cognitive integration, it will likely continue to be implemented in medical education widely.