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Student faculty rounds: a peer-mediated learning activity for internal medicine clerkships.

Peer-mediated learning is an effective educational strategy that is rarely used during clinical training for medical students. We developed a peer-mediated learning conference, Student-Faculty Rounds (SFR), for the ambulatory component of a medicine clerkship. Designed to broaden students' exposure to common medical problems and provide practice in small-group teaching, the 30-minute conference is conducted by each student once during their clerkship. Students choose their topics and instructional formats, but they are advised to supply written learning objectives and employ interactive, problem solving opportunities. We analysed evaluations written by 280 students and 17 faculty supervisors during 1998-2001. Students presented over 150 topics. The most common were hypercholesterolemia, diabetes, headache, smoking cessation, hypertension management, and cancer screening (each presented in 3-4% of rounds). On a scale of 10 (outstanding) to 0 (lost cause), students gave SFR a score of 9.2 (95% confidence interval 9.0-9.3). In written comments, students indicated that topics were relevant and that peers provided instruction at an appropriate level of complexity, but that quality was variable. Faculty supervisors reported that 35% of students did not provide written learning objectives and 35% chose topics too broad for a 30-minute conference. SFR is a popular conference that accomplishes its educational objectives. It recognizes students' ability to educate themselves, and introduces variability and challenge into the classroom curriculum. Adequate faculty guidance is needed to assure students design conferences for maximum educational effectiveness.

Ambulatory Care↗

Comparison of nurses' self-directed learning activities.

This study compares the self-directed learning (SDL) practices of baccalaureate (40) and master's (40) nurses. Using a personal interview format, nurses were queried as to the number and nature of their SDL projects. Based on the study data, nurses spend a greater portion of their SDL time on professional area content. Respondents indicated they spend an average of 313 hours per year on independent learning projects with 217 of those hours on professional topics. Master's-prepared nurses spend more time per year (398 hours) and slightly more time on professional content (71%) compared to the time baccalaureate-prepared nurses spend per year (230 hours) on professional content (67%). Implications for nursing education are identified with respect to learner motivation and accessibility of materials.

Adult↗

Boolean matrix logic programming for active learning of gene functions in genome-scale metabolic network models.

Reasoning about hypotheses and updating knowledge through empirical observations are central to scientific discovery. In this work, we applied logic-based machine learning methods to drive biological discovery by guiding experimentation. Genome-scale metabolic network models (GEMs) - comprehensive representations of metabolic genes and reactions - are widely used to evaluate genetic engineering of biological systems. However, GEMs often fail to accurately predict the behaviour of genetically engineered cells, primarily due to incomplete annotations of gene interactions. The task of learning the intricate genetic interactions within GEMs presents computational and empirical challenges. To efficiently predict using GEM, we describe a novel approach called Boolean Matrix Logic Programming (BMLP) by leveraging Boolean matrices to evaluate large logic programs. We developed a new system, [Formula: see text], which guides cost-effective experimentation and uses interpretable logic programs to encode a state-of-the-art GEM of a model bacterial organism. Notably, [Formula: see text] successfully learned the interaction between a gene pair with fewer training examples than random experimentation, overcoming the increase in experimental design space. [Formula: see text] enables rapid optimisation of metabolic models to reliably engineer biological systems for producing useful compounds. It offers a realistic approach to creating a self-driving lab for biological discovery, which would then facilitate microbial engineering for practical applications.

Active learning↗

Students' perceptions of learning outcomes from group-based, problem-based teaching and learning activities.

OBJECTIVE: A study aimed at exploring the variation in perceptions of learning outcomes reported by undergraduate nursing students enrolled in a problem-based learning subject in a pre-registration Bachelor of Nursing course (BN). METHOD: Students were asked to respond to four open-ended questions which focussed on their learning outcomes in the different teaching/learning modalities of the subject. Data were analysed in two phases using a modified phenomenographic analysis. In the first phase a set of categories of description were developed from the student responses to questions related to the learning modalities. In the second phase the individual responses were classified in terms of the categories. Finally, correlations between the learning modalities were identified. In this paper the approach to analysis, the process of category identification and the correlations between the learning modalities will be described and the implications for further research and teaching will be discussed. RESULTS: The findings indicated that there were two distinct groups of student responses. Inward focussed students who described outcomes in terms of their own learning and students whose focus was outward i.e. describing learning in terms of patient care and how learning relates to that care. Another important result shows the relationship between the learning modalities and outcomes. From the students' perspective, the most sophisticated outcomes of the lectures and laboratories were ideas and skills to be used and applied in clinical settings. Whereas, the group-based activities in which clinical problems were presented to the students in the form of Situation Improvement Packages (SIPS) focussed their attention on the clinical setting which constituted a preparation for the realities of clinical practice. CONCLUSION: The findings from this study indicate that students perceive their learning in the group based teaching/learning modality (SIPS) as effective in focussing them on the reality of their role in the clinical practice environment while lectures and laboratories provided the skills and knowledge required for this setting.

Curriculum↗

What do students want? The types of learning activities preferred by final year medical students.

CONTEXT: A well-aligned curriculum has consistent focus on curricular goals, teaching/learning activities and assessment. Poor alignment affects the way students budget learning time and may interfere with achievement of curricular goals. We noticed students' poor attendance in clinical clerkships prior to final examinations and hypothesised that they were responding to curricular misalignment. OBJECTIVES: To quantify the extent to which students and tutors perceived a mismatch between activities pertaining to their current clerkship and those they thought necessary to prepare for final examinations and internship. SUBJECTS: Medical students in final (sixth) year clerkships in medicine, surgery and critical care and clinical tutors. METHOD: A self-report questionnaire on time spent in clerkship activities was administered 3 months before the final examinations. RESULTS: The amounts of time spent on current activities were fairly evenly spread over teaching, study and self-directed patient contacts, and observing patient care (ward rounds, operating theatre, accident and emergency, outpatient department and clinical meetings). Less time was available for recreation. Students and tutors concurred, independently, that good examination and internship preparation required a shifting of the balance. Examination preparation redistributed time from observing patient care and recreation to study and self-directed patient contacts. Internship preparation redistributed time from teaching and recreation to observing patient care. CONCLUSION: Students and tutors perceived that current activities were not well aligned with assessment requirements but were better aligned with the requirements of internship. If we want students to direct their attention towards curricular goals, we need to bring goals, teaching/learning activities and assessment into alignment.

Australia↗

An active learning experience in health policy for baccalaureate nursing students.

Nurses have the potential to promote the public's health through active involvement in shaping health and social policy. Preparing nursing students to influence public policy is a major component of the curriculum in public/community health nursing. A series of learning experiences was designed to engage students in this process. First, students participate in information sessions at the State Health Department and the State House. This provides them with opportunities to engage in dialogue with public health leaders as well as advocates from both professional organizations and community groups. Next, students identify the legislators who represent them in the community and write a narrative that describes the legislators' interest and commitment to health-related legislation. Lastly, students work in clinical groups to analyze a public health problem that can be addressed through public policy interventions. This has led to the students testifying at legislative hearings and working with community groups involved with the issue. The students present their findings to their peers and to the wider college community. Through these learning experiences, students gain practical experience in understanding the political process that leads to important policy change. This in turn prepares them for their roles as professional nurses and involved citizens.

Attitude of Health Personnel↗

Using remote access to scientific instrumentation to create authentic learning activities in pharmaceutical analysis.

OBJECTIVES: To pilot test and evaluate a gas chromatography-mass spectrometry (GCMS) case study as a teaching and learning tool. DESIGN: A case study incorporating remote access to a GCMS instrument through the Integrated Laboratory Network (ILN) at Western Washington University was developed and implemented. Student surveys, faculty interviews, and examination score data were used to evaluate learning. ASSESSMENT: While the case study did not impact final examination scores, approximately 70% of students and all faculty members felt the ILN-supported case study improved student learning about GCMS. Faculty members felt the "live" instrument access facilitated more authentic teaching. Students and faculty members felt the ILN should continue to be developed as a teaching tool. CONCLUSION: Remote access to scientific instrumentation can be used to modify case studies to enhance student learning and teaching practice in pharmaceutical analysis.

Computer-Assisted Instruction↗

Learning activation rules rather than connection weights.

In the construction of neural networks involving associative recall, information is sometimes best encoded with a local representation. Moreover, a priori knowledge can lead to a natural selection of connection weights for these networks. With predetermined and fixed weights, standard learning algorithms that work by altering connection strengths are unable to train such networks. To address this problem, this paper derives a supervised learning rule based on gradient descent, where connection weights are fixed and a network is trained by changing the activation rule. It incorporates both traditional and competitive activation mechanisms, the latter being an efficient method for instilling competition in a network. The learning rule has been implemented, and the results from several test networks demonstrate that it works effectively.

Algorithms↗

ROPES: an experiential learning activity for leadership skills.

The cluster of activities called ROPES is borrowed and modified for teaching from OUTWARD Bound, the renowned outdoor management training program. ROPES uses experiential learning situations in which characteristic problem-solving tasks encourage the participants to stretch their personal limits and to learn teamwork. In doing so, trust, self-confidence, and communication and leadership skills develop through accomplishment of specific challenging activities. ROPES activities were found to be an effective method of instruction for teaching leadership in a senior nursing leadership course.

Clinical Competence↗