Content analysis of medical students’ seminars: a unique method of analyzing clinical thinking

BMC Medical Education

Hidekazu Terasawa^1,10  Hitomi Kataoka⁹  Tomoko Miyoshi⁹  Mikako Obika⁸  Yasuharu Tokuda^1,11  Hironobu Tokunaga^1,10  Hidetaka Kitazono⁵  Hitoshi Honda^1,12  Yuka Kitano³  Shun Kohsaka⁴  Akiko Arai¹  Kuniyuki Endo²  Gerald H Stein⁶  Yukari Takata⁷ 

[1] University of Florida College of Health and Human Performance, Gainesville, Florida, USA;Nagoya Daini Red Cross Hospital, Nagoya, Japan;St Marianna University School of Medicine, Kanazawa, Japan;Keio University School of Medicine, Tokyo, Japan;Noguchi Bayside Hospital, Chiba, Japan;Department of Medicine and Veterans Affairs Medical Center, University of Florida College of Medicine, Gainesville, Florida, USA;University of Florida College of Journalism and Communications, Gainesville, Florida, USA;Center for Graduate Medical Education, Okayama University Medical School, Okayama, Japan;Department of Medical Education and Primary Care, Okayama University Medical School, Okayama, Japan;Department of Emergency Medicine, University of Fukui Faculty of Medical Sciences, Fukui, Japan;Institute of Clinical Medicine, Graduate School of Comprehensive Human Sciences, University of Tsukuba School of Medicine, Mito, Ibaraki, Japan;Teine Keijinkai Hospital, Sapporo, Japan

关键词: Clinical thinking development;    Communication measurement;    Problem-based learning;   

Others  :  1135775
DOI  :  10.1186/1472-6920-13-156

 received in 2013-04-02, accepted in 2013-11-25,  发布年份 2013

【 摘 要 】

Background

The study of communication skills of Asian medical students during structured Problem-based Learning (PBL) seminars represented a unique opportunity to assess their critical thinking development. This study reports the first application of the health education technology, content analysis (CA), to a Japanese web-based seminar (webinar).

Methods

The authors assigned twelve randomly selected medical students from two universities and two clinical instructors to two virtual classrooms for four PBL structured tutoring sessions that were audio-video captured for CA. Both of the instructors were US-trained physicians. This analysis consisted of coding the students’ verbal comments into seven types, ranging from trivial to advanced knowledge integration comments that served as a proxy for clinical thinking.

Results

The most basic level of verbal simple responses accounted for a majority (85%) of the total students’ verbal comments. Only 15% of the students’ comments represented more advanced types of critical thinking. The male students responded more than the female students; male students attending University 2 responded more than male students from University 1. The total mean students’ verbal response time for the four sessions with the male instructor was 6.9%; total mean students’ verbal response time for the four sessions with the female instructor was 19% (p < 0.05).

Conclusions

This report is the first to describe the application of CA to a multi-university real time audio and video PBL medical student clinical training webinar in two Japanese medical schools. These results are preliminary, mostly limited by a small sample size (n = 12) and limited time frame (four sessions). CA technology has the potential to improve clinical thinking for medical students. This report may stimulate improvements for implementation.

【 授权许可】

   
2013 Takata et al.; licensee BioMed Central Ltd.

【 图 表 】

Figure 1.

Figure 2.

Figure 3.

Figure 4.

【 参考文献 】

• [1]Eva K: What every teacher needs to know about clinical reasoning. Med Educ 2004, 39:98-106.
• [2]Ark T, Brooks L, Eva K: Giving learners the best of both worlds: do clinical teachers need to guard against teaching pattern recognition to novices? Acad Med 2006, 81:405-409.
• [3]Rencic J: Twelve tips for teaching expertise in clinical reasoning. Med Teach 2011, 33(11):887-892.
• [4]Miflin B, Campbell C, Price D: A conceptual framework to guide development of self-directed, lifelong learning in problem-based medical curricula. Med Educ 2000, 34:299-306.
• [5]Wood D: ABC of learning and teaching in medicine. Problem based learning. BMJ 2003, 326:328-330.
• [6]Borg W, Gall M: The methods and tools of observational research. In Educational research: an introduction. 5th edition. Edited by Borg W, Gall M. London: Longman; 1989:473-530.
• [7]Hara N, Bonk C, Angeli C: Content analysis of online discussion in an applied educational psychology course. Instr Science 2000, 28:115-152.
• [8]Garrison D, Anderson T, Archer W: Critical thinking, cognitive presence and computer conferencing in distant education. Am J Dist Educ 2001, 15(1):7-23.
• [9]De Grave WS, Boshuizen HP, Schmidt HG: Problem based learning: cognitive and metacognitive processes during problem analysis. Instr Sci 1996, 24:321-341.
• [10]Goldszmidt M, Aziz N, Lingard L: Taking a detour: positive and negative effects of supervisors’ interruptions during admission case review discussions. Acad Med 2012, 87(10):1-7.
• [11]Khoo H: Implementation of problem-based learning in Asian medical schools and students’ perceptions of their experience. Med Educ 2003, 37:401-409.
• [12]Inada H, Mitsunami K, Motohara S, Fetters M: Increasing motivation of medical students through a participatory style of learning: a case study demonstrating how to move away from ‘osmotic learning. Med Educ (Japan) 2010, 41(5):347-351.
• [13]Teo A: The current state of medical education in Japan: a system under reform. Med Educ 2007, 41:302-308.
• [14]Rao H: Perspectives in medical education 5. Implementing a more integrated, interactive and interesting curriculum to improve Japanese medical education. Keio J Med 2007, 56:75-85.
• [15]Rao H, Rao K: Perspectives in medical education 9. Revisiting the blueprint for reform of medical education in Japan. Keio J Med 2010, 59(2):52-63.
• [16]Wimmer R, Dominick J: Mass Media Research: An Introduction. 6th edition. Belmont, California: Wadsworth; 2000:154.
• [17]Rees C, Sheard C, McPherson A: Communication skills assessment: the perceptions of medical students at the University of Nottingham. Med Educ 2002, 36:868-878.
• [18]Windish D, Eboni G, Clever S, Magaziner J, Thomas P: Teaching medical students the Important connection between communication and clinical Reasoning. J Gen Intern Med 2005, 20:1108-1113.
• [19]Mukohara K, Kitamura K, Wakabayashi H, Abe K, Sato J, Ban N: Evaluation of a communications skills seminar for students in a Japanese medical school: a non-randomized controlled study. BMC Med Educ 2004, 4:24. http://www.biomedcentral.com/1472-6920/4/24 webcite BioMed Central Full Text
• [20]Hauer KE, O’Brian BC, Hansen LA, Hirsh D, Ma IH, Ogur B, Poncelet AN, Alexander EK, Teherani A: More is better: students describe successful and unsuccessful experiences with teachers differently in brief and longitudinal relationships. Acad Med 2012, 87(10):1-8.
• [21]Prober CG, Heath C: Lecture halls without lectures - A proposal for medical education. N Eng J Med 2012, 366(18):1657-1659.
• [22]Rice K, Zwarenstein M, Conn LG, Kenaszchuk C, Russell A, Reeves S: An intervention to improve interprofessional collaboration and communication: a comparative qualitative study. J Interprof Care 2010, 24(4):350-361.
• [23]Riesenberg LA, Little BW, Wright V: Nonphysician medical educators: a literature review and job description resource. Acad Med 2009, 84(8):1078-1088.
• [24]Graneheim UH, Lundman B: Qualitative content analysis in nursing research: concepts, procedures and measures to achieve trustworthiness. Nurs Educ Today 2004, 24:105-112.
• [25]Elos S, Kyngas H: The qualitative content analysis process. J Adv Nurs 2008, 62(1):107-115.
• [26]Kondrack NL, Wellman NS, Amundson D: Content analysis: review of methods and their applications in nutrition education. J Nutr Educ Behav 2002, 34:224-230.
• [27]Levis DM, Westbrook K: A content analysis of preconception health education materials: characteristics, strategies, and clinical-behavioral components. Amer J Health Promo 2013, 27(3s):s36-s42.
• [28]Sokol J, Wackowski O, Lewis MJ: Marketing pharmaceutical drugs to women in magazines: a content analysis. A J Health Behav 2010, 34(4):402-411.
• [29]Hernández-Garbanzo Y, Griffin S, Cason KL, Loberger G, Williams J, Baker S, Coffee A, Linton B, Hall T, Hayden V: A content analysis of nutrition education curricula used with low-income audiences: implications for questionnaire development. Health Promot Pract 2013, 14(4):534-542.
• [30]WHO publication: Interprofessional collaborative practice in primary health care: nursing and midwifery perspectives. Hum Resour Health Obs 2013., (13) http://www.who.int/hrh/resources/observer13/en/index.html webcite
• [31]Dyrbye LN, Starr SR, Thompson GB, Lindor KD: A model for integration of formal knowledge and clinical experience: the advanced doctoring course at Mayo Medical School. Acad Med 2011, 86(9):1130-1136.
• [32]Onyon C: Problem-based learning: a review of the educational and psychological theory. Clin Teach 2012, 9:22-26.
• [33]Schmidt H, Muijtjens A, Cees P, Van der Vleuten C, Norman G: Differential student attrition and differential exposure mask effects of problem-based learning in curriculum comparison studies. Acad Med 2012, 87(4):2012.