Medical Science Educator Volume 15: No. 1

The Medical Educator’s Resource Guide

John R. Cotter, Ph.D.

The websites reviewed in the Medical Educator’s Resource Guide are recognized by our reviewers as sites that can be used by medical educators and students for instruction and learning of the medical sciences. Nonetheless, before deciding to augment a course with an additional instructional tool, some thought should be given to the way a website… Read more »

Guided Discovery Learning with Videotaped Case Presentation in Neurobiology

Robert A. Lavine, Ph.D.


Research in psychology and education with students at the pre-college level suggests that guided discovery learning is superior to the less-structured approach of pure discovery learning in promoting learning and knowledge transfer.1 In medical education, guided discovery learning is a learner-centered approach that combines didactic instruction with more student-centered and task-based approaches.2 Key features are (1) a framework for student learning, (2) student responsibility for exploring content needed for understanding, (3) study guides provided, and (4) application to clinical or experimental problems. This paper describes an example from an interdisciplinary neurobiology course for first-year medical students. Following didactic presentations of nervous system structure and function, we present an introduction to the clinical case, an outline of the neurological examination, and assignment of a written report. Study resources are provided. This is followed several days later by the presentation of a videotaped case of a patient admitted with a stroke one year ago, with a neurologist taking the history and reviewing the examination at admission. Each segment was followed by the instructor, a member of the neurology faculty, questioning students and inviting discussion on differential diagnosis based upon their knowledge of neuroanatomy and neurophysiology. Students were asked to evaluate this component of the course on a 1-6 Likert rating scale (1=strongly agree to 6=strongly disagree). 79 to 88% strongly agreed or agreed that it ??bf?increased my knowledge of neurobiology??bf?, ??bf?increased my motivation to learn neurobiology??bf?, ??bf?increased my ability to apply neurobiology to clinical problems??bf?, and ??bf?improved my understanding, motivation to learn, and/or ability to apply neurobiology more than a typical lecture??bf?. An objective performance measure is cited as an approach to the effect on learning. The results suggest that the clinical case presented by means of guided discovery learning serves to focus on real problems and adds relevance and motivation to mastery of related basic science information.

The Value of Scientific Drivers to Enhance Learning for Basic Science Clinicians, Faculty, and Students

L. K. Gunzburger, Ph.D.

Diabetes mellitus currently affects 17 million people in the United States, with the vast majority, 8% of the adult population, having Type 2 Diabetes Mellitus (T2DM). It has become epidemic in the past several decades due to the advancing age of the population, increased prevalence of obesity and decreased physical activity. Diabetes causes considerable morbidity… Read more »

Active Learning Strategies in Undergraduate Medical Education of Pathology: A Saskatoon Experience

Rani Kanthan, M.B.B.S.1 and Sheryl Mills, M.D.2


Medical education continues to be primarily structured around faculty authority and lecture. This promotes individualistic competitive environments rather than the co-operative ones needed for ??bf?patient-centered medicine.??bf? In much the same way as one can decide to either purchase a new home outright or renovate an existing home to better meet needs, in this study we set out to renovate an existing home by exploring the inclusion of active learning strategies — collaboration, metaphor and analogy, and summarization techniques –in a general pathology course within the traditional undergraduate medical curriculum framework. The aim was to create a collaborative classroom opportunity for analyzing, problem solving, summarizing, and using visual/verbal metaphors to explain complex medical concepts in a simple fashion. Through this participation, students earned 10% toward their final grade and received general immediate feedback on their submitted work. The inclusion of these strategies was evaluated through student performance on the midterm exam and by a questionnaire completed anonymously by all students at the same time. The student performance in the midterm exam was slightly higher than in previous years. Of the total number of 256 responses to the open-ended questions from the students, 170 (67%) were positive about the inclusion of these active learning strategies. Seventy-two responses were negative (28%) while 14 (5%) comments were neutral. Some students indicated that these strategies detracted somewhat from traditional lecture time or that analogy and metaphor were ??bf?too abstract.??bf? Based on feedback from students and observing student participation, we feel that these strategies, as a ??bf?renovation??bf? of the traditional lecture-based undergraduate medical curriculum, ??bf?do no harm??bf? and, in fact, contribute to learning and social interaction in the delivery of pathology. The long-term impact of using resonant analogies and metaphors to explain complex medical concepts to patients may only become apparent when these students are doctors in team-oriented, patient-centered clinical practices.

Distributed Immersive Virtual Reality Simulation Development for Medical Education

Dale C. Alverson, M.D.1, Stanley M. Saiki Jr, M.D.4, 8, Thomas P. Caudell, Ph.D.2, Kenneth Summers, Ph.D.2, Panaiotis, Ph.D.2, Andrei Sherstyuk, Ph.D.4, David Nickles, M.S.4, James Holten, III2, Timothy E. Goldsmith, Ph.D.3, Susan M. Stevens, M.S.3, Kathleen Kihmm4, Stewart Mennin, Ph.D.1, Summers Kalishman, Ph.D.1, Jan Mines, M.A.1, Lisa Serna1, Steven Mitchell, M.D.1, Marlene Lindberg Ph.D.4, Joshua Jacobs, M.D.4, Curtis Nakatsu, M.D.4, Scott Lozanoff, Ph.D.4, Diane S. Wax, M.P.A., M.B.A.1, Linda Saland, Ph.D.1, Jeffrey Norenberg, PharmD.5, George Shuster, DNSc.6, Marcus Keep, M.D.1, Rex Baker, M.D.1, Holly S. Buchanan, Ed.D.1, Randall Stewart, M.D.1, Mark Bowyer, M.D.7, Alan Liu, Ph.D.7, Gilbert Muniz, Ph.D.7, Robert Coulter, M.A.,1 Christina Maris1, David Wilks, M.D.1


Training professionals for real-world application of required knowledge and skills and assessing their competence are major challenges. Simulations are being used in education and training to enhance understanding, improve performance, and assess competence. Validated virtual reality (VR) simulations provide a means of making experiential learning reproducible and reusable. Advanced communication networks, such as Internet2 Access Grid, allow dissemination of these simulations and collaborative learning independent of distance. The prior experiences of our three universities led to an interdisciplinary collaboration to further develop and evaluate an integrated, fully immersive, interactive VR based system. This environment employs simulations that are visually three-dimensional and are driven dynamically by a rules-based artificial intelligence engine within Flatland, a virtual environments development software tool, and associated commodity hardware. Studies include usability and validation, deployment for distributed testing over Internet2, and evaluation of impact on training and performance using concept mapping and knowledge structure methods. Subject matter experts found face and content validity in our closed head injury simulation. Seven pairs of medical students participated collaboratively in problem solving and managing of the simulated patient in VR. Students stated that opportunities to make mistakes and repeat actions in VR were extremely helpful in learning specific principles and they felt more engaged than in standard text-based scenarios. 48 students participated in knowledge structure experiments pre and post simulation experiences. Knowledge structure relatedness ratings were significantly improved in those students with lower pre-VR relatedness ratings indicating a potential value of VR simulation in learning. This research cuts across the integration of computing, networking, human-computer interfaces, learning, and knowledge acquisition. VR creates a safe environment to make mistakes and could allow rapid deployment for just-in-time training or performance assessment.

Favorable Student Attitudes Towards Pharmacology in a Medical College in Western Nepal

Ravi Pathiyil Shankar, Arun Kumar Dubey, Subish Palaian, Mishra Pranaya, Archana Saha, and Vibhavri Yeshwant Deshpande


Traditional pharmacology teaching in medical schools does not adequately prepare the student for rational practice. Recently a number of modifications have been introduced in pharmacology teaching and learning. At the Manipal College of Medical Sciences, Pokhara, Nepal pharmacology is taught in an integrated manner with the other basic science subjects during the first four semesters of the undergraduate medical course. The present study was carried on second and third semester students during the month of March 2004 to obtain information on student attitude towards pharmacology, feedback on the assessment process, suggestions to improve pharmacology teaching and learning, basic demographic information about the respondents and to note the association, if any, of the student attitudes with demographic variables. Student attitude was assessed by noting their degree of agreement with 15 statements using a modified five-point Likert-type scale. The statements were grouped into those dealing with student attitude towards the subject and those concerned with improvements in pharmacology teaching and learning. The mean total, subject and improvement scores were calculated. Differences in the mean scores among different subgroups of respondents were analyzed (p<0

Using Standardized Patients to Introduce Bioterrorism-related material into a Medical Microbiology and Immunology Curriculum

Gina C. Wesley, Ph.D.1 , W. Paul McKinney, M.D.2 and Uldis N. Streips, Ph.D.3


The overall goal of this study was to determine how engagement in basic science courses and retention of the taught material by students could be improved. To achieve this goal we have piloted the use of Standardized Patients in various settings in the Medical Microbiology and Immunology course at the University of Louisville, School of Medicine. The availability of a high quality standardized patient program with extensive, excellent moulage (makeup) capability, allowed the Department of Microbiology and Immunology to present bioterrorism in the context of cases and patients who exhibit symptoms of the diseases studied. This type of approach is appreciated by the students as deviating form classical lecture format and also is retained far better than material which is not visually presented.

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