Original Articles

“Just tell me what I need to know to pass the exam!” Can active flipped learning overcome passivity?

Diane Kenwright, Wei Dai, Emma Osborne, Tehmina Gladman, Peter Gallagher, Rebecca Grainger

Although the flipped classroom approach has been theorised to encourage active learning, recorded lectures were used as flipped learning activities in the majority of the flipped learning studies, which many still consider to be passive knowledge input. To further promote active learning, the first four modules in a pathology course at University of Otago Wellington were flipped and delivered to fourth year medical students with redesigned active learning activities based on constructive theory of learning. The innovative active learning tasks were delivered via “kuraCloud” (an online-learning platform) and included short video clips, labeling exercises, written questions with immediate feedback, multiple-choice questions with explanatory text and links provided for further information. Students were required to complete all the activities prior to a face-to-face tutorial. A mixed methods design was used in which student engagement was assessed using both survey instruments and focus groups. Results showed that students did not engage with the new flipped learning activities designed to improve active learning, they preferred the passive learning approach with exam- or clinical practice- based core knowledge summarized and delivered to them directly. Three themes emerged: 1. Students considered the time invested in the active learning activities was inefficient. 2. The flipped course challenged students’ sense of predictability. 3. The knowledge construction process was valued as application rather than learning. This might be attributed to time-poor medical students judging the value of the learning task based on the relevance to their immediate learning goal: pass the exam, the new flipped learning activities imposing a heavy cognitive load that impairs the knowledge construction process and the less predictable structure of the flipped learning environment compared to the familiar traditional lectures. 

Keywords: Passive Learning; Active Learning; the Flipped Classroom; Course Structure; Cognitive Load

Profiling potential medical students and exploring determinants of career choice

Marcus A Henning, Christian U Krägeloh, Roger Booth, Erin M Hill, Julie Chen, Craig S Webster

At this university, a Biomedical Common Year 1 occurs prior to admission to the medical programme. Students achieving a minimum GPA of 6.0 are eligible for consideration for an admissions interview. The aim of this research was to assess the psycho-educational factors that underpin students’ intention to study medicine. The research question driving the research was, ‘If students have an interest in becoming a future doctor in their premedical course, does this relate to their levels of motivation, competitiveness, perceived stress, health-related quality of life (HRQOL), and grade attainment?’ A total of 339 students (response rate = 25%) who completed a biosciences assessment filled in a survey that asked them to disclose their grade and to respond to a series of questionnaires, namely the Motivated Strategies for Learning Questionnaire, World Health Organisation Quality Of Life questionnaire – New Zealand Version, Perceived Stress Scale, and Revised Competitiveness Index. The findings from the binary logistic regression indicated that several variables predicted students’ career intentions: grade achievement, Perceived Stress, Physical HRQOL, and Environmental HRQOL. Perceived Stress and Physical HRQOL were found to be influential variables that interacted with other variables reducing variability in the model and increasing its predictability. Students with an intention to become a doctor tend to attain higher grades and have better environmental HRQOL scores. Nonetheless, variable interactions suggested that those students with high levels of physical HRQOL and low levels of perceived stress have higher levels of enjoyment regarding competition, self-efficacy, and intrinsic value.

Keywords:        Biomedical and Health Science Students, New Zealand, Career Intention, Motivation, Physical Wellbeing, Competitiveness, Motivation, Academic Achievement

Short Communications

Assessment of trainee’s knowledge and practice behavior changes with the revised medication management service training program in Singapore General Hospital outpatient pharmacy

Giat Yeng Khee, Jia Yuan Tay, Sei Keng Koh, Melissa Mee Yin Chow, Wan Chee Ong, Paik Shia Lim

Aim: To assess trainee’s knowledge and practice behavior changes with the revised basic MMS training program.

Methods: Kirkpatrick’s four-level evaluation model was adopted in this study. A questionnaire was used to seek trainees’ feedback on the training program. For learning progression, trainees’ self- perception of their competency pre- and post-training, and results from a multiple-choice questions (MCQ) test were assessed.

Thirty-eight behavioral changes in the patient care delivery and problem solving competency cluster of the General Level Competency Framework (GLF) were compared pre- and 6 months post-training. Evaluation of level-4 results is pending as advanced training is in progress.

Results: Fourteen out of fifteen trainees who had completed the basic MMS training responded to the online questionnaire. Eleven trainees (78.6%) rated basic MMS training program as good or excellent. Positive response was highest in tutorials (84.3%), followed by continuous education sessions (70.6%) and clinic attachments (67.6%). Suggestions for improvement include increasing the frequency and opportunities of hands-on patient interview at clinic attachments.

Sixty-four percent of trainees perceived improvement (p<0.013) in delivering patient care post-training (median=3; IQR: 3-4) than pre-training (median=3; IQR: 2.75-3). All but one trainee passed the MCQ test (median score: 80; IQR: 76-86). A greater proportion of patient care delivery and problem solving behaviors (69.2% and 35.9% respectively) in GLF was graded highest performance at post-training compared to pre-training (35.3% and 14.3% respectively) .

Conclusions: The revised training program is well-received by trainees and feedback from trainees provides insights into future improvements in the content and delivery of the program.

Keywords:        Medication Management, Pharmacist, Training, Kirkpatrick

A peer observation program for the professional development of laboratory tutors

Helen Naug, Natalie Colson, Andrew Pearson, Eugene DuToit, Grace Qi

As undergraduate allied health programs continue to expand, there is increasing reliance on laboratory tutors, to engage, mentor and teach students. The bioscience laboratory is a specialised, tightly regulated learning environment and a potentially rich learning platform for students, but when the laboratory tutors are inadequately trained, the flow-on effects to the students can produce unfavourable learning outcomes. Traditionally, new tutors attend a generic sessional training workshop offered by the university. Due to the added health & safety considerations and the type of learning (kinaesthetic) that occurs in the laboratory, we identified a need for a specific professional development program for laboratory tutors. Our aim was to develop a program that allowed tutors to work within a framework tailored for laboratory teaching and, in a supportive environment, build teaching skills that promote student learning. Based on Lave’s theory of situated learning (Lave, 1991) and the recognised approach of supported reflective practice (Bell, 2001) we placed opportunities for peer observation at the centre of the program. The framework presented here (3P’s) was developed specifically for laboratory tutors and served as behavioural guidelines for peer observation sessions. Ten participants volunteered for the pilot program which concluded in 2015. Peer observation records and focus group data were gathered to evaluate the pilot program. Tutor feedback has initiated improvements in the program, and due to its overall success, it has been embedded into the recruitment/induction process for laboratory tutors in our department.

Keywords:        Peer Observation, Laboratory Teaching, Bioscience Education, Professional Development

Evaluation of mentors by postgraduate trainees in structured mentoring program

Dipanshi Patel, Namrata Baxi, Abhishek Agarwal, Kenyetta Givans, Krystal Hunter, Vijay Rajput, Anuradha Mookerjee

Introduction: In graduate medical education, trainees have different academic and professional growth needs throughout their career, but these needs have not been well studied (Gusic, Zenni, Ludwig & First, 2010). Traditional mentoring programs in many disciplines including medicine, science, law, business and education report individuals with mentors having higher earnings, higher job satisfaction and higher rates of promotion, compared to individuals without mentors (Bussey-Jones et al.,2006; Sambunak, Straus & Marusic, 2010).

Methods: We developed a structured mentoring program in the Department of Medicine in Cooper University Hospital which encourages both academic and professional growth through a major emphasis on academic scholarship. We created a 21 questions survey to evaluate mentee satisfaction towards their assigned mentors. The questions fit into four categories consisting of the mentor’s personal attributes and action characteristics and mentee’s short term and long term career goals. Sixty junior trainees (Post Graduate Year 1-3) and 39 senior trainees (Post Graduate Year 4-7) completed the survey.

Results and Conclusions: Senior trainees were more satisfied with their mentors’ intrinsic qualities (96%) compared to junior trainees (93%), c2 (1, N=980) = 5.72, p=0.017. Additionally, senior trainees were more satisfied with their mentors’ action characteristics (95%) compared to junior trainees (91%), c2(1, N=677) = 4.03, p=0.045. Junior trainees had a lower satisfaction rating, compared to their senior colleagues, which might imply that their needs and desires were not properly addressed by their mentors. Both junior and senior trainees identified the lowest satisfaction rates in their mentors’ communication skills and ability to challenge them. This was an area of weakness within the mentorship program which requires further research and attention.

Keywords:        Mentoring; Graduate Medical Education; Assessment

Personal View

Our first steps into surgery: The role of inspiring teachers

Niraj Mohan, Yi Yan Chia


Surgery is an apprenticeship – an art to be learned by the operating table from our mentors and a skill to be honed through years of training. This article is a discussion of the significance of good role models in surgical education with personal examples given from our fresh experiences with the intricacies of surgery during our undergraduate medical education years.