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Article ; Online: Methods to Improve Diagnostic Reasoning in Undergraduate Medical Education in the Clinical Setting: a Systematic Review.

Xu, Hongyun / Ang, Benson W G / Soh, Jian Yi / Ponnamperuma, Gominda G

2021 Volume 36, Issue 9, Page(s) 2745–2754

Abstract: Background: In recent years, there have been numerous studies exploring different teaching methods for improving diagnostic reasoning in undergraduate medical students. This systematic review examines and summarizes the evidence for the effectiveness of ...

Abstract	Background: In recent years, there have been numerous studies exploring different teaching methods for improving diagnostic reasoning in undergraduate medical students. This systematic review examines and summarizes the evidence for the effectiveness of these teaching methods during clinical training. Methods: PubMed, Embase, Scopus, and ERIC were searched. The inclusion criteria for the review consist of articles describing (1) methods to enhance diagnostic reasoning, (2) in a clinical setting (3) on medical students. Articles describing original research using qualitative, quantitative, or mixed study designs and published within the last 10 years (1 April 2009-2019) were included. Results were screened and evaluated for eligibility. Relevant data were then extracted from the studies that met the inclusion criteria. Results: Sixty-seven full-text articles were first identified. Seventeen articles were included in this review. There were 13 randomized controlled studies and four quasi-experimental studies. Of the randomized controlled studies, six discussed structured reflection, four self-explanation, and three prompts for generating differential diagnoses. Of the remaining four studies, two employed the SNAPPS Discussion: The authors posit a framework to teach diagnostic reasoning in the clinical setting. The framework targets specific deficiencies in the students' reasoning process. There remains a lack of studies comparing the effectiveness of different methods. More comparative studies with standardized assessment and evaluation of long-term effectiveness of these methods are recommended.
MeSH term(s)	Clinical Competence ; Education, Medical, Undergraduate ; Humans ; Problem Solving ; Students, Medical
Language	English
Publishing date	2021-06-22
Publishing country	United States
Document type	Systematic Review
ZDB-ID	639008-0
ISSN	1525-1497 ; 0884-8734
ISSN (online)	1525-1497
ISSN	0884-8734
DOI	10.1007/s11606-021-06916-0
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Article ; Online: Selection for postgraduate training.

Ponnamperuma, Gominda G

The clinical teacher

2010 Volume 7, Issue 4, Page(s) 276–280

Abstract: Background: Selection for an educational programme requires meticulous planning and the adoption of sound educational principles to decide on how and what should be assessed. This article provides a step-wise guide for developing a selection process for ...

Abstract	Background: Selection for an educational programme requires meticulous planning and the adoption of sound educational principles to decide on how and what should be assessed. This article provides a step-wise guide for developing a selection process for postgraduate specialty training, based on the best practice in the literature. Method: The literature on selecting applicants for educational programmes was reviewed to categorise the selection methods according to their purpose, and their relative strengths and weaknesses. A step-wise guide that encapsulated the best practice for designing a selection process for postgraduate specialty training was then developed. Results: The steps of developing a selection process for postgraduate specialty training are: determining the competencies required for the training programme; selecting the competencies that can be assessed at selection; identifying content for selection; blueprinting; choice of selection tests; development of test material; piloting; and implementation and evaluation of the selection process. There are robust tests to assess applicants' knowledge at the lower two levels of Miller's pyramid. Scenario-based testing holds promise for assessing at 'shows-how' level. Assessing at 'does' level during selection is difficult, but not impossible. Discussion: There is no one test that can be used to select an applicant for a postgraduate training programme. Rather a battery of tests that assesses all the competencies, sampled according to a blueprint, should be used. The eight-step guide proposed in this article provides an educationally sound and defensible procedure to develop a selection process.
MeSH term(s)	Career Choice ; Clinical Competence ; Decision Making ; Education, Medical, Graduate/methods ; Humans ; Internship and Residency ; Models, Educational ; Models, Psychological
Language	English
Publishing date	2010-12
Publishing country	England
Document type	Journal Article
ZDB-ID	2151518-9
ISSN	1743-498X ; 1743-4971
ISSN (online)	1743-498X
ISSN	1743-4971
DOI	10.1111/j.1743-498X.2010.00400.x
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Article ; Online: A randomized trial comparing cadaveric dissection and examination of prosections as applied surgical anatomy teaching pedagogies.

Koh, Zong Jie / Yeow, Marcus / Srinivasan, Dinesh Kumar / Ng, Yee Kong / Ponnamperuma, Gominda G / Chong, Choon Seng

Anatomical sciences education

2021

Abstract: Anatomy is an important component in the vertical integration of basic science and clinical practice. Two common pedagogies are cadaveric dissection and examination of prosected specimens. Comparative studies mostly evaluate their immediate effectiveness. ...

Abstract	Anatomy is an important component in the vertical integration of basic science and clinical practice. Two common pedagogies are cadaveric dissection and examination of prosected specimens. Comparative studies mostly evaluate their immediate effectiveness. A randomized controlled trial design was employed to compare both the immediate and long-term effectiveness of dissection and prosection. Eighty third-year medical students undergoing their surgical rotation from the Yong Loo Lin School of Medicine were randomized into two groups: dissection and prosection. Each participated in a one-day hands-on course following a similar outline that demonstrated surgical anatomy in the context of its clinical relevance. A pre-course test was conducted to establish baseline knowledge. A post-course test was conducted immediately after and at a one-year interval to evaluate learner outcome and knowledge retention. A post-course survey was conducted to assess participant perception. Thirty-nine and thirty-eight participants for the dissection and prosection groups, respectively, were included for analysis. There was no significant difference between mean pre-course test scores between the dissection and prosection groups [12.6 (3.47) vs. 12.7 (3.16), P > 0.05]. Both the mean immediate [27.9 (4.30) vs. 24.9 (4.25), P < 0.05] and 1 year [23.9 (4.15) vs. 19.9 (4.05), P < 0.05] post-course test scores were significantly higher in the dissection group. However, when adjusted for course duration [dissection group took longer than prosection group (mean 411 vs. 265 min)], these findings were negated. There is no conclusive evidence of either pedagogy being superior in teaching surgical anatomy. Based on learner surveys, dissection provides a greater learner experience.
Language	English
Publishing date	2021-12-30
Publishing country	United States
Document type	Journal Article
ZDB-ID	2483491-9
ISSN	1935-9780 ; 1935-9772
ISSN (online)	1935-9780
ISSN	1935-9772
DOI	10.1002/ase.2166
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Article ; Online: Examiner perceptions of a portfolio assessment process.

Davis, Margery H / Ponnamperuma, Gominda G

Medical teacher

2010 Volume 32, Issue 5, Page(s) e211–5

Abstract: Background: The portfolio assessment process is important for assessing learner achievement.: Aims: To study examiner perceptions of Dundee Medical School's portfolio assessment process, in years 4 and 5 of the 5-year curriculum, in relation to: ... ...

Abstract	Background: The portfolio assessment process is important for assessing learner achievement. Aims: To study examiner perceptions of Dundee Medical School's portfolio assessment process, in years 4 and 5 of the 5-year curriculum, in relation to: outcomes as a framework for the portfolio assessment process; portfolio content; portfolio assessment process; end points of the portfolio assessment process; appropriateness of the two part final exam format and examiner training. Methods: A questionnaire containing statements and open questions was used to obtain examiner feedback. Responses to each statement were compared over 3 years: 1999, 2000 and 2003. Results: Response rates were 100%, 88% and 61% in 1999, 2002 and 2003, respectively. Examiners were positive about the ability of institutionally set learning outcomes (Dundee 12 exit learning outcomes) to provide a framework for the portfolio assessment process. They found difficulties, however, with the volume of portfolio content and the time allocated to assess it. Agreeing a grade for each learning outcome for the candidate with their co-examiner did not present difficulties. The comprehensive, holistic picture of the candidate provided by the portfolio assessment process was perceived to be one of its strengths. Examiners were supportive of the final examination format, and were satisfied with their briefing about the process. Conclusions: The 12 exit learning outcomes of Dundee curriculum provide an appropriate framework for the portfolio assessment process, but the content of the portfolio requires fine-tuning particularly with regard to quantity. Time allocated to examiners for the portfolio assessment process needs to be balanced against practicability. The holistic picture of the candidate provided by the process was one of its strengths.
MeSH term(s)	Attitude ; Education, Medical, Undergraduate/methods ; Educational Measurement/methods ; Faculty, Medical ; Humans ; Sri Lanka ; Surveys and Questionnaires
Language	English
Publishing date	2010
Publishing country	England
Document type	Journal Article
ZDB-ID	424426-6
ISSN	1466-187X ; 0142-159X
ISSN (online)	1466-187X
ISSN	0142-159X
DOI	10.3109/01421591003690312
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Article ; Online: Ideal Sequence of Didactic Lectures and Simulation in Teaching Transesophageal Echocardiography Among Anesthesiologists.

Thampi, Swapna / Lee, Chang Chuan Melvin / Agrawal, Rohit Vijay / Ashokka, Balakrishnan / Ti, Lian Kah / Paranjothy, Suresh / Ponnamperuma, Gominda G

Journal of cardiothoracic and vascular anesthesia

2019 Volume 34, Issue 5, Page(s) 1244–1249

Abstract: Objective: Performing a basic perioperative transesophageal echocardiography (TEE) requires 3-dimensional knowledge of cardiac anatomy, psychomotor skills, and image interpretation. Commonly, lectures followed by simulation sequence is used for teaching ...

Abstract	Objective: Performing a basic perioperative transesophageal echocardiography (TEE) requires 3-dimensional knowledge of cardiac anatomy, psychomotor skills, and image interpretation. Commonly, lectures followed by simulation sequence is used for teaching TEE. Differences may occur among learners when this sequencing of instructional components is altered. The authors investigated the ideal sequence of lectures and simulation in teaching basic perioperative TEE. Design: Prospective randomized comparative study. Setting: Simulation room in a large academy tertiary care center. Participants: Noncardiac anesthesiologists in Singapore with no prior knowledge of TEE. Intervention: Comparison of acquisition and retention of knowledge and skills between the lecture followed by simulation group (LS) and the simulation followed by lecture (SL) group. Measurements and main results: Knowledge was assessed using multiple-choice questions (MCQs) and skills using a skill test. The primary outcome measured was the MCQ scores (post-course and retest) and the skill test scores (post-course and retest). Of the 43 anesthesiologists who were recruited, 22 were randomized into the LS group and 21 to the SL group. All participants took pre-course and post-course MCQs and post-course skill tests. Post-tests were repeated 1 month after the course to assess retention. There was no significant difference in the post-course MCQ (85.87% v 81.82%) and skill test scores (85.78% v 81.55%) between the SL and LS groups, respectively. The SL group demonstrated significantly better retention of knowledge at 1 month (MCQ score 83.5% v 72.73%; p = 0.003) and skills (skill test score 85.32% v 1.90%; p = 0.016) than the other. Conclusion: This study showed that, for retention (at 1 month) of both knowledge and skills, it is preferable to teach practical skills followed by theoretical knowledge to anesthesiologists who are complete novices to TEE.
MeSH term(s)	Anesthesiologists ; Clinical Competence ; Echocardiography, Transesophageal ; Humans ; Prospective Studies ; Singapore ; Teaching
Language	English
Publishing date	2019-12-16
Publishing country	United States
Document type	Journal Article
ZDB-ID	1067317-9
ISSN	1532-8422 ; 1053-0770
ISSN (online)	1532-8422
ISSN	1053-0770
DOI	10.1053/j.jvca.2019.12.011
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Article: Ophthalmology and trends in medical education.

Davis, Margery H / Ponnamperuma, Gominda G

Clinical & experimental ophthalmology

2007 Volume 35, Issue 4, Page(s) 301–302

MeSH term(s)	Australia ; Curriculum/standards ; Education, Medical, Undergraduate/trends ; Humans ; New Zealand ; Ophthalmology/education ; Teaching/standards
Language	English
Publishing date	2007-05
Publishing country	Australia
Document type	Comment ; Editorial
ZDB-ID	2014008-3
ISSN	1442-9071 ; 1442-6404
ISSN (online)	1442-9071
ISSN	1442-6404
DOI	10.1111/j.1442-9071.2007.01507.x
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Article ; Online: Medical education research at the crossroads.

Davis, Margery H / Ponnamperuma, Gominda G

Lancet (London, England)

2006 Volume 367, Issue 9508, Page(s) 377–378

MeSH term(s)	Education, Medical ; Humans ; Research/economics ; Research/trends ; United Kingdom
Language	English
Publishing date	2006-02-04
Publishing country	England
Document type	Journal Article
ZDB-ID	3306-6
ISSN	1474-547X ; 0023-7507 ; 0140-6736
ISSN (online)	1474-547X
ISSN	0023-7507 ; 0140-6736
DOI	10.1016/S0140-6736(06)68116-6
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Article: Portfolio assessment.

Davis, Margery H / Ponnamperuma, Gominda G

Journal of veterinary medical education

2005 Volume 32, Issue 3, Page(s) 279–284

MeSH term(s)	Animals ; Education, Veterinary/standards ; Educational Measurement/methods ; Humans
Language	English
Publishing date	2005-09-09
Publishing country	Canada
Document type	Journal Article ; Review
ISSN	0748-321X
ISSN	0748-321X
DOI	10.3138/jvme.32.3.279
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Article ; Online: Student perceptions of a portfolio assessment process.

Davis, Margery H / Ponnamperuma, Gominda G / Ker, Jean S

Medical education

2009 Volume 43, Issue 1, Page(s) 89–98

Abstract: Objectives: The objectives of this study were to identify and analyse students' attitudes to the portfolio assessment process over time.: Methods: A questionnaire containing statements and open questions was used to obtain feedback from students at ... ...

Abstract	Objectives: The objectives of this study were to identify and analyse students' attitudes to the portfolio assessment process over time. Methods: A questionnaire containing statements and open questions was used to obtain feedback from students at the University of Dundee Medical School, Scotland. The responses to each statement were compared over 4 years (1999, 2000, 2002 and 2003). Results: Response rates were 83% in 1999, 70% in 2000, 89% in 2002 and 88% in 2003. A major finding is that students perceived that portfolio building heightened their understanding of the exit learning outcomes and enabled reflection on their work. Student reactions to the portfolio process were initially negative, although they appreciated that senior staff took time to become familiar with their work through reviewing their portfolios. Student attitudes became more positive over the 4 years as the process evolved. Although portfolio assessment was recognised as supporting student learning, portfolio building was perceived to interfere with clinical learning as a result of the excessive amounts of paper evidence required. Conclusions: Paperwork should be kept within manageable limits. A student induction process that highlights the importance of providing evidence for achieving all learning outcomes, not just theoretical knowledge and skills, may be helpful in allaying student concern over portfolio building and assessment and support preparation for lifelong learning and reflective clinical practice.
MeSH term(s)	Attitude of Health Personnel ; Education, Medical, Undergraduate/methods ; Educational Measurement/methods ; Educational Status ; Forms and Records Control/methods ; Humans ; Scotland ; Students, Medical/psychology
Language	English
Publishing date	2009-01
Publishing country	England
Document type	Journal Article
ZDB-ID	195274-2
ISSN	1365-2923 ; 0308-0110
ISSN (online)	1365-2923
ISSN	0308-0110
DOI	10.1111/j.1365-2923.2008.03250.x
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Article: Stress and its effects on medical students: a cross-sectional study at a college of medicine in Saudi Arabia.

Abdulghani, Hamza M / AlKanhal, Abdulaziz A / Mahmoud, Ebrahim S / Ponnamperuma, Gominda G / Alfaris, Eiad A

Journal of health, population, and nutrition

2011 Volume 29, Issue 5, Page(s) 516–522

Abstract: Medical education is perceived as being stressful, and a high level of stress may have a negative effect on cognitive functioning and learning of students in a medical school. This cross-sectional study was conducted to determine the prevalence of stress ...

Abstract	Medical education is perceived as being stressful, and a high level of stress may have a negative effect on cognitive functioning and learning of students in a medical school. This cross-sectional study was conducted to determine the prevalence of stress among medical students and to observe an association between the levels of stress and their academic performance, including the sources of their stress. All the medical students from year one to year five levels from the College of Medicine, King Saud University, were enrolled in the study. The study was conducted using Kessler10 psychological distress (K10) inventory, which measures the level of stress according to none, mild, moderate, and severe categories. The prevalence of stress was measured and compared with the five study variables, such as gender, academic year, academic grades, regularity to course attendance, and perceived physical problems. The response rate among the study subjects was 87% (n=892). The total prevalence of stress was 63%, and the prevalence of severe stress was 25%. The prevalence of stress was higher (p<0.5) among females (75.7%) than among males (57%) (odds ratio=2.3, chi2=27.2, p<0.0001). The stress significantly decreased as the year of study increased, except for the final year. The study variables, including being female (p<0.0001), year of study (p<0.001), and presence of perceived physical problems (p<0.0001), were found as independent significant risk factors for the outcome variables of stress. Students' grade point average (academic score) or regularity to attend classes was not significantly associated with the stress level. The prevalence of stress was higher during the initial three years of study and among the female students. Physical problems are associated with high stress levels. Preventive mental health services, therefore, could be made an integral part of routine clinical services for medical students, especially in the initial academic years, to prevent such occurrence.
MeSH term(s)	Adult ; Cross-Sectional Studies ; Female ; Humans ; Male ; Saudi Arabia/epidemiology ; Self Report ; Stress, Physiological ; Stress, Psychological/epidemiology ; Stress, Psychological/ethnology ; Stress, Psychological/physiopathology ; Stress, Psychological/psychology ; Students, Medical/psychology ; Young Adult
Language	English
Publishing date	2011-11-20
Publishing country	Bangladesh
Document type	Journal Article
ZDB-ID	2025045-9
ISSN	2072-1315 ; 1606-0997
ISSN (online)	2072-1315
ISSN	1606-0997
DOI	10.3329/jhpn.v29i5.8906
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