Centre for Orofacial Research and Learning, School of Dentistry, The University of Adelaide, Adelaide, Australia.
Eur J Dent Educ. 2010 Aug;14(3):136-44. doi: 10.1111/j.1600-0579.2009.00606.x.
There is ongoing concern by health educators over the inability of professionals to accurately self-assess their clinical behaviour and standards, resulting in doubts over a key expectation of effective self-regulation in the health professions. Participation by students in the assessment process has been shown to increase the understanding of assessment criteria in written assessment tasks. How this might transfer to the clinical setting is the focus of this study. This paper is part of an ongoing investigation of the impact on learning of a series of activities that provides students with opportunities to discuss and apply criteria and standards associated with self-assessment in clinical dentistry. Our aim was to evaluate whether participation in these assessment activities improved the ability of first-year dental students to recognise behaviours demonstrated by 'peers' in videos of clinical scenarios and to relate these to the assessment criteria.
A series of three workshops in conjunction with weekly clinical assessment activities in Semesters 1 and 2 were use to support first-year students' learning of clinical assessment criteria. The design of the workshops was based on the principles of social constructivist theories of learning and the concept of tacit knowledge. Accordingly workshop activities were planned around videos that were specifically constructed to illustrate procedures and behaviours typical of those observed by staff and tutors in the first year of the dental course at The University of Adelaide, Australia. First-year students viewed the videos prior to and after the workshops and recorded observed behaviours that related to the assessment criteria that were used in their clinical practice course. Student learning outcomes were assessed 10-14 weeks after the initial workshop and again up to 42 weeks later. To check whether learning resulted from repeated viewing of the videos without formal discussion, a reference group of third-year students who did not attend the workshops also viewed the videos two times, separated by 12 weeks, and recorded observations in the same way.
There was no consistent evidence that repeat viewing of the videos in isolation resulted in improved recognition of 'peer' behaviours by third-year dental students. Results for the first-year students indicated that the workshops and clinical assessment activities had a significantly positive effect on the ability of students to identify 'peer' behaviours related to the criteria used for clinical assessment. In particular, students' recognition in others of knowledge and professional behaviours improved significantly. This improvement was retained over the year and students were able to recognise these behaviours in other scenarios relevant to their year level.
This early exposure to the process of clinical assessment, coupled with ongoing self-assessment and tutor feedback throughout first year, improved the ability of first-year students to identify and apply some key assessment criteria to observed 'peer' behaviour, and this ability was retained over time.
健康教育者一直关注的是,专业人员无法准确地自我评估其临床行为和标准,这导致人们对卫生专业人员有效自我监管的一个关键期望产生了怀疑。已经证明,学生参与评估过程可以提高他们对书面评估任务中评估标准的理解。这种方法如何转移到临床环境是本研究的重点。本文是正在进行的一系列研究的一部分,这些研究旨在探讨对学习的影响,这些活动为学生提供了讨论和应用与临床牙科自我评估相关的标准和准则的机会。我们的目的是评估参与这些评估活动是否能提高一年级牙科学生识别临床情景视频中“同行”表现出的行为的能力,并将这些行为与评估标准联系起来。
在第 1 学期和第 2 学期的每周临床评估活动中,结合三个研讨会,为一年级学生的临床评估标准学习提供支持。研讨会的设计基于社会建构主义学习理论的原则和隐性知识的概念。因此,研讨会的活动围绕着专门制作的视频展开,这些视频旨在说明澳大利亚阿德莱德大学牙科课程第一年中工作人员和导师观察到的程序和行为。一年级学生在参加研讨会之前和之后观看视频,并记录与他们临床实践课程中使用的评估标准相关的观察到的行为。学生学习成果在初始研讨会后 10-14 周和 42 周后进行评估。为了检查重复观看视频而没有正式讨论是否会导致学习,一个不参加研讨会的三年级学生的参考组也观看了两次视频,间隔 12 周,并以同样的方式记录观察结果。
没有一致的证据表明,单独重复观看视频会导致三年级牙科学生对“同行”行为的识别能力提高。一年级学生的结果表明,研讨会和临床评估活动对学生识别与临床评估使用的标准相关的“同行”行为的能力有显著的积极影响。特别是,学生对他人的知识和专业行为的认识显著提高。这种提高在一年内保持不变,学生能够识别与他们年级相关的其他场景中的这些行为。
这种早期接触临床评估过程,再加上整个第一年的持续自我评估和导师反馈,提高了一年级学生识别和应用一些关键评估标准来观察“同行”行为的能力,而且这种能力随着时间的推移而保持。