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      Developing knowledge and clinical competency in a respiratory system-based practice of final-year medical students through a novel structured bedside teaching module

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          Abstract

          BACKGROUND:

          Respiratory diseases are a major cause of mortality and morbidity worldwide. A sound knowledge of management of respiratory diseases is thus very vital. The clinical exposure of undergraduate medical students is limited to 2 weeks in pulmonary medicine. We hypothesized that the short duration of posting can be best utilized by developing need-based modules for bedside teaching.

          AIMS:

          This study aimed to determine gain in knowledge and skills of final-year medical students in diagnosis and management of common pulmonary diseases and assess students' perception of the module.

          METHODS:

          A one-group pretest-posttest quasi-experimental study design enrolled a convenience sample of 48 final-year medical students. Twenty-four students were posted at a given time for the bedside clinical posting in pulmonary medicine between August 2013 and November 2013. These students were divided randomly into two groups of 12 students each. All students consented to be part of the study. Two trained faculty taught in rotation. The bedside teaching module was prepared by Delphi technique and curriculum was based on Kern's six-step approach. History taking, physical examination, tuberculosis, chronic obstructive pulmonary disease, asthma, lung cancer, chest X-rays, and spirometry were taught. Students were administered pre- and post-test questionnaires to assess knowledge, while Objective Structured Clinical Examination assessed skills. Students' feedback questionnaire evaluated the teaching module. A two-tailed paired sample t-test assessed mean gain in knowledge and skills. Effect size was calculated by Cohen's d, while Cronbach's alpha estimated the reliability testing of perception questionnaire. Statistical analysis was performed using statistical software package IBM SPSS version 23.

          RESULTS:

          Mean pre- and posttest knowledge scores were 12.46 (8.09) and 43.17 (10.7), respectively, P = 0.001. Mean pre- and posttest skills scores were 7.00 (4.76) and 24.79 (3.31), respectively, P = 0.001, and Cohen's d showed large effect size. Most students stated that the module enhanced their clinical skills, helped to understand difficult material, and promoted inquiry and thinking. Cronbach's alpha for perception questionnaire was 0.854.

          CONCLUSIONS:

          Structured bedside teaching module in pulmonary medicine improved the knowledge and skills of undergraduate medical students. The contents and various teaching methodologies were evaluated positively.

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          Most cited references19

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          Delphi: A Versatile Methodology for Conducting Qualitative Research

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            The promise of competency-based education in the health professions for improving global health

            Competency-based education (CBE) provides a useful alternative to time-based models for preparing health professionals and constructing educational programs. We describe the concept of ‘competence’ and ‘competencies’ as well as the critical curricular implications that derive from a focus on ‘competence’ rather than ‘time’. These implications include: defining educational outcomes, developing individualized learning pathways, setting standards, and the centrality of valid assessment so as to reflect stakeholder priorities. We also highlight four challenges to implementing CBE: identifying the health needs of the community, defining competencies, developing self-regulated and flexible learning options, and assessing learners for competence. While CBE has been a prominent focus of educational reform in resource-rich countries, we believe it has even more potential to align educational programs with health system priorities in more resource-limited settings. Because CBE begins with a careful consideration of the competencies desired in the health professional workforce to address health care priorities, it provides a vehicle for integrating the health needs of the country with the values of the profession.
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              Twelve tips to improve bedside teaching.

              S Ramani (2003)
              Bedside teaching has long been considered the most effective method to teach clinical skills and communication skills. Despite this belief, the frequency of bedside rounds is decreasing and it is believed that this is a major factor causing a sharp decline in trainees' clinical skills. Several barriers appear to contribute to this lack of teaching at the bedside and have been discussed extensively in the literature. Concern about trainees' clinical skills has led organizations such as the American Council for Graduate Medical Education (ACGME) and the WHO Advisory Committee on Medical training to recommend that training programs should increase the frequency of bedside teaching in their clinical curricula. Although obstacles to bedside teaching are acknowledged, this article in the '12 tips' series is a detailed description of teaching strategies that could facilitate a return to the bedside for clinical teaching.
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                Author and article information

                Journal
                J Educ Health Promot
                J Educ Health Promot
                JEHP
                Journal of Education and Health Promotion
                Medknow Publications & Media Pvt Ltd (India )
                2277-9531
                2319-6440
                2018
                12 June 2018
                : 7
                : 82
                Affiliations
                [1] Department of Pulmonary Medicine, Goa Medical College, Bardez, Goa, India
                Author notes
                Address for correspondence: Dr. Lalita Fernandes, CA 3/8, Sapana Gardens, Chogm Road, Alto Porvorim, Bardez - 403 521, Goa, India. E-mail: drlalitafernandes@ 123456gmail.com
                Article
                JEHP-7-82
                10.4103/jehp.jehp_75_16
                6009136
                94054cca-e133-4490-8348-a4ded1e2a6e1
                Copyright: © 2018 Journal of Education and Health Promotion

                This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

                History
                : 11 September 2016
                : 17 March 2018
                Categories
                Original Article

                curriculum,education,educational measurement,medical,teaching methods,undergraduate

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