Medical education: Overview

Abstract
Introduction: Power outages in the OR are rare. However, anesthesia providers must be prepared to manage these situations until power is restored or their patient can be moved to a safe area. These situations occur so infrequently that many learners do not experience these events during their training. We designed a high-fidelity power outage simulation for anesthesiology residents to fill this training gap and enhance their preparedness and confidence.

Methods: In each simulation session consisting of up to four learners, one or two PGY 3/PGY 4 residents participated as anesthesiologists in a case involving an intraoperative power loss during a routine inguinal hernia repair of a patient under general anesthesia. After the simulation, residents received a debriefing focused on intraoperative power outage training. After concluding the debriefing, residents completed a 5-point Likert scale survey to assess their confidence in managing an intraoperative power loss.

Results: Over 2 years, 22 anesthesiology residents completed the simulation. Residents' mean ratings of confidence in managing a patient in the OR during a power outage improved by 1.2 points (p =.001), confidence in monitoring vital signs improved by 1.4 (p = .001), and confidence in planning appropriate disposition improved by 0.9 (p =.001). All participants found the simulation highly valuable.

Discussion: The anesthesiology-specific simulation proved to be an effective educational tool. Feedback was positive as residents agreed that the simulation was valuable for developing clinical reasoning and decision-making skills, significantly boosting their confidence to respond effectively and maintain patient safety.

Abstract
Background: In medical education, Lecture Based Learning (LBL) is the most common way of disseminating information. Team Based Learning (TBL), a new teaching method, is a teacher-guided method that employs teams in a class, showing suitability for medical education. Two teaching methods represent distinct educational approaches, each with its own set of advantages and limitations. In this study, we performed a systemic review on the efficacy of TBL pedagogy in medical education.

Methods: MEDLINE, EMBASE, the Cochrane Library, and Web of Science database were searched through July 2022. Standard mean difference (SMD) and 95% confidence intervals (CIs) were calculated.

Results: The analysis included 33 studies. Our analysis revealed that students utilizing the TBL method exhibited significantly higher pre-( SMD = 0.51, 95%CI 0.11 to 0.92) /post-test (SMD = 0.96, 95%CI 0.70 to 1.22) scores than students with LBL. Students in TBL classes had better development of scores, retention (SMD = 1.03, 95%CI 0.38 to 1.69), engagement (SMD = 2.26, 95%CI 0.23 to 4.29) and higher satisfactory rate (SMD = 1.08, 95%CI 0.87 to 1.29). However, students required more time to independently complete reading materials and preparatory tasks.

Conclusion: Our study indicates the gratifying effectiveness of TBL application in medical education. TBL pedagogy is compatible with the present medical education and should be generalized in more classrooms.

Abstract
Background: The transition from secondary education to university challenges students' learning strategies and academic performance, especially in self-directed, problem-based environments like medical school. Passive study methods often fail, while evidence-based strategies like retrieval practice, active learning, and growth mindset foster success. We evaluate a novel academic support programme (Academic Tutoring- (AT)) to enhance study skills, feedback use, and self-directed learning.

Methods: We developed and implemented AT for 1st year medical students, informed by the psychology of learning and behaviour change, AT aimed to support the development of self-efficacy and effective learning strategies during the transition into university. The programme involved meeting an Academic Tutor one-to-one once per term, and also as a group once per term. Academic Tutors engaged students in learner-centred conversations on study skills and professional development plus their wellbeing and welfare. A Likert questionnaire was designed to measure students' responses to the experiences and perceived outcomes of AT. We also measured self-efficacy and mindset. Qualitative data was gathered through open-ended response items. Demographic and socioeconomic data was also gathered.

Results: AT positively impacted time-management and learning strategies. 'Learning from successes and failures' and 'thinking how to achieve goals' were associated with a growth mindset. All outcome measures were associated with self-efficacy. We noted that students from a widening participation (WP) background tended to show higher growth mindset relative to those from a non-WP background (r = -0.223, p = 0.08) and female students reported higher engagement with the programme (r-0.294, p < 0.001). Students reported changes in behaviours and attitudes, and improved wellbeing.

Conclusions: Providing medical students with the tools to change their approach to work and revision can improve subjective reports of time management, implementation of successful learning strategies and wellbeing. Successful outcomes were associated with self-efficacy and mindset. These are modifiable constructs, and this work suggests that focussing conversations on self-efficacy and mindset may be beneficial for supporting positive behaviour change.