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Exploring how medical students learn during clinical rotations: a pilot study with a mobile application

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Abstract

Student engagement is an indicator that correlates with the overall quality of learning. Strategies such as the flipped-classroom approach aim to increase student engagement, but new learning designs require careful consideration in terms of how they are experienced by students and whether they mediate an enhanced learning experience. The study aimed to explore how student learning behaviour and well-being changed with a transition in learning design from the traditional lecture-based approach to a flipped-classroom approach. Students were recruited during three eight-week Child and Adolescent Health blocks of a four-year graduate-entry medical program. Students were invited to use the myStudyMate app as a daily activity tracker for one week, completing daily reports on perceived learning quality and physical and emotional well-being. There were 38 student participations in the study. Results show that most students had a healthy balanced day. Students spent more time studying online than reading prescribed textbooks, which was most pronounced during the lecture week using the flipped classroom approach. With the flipped classroom approach, students spent more time examining patients (0.51 h in traditional versus 1.18 h in flipped classroom p = 0.02) and taking patient histories (0.31 h in traditional versus 0.71 h in flipped classroom p = 0.03). Qualitative results emphasized the value of knowledgeable and enthusiastic educators who involved students in patient care and provided constructive feedback. In general, the study also demonstrated feasible use of a mobile application as a learning activity tracker to understand students’ learning behaviour. Integration of the myStudyMate app with the existing learning management systems has been identified as one potential avenue for future research.

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References

  1. Kennedy GE, Judd TS, Churchward A, Gray K, Krause K-L. First year students’ experiences with technology: are they really digital natives. Australas J Educ Technol. 2008;24(1):108–22.

    Article  Google Scholar 

  2. Scott K, Morris A, Marais B. Medical student use of digital learning resources. Clin Teach. 2018;15(1):29–33.

    Article  Google Scholar 

  3. Prober CG, Khan S. Medical education reimagined: a call to action. Acad Med. 2013;88(10):1407–10.

    Article  Google Scholar 

  4. Hew KF, Lo CK. Flipped classroom improves student learning in health professions education: a meta-analysis. BMC medical education. 2018;18(1):38.

    Article  Google Scholar 

  5. Sharma N, Lau C, Doherty I, Harbutt D. How we flipped the medical classroom. Medical teacher. 2015;37(4):327–30.

    Article  Google Scholar 

  6. Munson A, Pierce R. Flipping content to improve student examination performance in a pharmacogenomics course. Am J Pharm Educ. 2015;79(7):103.

    Article  Google Scholar 

  7. Cook DA, Ellaway RH. Evaluating technology-enhanced learning: a comprehensive framework. Medical Teacher. 2015;37(10):961–70.

    Article  Google Scholar 

  8. Butt A. Student views on the use of a flipped classroom approach: evidence from Australia. Business Education & Accreditation. 2014;6(1):33.

    Google Scholar 

  9. Sherman RO. Teaching the net set. J Nurs Educ. 2009;48(7):359–60.

    Article  Google Scholar 

  10. Denton GD, DeMott C, Pangaro LN, Hemmer PA. Literature reviews: narrative review: use of student-generated logbooks in undergraduate medical education. Teaching and learning in medicine. 2006;18(2):153–64.

    Article  Google Scholar 

  11. Rattner SL, Louis DZ, Rabinowitz C, Gottlieb JE, Nasca TJ, Markham FW, et al. Documenting and comparing medical students' clinical experiences. Jama. 2001;286(9):1035–40.

    Article  Google Scholar 

  12. Scott KM, Barrett J, Cheetham V, McCallum Z, Barzi F, Phelps M. Mismatch between medical student expectations and experience: student over-entitlement or programs needing reform? Focus on health professional education: A multi-disciplinary journal. 2014;15(3):41.

    Google Scholar 

  13. Van Tartwijk J, Driessen EW. Portfolios for assessment and learning: AMEE guide no. 45. Medical teacher. 2009;31(9):790–801.

    Article  Google Scholar 

  14. Alderson TSJ, Oswald N. Clinical experience of medical students in primary care: use of an electronic log in monitoring experience and in guiding education in the Cambridge community based clinical course. MEDICAL EDUCATION-OXFORD. 1999;33:429–33.

    Article  Google Scholar 

  15. Chen Z, Lin M, Chen F, Lane ND, Cardone G, Wang R, et al., editors. Unobtrusive sleep monitoring using smartphones. Pervasive Computing Technologies for Healthcare (PervasiveHealth), 2013 7th International Conference on; 2013: IEEE.

  16. Chen F, Wang R, Zhou X, Campbell AT, editors. My smartphone knows i am hungry. Proceedings of the 2014 workshop on physical analytics; 2014: ACM.

  17. Ben-Zeev D, Scherer EA, Wang R, Xie H, Campbell AT. Next-generation psychiatric assessment: using smartphone sensors to monitor behavior and mental health. Psychiatric rehabilitation journal. 2015;38(3):218.

    Article  Google Scholar 

  18. Wang R, Harari G, Hao P, Zhou X, Campbell AT, editors. SmartGPA: how smartphones can assess and predict academic performance of college students. Proceedings of the 2015 ACM international joint conference on pervasive and ubiquitous computing; 2015: ACM.

  19. O'Sullivan PS, Weinberg E, Boll AG, Nelson TR. Students' educational activities during clerkship. Academic medicine: journal of the Association of American Medical Colleges. 1997;72(4):308–13.

    Article  Google Scholar 

  20. Van Hell EA, Kuks J, Cohen-Schotanus J. Time spent on clerkship activities by students in relation to their perceptions of learning environment quality. Med Educ. 2009;43(7):674–9.

    Article  Google Scholar 

  21. Ruiz-Gallardo J-R, González-Geraldo JL, Castaño S. What are our students doing? Workload, time allocation and time management in PBL instruction. A case study in science education. Teach Teach Educ. 2016;53:51–62.

    Article  Google Scholar 

  22. Becker SA, Cummins M, Davis A, Freeman A, Hall CG, Ananthanarayanan V. NMC horizon report: 2017 higher education edition. The New Media Consortium; 2017.

  23. Kukulska-Hulme A. Introduction. Mobile Learning: Routledge; 2007. p. 17–22.

  24. Scott KM, Nerminathan A, Alexander S, Phelps M, Harrison A. Using mobile devices for learning in clinical settings: A mixed-methods study of medical student, physician and patient perspectives. British Journal of Educational Technology. 2015.

  25. Klasnja P, Pratt W. Healthcare in the pocket: mapping the space of mobile-phone health interventions. J Biomed Inform. 2012;45(1):184–98.

    Article  Google Scholar 

  26. Haim S, Wang R, Lord SE, Loeb L, Zhou X, Campbell AT, editors. The Mobile Stress Meter: A New Way to Measure Stress Using Images. 4th ACM Workshop on Mobile Systems for Computational Social Science; 2015 September 9–11, 2015; Osaka, Japan.

  27. Wang R, Campbell AT, Zhou X, editors. Using opportunistic face logging from smartphone to infer mental health: challenges and future directions. Adjunct Proceedings of the 2015 ACM International Joint Conference on Pervasive and Ubiquitous Computing and Proceedings of the 2015 ACM International Symposium on Wearable Computers; 2015: ACM.

  28. Li I, Dey AK, Forlizzi J, editors. Understanding my data, myself: supporting self-reflection with ubicomp technologies. Proceedings of the 13th international conference on Ubiquitous computing; 2011: ACM.

  29. Ellaway RH, Pusic MV, Galbraith RM, Cameron T. Developing the role of big data and analytics in health professional education. Medical teacher. 2014;36(3):216–22.

    Article  Google Scholar 

  30. Downe-Wamboldt B. Content analysis: method, applications, and issues. Health care for women international. 1992;13(3):313–21.

    Article  Google Scholar 

  31. Scott K, Morris A, Marais B. Medical student use of digital learning resources. The Clinical Teacher. 2017.

  32. Walters L, Greenhill J, Richards J, Ward H, Campbell N, Ash J, et al. Outcomes of longitudinal integrated clinical placements for students, clinicians and society. Med Educ. 2012;46(11):1028–41.

    Article  Google Scholar 

  33. Strayer J. The effects of the classroom flip on the learning environment: A comparison of learning activity in a traditional classroom and a flip classroom that used an intelligent tutoring system: The Ohio State University; 2007.

  34. Moffett J. Twelve tips for “flipping” the classroom. Medical Teacher. 2015;37(4):331–6.

    Article  Google Scholar 

  35. Rotellar C, Cain J. Research, perspectives, and recommendations on implementing the flipped classroom. Am J Pharm Educ. 2016;80(2):34.

    Article  Google Scholar 

  36. Wilkes Z. The student-mentor relationship: a review of the literature. Nursing Standard (through 2013). 2006;20(37):42.

    Article  Google Scholar 

  37. Löfmark A, Wikblad K. Facilitating and obstructing factors for development of learning in clinical practice: a student perspective. J Adv Nurs. 2001;34(1):43–50.

    Article  Google Scholar 

  38. Ryan RM, Deci EL. Self-determination theory and the facilitation of intrinsic motivation, social development, and well-being. Am Psychol. 2000;55(1):68.

    Article  Google Scholar 

  39. Kjeldstadli K, Tyssen R, Finset A, Hem E, Gude T, Gronvold NT, et al. Life satisfaction and resilience in medical school–a six-year longitudinal, nationwide and comparative study. BMC medical education. 2006;6(1):48.

    Article  Google Scholar 

  40. Thomas MR, Dyrbye LN, Huntington JL, Lawson KL, Novotny PJ, Sloan JA, et al. How do distress and well-being relate to medical student empathy? A multicenter study. J Gen Intern Med. 2007;22(2):177–83.

    Article  Google Scholar 

  41. Tolhurst HM, Stewart SM. Balancing work, family and other lifestyle aspects: a qualitative study of Australian medical students' attitudes. Med J Aust. 2004;181(7):361.

    Google Scholar 

  42. Harvey SB, Øverland S, Hatch SL, Wessely S, Mykletun A, Hotopf M. Exercise and the prevention of depression: results of the HUNT cohort study. Am J Psychiatr. 2017;175(1):28–36.

    Article  Google Scholar 

  43. Shanafelt TD, Boone S, Tan L, Dyrbye LN, Sotile W, Satele D, et al. Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Arch Intern Med. 2012;172(18):1377–85.

    Article  Google Scholar 

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Acknowledgements

We thank the University of Sydney’s Discipline of Child and Adolescent Health and Sydney Medical School for financial assistance, as well as the students who participated in the research.

Funding

The University of Sydney’s Discipline of Child and Adolescent Health and Sydney Medical School provided financial assistance to undertake this research.

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Authors and Affiliations

  1. School of Electrical and Information Engineering, University of Sydney, Sydney, Australia

    Yu Zhao

  2. Discipline of Child and Adolescent Health, Sydney Medical School, University of Sydney, Sydney, Australia

    Anne Morris, Ben J. Marais & Karen M. Scott

  3. Division of Information Technology, Engineering and the Environment, University of South Australia, Adelaide, Australia

    Abelardo Pardo

Authors
  1. Yu Zhao
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  2. Anne Morris
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  3. Ben J. Marais
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  4. Abelardo Pardo
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Correspondence to Karen M. Scott.

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Zhao, Y., Morris, A., Marais, B.J. et al. Exploring how medical students learn during clinical rotations: a pilot study with a mobile application. Health Technol. 9, 257–267 (2019). https://doi.org/10.1007/s12553-019-00305-8

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  • DOI: https://doi.org/10.1007/s12553-019-00305-8

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