Inam Haq

Portfolios are increasingly used in undergraduate and postgraduate medical education. Four medical schools have collaborated with an established NHS electronic portfolio provider to develop and implement an authentic professional electronic portfolio for undergraduate students. We hypothesized that using an authentic portfolio would have significant advantages for students, particularly in familiarizing them with the tool many will continue to use for years after graduation. This paper describes the early evaluation of this undergraduate portfolio at two participating medical schools. To gather data, a questionnaire survey with extensive free text comments was used at School 1, and three focus groups were held at School 2. This paper reports thematic analysis of students’ opinions expressed in the free text comments and focus groups. Five main themes, common across both schools were identified. These concerned the purpose, use and acceptability of the portfolio, advantages of and barriers to the use of the portfolio, and the impacts on both learning and professional identity. An authentic portfolio mitigated some of the negative aspects of using a portfolio, and had a positive effect on students’ perception of themselves as becoming past of the profession. However, significant barriers to portfolio use remained, including a lack of understanding of the purpose of a portfolio and a perceived damaging effect on feedback.

Movement alterations are often reported in individuals with back pain. However the mechanisms behind these movement alterations are not well understood. A commonly cited mechanism is pain. The aim of this study was to investigate the effect of pain reduction, from oral analgesia, on lumbar kinematics in individuals with acute and chronic low back pain. A prospective, cross-sectional, experimental repeated-measures design was used. Twenty acute and 20 chronic individuals with low back pain were recruited from General Practitioner and self-referrals to therapy departments for low back pain. Participants complained of movement evoked low back pain. Inertial sensors were attached to the sacrum and lumbar spine and used to measure kinematics. Kinematic variables measured were range of motion, angular velocity and angular acceleration as well as a determining movement irregularity (a measure of deviation from smooth motion). Kinematics were investigated before and after administration of oral analgesia to instigate pain reduction. Pain was significantly reduced following oral analgesia. There were no significant effects on the kinematic variables before and after pain reduction from oral analgesia. There was no interaction between the variables group (acute and chronic) and time (pre and post pain reduction). The results demonstrate that pain reduction did not alter lumbar range of motion, angular velocity, angular acceleration or movement irregularity questioning the role of pain in lumbar kinematics.

Building on a series of higher educational arts/medicine initiatives, an interdisciplinary drawing module themed on the human body was developed for both year 3 Craft students and year 3 Medicine degree students. This became the subject of a research project exploring how the collaborative approach to drawing adopted on this module impacted on the students’ learning. In this article, emphasis is given to issues thought to have most potential relevance to medical education. Using an ethnographic research design, the methods adopted were: direct observation of all aspects of the module sessions, audio and video recordings and photographs of the sessions, the incorporation of a semi-structured discussion at the end of each session, and anonymous student questionnaires. A number of key themes emerged. The complex, phased and multi-sensory nature of the ‘critical looking’ skills developed through the drawing exercises was seen as of potential value in medical education, being proposed as analogous to processes involved in clinical examination and diagnosis. The experience of interdisciplinary collaborative drawing was significant to the students as a creative, participatory and responsive form of learning. The emphasis on the physical experience of drawing and the thematic use of the human body as drawing subject led to reflective discussions about bodily knowledge and understanding. There were indications that students had a meta-cognitive awareness of the learning shifts that had occurred and the sessions provoked constructive self-reflective explorations of pre-professional identity. This preliminary study suggests, through the themes identified, that there may be potential learning outcomes for medical students in this model of interdisciplinary collaborative drawing of the human body. Further research is needed to explore their applicability and value to medical education. There is a need to explore in more depth the beliefs, motivations and learning styles of medical students opting for the module, the significance and weighting of different learning and teaching elements in the module and the impact of the learning on medical students in the immediate post-module phase.

Background: Mobile technology is increasingly being used by clinicians to access up-to-date information for patient care. These offer learning opportunities in the clinical setting for medical students but the underlying pedagogic theories are not clear. A conceptual framework is needed to understand these further. Our initial questions were how the medical students used the technology, how it enabled them to learn and what theoretical underpinning supported the learning. Methods: 387 medical students were provided with a personal digital assistant (PDA) loaded with medical resources for the duration of their clinical studies. Outcomes were assessed by a mixed-methods triangulation approach using qualitative and quantitative analysis of surveys, focus groups and usage tracking data. Results: Learning occurred in context with timely access to key facts and through consolidation of knowledge via repetition. The PDA was an important addition to the learning ecology rather than a replacement. Contextual factors impacted on use both positively and negatively. Barriers included concerns of interrupting the clinical interaction and of negative responses from teachers and patients. Students preferred a future involving smartphone platforms. Conclusions: This is the first study to describe the learning ecology and pedagogic basis behind the use of mobile learning technologies in a large cohort of undergraduate medical students in the clinical environment. We have developed a model for mobile learning in the clinical setting that shows how different theories contribute to its use taking into account positive and negative contextual factors. The lessons from this study are transferable internationally, to other health care professions and to the development of similar initiatives with newer technology such as smartphones or tablet computers.