Browsing by Author "Trujillo, Daniel J."

Now showing 1 - 3 of 3
  • Thumbnail Image
    Item
    How Do Medical Students Approach Critical Appraisal? Results from a Mixed-Methods Study
    (2023-05-19) Menard, Laura M.; Blevins, Amy E.; Vetter, Cecelia J.; Trujillo, Daniel J.
    OBJECTIVES: Our research team wanted to find out what principles and best practices medical students use when prompted by a clerkship assignment to complete a critical appraisal of an article of their choosing. Our hypothesis was that, outside of a structured classroom environment, many students would default to more basic literature evaluation strategies or even apply proxies for methodological rigor such as journal reputation or peer review status of a study. METHODS: All first-year clerkship students at the School of Medicine are required to complete a patient-focused evidence-based medicine (EBM) assignment during their Internal Medicine clerkship. A team of three librarians and one statistician undertook a mixed-methods approach to identify and quantify themes that emerged in the text of one year's worth of these assignments (n=343). A mixed method research approach was implemented to gain a greater understanding of the EBM principles and best practices that students reference in their assignments. Within this approach a qualitative content analysis was conducted, followed by a quantitative analysis of patterns within the sample. The research team used first- and second cycle coding and a collaboratively developed code list of nine major codes to ensure accuracy and standardization. Additionally, the research team's statistician implemented an inter-rater reliability plan and examined inter-class correlations to ensure grading consistency across team members and student assignments. Once all assignments had been coded, the team used statistical analysis to find correlations between codes as well as frequency of code application within the sample in order to identify five major critical appraisal themes which emerged in the students' assignments. RESULTS: After a rigorous coding process, several codes and related themes emerged. The research team identified nine main codes and five major themes. These themes are as follows: Theme 1: Comparing the study population to the patient being treated and recommending a course of action Theme 2: Identifying study type and position in hierarchy of evidence Theme 3: Identifying proxies for study quality, including provenance and timeliness of chosen study Theme 4: Summarizing study methodology and results Theme 5: Attempting a critical appraisal of chosen study Additionally, we identified correlations between themes as well as frequency of application in the sample. CONCLUSIONS: A few notable results from our analysis of this sample are the frequency with which students were able to summarize the results of their chosen study and apply what they had learned to patient care (54.5% and 46.9% of all assignments, respectively). However, a notable number of students (35.2%) incorrectly used journal reputation, peer review status, h-index, impact factor, or similar metric, as a proxy for critical appraisal without engaging with the study methodology. This indicates that there is a need for further education and engagement with clerkship directors regarding the utility and application of EBM skills in the clinical curriculum.
  • Thumbnail Image
    Item
    Medical Student Responses in Critical Appraisal: A Qualitative Analysis
    (2022-05-06) Vetter, Cecelia J.; Menard, Laura M.; Blevins, Amy E.; Trujillo, Daniel J.
    Title: Medical Student Responses in Critical Appraisal: A Qualitative Analysis Objectives: To identify themes in medical student critical appraisal skills when asked to complete an evidence-based medicine (EBM) assignment. Researchers will analyze identified themes to find common approaches used by medical students when critically appraising a research article. Methods: Our team (three medical librarians and a statistician) will conduct a qualitative analysis of first year clerkship (third year of medical school) students’ responses to an EBM assignment wherein students are asked to critically appraise a research article and apply it to patient care. Previously, we noted that many students use factors such as journal reputation or impact factor as proxies for critically appraising study methodology and results. The librarian team is conducting a qualitative analysis of textual responses by gathering one years’ worth of quiz responses. Each team member is individually reviewing each response for general themes. After this open coding is completed, librarian team members will collaboratively develop a code list. Each team member will then code each assignment individually. Statistics will be run for inter-rater reliability and discrepancies will be resolved by librarian group consensus. Results: The team will present main and secondary themes. Commentary and examples will be provided by the librarian team on trends seen in medical student critical appraisal. Conclusions: This project is ongoing. However, we anticipate that our results will inform EBM instruction by identifying common themes in medical trainees' early attempts to apply critical appraisal skills to a clinical scenario.
  • Thumbnail Image
    Item
    Student-led curricular approaches in medical education: the educational effects of a virtual fundamentals of COVID-19 course
    (Springer, 2022-03-08) Chiu, Megan Z.; Gerena, Rolando G.; Roll, Rebekah L.; Baker, Joseph M.; Gomez, Maritza; Brown, Cameron M.; Brenner, Abigail M.; Huang, Christina C.; Ko, Paul Y.; Bauer, Margaret E.; Trujillo, Daniel J.; Graduate Medical Education, School of Medicine
    Background As the field of education was adapting to virtual learning during the COVID-19 pandemic, a need quickly emerged for a course to prepare medical students for future clinical practice. This call to action was answered by creating an innovative Fundamentals of COVID-19 course at the Indiana University School of Medicine (IUSM). As a group of medical student leaders at IUSM, we developed this online course in order to support our fellow students and the community. Methods The study examined the educational effects of completing the Fundamentals of COVID-19 course. In order to examine these effects, the study asked enrolled students to complete both a pre- and post-course self-assessment survey. Students were asked an identical set of questions on each survey about their knowledge, skills, and abilities (KSA) regarding COVID-19. Composite scores were created for each KSA learning domain. Responses were provided using a five-point Likert scale ranging from 1 = strongly disagree to 5 = strongly agree. Results Out of the 724 students enrolled, 645 students completed both the pre- and post-course assessment surveys. Findings show that there were both meaningful and statistically significant differences in students’ responses to the pre- and post-course surveys. Results show 1.) a significant mean increase in the knowledge composite score of 1.01, 95% CI [0.95, 1.06], t(644) = 36.4, p < .001, d = 1.43; 2.) a significant mean increase in the skills composite score of .55, 95% CI [0.50, 0.60], t(644) = 20.70, p < .001, d = 0.81. and 3.) a significant mean increase of the abilities composite score of 1.02, 95% CI [.97, 1.07], t(644) = 36.56, p < .001, d = 1.44. Conclusions These findings demonstrate that the student-developed, online Fundamentals of COVID-19 course resulted in notable and statistically significant educational effects. The increase in students’ self-reported ratings, especially in the knowledge and abilities domains, indicate that meaningful learning occurred within the course. These findings have notable implications for medical student training during healthcare emergencies, such as a pandemic, as well as within modern clerkship environments. Overall, our findings provide evidence that student-led curricular design and virtual delivery of course content can be effective tools in undergraduate medical education.