Background Shared understanding is essential to effective collaborative learning. Interactive processes occurring in problem-based learning (PBL) tutorials have been explored to determine their cognitive and social advantages, but shared understanding is a relatively under-researched social process of PBL. The objective of this study is to describe how medical students share understanding in medical problem-based learning tutorials. Methods We recruited participants from first-year medical students in a single institution’s problem-based learning graduate entry curriculum. Transcripts from full cycles of eight tutorial groups were compiled to form the study corpus. Small interactional response words as indicators of shared understanding were measured using the Wmatrix 3 programme, and concordance lineswere analysed manually to determine word functions. Results Interactional response words were most prevalent in session 1 and least prevalent in session 2 of the PBL cycle. Interactional response words were used to mark unexpanded and simple and complex content expansion functions. While affirmation content expansion functions and reactive content expansion functions were more prevalent in sessions 1 and 3, negation content expansion functions were more frequent in session2. The frequency of interactional response words and their functions seem to align with the focus of each PBL tutorial session. Conclusions Demonstrating the feasibility of corpus linguistics methodology for PBL concept analysis, this study showed that students in PBL tutorials attained sophisticated levels of shared understanding. We discussed the implication of the results for interprofessional teamworking and patient-doctor communication.

Introduction: Due to methodological limitations, process-oriented studies have analyzed a group or fragments of problem-based learning (PBL) tutorial talk. Studies that examined several PBL tutorial talk and profile talk data into linguistic categories within a mixed methods analysis are scarce. The study aims to describe the knowledge construction processes of graduate entry medical students at Derby medical school PBL hybrid curriculum in the United Kingdom.

Background: The study aims to provide a more global understanding of the knowledge-negotiation interactions occurring in problem-based learning tutorials by analysing interactive conversational words (ICWs) as structural markers of students’ interactional boundaries. Methods: We used Wmatrix 3 software to extract frequent ICWs from 253,145 word-corpus compiled from professionally transcribed transcripts of 56 first-year medical students and seven facilitators. The concordance lines of the frequent ICWs were thematically analysed to define their functions. Extracts of verbal exchanges were provided to illustrate how the knowledge negotiation unfolded. Chi-square statistics were used to quantitatively compare the ICWs frequencies across the tutorial sessions. A significant p-value was set at less than 0.05. Results: Overall, the ICWs were least prevalent in the second tutorial session. Affirmation ICWs were more prevalent than other types of ICWs across the tutorial sessions. The ICWs served seventeen frequent functions of which acknowledgement, confirming and addition predominated. The students frequently discussed subject matter content, and the discussion was of exploratory nature. There were several incomplete and sentence-completion statements. Conclusion: The corpus-based analysis provides a complementary perspective on the verbal interactions occurring in the PBL tutorials in practice. The students’ verbal exchanges were collaborative and exploratory, but the students seemed to have had turn-taking problems. The implications of the study are that the corpus-based methodology could be used to explore several PBL research questions including those previously explored non-linguistically. The PBL discourse, as a means of initiating medical students into professional practice, requires monitoring to ensure compliance with educational theory and policy

AIMS:The aim of this research was to explore the perceptions of undergraduate dental students regarding clinical reasoning skills and also discover the influences of different curriculum designs on the acquisition of these skills by students.METHODS:Eighteen final-year students from three different dental schools with varied curricula and cultures participated in the current research. The research used qualitative methodology. The study took place in 2013-2014. Interviews captured the participants' own understanding of clinical reasoning and its acquisition plus they "talked through" a clinical problem using a "think-aloud" technique. Thematic analysis was used to analyse the transcripts of the recorded interviews. Results obtained were related to curriculum structure.RESULTS:Unfamiliarity with the term clinical reasoning was common in students. Students from different schools used different strategies to reason when discussing clinical vignettes. Clinical reasoning process was dominated by pattern recognition. Students' behaviours seemed to be influenced by cultural factors.CONCLUSIONS:This research contributes to a greater understanding of how students learn, understand and apply dental clinical reasoning which will improve educational practices in the future.

Objectives: To investigate the current undergraduate ophthalmology curricula provided by the UK medical schools, evaluate how they compare with the guidelines of the Royal College of Ophthalmologists (RCOphth) and International Council for Ophthalmology (ICO), and determine the views of the UK ophthalmology teaching leads on the future direction of the curriculum. Methods: A cross-sectional questionnaire was sent to teaching leads in 31 medical schools across the UK. The questionnaire evaluated eight themes of the curriculum: content and learning outcomes, communication of learning outcomes, organisation of the curriculum, assessment, educational resources, teaching methods used, and the educational environment. The ophthalmology teaching leads were also asked their opinion on the current and future management of the curriculum. These were compared with RCOphth and ICO guidelines and descriptive statistical analysis performed. Results: A response rate of 93% (n=29/31) was achieved. The knowledge and clinical skills taught by the UK medical schools match the RCOphth guidelines, but fail to meet the ICO recommendations. A diverse range of assessment methods are used by UK medical schools during ophthalmology rotations. Variation was also observed in the organisation and methods of ophthalmology teaching. However, a significant consensus about the future direction of the curriculum was reported by teaching leads. Conclusions: Comprehensive RCOphth guidance and resource sharing between medical schools could help to ensure ophthalmology's continuing presence in the medical curriculum and improve the effectiveness of undergraduate ophthalmology teaching, while reducing the workload of local teaching departments and medical schools.

Background There have been anecdotal concerns that the skill mix of recently qualified graduates is very different to those qualifying several years ago, in particular that the clinical skills on qualification are less. If true, such changes may have ramifications for providers of undergraduate training, postgraduate training, particularly at foundation training level, and ultimately the public. Aim The aim of this study was to assess changes in perceived standards of newly qualified graduates as reported by foundation trainers. Method A cross-sectional survey was conducted using a self-completed internet-based survey tool sent to all foundation trainers (FTs) in England, Northern Ireland and Wales. Results A total of 312 responses were obtained covering all postgraduate deaneries. There was mixed opinion regarding standards of new graduates, with 51% reporting that the overall standard of those entering foundation training was 'unsatisfactory'. Standards in key clinical areas were considered unsatisfactory by large proportions of respondents. Eighty-five percent considered standards to be unsatisfactory in 'crown and bridge', 75% in 'extraction of teeth', 74% in endodontics, 67% in removable prosthodontics, and 62% in treatment planning. Experienced trainers identified a decline in standards in particular clinical areas. Conclusions A large proportion of foundation trainers consider the current standard of new graduates to be unsatisfactory for entering foundation training. There are a number of key clinical areas of concern and a perception of declining standards.

As a medical educator, you may be directly or indirectly involved in the quality of assessments. Measurement has a substantial role in developing the quality of assessment questions and student learning. The information provided by psychometric data can improve pedagogical issues in medical education. Through measurement we are able to assess the learning experiences of students. Standard setting plays an important role in assessing the performance quality of students as doctors in the future. Presentation of performance data for standard setters may contribute towards developing a credible and defensible pass mark. Validity and reliability of test scores are the most important factors for developing quality assessment questions. Analysis of the answers to individual questions provides useful feedback for assessment leads to improve the quality of each question, and hence make students' marks fair in terms of diversity and ethnicity. Item Characteristic Curves (ICC) can send signals to assessment leads to improve the quality of individual questions.

Background While educational techniques to improve clinical reasoning (CR) skills among medical students have been developed, the lack of faculty expertise in teaching CR remains a significant barrier.1 Teaching the teachers how to teach a subject in which they themselves did not receive a formal teaching is a challenge. In order to introduce a clinical reasoning theme for clinician educators, we explored the current knowledge, beliefs and attitudes of teaching staff by interviewing them at Nottingham University Hospitals NHS Trust (NUH). Methods We carried out a qualitative interview with semi-structured questions, during which clinical teachers were asked to describe their own understanding of CR, how they have acquired and teach it, and how they could incorporate clinical reasoning teaching and learning better in their own teaching. A half-day workshop on ‘Teaching and Learning Clinical Reasoning‘ was introduced for teaching fellows and nurse educators who teach medical students at NUH. The objectives of the workshop were: * To appreciate the link between sound CR and patient safety * To understand what CR is and the different elements that make it up * To establish a shared vocabulary and know key contents of a CR syllabus * To provide practical advice for clinical teachers how introduce CR into the teaching Evaluation of the workshop was carried out by questionnaire. Results Teaching fellows and nurse educators found the training very useful and felt it would change their practice as clinicians and as educators. They had assumed CR is something that could not be explicitly taught, and now they had a better idea to inform their teaching practice. Sharing basic CR knowledge and tips on how to teach CR gave them new ideas to facilitate the CR process with learners in everyday educational interventions like case-based teaching, ward rounds, simulations and debriefing. Teaching fellows highlighted that the training made them think about how they think in their own clinical practice. Previous research on faculty development has highlighted a dual benefit – improvements in teaching skills and their own clinical reasoning skills.2 Conclusions All clinicians teach CR, whether intentionally or not, but to ensure effective teaching, teachers and learners require a shared vocabulary and understanding of what CR is, and the knowledge and skills facilitate learning in this important area. An effective faculty development programme is required to achieve this. Reference 1. Eva KW. What every teacher needs to know about clinical reasoning. Medical Education 2005;39(1):98–106. 2. Kogan J, Holmboe ES. Faculty development and dissemination. In RL Trowbridge, JJ Rencic, SJ Durning (Eds.), Teaching clinical reasoning 2015. ACP.