Development and validation of the student ratings in clinical teaching scale in Australia: a methodological study

Pin-Hsiang Huang,Anthony John O’Sullivan,Boaz Shulruf 한국보건의료인국가시험원 2023 보건의료교육평가 Vol.20 No.-

Purpose This study aimed to devise a valid measurement for assessing clinical students’ perceptions of teaching practices. Methods A new tool was developed based on a meta-analysis encompassing effective clinical teaching-learning factors. Seventy-nine items were generated using a frequency (never to always) scale. The tool was applied to the University of New South Wales year 2, 3, and 6 medical students. Exploratory and confirmatory factor analysis (exploratory factor analysis [EFA] and confirmatory factor analysis [CFA], respectively) were conducted to establish the tool’s construct validity and goodness of fit, and Cronbach’s α was used for reliability. Results In total, 352 students (44.2%) completed the questionnaire. The EFA identified student-centered learning, problem-solving learning, self-directed learning, and visual technology (reliability, 0.77 to 0.89). CFA showed acceptable goodness of fit (chi-square P<0.01, comparative fit index=0.930 and Tucker-Lewis index=0.917, root mean square error of approximation=0.069, standardized root mean square residual=0.06). Conclusion The established tool—Student Ratings in Clinical Teaching (STRICT)—is a valid and reliable tool that demonstrates how students perceive clinical teaching efficacy. STRICT measures the frequency of teaching practices to mitigate the biases of acquiescence and social desirability. Clinical teachers may use the tool to adapt their teaching practices with more active learning activities and to utilize visual technology to facilitate clinical learning efficacy. Clinical educators may apply STRICT to assess how these teaching practices are implemented in current clinical settings.

What impacts students’ satisfaction the most from Medicine Student Experience Questionnaire in Australia: a validity study

Pin-Hsiang Huang,Boaz Shulruf,Gary Velan,Greg Smith,Melanie Fentoullis,Sean Edward Kennedy,Karen Jane Gibson,Kerry Uebel 한국보건의료인국가시험원 2023 보건의료교육평가 Vol.20 No.-

Purpose This study evaluated the validity of student feedback derived from Medicine Student Experience Questionnaire (MedSEQ), as well as the predictors of students’ satisfaction in the Medicine program. Methods Data from MedSEQ applying to the University of New South Wales Medicine program in 2017, 2019, and 2021 were analyzed. Confirmatory factor analysis (CFA) and Cronbach’s α were used to assess the construct validity and reliability of MedSEQ respectively. Hierarchical multiple linear regressions were used to identify the factors that most impact students’ overall satisfaction with the program. Results A total of 1,719 students (34.50%) responded to MedSEQ. CFA showed good fit indices (root mean square error of approximation=0.051; comparative fit index=0.939; chi-square/degrees of freedom=6.429). All factors yielded good (α>0.7) or very good (α>0.8) levels of reliability, except the “online resources” factor, which had acceptable reliability (α=0.687). A multiple linear regression model with only demographic characteristics explained 3.8% of the variance in students’ overall satisfaction, whereas the model adding 8 domains from MedSEQ explained 40%, indicating that 36.2% of the variance was attributable to students’ experience across the 8 domains. Three domains had the strongest impact on overall satisfaction: “being cared for,” “satisfaction with teaching,” and “satisfaction with assessment” (β=0.327, 0.148, 0.148, respectively; all with P<0.001). Conclusion MedSEQ has good construct validity and high reliability, reflecting students’ satisfaction with the Medicine program. Key factors impacting students’ satisfaction are the perception of being cared for, quality teaching irrespective of the mode of delivery, and fair assessment tasks which enhance learning.

Factors predicting rural location employment intent and choice among medical students and graduates

Guilfoyle Charis,Huang Pin-Hsiang,Forster Lesley,Shulruf Boaz 한국의학교육학회 2022 Korean journal of medical education Vol.34 No.4

Purpose: Workforce shortage is a contributing cause of health inequality in rural Australia. There is inconclusive evidence demonstrating which factors cause doctors to choose rural practice. This study’s objective is to determine predictive factors for medical students’ intent to work rurally and for graduates’ current rural employment location choice.Methods: This prospective cohort study, utilized data gathered from the University of New South Wales about students and graduates who had spent one or more years in a Rural Clinical School. Participants were final year students and graduates already working in Australia. Stepwise logistic regression was used to determine predictive factors for the two outcomes.Results: Predictors for student intent to work rurally are rural background (odds ratio [OR], 7.16; 95% confidence interval [CI], 2.59–19.53), choosing to study at the Rural Clinical School (OR, 8.72; 95% CI, 1.32–57.63), and perceiving rural areas as opportunistic for career advancement (OR, 1.69; 95% CI, 1.15–2.49). Predictors for graduates currently working in a rural location are Bonded Medical Program participation (OR, 6.40; 95% CI, 1.15–35.59) and personal altruism (OR, 1.91; 95% CI, 1.02–3.57).Conclusion: While intent is predicted by having a rural background, choosing to study at the Rural Clinical School and perception of rural areas as having positive career opportunities, a current rural workplace location among graduates is predicted by holding a bonded medical position and a desire to serve an under-resourced population. Maintaining the Bonded Medical Program and clear communication regarding training pathways may increase numbers of rural doctors.

Equal Z standard-setting method to estimate the minimum number of panelists for a medical school’s objective structured clinical examination in Taiwan: a simulation study

Ying-Ying Yang,Pin-Hsiang Huang,Ling-Yu Yang,Chia-Chang Huang,Chih-Wei Liu,Shiau-Shian Huang,Chen-Huan Chen,Fa-Yauh Lee,Shou-Yen Kao,Boaz Shulruf 한국보건의료인국가시험원 2022 보건의료교육평가 Vol.19 No.-

Purpose Undertaking a standard-setting exercise is a common method for setting pass/fail cut scores for high-stakes examinations. The recently introduced equal Z standard-setting method (EZ method) has been found to be a valid and effective alternative for the commonly used Angoff and Hofstee methods and their variants. The current study aims to estimate the minimum number of panelists required for obtaining acceptable and reliable cut scores using the EZ method. Methods The primary data were extracted from 31 panelists who used the EZ method for setting cut scores for a 12-station of medical school’s final objective structured clinical examination (OSCE) in Taiwan. For this study, a new data set composed of 1,000 random samples of different panel sizes, ranging from 5 to 25 panelists, was established and analyzed. Analysis of variance was performed to measure the differences in the cut scores set by the sampled groups, across all sizes within each station. Results On average, a panel of 10 experts or more yielded cut scores with confidence more than or equal to 90% and 15 experts yielded cut scores with confidence more than or equal to 95%. No significant differences in cut scores associated with panel size were identified for panels of 5 or more experts. Conclusion The EZ method was found to be valid and feasible. Less than an hour was required for 12 panelists to assess 12 OSCE stations. Calculating the cut scores required only basic statistical skills.

Real-World Effectiveness and Safety of SOF/LDV for Pa-tients with Chronic Hepatitis C in Taiwan

( Ching-chu Lo ),( Pin-nan Cheng ),( Chi-yi Chen ),( Chung-feng Huang ),( Hsing-tao Kuo ),( Kuo-chih Tseng ),( Yi-hsiang Huang ),( Chi-ming Tai ),( Cheng-yuan Peng ),( Ming-jong Bair ),( Chien-hung Ch 대한간학회 2021 춘·추계 학술대회 (KASL) Vol.2021 No.1

Efficacy and Safety of 12 Weeks of Daclatasvir, Asunaprevir Plus Ribavirin for the Treatment of HCV Genotype 1b Infection without Baseline NS5A Resistance-Associated Variants (DARING)-Interim Report

( Ming-lung Yu ),( Chao-hung Hung ),( Yi-hsiang Huang ),( Cheng-yuan Peng ),( Chun-yen Lin ),( Pin-nan Cheng ),( Rong-nan Chien ),( Shih-jer Hsu ),( Chen-hua Liu ),( Jee-fu Huang ),( Chung-feng Huang 대한간학회 2018 춘·추계 학술대회 (KASL) Vol.2018 No.1

Aims: The current study aims to elucidate the treatment efficacy (defined as undetectable HCV RNA throughout 12 weeks of post-treatment follow-up, SVR12) and safety DCV/ASV plus ribavirin for 12 weeks in HCV-1b patients without NS5A RAS. Methods: This is a single-arm, open-label phase 2 study. Seventy directly acting antivirals (DAA)-naïve HCV-1b patients without L31/Y93 RAS are planned to receive daclatasvir (60 mg/ day) and asunaprevir (100 mg twice daily) plus weight-based ribavirin (1000-1200 mg/day) for 12 weeks. After treatment they were followed up for 12 weeks. Results: As of 31 Oct 2017, 58 eligible patients are allocated to treatment, with a mean age of 59.3 years and female predominance (67.2%, 39/58). The mean HCV RNA was 5.87+0.77 log10 IU/mL; 23 patients (39.7 %) had significant hepatic fibrosis (>F2). In the modified intention-to-treat analysis, the rate of undetectable HCV at week 1, week 2, week 4, week 8 and endof- treatment was 25 % (14/56), 84.8 % (39/46), 100 % (46/46), 100 % (38/38) and 100 % (27/27), respectively. Undetectable HCV RNA were observed in all of the patients with HCV RNA assessable 4 weeks (SVR4, 18/18) and 12 weeks (SVR12, 12/12) post treatment. None of the 18 patients who completed the 12-week treatment experienced relapse during post-treatment follow-up. The most common adverse event was fatigue (78.3 %), followed by pruritus (65.2 %) and dizziness (52.2 %), of which were considered as ribavirin related. None of the participating subjects withdrew treatment or follow-up throughout the trial peroid. Three serious adverse events were reported which included urosepsis, appendicitis and left ureteral stone. All were unrelated to the investigating drugs. Conclusions: 12 weeks of DCV/ASV plus ribavirin was highly effective and safe in HCV-1b patients without NS5A RAS in the interim analysis. The satisfactory results would be anticipated in the full patient set.