Materials and Methods
Approval was obtained from the University of Tennessee Health Science Center Institutional Review Board (#10-00715XM) for a randomized, controlled, blinded study to assess the impact of the GOLE model on achievement of ACGME Core Competencies among learners in a clinical setting. The study was conducted over a 1-year period from February 2010 through January 2011.
Subject enrollment
Study participants were recruited from third-year medical students rotating on the gynecologic oncology service over a 2-week period as part of their obstetrics and gynecology clerkship. Third-year medical students were enrolled only after informed consent and explanation of the study. The consent statement was given to students to explain the purpose of the research, instruct on the voluntary nature of the study, and clarify that participation would not adversely or positively affect their clinical evaluation or grading on the rotation. Completion of the baseline survey served as documentation of informed consent.
Participation in this study involved independently selecting a clinical topic of interest, creating a brief presentation, and completing a survey before and after the presentation. Upon enrollment, each student received a packet that was randomized to GOLE (intervention) or the control group. Within the packets were instructions for completing a survey prior to investigating a self-chosen clinical question. All packets included definitions for EBM, suggested EBM resources, and instructions to create a presentation of findings. The packets differed only by explanation of the GOLE model and the request to use it to complete the presentation in the intervention group. Subjects were randomized in blocks based on the number of students on the clinical rotation with the allocation sequence determined by a random number generator. The randomization was blinded to all subjects and evaluators participating in the study. A separate party was responsible for randomization, distribution, and collection of packets.
Enrolled students were given 1 week to prepare a presentation of their independently chosen clinical question according to their randomization. When the presentation topic was chosen, the presenter completed a survey (“Survey instrument” below) to assess baseline perceived knowledge of the chosen topic. Immediately after delivering the presentation, the presenter repeated the survey to assess change in self-perceived knowledge. Blinded resident/faculty evaluators completed an identical survey after each presentation. Verbal feedback was given to the students after they completed their presentation and postpresentation survey.
Survey instrument
A survey instrument was created to assess perceived improvement in knowledge of clinical topics. Based on the ACGME Core Competencies, a list of potential survey questions was compiled ( Table 1 ). A process of expert review was used to produce a final validated survey instrument. The potential survey questions were distributed to a panel of obstetrics and gynecology department chairs, residency program directors, and Association of Professors of Gynecology and Obstetrics Solvay Scholars. The reviewers were asked to rate each question and the content being tested on a scale of “essential,” “useful, but not essential,” and “not necessary” in the context of clinical education. The content validity ratio (CVR) was calculated based on the formula : CVR=ne−N2N2
CVR = n e − N 2 N 2
where n e equals the number of reviewers indicating “essential” and N equals the total number of content reviewers. Calculated CVRs were then compared to levels required for statistical significance. A minimum CVR value of 0.51 was necessary for statistical significance at P < .05 based on 14 content reviewers. The final survey instrument contained 10 items ( Table 1 ) corresponding to ACGME Core Competencies (7 of 10 items) or relevant presentation skills (3 of 10 items). Each survey item included a 10-point Likert scale to assess the perceived presentation content of the presenter.
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
