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Medical schools worldwide are promoting a student-centered and patient-centered care curriculum by using problem-based learning (PBL) strategy, emphasizing group dynamics and discussions. This approach facilitates student engagement, participation, and partnership interaction. However, in the context of the wide power-distance or the existence of socio-hierarchical gaps in Indonesia, two-way dialogue is limited. Few studies describe the one-way paternalistic communication styles between physician-patient, teacher-student, and parents-children, which can lead to less effective learning and healthcare environments. In this study, we investigated if students in an Indonesian medical school, who have been learning and practicing a partnership style of communication in a PBL curriculum for three years, are using the same style of communication with their junior peers outside the classroom. We examined the communication style between senior and new medical students, using surveys, observations, and focus group discussions, during a three-day orientation at the beginning of medical education. The results indicated that senior students used a one-sided communication style with their juniors, whereas new students expressed the need for egalitarian interaction with seniors. A classic dilemma of nature versus nurture was found and discussed. To change the traditional values, robust, constructive, and systematic formative training is key.

Anatomy education often consists of a combination of lectures and laboratory sessions, the latter frequently including surface anatomy. Studying surface anatomy enables students to elaborate on their knowledge of the cadaver's static anatomy by enabling the visualization of structures, especially those of the musculoskeletal system, move and function in a living human being. A recent development in "teaching methods" for surface anatomy is body painting, which several studies suggest increases both student motivation and knowledge acquisition. This article focuses on a "teaching approach" and is a translational contribution to existing literature. In line with best evidence medical education, the aim of this article is twofold: to briefly inform teachers about constructivist learning theory and elaborate on the principles of constructive, collaborative, contextual, and self-directed learning; and to provide teachers with an example of how to implement these learning principles to change the approach to teaching surface anatomy. Student evaluations of this new approach demonstrate that the application of these learning principles leads to higher student satisfaction. However, research suggests that even better results could be achieved by further adjustments in the application of contextual and self-directed learning principles. Successful implementation and guidance of peer physical examination is crucial for the described approach, but research shows that other options, like using life models, seem to work equally well. Future research on surface anatomy should focus on increasing the students' ability to apply anatomical knowledge and defining the setting in which certain teaching methods and approaches have a positive effect. (Contains 1 table and 3 figures.)

Many evaluation instruments have been developed to provide feedback to physicians on their clinical teaching but written feedback alone is not always effective. We explored whether feedback effectiveness improved when teachers' self-assessment was added to written feedback based on student ratings. 37 physicians (10 residents, 27 attending physicians) from different specialties (Internal Medicine, Surgery, Obstetrics/Gynecology, Pediatrics, Neurology, Dermatology, Ophthalmology, ENT, and Psychiatry) were invited to fill out a self-assessment questionnaire on their teaching skills. Students completed an almost identical questionnaire to evaluate the same teachers based on their experiences during clerkships. After receiving written feedback incorporating their self-assessment and the student ratings, the teachers indicated their perceptions of the self-assessment exercise and the written feedback in a questionnaire (five-point Likert scale items) and next, in more detail, in semi-structured interviews with a purposive sample of 12 of the participating teachers. 25 physicians participated (67%). The results showed that self-assessment and student feedback were both perceived as useful (3.7, SD 1.0) but the latter was considered more effective. The physicians we interviewed considered the combination of self-assessment with student ratings more effective than either self-assessment or written feedback alone. Notably, discrepancies between student ratings and self-assessment were deemed a strong incentive for change. We conclude that self-assessment can be a useful tool to stimulate improvement of clinical teaching when it is combined with written feedback based on student ratings. Future research among larger groups is needed to confirm our findings and examine whether these combined tools actually lead to improved teaching. (Contains 5 tables.)

Innovations in undergraduate medical education, such as integration of disciplines and problem based learning, have given rise to concerns about students' knowledge of anatomy. This article originated from several studies investigating the knowledge of anatomy of students at the eight Dutch medical schools. The studies showed that undergraduate students uniformly perceived deficiencies in their anatomical knowledge when they started clinical training regardless of their school's didactic approach. A study assessing students' actual knowledge of clinical anatomy revealed no relationship between students' knowledge and the school's didactic approach. Test failure rates based on absolute standards set by different groups of experts were indicative of unsatisfactory levels of anatomical knowledge, although standards differed markedly between the groups of experts. Good test performance by students seems to be related to total teaching time for anatomy, teaching in clinical context, and revisiting anatomy topics in the course of the curriculum. These factors appeared to outweigh the effects of disciplinary integration or whether the curriculum was problem-based or traditional.

Introduction: Many of the residents who supervise medical students in clinical practice are unfamiliar with the principles of effective supervision. Training in teaching skills is therefore seen as an effective strategy to improve the quality of clinical supervision. Method: Twenty seven medical residents were matched and assigned to an experimental group (n = 14) and a control group (n = 13). The experimental group participated in a two-day workshop on teaching skills. Using standardized questionnaires, the teaching abilities of all participants were assessed anonymously by medical students, before and after the workshop, to determine for any effect of the intervention. Results: A significant improvement in the teaching abilities of the medical residents in the experimental group was observed following the workshop (t = -2.68, p = 0.02). The effect size within the experimental group was large (d = 1.17), indicating that the workshop led to a measurable positive change in the medical residents' teaching abilities. The effect size estimated from the post intervention scores on teaching ability of the two groups showed a moderate improvement (d = 0.57) in the experimental group compared with the control group. Discussion: Medical students rated the teaching abilities of the workshop participants after the training more highly than those of the residents in the control group. The ability to adjust teaching to the needs of the students and teach effective communication and diagnostic clinical skills were among the features that characterized effective teaching. Properly designed, teacher-training workshops could be effective and feasible methods to improve the quality of teaching by medical residents.

Discusses the attitude differences between university staff, researchers, and teachers. Considers student learning with two different assumptions, "teaching is learning" and "the more we teach, the more students learn." Evaluates the relationship of student assessment curriculum to educational practice and points out the importance of tests in student evaluation. (Contains 16 references.) (Author/YDS)

Compares the academic achievement of students from two Dutch medical schools, one employing problem-based learning (PBL) and one using non-PBL methods. No systematic differences were found on total test scores. Differences were demonstrated only at the level of individual questions. Results indicate that PBL and non-PBL instructional methods have similar effects on medical factual knowledge. (Author/PVD)