Get Permission Teli and Kate: Effect of group dynamics on performance of first year medical students


Introduction

Cadaver dissection is integral part of anatomy curriculum for studying gross structure of human body. Anatomy knowledge is required for Medical practitioners, surgeons, anatomy teachers, and researchers to be a competent professional. For clinically oriented teaching prosections are used in some part.1 Still collective data indicate that cadaver dissection in the undergraduate curriculum has continued in many institutions across the world.4, 3, 2

Depending upon availability of cadavers, 8 to 20 students are dissecting on one cadaver. practically maximum 3 students can dissect on each side of cadaver. There are no explicit guidelines about what other students can do or utilize the time during dissection hours. Each teacher tries to engage or have different idea about what other students should do. We conducted this study to know if dissection related task roles allotted to students help utilise the time effectively [when not dissecting], their perception about working as a team, effect of team work on their performance.

Objectives

  1. To compare students’ perception of cadaveric dissection practices between following group dynamics and not following group dynamics.

  2. To know if following group dynamics during cadaveric dissection practices helps students to understand and perform better.

Materials and Methods

Institutional ethical committee clearance was obtained. written informed consent taken from participants.

Inclusion criteria

Students willing to participate in study

Exclusion criteria

Absentee / students not willing to participate in study

Sampling technique

80 willing participants of 100 students divided according to roll numbers into 4 tables for dissection

Data collection

Two tables were following traditional method during dissection time wherein 4 -6 students were dissecting and others observing. Remaining students were not allotted any particular role and were self- studying.

For other two tables out of 10 students each was given a role /responsibility to read and explain with clear instructions about what is expected from them for initial 2 weeks.

Once the students were aware of roles distribution, it was decided by team leader from table.

On each table of 10 students doing any regional dissection

1 leader was appointed to coordinate / moderate discussion – and maintain daily log

2 dissectors - were allotted to do the dissection

1 student read the surface projections/landmarks and dictated steps from dissection guide

2 students would read and explain osteology related to the dissection

2 students read and explained muscles in the region

2 read and explained vessels /nerves related in the region

Students were doing all roles in rotation so in week schedule each will play each role once sequence of topic and time needed to complete was flexible according to students need. Initial 10 min was for distributing roles and hand over of previous session roles. Each one will do the allotted study for 30-40 min followed by discussion and demonstration of dissected parts simultaneously for 30 min. A faculty was moderating activities and discussions as well addressing any doubts.

Statistical methods

The perception of students was obtained by using a questionnaire on Likert scale from strongly disagree to strongly agree.

Descriptive statistics

Parametric test -two tailed unpaired ‘t’ test was applied to compare the knowledge scores of students. Non parametric test- rank based, Mann – Whitney u test was applied.

Results

Graph 1

Perceptions of students

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Figure 1 showing - Perceptions of students [in %] about dissection practices not following [Group I]and following dynamics [Group II]

Graph 2

Theory score of control group

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Figure 2 shows marks scored by individual student in theory I &II of control group

Graph 3

Practical scores of control group

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Figure 3 shows marks scored by individual student in practical I &II of control group

Graph 4

Theory scores of study group

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Figure 4 shows marks scored by individual student in theory I &II of study group

Graph 5

Practical scores of study group

https://typeset-prod-media-server.s3.amazonaws.com/article_uploads/ca99b55a-2f55-4947-a96d-8220e33ba93a/image/97da1ee3-3f8d-404c-a459-143922f7e6d6-uimage.png

Figure 5 shows marks scored by individual student in practical I &II of study group

Graph 6

Comparison of average marks between study and control group

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Figure 6 shows comparison of average marks scored by control [group 1] and study [group 2] in theory and practical

Table 1
Particular Average score theory 1 Average score theory 2 Diff of average scores in theory Average score practical 1 Average score practical 2 Diff of average score in practical
Group 1-control 40.9 35.8 -5.1 54.25 43.75 -10.5
Group2-study 46.15 44.35 -1.8 59.8 64.49 4.69
Std Dev Gp1-control 14.27 14.71 20.77 27.68 18.19 26.64
Std Dev Gp2 -study 19.70 10.45 25.19 32.59 10.91 31.19
t- value -0.88092 -2.89734 -2.96954 -6.94337
p value .38107 not significant .004883 Significant at p < .05. .003961 significant at p < .05. < .00001 significant at p < .05.
Mann -Whitney U 512 460 203
Z -0.61103 -2.76166 3.12805 -5.73501
p value .54186 not significant .00578. significant at p < .05. .00174 significant at p < .05. < .00001 significant at p < .05.

Showing comparison of control and study group performance and statistical significance

Discussion

Students subjected to group dynamics agreed strongly [70%] that learning objectives are clear, Work is properly distributed on dissection table [60%] and they can dissect in rotations equally [60%] as compared to control group [20-30%] students.

Students [60%] in study group strongly appreciated the proper time-management, responsibility [task]accountability and regular feedback as compared to only 20% strongly agreed in control group. [Figure 1]

Control group average score in first formative assessment was 41% & 54% in theory and practical respectively while the score in second formative assessment was 36% and 44% in theory and practical respectively. The performance of control group showed fall in theory and practical as well by 5 and 10 % respectively. [Figure 2, Figure 4]

Study group average score in first formative assessment was 46% & 60% in theory and practical respectively while the score in second formative assessment was 44 % and 64 % in theory and practical respectively. The performance of control group showed improvement in practical by 4% but remained consistent in theory. [Figure 3, Figure 4]

Compared to control group, study group performed better in all formative assessments and could perform consistently even with more syllabus for second formative assessment. The difference in performance is statistically significant in first practical and second formative assessments. [Table 1]

Students of study group performed better in first formative assessment of theory was not statistically significant as compared to control group. Performance of study group was significantly better in practical suggested that group dynamics in dissection lab help to improve the skills related to practical. Study group performed significantly better in second formative assessment both in theory and practical. Due to group dynamics students are actively involved in learning all aspects of anatomy [ surface landmarks, osteology, myology, vessels and nerves and dissection correlating relations of structures]. Improved performance in theory and practical of second formative assessment suggests distributing task, feedback and peer leaning helps in long term learning, recall and performance.

Good group dynamics help learning, retention and reinforce skills relevant to group and individual7, 6, 5 Informal feedback from students suggested applying group norms and following dynamics regularly helped them to make complex tasks easy, manage time. They could discuss, explain give and receive feedback on performance of /from peers. They felt responsible & accountable for allotted task. Non-English-speaking students reported it was helpful to develop communication skills which helped in improving performance in viva-voce. Efforts were made to meet learning objectives as daily progress and expected target was monitored by table teacher.

Limitations

We cannot attribute the better performance of study group only to group study, student self-study and involvement cannot be ruled out. We could not study performance of control group following group dynamics because of time constrains and students were to appear for university examinations. We commented about improvement in time management, leadership qualities and communication skills which are self-reported by students or observed by table in-charge. We could not give exact numerical for improvement of soft skills.

Conclusions

Positive group dynamics help learning, retention and reinforce skills relevant to group and individual. Sensitising students and using group dynamics in daily practices will help students to step towards the IMG standard of MCI8 by being able to communicate, lead, learn from peers, handle the groups and to perform better. We suggest to make students aware of group dynamics and use in daily practices as dissection hall, labs, clinical settings, even in administration to be an effective performing group.

Source of Funding

None.

Conflicts of Interest

None.

References

1 

Dick Rainsbury Alex Barbour Vishy Mahadevan College launches National Anatomy ProjectAnn R Coll Surg Engl 20078919

2 

H Gangata P Ntaba P Akol 10 Izunya AM, Oaikhena GA, Nwaopara AO: Attitudes to cadaver dissection in a Nigerian medical schoolAsian J Med Sci201038994

3 

Assegedech Bekele Dieter Reissig Sabine Löffler Andreas Hinz Experiences with dissection courses in human anatomy: A comparison between Germany and EthiopiaAsian J Med Sci20111932163167

4 

K Ongeti Pedagogical value of dissection anatomy in KenyaSingapore Med J201253712714

5 

R. Eisma C. Lamb R.W. Soames From formalin to thiel embalming: What changes? One anatomy department's experiencesClin Anat201326556457110.1002/ca.22222

6 

A Astin What matters in college? Four critical years revisitedJossey-BassSan Francisco1993

7 



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Article DOI

https://doi.org/ 10.18231/j.ijcap.2020.009


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