There is strong evidence that certain neurophysiological processes link action and observation (Higuchi et al., 2012), which supports the idea that learning a motor skill is enhanced via skill observation (Hayes et al., 2010). Skill learning through observation is optimized when the observation includes a combination of expert and novice models (Rohbanfard and Proteau, 2011). The purported advantage lies in the two types of models’ dissimilar ability (Andrieux & Proteau, 2013). The novice model is characterized by larger margins of error that manifest as variable attempts. Increased variability has been shown to be beneficial in physical practice (Moxley, 1979). The purpose of the first study was to examine the observation of novice variability effect to explore whether it is Schmidt’s (1975) generalized motor programs or schema parameterization representations that is acquired when observing modeled performances. Participants engaged in an observational period in which they observed a criterion model with no variability, a model demonstrating absolute timing variability, a model demonstrating relative timing variability, or a model demonstrating variability in both relative and absolute timing. The results indicate that variability in relative timing information contributes to observational learning, which suggests that generalized motor programs are acquired through observation but not schematic parameterizations. The purpose of the second study was to apply the Rohbanfard and Proteau (2011) paradigm in the medical education context by exploring the impact of video-based observational practice on the clinical learning. First year medical students learned a common surgical skill by observing expert demonstrations of the skill, novice demonstrations, or demonstrations by both an expert and novice model. The study demonstrated a robust effect of observational learning in that all groups improved over time regardless of the type of model they observed. Both studies highlight that an expert model may be the most beneficial when engaging in observational practice. / Thesis / Master of Science (MSc)

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Indiana University-Purdue University Indianapolis (IUPUI) / Metacognition, the ability to self-regulate one’s learning and performance, is well-known to provide numerous academic and professional benefits for students, educators, and clinicians. However, few studies have studied metacognition specifically in the context of anatomical sciences education. Therefore, the overarching purpose of this dissertation was to explore the metacognition of students and educators who are learning and teaching the anatomical sciences. This dissertation investigated the metacognition of allied health students (physical therapy, physician assistant, and occupational therapy; n=109), first-year medical students (n=1802), and anatomy educators (faculty, associate instructors, and teaching assistants; n=13) in anatomy courses through three multiple-methods studies. Quantitative data were collected using assessment data and either the Metacognition Awareness Inventory (MAI), Practice-Based Learning and Improvement (PBLI) assignments, or Teacher Metacognition Inventory (TMI). These data were then analyzed using the appropriate descriptive and inferential statistics. Qualitative data were also collected through reflective writing activities (e.g., online discussion boards or reflective journals) and analyzed using thematic or framework analysis. Overall, both students and educators improved their metacognition across a semester of either learning or teaching anatomy, with certain subgroups demonstrating greater metacognitive ability or growth than others. Higher performing allied health and medical students were both more accurate at predicting their exam performances compared to their lower performing peers. Faculty also demonstrated the greatest teaching-specific metacognition, though teaching assistants exhibited the greatest growth in their teaching-specific metacognition. These improvements were primarily in their reflective ability and awareness of personal strengths and weaknesses as teachers. Several notable themes relating to metacognition were also identified such as student willingness to monitor learning diminishing over time due to competing academic or professional commitments. Additionally, novice educators were more inwardly-focused on personal traits and content mastery, whereas experienced educators were more outwardly-focused on interpersonal factors (e.g., student rapport and inclusive language). These insights into the metacognition of both students and educators can inform how to best support and improve teaching and learning in the anatomical sciences. Given the significance of metacognition, it may be beneficial to incorporate educational activities that can support the metacognition of both students and educators, simultaneously.

To ensure medical residents are prepared to work in complex and evolving settings, postgraduate medical education is transitioning to competency-based medical education, which is known as Competence by Design (CBD) in Canada. To understand how CBD is operationalized within specific residency programs and how it contributes to patient, faculty, and learner outcomes, there is a need to engage in program evaluation. However, the actual extent that, reasons for, and methods in which CBD programs are engaging in program evaluation remain unclear. Furthermore, minimal attention has been given to building program evaluation capacity within medical education programs (i.e., doing evaluation and using evaluation findings). In this research project, I explore and formally document: (a) the extent that and the ways in which CBD programs are engaging in program evaluation, (b) the reasons why these programs are engaging or not engaging in program evaluation, (c) the actual and potential positive and negative consequences of these programs engaging in program evaluation, (d) the ways that these programs build their capacities to do program evaluation and use evaluation findings, (e) the ways that program evaluators currently support these programs, and (f) the ways that program evaluators can help stakeholders build their capacities to do program evaluation and use evaluation findings. Through this research, I contribute to the limited body of empirical research on program evaluation in medical education. Confirming how CBD programs are engaging in program evaluation can advise stakeholders and program evaluators on how best to support CBD programs in building their capacities to do program evaluation and use evaluation findings, inform the design and implementation of other medical education programs, and, ultimately, enlighten program evaluation research on authentic and current evaluation practices in medical education. To meet the objectives of this study, I used a three-phase, sequential mixed methods approach. In Phase 1, I conducted a survey of Canadian program directors whose programs have transitioned to CBD to determine: (a) the extent to which CBD programs are engaging in program evaluation, and (b) the reasons why CBD programs are engaging or not engaging in program evaluation. In Phase 2, I interviewed interested program directors to explore: (c) how CBD programs are engaging in program evaluation, and (d) the ways in which CBD programs can build their capacities to do program evaluation and use evaluation findings. In Phase 3, I interviewed Canadian program evaluators to investigate: (e) how program evaluators are currently supporting CBD programs in program evaluation, and (f) how program evaluators can help CBD programs build their capacities to do program evaluation and use evaluation findings. Overall, the Phase 1 findings show that: (a) over three quarters of respondents indicated that their program does engage in program evaluation and most invite stakeholders to participate. However, most programs rarely leverage the expertise of a program evaluator and acknowledge interpreting quantitative program evaluation data is a challenge. Additionally, (b) most programs engage in program evaluation to improve their program and make decisions. However, most programs do not have an employee whose primary responsibility is program evaluation. They do not receive funding for program evaluation which affects their abilities to engage in program evaluation. Moreover, some programs do not engage in program evaluation because they do not know how to do program evaluation. The Phase 2 findings show that: (c) when program directors do engage in program evaluation, they are using ad hoc evaluation methods and a team-based format. However, program directors of CBD programs are struggling to engage in program evaluation because of limited available resources (i.e., time, financial, human resources, and technology infrastructure) and buy-in. Additionally, (d) program directors are building their capacity to do evaluation and use the findings from their specialty/subspecialty program evaluation. The Phase 3 findings show that: (e) program evaluators are supporting CBD programs by responding in a reactive way as temporary and external evaluation consultants. Finally, (f) program evaluators can help CBD programs build their capacities to do program evaluation and use the findings by using a participatory evaluation approach, leveraging existing data, encouraging the use of program evaluation approaches that are appropriate to the CBD implementation context, or encouraging programs to share findings which establishes an accountability cycle. In light of these findings, I discuss ways to engage in program evaluation, build capacity to do evaluation, and build capacity to use evaluation findings in CBD programs.

The doctor-patient relationship is a very important aspect of a patient's health and wellbeing. It is a complex relationship that requires trust and understanding by both parties. Doctor shopping and changes in technology that allow patients to independently learn about their health have further complicated this relationship. This study looks at how participants perceive controlling language depending on the gender of the doctor. Participants were 339 University of Central Florida undergraduate students (112 men and 227 women, age M= 19.29, SD = 3.60) recruited through SONA. Participants first listened to a recording of a male or female doctor speaking to a patient using high or low level controlling language. They then answered questions about their opinion of the doctor, how they would behave in the patient's situation, and their beliefs about the role of doctors in the doctor-patient relationship. Results indicated both level of controlling language and doctor gender had significant effects on participants' perception of the doctor. Doctors who spoke with high level controlling language were seen as less helpful and supportive than doctors who spoke with low level controlling language. Participants also were less likely to recommend them to another person. Male doctors were seen as ruder than female doctors. These results suggest that doctors must communicate with each patient in that makes them both the most comfortable, and that male doctors may need to work harder to communicate empathy to their patients.

Introduction The purpose of this project is to implement an innovative, and engaging knowledge transfer pedagogy for 5th grade science students. This project utilized Stealth Learning, a learning pedagogy developed by Dr. James Rosser.99,100,109,110 The program featured applied learning to develop skill sets in general and drone aviation, as well as minimally invasive surgery techniques. This was facilitated through the use of computers, table simulators, and drones. Methodology This project took standardized subject matter from the Florida Comprehensive Assessment Test (FCAT) and converted it into content featuring the Stealth approach. The section that was converted was the "Practice of Science and the Characteristics of Scientific Knowledge" portion of the FCAT. This program includes curriculum workbooks and worksheets, mini drones, scientifically-validated video games (Super Monkey Ball 2), Stealth Learning music-vocab videos (Animotos), surgical simulation skill drills (Bean Drop), and competitions material (Spelling Bee). A website was also made to allow students to review material at home. This program was administered with the assistance of healthcare and aviation professionals to provide a mentoring component. The program included an execution phase consisting of seven sessions, which took place for 45 minutes each during the Spring Semester (April 2016). Preliminary Findings There are preliminary results for this project, which must be explored further in future studies. This project first analyzed the Science FCAT scores for 72 students in the 5th grade. Of the 72 students in the class, 22 (30.5%) passed the exam. Eleven of the students were enrolled in our program and 54% (6 of 11) passed in comparison to twenty-six percent of the students that underwent standard preparation passed the exam. Conclusion Especially for minorities and the socioeconomically disadvantaged, student performance on state standard exams is one of the most pressing challenges faced in education today. This study suggests that a state standard-based 5th grade curriculum can be converted into an innovative brain-based lesson plan to enhance performance on state standard exams. This initial investigation offers some encouragement for others to further pursue this research.

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The purpose of the study was to investigate and analyze some sources of validity evidence acquired from data (i.e., scores) of comprehensive clinical competency-focused components of the assessment system within the context of one school of dentistry through retrospective analysis of students’ data. Assessments in dental education need some form of evidence of validity to support the proposed interpretations of scores. The approach for evaluating evidence on test scores is presented as an argument, based on theory and logic, according to the four inferences in Kane’s view on validity: scoring, generalization, extrapolation, and implication. Based on our available data sets, we selected and organized specific sources of evidence to serve our purpose. Our primary approach to the evaluation of the data was through the use of a multitrait multimethod (MTMM) matrix and a multiple regression model. The analysis combined data from three cohorts to provide more reliable estimates. The analyses in this study discussed three sources of validity evidence – reliability, construct validity, and predictive criterion-related validity – in the specific assessment context that support the extrapolation component of the argument. The other three components were presented based on qualitative evaluation, not relying heavily on psychometric data. The results from this preliminary study indicated that the assessment components employed are supported by psychometric reliability and validity qualities. Results of the statistical analysis indicated that the overall intrinsic reliability using Cronbach’s of the OSCE tests, nonetheless, were lower than research standards. Findings on construct validity using the MTMM matrix showed evidence on convergent and divergent validity based on the intercorrelations between the assessment components. Using multiple regression modeling, results supported evidence of incremental predictive validity explained by the change in proportion of variation accounted for in the criterion variable in the series of analyses. The reported evidence is vital for sharing knowledge and contributes to the overall validity argument of the assessment program, but only represents a preliminary step and identifies the basis for future research.