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- Knowledge attainment, learning approaches, and self-perceived study burnout among European veterinary studentsPublication . Iivanainen, Antti; Wandall, Jakob; Parpala, Anna; Nevgi, Anne; Keto-Timonen, Riikka; Tipold, Andrea; Schaper, Elisabeth; van Haeften, Theo; Pihl, Tina Holberg; Press, Charles McLean; Holm, Peter; Collares, CarlosThis study investigates the relationship between approaches to learning, self-perceived study burnout, and the level of knowledge among veterinary students. Veterinary educational programs are under regular development and would benefit greatly from detailed feedback on students' knowledge, proficiency, influencing factors, and coping mechanisms.Methods The VetRepos consortium developed and calibrated an item repository testing knowledge across the entire veterinary curriculum. Two hundred forty-eight students from seven European veterinary institutions took the VetRepos test, comprising a subset of the repository. They also responded to a questionnaire assessing deep and unreflective learning approaches and self-perceived study burnout, represented by exhaustion and cynicism. Structural equation modeling analyzed the relationship between these latent traits and the VetRepos test score.Results The model failed the exact-fit test but was retained based on global fit indices, inter-item residual correlations, and standardized residual covariances. Root Mean Square Error of Approximation with robust standard errors and scaled test statistic was 0.049 (95% confidence interval 0.033-0.071), scaled and robust Comparative Fit Index 0.95 (0.90-0.98), and scaled Standardized Root Mean Square Residual 0.056 (0.049-0.071). Measurement invariance across study years was not violated (Delta CFI = 0.00, chi 2 = 3.78, Delta df = 4, p = 0.44), but it could not be confirmed between genders or universities. The VetRepos test score regressed on the study year [standardized regression coefficient = 0.68 (0.62-0.73)], showed a negative regression on the unreflective learning approach [-0.25 (-0.47 to -0.03)], and a positive regression on the deep approach [0.16 (0.03-0.28)]. No direct association with perceived burnout was observed; however, a significant, medium-sized association was found between the unreflective approach and self-perceived study burnout. No significant differences in learning approaches or perceived burnout were found between study years.Discussion The most important source of variance in VetRepos test scores, unrelated to the study year, was the learning approach. The association between the VetRepos test score and self-perceived burnout was indirect. Future research should complement this cross-sectional approach with longitudinal and person-oriented studies, further investigating the relationship between study burnout and learning approaches.
- Longitudinal variation of correlations between different components of assessment within a medical schoolPublication . Sousa, Rita Matos; Collares, Carlos; Pereira, Vítor HugoAn assessment program should be inclusive and ensure that the various components of medical knowledge, clinical skills, and professionalism are assessed. The level and the variation over time in the strength of the correlation between these components of assessment is still a matter of study. Based on the meaningful learning theory and the integrated learning theory, we hypothesize that these components increase their connections during the medical school course. MethodsThis is a retrospective cohort study that analyzed data collected for a 10-year period in one medical school. We included students from the 3rd to 6th year of medical school from 2011 to 2021. Three assessment components were addressed: Knowledge, Clinical Skills, and Professionalism. For data analysis, Pearson correlation coefficients (R) and R2 were calculated to study the correlation between variables and a z-test on Fisher's r-to-z was used to determine the differences between correlation coefficients.Results949 medical students were included in the study. The correlation between Clinical Skills and Professionalism showed a medium to strong association (Pearson's R ranging from 0.485 to 0.734), while the correlation between Knowledge and Professionalism was weaker but exhibited a steady evolution with Pearson's R fluctuating between 0.075 and 0.218. The Knowledge and Clinical Skills correlation became statistically significant from 2013 onwards and peaking at Pearson's R of 0.440 for the cohort spanning 2016-2019. We also revealed a strengthening of correlations between Professionalism and Clinical Skills from the beginning to the end of clinical training, but not with the knowledge component. Conclusions This analysis contributes to our understanding of the dynamics of correlations of different assessment components within an institution and provides a framework for how they interact and influence each other. Trial registration. This study was not a clinical trial, but a retrospective observational study, without health care interventions. Nevertheless, we provide herein the number of the study as submitted to the Ethics committee - CEICVS 146/2021.
- Assessing the impact of different feedback mechanisms on suture skills acquisition: a mixed methods study using phenomenological and quantitative analysisPublication . Gonçalves, Nuno Silva; Collares, Carlos; Pêgo, José MiguelBACKGROUND: Even though suture skills are recognized as important for medical graduates, they are often underdeveloped due to reduced surgical exposure, limited feedback opportunities, and constraints on teaching resources. While various feedback strategies exist to support skill acquisition, comparative evidence on their effectiveness from the learner’s perspective is limited. OBJECTIVE: To assess the impact of 3 feedback modalities: video review alone, video review with structured self-assessment, and video review with expert feedback, on the acquisition of basic suture skills among medical students, using both quantitative and qualitative methods. METHODS: Sixty-eight students were randomly assigned to 3 feedback groups (A: video only, B: video + structured self-assessment, and C: video + expert feedback). Each performed a basic suture task (Part A), received group-specific feedback, and repeated the task (Part B). Performances were video-recorded and rated by blinded assessors using a 15-item checklist and a global score. Additionally, thirteen participants from group C completed semi-structured interviews on their feedback experience. RESULTS: The mean global score rose from 3.24 to 3.52 in Group A, 3.46 to 3.63 in Group B, and 3.51 to 3.76 in Group C. ANOVA showed no significant differences between groups (F(2,65) = 0.669, p = 0.516, hp2 = 0.020). Qualitative findings indicated that expert feedback, particularly when combined with video review, significantly enhanced motivation, confidence, and clarity. Group C participants described shifting from “fear of performing sutures” to “confidence,” attributing this to the personalized, emotionally supportive feedback. CONCLUSION: Although performance outcomes were similar across feedback types, expert feedback offered unique emotional and cognitive benefits. These findings support the integration of structured, learner-centered feedback in surgical training, combining scalability with pedagogical value.
- Development and psychometric validation of the Minho suture assessment scale (Minho-SAS) for medical studentsPublication . Gonçalves, Nuno Silva; Sousa, Rita Matos; Collares, Carlos; Pereira, Vítor Hugo; Pêgo, José Miguel; Anderson, M. BrownellIntroduction: Even though mastery of suturing is a core technical skill in surgical education, existing tools for its assessment often lack psychometric validation or are not specifically designed for undergraduate training. The aim of this study was to develop and validate the Minho Suture Assessment Scale (Minho-SAS), a structured instrument to evaluate fundamental suturing competencies in medical students. The research question was whether the Minho-SAS demonstrates validity and reliability as a psychometric tool. Methods: The development process involved collaboration with multidisciplinary surgical teams and experienced practitioners to ensure content validity. Data from a cohort of medical students were utilized for psychometric evaluation. Dimensionality was assessed using parallel analysis, Bayesian information criterion, unidimensional congruence, item unidimensional congruence, explained common variance, item explained common variance and mean of item residual absolute loadings. Validity based on internal structure was assessed with Rasch model analysis and factor analysis from the tetrachoric correlation matrix. Reliability was assessed using Rasch model standard errors of measurement to obtain a conditional reliability curve and Cronbach's alpha and McDonald's omega internal consistency coefficients. Results: Analyses supported a unidimensional structure for the Minho-SAS. The single-factor solution explained 39.96% of variance, and Rasch measures accounted for 29.15% (16.43% by persons, 12.72% by items). Residual correlations, factor loadings, and item fit statistics were within acceptable ranges. Reliability indices were satisfactory: Rasch reliability = 0.706; McDonald's omega = 0.889; Cronbach's alpha = 0.883. Conclusion: The Minho-SAS is a robust instrument specifically tailored for assessing fundamental suturing skills among medical students. Rasch model analysis yielded less favorable results than factor analysis, yet still acceptable. While demonstrating considerable potential, further exploration of Minho-SAS across diverse populations and educational settings is crucial to affirm its broader applicability and impact in medical education and clinical practice.