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Jewell TI, Petty EM. LGBTQ+ health education for medical students in the United States: a narrative literature review. MEDICAL EDUCATION ONLINE 2024; 29:2312716. [PMID: 38359164 PMCID: PMC10877666 DOI: 10.1080/10872981.2024.2312716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Accepted: 01/26/2024] [Indexed: 02/17/2024]
Abstract
INTRODUCTION People who identify as lesbian, gay, bisexual, transgender, queer/questioning, intersex, and other sexual/gender minorities (LGBTQ+) may experience discrimination when seeking healthcare. Medical students should be trained in inclusive and affirming care for LGBTQ+ patients. This narrative literature review explores the landscape of interventions and evaluations related to LGBTQ+ health content taught in medical schools in the USA and suggests strategies for further curriculum development. METHODS PubMed, ERIC, and Education Research Complete databases were systematically searched for peer-reviewed articles on LGBTQ+ health in medical student education in the USA published between 1 January 2011-6 February 2023. Articles were screened for eligibility and data was abstracted from all eligible articles. Data abstraction included the type of intervention or evaluation, sample population and size, and key outcomes. RESULTS One hundred thirty-four articles met inclusion criteria and were reviewed. This includes 6 (4.5%) that evaluate existing curriculum, 77 (57.5%) study the impact of curriculum components and interventions, 36 (26.9%) evaluate student knowledge and learning experiences, and 15 (11.2%) describe the development of broad learning objectives and curriculum. Eight studies identified student knowledge gaps related to gender identity and affirming care and these topics were covered in 34 curriculum interventions. CONCLUSION Medical student education is important to address health disparities faced by the LGBTQ+ community, and has been an increasingly studied topic in the USA. A variety of curriculum interventions at single institutions show promise in enhancing student knowledge and training in LGBTQ+ health. Despite this, multiple studies indicate that students report inadequate education on certain topics with limitations in their knowledge and preparedness to care for LGBTQ+ patients, particularly transgender and gender diverse patients. Additional integration of LGBTQ+ curriculum content in areas of perceived deficits could help better prepare future physicians to care for LGBTQ+ patients and populations.
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Affiliation(s)
- Tess I. Jewell
- University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Elizabeth M. Petty
- Department of Pediatrics, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
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Kasai H, Saito G, Takeda K, Tajima H, Kawame C, Hayama N, Shikino K, Shimizu I, Yamauchi K, Asahina M, Suzuki T, Ito S. Effect of a workplace-based learning program on clerkship students' behaviors and attitudes toward evidence-based medicine practice. MEDICAL EDUCATION ONLINE 2024; 29:2357411. [PMID: 38785167 PMCID: PMC11134098 DOI: 10.1080/10872981.2024.2357411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Accepted: 05/15/2024] [Indexed: 05/25/2024]
Abstract
In clinical clerkship (CC), medical students can practice evidence-based medicine (EBM) with their assigned patients. Although CC can be a valuable opportunity for EBM education, the impact of EBM training, including long-term behavioral changes, remains unclear. One hundred and nine fourth- and fifth-year medical students undergoing CC at a medical school in Japan attended a workplace-based learning program for EBM during CC (WB-EBM), which included the practice of the five steps of EBM. The program's effect on the students' attitudes toward EBM in CC was assessed through questionnaires. A total of 88 medical students participated in the program. Responses to the questionnaire indicated high satisfaction with the WB-EBM program. The most common theme in students' clinical problems with their assigned patients was the choice of treatment, followed by its effect. Based on the responses in the post-survey for the long-term effects of the program, the frequency of problem formulation and article reading tended to increase in the 'within six months' group comprising 18 students who participated in the WB-EBM program, compared with the control group comprising 34 students who did not. Additionally, the ability to self-assess problem formulation was significantly higher, compared with the control group. However, among 52 students who participated in the WB-EBM program more than six months later, EBM-related behavioral habits in CC and self-assessments of the five steps of EBM were not significantly different from those in the control group. The WB-EBM program was acceptable for medical students in CC. It motivated them to formulate clinical questions and enhanced their critical thinking. Moreover, the WB-EBM program can improve habits and self-evaluations about EBM. However, as its effects may not last more than six months, it may need to be repeated across departments throughout CC to change behavior in EBM practice.
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Affiliation(s)
- Hajime Kasai
- Department of Medical Education, Graduate School of Medicine, Chiba University, Chiba, Japan
- Health Professional Development Center, Chiba University Hospital, Chiba, Japan
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Go Saito
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Kenichiro Takeda
- Health Professional Development Center, Chiba University Hospital, Chiba, Japan
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Hiroshi Tajima
- Department of Medical Education, Graduate School of Medicine, Chiba University, Chiba, Japan
- Health Professional Development Center, Chiba University Hospital, Chiba, Japan
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Chiaki Kawame
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Nami Hayama
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Kiyoshi Shikino
- Health Professional Development Center, Chiba University Hospital, Chiba, Japan
- Department of General Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
- Department of Community-Oriented Medical Education, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Ikuo Shimizu
- Department of Medical Education, Graduate School of Medicine, Chiba University, Chiba, Japan
- Health Professional Development Center, Chiba University Hospital, Chiba, Japan
| | - Kazuyo Yamauchi
- Health Professional Development Center, Chiba University Hospital, Chiba, Japan
- Department of Community-Oriented Medical Education, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Mayumi Asahina
- Health Professional Development Center, Chiba University Hospital, Chiba, Japan
| | - Takuji Suzuki
- Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Shoichi Ito
- Department of Medical Education, Graduate School of Medicine, Chiba University, Chiba, Japan
- Health Professional Development Center, Chiba University Hospital, Chiba, Japan
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He Q, Lei J, Chong D, Luk P, Chan E, Shen X, Tipoe GL, Chan L, Manio MM, Dizon JIWT, Ganotice FA. Unpacking the perceptions and experiences of student facilitators in interprofessional education: a qualitative study. MEDICAL EDUCATION ONLINE 2024; 29:2330257. [PMID: 38493489 PMCID: PMC10946269 DOI: 10.1080/10872981.2024.2330257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Accepted: 03/08/2024] [Indexed: 03/19/2024]
Abstract
Enhancing health professional students' effective learning and collaborative practice requires a deep understanding of strategies for facilitating interprofessional learning. While faculty members and clinical preceptors are recognized as facilitators in interprofessional education (IPE), there is limited knowledge about the impact of student facilitators' engagement in IPE. Accordingly, this study aims to explore the perceptions and experiences of student facilitators in IPE. Thirteen student facilitators were recruited to lead an interprofessional learning program, and they were subsequently invited to participate in one-on-one interviews. An interview guide was developed to explore their motivations, expectations, engagement, effectiveness, and achievements in IPE facilitation. Thematic analysis was conducted using MAXQDA software to analyze the student facilitators' experiences and perceptions. Eight interviewees from various disciplines, including Medicine, Nursing, Pharmacy, Speech and Hearing Sciences, and Social Work, took part in the study. The findings revealed that student facilitators highly valued their IPE facilitation experience, which aligned with their expectations and led to the creation of social networks, increased confidence, improved understanding of other professions, and the development of lifelong skills. Furthermore, the student facilitators demonstrated cognitive and social congruence by establishing a relaxed learning environment, displaying empathetic and supportive behaviors, and using inclusive language to engage IPE learners in group discussions. This study provides a comprehensive understanding of the role of student facilitators in IPE, contributing to the evolving literature on IPE. A conceptual framework was developed to explore the entire facilitation experience, encompassing the motivations and expectations of student facilitators, their engagement and effectiveness, and the observed achievements. These findings can inform the development of peer teaching training in IPE and stimulate further research in identifying relevant facilitator competencies for optimal delivery of IPE.
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Affiliation(s)
- Qing He
- Bau Institute of Medical and Health Sciences Education, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Junru Lei
- Bau Institute of Medical and Health Sciences Education, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Doris Chong
- Department of Physiotherapy, School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, China
| | - Pauline Luk
- Bau Institute of Medical and Health Sciences Education, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- Medical Ethic and Humanities Unit, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Enoch Chan
- School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Xiaoai Shen
- Bau Institute of Medical and Health Sciences Education, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - George Lim Tipoe
- Bau Institute of Medical and Health Sciences Education, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Linda Chan
- Bau Institute of Medical and Health Sciences Education, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- Department of Family Medicine and Primary Care, School of Clinical Medicine, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- Department of Family Medicine and Primary Care, The University of Hong Kong - Shenzhen Hospital, Shenzhen, Guangdong, China
| | - Michael M. Manio
- School of Biomedical Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - John Ian Wilzon T. Dizon
- Bau Institute of Medical and Health Sciences Education, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Fraide A. Ganotice
- Bau Institute of Medical and Health Sciences Education, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
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Der Sahakian G, de Varenne M, Buléon C, Alinier G, Balmer C, Blanié A, Bech B, Bellot A, Boubaker H, Dubois N, Guevara F, Guillouet E, Granry JC, Jaffrelot M, Lecomte F, Lois F, Mouhaoui M, Ortolé O, Paquay M, Piazza J, Pittaco M, Plaisance P, Benhamou D, Chiniara G, Rivière E. The 2024 French guidelines for scenario design in simulation-based education: manikin-based immersive simulation, simulated participant-based immersive simulation and procedural simulation. MEDICAL EDUCATION ONLINE 2024; 29:2363006. [PMID: 38845343 PMCID: PMC11164058 DOI: 10.1080/10872981.2024.2363006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 05/29/2024] [Indexed: 06/12/2024]
Abstract
BACKGROUND Simulation-based education in healthcare encompasses a wide array of modalities aimed at providing realistic clinical experiences supported by meticulously designed scenarios. The French-speaking Society for Simulation in Healthcare (SoFraSimS) has developed guidelines to assist educators in the design of scenarios for manikin- or simulated participant- based immersive simulation and procedural simulation, the three mainly used modalities. METHODS After establishing a French-speaking group of experts within the SoFraSimS network, we performed an extensive literature review with theory-informed practices and personal experiences. We used this approach identify the essential criteria for practice-based scenario design within the three simulation modalities. RESULTS We present three comprehensive templates for creating innovative scenarios and simulation sessions, each tailored to the specific characteristics of a simulation modality. The SoFraSimS templates include five sections distributed between the three modalities. The first section contextualizes the scenario by describing the practicalities of the setting, the instructors and learners, and its connection to the educational program. The second section outlines the learning objectives. The third lists all the elements necessary during the preparation phase, describing the educational method used for procedural simulation (such as demonstration, discovery, mastery learning, and deliberate practice). The fourth section addresses the simulation phase, detailing the behaviors the instructor aims to analyze, the embedded triggers, and the anticipated impact on simulation proceedings (natural feedback). This ensures maximum control over the learning experience. Finally, the fifth section compiles elements for post-simulation modifications to enhance future iterations. CONCLUSION We trust that these guidelines will prove valuable to educators seeking to implement simulation-based education and contribute to the standardization of scenarios for healthcare students and professionals. This standardization aims to facilitate communication, comparison of practices and collaboration across different learning and healthcare institutions.
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Affiliation(s)
| | - Maxime de Varenne
- Department of Anesthesiology and Intensive Care, Université Laval, Québec, QC, Canada
| | - Clément Buléon
- Center for Medical Simulation, Liège University Hospital, LiègeBelgium
- Center for Medical Simulation, Boston, MA, USA
- Department of Anesthesiology, Intensive Care and Perioperative Medicine, Caen Normandy University Hospital, Caen, France
| | - Guillaume Alinier
- School of Health and Social Work, University of Hertfordshire, Hatfield, Hertfordshire, UK
- Faculty of Health and Life Sciences, Northumbria University, Newcastle Upon Tyne, UK
- Hamad Medical Corporation Ambulance Service, Doha, Qatar
| | - Christian Balmer
- Paediatric Cardiology, Paediatric Heart Center, Department of Surgery, University Children’s Hospital, Zurich, Switzerland
| | - Antonia Blanié
- Department of Anesthesiology, Intensive Care and Perioperative Medicine, Kremlin Bicêtre University Hospital, APHP, Paris, France
| | - Bertrand Bech
- Department of Anesthesiology, Intensive Care and Perioperative Medicine, Kremlin Bicêtre University Hospital, APHP, Paris, France
| | - Anne Bellot
- Centre de simulation NorSimS & Service de néonatalogie, Centre Hospitalier Universitaire de Caen Normandie & Université de Caen-Normandie, Caen, France
| | - Hamdi Boubaker
- Emergency Department, Fattouma Bourguiba University Hospital & Research Laboratory, University of Monastir, Monastir, Tunisia
| | - Nadège Dubois
- Department of Emergency Medicine, Quartier Hôpital, University Hospital of Liege & Center for Medical Simulation, Liège University Hospital, Liège, Belgium
| | - Francisco Guevara
- Chargé de projets en simulation continue et initiale, Cadre de santé formateur en simulation en santé, IFSI Croix Saint Simon, Montreuil, France
| | - Erwan Guillouet
- Center for Medical Simulation, Liège University Hospital, LiègeBelgium
- Center for Medical Simulation, Boston, MA, USA
- Department of Anesthesiology, Intensive Care and Perioperative Medicine, Caen Normandy University Hospital, Caen, France
| | - Jean-Claude Granry
- AllSims Center for Simulation in Healthcare, University Hospital of Angers, Angers, France
| | - Morgan Jaffrelot
- Department of Anesthesiology and Intensive Care, Université Laval, Québec, QC, Canada
- Independent Consultant in Simulation, Brest, France
| | - François Lecomte
- Department of Emergency Medicine, Cochin University Hospital, APHP, Paris, France
| | - Fernande Lois
- Department of Anesthesiology, Intensive Care and Perioperative Medicine, Liège University Hospital, Liège, Belgium
| | - Mohammed Mouhaoui
- Faculty of Medicine and Pharmacy, Hassan II University, Casablanca, Morocco
| | - Ollivier Ortolé
- Department of Emergency Medicine & CESU Martinique, University Hospital Center of Martinique, Fort-de-France, France
| | - Méryl Paquay
- Department of Emergency Medicine, Quartier Hôpital, University Hospital of Liege & Center for Medical Simulation, Liège University Hospital, Liège, Belgium
| | - Justine Piazza
- Department of Emergency Medicine, Quartier Hôpital, University Hospital of Liege & Center for Medical Simulation, Liège University Hospital, Liège, Belgium
| | - Marie Pittaco
- Department of Emergency Medicine, Centre Hospitalier d’Orange, Orange, France
| | - Patrick Plaisance
- Department of Emergency Medicine, Lariboisière University Hospital, APHP, Université de Paris & ILumens Platform of Medical Simulation Paris University, Paris, France
| | - Dan Benhamou
- Department of Anesthesiology, Intensive Care and Perioperative Medicine, Kremlin Bicêtre University Hospital, APHP, Paris, France
| | - Gilles Chiniara
- Department of Anesthesiology and Intensive Care, Université Laval, Québec, QC, Canada
| | - Etienne Rivière
- Department of Emergency Medicine, Cochin University Hospital, APHP, Paris, France
- Internal Medicine and Infectious Diseases unit, Haut-Leveque Hospital, University Hospital Centre of Bordeaux, Pessac Cedex, France
- Faculty of Medicine, Bordeaux University, Bordeaux, France
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Blaszczak J, Wiener S, Plegue M, Shumer D, Shatzer J, Hernandez A. Evaluating the effectiveness of an online curriculum on caring for transgender and nonbinary patients. MEDICAL EDUCATION ONLINE 2024; 29:2311481. [PMID: 38320110 PMCID: PMC10848997 DOI: 10.1080/10872981.2024.2311481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Accepted: 01/24/2024] [Indexed: 02/08/2024]
Abstract
BACKGROUND AND OBJECTIVES It is well established that provider lack of knowledge in the field of transgender and nonbinary health is as ignificant barrier to care and that training in this area is lacking. This study examined how family medicine residents' self-confidence and medical knowledge in providing gender-affirming care changed after completing a novel, online curriculum on transgender and nonbinary care. METHODS Thirty-nine family medicine residents were invited to complete the curriculum. Change inself-confidence was determined by the difference in scores on a Likert scale on a pre- and post-survey. Change in medical knowledge was assessed by examining the difference between pre- and post-test scores on a novel multiple-choice examination. RESULTS Only 7% of current residents agreed that their current training is adequate in order to provide comprehensive primary care to transgender and nonbinary people. After completion of the curriculum, 100% of participants felt at least somewhat confident providing primary care to transgender and nonbinary people, including hormone therapy. Average medical knowledge post-test scores trended higher than the pre-test results (mean (SD) at pre = 11.2 (1.4) vs post = 14.6 (2.8)). CONCLUSIONS An online, self-directed curriculum on caring for transgender and nonbinary patients in the primary care setting, including management of gender-affirming hormone therapy, has the potential to increase confidence and knowledge in this field, decreasing barriers to care for this population.
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Affiliation(s)
- Julie Blaszczak
- Department of Family Medicine University of Michigan, Ann Arbor, MI, USA
| | - Sara Wiener
- Department of Organizational Learning University of Michigan, Ann Arbor, MI, USA
| | - Melissa Plegue
- Department of Family Medicine University of Michigan, Ann Arbor, MI, USA
| | - Dan Shumer
- Department of Pediatric Endocrinology University of Michigan, Ann Arbor, MI, USA
| | - John Shatzer
- School of Education Johns Hopkins, Baltimore, MD, USA
| | - Anita Hernandez
- Department of Family Medicine University of Michigan, Ann Arbor, MI, USA
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Wong L, Sacoransky E, Hopman W, Islam O, Chung AD, Kwan BYM. Radiologist preferences for faculty development initiatives to improve resident feedback in the era of competency-based medical education. MEDICAL EDUCATION ONLINE 2024; 29:2357412. [PMID: 38810150 PMCID: PMC11138222 DOI: 10.1080/10872981.2024.2357412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2024] [Accepted: 05/15/2024] [Indexed: 05/31/2024]
Abstract
INTRODUCTION Since 2022, all Canadian post-graduate medical programs have transitioned to a Competence by Design (CBD) model within a Competency-Based Medical Education (CBME) framework. The CBME model emphasized more frequent, formative assessment of residents to evaluate their progress towards predefined competencies in comparison to traditional medical education models. Faculty members therefore have increased responsibility for providing assessments to residents on a more regular basis, which has associated challenges. Our study explores faculty assessment behaviours within the CBD framework and assesses their openness to opportunities aimed at improving the quality of written feedback. Specifically, we explore faculty's receptiveness to routine metric performance reports that offer comprehensive feedback on their assessment patterns. METHODS Online surveys were distributed to all 28 radiology faculty at Queen's University. Data were collected on demographics, feedback practices, motivations for improving the teacher-learner feedback exchange, and openness to metric performance reports and quality improvement measures. Following descriptive statistics, unpaired t-tests and one-way analysis of variance were conducted to compare groups based on experience and subspecialty. RESULTS The response rate was 89% (25/28 faculty). 56% of faculty were likely to complete evaluations after working with a resident. Regarding the degree to which faculty felt written feedback is important, 62% found it at least moderately important. A majority (67%) believed that performance reports could influence their evaluation approach, with volume of written feedback being the most likely to change. Faculty expressed interest in feedback-focused development opportunities (67%), favouring Grand Rounds and workshops. CONCLUSION Assessment of preceptor perceptions reveals that faculty recognize the importance of offering high-quality written feedback to learners. Faculty openness to quality improvement interventions for curricular reform relies on having sufficient time, knowledge, and skills for effective assessments. This suggests that integrating routine performance metrics into faculty assessments could serve as a catalyst for enhancing future feedback quality.
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Affiliation(s)
- Laura Wong
- Department of Diagnostic Radiology, Kingston Health Sciences Centre, Kingston, ON, Canada
| | - Ethan Sacoransky
- School of Medicine, Faculty of Health Sciences, Queen’s University, Kingston, ON, Canada
| | - Wilma Hopman
- Kingston General Hospital Research Institute, Kingston Health Sciences Centre, Kingston, ON, Canada
| | - Omar Islam
- Department of Diagnostic Radiology, Kingston Health Sciences Centre, Kingston, ON, Canada
| | - Andrew D. Chung
- Department of Diagnostic Radiology, Kingston Health Sciences Centre, Kingston, ON, Canada
| | - Benjamin Y. M. Kwan
- Department of Diagnostic Radiology, Kingston Health Sciences Centre, Kingston, ON, Canada
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Rich A, Viney R, Silkens M, Griffin A, Medisauskaite A. The experiences of students with mental health difficulties at medical school: a qualitative interview study. MEDICAL EDUCATION ONLINE 2024; 29:2366557. [PMID: 38870397 DOI: 10.1080/10872981.2024.2366557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 06/06/2024] [Indexed: 06/15/2024]
Abstract
BACKGROUND High rates of burnout, anxiety, and depression in medical students are widespread, yet we have limited knowledge of the medical school experiences of students with mental health issues. The aim of the study is to understand the impact of mental health issues on students' experience and training at medical school by adopting a qualitative approach. METHODS Qualitative study using in-depth semi-structured interviews with 20 students with mental health issues from eight UK medical schools of varying size and location. Students were purposefully sampled to gain variety in the type of mental health issue experienced and demographic characteristics. Reflexive thematic analysis was employed using NVivo software. RESULTS Three themes were identified. 1) Culture of medicine: medical culture contributed to causing mental ill-health through study demands, competitiveness with peers, a 'suck it up' mentality where the expectation is that medical school is tough and medical students must push through, and stigma towards mental ill-health. 2) Help-seeking: students feared others discovering their difficulties and thus initially tried to cope alone, hiding symptoms until they were severe. There were multiple barriers to help-seeking including stigma and fear of damage to their career. 3) Impact on academic life: mental health issues had a detrimental impact on academic commitments, with students' unable to keep up with their studies and some needing to take time out from medical school. CONCLUSION This study provides insight into how medical culture contributes both to the cause of mental health difficulties and the reluctance of medical students to seek help. Mental health issues had a considerable negative impact on medical students' ability to learn and progress through their degree. Addressing the medical culture factors that contribute to the cause of mental health issues and the barriers to help-seeking must be a priority to ensure a healthier medical workforce.
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Affiliation(s)
- Antonia Rich
- Research Department of Medical Education, UCL Medical School, University College London, London, UK
| | - Rowena Viney
- Research Department of Medical Education, UCL Medical School, University College London, London, UK
| | - Milou Silkens
- Centre for Healthcare Innovation Research, Department of Health Services Research and Management, School of Health and Psychological Sciences, City University of London, London, UK
- Erasmus School of Health Policy and Management, Erasmus University Rotterdam, Rotterdam, the Netherlands
| | - Ann Griffin
- Research Department of Medical Education, UCL Medical School, University College London, London, UK
| | - Asta Medisauskaite
- Research Department of Medical Education, UCL Medical School, University College London, London, UK
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Barbosa-Camacho FJ, Rodríguez-Machuca VU, Ibarrola-Peña JC, Chejfec-Ciociano JM, Guzmán-Ruvalcaba MJ, Tavares-Ortega JA, Delgado-Hernandez G, Cervantes-Guevara G, Cervantes-Pérez E, Ramírez-Ochoa S, Fuentes-Orozco C, Gonzalez-Ojeda A. COVID-19 pandemic and its impact on medical interns' mental health of public and private hospitals in Guadalajara. MEDICAL EDUCATION ONLINE 2024; 29:2308360. [PMID: 38281205 PMCID: PMC10823882 DOI: 10.1080/10872981.2024.2308360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 01/16/2024] [Indexed: 01/30/2024]
Abstract
INTRODUCTION Burnout syndrome is a global burden characterized by exhaustion, work detachment, and a sense of ineffectiveness. It affects millions of individuals worldwide, with a particularly high prevalence among medical students. Factors such as demanding education, exposure to suffering, and the COVID-19 pandemic have contributed to elevated stress levels. Addressing this issue is crucial due to its impact on well-being and health-care quality. MATERIALS AND METHODS This cross-sectional survey study assessed fear of COVID-19 and burnout levels among medical student interns in hospitals in Guadalajara, Jalisco. The study used validated scales and collected data from September 2021 to September 2022. A snowball sampling method was employed and a minimum sample size of 198 participants was calculated. RESULTS This study included 311 medical students (62.1% female and 37.9% male with a mean age of 23.51 ± 2.21 years). The majority were in their second semester of internship (60.5%) and from public hospitals (89.1%). Most students believed that the COVID-19 pandemic affected the quality of their internship (82.6%). Female students had higher personal burnout scores, while male students had higher work-related burnout scores. The mean score for fear of COVID-19 was 13.71 ± 6.28, with higher scores among women (p = 0.004) and those from public hospitals (p = 0.009). A positive weak correlation was found between COVID-19 scores and burnout subscales. CONCLUSION Our study emphasizes the significant impact of various factors on burnout levels among medical students and health-care professionals during the COVID-19 pandemic. Prolonged exposure to COVID-19 patients, reduced staffing, and increased workload contributed to burnout, affecting well-being and quality of care. Targeted interventions and resilience-building strategies are needed to mitigate burnout and promote well-being in health-care settings.
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Affiliation(s)
- Francisco José Barbosa-Camacho
- Unidad de Investigación Biomédica 02 Hospital de Especialidades, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, México
- Hospital Civil de Guadalajara “Fray Antonio Alcalde”, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
| | | | - Juan Carlos Ibarrola-Peña
- Hospital General y Medicina Familiar de Zona No. 2, Instituto Mexicano del Seguro Social, Nuevo León, Monterrey, México
| | - Jonathan Matías Chejfec-Ciociano
- Unidad de Investigación Biomédica 02 Hospital de Especialidades, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, México
| | - Mario Jesús Guzmán-Ruvalcaba
- Unidad de Investigación Biomédica 02 Hospital de Especialidades, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, México
| | - Jaime Alberto Tavares-Ortega
- Unidad de Investigación Biomédica 02 Hospital de Especialidades, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, México
| | - Gonzalo Delgado-Hernandez
- Unidad de Investigación Biomédica 02 Hospital de Especialidades, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, México
| | - Gabino Cervantes-Guevara
- Departamento de Bienestar y Desarrollo Sustentable, Centro Universitario del Norte, Universidad de Guadalajara, Colotlán, Jalisco, México
| | - Enrique Cervantes-Pérez
- Hospital Civil de Guadalajara “Fray Antonio Alcalde”, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
| | - Sol Ramírez-Ochoa
- Hospital Civil de Guadalajara “Fray Antonio Alcalde”, Universidad de Guadalajara, Guadalajara, Jalisco, Mexico
| | - Clotilde Fuentes-Orozco
- Unidad de Investigación Biomédica 02 Hospital de Especialidades, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, México
| | - Alejandro Gonzalez-Ojeda
- Unidad de Investigación Biomédica 02 Hospital de Especialidades, Centro Médico Nacional de Occidente, Instituto Mexicano del Seguro Social, Guadalajara, Jalisco, México
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Park KY, Kang YJ, Park HK, Hwang HS. Exploring effective video-review strategies of patient encounters for medical students: precepted review versus peer discussion. MEDICAL EDUCATION ONLINE 2024; 29:2392428. [PMID: 39154381 PMCID: PMC11332281 DOI: 10.1080/10872981.2024.2392428] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 08/08/2024] [Accepted: 08/09/2024] [Indexed: 08/20/2024]
Abstract
BACKGROUND Video-recordings review of patient encounters is reported to improve the clinical performance of medical students. However, evidence on specific remediation strategies or outcomes are lacking. We aimed to implement videorecording-based remediation of standardized patient encounters among medical students, combined with preceptor one-on-one feedback or peer group discussion, and evaluate the effectiveness of the two remediation methods using objective structured clinical examination (OSCE). METHODS Following standardized patient encounters, 107 final-year medical students were divided into two groups based on different remediation methods of video review: (1) precepted video review with preceptor feedback (N = 55) and (2) private video review and subsequent peer group discussion under supervision (N = 52). All students underwent twelve-stations of OSCE both before and after the video review. Students' pre- and post-remediation OSCE scores, self-efficacy level in patient encounters, and level of educational satisfaction with each method were assessed and compared between different video-based remediation methods to evaluate their respective effects. RESULTS After remediation, the total and subcomponent OSCE scores, such as history taking, physical examination, and patient - physician interaction (PPI), among all students increased significantly. Post-remediation OSCE scores showed no significant difference between two remediation methods (preceptor module, 79.6 ± 4.3 vs. peer module, 79.4 ± 3.8 in the total OSCE score). Students' self-efficacy levels increased after remediation in both modules (both p-value <0.001), with no difference between the two modules. However, students' satisfaction level was higher in the preceptor module than in the peer module (80.1 ± 17.7 vs. 59.2 ± 25.1, p-value <0.001). Among students with poor baseline OSCE performance, a prominent increase in PPI scores was observed in the preceptor-based module. CONCLUSION Video-based remediation of patient encounters, either through preceptor review with one-on-one feedback or through private review with peer discussion, was equally effective in improving the OSCE scores and self-efficacy levels of medical students. Underperforming students can benefit from precepted video reviews for building PPI.
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Affiliation(s)
- Kye-Yeung Park
- Department of Family Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Ye Ji Kang
- Department of Medical Education, Hanyang University College of Medicine, Seoul, Korea
| | - Hoon-Ki Park
- Department of Family Medicine, Hanyang University College of Medicine, Seoul, Korea
| | - Hwan-Sik Hwang
- Department of Family Medicine, Hanyang University College of Medicine, Seoul, Korea
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10
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Reid H, Hocking C, Smythe E. Occupational therapy's oversight: How science veiled our humanity. Scand J Occup Ther 2024; 31:2306585. [PMID: 38261715 DOI: 10.1080/11038128.2024.2306585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 01/12/2024] [Indexed: 01/25/2024]
Abstract
BACKGROUND Occupational therapy's connection to positivist science predates the profession's formal beginning, with important contributing knowledge sources coming from mathematics, physics, psychology, and systems theory. While these sources of objective knowledge provide a rational, defendable position for practice, they can only explain a portion of what it means to exist as an occupational being. AIMS/OBJECTIVES This article aims to reveal some of the history of science within occupational therapy and reveal the subjective, ontological nature of doing everyday activities that the profession's preoccupation with positivist science has obscured. METHODS This research used a history of ideas methodology to uncover how occupational therapy perceived people and how practice was conceptualised and conducted between 1800 and 1980s, as depicted in writing of the time. CONCLUSION Analysis showed that, through history, people were increasingly categorised and delimited. Practice also became systematically controlled, moving occupational therapy into a theoretical, scientific, and abstract realm. SIGNIFICANCE The emphasis placed on objectivity diminishes the attention given to human ways of practicing, where the subjective experience is central to our thinking.
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Affiliation(s)
- Heleen Reid
- School of Clinical Sciences, AUT University, Auckland, New Zealand
| | - Clare Hocking
- School of Clinical Sciences, AUT University, Auckland, New Zealand
| | - Elizabeth Smythe
- School of Clinical Sciences, AUT University, Auckland, New Zealand
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11
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Kiviharju MJ, Gulash SK, Balsom AA, Gordon JL. Testing the efficacy of a narrative short film in educating the public about providing emotional support to individuals with fertility problems. J Psychosom Obstet Gynaecol 2024; 45:2378330. [PMID: 39007900 DOI: 10.1080/0167482x.2024.2378330] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2024] [Accepted: 07/05/2024] [Indexed: 07/16/2024] Open
Abstract
BACKGROUND To educate the public on how best to support people with fertility problems, a narrative short film "Ten Things Not to Say to Someone Struggling with Infertility" was created, depicting the impact that helpful versus unhelpful dialogue has on someone with fertility problems. METHODS Before and after watching the video, 419 participants from the public were presented with a hypothetical vignette describing a woman experiencing fertility problems and asked about the likelihood that they would endorse a series of helpful and unhelpful statements when communicating with the protagonist. Pre and post endorsement of helpful versus unhelpful statements were compared, as were self-perceived knowledge about the mental health aspects of fertility problems, confidence in providing emotional support to someone with fertility problems, and empathy for the protagonist. RESULTS Participants endorsed fewer unhelpful statements after the video relative to before (M(SD) = 2.2(2.3) vs. 1.3(2.3), p < .001) and fewer participants endorsed at least one unhelpful statement (72% to 47%, p < .001). Self-perceived knowledge of fertility problems, confidence in providing support, and empathy increased at post-test (ps < .001; Cohen's d = .56-.83) indicating medium-large effects. CONCLUSIONS A narrative short film appears to be an effective dissemination strategy for sensitizing the public to the emotional struggles of individuals experiencing fertility problems.
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Affiliation(s)
- Maija J Kiviharju
- Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
| | - Sarah K Gulash
- Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
| | - Ashley A Balsom
- Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
| | - Jennifer L Gordon
- Department of Psychology, University of Regina, Regina, Saskatchewan, Canada
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12
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D'Orleans CC, Hechenbleikner EM, Papandria DJ, Xiao K, Patel D, Srinivasan JK, Chahine AA, Pettitt BJ, Knauer EM. The Impact of the COVID-19 Pandemic on Geographic Placement of Applicants to General Surgery Residency Programs. JOURNAL OF SURGICAL EDUCATION 2024; 81:1198-1202. [PMID: 38910102 DOI: 10.1016/j.jsurg.2024.05.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 05/15/2024] [Accepted: 05/30/2024] [Indexed: 06/25/2024]
Abstract
OBJECTIVE COVID-19 greatly influenced medical education and the residency match. As new guidelines were established to promote safety, travel was restricted, visiting rotations discontinued, and residency interviews turned virtual. The purpose of this study is to assess the geographic trends in distribution of successfully matched General Surgery applicants prior to and after the implementation of pandemic guidelines, and what we can learn from them as we move forward. DESIGN This was a retrospective review of 129 Accreditation Council for Graduate Medical Education (ACGME) accredited, academic General Surgery Residency Programs across 46 states and the District of Columbia. Categorically matched residents' medical schools (i.e., home institutions), medical school states, and medical school regions as defined per the Association of American Medical Colleges (AAMC), were compared to the same geographic datapoints as their residency program. Preliminary residents were excluded. Residents in the 2018, 2019, and 2020 cycles were sub-categorized into the "pre-COVID" group and residents in the 2021 and 2022 applications cycles were sub-categorized into the "post-COVID" group. The percentages of residents who matched at their home institution, in-state, and in-region were examined. SETTING Multiple ACGME-accredited, university-affiliated General Surgery Residency Programs across the United States of America. PARTICIPANTS A total of 4033 categorical General Surgery residents were included. RESULTS Of 4033 categorical residents who matched between 2018 and 2022, 56.1% (n = 2,263) were in the pre-COVID group and 43.9% (n = 1770) were in the post-COVID group. In the pre-COVID group 14.4% (n = 325) of residents remained in-home (IH), 24.4% (n = 553) in-state (IS), and 37.0% (n = 837) in- region (IR), compared to 18.8% IH (n = 333), 27.8% IS (n = 492), and 39.9% IR (n = 706) in the post-COVID group, respectively. Significant increases for IH and IS resident matching at 4.5% and 3.4%, respectively, were noted in the post-COVID period (p < 0.05). CONCLUSION The COVID-19 pandemic, and the ensuing changes adopted to promote safety, significantly impacted medical student opportunities and the General Surgery residency application process. General Surgery match data over the last 5 years reveals a statistically significant increase in the percentage of applicants matching at in-home and in-state institutions after the pandemic.
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Affiliation(s)
| | | | - Dominic J Papandria
- Department of Surgery, Emory University School of Medicine, Atlanta, Georgia 30322
| | - Kevin Xiao
- The Ohio State University College of Medicine, Columbus, Ohio 43210
| | - Dipan Patel
- Department of Surgery, Emory University School of Medicine, Atlanta, Georgia 30322
| | - Jahnavi K Srinivasan
- Department of Surgery, Emory University School of Medicine, Atlanta, Georgia 30322
| | - A Alfred Chahine
- Department of Surgery, Emory University School of Medicine, Atlanta, Georgia 30322
| | - Barbara J Pettitt
- Department of Surgery, Emory University School of Medicine, Atlanta, Georgia 30322
| | - Eric M Knauer
- Department of Surgery, Emory University School of Medicine, Atlanta, Georgia 30322.
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Vergeron L, Morvan Y, Hadouiri N, Haas-Jordache A, Gouy E, Mathieu L, Goulard A, Rolland F, Frajerman A. Use of service and treatment adequacy in medical students and residents suffering from depression in France: A nationwide study. Psychiatry Res 2024; 339:115975. [PMID: 38875916 DOI: 10.1016/j.psychres.2024.115975] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Revised: 05/21/2024] [Accepted: 05/23/2024] [Indexed: 06/16/2024]
Abstract
Depression was already a public health issue before the Covid-19 pandemic. Use of service and treatment adequacy in medical students was poorly known. A 2021 French national study found the prevalence of 12-month major depressive disorder (MDD) was 25 % in medical school students and residents (MSSR). The main objective of our study was to measure the prevalence of service use and adequate treatment (therapy and/or recommended pharmacotherapy) and their associated factors. A national online survey was conducted in 2021. The Composite International Diagnostic Interview Short-Form questionnaire was used to assess MDD; 12-months service use and pharmacotherapy were assessed. Univariate and multivariate logistic regressions were performed between students' demographic characteristics, use of services, and treatment adequacy. Among included MSSR who experienced MDD in the last 12 months, only 32 % received adequate treatment, including 20 % with recommended pharmacotherapy. Being more advanced in medical studies and being treated both by a general practitioner and a psychiatrist were associated with receiving recommended pharmacotherapy. To our knowledge, our study is the largest to assess use of service and treatment adequacy in MSSR. Given the low percentage of depressed students receiving recommended treatment, it seems important to develop new interventions to better detect and treat MDD in MSSR.
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Affiliation(s)
- Laure Vergeron
- MOODS Team, INSERM U1018, CESP, Université Paris-Saclay, Faculté de Médecine Paris-Saclay, Le Kremlin-Bicêtre F-94275, France
| | - Yannick Morvan
- Center for research in epidemiology and population health (CESP), National Institute of Health and Medical Research (INSERM) U1018, Paris-Saclay University, Villejuif, France; Université Paris Nanterre - UFR SPSE - laboratoire CLIPSYD, EA4430, Nanterre, France
| | - Nawale Hadouiri
- Pôle rééducation-réadaptation, CHU de Dijon, 23 rue Gaffarel, 21078 Dijon, France
| | - Adrien Haas-Jordache
- ISNAR-IMG (InterSyndicale Nationale Autonome Représentative des Internes de Médecine Générale), 286 Rue Vendôme, 69003 Lyon, France
| | - Evan Gouy
- Service de génétique médicale, Hospices Civils de Lyon, 59 boulevard Pinel, 69500 Bron, France
| | - Loona Mathieu
- ANEMF (Association Nationale des Étudiants en Médecine de France), 79 rue Périer, 92120 Montrouge, France
| | - Anne Goulard
- ISNAR-IMG (InterSyndicale Nationale Autonome Représentative des Internes de Médecine Générale), 286 Rue Vendôme, 69003 Lyon, France
| | - Franck Rolland
- Center for research in epidemiology and population health (CESP), National Institute of Health and Medical Research (INSERM) U1018, Paris-Saclay University, Villejuif, France; MGEN Action sanitaire et sociale - groupe VYV, Établissement de Santé Mentale de Rueil-Malmaison, 2 rue du Lac, 92500 Rueil-Malmaison, France
| | - Ariel Frajerman
- MOODS Team, INSERM U1018, CESP, Université Paris-Saclay, Faculté de Médecine Paris-Saclay, Le Kremlin-Bicêtre F-94275, France; Service Hospitalo-Universitaire de Psychiatrie de Bicêtre, Mood Center Paris Saclay, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Saclay, Hôpital de Bicêtre F-94275, France.
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14
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Gomez K, Edwards HL, Kirby J. Livestreaming clinical experience to remotely located learners: A critical narrative review. MEDICAL EDUCATION 2024; 58:1032-1041. [PMID: 38606897 DOI: 10.1111/medu.15392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/10/2023] [Revised: 03/04/2024] [Accepted: 03/06/2024] [Indexed: 04/13/2024]
Abstract
CONTEXT Medical education relies on real patient learning (RPL) to provide medical students with essential clinical experience. However, growing demand for clinical placements continues to be a challenge in providing sufficient RPL opportunities. The COVID-19 pandemic forced academic institutions to rethink the delivery of traditional clinical training and innovations in online clinical learning experiences, specifically livestreamed clinical experiences, have emerged which show promise in addressing the capacity limitations of traditional placements. Although previous reviews have explored the use of livestreamed clinical experiences during the pandemic, there is a lack of rigorous theoretical framing to support these innovations. OBJECTIVES The aim of this review is two-fold: to examine the effectiveness of livestreamed clinical experiences through an experience-based learning (ExBL) theory perspective and to provide practical recommendations to optimise and implement these innovations. METHODS A review of literature was conducted to identify journal articles published between September 2019 and January 2023 reporting on innovations relating to livestreamed clinical experiences. The search focused on undergraduate and postgraduate medical education but relevant evidence from other healthcare professions were also included due to a limited evidence base. Strengths and weaknesses were derived from the literature and analysed in relation to ExBL components. RESULTS Principal strengths of livestreamed clinical experiences included expanded access to RPL opportunities and medical specialties, enhanced standardisation of learning experiences and positive perceptions from students regarding convenience. Clinical educators found these innovations enabled teaching at scale. Patients did not perceive such innovations to negatively impact their standard of care. Limitations included the inability to practice physical examination skills, challenges in ensuring learner engagement and connectivity issues. CONCLUSION Livestreamed clinical experiences have the potential to effectively expand placement capacity and provide high-quality educational experiences for medical students. Although certain limitations exist, technological and pedagogical adaptations can help overcome these challenges. The application of theoretical frameworks to future online innovations will be fundamental to ensure effective clinical learning.
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Affiliation(s)
- Kelvin Gomez
- Leeds Institute of Medical Education, Leeds School of Medicine, University of Leeds, Leeds, UK
| | - Helen L Edwards
- Leeds Institute of Health Sciences, Leeds School of Medicine, University of Leeds, Leeds, UK
| | - Jane Kirby
- Leeds Institute of Health Sciences, Leeds School of Medicine, University of Leeds, Leeds, UK
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15
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Hardin J, Desy J, McLaughlin K. Dermatology is the natural lab for studying implicit associations in medicine. MEDICAL TEACHER 2024; 46:1249-1250. [PMID: 38835319 DOI: 10.1080/0142159x.2024.2362229] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 05/28/2024] [Indexed: 06/06/2024]
Affiliation(s)
- Jori Hardin
- Office of Undergraduate Medical Education, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
- Division of Dermatology, Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Janeve Desy
- Office of Undergraduate Medical Education, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Kevin McLaughlin
- Office of Undergraduate Medical Education, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
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Červený M, Balounová L, Kratochvílová I, Doležalová J, Tóthová V. Perceptions of nurses on the scope of culturally competent care in critical care: A qualitative study. Nurs Crit Care 2024; 29:997-1004. [PMID: 38302708 DOI: 10.1111/nicc.13034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2023] [Revised: 12/06/2023] [Accepted: 01/05/2024] [Indexed: 02/03/2024]
Abstract
BACKGROUND The cultural competence of nurses is crucial in providing nursing care for patients from different cultures. The absence of cultural competence can negatively impact the entire course of care; however, implementing cultural competence in critical care unit can be complicated. AIM This study aimed to determine nurses' perceptions regarding cultural competence in critical care units. STUDY DESIGN This study used a qualitative design with semi-structured interviews with nurses (n = 10) working in critical unites. Data were collected from February to June 2022 and then categorized and evaluated. Atlas.ti was used for the inductive thematic content analysis. RESULTS Three key areas identified were as follows: (1) nurses and culturally competent care in critical care, (2) cultural challenges in practice and (3) suggestions for improving culturally competent care. The participants expressed that culturally competent care in critical care units has specific limitations because of the nature of the intensive care units (ICUs). Additional learning included opportunities to improve culturally competent care, such as raising cultural awareness, developing language skills and promoting culturally competent care. CONCLUSIONS Providing culturally competent care in critical care units is an understudied area. Identifying barriers and cultural challenges is one strategy nurses can use to improve culturally competent ICU care. RELEVANCE TO CLINICAL PRACTICE Creating cultural awareness by training nurses in their own culture, in cultural diversity, and in overcoming prejudices and stereotypes is an essential step towards increasing cultural competence. Understanding nurses' perceptions on this topic can provide valuable insights into the challenges and opportunities for providing culturally sensitive care in a critical care setting.
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Affiliation(s)
- Martin Červený
- Faculty of Health and Social Sciences, University of South Bohemia in Ceske Budejovice, Ceske Budejovice, Czech Republic
| | - Lucie Balounová
- Faculty of Health and Social Sciences, University of South Bohemia in Ceske Budejovice, Ceske Budejovice, Czech Republic
| | - Inka Kratochvílová
- Faculty of Health and Social Sciences, University of South Bohemia in Ceske Budejovice, Ceske Budejovice, Czech Republic
| | - Jitka Doležalová
- Faculty of Health and Social Sciences, University of South Bohemia in Ceske Budejovice, Ceske Budejovice, Czech Republic
| | - Valérie Tóthová
- Faculty of Health and Social Sciences, University of South Bohemia in Ceske Budejovice, Ceske Budejovice, Czech Republic
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17
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Camargo A, Radmard M, Dabiri M, Carson KA, Hsu L, Yousem DM. Discrimination faced by radiology residents: an analysis of experiences and mitigation strategies. Curr Probl Diagn Radiol 2024; 53:600-605. [PMID: 38714392 PMCID: PMC11283936 DOI: 10.1067/j.cpradiol.2024.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2024] [Accepted: 05/02/2024] [Indexed: 05/09/2024]
Abstract
RATIONALE AND OBJECTIVES Literature shows that discrimination has been pervasive in the field of medicine. The aim of this study was to collect experiences related to discrimination among US radiology residents, including type and source, as well as the residents' perception on lectures about discrimination and harassment. We also explored the barriers to reporting, and suggested strategies to overcome them. MATERIAL AND METHODS Following Institutional Review Board (IRB) approval, an online survey was sent to program directors and coordinators across the US, who were asked to forward the link to their radiology residents. A reminder email was sent over a period of 4 months. The participants were reassured the survey was confidential and anonymous. RESULTS Among the respondents, the most reported types of discrimination were based in gender, race and nationality, the majority of which not being reported. The most common perpetrators were attending radiologists, co-residents, technologists, and patients. The main barriers for reporting were fear of retaliation, confidentiality concerns, and skepticism about a positive outcome. CONCLUSION Our study examines some experiences of discrimination shared by residents during their training, with gender and race being the most common causes. This sheds light into a hidden and unspoken issue and highlights the need for more active discussions in radiology on microaggressions and implicit bias. Our data can guide future studies as well as residency programs to build effective strategies to address discrimination, aiming for sustainable changes.
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Affiliation(s)
- Aline Camargo
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, 1364 Clifton Road NE, Atlanta, GA, 30322 USA.
| | - Mahla Radmard
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institution, 1800 Orleans Street, Baltimore, MD, 21287 USA
| | - Mona Dabiri
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institution, 1800 Orleans Street, Baltimore, MD, 21287 USA
| | - Kathryn A Carson
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD, 21205 USA
| | - Liangge Hsu
- Department of Radiology, Brigham and Women's Hospital/Harvard Medical School, 75 Francis Street, Boston, MA, 02115 USA
| | - David M Yousem
- Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medical Institution, 1800 Orleans Street, Baltimore, MD, 21287 USA
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Clark Dula CA, Jackson K, King SA, Nebergall S, Matthews DE. Developing supervisory and precepting skills through simulation: Near peer teaching in a skills laboratory. CURRENTS IN PHARMACY TEACHING & LEARNING 2024; 16:102121. [PMID: 38865874 DOI: 10.1016/j.cptl.2024.102121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 05/17/2024] [Accepted: 05/30/2024] [Indexed: 06/14/2024]
Abstract
BACKGROUND AND PURPOSE Near-peer teaching is an innovative approach to teaching the skills of supervising and precepting while benefiting students with different levels of experience and academic training. This study describes near-peer activities in skills-based laboratory courses that provided opportunities for one-on-one teaching to benefit learners in the introductory lab courses while simultaneously training more advanced students for future supervisory and precepting roles. EDUCATIONAL ACTIVITY & SETTING Three community pharmacy near-peer teaching simulations were designed and implemented: 1) Patient Counseling and Medication Adherence, 2) Dispensing and Patient Counseling, and 3) Drug Utilization Review and Prescriber Calls. These activities took place over two semesters of a pharmacy skills lab with all first- and third-year Doctor of Pharmacy students. FINDINGS In Autumn 2019, 80% (111/139) of P1s and 67% (80/119) of P3s responded to the course evaluation survey. In Spring 2020, 73% (100/137) of P1s and 68% (80/118) of P3s responded to the course evaluation survey. The P3s reported increased confidence in their ability to provide meaningful feedback, while P1s reported increased confidence in communicating with patients and healthcare providers. Performance data revealed that most P1s and P3s completed dispensing and communication activities accurately using a near-peer approach. Overall, the P1s and P3s felt the activities were valuable learning experiences. SUMMARY The near-peer activities described in this study fill a gap in the training of pharmacy graduates for future precepting and supervisory roles. Evaluation of these near-peer activities suggest that both junior and senior learners benefit from simulated preceptor-intern interactions, supporting this innovative approach to address supervisory and precepting responsibilities.
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Affiliation(s)
- Colleen A Clark Dula
- The Ohio State University College of Pharmacy, 500 West 12th Avenue, Columbus, OH 43210, United States.
| | - Kristy Jackson
- The Ohio State University College of Pharmacy, 500 West 12th Avenue, Columbus, OH 43210, United States.
| | - Stacy A King
- The Ohio State University College of Pharmacy, 500 West 12th Avenue, Columbus, OH 43210, United States.
| | - Sean Nebergall
- The Ohio State University College of Pharmacy, 500 West 12th Avenue, Columbus, OH 43210, United States.
| | - David E Matthews
- The Ohio State University College of Pharmacy, 500 West 12th Avenue, Columbus, OH 43210, United States.
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Al-Sabiry M, Barnhoorn P, Slootweg I, van Mook W, Numans M. Which 'end' do you have in mind? Clinical supervisors' perceptions of Professional Identity Formation outcomes in GP residency. MEDICAL TEACHER 2024; 46:1236-1242. [PMID: 38295758 DOI: 10.1080/0142159x.2024.2308070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/23/2023] [Accepted: 01/17/2024] [Indexed: 02/08/2024]
Abstract
PURPOSE Professional Identity Formation (PIF) is crucial for high-quality patient care and physician well-being. Few empirical studies examined PIF in residency from the perspective of supervisors. In GP residency, residents are supervised with an 'end in mind' that remains unexplored. To encourage supervisors to reflect on their teaching behaviours, this study investigated GP clinical supervisors' perceptions of PIF outcomes in GP residency. METHODS Applying qualitative description, focus group interviews were conducted between spring and autumn 2019. Using a semi-structured interview guide, supervisors' perceptions of PIF outcomes were explored. In an iterative coding process applying constant comparison, a thematic analysis was performed of focus group transcripts. RESULTS We conducted eight focus groups with 55 supervisors at four training institutes across the Netherlands. Half of the supervisors were female. GP supervisors tend to address the 'poor GP' when prompted to address the 'good GP'. PIF outcomes in GP residency should revolve around taking ownership in patient care, self-care and the persistence of GP as a profession. CONCLUSION PIF can be challenged by a lack of positive language. Supervisors' strong beliefs regarding ideals of the profession potentially compromise PIF when they do not resonate with residents' beliefs, resulting in poor educational alliance.
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Affiliation(s)
- Miami Al-Sabiry
- Department of Public Health and Primary Care, Leiden University Medical Center, the Netherlands
| | - Pieter Barnhoorn
- Department of Public Health and Primary Care, Leiden University Medical Center, the Netherlands
| | - Irene Slootweg
- Department of Public Health and Primary Care, Leiden University Medical Center, the Netherlands
| | - Walther van Mook
- Department of Intensive Care Medicine, Maastricht University Medical Centre, the Netherlands
- School of Health Professions Education, Maastricht University, the Netherlands
| | - Mattijs Numans
- Department of Public Health and Primary Care, Leiden University Medical Center, the Netherlands
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Anderson H, Studer AC. How are medical students learning to care for patients with intellectual disabilities? A scoping review. JOURNAL OF APPLIED RESEARCH IN INTELLECTUAL DISABILITIES 2024; 37:e13290. [PMID: 39128868 DOI: 10.1111/jar.13290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 07/10/2024] [Accepted: 07/26/2024] [Indexed: 08/13/2024]
Abstract
BACKGROUND Individuals with intellectual disabilities experience barriers to quality healthcare. To reduce this disparity, equipping medical trainees with the knowledge and skills required for treating this patient population is critical. Our aim is to describe the breadth of instructional interventions and identify gaps in intellectual disability medical education curricula. METHOD Using scoping review methods, the intellectual disability programmes described in 27 articles were evaluated and their coverage of the six core competencies on disability for health care education was examined. RESULTS The most frequently represented core competencies were disability conceptual frameworks, professionalism and communication, and clinical assessment, which were, in most programmes, fulfilled by activities involving individuals with intellectual disabilities. Uneven competency coverage warrants consideration. CONCLUSIONS Considerable variabilities exist in medical school curricula on intellectual disabilities. Using core competencies on disability for health care education for curricular design and evaluation would provide a coherent training experience in this important area.
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Affiliation(s)
- Hana Anderson
- Department of Internal Medicine, School of Medicine, University of California, Davis, Davis, California, USA
- Department of Cell Biology and Human Anatomy, School of Medicine, University of California, Davis, Davis, California, USA
| | - Amy C Studer
- Blaisdell Medical Library, University of California, Davis, Davis, California, USA
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Regaira-Martínez E, Ferraz-Torres M, Mateo-Cervera AM, Vázquez-Calatayud M. Registered nurses' perceptions of nursing student preceptorship: Content analysis of open-ended survey questions. Nurs Health Sci 2024; 26:e13142. [PMID: 39013556 DOI: 10.1111/nhs.13142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Revised: 06/13/2024] [Accepted: 07/01/2024] [Indexed: 07/18/2024]
Abstract
Nursing preceptors play a crucial role in supporting and educating clinical students. Understanding the perceptions and needs of nurse preceptors is essential to enhance their role as preceptors and to improve their teaching practices. This study aimed to explore preceptorship in diverse settings and specific contexts. Content analysis was performed to analyze open-ended responses from a questionnaire based on nurses' perceptions of preceptorship with undergraduate nursing students. Data were collected from two university hospitals, with different healthcare provision levels. Of the 370 responses, 295 (96%) were those of women, and 34.5% were in the age group of 41-50 years. Three main themes were identified: (1) the role of preceptorship as a key component in learning, (2) challenges in student preceptorship, and (3) personal recognition and compensation for teaching work. This study highlights the positive experiences and provides valuable insights into the challenges and opportunities faced by nurse preceptors in their teaching roles, and emphasizes the need for institutional support and educational programs to enhance their teaching responsibilities. Improving communication and collaboration among stakeholders is crucial for improving learning outcomes and satisfaction.
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Affiliation(s)
| | - M Ferraz-Torres
- Navarra's Health Research Institute (IdiSNA), Pamplona, Spain
- Public University of Navarre, Pamplona, Spain
- University Hospital of Navarra, Pamplona, Spain
| | | | - M Vázquez-Calatayud
- University of Navarra Clinic, Pamplona, Spain
- Navarra's Health Research Institute (IdiSNA), Pamplona, Spain
- University of Navarra. Innovation for a Person-Centred Care Research Group (ICCP-UNAV), Pamplona, Spain
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Lechien NM, Dempsey SA. Lesbian, Gay, Bisexual, Transgender, Queer, Plus Curriculum in Physician Assistants/Associate Education: A Call to Action. J Physician Assist Educ 2024; 35:310-313. [PMID: 38377303 DOI: 10.1097/jpa.0000000000000576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
ABSTRACT Healthcare avoidance of the LGBTQIA+ community is growing, in part, due to a knowledge gap in medical learners on LGBTQIA+-related topics. Barriers of including LGBTQIA+ topics in medical education include perceived lack of applicability and preceptor knowledge gaps. Advocating for a weave-like integration approach, topics such as personal biases, hormone replacement therapy, STI prevention, and health inequities should be included. It is imperative that PA educators use this call to action to avoid perpetuating the cultural incompetence of new graduate PAs.
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Affiliation(s)
- Nathan M Lechien
- Nathan M. Lechien, DMSc, MPAS, PA-C, is a clinical education director, clinical assistant professor at Indiana University Indianapolis, Indianapolis, Indiana
- Shea A. Dempsey, DMSc, MBA, PA-C, EM-CAQ, is a director doctor of medical science, assistant professor, Shenandoah University, Winchester, Virginia
| | - Shea A Dempsey
- Nathan M. Lechien, DMSc, MPAS, PA-C, is a clinical education director, clinical assistant professor at Indiana University Indianapolis, Indianapolis, Indiana
- Shea A. Dempsey, DMSc, MBA, PA-C, EM-CAQ, is a director doctor of medical science, assistant professor, Shenandoah University, Winchester, Virginia
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McCarrick CA, Moynihan A, Khan MF, Lennon F, Stokes M, Donnelly S, Heneghan H, Cahill RA. Impact of Simulation Training on Core Skill Competency of Undergraduate Medical Students. JOURNAL OF SURGICAL EDUCATION 2024; 81:1222-1228. [PMID: 38981819 DOI: 10.1016/j.jsurg.2024.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2024] [Revised: 06/04/2024] [Accepted: 06/10/2024] [Indexed: 07/11/2024]
Abstract
INTRODUCTION Simulation based medical training (SBMT) is gaining traction for undergraduate learning and development. We designed, implemented, and independently assessed the impact of an SBMT programme on competency in surgical history taking and clinical examination for senior clinical students. METHODS With institutional ethical approval and initial pilot study of student volunteers that ensured format appropriateness, we implemented an SBMT programme weekly for ten weeks during the core surgery module of our Medicine degree programme. Groups of 5 students collaboratively undertook an observed focused history and physical examination while simultaneously directing care on a simulated surgical patient (actor) with acute abdominal pain. This was conducted in a nonclinical, standardised, tutor-supervised environment and followed by a group debriefing led by both the simulated patient and tutor discussing student interaction and competency. All students undertook Southampton Medical Assessment Tool (SMAT) on a surgical inpatient prior to (baseline) and within 2 weeks after SBMT. Students without simulation training functioned as a control group and randomized cluster sampling was utilised for group selection. Second assessments were by independent surgical academics blinded to student group. Feedback was collected via anonymous questionnaire from those who undertook SBMT. RESULTS One hundred students took part, fifty of whom undertook SBMT. Global mean SMAT scores were similar between the control and intervention group at baseline (p > 0.05). Scores on the second assessment were significantly higher (p = 0.0006) for those who had undertaken SBMT vs. controls; 94% of students taking SBMT reported benefit via questionnaire with 85% stating increased confidence in history-taking and 78% reporting improved abdominal examination. CONCLUSIONS Undergraduate simulation training at scale is feasible and positively impacts undergraduate student core task competency.
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Affiliation(s)
- Cathleen A McCarrick
- Department of Surgery, School of Medicine, University College Dublin; Department of Surgery, Mater Misericordiae University Hospital
| | - Alice Moynihan
- Department of Surgery, School of Medicine, University College Dublin; Department of Surgery, Mater Misericordiae University Hospital
| | - Mohammad Faraz Khan
- Department of Surgery, School of Medicine, University College Dublin; Department of Surgery, Mater Misericordiae University Hospital
| | - Finbar Lennon
- Department of Surgery, School of Medicine, University College Dublin
| | - Maurice Stokes
- Department of Surgery, School of Medicine, University College Dublin; Department of Surgery, Mater Misericordiae University Hospital
| | - Suzanne Donnelly
- Department of Surgery, School of Medicine, University College Dublin; Department of Surgery, Mater Misericordiae University Hospital
| | - Helen Heneghan
- Department of Surgery, School of Medicine, University College Dublin
| | - Ronan A Cahill
- Department of Surgery, School of Medicine, University College Dublin; Department of Surgery, Mater Misericordiae University Hospital.
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Birch A, Varty M. Educational Interventions for Rapid Response Team Members: A Narrative Literature Review. Dimens Crit Care Nurs 2024; 43:266-271. [PMID: 39074232 DOI: 10.1097/dcc.0000000000000655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/31/2024] Open
Abstract
BACKGROUND Research continues to be conducted on rapid response systems as patient outcomes associated with rapid response team activations are still not consistently showing benefit. One particular area of focus that is a growing area is the literature regarding training and education for individual team members of the rapid response team. OBJECTIVE The purpose of this narrative review was to describe the current literature regarding educational interventions for rapid response team members. METHODS This review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. To be included in the narrative review, studies needed to be reporting on educational interventional research for rapid response team members of the efferent limb. No studies were excluded based upon study design or publication years. RESULTS This narrative review included 6 studies. Four studies assessed outcomes associated with rapid response team members, and 2 of the studies assessed patient outcomes associated with implementing education routinely for rapid response teams. All studies found a positive impact of implementing educational interventions. DISCUSSION Our narrative review found that limited research has been conducted in the area of educational interventions for rapid response team members, and of the articles identified, most did not assess patient-associated outcomes. The findings demonstrate that this area of research is in its early stages, and further work is needed to identify what content should be provided in the education and what educational methodologies should be employed, and to continue to assess patient health outcomes associated with educational interventions for rapid response team members.
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Basel MT. Using a flipped classroom in a veterinary systems physiology course increases student performance on basic knowledge and clinical applicability questions. ADVANCES IN PHYSIOLOGY EDUCATION 2024; 48:550-557. [PMID: 38779746 DOI: 10.1152/advan.00042.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Revised: 04/15/2024] [Accepted: 05/13/2024] [Indexed: 05/25/2024]
Abstract
Flipped classrooms are being utilized more frequently in biomedical education to provide more active learning opportunities to students although there are mixed results on the benefits of the flipped classroom in biomedical education. In this study, the effects of using a flipped classroom with case-based learning in the endocrine section of a first-year veterinary-integrated histology and physiology course were investigated. Results demonstrated that the flipped classroom improved performance on the endocrine section exam by 15.9% (Cohen's d = 1.08; P < 0.001) with improvements on both clinically applicable and basic knowledge questions. Student satisfaction with the flipped classroom was also investigated. Students reported high satisfaction with the in-class case-based learning opportunities but lower satisfaction with the asynchronous content delivery and the time required outside of class. Student perceptions of the flipped classroom were measured again after being exposed to the results of the flipped classroom on student learning. After seeing the results, students were significantly more likely to value the time spent in the flipped classroom and to desire more opportunities for flipped classrooms in the future.NEW & NOTEWORTHY A flipped classroom using case-based learning can significantly improve student performance in a veterinary physiology course with the largest gains going to lower performing students. Student perception of the flipped classroom can be improved by showing students data on the improvement in performance on examinations.
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Affiliation(s)
- Matthew T Basel
- Department of Anatomy and Physiology, Kansas State University College of Veterinary Medicine, Manhattan, Kansas, United States
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Herndon JS, Louwagie VS, Strelow BA, Schenzel HA, Cumberland EA, Oxentenko AS. Mentorship effect for PAs at an academic medical center and its healthcare system. JAAPA 2024; 37:31-36. [PMID: 39162645 DOI: 10.1097/01.jaa.0000000000000111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/21/2024]
Abstract
PURPOSE Mentorship has many notable benefits. Research about mentorship for physician associates/assistants (PAs) is limited. This study sought to uncover more detailed information on mentorship and its effect on PAs. METHODS A survey was sent via email to all PAs and advanced practice registered nurses at our institution. Subgroup analysis was performed on PA respondents, including satisfaction and independent predictors associated with mentorship. RESULTS Of the 295 PAs, 63 (21.4%) identified having a mentor. Those with a mentor were statistically more likely to function as a mentor (OR 2.7 [95% CI 1.5-4.9], P = .001), have an academic rank of assistant professor or higher (OR 2.7 [95% CI 1.3-5.5], P = .007), be under age 45 years (OR 6.1 [95% CI 2.1-17.4], P = .008), be less than 10 years into their career (OR 3.1 [95% CI 1.7-5.7], P = .002), and be satisfied with mentorship (88.9% versus 23.9%, P < .001). CONCLUSIONS Mentorship for PAs is crucial and can boost academic promotion and career satisfaction.
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Affiliation(s)
- Justine S Herndon
- Justine S. Herndon practices in endocrinology at the Mayo Clinic in Rochester, Minn. Victoria S. Louwagie practices in gastroenterology and hepatology at the Mayo Clinic Health System in Mankato, Minn. Brittany A. Strelow practices in community internal medicine at the Mayo Clinic. Holly A. Schenzel practices in hospital internal medicine at the Mayo Clinic. Elizabeth A. Cumberland practices in anesthesiology at the Mayo Clinic Health System. Amy S. Oxentenko practices in gastroenterology at the Mayo Clinic. Small grant funding for this research was provided by the Office of Mayo Clinic Health System Research. The authors have disclosed no potential conflicts of interest, financial or otherwise
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Dufayet L, Piot MA, Geoffroy PA, Oulès B, Petitjean-Brichant C, Peiffer-Smadja N, Bouzid D, Tran Dinh A, Mirault T, Faye A, Lemogne C, Ruszniewski P, Peyre H, Vodovar D. CARECOS study: Medical students' empathy as assessed with the CARE measure by examiners versus standardized patients during a formative Objective and Structured Clinical Examination (OSCE) station. MEDICAL TEACHER 2024; 46:1187-1195. [PMID: 38285021 DOI: 10.1080/0142159x.2024.2306840] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 01/15/2024] [Indexed: 01/30/2024]
Abstract
PURPOSE To assess the Consultation And Relational Empathy (CARE) measure as a tool for examiners to assess medical students' empathy during Objective and Structured Clinical Examinations (OSCEs), as the best tool for assessing empathy during OSCEs remains unknown. METHODS We first assessed the psychometric properties of the CARE measure, completed simultaneously by examiners and standardized patients (SP, either teachers - SPteacher - or civil society members - SPcivil society), for each student, at the end of an OSCE station. We then assessed the qualitative/quantitative agreement between examiners and SP. RESULTS We included 129 students, distributed in eight groups, four groups for each SP type. The CARE measure showed satisfactory psychometric properties in the context of the study but moderate, and even poor inter-rater reliability for some items. Considering paired observations, examiners scored lower than SPs (p < 0.001) regardless of the SP type. However, the difference in score was greater when the SP was a SPteacher rather than a SPcivil society (p < 0.01). CONCLUSION Despite acceptable psychometric properties, inter-rater reliability of the CARE measure between examiners and SP was unsatisfactory. The choice of examiner as well as the type of SP seems critical to ensure a fair measure of empathy during OSCEs.
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Affiliation(s)
- Laurene Dufayet
- UFR de médecine, Université Paris Cité, Paris, France
- Unité Médico-judiciaire, Hôtel-Dieu, AP-HP, Paris, France
- Centre Antipoison de Paris, Hôpital Fernand-Widal, AP-HP, Paris, France
- INSERM, UMRS-1144, Faculté de pharmacie, Paris, France
| | - Marie-Aude Piot
- UFR de médecine, Université Paris Cité, Paris, France
- Département de psychiatrie de l'enfant et de l'adolescent, Hôpital Necker, AP-HP, Paris, France
- INSERM, UMR 1018, Université Paris-Saclay, Villejuif cedex, France
| | - Pierre-Alexis Geoffroy
- UFR de médecine, Université Paris Cité, Paris, France
- Département de psychiatrie et d'addictologie, Hôpital Bichat-Claude Bernard, AP-HP, Paris, France
- Psychiatrie & Neurosciences, Hôpital Saint-Anne, GHU Paris, Paris, France
- Université de Paris, NeuroDiderot, Inserm, FHU I2-D2, Paris, France
| | - Bénédicte Oulès
- UFR de médecine, Université Paris Cité, Paris, France
- Service de dermatologie, Hôpital Saint-Louis, AP-HP, Paris, France
| | - Clara Petitjean-Brichant
- Département de psychiatrie et d'addictologie, Hôpital Bichat-Claude Bernard, AP-HP, Paris, France
| | - Nathan Peiffer-Smadja
- UFR de médecine, Université Paris Cité, Paris, France
- Service de maladies infectieuses et tropicales, Hôpital Bichat-Claude Bernard, AP-HP, Paris, France
- Université Paris Cité, INSERM UMR1137, IAME, Paris, France
| | - Donia Bouzid
- UFR de médecine, Université Paris Cité, Paris, France
- Université Paris Cité, INSERM UMR1137, IAME, Paris, France
- Service d'accueil des urgences, Hôpital Bichat-Claude Bernard, AP-HP, Paris, France
| | - Alexy Tran Dinh
- UFR de médecine, Université Paris Cité, Paris, France
- Département d'anesthésie-réanimation, Hôpital Bichat-Claude Bernard, AP-HP, Paris, France
| | - Tristan Mirault
- UFR de médecine, Université Paris Cité, Paris, France
- Service de médecine vasculaire, Hôpital Européen Georges Pompidou, Paris, France
| | - Albert Faye
- UFR de médecine, Université Paris Cité, Paris, France
- Service de Pédiatrie générale, Maladies infectieuses et Médecine interne, Hôpital Robert Debré, AP-HP, Paris, France
| | - Cédric Lemogne
- UFR de médecine, Université Paris Cité, Paris, France
- Service de Psychiatrie de l'adulte, AP-HP, Hôpital Hôtel-Dieu, Paris, France
- Center for Research in Epidemiology and StatisticS (CRESS), Université Paris Cité and Université Sorbonne Paris Nord, INSERM, INRAE, Paris, France
| | - Philippe Ruszniewski
- UFR de médecine, Université Paris Cité, Paris, France
- Service de gastro-entérologie et pancréatologie, Hôpital Beaujon AP-HP, Clichy, France
| | - Hugo Peyre
- UFR de médecine, Université Paris Cité, Paris, France
- Service de psychiatrie de l'enfant et de l'adolescent, Hôpital Robert Debré, APHP, Paris, France
- INSERM UMR 1141, Université Paris Cité, Paris, France
| | - Dominique Vodovar
- UFR de médecine, Université Paris Cité, Paris, France
- Centre Antipoison de Paris, Hôpital Fernand-Widal, AP-HP, Paris, France
- INSERM, UMRS-1144, Faculté de pharmacie, Paris, France
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Rushworth GF, Forsyth P, Radley A, Duggan C, Sampson R, Cunningham S, Maguire B. A Pharmacist Clinician Model as part of a collaborative clinical workforce: A philosophical critique. Res Social Adm Pharm 2024; 20:918-925. [PMID: 38902135 DOI: 10.1016/j.sapharm.2024.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 06/05/2024] [Accepted: 06/10/2024] [Indexed: 06/22/2024]
Abstract
The term 'clinician' is not reserved for any healthcare professional group. However, there is a general acceptance that a clinician would have the knowledge, skills and behaviours to enable them to clinically assess and manage a patient autonomously. The expectation, in a modern collaborative healthcare system, is that this work would be completed as a part of a planned and integrated multi-disciplinary care delivery structure, where any given clinician delivers a devolved element of that patient's care. Forthcoming changes to regulation and professional development pathways in the UK will have a profound impact on pharmacist professional identity and practice. From 2026, all new UK pharmacist registrants will have full independent prescribing rights. A paradigm shift is expected to enable the development of a Pharmacist Clinician Model, incorporating pharmaceutical care needs with wider clinical assessment, diagnostic, and clinical management responsibilities. Consideration is given to this model and its implications. Changes to regulation, policy, education, and the governance required to deliver safe and effective pharmacist clinicians are outlined. A philosophical critique on the nature of being a clinician, and the differentiation of pharmacist clinician roles compared to other healthcare professions, is given. A further examination of the projected risks and expected benefits of this transformative practice model are then explored.
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Affiliation(s)
- Gordon F Rushworth
- School of Pharmacy & Life Sciences, Robert Gordon University, Aberdeen, AB10 7GJ, UK; Highland & Islands Pharmacy Education & Research (HIPER), NHS Highland, Inverness, IV2 3UJ, UK.
| | - Paul Forsyth
- Clinical Cardiology, Pharmacy, NHS Greater Glasgow & Clyde, Clarkston Court, 56 Busby Road, Glasgow, G76 7AT, UK.
| | - Andrew Radley
- Public Health Pharmacy, NHS Tayside, UK; School of Population Health and Genomics, University of Dundee Medical School, Ninewells Hospital, James Arrott Dr, Dundee, DD2 1SG, UK.
| | | | - Rod Sampson
- Cairn Medical Practice, Culduthel Road, Inverness, IV2 4AG, UK.
| | - Scott Cunningham
- School of Pharmacy & Life Sciences, Robert Gordon University, Aberdeen, AB10 7GJ, UK.
| | - Barry Maguire
- Philosophy, Psychology, and Language Sciences, The University of Edinburgh, 40 George St, Edinburgh, EH8 9JX, UK.
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Yang SY, Oh YH. Development of neonatal Apgar scoring training program utilizing contactless hand tracking in immersive virtual reality. NURSE EDUCATION TODAY 2024; 140:106294. [PMID: 38944937 DOI: 10.1016/j.nedt.2024.106294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 06/03/2024] [Accepted: 06/19/2024] [Indexed: 07/02/2024]
Abstract
BACKGROUND The rapid and accurate assessment of neonatal asphyxia is critical to preventing potentially fatal outcomes. Therefore, nursing students must acquire the skills to assess newborn conditions immediately after birth and implement appropriate interventions. Virtual reality (VR) simulation education has emerged as a promising tool for nursing education, offering repetitive and customizable clinical training while ensuring patient safety and overcoming spatiotemporal limitations. AIM This study investigated the effects of a contactless hand-tracking-based immersive VR neonatal Apgar scoring program, adapted from experiential learning theory. DESIGN A non-randomized controlled trial with a pre-post-test, quasi-experimental design was conducted. SETTINGS The study was conducted at two nursing schools from July to October 2023. PARTICIPANTS Participants comprised nursing students holding bachelor's degrees in nursing, with three or four years of experience and successful completion of a neonatal nursing theory course. Additionally, individuals with at least six months of experience working in a neonatal ward or delivery room before enrolling in nursing school were eligible. METHODS The participants were divided into three groups: the VR group (n = 27) received contactless hand-tracking-based immersive VR neonatal Apgar scoring training; the simulation group (n = 28) received face-to-face Apgar scoring simulation training; and the control group (n = 26) received instruction on the Apgar scoring criteria. Changes in scores among the VR, simulation, and control groups were statistically compared using ANOVA with SPSS-WIN 27.0. RESULTS The VR group exhibited significant improvements in knowledge, learning satisfaction, self-confidence, immersion, and motivation compared to the simulation and control groups. Moreover, satisfaction was significantly higher in the VR group than in the simulation group. CONCLUSIONS The hand-tracking-based immersive VR neonatal Apgar scoring program represents an innovative and effective educational tool, prioritizing the privacy and rights of mothers and infants. It can potentially replace traditional delivery-room clinical training, which is observation-based and limited.
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Affiliation(s)
- Sun-Yi Yang
- College of Nursing, Konyang University, Daejeon, Republic of Korea.
| | - Yun-Hee Oh
- Department of Nursing, Cheju-Halla University, Jeju, Republic of Korea
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Cheung YTD, Zhang G, Luk TT, Zhang M, Lam VSF, Chan MMK, Wang MP, Chan SSC. Effect of narrative videos and mini-VR games in nursing smoking cessation training on empathy and self-efficacy of smoking cessation counseling: A randomized controlled trial. NURSE EDUCATION TODAY 2024; 140:106272. [PMID: 38851019 DOI: 10.1016/j.nedt.2024.106272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/15/2024] [Revised: 05/09/2024] [Accepted: 06/02/2024] [Indexed: 06/10/2024]
Abstract
BACKGROUND Empathy and self-efficacy for smoking cessation counseling can be enhanced through smoking cessation training. Narrative videos and virtual reality (VR) games have been applied in medical education, but their application in smoking cessation training is limited and understudied. OBJECTIVES To evaluate the effect of smokers' narrative videos and mini-VR games on nursing students' empathy towards smokers (State Empathy Scale), confidence in practicing empathy, self-efficacy in smoking cessation counseling, and learning satisfaction. DESIGN An open-labeled randomized controlled trial, registration number: NCT05440877 (ClinicalTrials.gov). SETTING AND PARTICIPANTS Master of nursing students from the University in Hong Kong who enrolled in a smoking cessation course. METHODS All students attended a tutorial including case-based discussions and role-play. The intervention group could additionally access the narrative videos and mini-VR games of smokers' cases. Linear mixed models and Cohen's d were used to evaluate the intervention effect on the self-reported learning outcomes after the intervention. RESULTS 26 students enrolled in this trial, with 13 in each trial arm. All completed the trial. Post-test state empathy scores were significantly higher in the control group than in the intervention group (Cohen's d = 0.814, p = 0.049). No significant group differences were observed in the change of confidence in practicing empathy (β = -11.154, p = 0.073), self-efficacy (β = 4.846, p = 0.096), and students' learning satisfaction (Cohen's d = 0.041, p = 0.917). Both groups showed a significant increase in self-efficacy post-test (p < 0.001). CONCLUSIONS Narrative videos showing smoking scenes and reluctance to quit, and our mini-VR games may weaken nursing students' empathy towards smokers. Smoking cessation training involving narrative videos should be modified. Debriefing and guidance to understand smokers' difficulties and express empathy are needed. VR games for smoking cessation training can involve more frame stories and challenging tasks to increase engagement.
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Affiliation(s)
- Yee Tak Derek Cheung
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong.
| | - Guowen Zhang
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong.
| | - Tzu Tsun Luk
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Minjin Zhang
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Veronica Suk Fun Lam
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Maggie Mee Kie Chan
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Man Ping Wang
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
| | - Sophia Siu Chee Chan
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong
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Guest H, Miller CL. Trauma-Informed Care in Nursing Curricula: Development of a Simulation-Based Educational Framework to Guide Health Professions. Nurs Educ Perspect 2024; 45:271-275. [PMID: 39159250 DOI: 10.1097/01.nep.0000000000001313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/21/2024]
Abstract
AIM This research aimed to uncover elements of a comprehensive, trauma-informed (TI) multidisciplinary health professions simulation framework to improve the delivery of care to traumatized patients. BACKGROUND Trauma is a pervasive public health problem requiring a TI approach. Simulation is an evidence-based teaching strategy that advances knowledge and clinical reasoning. There is a lack of scientifically based simulation education models addressing the delivery of TI care for the health professions. METHOD A Delphi study utilizing a panel of experts was conducted to identify the most critical elements of a simulation framework. RESULTS Phase one identified 10 content areas and 111 subcontent areas. Phase two analysis revealed 99 percent of the 111 subcontent areas achieved expert consensus. CONCLUSION This Delphi study provides the first scientifically based framework to guide the development of a comprehensive, TI, multidisciplinary simulation framework to recognize trauma survivors and subsequently display concern and respect.
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Affiliation(s)
- Heather Guest
- About the Authors Heather Guest, PhD, RN, CNE, CHSE, is an assistant professor, Texas Tech University Health Sciences Center, Lubbock, Texas. Cathy L. Miller, PhD, RN, is a professor, College of Nursing and Health Science, University of Texas at Tyler, Tyler, Texas. This research was supported by a 2022 NLN Research in Nursing Education Mary Anne Rizzolo Doctoral Research Award. For more information, contact Dr. Guest at
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Bordelon C, Polancich S. Transforming DNP Projects: Navigating Success With Project Management Tools in Nursing Education. Nurse Educ 2024; 49:E294-E295. [PMID: 38814589 DOI: 10.1097/nne.0000000000001659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2024]
Affiliation(s)
- Curry Bordelon
- Associate Professor (Dr Bordelon), Professor (Dr Polancich), University of Alabama at Birmingham School of Nursing, Birmingham, Alabama
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Lindsay J, Cropley S, Ramirez E. Prevalence of Impostor Phenomenon Among Final-Semester Baccalaureate Nursing Students. Dimens Crit Care Nurs 2024; 43:272-276. [PMID: 39074233 DOI: 10.1097/dcc.0000000000000653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/31/2024] Open
Abstract
BACKGROUND Impostor phenomenon (IP) is characterized as an internal sense of intellectual fraudulence and the inability to internalize success. It was identified by Clance and Imes in 1978 in a study with high-achieving women and has since been found among other professionals. Studies regarding IP are limited in nursing and among nursing students. PURPOSE The purpose of the study was to evaluate the prevalence of IP among senior baccalaureate nursing (BSN) students at a public central Texas university immediately prior to graduation. METHODS Senior BSN students were given an anonymous survey utilizing the Clance Impostor Phenomenon Scale. RESULTS Of the 86 senior BSN students, 82.5% completed the anonymous survey. Among students, 45.1% experienced moderate IP, 46.5% experienced frequent IP, and 8.5% experienced intense IP. CONCLUSIONS The incidence of IP was higher than expected. This study has implications for the future of nursing, including academic retention and postgraduation performance.
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Drumm BT, Bree R, Griffin CS, O'Leary N. Diversifying laboratory assessment modes broadens engagement with practical competencies in life science students. ADVANCES IN PHYSIOLOGY EDUCATION 2024; 48:527-546. [PMID: 38721652 DOI: 10.1152/advan.00257.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2023] [Revised: 05/02/2024] [Accepted: 05/02/2024] [Indexed: 06/19/2024]
Abstract
Laboratory practicals in life science subjects are traditionally assessed by written reports that reflect disciplinary norms for documenting experimental activities. However, the exclusive application of this assessment has the potential to engage only a narrow range of competencies. In this study, we explored how multiple modes of laboratory assessment might affect student perceptions of learned skills in a life science module. We hypothesized that while a mixture of assessments may not impact student summative performance, it might positively influence student perceptions of different skills that varied assessments allowed them to practice. This was informed by universal design for learning and teaching for understanding frameworks. In our study, in a third-year Bioscience program, written reports were complemented with group presentations and online quizzes via Moodle. Anonymous surveys evaluated whether this expanded portfolio of assessments promoted awareness of, and engagement with, a broader range of practical competencies. Aspects that influenced student preferences in assessment mode included time limitations, time investment, ability to practice new skills, links with lecture material, and experience of assessment anxiety. In particular, presentations were highlighted as promoting collaboration and communication and the quiz as an effective means of diversifying assessment schedules. A key takeaway from students was that while reports were important, an overreliance on them was detrimental. This study suggests that undergraduate life science students can benefit significantly from a holistic assessment strategy that complements reports with performance-based approaches that incorporate broader competencies and allow for greater student engagement and expression in undergraduate modules.NEW & NOTEWORTHY This study suggests that undergraduate life science students can benefit significantly from a holistic assessment strategy that complements reports with performance-based approaches that incorporate broader competencies and allow for greater student engagement and expression in undergraduate modules.
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Affiliation(s)
- Bernard T Drumm
- Department of Life and Health Science, Dundalk Institute of Technology, Dundalk, Louth, Ireland
| | - Ronan Bree
- Department of Life and Health Science, Dundalk Institute of Technology, Dundalk, Louth, Ireland
| | - Caoimhin S Griffin
- Department of Life and Health Science, Dundalk Institute of Technology, Dundalk, Louth, Ireland
| | - Niall O'Leary
- School of Microbiology and Environmental Research Institute, University College Cork, Cork, Ireland
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Blalock AE, Ozdemir S, Garcia AJ, Lyons EG. "The faculty was really hearing what I had to say and really validating who I was": Learning from validation theory to support students of colour in undergraduate medical education. MEDICAL EDUCATION 2024; 58:1117-1125. [PMID: 38376060 DOI: 10.1111/medu.15364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/20/2023] [Revised: 01/29/2024] [Accepted: 01/31/2024] [Indexed: 02/21/2024]
Abstract
BACKGROUND Medical students of colour face numerous challenges during their undergraduate training period, reflecting the harmful norms and cultures in the learning context of medical school. Despite negative experiences for students of colour in medicine, there are episodes of support and encouragement that come from faculty or staff. This asset-based qualitative study uses Rendón's Validation Theory to illuminate specific ways faculty at a community-based medical college support medical students of colour, thereby challenging structural injustices in medical school. METHODS This study is grounded in a humanising and asset-based perspective, where participants are viewed as legitimate knowers from whom researchers can learn. Twenty-four medical students of colour and 14 faculty identified by students as supportive participated in five focus groups where participants shared how they felt validated and supported during their undergraduate medical school experiences. Inductive open-coding followed by deductive thematic coding using Validation Theory-a theory that describes how external validation is a necessary component of fostering students' personal and academic drive-and literature about the context of medical school informed the three findings. FINDINGS Three major themes provide examples of ways faculty validated students. First, participants indicated the importance of acknowledging identities and experiences to understand the socio, historical and cultural context of learning. Second, participants implored the value of giving praise and offering encouragement to work against professional expectations. Finally, participants shared the intimacy of fostering personal relationships to reduce hierarchies. CONCLUSION This study offers concrete guidance on teaching practices faculty can use to support students of colour. As medical schools may seek to move toward a more student-centred approach, promoting feelings of validation for students of colour can be a key practice in teaching and learning to ensure support for medical students throughout their medical school journey.
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Affiliation(s)
- A Emiko Blalock
- Department of Family Medicine, Michigan State University, East Lansing, Michigan, USA
| | - Sevil Ozdemir
- Michigan State University, East Lansing, Michigan, USA
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Fonseca M, Marvão P, Oliveira B, Heleno B, Carreiro-Martins P, Neuparth N, Rendas A. The effectiveness of concept mapping as a tool for developing critical thinking in undergraduate medical education - a BEME systematic review: BEME Guide No. 81. MEDICAL TEACHER 2024; 46:1120-1133. [PMID: 37980607 DOI: 10.1080/0142159x.2023.2281248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/21/2023]
Abstract
BACKGROUND Concept maps (CMs) visually represent hierarchical connections among related ideas. They foster logical organization and clarify idea relationships, potentially aiding medical students in critical thinking (to think clearly and rationally about what to do or what to believe). However, there are inconsistent claims about the use of CMs in undergraduate medical education. Our three research questions are 1) What studies have been published on concept mapping in undergraduate medical education; 2) What was the impact of CMs on students' critical thinking; 3) How and why have these interventions had an educational impact? METHODS Eight databases were systematically searched (plus a manual and an additional search were conducted). After eliminating duplicate entries, titles and abstracts and full-texts were independently screened by two authors. Data extraction and quality assessment of the studies were independently performed by two authors. Qualitative and quantitative data were integrated using mixed-methods. The results were reported using the STructured apprOach to the Reporting In healthcare education of Evidence Synthesis statement and BEME guidance. RESULTS Thirty-nine studies were included from 26 journals (19 quantitative, 8 qualitative and 12 mixed-methods studies). CMs were considered as a tool to promote critical thinking, both in the perception of students and tutors, as well as in assessing students' knowledge and/or skills. In addition to their role as facilitators of knowledge integration and critical thinking, CMs were considered both a teaching and a learning methods. CONCLUSIONS CMs are teaching and learning tools which seem to help medical students develop critical thinking. This is due to the flexibility of the tool as a facilitator of knowledge integration, as a learning and teaching method. The wide range of contexts, purposes, and variations in how CMs and instruments to assess critical thinking are used increases our confidence that the positive effects are consistent.
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Affiliation(s)
- Marta Fonseca
- Comprehensive Health Research Centre, Department of Pathophysiology, NOVA Medical School, Lisbon, Portugal
- NOVA Medical School, Lisbon, Portugal
| | | | | | - Bruno Heleno
- Comprehensive Health Research Centre, Department of Pathophysiology, NOVA Medical School, Lisbon, Portugal
- NOVA Medical School, Lisbon, Portugal
| | - Pedro Carreiro-Martins
- Comprehensive Health Research Centre, Department of Pathophysiology, NOVA Medical School, Lisbon, Portugal
- NOVA Medical School, Lisbon, Portugal
| | - Nuno Neuparth
- Comprehensive Health Research Centre, Department of Pathophysiology, NOVA Medical School, Lisbon, Portugal
- NOVA Medical School, Lisbon, Portugal
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Allen LM, Balmer D, Varpio L. Physicians' lifelong learning journeys: A narrative analysis of continuing professional development struggles. MEDICAL EDUCATION 2024; 58:1086-1096. [PMID: 38605442 DOI: 10.1111/medu.15375] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 01/18/2024] [Accepted: 02/14/2024] [Indexed: 04/13/2024]
Abstract
INTRODUCTION Despite tenacious efforts of continuing professional development (CPD) developers and educators, physician engagement in CPD is fraught with challenges. Research suggests that these educational interventions and the maintenance of professional competence systems that mandate them are often seen as impractical, decontextualized and check-box activities by participants. This study explores physicians' learning post graduate medical education (GME) training across their CPD journey to understand how they (a) conceive of themselves as learners and (b) engage in lifelong learning across the course of their professional careers. METHODS Using narrative inquiry and holistic narrative analysis situated within a social constructivist orientation, we carried out individual interviews with physicians from across a large children's hospital network including academic hospitals, community hospitals and primary care practices. Timelines and story arcs were used to support the narrative analysis's re-storying. RESULTS Twelve physicians from six different sub-specialties were interviewed. We identified three noteworthy challenges as particularly salient across participants' re-storied narratives: (i) train-on-a-track to treading water, (ii) learning takes a backseat, and (iii) learning through foraging or hunting and gathering. Participants described significant change when transitioning from GME to CPD learning. While participants identified as learners, they described the disorienting impact of losing GME's formal supports and structures. They articulated that patient care trumped learning as their top priority. They lamented having limited insight into their learning needs (e.g. little feedback data) and so resorted to engaging in CPD activities that were readily at hand-but not necessarily relevant-and to finding learning resources that might not be formally recognised for CPD credit. CONCLUSIONS Physicians' learning journeys post-GME are challenging, and the systems created to support that learning are ill equipped to meet the needs of physicians transitioning from GME to CPD. To encourage meaningful learning, the complex interplay of factors impeding CPD engagement should inform future innovations.
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Affiliation(s)
- Louise M Allen
- Department of Medical Education, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
| | - Dorene Balmer
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
| | - Lara Varpio
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
- The Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
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King SM, Anas S, Carnicer Hijazo R, Jordaan J, Potter JDF, Low-Beer N. Twelve tips for designing and implementing an academic coaching program. MEDICAL TEACHER 2024; 46:1140-1146. [PMID: 38295433 DOI: 10.1080/0142159x.2024.2308058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 01/17/2024] [Indexed: 02/02/2024]
Abstract
Coaching has become increasingly popular as a mechanism to support learning across the health professions education (HPE) continuum. While there is a growing body of literature in this area, there is minimal guidance related to the design and implementation of academic coaching in health professional courses. This paper seeks to contribute to this literature by presenting guidance for academic developers who are considering introducing academic coaching into a health professional course. The 12 tips are based on the authors' collective experiences of designing and implementing academic coaching in university medical courses in Australia and the UK. Although focused on medical education, this paper is intended to have applicability across the health professions, and potentially across university and postgraduate training contexts. Together, the tips offer a strategic and operational framework to guide the design and implementation of academic coaching initiatives in health professions education.
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Affiliation(s)
- Svetlana M King
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | | | | | - Johanna Jordaan
- College of Medicine and Public Health, Flinders University, Adelaide, Australia
| | - Jean D F Potter
- Brunel Medical School, Brunel University London, UK
- The Hillingdon Hospital Pield Heath Road, Uxbridge Middlesex, UK
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Towle A, Wang L, Ong K, Kline CC. Guiding Principles for Patient and Public Engagement in the Educational Missions of Medical Schools. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2024; 99:1016-1023. [PMID: 38574203 DOI: 10.1097/acm.0000000000005728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
PURPOSE The purpose of this research was to cocreate with patients and the public a set of evidence-informed guiding principles for their authentic, responsive, ongoing, and sustainable engagement in the mission, goals, curriculum, and delivery of medical education. METHOD A set of guiding principles of relevance to medical education was identified from the literature. Eight focus groups with patients and community members representing a wide variety of perspectives were conducted in April and May 2022. Participants reviewed, prioritized, and discussed the principles and described successful engagement, resulting in 8 guiding principles in priority order. A summary report was circulated to participants for feedback. The principles were reviewed and endorsed by senior leaders in the medical school. RESULTS The 8 focus groups were attended by 38 people (age range, mid-20s to postretirement; 7 male, 27 female, and 4 unknown gender). Accountability (19%), inclusion (18%), reciprocity (17%), and partnership and shared decision-making (14%) were chosen as the most important principles. Participants want evidence that their contributions are valued and have made a difference. They want the medical school to include and support a diversity of perspectives that reflect the populations being served by the health care system. They want the medical school to invest in building trusting and respectful long-term relationships with patients and the public. CONCLUSIONS The guiding principles could be used by medical schools as a starting point to build relationships with their local communities to increase the authentic and sustainable engagement of patients and the public in the educational mission of the medical school.
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Romanova A, Touchie C, Ruller S, Kaka S, Moschella A, Zucker M, Cole V, Humphrey-Murto S. Learning Plan Use in Undergraduate Medical Education: A Scoping Review. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2024; 99:1038-1045. [PMID: 38905130 DOI: 10.1097/acm.0000000000005781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/23/2024]
Abstract
PURPOSE How to best support self-regulated learning (SRL) skills development and track trainees' progress along their competency-based medical education learning trajectory is unclear. Learning plans (LPs) may be the answer; however, information on their use in undergraduate medical education (UME) is limited. This study summarizes the literature regarding LP use in UME, explores the student's role in LP development and implementation, and identifies additional research areas. METHOD MEDLINE, Embase, PsycInfo, Education Source, and Web of Science databases were searched for articles published from database inception to March 6, 2024, and relevant reference lists were manually searched. The review included studies of undergraduate medical students, studies of LP use, and studies of the UME stage in any geographic setting. Data were analyzed using quantitative and qualitative content analyses. RESULTS The database search found 7,871 titles and abstracts with an additional 25 found from the manual search for a total of 7,896 articles, of which 39 met inclusion criteria. Many LPs lacked a guiding framework. LPs were associated with self-reported improved SRL skill development, learning structure, and learning outcomes. Barriers to their use for students and faculty were time to create and implement LPs, lack of training on LP development and implementation, and lack of engagement. Facilitators included SRL skill development, LP cocreation, and guidance by a trained mentor. Identified research gaps include objective outcome measures, longitudinal impact beyond UME, standardized framework for LP development and quality assessment, and training on SRL skills and LPs. CONCLUSIONS This review demonstrates variability of LP use in UME. LPs appear to have potential to support medical student education and facilitate translation of SRL skills into residency training. Successful use requires training and an experienced mentor. However, more research is required to determine whether benefits of LPs outweigh the resources required for their use.
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Tran J, Meller L, Le V, Tam J, Nicholas A. Behavioral assessment of soft skill development in a highly structured pre-health biology course for undergraduates. JOURNAL OF MICROBIOLOGY & BIOLOGY EDUCATION 2024; 25:e0019223. [PMID: 38860778 DOI: 10.1128/jmbe.00192-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/22/2023] [Accepted: 04/25/2024] [Indexed: 06/12/2024]
Abstract
In this study, we assessed a highly structured, yearlong, case-based course designed for undergraduate pre-health students. We incorporated both content learning assessments and developed a novel method called Multiple Mini Exams for assessing course impact on the development of skills that professional schools often seek in pre-health students, focusing on students' abilities to collaborate with others, display bedside manners, synthesize patient case details, appropriately use scientific and medical language, and effectively attain patients' medical histories. This novel method utilized a rubric based on desired medical student skills to score videotaped behaviors and interactions of students role playing as doctors in a hypothetical patient case study scenario. Overall, our findings demonstrate that a highly structured course, incorporating weekly student performance and presentation of patient cases encompassing history taking, diagnosis, and treatment, can result in content learning, as well as improve desired skills specific for success in medical fields.
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Affiliation(s)
- Joanne Tran
- Human Biology (B.S.), Department of Biological Sciences, University of California, Irvine, Irvine, California, USA
| | - Leo Meller
- Human Biology (B.S.), Department of Biological Sciences, University of California, Irvine, Irvine, California, USA
| | - Vy Le
- Human Biology (B.S.), Department of Biological Sciences, University of California, Irvine, Irvine, California, USA
| | - Jasmine Tam
- Human Biology (B.S.), Department of Biological Sciences, University of California, Irvine, Irvine, California, USA
| | - Andrea Nicholas
- Department of Neuroscience, University of California, Irvine, Irvine, California, USA
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Davies L, de Wildt G, Benyamini Y, Ramkumar A, Adams R. Exploring the experiences of English-speaking women who have moved to Israel and subsequently used Israeli fertility treatment services: A qualitative study. PLoS One 2024; 19:e0309265. [PMID: 39197013 DOI: 10.1371/journal.pone.0309265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 08/07/2024] [Indexed: 08/30/2024] Open
Abstract
BACKGROUND Israel's pronatalist cultures result in a social expectation to have children and drive Israel's fertility rate of 2.9. Israeli policy reflects this through funding unlimited fertility treatment up to two children. Societal pressure to have children exacerbates challenges of fertility treatment. Furthermore, the lack of financial burden creates a culture of perseverance following treatment failures. Whilst the experiences of Israeli women using fertility treatment have been studied, the experiences of women who migrated to Israel and were therefore raised in a different society have not. This study aimed to address this gap in knowledge. METHODS A qualitative study using semi-structured interviews to investigate the experiences of 13 English-speaking women who utilised Israeli state funded fertility treatment. Participants were located across Israel and were recruited using purposive sampling through social media. Data was analysed using framework analysis. RESULTS Despite not being aimed at specific ethnic or religious groups, all respondents were Jewish. Three themes were identified: 1. Systemic factors: The lack of financial burden was positive, however, participants struggled to navigate the bureaucratic healthcare system, especially when experiencing a language barrier. 2. Influence of others: Encountering a cold bedside manner alongside contending with the expectations of a pronatalist society was challenging. Participants utilised support from other migrants who appreciated the same culture shock. Understanding of healthcare professionals regarding shared religious values further improved treatment experiences. 3. Impact of journey: Participants often withdrew socially and the treatment process implicated upon their lives, jobs and relationships. CONCLUSION Navigating a bureaucratic system and pronatalist society are difficulties associated with fertility treatment in Israel. The lack of financial burden and an understanding of religious and cultural beliefs by healthcare providers improved treatment experience. Better provision of resources in English and further research into supporting women who are navigating Israel's pronatalist society is required.
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Affiliation(s)
- Lucy Davies
- Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Gilles de Wildt
- Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Yael Benyamini
- Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
| | - Anoushka Ramkumar
- Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Edgbaston, Birmingham, United Kingdom
| | - Rachel Adams
- Health Services Management Centre, University of Birmingham, Edgbaston, Birmingham, United Kingdom
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Dolan S, Nowell L. Interprofessional Education Opportunities for Health Care Educators in the Practice Setting: An Integrative Review. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2024:00005141-990000000-00127. [PMID: 39190560 DOI: 10.1097/ceh.0000000000000573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/29/2024]
Abstract
INTRODUCTION Health care educators in the practice setting are responsible for providing education to frontline staff and require knowledge and skills to interact with interprofessional health care providers and teach content in an effective way. Interprofessional education opportunities for health care educators in the practice setting may be helpful in preparing educators to meet the needs of frontline staff, yet the extant state of literature on this topic has not been recently synthesized. In this integrative review, we aimed to explore what is known about interprofessional education opportunities offered to health care educators who are responsible for educating other health care professionals in practice settings and assess how these education opportunities were described and evaluated in the literature. METHODS We conducted an integrative literature review following the methodology put forth by Toronto and Remington. RESULTS Of the 3690 publications identified, 30 met our inclusion criteria. Overall, the publications lacked rigorous methodology. Education interventions varied in content, duration, and teaching strategies. Key findings were identified: (1) educator satisfaction and content relevance, (2) impact on knowledge, skills, and confidence, (3) impact on teaching practice, (4) impact on clinical practice, (5) impact on interprofessional competencies and attitudes, (6) challenges to implementing interprofessional education opportunities, and (7) facilitators to implementing interprofessional education opportunities. DISCUSSION Although interprofessional education opportunities for health care educators in the practice setting may be beneficial to educators and the frontline staff they serve, more rigorous research is needed to understand how these opportunities can influence teaching and clinical practice.
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Affiliation(s)
- Sara Dolan
- Dr. Dolan: Postdoctoral Scholar, Faculty of Social Work, University of Calgary, Calgary, Alberta, Canada. Dr. Nowell: Associate Professor, Assistant Dean, Graduate Programs, Faculty of Nursing, University of Calgary, Calgary, Alberta, Canada
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Son Y, Dubovoy A, Hu Y. Cumulative sum (CUSUM) analysis to assess caudal block performance among anesthesia residents. Paediatr Anaesth 2024. [PMID: 39189354 DOI: 10.1111/pan.14986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 08/06/2024] [Accepted: 08/07/2024] [Indexed: 08/28/2024]
Affiliation(s)
- Yena Son
- Department of Anesthesiology, Virginia Commonwealth University Health System, Children's Hospital of Richmond, Richmond, Virginia, USA
| | - Arkadiy Dubovoy
- Department of Anesthesiology, Virginia Commonwealth University Health System, Children's Hospital of Richmond, Richmond, Virginia, USA
| | - Yaqi Hu
- Department of Anesthesiology, Virginia Commonwealth University Health System, Children's Hospital of Richmond, Richmond, Virginia, USA
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Yun JY, Ryu H, Kim JW, Yoon HB, Choi S, Park WB, Bae EJ, Yim JJ, Myung SJ. Subtyping of Performance Trajectory During Medical School, Medical Internship, and the First Year of Residency in Training Physicians: A Longitudinal Cohort Study. J Korean Med Sci 2024; 39:e239. [PMID: 39189712 PMCID: PMC11347187 DOI: 10.3346/jkms.2024.39.e239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 07/01/2024] [Indexed: 08/28/2024] Open
Abstract
BACKGROUND Developmental trajectories of clinical skills in training physicians vary among tasks and show interindividual differences. This study examined the predictors of medical internship performance and residency entrance and found subtypes of performance trajectory in training physicians. METHODS This retrospective cohort study involved 888 training physicians who completed a medical internship between 2015 and 2019. After the internship, 627 physicians applied for residency training between 2016 and 2020. Finally, 160 of them completed their first-year residency in internal medicine, surgery, pediatrics, and psychiatry departments between 2016 and 2020. Pearson's correlation coefficients of internship performance and first year-residency performance (n = 160) were calculated. Latent profile analysis identified performance trajectory subtypes according to medical school grade point average (GPA), internship performance, English proficiency, and residency selection procedures. Multivariate logistic regression models of residency acceptance (n = 627) and performance in the top 30%/lower 10% in the first year of residency were also constructed. RESULTS Medical internship performance showed a significant positive correlation with the medical school GPA (r = 0.194) and the written score for the medical licensing examination (r = 0.125). Higher scores in the interview (adjusted odds ratio [aOR], 2.57) and written examination (aOR, 1.45) of residency selection procedures and higher medical internship performance (aOR, 1.19) were associated with a higher chance of residency acceptance. The latent profile analyses identified three training physician subgroups: average performance, consistently high performance (top 30%), and adaptation to changes (lowest 10%). Higher scores in the interview for residency selection (aOR, 1.35) and lower scores for medical internship performance (aOR, 0.79) were associated with a higher chance of performing in the top 30% or lowest 10% in the first year of residency, respectively. CONCLUSION Performance in the interview and medical internship predicted being among the top 30% and lowest 10% of performers in the first year of residency training, respectively. Individualized educational programs to enhance the prospect of trainees becoming high-functioning physicians are needed.
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Affiliation(s)
- Je-Yeon Yun
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
- Yeongeon Student Support Center, Seoul National University College of Medicine, Seoul, Korea
| | - Hyunjin Ryu
- Office of Medical Education, Seoul National University College of Medicine, Seoul, Korea
| | - Ju Whi Kim
- Office of Medical Education, Seoul National University College of Medicine, Seoul, Korea
| | - Hyun Bae Yoon
- Office of Medical Education, Seoul National University College of Medicine, Seoul, Korea
| | - Seung Choi
- Department of Educational Psychology, College of Education, University of Texas at Austin, TX, USA
| | - Wan Beom Park
- Office of Medical Education, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Eun Jung Bae
- Department of Pediatrics, Seoul National University Children's Hospital, Seoul, Korea
- Department of Pediatrics, Seoul National University School of Medicine, Seoul, Korea
| | - Jae-Joon Yim
- Office of Medical Education, Seoul National University College of Medicine, Seoul, Korea
- Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Sun Jung Myung
- Office of Medical Education, Seoul National University College of Medicine, Seoul, Korea.
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McKimm J, Balasooriya C, Fyfe M, Aboulsoud S, Brouwer E, Nadkar AA. International collaboration in health professions education. MEDICAL TEACHER 2024:1-8. [PMID: 39186666 DOI: 10.1080/0142159x.2024.2391440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/30/2024] [Accepted: 08/08/2024] [Indexed: 08/28/2024]
Abstract
This article explores the essential elements for achieving excellence in international collaborations within health professions education (HPE), drawing on the Association for Medical Education in Europe (AMEE) ASPIRE Award criteria for International Collaboration. The International Collaboration award transcends recognition of excellence through the award; it aims to foster excellence in international HPE collaborations more broadly, by establishing a framework for evaluation and development that functions cross-culturally. This framework is based on five key elements that contribute to successful collaborations: mutually agreed goals; shared responsibilities and leadership structures; processes that support collaboration; demonstrated long-term impact and sustainability, and evaluation and practice sharing. Recognizing the historical context of unequal power dynamics in international partnerships, this article promotes the development of ethical and equitable collaborations. We advocate for integrating cultural competence, epistemic plurality, and leadership skills into HPE curricula to prepare future healthcare professionals for effective international collaboration.
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Affiliation(s)
- J McKimm
- Chester Medical School, Chester University, Chester, UK
| | - C Balasooriya
- Office of Medical Education, Faculty of Medicine & Health, UNSW Sydney, Sydney, Australia
| | - M Fyfe
- University of California San Francisco, San Francisco, CA, USA
| | - S Aboulsoud
- Faculty of Medicine, Cairo University, Giza, Egypt
| | - E Brouwer
- School of Health Professions Education, Department of Educational Development & Research, Maastricht University, Maastricht, The Netherlands
| | - A A Nadkar
- Karl Bremer Hospital, Faculty of Medicine and Health Sciences, Stellenbosch University, Western Cape, South Africa
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Odontides L, Scheiter K, Shiozawa T, Fischer MR, Kugelmann D, Berndt M. Influence of learning strategies and motivation on anatomy test performance of undergraduate medical students. Ann Anat 2024:152320. [PMID: 39182586 DOI: 10.1016/j.aanat.2024.152320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 07/20/2024] [Accepted: 08/19/2024] [Indexed: 08/27/2024]
Abstract
To learn and comprehend the large amount of information in gross anatomy, undergraduate students must self-regulate their learning to be properly prepared for the exams within the available time. Even though there are many studies on learning strategies and their influence on test results and motivation, the aim of this study is to investigate characteristics of learning strategies in detail and in relation to the anatomy course of first semester students and how their use is related to anatomy test performance. For assessing the learning strategies, we used the short version of the questionnaire "Learning Strategies of University Students" (LIST-K) (Klingsieck, 2018). Further, we investigated potential influences of motivation and resources used during the self-regulated learning process. The participants in this study (N = 108) filled in the above-mentioned questionnaire LIST-K and a written multiple-choice anatomy test. A k-means cluster analysis revealed three groups of students differing in their self-reported use of learning strategies. Students used either (1) predominantly metacognitive and resource-related strategies, (2) predominantly cognitive strategies, or (3) no specific learning strategies at all. We found no significant overall relationships between the use of learning strategies and test performance. A stepwise linear regression identified the use of cognitive learning strategies (β =.269) as a significant predictor for test performance (R² =.149, p =.003), possibly as these specific learning strategies help with a systematic and effective approach while studying anatomy and retrieving large amount of memorized information. Further, motivation was identified as a negative predictor (β = -.277), which might be a result of the short time periods students have to study for exams. Overall findings underline the importance of self-regulated learning as a positive predictor on academic performance. By understanding these factors, a more student-centered approach could be adopted by educators to improve medical education and equip students with valuable approaches for their continuous education, even beyond university.
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Affiliation(s)
- Laura Odontides
- Institute of Medical Education, LMU University Hospital, LMU Munich, Munich, Germany
| | - Katharina Scheiter
- Leibniz-Institut für Wissensmedien, Tuebingen, Germany; Department of Educational Science, University of Potsdam, Germany
| | - Thomas Shiozawa
- Department of Anatomy, Institute of Clinical Anatomy and Cell Analysis, Faculty of Medicine, Eberhard Karls University of Tuebingen, Tuebingen, Germany
| | - Martin R Fischer
- Institute of Medical Education, LMU University Hospital, LMU Munich, Munich, Germany
| | - Daniela Kugelmann
- Chair of Vegetative Anatomy, Faculty of Medicine, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Markus Berndt
- Institute of Medical Education, LMU University Hospital, LMU Munich, Munich, Germany.
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Alshareef N, Fletcher I, Giga S. The role of emotions in academic performance of undergraduate medical students: a narrative review. BMC MEDICAL EDUCATION 2024; 24:907. [PMID: 39180051 PMCID: PMC11342563 DOI: 10.1186/s12909-024-05894-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/08/2024] [Accepted: 08/12/2024] [Indexed: 08/26/2024]
Abstract
BACKGROUND This paper is devoted to a narrative review of the literature on emotions and academic performance in medicine. The review aims to examine the role emotions play in the academic performance of undergraduate medical students. METHODS Eight electronic databases were used to search the literature from 2013 to 2023, including Academic Search Ultimate, British Education Index, CINAHL, Education Abstract, ERIC, Medline, APA Psych Articles and APA Psych Info. Using specific keywords and terms in the databases, 3,285,208 articles were found. After applying the predefined exclusion and inclusion criteria to include only medical students and academic performance as an outcome, 45 articles remained, and two reviewers assessed the quality of the retrieved literature; 17 articles were selected for the narrative synthesis. RESULT The findings indicate that depression and anxiety are the most frequently reported variables in the reviewed literature, and they have negative and positive impacts on the academic performance of medical students. The included literature also reported that a high number of medical students experienced test anxiety during their study, which affected their academic performance. Positive emotions lead to positive academic outcomes and vice versa. However, Feelings of shame did not have any effect on the academic performance of medical students. DISCUSSION The review suggests a significant relationship between emotions and academic performance among undergraduate medical students. While the evidence may not establish causation, it underscores the importance of considering emotional factors in understanding student performance. However, reliance on cross-sectional studies and self-reported data may introduce recall bias. Future research should concentrate on developing anxiety reduction strategies and enhancing mental well-being to improve academic performance.
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Affiliation(s)
- Nora Alshareef
- King Abdulaziz University, Jeddah, Saudi Arabia.
- Lancaster University, Lancaster, UK.
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Eldeeb K. Analysis of self-reported confidence in independent prescribing among osteopathic medical graduating seniors. J Osteopath Med 2024:jom-2022-0187. [PMID: 39190781 DOI: 10.1515/jom-2022-0187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2022] [Accepted: 05/17/2024] [Indexed: 08/29/2024]
Abstract
CONTEXT Prescribing medications is one of the physicians' most important professional activities throughout their careers. Lack of confidence and competency to prescribe may lead to preventable medical errors. The prevalence of prescription errors among new graduate physicians has been widely studied. Studies have linked this to inadequate foundational pharmacology education and work environment, among other factors. Suggestions were made for different educational interventions to increase the physicians' confidence and competency in prescribing to reduce the risk of medical errors. However, many of these studies were about students or graduates of medical schools other than osteopathic medical schools. OBJECTIVES This study analyzed the self-reported confidence of graduating seniors in the United States osteopathic medical schools in their current ability to prescribe safely and independently and the possible associated factors. METHODS This study analyzed secondary data on the graduating seniors' surveys published by the American Association of Colleges of Osteopathic Medicine (AACOM) from the 2012/2013 to 2020/2021 academic years. Data were analyzed utilizing SPSS version 26.0 and MedCalc version 22.009, and statistical inferences were considered significant whenever p≤0.05. RESULTS The aggregated data show that 38,712 Doctor of Osteopathic Medicine (DO) seniors responded to the AACOM survey, representing 72.1 % of expected graduates during the study period. Most of the DO graduating seniors (70.8 %) reported feeling confident in their current abilities to independently write safe and indicated orders and to prescribe therapies or interventions in various settings. The percentage of respondents who perceived the time devoted to clinical pharmacology instruction as appropriate increased systematically over these reported years. A positive correlation was found between the percentage of students who reported the time dedicated to clinical pharmacology as excessive and the percentage of students who reported being confident in prescribing. A statistically significant positive correlation was found between the percentage of students who agreed that the first two years of medical school were well organized and the percentage of students who reported being confident in prescribing. A statistically significant correlation was found between the percentage of students who agreed with statements about frequent interactions with the attendee, testing at the end of each rotation, and being prepared for Comprehensive Osteopathic Medical Licensing Examination Level 2-Cognitive Evaluation (COMLEX Level 2-CE) during the required clerkships and the percentage of students who reported being confident in independent prescribing. CONCLUSIONS During this study period, most osteopathic medical graduating seniors (70.8 %) felt confident about their current prescribing abilities; the rest did not, which can increase the risk of preventable medical errors. The prescription confidence may be boosted by more organization for the first 2 years, increasing the time devoted to clinical pharmacology education, and developing more interactive courses during the required clerkships in clinical education.
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Affiliation(s)
- Khalil Eldeeb
- Jerry M. Wallace School of Osteopathic Medicine, 2078 Campbell University , Lillington, NC, USA
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Flornoy-Guédon A, Fonzo-Christe C, Meier E, Gazengel-Marchand M, Francois O, Gschwind L, Bonnabry P. Development and evaluation of a blended learning training programme for pharmacy technicians' continuing education. Eur J Hosp Pharm 2024; 31:403-408. [PMID: 36898765 PMCID: PMC11347261 DOI: 10.1136/ejhpharm-2022-003679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Accepted: 02/22/2023] [Indexed: 03/12/2023] Open
Abstract
OBJECTIVES The role of the pharmacy technician (PT) has expanded in recent years, requiring new competencies, better communications skills and high-level knowledge about drugs. The objective of this study is to develop and evaluate a blended learning programme for PTs' continuing professional development. METHODS A blended learning programme designed to enhance knowledge, skills and attitudes was created using a six-step approach to curriculum development for medical education. The first part included three short microlearning videos to improve knowledge; the second consisted of a 1.5 hour 'edutainment' session for groups of 5-6 PTs to deepen their knowledge and practice skills. Impacts on knowledge, degree of certainty and self-perceived competence were evaluated before training (pre-test), after the microlearning (post-test 1) and after the edutainment session (post-test 2). RESULTS The three microlearnings were entitled 'Communication', 'Cut-crush a tablet/open a capsule' and 'Pharmacy website'. The edutainment session used team-based learning, game-based learning, peer instruction and simulation. Twenty-six PTs of mean±SD age 36±8 years participated. Pre-test and post-test 1 evaluation scores showed significant overall improvements in mean knowledge (9.1/18 vs 12.1/18, p<0.001), mean degree of certainty (3.4/5 vs 4.2/5, p<0.001) and mean self-perceived competence (58.6/100 vs 72.3/100, p<0.001). After post-test 2, mean knowledge (12.1/18 vs 13.1/18, p=0.010) and mean self-perceived competence (72.3/100 vs 81.1/100, p=0.001) scores had improved, but not mean degree of certainty (4.2/5 vs 4.4/5, p=0.105). All participants found the blended learning programme suitable for their continuing professional development. CONCLUSIONS The present study showed the positive effects of using our blended learning programme to improve PTs' knowledge, degree of certainty and self-perceived competence, to their great satisfaction. This pedagogical format will be integrated into PTs' continuing professional development and include other educational topics.
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Affiliation(s)
| | | | - Emy Meier
- Pharmacy, Geneva University Hospitals, Geneva, Switzerland
| | | | | | | | - Pascal Bonnabry
- Pharmacy, Geneva University Hospitals, Geneva, Switzerland
- School of Pharmaceutical Sciences, Institute of Pharmaceutical Sciences of Western Switzerland (ISPSO), University of Geneva, Geneva, Switzerland
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