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Burbage AK, Jia Y, Hoang T. The impact of community of inquiry and self-efficacy on student attitudes in sustained remote health professions learning environments. BMC MEDICAL EDUCATION 2023; 23:481. [PMID: 37380947 PMCID: PMC10303336 DOI: 10.1186/s12909-023-04382-2] [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: 12/22/2022] [Accepted: 05/21/2023] [Indexed: 06/30/2023]
Abstract
BACKGROUND Sustained remote learning environments, like those experienced in late 2020 due to the COVID-19 pandemic, share characteristics with online courses but were not intentionally designed to delivered virtually. The purpose of this study was to investigate the impact of Community of Inquiry, a widely used online learning environment framework, and self-efficacy on perceived student attitudes within sustained remote learning environments. METHODS An interinstitutional team of health professions education researchers collected survey data from 205 students representing a wide range of health professions in five U.S. institutions. Latent mediation models under structural equation modeling framework were used to examine whether student self-efficacy mediates the relationship between Community of Inquiry presence and student's favorability of sustained remote learning delivered in the prolonged stages of the COVID-19 pandemic. RESULTS Higher levels of teaching presence and social presence in the remote learning environment were associated with higher levels of remote learning self-efficacy which, in turn, predicts variance in positive attitudes toward remote learning. When mediated by self-efficacy, significant variance in student's favorability of sustained remote learning was explained by teaching presence (61%), social presence (64%), and cognitive presence (88%) and self-efficacy. Significant direct and indirect effects for teaching and social presence, and only direct effects for cognitive presence were observed. CONCLUSIONS This study establishes the Community of Inquiry and its three presence types as a relevant and stable framework for investigating sustained remote health professions teaching and learning environments, not only carefully designed online learning environments. Faculty may focus course design strategies which enhance presence and increase student self-efficacy for the sustained remote learning environment.
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Affiliation(s)
- Amanda K Burbage
- Eastern Virginia Medical School, School of Health Professions, P.O. Box 1980, Norfolk, VA, 23501-1980, USA.
| | - Yuane Jia
- School of Health Professions, The State University of New Jersey, Newark, NJ, USA
| | - Thuha Hoang
- Department of Physical Therapy, Louisiana State University Health Sciences Center- New Orleans, New Orleans, LA, USA
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Turner A, Ryan M, Wolvaardt J. We know but we hope: A qualitative study of the opinions and experiences on the inclusion of management, health economics and research in the medical curriculum. PLoS One 2022; 17:e0276512. [PMID: 36269759 PMCID: PMC9586360 DOI: 10.1371/journal.pone.0276512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Accepted: 10/10/2022] [Indexed: 11/25/2022] Open
Abstract
The achievement of global and national health goals requires a health workforce that is sufficient and trained. Despite considerable steps in medical education, the teaching of management, health economics and research skills for medical doctors are often neglected in medical curricula. This study explored the opinions and experiences of medical doctors and academic educationalists on the inclusion of management, health economics and research in the medical curriculum. A qualitative study was undertaken at four medical schools in Southern Africa (February to April 2021). The study population was medical doctors and academic educationalists. Semi-structured interviews with purposively sampled participants were conducted. All interviews were recorded and professionally transcribed. Constructivist grounded theory guided the analysis with the use of ATLAS.ti version 9.1.7.0 software. In total, 21 academic educationalists and 28 medical doctors were interviewed. In the first theme We know, participants acknowledged the constraints of medical schools but were adamant that management needed to be taught intentionally and explicitly. The teaching and assessment of management and health economics was generally reported to be ad hoc and unstructured. There was a desire that graduates are able to use, but not necessarily do research. In comparison to management and research, support for the inclusion of health economics in the curriculum was insignificant. Under We hope, educationalists hoped that the formal clinical teaching will somehow instil values and best practices of management and that medical doctors would become health advocates. Most participants wished that research training could be optimised, especially in relation to the duration of allocated time; the timing in the curriculum and the learning outcomes. Despite acknowledgement that management and research are topics that need to be taught, educationalists appeared to rely on chance to teach and assess management in particular. These qualitative study findings will be used to develop a discrete choice experiment to inform optimal curricula design.
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Affiliation(s)
- Astrid Turner
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
- * E-mail:
| | - Mandy Ryan
- Health Economics Research Unit, University of Aberdeen, King’s College, Aberdeen, Scotland
| | - Jacqueline Wolvaardt
- School of Health Systems and Public Health, Faculty of Health Sciences, University of Pretoria, Pretoria, South Africa
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Cleland JA, Cook DA, Maloney S, Tolsgaard MG. "Important but risky": attitudes of global thought leaders towards cost and value research in health professions education. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2022; 27:989-1001. [PMID: 35708798 DOI: 10.1007/s10459-022-10123-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 05/08/2022] [Indexed: 06/15/2023]
Abstract
Studies of cost and value can inform educational decision making, yet our understanding of the barriers to such research is incomplete. To address this gap, our aim was to explore the attitudes of global thought leaders in HPE towards cost and value research. This was a qualitative virtual interview study underpinned by social constructionism. In telephone or videoconference interviews in 2018-2019, we asked global healthcare professional thought leaders their views regarding HPE cost and value research, outstanding research questions in this area and why addressing these questions was important. Analysis was inductive and thematic, and incorporated review and comments from the original interviewees (member checking). We interviewed 11 thought leaders, nine of whom gave later feedback on our data interpretation (member checking). We identified four themes: Cost research is really important but potentially risky (quantifying and reporting costs provides evidence for decision-making but could lead to increased accountability and loss of autonomy); I don't have the knowledge and skills (lack of economic literacy); it's not what I went into education research to do (professional identity); and it's difficult to generate generalizable findings (the importance of context). This study contributes to a wider conversation in the literature about cost and value research by bringing in the views of global HPE thought leaders. Our findings provide insight to inform how best to engage and empower educators and researchers in the processes of asking and answering meaningful, acceptable and relevant cost and value questions in HPE.
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Affiliation(s)
- J A Cleland
- Lee Kong Chian School of Medicine, Nanyang Technological University Singapore, 11 Mandalay Road, Singapore, 308232, Singapore.
| | - D A Cook
- Office of Applied Scholarship and Education Science, Mayo Clinic College of Medicine and Science; and Division of General Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - S Maloney
- Faculty Medicine, Nursing and Health Sciences, School of Primary and Allied Health Care, Monash University, Melbourne, Australia
| | - M G Tolsgaard
- Copenhagen Academy for Medical Education and Simulation (CAMES) and Department of Obstetrics, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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Davies DJ, Sam AH, Murphy KG, Khan SA, Choe R, Cleland J. BMAT's predictive validity for medical school performance: A retrospective cohort study. MEDICAL EDUCATION 2022; 56:936-948. [PMID: 35514145 PMCID: PMC9545404 DOI: 10.1111/medu.14819] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 04/24/2022] [Accepted: 04/30/2022] [Indexed: 05/09/2023]
Abstract
BACKGROUND Although used widely, there is limited evidence of the BioMedical Admissions Test's (BMAT) predictive validity and incremental validity over prior educational attainment (PEA). We investigated BMAT's predictive and incremental validity for performance in two undergraduate medical schools, Imperial College School of Medicine (ICSM), UK, and Lee Kong Chian School of Medicine (LKCMedicine), Singapore. Our secondary goal was to compare the evidence collected with published evidence relating to comparable tools. METHODS This was a retrospective cohort study of four ICSM (1188 students, entering 2010-2013) and three LKCMedicine cohorts (222 students, 2013-2015). We investigated associations between BMAT Section 1 ('Thinking Skills'), Section 2 ('Scientific Knowledge and Applications') and Section 3a ('Writing Task') scores, with written and clinical assessment performance across all programme years. Incremental validity was investigated over PEA (A-levels) in a subset of ICSM students. RESULTS When BMAT sections were investigated independently, Section 2 scores predicted performance on all written assessments in both institutions with mainly small effect sizes (standardised coefficient ranges: ICSM: 0.08-0.19; LKCMedicine: 0.22-0.36). Section 1 scores predicted Years 5 and 6 written assessment performance at ICSM (0.09-0.14) but nothing at LKCMedicine. Section 3a scores only predicted Year 5 clinical assessment performance at ICSM with a coefficient <0.1. There were no positive associations with standardised coefficients >0.1 between BMAT performance and clinical assessment performance. Multivariable regressions confirmed that Section 2 scores were the most predictive. We found no clear evidence of incremental validity for any BMAT section scores over A-level grades. DISCUSSION Schools who wish to assess scientific knowledge independently of A-levels may find BMAT Section 2 useful. Comparison with previous studies indicates that, overall, BMAT seems less useful than comparable tools. Larger scale studies are needed. Broader questions regarding why institutions adopt certain admissions tests, including those with little evidence, need consideration.
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Affiliation(s)
- Daniel J. Davies
- Imperial College School of MedicineImperial College LondonLondonUK
| | - Amir H. Sam
- Imperial College School of MedicineImperial College LondonLondonUK
| | - Kevin G. Murphy
- Imperial College School of MedicineImperial College LondonLondonUK
| | - Shahid A. Khan
- Imperial College School of MedicineImperial College LondonLondonUK
| | - Ruth Choe
- Lee Kong Chian School of MedicineNanyang Technological University SingaporeSingapore
| | - Jennifer Cleland
- Lee Kong Chian School of MedicineNanyang Technological University SingaporeSingapore
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Foo J, Cook DA, Tolsgaard M, Rivers G, Cleland J, Walsh K, Abdalla ME, You Y, Ilic D, Golub R, Levin H, Maloney S. How to conduct cost and value analyses in health professions education: AMEE Guide No. 139. MEDICAL TEACHER 2021; 43:984-998. [PMID: 33280483 DOI: 10.1080/0142159x.2020.1838466] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Growing demand for accountability, transparency, and efficiency in health professions education is expected to drive increased demand for, and use of, cost and value analyses. In this AMEE Guide, we introduce key concepts, methods, and literature that will enable novices in economics to conduct simple cost and value analyses, hold informed discussions with economic specialists, and undertake further learning on more advanced economic topics. The practical structure for conducting analyses provided in this guide will enable researchers to produce robust results that are meaningful and useful for improving educational practice. Key steps include defining the economic research question, identifying an appropriate economic study design, carefully identifying cost ingredients, quantifying, and pricing the ingredients consumed, and conducting sensitivity analyses to explore uncertainties in the results.
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Affiliation(s)
- Jonathan Foo
- School of Primary and Allied Health Care, Monash University, Melbourne, Australia
| | - David A Cook
- Division of General Internal Medicine, Mayo Clinic College of Medicine and Science, Rochester, NY, USA
| | - Martin Tolsgaard
- Centre for Clinical Education, University of Copenhagen, Copenhagen, Denmark
| | - George Rivers
- Department of Economics, Monash Business School, Monash University, Melbourne, Australia
| | - Jennifer Cleland
- Medical Education Research and Scholarship Unit, Nanyang Technological University, Singapore
| | - Kieran Walsh
- BMJ Learning and Quality, BMJ, London, United Kingdom
| | | | - You You
- National Center for Health Professions Education Development, Institute of Medical Education, and Institute of Economics of Education, Peking University, Beijing, China
| | - Dragan Ilic
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Robert Golub
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - Henry Levin
- Teachers College, Columbia University, New York, NY, USA
| | - Stephen Maloney
- School of Primary and Allied Health Care, Monash University, Melbourne, Australia
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Ellaway R, Tolsgaard M, Martimianakis MA. What divides us and what unites us? ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2020; 25:1019-1023. [PMID: 33258050 DOI: 10.1007/s10459-020-10016-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/04/2020] [Indexed: 06/12/2023]
Affiliation(s)
- Rachel Ellaway
- Department of Community Health Sciences, and Office of Health and Medical Education Scholarship, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
| | - Martin Tolsgaard
- Copenhagen Academy for Medical Education and Simulation, and Centre for Fetal Medicine, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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