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Bisgaard CH, Rodt SA, Musaeus P, Petersen JAK, Rubak SLM. Early procedural training increases anesthesiology residents' clinical production: a comparative pre-post study of the payoff in clinical training. BMC MEDICAL EDUCATION 2021; 21:262. [PMID: 33957915 PMCID: PMC8103582 DOI: 10.1186/s12909-021-02693-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/21/2021] [Accepted: 04/05/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Competency-based education has been shown to enhance clinical skills, improve patient care, and reduce number of complications resulting in a better return on investments. Residents constitute an important workforce at many hospitals. Yet, the effect of training on residents' contribution to production in patient care is scarcely studied. This study evaluated the effects of early competency-based procedural training on residents' contribution to patient care in central venous catheterization and spinal and epidural anesthesia. METHODS The design was a non-randomized cohort study of first-year anesthesiology residents. The intervention group received additional early focused skills training while three control groups received traditional competency-based education. The residents' contributions to patient care were compared between the intervention group (n = 20), a historical control group (n = 19), and between a contemporary control group (n = 7) and a historical control group (n = 7) from different departments. The residents' vs specialists' procedural production share was compared between years within each study group. We calculated specialist time saved compared to the time spent providing additional skills training in the intervention group. RESULTS We found statistically significant increases in residents' vs specialists' share of total production after the intervention for epidural anesthesia: 2015: 0.51 (0.23, 0.70) to 2017: 0.94 (0.78, 1.05), p = 0.011 and central venous catheterization: 2015: 0.30 (0.23, 0.36) to 2016: 0.46 (0.35, 0.55), p = .008; and to 2017: 0.64 (0.50, 0.79), p = 0.008. Comparison between residents and specialists on production of the three procedures before and after the intervention showed a surplus of 21 h of freed specialist time per year. CONCLUSIONS Early procedural training results in more productive residents and freed specialist time for additional supervision, other clinical tasks or research. This provides empirical support for a positive correlation between early focused training and increased independent production among residents.
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Affiliation(s)
- Claus Hedebo Bisgaard
- Centre for Health Sciences Education, Faculty of Health, Aarhus University, Palle Juul Jensens Boulevard 82, Building B, DK-8200 Aarhus N, Denmark
| | - Svein Aage Rodt
- Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark
| | - Peter Musaeus
- Centre for Educational Development, Aarhus University, Palle Juul Jensens Boulevard 82, Building B, DK-8200 Aarhus N, Denmark
| | - Jens Aage Kølsen Petersen
- Department of Anaesthesiology, Aarhus University Hospital, Palle Juul-Jensens Boulevard 99, 8200 Aarhus N, Denmark
| | - Sune Leisgaard Mørck Rubak
- Department of Paediatrics and Adolescent Medicine, Center of Paediatric Pulmonology and Allergology, Aarhus University Hospital, Palle Juul Jensens Boulevard 99, 8200 Aarhus N, Denmark
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Kalafatis N, Sommerville TE, Gopalan PD. Do South African anaesthesiology graduates consider themselves fit for purpose? A longitudinal study. SOUTHERN AFRICAN JOURNAL OF ANAESTHESIA AND ANALGESIA 2021. [DOI: 10.36303/sajaa.2021.27.3.2479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- N Kalafatis
- Department of Anaesthesiology and Critical Care, Nelson R Mandela School of Medicine, University of KwaZulu-Natal,
South Africa
| | - TE Sommerville
- Department of Anaesthesiology and Critical Care, Nelson R Mandela School of Medicine, University of KwaZulu-Natal,
South Africa
| | - PD Gopalan
- Department of Anaesthesiology and Critical Care, Nelson R Mandela School of Medicine, University of KwaZulu-Natal,
South Africa
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Hammond Mobilio M, Brydges R, Patel P, Glatt D, Moulton CAE. Struggles with autonomy: Exploring the dual identities of surgeons and learners in the operating room. Am J Surg 2020; 219:233-239. [DOI: 10.1016/j.amjsurg.2019.12.010] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Revised: 10/09/2019] [Accepted: 12/06/2019] [Indexed: 12/21/2022]
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Kalafatis NK, Sommerville TS, Gopalan PG. Are South African anaesthesiologists fit for purpose? A comparison of opinions of graduates, teachers and examiners. SOUTHERN AFRICAN JOURNAL OF ANAESTHESIA AND ANALGESIA 2020. [DOI: 10.36303/sajaa.2020.26.6.2397] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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Whitehurst KE, Carraway M, Riddick A, Basnight LL, Garrison HG. Making the Learning Continuum a Reality: The Critical Role of a Graduate Medical Education-Continuing Medical Education Partnership. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2019; 39:279-284. [PMID: 31652172 DOI: 10.1097/ceh.0000000000000271] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
A true continuum of learning in physician education, envisioned as the seamless integration of undergraduate, graduate, and continuing medical education that results in lifelong learning, has yet to be realized. Rapid clinical change, evolving systems of health care, and a shift to competency-based training make the continuum and lifelong learning even more critical. Because they function independently, the efforts of Graduate Medical Education (GME) and Continuing Medical Education (CME) have fallen short of the integrated ideal. The complementary threads of accreditation requirements, expertise, resources, and scholarly activities provide an opportunity for GME and CME to operate in a more integrated and coordinated fashion. Our local GME-CME partnership model demonstrates that these complimentary threads can be tied together to effectively facilitate lifelong learning and promote an integrated learning continuum.
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Affiliation(s)
- Kelley E Whitehurst
- Ms. Whitehurst: Program Manager, Medical Affairs and GME Education, Vidant Medical Center, Greenville, NC. Ms. Carraway: Director, Continuing Medical, Dental, and Pharmacy Education, Eastern Area Health Education Center, The Brody School of Medicine at East Carolina University, Greenville, NC. Ms. Riddick: Director, GME, and Medical Staff Support, Vidant Medical Center, Greenville, NC. Dr. Basnight: Associate Dean for Continuing Medical Education, Associate Professor of Pediatrics, The Brody School of Medicine at East Carolina University, Executive Director, Eastern Area Health Education Center, Greenville, NC. Dr. Garrison: Associate Dean for Graduate Medical Education, Professor of Emergency Medicine, The Brody School of Medicine at East Carolina University, Greenville, NC
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van Vendeloo SN, Brand PLP, Kollen BJ, Verheyen CCPM. Changes in Perceived Supervision Quality After Introduction of Competency-Based Orthopedic Residency Training: A National 6-Year Follow-Up Study. JOURNAL OF SURGICAL EDUCATION 2018; 75:1624-1629. [PMID: 29706298 DOI: 10.1016/j.jsurg.2018.04.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2017] [Revised: 01/28/2018] [Accepted: 04/03/2018] [Indexed: 06/08/2023]
Abstract
OBJECTIVE To evaluate the perceived quality of the learning environment, before and after introduction of competency-based postgraduate orthopedic education. DESIGN From 2009 to 2014, we conducted annual surveys among Dutch orthopedic residents. The validated Dutch Residency Educational Climate Test (D-RECT, 50 items on 11 subscales) was used to assess the quality of the learning environment. Scores range from 1 (poor) to 5 (excellent). SETTING Dynamic cohort follow-up study. PARTICIPANTS All Dutch orthopedic residents were surveyed during annual compulsory courses. RESULTS Over the 6-year period, 641 responses were obtained (response rate 92%). Scores for "supervision" (95% CI for difference 0.06-0.28, p = 0.002) and "coaching and assessment" (95% CI 0.11-0.35, p < 0.001) improved significantly after introduction of competency-based training. There was no significant change in score on the other subscales of the D-RECT. CONCLUSIONS After the introduction of some of the core components of competency-based postgraduate orthopedic education the perceived quality of "supervision" and "coaching and assessment" improved significantly.
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Affiliation(s)
- Stefan N van Vendeloo
- Department of Orthopaedic Surgery and Traumatology, Isala Hospital, Zwolle, The Netherlands.
| | - Paul L P Brand
- Department of Pediatrics, Princess Amalia Children's Centre, Isala Hospital, Zwolle, The Netherlands; UMCG Postgraduate School of Medicine, University Medical Centre Groningen, University of Groningen, The Netherlands
| | - Boudewijn J Kollen
- Department of General Practice, University Medical Centre Groningen, University of Groningen, The Netherlands
| | - Cees C P M Verheyen
- Department of Orthopaedic Surgery and Traumatology, Isala Hospital, Zwolle, The Netherlands
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Perspectives on Canadian core fellowship training in pediatric anesthesia: a survey of graduate fellows. Can J Anaesth 2015; 62:1071-81. [DOI: 10.1007/s12630-015-0427-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2015] [Revised: 05/01/2015] [Accepted: 06/27/2015] [Indexed: 10/23/2022] Open
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Lutz K, Yazdani A, Ross D. From time-based to competency-based standards: core transitional competencies in plastic surgery. JOURNAL OF SURGICAL EDUCATION 2015; 72:228-234. [PMID: 25481801 DOI: 10.1016/j.jsurg.2014.08.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2014] [Revised: 08/18/2014] [Accepted: 08/24/2014] [Indexed: 06/04/2023]
Abstract
PURPOSE Competency-based medical education is becoming increasingly prevalent and is likely to be mandated by the Royal College in the near future. The objective of this study was to define the core technical competencies that should be possessed by plastic surgery residents as they transition into their senior (presently postgraduate year 3) years of training. METHODS A list of potential core competencies was generated using a modified Delphi method that included the investigators and 6 experienced, academic plastic surgeons from across Canada and the United States. Generated items were divided into 7 domains: basic surgical skills, anesthesia, hand surgery, cutaneous surgery, esthetic surgery, breast surgery, and craniofacial surgery. Members of the Delphi group were asked to rank particular skills on a 4-point scale with anchored descriptors. Item reduction resulted in a survey consisting of 48 skills grouped into the aforementioned domains. This self-administered survey was distributed to all Canadian program directors (n = 11) via e-mail for validation and further item reduction. RESULTS The response rate was 100% (11/11). Using the average rankings of program directors, 26 "core" skills were identified. There was agreement of core skills across all domains except for breast surgery and esthetic surgery. Of them, 7 skills were determined to be above the level of a trainee at this stage; a further 15 skills were agreed to be important, but not core, competencies. CONCLUSIONS Overall, 26 competencies have been identified as "core" for plastic surgery residents to possess as they begin their senior, on-service years. The nature of these skills makes them suitable for teaching in a formal, simulated environment, which would ensure that all plastic surgery trainees are competent in these tasks as they transition to their senior years of residency.
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Affiliation(s)
- Kristina Lutz
- Division of Plastic and Reconstructive Surgery, Western University, St. Joseph's Health Care, London, Ontario, Canada
| | | | - Douglas Ross
- Roth-McFarlane Hand and Upper Limb Centre, St. Joseph's Health Centre, London, Ontario, Canada.
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Wenghofer EF, Campbell C, Marlow B, Kam SM, Carter L, McCauley W. The effect of continuing professional development on public complaints: a case-control study. MEDICAL EDUCATION 2015; 49:264-75. [PMID: 25693986 DOI: 10.1111/medu.12633] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 05/16/2014] [Accepted: 09/23/2014] [Indexed: 05/12/2023]
Abstract
OBJECTIVES This study aimed to investigate the relationship between participation in different types of continuing professional development (CPD), and incidences and types of public complaint against physicians. METHODS Cases included physicians against whom complaints were made by members of the public to the medical regulatory body in Ontario, Canada, the College of Physicians and Surgeons of Ontario (CPSO), during 2008 and 2009. The control cohort included physicians against whom no complaints were documented during the same period. We focused on complaints related to physician communication, quality of care and professionalism. The CPD data included all Royal College of Physicians and Surgeons of Canada (RCPSC) and College of Family Physicians of Canada (CFPC) CPD programme activities reported by the case and control physicians. Multivariate logistic regression models were used to determine if the independent variable, reported participation in CPD, was associated with the dependent variable, the complaints-related status of the physician in the year following reported CPD activities. RESULTS A total of 2792 physicians were included in the study. There was a significant relationship between participation in CPD, type of CPD and type of complaint received. Analysis indicated that physicians who reported overall participation in CPD activities were significantly less likely (odds ratio 0.604; p = 0.028) to receive quality of care-related complaints than those who did not report participating in CPD. Additionally, participation in group-based CPD was less likely (OR 0.681; p = 0.041) to result in quality of care-related complaints. CONCLUSIONS The findings demonstrate a positive relationship between participation in the national CPD programmes of the CFPC and RCPSC, and lower numbers of public complaints received by the CPSO. As certification bodies and regulators alike are increasingly mandating CPD, they are encouraged to continually evaluate the effectiveness of their programmes to maximise programme impact on physician performance at the population level.
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Affiliation(s)
- Elizabeth F Wenghofer
- School of Rural and Northern Health, Laurentian University, Sudbury, Ontario, Canada; Human Sciences Division, Northern Ontario School of Medicine, Sudbury, Ontario, Canada
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Hoogenes J, Mironova P, Safir O, McQueen SA, Abdelbary H, Drexler M, Nousiainen M, Ferguson P, Kraemer W, Alman B, Reznick RK, Sonnadara RR. Student-led learning: a new teaching paradigm for surgical skills. Am J Surg 2014; 209:107-14. [PMID: 25454965 DOI: 10.1016/j.amjsurg.2014.08.037] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2014] [Revised: 08/11/2014] [Accepted: 08/21/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND Competency-based education and simulation are being used more frequently in surgical skills curricula. We explored a novel student-led learning paradigm, which allows trainees to become more active participants in the learning process while maintaining expert guidance and supervision. METHODS Twelve first-year orthopedic residents were randomized to either a student-led (SL) or a traditional instructor-led group during an intensive, month-long, laboratory-based technical skills training course. A rigorous qualitative-description approach was used for analysis. RESULTS Four prominent themes emerged: instructional style, feedback, peer and instructor collaboration, and self-efficacy. Compared with the instructor-led group, there was more peer assistance, feedback, collaboration, and hands-on and active learning observed in the SL group. CONCLUSIONS The flexible and socially rich nature of the SL learning environment may aid in development of both technical and nontechnical skills early in residency and ultimately privilege later clinical learning.
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Affiliation(s)
- Jen Hoogenes
- Department of Surgery, McMaster University, A. N. Bourns Science Building Room 131, 1280 Main Street West, Hamilton, Ontario, Canada L8S 4K1
| | - Polina Mironova
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Department of Surgery, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Oleg Safir
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Department of Surgery, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Sydney A McQueen
- Department of Surgery, McMaster University, A. N. Bourns Science Building Room 131, 1280 Main Street West, Hamilton, Ontario, Canada L8S 4K1
| | - Hesham Abdelbary
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Department of Surgery, Mount Sinai Hospital, Toronto, Ontario, Canada; Department of Surgery, University of Ottawa, Ottawa, Ontario, Canada
| | - Michael Drexler
- Department of Surgery, Mount Sinai Hospital, Toronto, Ontario, Canada; Department of Surgery, Tel Aviv Sourasky Medical Center, Tel Aviv, Israel
| | - Markku Nousiainen
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Peter Ferguson
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Department of Surgery, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - William Kraemer
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Benjamin Alman
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Richard K Reznick
- Department of Surgery, University of Ottawa, Ottawa, Ontario, Canada; Department of Surgery, Queen's University, Kingston, Ontario, Canada
| | - Ranil R Sonnadara
- Department of Surgery, McMaster University, A. N. Bourns Science Building Room 131, 1280 Main Street West, Hamilton, Ontario, Canada L8S 4K1; Department of Surgery, University of Toronto, Toronto, Ontario, Canada; Department of Surgery, Mount Sinai Hospital, Toronto, Ontario, Canada.
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Wenghofer EF, Marlow B, Campbell C, Carter L, Kam S, McCauley W, Hill L. The relationship between physician participation in continuing professional development programs and physician in-practice peer assessments. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2014; 89:920-927. [PMID: 24871244 DOI: 10.1097/acm.0000000000000243] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
PURPOSE To investigate the relationship between physicians' performance, as evaluated through in-practice peer assessments, and their participation in continuing professional development (CPD). METHOD The authors examined the predictive effects of participating in the CPD programs of the Royal College of Physicians and Surgeons of Canada and the College of Family Physicians of Canada one year before in-practice peer assessments conducted by the medical regulatory authority in Ontario, Canada, in 2008-2009. Two multivariate logistic regression models were used to determine whether physicians who reported participating in any CPD and group-based, assessment-based, and/or self-directed CPD activities were more or less likely to receive satisfactory assessments than physicians who had not. All models were adjusted for the effects of sex, age, specialty certification, practice location, number of patient visits per week, hours worked per week, and international medical graduate status. RESULTS A total of 617 physicians were included in the study. Analysis revealed that physicians who reported participating in any CPD activities were significantly more likely (odds ratio [OR] = 2.5; P = .021) to have satisfactory assessments than those who had not. In addition, physicians participating in group-based CPD activities were more likely to have satisfactory assessments than those who did not (OR = 2.4; P = .016). CONCLUSIONS There is encouraging evidence supporting a positive predictive association between participating in CPD and performance on in-practice peer assessments. The findings have potential implications for policies which require physicians to participate in programs of lifelong learning.
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Affiliation(s)
- Elizabeth F Wenghofer
- Dr. Wenghofer is associate professor, School of Rural and Northern Health, and Northern Ontario School of Medicine, Laurentian University, Sudbury, Ontario, Canada. Dr. Marlow is assistant professor, Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada. Dr. Campbell is director of professional affairs, Royal College of Physicians and Surgeons of Canada, Ottawa, Ontario, Canada, and associate professor, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada. Dr. Carter is director, Centre for Flexible Learning, Nipissing University, North Bay, Ontario, Canada, and professor, Northern Ontario School of Medicine, Sudbury, Ontario, Canada. Ms. Kam is a PhD student, School of Rural and Northern Health, Laurentian University, Sudbury, Ontario, Canada. Dr. McCauley is medical advisor, Quality Management Division, College of Physicians and Surgeons of Ontario, Toronto, Ontario, Canada, and associate professor, Schulich School of Medicine & Dentistry, University of Western Ontario, London, Ontario, Canada. Ms. Hill is former manager, Continuing Professional Development, College of Family Physicians of Canada, Mississauga, Ontario, Canada
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Cook DA, Zendejas B, Hamstra SJ, Hatala R, Brydges R. What counts as validity evidence? Examples and prevalence in a systematic review of simulation-based assessment. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2014; 19:233-50. [PMID: 23636643 DOI: 10.1007/s10459-013-9458-4] [Citation(s) in RCA: 195] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2012] [Accepted: 04/09/2013] [Indexed: 05/26/2023]
Abstract
Ongoing transformations in health professions education underscore the need for valid and reliable assessment. The current standard for assessment validation requires evidence from five sources: content, response process, internal structure, relations with other variables, and consequences. However, researchers remain uncertain regarding the types of data that contribute to each evidence source. We sought to enumerate the validity evidence sources and supporting data elements for assessments using technology-enhanced simulation. We conducted a systematic literature search including MEDLINE, ERIC, and Scopus through May 2011. We included original research that evaluated the validity of simulation-based assessment scores using two or more evidence sources. Working in duplicate, we abstracted information on the prevalence of each evidence source and the underlying data elements. Among 217 eligible studies only six (3 %) referenced the five-source framework, and 51 (24 %) made no reference to any validity framework. The most common evidence sources and data elements were: relations with other variables (94 % of studies; reported most often as variation in simulator scores across training levels), internal structure (76 %; supported by reliability data or item analysis), and content (63 %; reported as expert panels or modification of existing instruments). Evidence of response process and consequences were each present in <10 % of studies. We conclude that relations with training level appear to be overrepresented in this field, while evidence of consequences and response process are infrequently reported. Validation science will be improved as educators use established frameworks to collect and interpret evidence from the full spectrum of possible sources and elements.
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Affiliation(s)
- David A Cook
- Office of Education Research, Mayo Medical School, Rochester, MN, USA,
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Sonnadara RR, Mui C, McQueen S, Mironova P, Nousiainen M, Safir O, Kraemer W, Ferguson P, Alman B, Reznick R. Reflections on competency-based education and training for surgical residents. JOURNAL OF SURGICAL EDUCATION 2014; 71:151-8. [PMID: 24411437 DOI: 10.1016/j.jsurg.2013.06.020] [Citation(s) in RCA: 79] [Impact Index Per Article: 7.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Revised: 06/19/2013] [Accepted: 06/28/2013] [Indexed: 05/17/2023]
Affiliation(s)
- Ranil R Sonnadara
- Department of Surgery, McMaster University, Hamilton, Ontario, Canada; Department of Surgery, University of Toronto, Ontario, Canada; Mount Sinai Hospital, Toronto, Ontario, Canada.
| | - Carween Mui
- Department of Surgery, University of Toronto, Ontario, Canada; Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Sydney McQueen
- Department of Surgery, McMaster University, Hamilton, Ontario, Canada
| | - Polina Mironova
- Department of Surgery, University of Toronto, Ontario, Canada; Mount Sinai Hospital, Toronto, Ontario, Canada
| | | | - Oleg Safir
- Department of Surgery, University of Toronto, Ontario, Canada; Mount Sinai Hospital, Toronto, Ontario, Canada
| | - William Kraemer
- Department of Surgery, University of Toronto, Ontario, Canada
| | - Peter Ferguson
- Department of Surgery, University of Toronto, Ontario, Canada; Mount Sinai Hospital, Toronto, Ontario, Canada
| | - Benjamin Alman
- Department of Surgery, University of Toronto, Ontario, Canada
| | - Richard Reznick
- Department of Surgery, Queen's University, Kingston, Ontario, Canada
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Hodgson JL, Pelzer JM, Inzana KD. Beyond NAVMEC: competency-based veterinary education and assessment of the professional competencies. JOURNAL OF VETERINARY MEDICAL EDUCATION 2013; 40:102-118. [PMID: 23709107 DOI: 10.3138/jvme.1012-092r] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
The implementation of competency-based curricula within the health sciences has been an important paradigm shift over the past 30 years. As a result, one of the five strategic goals recommended by the North American Veterinary Medical Education Consortium (NAVMEC) report was to graduate career-ready veterinarians who are proficient in, and have the confidence to use, an agreed-upon set of core competencies. Of the nine competencies identified as essential for veterinary graduates, seven could be classified as professional or non-technical competencies: communication; collaboration; management (self, team, system); lifelong learning, scholarship, value of research; leadership; diversity and multicultural awareness; and adaptation to changing environments. Traditionally, the professional competencies have received less attention in veterinary curricula and their assessment is often sporadic or inconsistent. In contrast, the same or similar competencies are being increasingly recognized in other health professions as essential skills and abilities, and their assessment is being undertaken with enhanced scrutiny and critical appraisal. Several challenges have been associated with the assessment of professional competencies, including agreement as to their definition and therefore their evaluation, the fact that they are frequently complex and require multiple integrative assessments, and the ability and/or desire of faculty to teach and assess these competencies. To provide an improved context for assessment of the seven professional competencies identified in the NAVMEC report, this article describes a broad framework for their evaluation as well as specific examples of how these or similar competencies are currently being measured in medical and veterinary curricula.
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Affiliation(s)
- Jennifer L Hodgson
- Virginia Maryland Regional College of Veterinary Medicine, Virginia Polytechnic & State University, Blackburg, VA 24061, USA.
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O'Brien BC, Irby DM. Enacting the Carnegie Foundation call for reform of medical school and residency. TEACHING AND LEARNING IN MEDICINE 2013; 25 Suppl 1:S1-S8. [PMID: 24246101 DOI: 10.1080/10401334.2013.842915] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
On the 100th anniversary of the Flexner Report, the Carnegie Foundation for the Advancement of Teaching published a new study of medical education. This study, titled Educating Physicians: A Call for Reform of Medical Schools and Residency Programs, contained four primary recommendations intended to stimulate innovation and improvement in medical education. In this article, the authors examined the ways others have applied the four recommendations from Educating Physicians within and beyond medical education. In their review of 246 publications citing the Carnegie work, they found that the recommendation for integration was addressed most frequently, often through descriptions of integration of curricular content in undergraduate medical education. The recommendation to focus on professional identity formation was the second most frequently addressed, followed by standardization and individualization, then inquiry, innovation, and improvement. The publications related to these latter three recommendations tended to be conceptual rather than descriptive or empirical. Publications spanned the continuum of medical education (from medical school to residency to physicians in practice) and even into other fields, but undergraduate medical education received the most attention. The authors discuss common themes among the citing publications and highlight opportunities for further discussion and innovation. Many exciting developments have occurred in medical education and beyond since the publication of Educating Physicians in 2010. Thus far, most of the publications citing the Carnegie recommendations describe incremental changes in medical education, particularly in the area of integration. Some of the conceptual work around these recommendations, coupled with a variety of external factors such as changes in health care and accreditation systems, suggests the potential for changes that are more transformative in nature.
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MESH Headings
- Curriculum/standards
- Curriculum/trends
- Diffusion of Innovation
- Education, Medical, Graduate/standards
- Education, Medical, Graduate/trends
- Education, Medical, Undergraduate/standards
- Education, Medical, Undergraduate/trends
- Humans
- Internship and Residency/standards
- Internship and Residency/trends
- Models, Educational
- Professional Competence/standards
- Quality Improvement
- Schools, Medical/organization & administration
- United States
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Affiliation(s)
- Bridget C O'Brien
- a Office of Research and Development in Medical Education , University of California , San Francisco , California , USA
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Naik VN, Brien SE. Review article: simulation: a means to address and improve patient safety. Can J Anaesth 2012; 60:192-200. [PMID: 23239487 DOI: 10.1007/s12630-012-9860-z] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2012] [Accepted: 11/27/2012] [Indexed: 11/28/2022] Open
Abstract
PURPOSE The purpose of this article is to review the role of technical and nontechnical skills in routine and crisis situations. We discuss the role of different simulation modalities in addressing these skills and competencies to enhance patient safety. PRINCIPAL FINDINGS Human and system errors are a recognized cause of significant morbidity and mortality. Technical skills encompass the medical and procedural knowledge required for patient care, while nontechnical skills are behaviour-based and include task management, situation awareness, teamwork, decision-making, and leadership. Both sets of skills are required to improve patient safety. Healthcare simulation can provide an opportunity to practice technical and nontechnical skills in a patient-safe environment. More specifically, these skills are most required in dynamic and crisis situations, which may best be practiced in a simulated patient setting. CONCLUSION Healthcare simulation is a valuable tool to improve patient safety. Simulation-based education can focus on the necessary technical and nontechnical skills to enhance patient safety. Simulation-based research can serve as a means to identify gaps in current practice, test different solutions, and show improved practice patterns by studying performance in a setting that does not compromise patient safety.
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Affiliation(s)
- Viren N Naik
- Department of Anesthesiology, The Ottawa Hospital, University of Ottawa Skills and Simulation Centre, 725 Parkdale Ave, Ottawa, ON, K1Y 4E9, Canada.
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Hamstra SJ. Keynote address: the focus on competencies and individual learner assessment as emerging themes in medical education research. Acad Emerg Med 2012; 19:1336-43. [PMID: 23279242 DOI: 10.1111/acem.12021] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2012] [Accepted: 07/06/2012] [Indexed: 12/01/2022]
Abstract
This article describes opportunities for scholarship in medical education, based on a brief overview of recent changes in medical education. The implications arising from these changes are discussed, with recommendations for focus, and suggestions and examples for making progress in this field. The author discusses 1) the historical context of the current shift toward competency-based medical education, 2) the potential contribution of social and behavioral sciences to medical education scholarship, 3) methods and approaches for supporting scholarship in medical education, and very briefly 4) trends in simulation. The author concludes with a call for quality in medical education scholarship and argues that the most promising and fruitful area of medical education scholarship for the future lies in the field of assessment of individual competence.
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Affiliation(s)
- Stanley J. Hamstra
- Academy for Innovation in Medical Education (AIME); University of Ottawa Skills and Simulation Centre; Departments of Medicine, Surgery, and Anesthesia; Faculty of Medicine University of Ottawa; Ottawa; Ontario; Canada
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Arab AA, Fraser A, Naik VN. The Royal College written examination: Is curriculum driving assessment or vice versa? Can J Anaesth 2012; 59:807-8. [DOI: 10.1007/s12630-012-9723-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2012] [Accepted: 04/20/2012] [Indexed: 10/28/2022] Open
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Miller DR. Special theme issue on advances in education in anesthesiology. Can J Anaesth 2011; 59:127-31. [PMID: 22147644 DOI: 10.1007/s12630-011-9632-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2011] [Accepted: 11/15/2011] [Indexed: 11/30/2022] Open
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