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Ellaway RH, O'Brien BC, Sherbino J, Maggio LA, Artino AR, Nimmon L, Park YS, Young M, Thomas A. Is There a Problem With Evidence in Health Professions Education? ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2024; 99:841-848. [PMID: 38574241 DOI: 10.1097/acm.0000000000005730] [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
ABSTRACT What constitutes evidence, what value evidence has, and how the needs of knowledge producers and those who consume this knowledge might be better aligned are questions that continue to challenge the health sciences. In health professions education (HPE), debates on these questions have ebbed and flowed with little sense of resolution or progress. In this article, the authors explore whether there is a problem with evidence in HPE using thought experiments anchored in Argyris' learning loops framework.From a single-loop perspective ("How are we doing?"), there may be many problems with evidence in HPE, but little is known about how research evidence is being used in practice and policy. A double-loop perspective ("Could we do better?") suggests expectations of knowledge producers and knowledge consumers might be too high, which suggests more system-wide approaches to evidence-informed practice in HPE are needed. A triple-loop perspective ("Are we asking the right questions?") highlights misalignments between the dynamics of research and decision-making, such that scholarly inquiry may be better approached as a way of advancing broader conversations, rather than contributing to specific decision-making processes.The authors ask knowledge producers and consumers to be more attentive to the translation from knowledge to evidence. They also argue for more systematic tracking and audit of how research knowledge is used as evidence. Given that research does not always have to serve practical purposes or address the problems of a particular program or institution, the relationship between knowledge and evidence should be understood in terms of changing conversations and influencing decisions.
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Baker MJ, Maggio LA, Dorris CS, Uijtdehaage S, Soh M. Clinical supervision in medical education: A citation analysis. MEDICAL TEACHER 2024; 46:505-511. [PMID: 37949084 DOI: 10.1080/0142159x.2023.2257375] [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: 11/12/2023]
Abstract
PURPOSE Medical education relies on clinical supervision for critical functions, including trainee assessment and ensuring patient safety. Yet, there is substantial variance in supervision, which has led to calls for a shared definition of the concept and guidelines to inform practice. AMEE Guide No. 27 provided these desired elements and is highly cited, suggesting that translation and utilization of the Guide's knowledge is suboptimal. This study investigates utilization by systematically characterizing citations to the Guide and by describing translation of its recommendations in relation to supervision. MATERIALS AND METHODS Citations were identified using Web of Science, Scopus, and Google Scholar. The authors coded all citations and conducted a subanalysis of studies specific to supervision. RESULTS 583 studies were identified; 268 met inclusion criteria for general analysis of which 167 studies were further analyzed. Most studies reiterated the Guide's characterization of effective supervision, but few demonstrate how these recommendations inform innovations in supervisory practice. CONCLUSION Translation of the Guide's recommendations regarding clinical supervision appears limited. Future research should consider the extent of knowledge translation occurring in clinical supervision literature as well as AMEE Guides. Increased attention to knowledge translation in medical education may benefit the distribution of similar knowledge products.
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Affiliation(s)
- M J Baker
- Center for Health Professions Education, Uniformed Services University, Bethesda, MD, USA
- Department of Psychiatry, Wright State University, Boonshoft School of Medicine, Dayton, OH, USA
| | - L A Maggio
- Center for Health Professions Education, Uniformed Services University, Bethesda, MD, USA
| | - C S Dorris
- Dahlgren Memorial Library, Georgetown University Medical Center, Washington, DC, USA
| | - S Uijtdehaage
- Center for Health Professions Education, Uniformed Services University, Bethesda, MD, USA
| | - M Soh
- Center for Health Professions Education, Uniformed Services University, Bethesda, MD, USA
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Ioannidis JPA. Educating educators on research on research. PERSPECTIVES ON MEDICAL EDUCATION 2022; 11:137-138. [PMID: 33877586 PMCID: PMC9240132 DOI: 10.1007/s40037-021-00662-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/24/2021] [Indexed: 05/04/2023]
Affiliation(s)
- John P A Ioannidis
- Departments of Medicine, of Epidemiology and Population Health, of Biomedical Data Science, and of Statistics, and Meta-Research Innovation Center at Stanford (METRICS), Stanford University, Stanford, CA, USA.
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Hallé MC, Bussières A, Asseraf-Pasin L, Storr C, Mak S, Root K, Thomas A. Building evidence-based practice competencies among rehabilitation students: a qualitative exploration of faculty and preceptors' perspectives. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2021; 26:1311-1338. [PMID: 33895888 DOI: 10.1007/s10459-021-10051-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 04/09/2021] [Indexed: 06/12/2023]
Abstract
Medical education literature suggests clinically-integrated teaching may be the most effective approach to teach evidence-based practice (EBP). Before implementing this educational best practice in rehabilitation curricula, it is imperative to better understand the current context, barriers and facilitators to teach EBP in rehabilitation from the academic to the clinical setting. The aim of this study was to explore faculty and preceptors' experiences and perceptions of teaching EBP in rehabilitation professions, namely occupational therapy, physical therapy and speech-language pathology. We gathered data from seven focus groups and an individual interview with a sample of 24 faculty and 15 preceptors, i.e., clinical supervisors. Data collected were subjected to inductive thematic content analysis. We identified three overarching themes and corresponding strategies. First, "Recognizing EBP as a multifaceted concept" denoted participants' lack of consensus regarding the meaning and scope of EBP, and their awareness of such discrepancies. Second, "Complexity of EBP is at the core of teaching practices and experiences" referred to participants' perception of EBP as a complex process involving high-level cognitive skills, which influenced their teaching practices and challenged students and themselves. Third, "Connections and divides between research and practice" represented the limited and delicate connection between faculty and preceptors, the factors either bridging or maintaining the gap between them, and the impacts of such connections and divides on teaching. Improving collaboration between faculty and preceptors constitutes an essential first step towards more effective EBP training programs in rehabilitation that could be facilitated through online communities of practice or integrated knowledge translation research projects.
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Affiliation(s)
- Marie-Christine Hallé
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Canada
| | - André Bussières
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Canada
- Département chiropratique, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
| | - Liliane Asseraf-Pasin
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
| | - Caroline Storr
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
| | - Susanne Mak
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Canada
- Institute of Health Sciences Education, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
| | - Kelly Root
- School of Communication Sciences and Disorders, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
| | - Aliki Thomas
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada.
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal, Canada.
- Institute of Health Sciences Education, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada.
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Thomas A, Bussières A. Leveraging knowledge translation and implementation science in the pursuit of evidence informed health professions education. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2021; 26:1157-1171. [PMID: 33651210 DOI: 10.1007/s10459-020-10021-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/08/2020] [Accepted: 12/17/2020] [Indexed: 06/12/2023]
Abstract
Evidence informed approaches to health professions education can ensure accountability to learners and society in providing meaningful and effective education and helping resource strained systems via streamlined and cost-efficient practices. Knowledge translation and implementation science are two areas of study originally developed in clinical medicine in response to concerns that health care practices were incongruent with the scientific evidence. Two decades of research have led to important advances in our understanding of the nature and magnitude of research-practice gaps, the factors that support or impede adoption of evidence in clinical decision-making, and in the design and evaluation of theory driven interventions to reduce gaps. This paper borrows concepts from knowledge translation and implementation science to further our thinking about how health professions education can 'truly' be evidence informed. The article is organised in four sections: a discussion of the impetus for the evidence informed health professions education movement; a description of the origins of knowledge translation and implementation science; a discussion on how knowledge translation and implementation science can be leveraged to advance the evidence informed health professions education agenda; and suggestions for future discussion and research. An example is used to illustrate the application of the underpinning principles of knowledge translation and implementation science. The authors suggest a theory driven, staged and systematic approach that integrates knowledge translation principles and processes and involves key stakeholders interested in promoting the application of educational research of evidence.
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Affiliation(s)
- Aliki Thomas
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada.
- Institute of Health Sciences Education, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada.
- Centre for Interdisciplinary Research in Rehabilitation, Montreal, Canada.
| | - André Bussières
- School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada
- Centre for Interdisciplinary Research in Rehabilitation, Montreal, Canada
- Département Chiropratique, Université du Québec à Trois-Rivières, Trois-Rivières, Canada
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Maheshwari S, Jain P, Ligon BL, Thammasitboon S. Twelve Tips for Creating and Supporting a Meaningful Asynchronous Learning as Parts of Virtual Transition of a Curriculum. MEDEDPUBLISH 2021; 10:111. [PMID: 38486603 PMCID: PMC10939517 DOI: 10.15694/mep.2021.000111.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024] Open
Abstract
This article was migrated. The article was marked as recommended. With increasing use of online learning, the focus is rapidly shifting from in-person learning to virtual asynchronous learning (ASL). The flexibility offered by ASL coupled with advancements in technologies have enabled increased engagement of learners. However, ASL has inherent challenges associated with it, especially for educators. Successful curricula designed for virtual learning should deliver high-quality education, leverage existing technologies, and incorporate evidence-informed educational practices. Contrariwise, if the discourse becomes diluted due to lack of clear goals and objectives, it can lead to identity challenges in educators and dissatisfaction among learners. In this contemporary review, we offer practical tips for educators to guide development and/or implementation of curricula in asynchronous platforms using a Community of Inquiry framework. The guide also elaborates on practical use of various technologies to conform with one's teaching identity as identified by Pratt's teaching perspectives.
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Doja A, Eady K, Warren A, Wiesenfeld L, Writer H. Utilization of evidence-based tools and medical education literature by Canadian postgraduate program directors in the teaching and assessment of the CanMEDS roles. CANADIAN MEDICAL EDUCATION JOURNAL 2021; 12:e57-e62. [PMID: 33995720 PMCID: PMC8105561 DOI: 10.36834/cmej.70183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND Researchers have shown that clinical educators feel insufficiently informed about how to teach and assess the CanMEDS roles. Thus, our objective was to examine the extent to which program directors utilize evidence-based tools and the medical education literature in teaching and assessing the CanMEDS roles. METHODS In 2016, the authors utilized an online questionnaire to survey 747 Canadian residency program directors (PD's) of Royal College of Physicians and Surgeons of Canada (RCPSC) accredited programs. RESULTS Overall, 186 PD's participated (24.9%). 36.6% did not know whether the teaching strategies they used were evidence-based and another third (31.9%) believed they were "not at all" or "to a small extent" evidence-based. Similarly, 31.8% did not know whether the assessment tools they used were evidence-based and another third (39.7%) believed they were "not at all" or "to a small extent" evidence-based. PD's were aware of research on teaching strategies (62.4%) and assessment tools (51.9%), but felt they did not have sufficient time to review relevant literature (72.1% for teaching and 64.1% for assessment). CONCLUSIONS Canadian PD's reported low awareness of evidence-based tools for teaching and assessment, implying a potential knowledge translation gap in medical education research.
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Affiliation(s)
- Asif Doja
- Department of Pediatrics, University of Ottawa, Ontario, Canada
| | - Kaylee Eady
- Faculty of Education, University of Ottawa, Ontario, Canada
| | - Andrew Warren
- Postgraduate Medical Education, Dalhousie Medical School, Dalhousie University, Nova Scotia, Canada
| | - Lorne Wiesenfeld
- Postgraduate Medical Education, University of Ottawa, Ontario, Canada
| | - Hilary Writer
- Department of Pediatrics, University of Ottawa, Ontario, Canada
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Maggio LA, Costello JA, Norton C, Driessen EW, Artino AR. Knowledge syntheses in medical education: A bibliometric analysis. PERSPECTIVES ON MEDICAL EDUCATION 2021; 10:79-87. [PMID: 33090330 PMCID: PMC7580500 DOI: 10.1007/s40037-020-00626-9] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 09/22/2020] [Accepted: 09/30/2020] [Indexed: 05/04/2023]
Abstract
PURPOSE This bibliometric analysis maps the landscape of knowledge syntheses in medical education. It provides scholars with a roadmap for understanding where the field has been and where it might go in the future, thereby informing research and educational practice. In particular, this analysis details the venues in which knowledge syntheses are published, the types of syntheses conducted, citation rates they produce, and altmetric attention they garner. METHOD In 2020, the authors conducted a bibliometric analysis of knowledge syntheses published in 14 core medical education journals from 1999 to 2019. To characterize the studies, metadata were extracted from PubMed, Web of Science, Altmetrics Explorer, and Unpaywall. RESULTS The authors analyzed 963 knowledge syntheses representing 3.1% of the total articles published (n = 30,597). On average, 45.9 knowledge syntheses were published annually (SD = 35.85, median = 33), and there was an overall 2620% increase in the number of knowledge syntheses published from 1999 to 2019. The journals each published, on average, a total of 68.8 knowledge syntheses (SD = 67.2, median = 41) with Medical Education publishing the most (n = 189; 19%). Twenty-one types of knowledge synthesis were identified, the most prevalent being systematic reviews (n = 341; 35.4%) and scoping reviews (n = 88; 9.1%). Knowledge syntheses were cited an average of 53.80 times (SD = 107.12, median = 19) and received a mean Altmetric Attention Score of 14.12 (SD = 37.59, median = 6). CONCLUSIONS There has been considerable growth in knowledge syntheses in medical education over the past 20 years, contributing to medical education's evidence base. Beyond this increase in volume, researchers have introduced methodological diversity in these publications, and the community has taken to social media to share knowledge syntheses. Implications for the field, including the impact of synthesis types and their relationship to knowledge translation, are discussed.
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Affiliation(s)
- Lauren A Maggio
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
| | - Joseph A Costello
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Candace Norton
- Uniformed Services University of the Health Sciences, Bethesda, MD, USA
| | - Erik W Driessen
- Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Anthony R Artino
- School of Medicine and Health Sciences, The George Washington University, Washington, DC, USA
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Horsley T, Steinert Y, Leslie K, Oswald A, Friesen F, Ellaway RH. The use of BEME reviews in the medical education literature. MEDICAL TEACHER 2020; 42:1171-1178. [PMID: 32772602 DOI: 10.1080/0142159x.2020.1798909] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
INTRODUCTION Knowledge syntheses in medical education are intended to promote the translation to, and mobilization of, research knowledge into practice. Despite the effort invested in conducting them, how these knowledge syntheses are used is unclear. This study aimed to explore how knowledge syntheses published by the Best Evidence Medical Education Collaboration (BEME) have been used in a cross-section of published literature. METHODS Citation patterns for BEME reviews were explored using data drawn from Web of Science and Scopus, and a sub-sample of citing papers. RESULTS Bibliometric data on 3419 papers citing 29 BEME reviews were analysed. More detailed data were extracted from a random sample of 629 full-text papers. DISCUSSION BEME reviews were most often positioned to consolidate and summarize the current state of knowledge on a particular topic and to identify gaps in the literature; they were also used to justify current research, and less frequently to contextualize and explain results, or direct future areas of research. Their use to identify instruments or methodological approaches was relatively absent. CONCLUSION While BEME reviews are primarily used to justify and support other studies, the current literature does not demonstrate their translation to educational practice.
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Affiliation(s)
- Tanya Horsley
- Research Unit, Royal College of Physicians and Surgeons of Canada, Ottawa, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Canada
| | - Yvonne Steinert
- Institute of Health Sciences Education and Department of Family Medicine, Faculty of Medicine, McGill University, Montreal, Canada
| | - Karen Leslie
- Centre for Faculty Development and Department of Paediatrics, Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Anna Oswald
- Department of Medicine, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Canada
| | - Farah Friesen
- Centre for Faculty Development, Faculty of Medicine, University of Toronto at St. Michael's Hospital, Toronto, Canada
| | - Rachel H Ellaway
- Community Health Sciences, Cumming School of Medicine, University of Calgary, Calgary, Canada
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Ziedonis D, Ahn MS. Professional Development for Clinical Faculty in Academia: Focus on Teaching, Research, and Leadership. Psychiatr Clin North Am 2019; 42:389-399. [PMID: 31358119 DOI: 10.1016/j.psc.2019.05.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Clinical faculty need creative, systematic, and supportive approaches for their success. Academic institutions and departments have a unique opportunity to engage its faculty by sponsoring and creating innovative professional development programs to enhance leadership, research, teaching, and clinical skills. The added benefit of these "homegrown" programs is that clinical faculty members feel more valued, engaged, and supported and will want to better align their priorities with the strategic priorities of the institution. There are excellent national resources to learn from to support and complement local professional development efforts. Each department needs to balance any standard with customized approaches.
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Affiliation(s)
- Douglas Ziedonis
- University of California San Diego, Biomedical Sciences Building, 9500 Gilman Drive #0602, La Jolla, CA 92093-0602, USA.
| | - Mary S Ahn
- University of California San Diego, Biomedical Sciences Building, 9500 Gilman Drive #0602, La Jolla, CA 92093-0602, USA
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Thomas A, D Gruppen L, van der Vleuten C, Chilingaryan G, Amari F, Steinert Y. Use of evidence in health professions education: Attitudes, practices, barriers and supports. MEDICAL TEACHER 2019; 41:1012-1022. [PMID: 31050311 DOI: 10.1080/0142159x.2019.1605161] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Introduction: Health professions educators are increasingly called upon to apply an evidence-informed approach to teaching and assessment practices. There is scant empirical research exploring educators' attitudes, practices, and perceived barriers and supports to using research evidence in educational practice. Methods: We conducted a survey of AMEE members to explore three domains related to evidence-informed health professions education: (1) attitudes; (2) practices; and (3) supports and barriers. Analyses involved descriptive statistics to characterize participants' responses per domain, exploratory factor analysis, and multivariate regression analyses. Results: Three hundred ninety-six (∼10%) participants representing health professions educators (HPEs) and non HPEs (e.g. PhDs) and different roles (e.g. teacher, administrator) completed the survey. Attitudes toward evidence-informed HPE were generally favorable. Several barriers preclude participants from engaging in evidence-informed approaches to health professions education (HPE). Discussion: This study provides preliminary evidence on the attitudes toward and perceived barriers and supports of research use in HPE from different groups of HP educators, clinicians, and administrators. The findings for each of the three domains require additional exploration using qualitative methodologies. Conclusion: Targeted interventions designed to increase the uptake of research in HPE should consider different stakeholder groups' perceptions regarding these approaches, current vs. best practices, and factors that may impede evidence-informed approaches.
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Affiliation(s)
- Aliki Thomas
- School of Physical and Occupational Therapy, Institute of Health Sciences Education, Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, McGill University , Montreal , Canada
| | - Larry D Gruppen
- Medical School, University of Michigan , Ann Arbor , MI , USA
| | - Cees van der Vleuten
- Department of Educational Development and Research, Maastricht University , Maastricht , the Netherlands
| | - Gevorg Chilingaryan
- Feil and Oberfeld Research Centre, Jewish Rehabilitation Hospital, Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal , Laval , Canada
| | - Fatima Amari
- School of Physical and Occupational Therapy, McGill University , Montreal , Canada
| | - Yvonne Steinert
- Department of Family Medicine, Institute of Health Sciences Education, McGill University , Montréal , Canada
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