Long-term effect of a course on in-training assessment in postgraduate specialist education

A Qualitative Exploration of the Intern Experience in Assessing Medical Student Performance

BACKGROUND

Interns play a key role in medical student education, often observing behaviors that others do not. Their role in assessment, however, is less clear. Despite accreditation standards pertaining to residents' assessment skills, they receive little guidance or formal training in it. In order to better prepare residents for their role in medical student assessment, we need to understand their current experience.

OBJECTIVE

We aimed to describe the first-year resident experience assessing students' performance and providing input to faculty for student clinical performance assessments and grades in the inpatient setting.

METHODS

Pediatric interns at Children's National Hospital (CN) from February 2018 to February 2019 were invited to participate in semistructured interviews about their experience assessing students. Constant comparative methodology was used to develop themes. Ten interviews were conducted, at which point thematic saturation was reached.

RESULTS

We identified 4 major themes: 1) Interns feel as though they assess students in meaningful, unique ways. 2) Interns encounter multiple barriers and facilitators to assessing students. 3) Interns voice varying levels of comfort and motivation assessing different areas of student work. 4) Interns see their role in assessment limited to formative rather than summative assessment.

CONCLUSIONS

These findings depict the intern experience with assessment of medical students at a large pediatric residency program and can help inform ways to develop and utilize the assessment skills of interns.

Improved patient-reported outcomes after interprofessional training in mental health: a nonrandomized intervention study

BACKGROUND

Collaborative interprofessional practices are essential in caring for people with complex mental health problems. Despite the difficulties of demonstrating positive impacts of interprofessional education (IPE), it is believed to enhance interprofessional practices. We aimed to assess impacts on patient satisfaction, self-reported psychological distress and mental health status in a psychiatric ward.

METHODS

We conducted a nonrandomized intervention study with patient satisfaction, psychological distress, and health status as outcomes. Mental health inpatients were referred to either an interprofessional training unit (intervention group) or to a conventionally organized ward (comparison group). Outcomes were assessed using the Short Form Health Survey (SF-36), the Kessler Psychological Distress Scale (K10), and the Client Satisfaction Questionnaire (CSQ-8).

RESULTS

The intervention group included 129 patients, the comparison group 123. The former group reported better mental health status than the latter; the postintervention mean difference between them being 5.30 (95% CI 2.71-7.89; p = 0.001; SF-36), with an effect size of 0.24. The intervention group patients also scored higher on satisfaction (mean difference 1.01; 95% CI 0.06-1.96; p = 0.04), with an effect size of 0.31. The groups' mean scores of psychological distress were identical.

CONCLUSION

Our results support the hypothesized value of interprofessional training: intervention group patients reported higher scores regarding mental health status and satisfaction than did comparison group patients. As IPE interventions have rarely involved patients and fewer have taken place in practice settings, further research into both the processes and the long-term effects of IPE in mental healthcare is needed.

TRIAL REGISTRATION

The study was registered in ClinicalTrials.gov: NCT03070977 on March 6, 2017.

The International Literature on Teaching Faculty Development in English-Language Journals: A Scoping Review and Recommendations for Core Topics

BACKGROUND

With increasing physician mobility, there is interest in how medical schools and postgraduate medical education institutions across the world develop and maintain the competence of medical teachers. Published reviews of faculty development (FD) have predominantly included studies from the United States and Canada.

OBJECTIVE

We synthesized the international FD literature (beyond the US and Canada), focusing on FD type, intended audience, study format, effectiveness, differences among countries, and potential unique features.

METHODS

We identified English-language publications that addressed FD for medical faculty for teaching and related activities, excluding US and Canadian publications.

RESULTS

A search of 4 databases identified 149 publications, including 83 intervention studies. There was significant growth in international FD publications for the most recent decade, and a sizable number of studies were from developing economies and/or resulted from international collaborations. Focal areas echo those in earlier published reviews, suggesting the international FD literature addresses similar faculty needs and organizational concerns.

CONCLUSIONS

The growth in publications in recent years and a higher proportion of reporting on participant reactions, coupled with less frequent reporting of results, transfer to practice, and impact on learners and the organization, suggest this is an evolving field. To enhance international FD, educators and researchers should focus on addressing common needs expressed by faculty, including curriculum design and evaluation, small group teaching, assessing professionalism and providing feedback. Future research should focus on approaches for developing comprehensive institutional FD programs that include communities of learning and practice and evaluating their impact.

Interprofessional clinical training in mental health improves students' readiness for interprofessional collaboration: a non-randomized intervention study

BACKGROUND

Over the past decades, the health sector in general has increasingly acknowledged the effectiveness of interprofessional clinical training in enhancing teamwork. In psychiatry, however, knowledge of the benefits of collaborative clinical training is sparse. This study aimed to investigate the impact of interprofessional training on students' readiness for interprofessional collaboration in a psychiatric ward.

METHODS

An intervention study assessed interprofessional clinical training in a training ward. Undergraduate students from the disciplines of medicine, nursing, psychotherapy, pedagogy, and social work were allocated either to an intervention group receiving interprofessional training or to a comparison group receiving conventional clinical training. Outcomes were assessed using the Readiness for Interprofessional Learning Scale (RIPLS) and the Assessment of Interprofessional Team Collaboration Scale (AITCS). Linear mixed regression was used to compare differences in mean scores postintervention, adjusted for baseline score, gender, and profession.

RESULTS

Mean postintervention scores were higher in the intervention group (n = 87) than in the comparison group (n = 108) for both scales (overall sum score). For the RIPLS, the mean difference was 2.99 (95% CI 0.82 to 5.16; p = 0.007); for the AITCS it was 8.11 (95% CI 2.92-13.30; p = 0.002). Improvement in readiness for interprofessional learning and team collaboration in the intervention group remained statistically significant after adjustment for baseline differences between the two groups.

CONCLUSION

Students' self-reported readiness for interprofessional learning and their team collaboration were improved after interprofessional clinical training. Still, further studies of both the processes and the long-term effects of undergraduate IPE in mental healthcare are needed. The study was registered March 62,017 on ClinicalTrials.gov: NCT03070977 (Retrospectively registrered).

A systematic review of faculty development initiatives designed to enhance teaching effectiveness: A 10-year update: BEME Guide No. 40

BACKGROUND

This review, which focused on faculty development initiatives designed to improve teaching effectiveness, synthesized findings related to intervention types, study characteristics, individual and organizational outcomes, key features, and community building.

METHODS

This review included 111 studies (between 2002 and 2012) that met the review criteria.

FINDINGS

Overall satisfaction with faculty development programs was high. Participants reported increased confidence, enthusiasm, and awareness of effective educational practices. Gains in knowledge and skills, and self-reported changes in teaching behaviors, were frequently noted. Observed behavior changes included enhanced teaching practices, new educational initiatives, new leadership positions, and increased academic output. Organizational changes were infrequently explored. Key features included evidence-informed educational design, relevant content, experiential learning, feedback and reflection, educational projects, intentional community building, longitudinal program design, and institutional support.

CONCLUSION

This review holds implications for practice and research. Moving forward, we should build on current success, broaden the focus beyond individual teaching effectiveness, develop programs that extend over time, promote workplace learning, foster community development, and secure institutional support. We should also embed studies in a theoretical framework, conduct more qualitative and mixed methods studies, assess behavioral and organizational change, evaluate transfer to practice, analyse key features, and explore the role of faculty development within the larger organizational context.

Teaching Our Students, Our Residents and Ourselves

Even though postgraduate medical education has been the focus of interest in anaesthesiology education, in a broader sense the entire medical community can be considered appropriate learners of anaesthesiology. Anaesthesiologists are equipped to teach physiology, pharmacology, resuscitation, pain management, perioperative assessment, and medical technology. For residency training, an approach based on competencies, skills and professionalism should be used instead of the traditional "apprenticeship" model. When teaching ourselves as qualified anaesthesiologists, areas of continuing professional development, academic career training and continuing medical education should be taken into account. Whereas the responsibility for undergraduate medical education rests with university medical schools, postgraduate medical education is carried out by universities and/or the national health authorities/services. Establishment of partnerships between health-care services and universities should be central to the provision of postgraduate education so as not to dissociate various stages of education. When determining educational strategies, institutional preferences, target populations and their learning styles should be taken into account. To this end, especially for high risk situations simulation-based approaches, scenarios, standardized patients, research, mentoring, journal clubs, seminars, lectures, case discussions, bed-side discussions, courses, games and portfolios have been and are being used widely. Departments of anaesthesiology should establish and maintain a strong presence in undergraduate medical education. Besides being good clinicians, anaesthesiologists should understand all aspects of education and educational outcome in order to better teach students, residents and themselves. Quality of education and the teaching environment should continually be evaluated within the context of quality assurance.