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Driscoll AM, Suresh R, Popa G, Berglund L, Azer A, Hed H, Duan Y, Chu A, McGrath A. Do educational interventions reduce the gender gap in communication skills?- a systematic review. BMC MEDICAL EDUCATION 2024; 24:827. [PMID: 39085838 PMCID: PMC11293108 DOI: 10.1186/s12909-024-05773-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2024] [Accepted: 07/12/2024] [Indexed: 08/02/2024]
Abstract
BACKGROUND Efficient doctor-patient communication is essential for improving patient care. The impact of educational interventions on the communication skills of male and female students has not been systematically reviewed. The aim of this review is to identify interventions used to improve communication skills in medical curricula and investigate their effectiveness in improving the communication skills of male and female medical students. METHODS A systematic review of the literature was conducted using the PRISMA guidelines. Inclusion criteria were as follows: used intervention strategies aiming to improve communication skills, participants were medical students, and studies were primary research studies, systematic reviews, or meta-analyses. RESULTS 2913 articles were identified based on search terms. After title, abstract, and full-text review, 58 studies were included with interventions consisting of Training or Drama Courses, Curriculum-Integrated, Patient Learning Courses, and Community-Based Learning Courses. 69% of articles reported improved communication skills for both genders equally, 28% for women more than men, and 3% for men more than women. 16 of the 58 articles reported numerical data regarding communication skills pre-and post-intervention. Analysis revealed that post-intervention scores are significantly greater than pre-intervention scores for both male (p < 0.001) and female students (p < 0.001). While the post-test scores of male students were significantly lower than that of female students (p = 0.01), there is no significant difference between genders for the benefits, or difference between post-intervention and pre-intervention scores (p = 0.15), suggesting that both genders benefited equally. CONCLUSION Implementation of communication training into medical education leads to improvement in communication skills of medical students, irrespective of gender. No specific interventions benefitting male students have been identified from published literature, suggesting need of further studies to explore the phenomenon of gender gap in communication skills and how to minimize the differences between male and female students.
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Affiliation(s)
- Alexis M Driscoll
- Department of Orthopaedic Surgery, Rutgers New Jersey Medical School, Newark, NJ, 07103, USA
| | - Rohan Suresh
- Department of Orthopaedic Surgery, Rutgers New Jersey Medical School, Newark, NJ, 07103, USA
| | - George Popa
- Department of Orthopaedic Surgery, Rutgers New Jersey Medical School, Newark, NJ, 07103, USA
| | - Leif Berglund
- Department of Clinical Sciences, Umeå university, Umeå, Sweden
| | - Amanda Azer
- Department of Orthopaedic Surgery, Rutgers New Jersey Medical School, Newark, NJ, 07103, USA
| | - Helen Hed
- Umeå University Library, Umeå, Sweden
| | - Yajie Duan
- Department of Statistics, Rutgers University, New Brunswick, NJ, 08901, USA
| | - Alice Chu
- Department of Orthopaedic Surgery, Rutgers New Jersey Medical School, Newark, NJ, 07103, USA
| | - Aleksandra McGrath
- Department of Clinical Sciences, Umeå university, Umeå, Sweden.
- Department of Surgical and Perioperative Sciences, Umeå university, Umeå, Sweden.
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Kraakevik JA, Haedinger LA, Guzman CEV, Kahl L, Smeraglio A, Bonura E, Hasan R, Paquin A, Moulton B, Carney PA. Impact of Students' Scheduling Choice on Clerkship Examination Score Performance in a Time-Varying Competency-Based Curriculum. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2023; 98:98-104. [PMID: 36576771 DOI: 10.1097/acm.0000000000004952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Abstract
PURPOSE Standardized end-of-clerkship examinations typically occur on the last day of the clerkship. However, recent trends toward time-varying competency-based medical education have offered students more test scheduling flexibility, creating an opportunity to study the impact of student-selected examination timing. METHOD Starting with the graduating class of 2018, students took the required standardized end-of-core clerkship examinations at any available time they chose during their clinical years. Before this change, these examinations were administered to all students on the last day of the clerkship. Students' examination dates relative to clerkship completion were analyzed between 2017 and 2020 (inclusive of before and after flexible exam timing) to assess the impact that student-selected exam timing had on test performance on National Board of Medical Examiners shelf clinical science examinations for required core clerkships. RESULTS Data on 146 medical students in 2017 (fixed exam timing) and 466 medical students between 2018 and 2020 (flexible exam timing) were included. Among students offered flexible exam timing, between 2.7% (internal medicine) and 14.6% (psychiatry) took their exam before actually taking clerkship, while between 22.7% (psychiatry) and 40.0% (surgery) took their exam more than 90 days after the clerkship ended. Exam scores were statistically higher for those who took the exam at a time of their choosing compared with those who were required to take it at the end of individual rotations and when the exam scores were combined (fixed exam timing mean = 73.9, standard deviation [SD] = 7.8; flexible exam timing mean = 77.4, SD = 6.0, P < .001). The percent of students with passing scores was statistically higher in internal medicine, pediatrics, and psychiatry. CONCLUSIONS Self-selection of shelf exam timing appears to increase shelf exam scores. As more medical schools transition to competency-based medical education, providing scheduling flexibility appears not to negatively affect student achievement.
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Affiliation(s)
- Jeff A Kraakevik
- J.A. Kraakevik is associate professor of neurology, School of Medicine, Oregon Health & Science University, Portland, Oregon
| | - Leslie A Haedinger
- L.A. Haedinger is program manager, UME Assessments, School of Medicine, Oregon Health & Science University, Portland, Oregon
| | - Cirila Estela Vasquez Guzman
- C.E.V. Guzman is assistant professor of family medicine, School of Medicine, Oregon Health & Science University, Portland, Oregon
| | - Leslie Kahl
- L. Kahl is professor of medicine, Division of Arthritis and Rheumatic Diseases, and associate dean, Strategic Initiatives, School of Medicine, Oregon Health & Science University, Portland, Oregon
| | - Anne Smeraglio
- A. Smeraglio is assistant professor of medicine, School of Medicine, Oregon Health & Science University, Portland, Oregon
| | - Erin Bonura
- E. Bonura is assistant professor of medicine, Division of Infectious Diseases, School of Medicine, Oregon Health & Science University, Portland, Oregon
| | - Reem Hasan
- R. Hasan is associate professor of medicine and associate professor of pediatrics, School of Medicine, Oregon Health & Science University, Portland, Oregon
| | - Ashley Paquin
- A. Paquin is an internal medicine resident, School of Medicine, Oregon Health & Science University, Portland, Oregon
| | - Bart Moulton
- B. Moulton is associate professor of medicine, Division of Pulmonary and Critical Care Medicine, School of Medicine, Oregon Health & Science University, Portland, Oregon
| | - Patricia A Carney
- P.A. Carney is professor of family medicine, School of Medicine, Oregon Health & Science University, Portland, Oregon; ORCID: http://orcid.org/0000-0002-2937-655X
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Loureiro M, Mesquita I, Ramos A, Coutinho P, Ribeiro J, Clemente FM, Nakamura FY, Afonso J. Flexible Training Planning Coupled with Flexible Assessment: A 12-Week Randomized Feasibility Study in a Youth Female Volleyball Team. CHILDREN (BASEL, SWITZERLAND) 2022; 10:children10010029. [PMID: 36670580 PMCID: PMC9856447 DOI: 10.3390/children10010029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 12/20/2022] [Accepted: 12/21/2022] [Indexed: 12/28/2022]
Abstract
According to the Quality Education and Gender Equality ambitions established at the 2030 Agenda for Sustainable Development Goals, we aimed to test the feasibility of a flexible planning and assessment process, using ongoing, bidirectional feedback between planning and assessment. Eighteen players (11.5 ± 0.5 years of age) from a U13 female volleyball team were randomized into an experimental group (in which the plan could be changed daily) or a contrast group (pre-defined planning, adjusted monthly). The pedagogical intervention lasted three months. Besides ongoing daily assessments from the training practices, the Game Performance Assessment Instrument was adopted as a starting point for the weekly assessments in 4 vs. 4 game-forms (i.e., the instrument was modified monthly based on feedback from the training process). Information from daily and weekly formal assessment was used in the planning of the experimental group, and monthly in the contrast group. Data suggested that pre-established and strict planning (even updated monthly) failed to fit current learner needs. Over 12 weeks, the pre-established planning suffered regular modifications in the experimental group, and the assessment tool changed monthly. In conclusion, both planning and assessment should be open and flexible to exchange information mutually, and support the design of tailor-made learning environments.
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Affiliation(s)
- Manuel Loureiro
- Centre for Research, Education, Innovation, and Intervention in Sport (CIFI2D), Faculty of Sport of the University of Porto (FADEUP), Rua Dr. Plácido da Costa 91, 4200-450 Porto, Portugal
- Correspondence: ; Tel.: +351-918636417
| | - Isabel Mesquita
- Centre for Research, Education, Innovation, and Intervention in Sport (CIFI2D), Faculty of Sport of the University of Porto (FADEUP), Rua Dr. Plácido da Costa 91, 4200-450 Porto, Portugal
| | - Ana Ramos
- Centre for Research, Education, Innovation, and Intervention in Sport (CIFI2D), Faculty of Sport of the University of Porto (FADEUP), Rua Dr. Plácido da Costa 91, 4200-450 Porto, Portugal
| | - Patrícia Coutinho
- Centre for Research, Education, Innovation, and Intervention in Sport (CIFI2D), Faculty of Sport of the University of Porto (FADEUP), Rua Dr. Plácido da Costa 91, 4200-450 Porto, Portugal
| | - João Ribeiro
- Centre for Research, Education, Innovation, and Intervention in Sport (CIFI2D), Faculty of Sport of the University of Porto (FADEUP), Rua Dr. Plácido da Costa 91, 4200-450 Porto, Portugal
- Football Department, Lusophone University of Porto, 4000-098 Porto, Portugal
| | - Filipe Manuel Clemente
- Escola Superior Desporto e Lazer, Instituto Politécnico de Viana do Castelo, Rua Escola Industrial e Comercial de Nun’Álvares, 4900-347 Viana do Castelo, Portugal
- Research Center in Sports Performance, Recreation, Innovation and Technology (SPRINT), 4960-320 Melgaço, Portugal
- Instituto de Telecomunicações, Delegação da Covilhã, 1049-001 Lisboa, Portugal
| | - Fábio Yuzo Nakamura
- Research Centre in Sports Sciences, Health Sciences and Human Development, CIDESD, University of Maia, ISMAI, Av. Carlos de Oliveira Campos, 4475-690 Maia, Portugal
| | - José Afonso
- Centre for Research, Education, Innovation, and Intervention in Sport (CIFI2D), Faculty of Sport of the University of Porto (FADEUP), Rua Dr. Plácido da Costa 91, 4200-450 Porto, Portugal
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Jones RL, Miller Juve A, Hasan R, Shuford A, Carney PA. Leveraging existing education innovations to establish a community of practice to promote medical education scholar development. MEDICAL EDUCATION ONLINE 2022; 27:2133587. [PMID: 36217945 PMCID: PMC9559469 DOI: 10.1080/10872981.2022.2133587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 09/25/2022] [Accepted: 10/05/2022] [Indexed: 06/16/2023]
Abstract
PROBLEM While some academic health centers have organizational structures to support educational scholarship, such as Medical Education Research Units (MERU), many education scholars may lack access to such institutional resources to support their research agenda and professional growth. APPROACH In 2014, as part of an externally funded education grant, three faculty educators established a unique education data management system Research & Evaluation Data for Educational Improvement (REDEI). Lacking an institutional MERU, they established an educational research community of practice (CoP) using REDEI as the research dataset. The senior faculty member's effort to facilitate the group is funded by the Dean's Office. OUTCOMES The CoP meets every 2 weeks to generate research ideas, discuss analytic approach and strategy, review analyses designed to address or explore a research question, and plans for manuscript development. Our CoP has grown from 3 to 18 members representing faculty educators, administrators, and staff across many departments in the School of Medicine. As of 2021, the REDEI system contains performance data on 1,246 students across all years of undergraduate medical education. To date, we have published 11 peer-reviewed educational research manuscripts. Five learners have served as coauthors (three medical students and two residents), three of whom were first authors. Eleven additional papers are in process. This community of practice supports productivity, provides mentorship, overcomes barriers, and is flexible enough for people to join when they can or when an area of interest is actively under development. NEXT STEPS We are working on educational interdisciplinary research grant submission and creating collaborations with other institutions. Our focus remains on honing skills in grantsmanship, identification of impactful research questions, application of rigorous methods and instrumentation to address them, and refining process of budget development, timelines, and other planning strategies.
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Affiliation(s)
- R. Logan Jones
- Department of Internal Medicine, Oregon Health & Science University, USA
| | - Amy Miller Juve
- Department of Anesthesiology and Perioperative Medicine, Oregon Health & Science University, USA
| | - Reem Hasan
- Departments of Internal Medicine and Pediatrics, Oregon Health & Science University, USA
| | - Alexandra Shuford
- Undergraduate Medical Education Assessments, Oregon Health & Science University, USA
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Tan R, Qi Ting JJ, Zhihao Hong D, Sing Lim AJ, Ong YT, Pisupati A, Xin Chong EJ, Chiam M, Inn Lee AS, Shuen Tan LH, Chew Chin AM, Wijaya L, Fong W, Radha Krishna LK. Medical Student Portfolios: A Systematic Scoping Review. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2022; 9:23821205221076022. [PMID: 35274044 PMCID: PMC8902199 DOI: 10.1177/23821205221076022] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Accepted: 12/06/2021] [Indexed: 06/14/2023]
Abstract
PHENOMENON Medical Student Portfolios (MSP)s allow medical students to reflect and better appreciate their clinical, research and academic experiences which promotes their individual personal and professional development. However, differences in adoption rate, content design and practice setting create significant variability in their employ. With MSPs increasingly used to evaluate professional competencies and the student's professional identity formation (PIF), this has become an area of concern. APPROACH We adopt Krishna's Systematic Evidence-Based Approach to carry out a Systematic Scoping Review (SSR in SEBA) on MSPs. The structured search process of six databases, concurrent use of thematic and content analysis in the Split Approach and comparisons of the themes and categories with the tabulated summaries of included articles in the Jigsaw Perspective and Funnelling Process offers enhanced transparency and reproducibility to this review. FINDINGS The research team retrieved 14501 abstracts, reviewed 779 full-text articles and included 96 articles. Similarities between the themes, categories and tabulated summaries allowed the identification of the following funnelled domains: Purpose of MSPs, Content and structure of MSPs, Strengths and limitations of MSPs, Methods to improve MSPs, and Use of E-portfolios. INSIGHTS Variability in the employ of MSPs arise as a result of a failure to recognise its different roles and uses. Here we propose additional roles of MSPs, in particular, building on a consistent set of content materials and assessments of milestones called micro-competencies. Whislt generalised micro-competencies assess achievement of general milestones expected of all medical students, personalised micro-competencies record attainment of particular skills, knowledge and attitudes balanced against the medical student's abilities, context and needs. This combination of micro-competencies in a consistent framework promises a holistic, authentic and longitudinal perspective of the medical student's development and maturing PIF.
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Affiliation(s)
- Rei Tan
- Yong Loo Lin School of Medicine, National University of Singapore,
Singapore
- Division of Supportive and Palliative Care, National Cancer Centre
Singapore, Singapore
| | - Jacquelin Jia Qi Ting
- Yong Loo Lin School of Medicine, National University of Singapore,
Singapore
- Division of Supportive and Palliative Care, National Cancer Centre
Singapore, Singapore
| | - Daniel Zhihao Hong
- Yong Loo Lin School of Medicine, National University of Singapore,
Singapore
- Division of Supportive and Palliative Care, National Cancer Centre
Singapore, Singapore
| | - Annabelle Jia Sing Lim
- Yong Loo Lin School of Medicine, National University of Singapore,
Singapore
- Division of Supportive and Palliative Care, National Cancer Centre
Singapore, Singapore
| | - Yun Ting Ong
- Yong Loo Lin School of Medicine, National University of Singapore,
Singapore
- Division of Supportive and Palliative Care, National Cancer Centre
Singapore, Singapore
| | - Anushka Pisupati
- Yong Loo Lin School of Medicine, National University of Singapore,
Singapore
- Division of Supportive and Palliative Care, National Cancer Centre
Singapore, Singapore
| | - Eleanor Jia Xin Chong
- Yong Loo Lin School of Medicine, National University of Singapore,
Singapore
- Division of Supportive and Palliative Care, National Cancer Centre
Singapore, Singapore
| | - Min Chiam
- Division of Cancer Education, National Cancer Centre Singapore,
Singapore
| | - Alexia Sze Inn Lee
- Division of Cancer Education, National Cancer Centre Singapore,
Singapore
| | - Laura Hui Shuen Tan
- Division of Supportive and Palliative Care, National Cancer Centre
Singapore, Singapore
| | | | - Limin Wijaya
- Duke-NUS Medical School, National University of Singapore,
Singapore
- Division of Infectious Disease, Singapore General Hospital,
Singapore
| | - Warren Fong
- Yong Loo Lin School of Medicine, National University of Singapore,
Singapore
- Duke-NUS Medical School, National University of Singapore,
Singapore
- Department of Rheumatology and Immunology, Singapore General
Hospital, Singapore
| | - Lalit Kumar Radha Krishna
- Yong Loo Lin School of Medicine, National University of Singapore,
Singapore
- Division of Cancer Education, National Cancer Centre Singapore,
Singapore
- Duke-NUS Medical School, National University of Singapore,
Singapore
- Centre of Biomedical Ethics, National University of Singapore,
Singapore
- PalC, The Palliative Care Centre for Excellence in Research and
Education, Singapore
- Palliative Care Institute Liverpool, Academic Palliative & End
of Life Care Centre, University of Liverpool, United Kingdom
- Cancer Research Centre, University of LiverpoolLiverpool, United
Kingdom
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Nathaniel TI, Black AC. An Adaptive Blended Learning Approach in the Implementation of a Medical Neuroscience Laboratory Activities. MEDICAL SCIENCE EDUCATOR 2021; 31:733-743. [PMID: 33850633 PMCID: PMC8032318 DOI: 10.1007/s40670-021-01263-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/01/2021] [Indexed: 05/06/2023]
Abstract
Background The COVID-19 pandemic revealed existing gaps in the medical educational system that is heavily dependent on the presence of medical students and teachers in laboratory and class for instruction. This affects continuity in the implementation of the neuroanatomy component of the medical neuroscience laboratory activities during COVID-19. We hypothesized that pivoting wet laboratory neuroanatomy activities to online using an adaptive flexible blended method might represent an effective approach in the implementation of laboratory neuroanatomy activities during a pandemic. Methods The current study describes an adaptive flexible blended learning approach that systematically mixes virtual face-to-face interaction activities with the online learning of brain structures, and the discussion of clinical cases. Learning materials are delivered through both synchronous and asynchronous modes, and Year 1 medical students learn neuroanatomy laboratory activities at different locations and different times. Student performances in the adaptive flexible blended learning approach were compared with the learning of similar activities during an in-person implementation of neuroscience laboratory activities. Results The results of using this adaptive flexible blended learning approach provided an autonomous independent learning, self-study approach that broadened student performance such that we have more students scoring between 80 and 89%, whereas the in-person learning resulted in most of the students scoring > 90% in the medical neuroscience laboratory activities. Conclusion An adaptive flexible blended learning approach that combined virtual face-to-face instruction using digital technology with online learning of neuroscience laboratory activities provided a unique educational experience for Year 1 medical students to learn neuroscience laboratory activities during the COVID-19 pandemic.
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Affiliation(s)
- Thomas I. Nathaniel
- University of South Carolina School of Medicine-Greenville, Greenville, SC 29605 USA
| | - Asa C Black
- University of South Carolina School of Medicine-Greenville, Greenville, SC 29605 USA
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Farah-Franco SM, Hasel R, Tahir A, Chui B, Ywom J, Young B, Singh M, Turchi S, Pape G, Henson B. A preclinical hybrid curriculum and its impact on dental student learning outcomes. J Dent Educ 2020; 85:679-689. [PMID: 33368285 DOI: 10.1002/jdd.12517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2020] [Revised: 11/25/2020] [Accepted: 12/05/2020] [Indexed: 11/11/2022]
Abstract
OBJECTIVES The purpose of this study is to measure how the implementation of an online, preclinical hybrid curriculum impacts dental student clinic readiness, the outcomes of grades, critical thinking skills, and student and faculty perceptions respectively. METHODS This longitudinal comparative and descriptive study used objective data and subjective (survey) data for 4 dental class cohorts. Groups A and B experienced a traditional lecture-based curriculum, while Groups C and D experienced a hybrid curriculum that was lecture-free and implemented active learning. The Health Sciences Reasoning Test (HSRT), an objective assessment, was used to measure students' critical thinking skills. RESULTS Dental student outcomes have either remained steady or improved with the transition to a new hybrid curriculum. According to the student and faculty survey results, the hybrid curriculum promoted student learning, independence, critical thinking, initiative and self-motivation, and clinic practice readiness. Group C (N = 68) Total Online Platform mean scores demonstrated a significant and moderately strong correlation with the preclinical course mean grades (r = 0.68, P = 0.00). Group D HSRT (n = 63) for Attempt 1 (end of year 1) and Attempt 2 (end of Year 2) paired T test resulted in HSRT Overall (mean difference = -2.27, SD = 7.21, t = -2.5, P = 0.02) for the second preclinical year. CONCLUSION The hybrid curricular approach afforded many benefits. Faculty took an active role in imparting knowledge when compared to the lecture hall. Having students immersed in continual assessment through an online adaptive platform and active learning promoted self-motivation, deeper learning, applied knowledge, and discouraged superficial memorization.
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Affiliation(s)
| | - Robert Hasel
- College of Dental Medicine, Associate Dean Emeritus, Western University of Health Sciences, Pomona, California, USA
| | - Analia Tahir
- Dental Sciences, College of Dental Medicine, Western University of Health Sciences, Pomona, California, USA
| | - Brian Chui
- Dental Sciences, College of Dental Medicine, Western University of Health Sciences, Pomona, California, USA
| | - James Ywom
- Dental Sciences, College of Dental Medicine, Western University of Health Sciences, Pomona, California, USA
| | - Briana Young
- Online Education, Western University of Health Sciences, Pomona, California, USA
| | - Menmeet Singh
- Dental Sciences, College of Dental Medicine, Western University of Health Sciences, Pomona, California, USA
| | - Scott Turchi
- Dental Sciences, College of Dental Medicine, Western University of Health Sciences, Pomona, California, USA
| | - Gary Pape
- Dental Sciences, College of Dental Medicine, Western University of Health Sciences, Pomona, California, USA
| | - Bradley Henson
- Research and Biomedical Sciences, College of Dental Medicine, Western University of Health Sciences, Pomona, California, USA
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McKerrow I, Carney PA, Caretta-Weyer H, Furnari M, Miller Juve A. Trends in medical students' stress, physical, and emotional health throughout training. MEDICAL EDUCATION ONLINE 2020; 25:1709278. [PMID: 31902315 PMCID: PMC6968533 DOI: 10.1080/10872981.2019.1709278] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Background: Medical student wellness, including physical health, emotional health, and levels of perceived stress, appears to decline during training, with students reporting high levels of depression, anxiety, and burnout as early as the first year of medical school. The impact of curricular changes on health and stress remains unclear, and a modified curriculum that compresses training of the foundational sciences and its effect on wellness has not been studied. Oregon Health & Science University School of Medicine has recently instituted a unique competency-based model, which provides an important opportunity to assess the effects of curricular change on student wellness.Objective: Assess the effects of curricular change on student wellness.Design: Medical students at a single institution were administered the SF-8, an 8-item health-related quality of life survey, as well as the Perceived Stress Scale, a 10-item scale that measures the degree to which life situations are appraised as stressful, at baseline (matriculation) and at the end of Year 1, 2 and 3. Individual variables were assessed over time, as well as a trend analysis of summary domain scores over the 4 time periods.Results: Physical, emotional, and overall health were highest at baseline and lowest at the end of Year 1, after which they improved but never again reached baseline levels. Physical health declined less than emotional health. Perceived stress levels did not change over time but remained moderately high. There were no differences in health or perceived stress based on demographic variables.Conclusions: In a competency-based curriculum, physical, emotional and overall health significantly worsened during Year 1 but improved thereafter, while perceived stress remained unchanged. Early in training, stress and poor overall health may be related to concerns about self-efficacy and workload. Although advanced students show improved wellness, concerns remained about emotional difficulties, such as anxiety and irritability, and feeling a lack of control.
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Affiliation(s)
- Isla McKerrow
- Oregon Health & Science University, Portland, OR, USA
| | - Patricia A. Carney
- Department of Family Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Holly Caretta-Weyer
- Department of Emergency Medicine, Stanford University School of Medicine, Palo Alto, CA, USA
| | - Megan Furnari
- Department of Pediatrics, Oregon Health & Science University, Portland, OR, USA
| | - Amy Miller Juve
- Department of Anesthesiology & Perioperative Medicine, Oregon Health & Science University, Portland, OR, USA
- CONTACT Amy Miller Juve Oregon Health & Science University, Portland, OR, USA
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de Leeuw R, Scheele F, Walsh K, Westerman M. A 9-Step Theory- and Evidence-Based Postgraduate Medical Digital Education Development Model: Empirical Development and Validation. JMIR MEDICAL EDUCATION 2019; 5:e13004. [PMID: 31333194 PMCID: PMC6876560 DOI: 10.2196/13004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 04/03/2019] [Accepted: 04/23/2019] [Indexed: 05/03/2023]
Abstract
BACKGROUND Digital education tools (e-learning, technology-enhanced learning) can be defined as any educational intervention that is electronically mediated. Decveloping and applying such tools and interventions for postgraduate medical professionals who work and learn after graduation can be called postgraduate medical digital education (PGMDE), which is increasingly being used and evaluated. However, evaluation has focused mainly on reaching the learning goals and little on the design. Design models for digital education (instructional design models) help educators create a digital education curriculum, but none have been aimed at PGMDE. Studies show the need for efficient, motivating, useful, and satisfactory digital education. OBJECTIVE Our objective was (1) to create an empirical instructional design model for PGMDE founded in evidence and theory, with postgraduate medical professionals who work and learn after graduation as the target audience, and (2) to compare our model with existing models used to evaluate and create PGMDE. METHODS Previously we performed an integrative literature review, focus group discussions, and a Delphi procedure to determine which building blocks for such a model would be relevant according to experts and users. This resulted in 37 relevant items. We then used those 37 items and arranged them into chronological steps. After we created the initial 9-step plan, we compared these steps with other models reported in the literature. RESULTS The final 9 steps were (1) describe who, why, what, (2) select educational strategies, (3) translate to the real world, (4) choose the technology, (5) complete the team, (6) plan the budget, (7) plan the timing and timeline, (8) implement the project, and (9) evaluate continuously. On comparing this 9-step model with other models, we found that no other was as complete, nor were any of the other models aimed at PGMDE. CONCLUSIONS Our 9-step model is the first, to our knowledge, to be based on evidence and theory building blocks aimed at PGMDE. We have described a complete set of evidence-based steps, expanding a 3-domain model (motivate, learn, and apply) to an instructional design model that can help every educator in creating efficient, motivating, useful, and satisfactory PGMDE. Although certain steps are more robust and have a deeper theoretical background in current research (such as education), others (such as budget) have been barely touched upon and should be investigated more thoroughly in order that proper guidelines may also be provided for them.
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Affiliation(s)
- Robert de Leeuw
- Athena Institute for Trans-Disciplinary Research, VU University Amsterdam, Amsterdam, Netherlands
| | - Fedde Scheele
- Athena Institute for Trans-Disciplinary Research, VU University Amsterdam, Amsterdam, Netherlands
| | - Kieran Walsh
- British Medical Journal Learning, British Medical Association House, London, United Kingdom
| | - Michiel Westerman
- Department of Internal Medicine, Franciscus Gasthuis & Vlietland Hospital, Rotterdam, Netherlands
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Radabaugh CL, Hawkins RE, Welcher CM, Mejicano GC, Aparicio A, Kirk LM, Skochelak SE. Beyond the United States Medical Licensing Examination Score: Assessing Competence for Entering Residency. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2019; 94:983-989. [PMID: 30920448 DOI: 10.1097/acm.0000000000002728] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
Assessments of physician learners during the transition from undergraduate to graduate medical education generate information that may inform their learning and improvement needs, determine readiness to move along the medical education continuum, and predict success in their residency programs. To achieve a constructive transition for the learner, residency program, and patients, high-quality assessments should provide meaningful information regarding applicant characteristics, academic achievement, and competence that lead to a suitable match between the learner and the residency program's culture and focus.The authors discuss alternative assessment models that may correlate with resident physician clinical performance and patient care outcomes. Currently, passing the United States Medical Licensing Examination Step examinations provides one element of reliable assessment data that could inform judgments about a learner's likelihood for success in residency. Yet, learner capabilities in areas beyond those traditionally valued in future physicians, such as life experiences, community engagement, language skills, and leadership attributes, are not afforded the same level of influence when candidate selections are made.While promising new methods of screening and assessment-such as objective structured clinical examinations, holistic assessments, and competency-based assessments-have attracted increased attention in the medical education community, currently they may be expensive, be less psychometrically sound, lack a national comparison group, or be complicated to administer. Future research and experimentation are needed to establish measures that can best meet the needs of programs, faculty, staff, students, and, more importantly, patients.
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Affiliation(s)
- Carrie L Radabaugh
- C.L. Radabaugh is vice president, governance and board relations, American Board of Medical Specialties, Chicago, Illinois. R.E. Hawkins is president and chief executive officer, American Board of Medical Specialties, Chicago, Illinois. C.M. Welcher is senior policy analyst, Medical Education Programs, American Medical Association, Chicago, Illinois. G.C. Mejicano is professor and senior associate dean for education, School of Medicine, Oregon Health & Science University, Portland, Oregon. A. Aparicio is director, Medical Education Programs, American Medical Association, Chicago, Illinois. L.M. Kirk is professor, Internal Medicine/Family & Community Medicine, Southwestern Medical School, University of Texas Southwestern Medical Center, Dallas, Texas. S.E. Skochelak is chief academic officer and medical education group vice president, American Medical Association, Chicago, Illinois
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Coker I, Morgan R. Perspectives of UK medical students on the introduction of the adaptive curriculum in the USA. MEDICAL TEACHER 2019; 41:847. [PMID: 30457406 DOI: 10.1080/0142159x.2018.1530743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- India Coker
- a School of Medicine , Cardiff University , Cardiff , UK
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Quirk M, Chumley H. The adaptive medical curriculum: A model for continuous improvement. MEDICAL TEACHER 2018; 40:786-790. [PMID: 30033792 DOI: 10.1080/0142159x.2018.1484896] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
This paper describes the medical curriculum designed to foster adaptive expertise. Engaging in the formal and informal curriculum, students learn to achieve desired outcomes in novel situations, perform comfortably with uncertainty, and are often recognized for creative problem-solving. Students learn by asking and answering their own and others' questions. They readily operate at the metacognitive level, anticipating events, self-monitoring, and checking decisions and emotions. A key function of the reflective process is to identify gaps or shortcomings in the thinking process. The adaptive learner shifts into reflective thinking when confronted with complex contextual and situational demands. We are only beginning to understand how to create educational pathways to foster adaptive learning. An essential focus is the adaptive teacher who frames learning and assessment around predictive analytics, reflective spaced practice, and authentic learning material. To be effective, the teacher must engage the learner outside the formal classroom in the parallel curriculum. A major premise is that learning occurs individually and together with peers, teachers, and team members in multiple contexts. During the learning process, the learner readily operates at the metacognitive level, anticipating behavior, self-monitoring and assessing, and checking theirs and others decisions and emotions. The adaptive medical curriculum provides the pathway for such learning.
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Affiliation(s)
- Mark Quirk
- a American University of the Caribbean, School of Medicine , Sint Maarten
| | - Heidi Chumley
- a American University of the Caribbean, School of Medicine , Sint Maarten
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