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O’Brien BC, Collins S, Haddock LM, Sani S, Rivera JA. More Than Maintaining Competence: A Qualitative Study of How Physicians Conceptualize and Engage in Lifelong Learning. PERSPECTIVES ON MEDICAL EDUCATION 2024; 13:380-391. [PMID: 38974779 PMCID: PMC11225866 DOI: 10.5334/pme.1327] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2024] [Accepted: 06/19/2024] [Indexed: 07/09/2024]
Abstract
Purpose Physicians have a professional responsibility to engage in lifelong learning. Some of this lifelong learning is required to maintain licensure and certification. Yet, this conceptualization captures only a small portion of the content areas and learning processes that physicians need to engage with to ensure quality patient care. Additionally, purposes beyond regulatory requirements and professional obligations likely drive physicians lifelong learning, though these purposes have not been explored. Given the centrality of lifelong learning to quality patient care, our study explores how physicians conceptualize and engage in lifelong learning. Method We conducted a qualitative interview study using an interpretivist approach. In 2019, we recruited 34 academic physicians from one institution. We analyzed our data to identify themes related to conceptualization of purposes, content areas, and processes of lifelong learning and actual lifelong learning practices. Results We interpreted participants' descriptions and examples of lifelong learning as serving three purposes: maintaining competence, supporting personal growth and fulfillment, and engaging in professional stewardship. Much of participants' discussion of lifelong learning centered around keeping up to date with medical knowledge and clinical/procedural skills, though some also mentioned efforts to improve communication, leadership, and teamwork. Participants engaged in lifelong learning through contextual, social, and individual processes. Discussion Academic physicians engage in lifelong learning for reasons beyond maintaining competence. Medical knowledge and clinical/procedural skills receive most attention, though other areas are recognized as important. Our findings highlight opportunities for a broader, more comprehensive approach to lifelong learning that spans all areas of medical practice.
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Affiliation(s)
- Bridget C. O’Brien
- Professor in the Department of Medicine and an education scientist, Center for Faculty Educators, University of California, San Francisco, San Francisco, California, US
| | - Sally Collins
- Research associate with the Center for Faculty Educators, University of California, San Francisco, California, US
| | - Lindsey M. Haddock
- Clinical assistant professor in the Section of Geriatrics, Division of Primary Care and Population Health, Department of Medicine at Stanford University School of Medicine, Stanford, California, US
| | - Sara Sani
- Assistant clinical professor in the Divisions of Hospital and Emergency Medicine, Department of Medicine, San Francisco Veterans Affairs, San Francisco, California, US
| | - Josette A. Rivera
- Professor in the Division of Geriatrics, Department of Medicine, University of California, San Francisco, California, US
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Ruczynski LI, Schouwenberg BJ, Custers E, Fluit CR, van de Pol MH. The influence of a digital clinical reasoning test on medical student learning behavior during clinical clerkships. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2024; 29:935-947. [PMID: 37851160 PMCID: PMC11208212 DOI: 10.1007/s10459-023-10288-x] [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: 04/25/2023] [Accepted: 09/24/2023] [Indexed: 10/19/2023]
Abstract
Recently, a new digital clinical reasoning test (DCRT) was developed to evaluate students' clinical-reasoning skills. Although an assessment tool may be soundly constructed, it may still prove inadequate in practice by failing to function as intended. Therefore, more insight is needed into the effects of the DCRT in practice. Individual semi-structured interviews and template analysis were used to collect and process qualitative data. The template, based on the interview guide, contained six themes: (1) DCRT itself, (2) test debriefing, (3) reflection, (4) practice/workplace, (5) DCRT versus practice and (6) 'other'. Thirteen students were interviewed. The DCRT encourages students to engage more in formal education, self-study and workplace learning during their clerkships, particularly for those who received insufficient results. Although the faculty emphasizes the different purposes of the DCRT (assessment of/as/for learning), most students perceive the DCRT as an assessment of learning. This affects their motivation and the role they assign to it in their learning process. Although students appreciate the debriefing and reflection report for improvement, they struggle to fill the identified knowledge gaps due to the timing of receiving their results. Some students are supported by the DCRT in exhibiting lifelong learning behavior. This study has identified several ways in which the DCRT influences students' learning practices in a way that can benefit their clinical-reasoning skills. Additionally, it stresses the importance of ensuring the alignment of theoretical principles with real-world practice, both in the development and utilization of assessment tools and their content. Further research is needed to investigate the long-term impact of the DCRT on young physicians' working practice.
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Affiliation(s)
- Larissa Ia Ruczynski
- Research on Learning and Education, Radboudumc Health Academy, Radboud University Medical Center, Gerard van Swietenlaan 2 (route 51), 6525 GB, Nijmegen, Netherlands.
| | - Bas Jjw Schouwenberg
- Department of Pharmacology and Toxicology, Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands
- Department of Internal Medicine, Radboud University Medical Center Nijmegen, Nijmegen, the Netherlands
| | - Eugène Custers
- Department of Online Learning and Instruction, Faculty of Educational Sciences, Open Universiteit, Heerlen, Netherlands
| | - Cornelia Rmg Fluit
- Research on Learning and Education, Radboudumc Health Academy, Radboud University Medical Center, Nijmegen, Netherlands
| | - Marjolein Hj van de Pol
- Department of Primary and Community care, Radboud University Medical Center Nijmegen, Nijmegen, Netherlands
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Zhao CX, Wang ZJ, Yang XJ, Ma X, Cui Y, Zhang YX, Cheng XH, Zhang SE, Guo QF, Cao DP. Promotion of self-directed learning abilities among Chinese medical students through preparing for career calling and enhancing teaching competencies in medical education: a cross-sectional study. BMC MEDICAL EDUCATION 2024; 24:386. [PMID: 38589890 PMCID: PMC11003071 DOI: 10.1186/s12909-024-05330-4] [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: 02/01/2024] [Accepted: 03/20/2024] [Indexed: 04/10/2024]
Abstract
BACKGROUND Medical students face a heavy burden as they are tasked with acquiring a vast amount of medical knowledge within a limited time frame. Self-directed learning (SDL) has become crucial for efficient and ongoing learning among medical students. However, effective ways to foster SDL ability among Chinese medical students are lacking, and limited studies have identified factors that impact the SDL ability of medical students. This makes it challenging for educators to develop targeted strategies to improve students' SDL ability. This study aims to assess SDL ability among Chinese medical students and examine the effects of career calling and teaching competencies on SDL ability, as well as the possible mechanisms linking them. METHODS Data were collected from 3614 respondents (effective response rate = 60.11%) using cross-sectional online questionnaires and analyzed using IBM SPSS Statistics 22.0. The questionnaire comprised a Demographic Characteristics Questionnaire, Self-directed Learning Ability Scale (Cronbach's alpha = 0.962), Teaching Competencies Scale, and Career Calling Scale. RESULTS The average SDL ability score of Chinese medical students was 3.68 ± 0.56, indicating a moderate level of SDL ability. The six factors of the Self-directed Learning Ability Scale-self-reflection, ability to use learning methods, ability to set study plans, ability to set studying objectives, ability to adjust psychological state, and willpower in studying-accounted for 12.90%, 12.89%, 12.39%, 11.94%, 11.34%, and 8.67% of the variance, respectively. Furthermore, career calling was positively associated with SDL learning ability (β = 0.295, p < 0.001), and SDL learning ability was positively associated with teaching competencies (β = 0.191, p < 0.01). Simple slope analysis showed that when the level of teaching competencies was higher, the influence of career calling on SDL ability was stronger. CONCLUSIONS Chinese medical students' SDL ability has room for improvement. Medical students could strengthen their willpower in studying by setting milestones goals with rewards, which could inspire their motivation for the next goals. Teachers should guide students to learn experience to improve students' reflective ability. Educators play a crucial role in bridging the gap between career calling education and SDL ability enhancement, highlighting the significance of optimal teaching competencies. Colleges should focus on strengthening teachers' sense of career calling and teaching competencies.
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Affiliation(s)
- Chen-Xi Zhao
- Academic Affairs Office, First Affiliated Hospital of Harbin Medical University, 150001, Harbin, China
| | - Zi-Jiao Wang
- Department of Health Management, School of Health Management, Harbin Medical University, 150081, Harbin, China
| | - Xiao-Jing Yang
- Department of Health Management, School of Health Management, Harbin Medical University, 150081, Harbin, China
| | - Xing Ma
- Center for the Evaluation of Higher Education Teaching and Learning of Harbin Medical University, 150081, Harbin, China
| | - Ying Cui
- Academic Affairs Office, First Affiliated Hospital of Harbin Medical University, 150001, Harbin, China
| | - Yan-Xin Zhang
- Academic Affairs Office, First Affiliated Hospital of Harbin Medical University, 150001, Harbin, China
| | - Xin-Hui Cheng
- Academic Affairs Office, First Affiliated Hospital of Harbin Medical University, 150001, Harbin, China
| | - Shu-E Zhang
- Department of Health Management, School of Health Management, Harbin Medical University, 150081, Harbin, China.
| | - Qing-Feng Guo
- Academic Affairs Office, First Affiliated Hospital of Harbin Medical University, 150001, Harbin, China.
| | - De-Pin Cao
- Department of Health Management, School of Health Management, Harbin Medical University, 150081, Harbin, China.
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Salajegheh M, Rooholamini A, Norouzi A. Investigating the role of clinical exposure on motivational self-regulation skills in medical students based on cognitive apprenticeship model. BMC MEDICAL EDUCATION 2024; 24:257. [PMID: 38459546 PMCID: PMC10921607 DOI: 10.1186/s12909-024-05253-0] [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: 10/28/2023] [Accepted: 03/03/2024] [Indexed: 03/10/2024]
Abstract
BACKGROUND The importance of motivation regulation in medical students is highly significant due to their unique educational circumstances, such as clinical exposure. However, the role of clinical exposure in learning motivational self-regulation skills in students has not been explored thus far. This current study aims to investigate the role of clinical exposure on motivational self-regulation skills in medical students based on cognitive apprenticeship model. METHOD This study was descriptive-analytical research conducted in 2022 on medical students. Data collection involved two questionnaires including Meta motivational Strategies in Medical Students Questionnaire and Maastricht Clinical Teaching Questionnaire. The research comprised two stages including measuring motivational self-regulation strategies in students before entering the clinical exposure phase, and simultaneous measurement of clinical exposure based on the student's viewpoint and their motivational self-regulation strategies at the end of the first term of clinical exposure. RESULTS The results revealed a significant relationship between six dimensions of the cognitive apprenticeship model, including modeling, coaching, scaffolding, reflection, exploration, and learning environment, with motivational self-regulation strategies. However, there was no significant relationship between the articulation dimension of the cognitive apprenticeship model and motivational self-regulation strategies. CONCLUSION Clinical exposure indirectly enhances students' metacognitive skills. Observing the behavior of clinical faculty in the clinical exposure setting leads to the improvement of motivational self-regulation strategies in medical students.
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Affiliation(s)
- Mahla Salajegheh
- Department of Medical Education, Medical Education Development Center, Kerman University of Medical Sciences, Kerman, Iran
| | - Azadeh Rooholamini
- Department of Medical Education, Medical Education Development Center, Kerman University of Medical Sciences, Kerman, Iran.
| | - Ali Norouzi
- Education Development Center, School of Medicine, Zanjan University of Medical Sciences, Zanjan, Iran
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Surapaneni KM. Innovative Self-directed, Problem-oriented, Lifelong learning, Integrated Clinical case Exercise (SPLICE) modules promote critical thinking skills, early clinical exposure, and contextual learning among first professional-year medical students. ADVANCES IN PHYSIOLOGY EDUCATION 2024; 48:69-79. [PMID: 38031725 DOI: 10.1152/advan.00211.2023] [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: 09/29/2023] [Revised: 10/31/2023] [Accepted: 11/27/2023] [Indexed: 12/01/2023]
Abstract
Medical education is undergoing various transformations to promote a more personalized and contextual way of learning. In light of this, the innovative "Self-directed, Problem-oriented, Lifelong learning, Integrated Clinical case Exercise" (SPLICE) modules were designed, implemented, and evaluated for medical students in the first professional year as a strategy for early clinical exposure in a collaborative and self-directed way of learning. This is a mixed methods study involving first-year medical students. Students were divided randomly into the control and the intervention groups. Six SPLICE modules were administered to the intervention while the control group followed the traditional curricula. The educational outcome was compared using an end-of-module assessment. In addition, 13-item and 8-item questionnaires were administered to students to evaluate the SPLICE and plenary sessions on a 5-point Likert scale. Furthermore, students' feedback was obtained on a 10-point rating scale and in in-depth small-group interviews. The majority of students perceived that the SPLICE module improved their communication and encouraged meaningful, active learning. Students found the plenary sessions to be well organized, with sufficient interaction with professionals. Students also gave excellent scores for feedback on SPLICE modules, demonstrating the effectiveness of the innovation. In terms of test scores used in assessing learning outcomes, the intervention group outperformed the control group (P < 0.0001). The innovative SPLICE curriculum facilitated early clinical exposure and active self-directed learning. Students perceived SPLICE modules to be highly helpful in terms of promoting meaningful learning and the future application of knowledge.NEW & NOTEWORTHY The very essence of this innovative "Self-directed, Problem-oriented, Lifelong learning, Integrated Clinical case Exercise" (SPLICE) curriculum is the team-based learning of integrated pre-, para-, and clinical learning objectives right from the first professional year of study serving as an early clinical exposure. This unique way of learning creates a holistic educational environment by combining both academic and professional development thereby empowering the next generation of physician leaders to take autonomy of their own learning strategies and emerge as competent lifelong learners.
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Affiliation(s)
- Krishna Mohan Surapaneni
- Department of Biochemistry, Panimalar Medical College Hospital & Research Institute, Varadharajapuram, Poonamallee, Chennai, Tamil Nadu, India
- Department of Medical Education, Panimalar Medical College Hospital & Research Institute, Varadharajapuram, Poonamallee, Chennai, Tamil Nadu, India
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Thompson B, Brag K. Twelve tips for integrating medical students into specialty clinics. MEDICAL TEACHER 2024; 46:337-340. [PMID: 37917992 DOI: 10.1080/0142159x.2023.2274620] [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: 11/04/2023]
Abstract
The specialty clinic is an excellent educational environment for medical students. However, preceptors face several challenges as they seek to balance treating complex system-specific conditions with effective teaching, including time constraints, clinical tasks, engaging multi-level learners, and perhaps a lack of guidelines for or training in outpatient medical education. We thus propose twelve tips for integrating medical students into specialty clinics in a feasible and mutually fulfilling way. The first three tips focus on planning the session and setting expectations, the next seven tips detail specific, actionable strategies for enhancing learning while maximizing efficiency, and the final two tips discuss how to optimally close the session with feedback and debriefing.
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Affiliation(s)
| | - Katherine Brag
- Harvard Medical School, Boston, MA, USA
- Department of Dermatology, Beth Israel Deaconess Medical Center, Boston, MA, USA
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Heidemann LA, Rustici M, Buckvar-Keltz L, Anderson A, Plant J, Morgan HK, Goforth J, Atkins KM. Transition to Residency Courses: Recommendations for Creation and Implementation. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2024; 11:23821205231225009. [PMID: 38304278 PMCID: PMC10832425 DOI: 10.1177/23821205231225009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2023] [Accepted: 12/19/2023] [Indexed: 02/03/2024]
Abstract
Transition to Residency (TTR) courses help ease the critical transition from medical school to residency, yet there is little guidance for developing and running these courses. In this perspective, the authors use their expertise as well as a review of the literature to provide guidance and review possible solutions to challenges unique to these courses. TTR courses should be specialty-specific, allow for flexibility, and utilize active learning techniques. A needs assessment can help guide course content, which should focus on what is necessary to be ready for day one of residency. The use of residents in course planning and delivery can help create a sense of community and ensure that content is practical. While course assessments are largely formative, instructors should anticipate the need for remediation, especially for skills likely to be performed with limited supervision during residency. Additionally, TTR courses should incorporate learner self-assessment and goal setting; this may be valuable information to share with learners' future residency programs. Lastly, TTR courses should undergo continuous quality improvement based on course evaluations and surveys. These recommendations are essential for effective TTR course implementation and improvement.
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Affiliation(s)
| | | | | | - Andrea Anderson
- George Washington School of Medicine and Health Sciences, Washington, DC, USA
| | | | | | - Jon Goforth
- Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Katharyn M. Atkins
- Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
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Green XA, Flores Tindall KJ, Flores Tindall AL, Anderson H, Hou MY. Assisted Reproduction for a Same-Sex Couple: Interdisciplinary Preclinical Active Learning Module Combining Case-Based Small Group Discussion and Patient Panel. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2024; 11:23821205241257325. [PMID: 38799176 PMCID: PMC11119406 DOI: 10.1177/23821205241257325] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 05/09/2024] [Indexed: 05/29/2024]
Abstract
OBJECTIVE Physicians often feel they are not equipped to serve the lesbian, gay, bisexual, and queer (LGBTQ) community, but integrating education that incorporates LGBTQ content and perspective into an already-condensed medical school curriculum is challenging. We developed a preclinical active learning module on assisted reproductive technologies (ART) in LGBTQ care, integrating clinical and basic science content with patient perspective. METHODS We created a module that combined a case-based small group discussion with a patient panel. We developed a case for discussion in collaboration with a female cis-gender same-sex couple who conceived through ART. A patient panel with the same couple followed the discussion. All first-year medical students attended both parts of the module. Prior to participation, students learned reproductive endocrinology and genetics concepts through lectures. After the module, students voluntarily completed an anonymous survey to evaluate self-perceived changes in familiarity and confidence with LGBTQ patients and satisfaction with the module. RESULTS Of the 126 students who attended, 72 (57%) completed the survey. Of these, 69 (95.8%) felt the module gave them better perspectives on LGBTQ patient experiences, and 66 to 69 (92-96%) agreed the small group discussion achieved its learning objectives on LGBTQ health barriers and the application of ART. Students valued the patient panel (84.7%) and cited a better understanding of reproductive barriers for LGBTQ patients as its most valuable point. CONCLUSION A preclerkship module combining a case-based small group discussion and patient panel on ART delivered in the context of a real-life LGBTQ patient experience provided an opportunity for the students to integrate basic science and clinical science knowledge to reflect on the healthcare needs of this patient population. Creating the case in collaboration with the same-sex couple and having them present their own experience provided an authentic perspective to students on reproductive healthcare issues and how they impact members of the LGBTQ community.
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Affiliation(s)
- Xochitl A. Green
- University of California, Davis School of Medicine, Sacramento, CA, USA
| | - Kayla J. Flores Tindall
- Department of Adult and Family Medicine, Kaiser Permanente Santa Rosa, Santa Rosa, CA, USA
- North Bay LGBTQI Families, Santa Rosa, CA, USA
| | | | - Hana Anderson
- Department of Internal Medicine, Department of Cell Biology and Human Anatomy, University of California, Davis, Sacramento, CA, USA
| | - Melody Y. Hou
- Department of Obstetrics and Gynecology, University of California, Davis, Sacramento, CA, USA
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Taylor TA, Kemp K, Mi M, Lerchenfeldt S. Self-directed learning assessment practices in undergraduate health professions education: a systematic review. MEDICAL EDUCATION ONLINE 2023; 28:2189553. [PMID: 36919556 PMCID: PMC10026772 DOI: 10.1080/10872981.2023.2189553] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/17/2022] [Revised: 03/06/2023] [Accepted: 03/07/2023] [Indexed: 06/18/2023]
Abstract
PURPOSE The goal of this systematic review was to examine self-directed learning (SDL) assessment practices in undergraduate health professions education. METHODS Seven electronic databases were searched (PubMed, Embase, PsycINFO, ERIC, CINAHL, Scopus, and Web of Science) to retrieve English-language articles published between 2015 and July of 2022, investigating assessment of SDL learning outcomes. Extracted data included the sample size, field of study, study design, SDL activity type, SDL assessment method, number of SDL assessments used, study quality, number of SDL components present utilising the framework the authors developed, and SDL activity outcomes. We also assessed relationships between SDL assessment method and number of SDL components, study quality, field of study, and study outcomes. RESULTS Of the 141 studies included, the majority of study participants were medical (51.8%) or nursing (34.8%) students. The most common SDL assessment method used was internally-developed perception surveys (49.6%). When evaluating outcomes for SDL activities, most studies reported a positive or mixed/neutral outcome (58.2% and 34.8%, respectively). There was a statistically significant relationship between both number and type of assessments used, and study quality, with knowledge assessments (median-IQR 11.5) being associated with higher study quality (p < 0.001). Less than half (48.9%) of the studies used more than one assessment method to evaluate the effectiveness of SDL activities. Having more than one assessment (mean 9.49) was associated with higher quality study (p < 0.001). CONCLUSIONS The results of our systematic review suggest that SDL assessment practices within undergraduate health professions education vary greatly, as different aspects of SDL were leveraged and implemented by diverse groups of learners to meet different learning needs and professional accreditation requirements. Evidence-based best practices for the assessment of SDL across undergraduate healthcare professions education should include the use of multiple assessments, with direct and indirect measures, to more accurately assess student performance.
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Affiliation(s)
- Tracey A.H. Taylor
- Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Kyeorda Kemp
- Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Misa Mi
- Medical Library, Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Sarah Lerchenfeldt
- Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI, USA
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Ohta R, Nishikura N, Sano C. What Do Medical Students Learn about Community Care from Discussions with General Physicians? A Thematic Analysis. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1855. [PMID: 37893573 PMCID: PMC10607926 DOI: 10.3390/medicina59101855] [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: 08/27/2023] [Revised: 10/14/2023] [Accepted: 10/17/2023] [Indexed: 10/29/2023]
Abstract
Background and Objectives: Sustainable healthcare is fundamentally rooted in community medicine education. The COVID-19 pandemic disrupted global advancement in integrating traditional teaching and experiential learning. Additionally, an alarming decline in interest in community care has been observed among senior medical students. Here, we examined the perspectives on community care obtained from conversations with general physicians in rural medical universities. Materials and Methods: Using a constructivist lens, a qualitative methodology was employed to examine the perceptions of second-year medical students from Shimane University Medical School regarding community care, informed by dialogues with general physicians. We conducted a thematic analysis at Shimane University, Japan, an area known for its aging population. In 2023, 116 second-year students participated, none of whom had prior formal training in community care. The study was structured into three phases: (1) Pre-education: Students wrote essays about their initial understanding of community care, its advantages, disadvantages, and potential improvements; (2) Dialogue: Grouped by topic, students engaged in discussions that culminated in a comprehensive session with general physicians; and (3) Reflection: After discussions, students wrote essays reflecting any shift in their views on community care. A thematic analysis of essays from the pre-education and reflection phases provided a comparative perspective on the students' understanding. Results: Five dominant themes emerged from the thematic analysis: (1) Re-evaluating community care: Recognizing diversity and addressing societal challenges; (2) Interdisciplinary collaboration: Promoting shared roles and teamwork; (3) Learning and practice: Emphasizing hands-on experience and self-reflection; (4) Technological influence: The mutual relationship between community care and technological advancements; and (5) Challenges and resolutions: Identifying problems and crafting solutions. Conclusions: This study sheds light on the evolution of medical students' views on community care and underscores the importance of continuous adaptation in medical education programs.
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Affiliation(s)
- Ryuichi Ohta
- Community Care, Unnan City Hospital, 96-1 Iida, Daito-cho, Unnan 699-1221, Japan;
| | - Nozomi Nishikura
- Community Care, Unnan City Hospital, 96-1 Iida, Daito-cho, Unnan 699-1221, Japan;
| | - Chiaki Sano
- Department of Community Medicine Management, Faculty of Medicine, Shimane University, 89-1 Enya cho, Izumo 693-8501, Japan;
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Jaqua B, Robinson S, Belfer J, Xi AS. The Trainee Perspective on Getting Started With Scholarship in Graduate Medical Education. J Grad Med Educ 2023; 15:512-515. [PMID: 37637331 PMCID: PMC10449334 DOI: 10.4300/jgme-d-23-00428.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/29/2023] Open
Affiliation(s)
- Breanne Jaqua
- Breanne Jaqua, DO, MPH, is an Emergency Medicine Physician and Assistant Professor, Clinical Education Department, A.T. Still University, School of Osteopathic Medicine, and Chair, Council of Review Committee Residents (CRCR), Accreditation Council for Graduate Medical Education (ACGME)
| | - Shanice Robinson
- Shanice Robinson, MD, is a Resident Physician in Obstetrics and Gynecology, University of Missouri-Kansas City, Resident Representative, OB/GYN Review Committee, and Vice Chair, CRCR, ACGME
| | - Joshua Belfer
- Joshua Belfer, MD, is a Pediatric Emergency Medicine Fellow, Department of Emergency Medicine, NewYork-Presbyterian Morgan Stanley Children’s Hospital/Columbia University Irving Medical Center, and Member, Back to Bedside Work and Advisory Group, ACGME; and
| | - Amanda S. Xi
- Amanda S. Xi, MD, MSE, is a Critical Care Anesthesiologist, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, and Vice Chair, Back to Bedside Working and Advisory Group, ACGME
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12
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Qian J, Li X, Liu T, Zhang M, Li K. Direct and indirect effects of self-directed learning on creativity in healthcare undergraduates: a chain mediation model of openness to challenge and diversity and creative self-efficacy. Front Psychol 2023; 14:1182692. [PMID: 37377704 PMCID: PMC10291263 DOI: 10.3389/fpsyg.2023.1182692] [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] [Received: 03/09/2023] [Accepted: 05/24/2023] [Indexed: 06/29/2023] Open
Abstract
Background Creativity and self-directed learning (SDL) are prominent for undergraduate healthcare students to provide quality patient care in an increasingly complex healthcare environment. Research suggested that SDL is linked with creativity, yet the mechanism underlying the relationship between SDL and creativity has not been fully understood. Objective This study examined the relationship between SDL and creativity and constructed a chain mediation model to identify the mediating effect of openness to diversity and challenge (ODC) and creative self-efficacy (CSE). Methods Through convenience sampling, 575 healthcare undergraduates (average age = 19.28 years, SD = 1.124 years) were surveyed from Shandong Province in China. Creativity, SDL, ODC, and CSE were assessed using corresponding scales. Pearson's correlation analysis, hierarchical multiple linear regression analysis, a serial multiple mediation analysis, and bias-corrected percentile Bootstrap method were conducted by using structural equation modeling by AMOS 26.0. Results The direct path between SDL and creativity was significant. SDL can positively predict both ODC and CSE, and the latter two variables can significantly and positively predict creativity. ODC and CSE played a significant partial mediating role in the relationship between SDL and creativity. The mediating effect consists of three indirect effects: SDL → ODC → creativity (the mediating effect value is 0.193, p = 0.012), SDL → CSE → creativity (the mediating effect value is 0.096,p = 0.001), and SDL → ODC → CSE → creativity (the mediating effect value is 0.035, p = 0.031). Conclusion SDL can positively predict creativity. ODC and CSE had significant mediating effects between SDL and creativity, including single partial mediating effects of ODC and CSE and chain mediating effects of ODC-CSE.
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Krimmel-Morrison JD, Dhaliwal G. How to Keep Training-After Residency Training. J Gen Intern Med 2022; 37:1524-1528. [PMID: 35226236 PMCID: PMC9086009 DOI: 10.1007/s11606-021-07240-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 10/20/2021] [Indexed: 11/30/2022]
Abstract
Lifelong learning in medicine is an important skill and ethical obligation, but many residents do not feel prepared to be effective self-directed learners when training ends. The learning sciences offer evidence to guide self-directed learning, but these insights have not been integrated into a practical and actionable plan for residents to improve their clinical knowledge and reasoning. We encourage residents to establish a self-directed learning plan, just as an athlete employs a training plan in the pursuit of excellence. We highlight four evidence-based learning principles (spaced practice, mixed practice, retrieval practice, and feedback) and four training strategies comprising a weekly training plan: case tracking, simulated cases, quizzing, and new evidence integration. We provide tips for residents to implement and refine their approach and discuss how residency programs can foster these routines and habits. By optimizing their scarce self-directed learning time with a training plan, residents may enhance patient care and their career satisfaction through their pursuit of clinical mastery.
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Affiliation(s)
- Jeffrey D Krimmel-Morrison
- Division of General Internal Medicine, Department of Medicine, University of Washington, Seattle, WA, 98195-6420, USA.
| | - Gurpreet Dhaliwal
- Department of Medicine, University of California, San Francisco and Medical Service, San Francisco VA Medical Center, San Francisco, CA, USA
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Kemp K, Baxa D, Cortes C. Exploration of a Collaborative Self-Directed Learning Model in Medical Education. MEDICAL SCIENCE EDUCATOR 2022; 32:195-207. [PMID: 35003877 PMCID: PMC8725963 DOI: 10.1007/s40670-021-01493-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 12/08/2021] [Indexed: 05/31/2023]
Abstract
PURPOSE One of the aims of medical education is to generate lifelong learners, leading to the identification of self-directed learning (SDL) as an essential component of medical education. While SDL is focused on an individual learner, collaboration is critically important in medicine. We developed an online course using the collaborative SDL (CSDL) framework. A goal for the course was for students to gain a better appreciation for the SDL process by exploring the COVID-19 pandemic. METHODS We utilized CSDL to implement a 2-week elective attended by fifteen M3 and M4 medical students. Students submitted short videos reflecting on their course experience and the relevance of the material to their future training. Qualitative analysis of reflections was conducted to determine the effectiveness of the CSDL framework, and an assessment of the course evaluations was performed to explore student perceptions of the course and its effectiveness at preparing them for practice. A survey regarding student perceptions of SDL was offered to M3 and M4 students in order to explore their experiences with SDL and perceptions of its importance in the context of the school curriculum. RESULTS The CSDL framework was effective in making students aware of the importance of SDL in medical practice. Students gained basic and clinical knowledge about the subject, experienced increased confidence, and appreciated collaborating with their peers. The survey offered to the general student body reflected that all students perceived that they employed SDL in their time as medical students. However, many students indicated that they had not utilized components of SDL beyond synthesizing and assessing their learning needs. CONCLUSION CSDL is an effective method for promoting self-directed learning. Undergraduate medical course constructs utilizing CSDL will benefit students as they continue their career development. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s40670-021-01493-7.
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Affiliation(s)
- Kyeorda Kemp
- Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, 586 Pioneer Dr, Rochester, MI 48309 USA
| | - Dwayne Baxa
- Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, 586 Pioneer Dr, Rochester, MI 48309 USA
| | - Claudio Cortes
- Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, 586 Pioneer Dr, Rochester, MI 48309 USA
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