Educational needs assessment, development of learning objectives, and choosing a teaching approach

Teaching Strategies in Psychiatric Nursing Based on Bloom's Taxonomy of Educational Objectives

Bloom's Taxonomy of Educational Objective (BTEO), as a classic method for categorizing educational objectives, provides a clear and specific framework for formulating teaching goals in the global education field. Psychiatric nursing, as a highly specialized discipline, demands high requirements for students in both theoretical knowledge and practical skills. However, traditional teaching methods often focus excessively on knowledge impartation, neglecting the cultivation of students' practical abilities and emotional attitudes. Therefore, the purpose of this study was to Improve the existing psychiatric nursing curriculum by combining Bloom's educational goals theory, which emphasizes the comprehensive development of cognitive, affective, and psychomotor skills, providing new perspectives and methods for psychiatric nursing education. By applying BTEO, specific teaching goals at different levels can be defined more clearly, and corresponding teaching strategies and methods can be employed to achieve these goals. Furthermore, the application of BTEO requires effective interaction between teachers and students. Teachers need to monitor students' learning progress, adjust teaching strategies promptly, and ensure that students comprehensively grasp knowledge and skills. Thus, the application of this teaching strategy contributes to improving the quality of psychiatric nursing education and cultivating outstanding psychiatric nursing professionals. We hope to cultivate students' theoretical knowledge and practical skills in mental care by helping them develop their overall skills.

Needs assessment of a pythiosis continuing professional development program

BACKGROUND

Pythiosis is a rare disease with high mortality, with over 94% of cases reported from Thailand and India. Prompt diagnosis and surgery improves patient outcomes. Therefore, continuing professional development (CPD) is essential for early recognition. However, a needs assessment related to a pythiosis CPD program has not been performed.

OBJECTIVES

We conducted a needs assessment to develop a pythiosis CPD program.

PATIENTS/METHODS

We conducted a survey study with 267 King Chulalongkorn Memorial Hospital residents (141 internal medicine (IM) residents and 126 surgery residents). A 30-item survey consisting of a knowledge assessment, demographic section, and an attitudes portion was distributed both electronically and via paper. The data was analyzed with descriptive and inferential statistics.

RESULTS

Sixty-seven percent completed the survey (110/141 IM residents, 70/126 surgery residents). The mean score [95% confidence interval] on the knowledge assessment was 41.67% [39.64%-43.69%] across all objectives. The three domains with the highest scores were pythiosis risk factors (67.22% correct), microbiologic characteristics (50.83%), and radiographic interpretation (50.56%). The three domains with the lowest scores were laboratory investigation (15.00%), epidemiology (29.17%), and symptomatology (30.83%). Most participants noted that the program should be online with both synchronous and asynchronous sessions, with a preferred length of 60-90 minutes per session.

CONCLUSION

The pythiosis CPD program should emphasize education regarding symptomatology, laboratory investigation, and epidemiology, all of which are critical for the early detection of pythiosis to decrease mortality from this devastating disease. Most respondents felt this program was necessary and should be implemented in a virtual blended format.

Preparing for the PICU: A Qualitative Study of Residents as They Prepare for Their First Pediatric Critical Care Rotation

Learning critical care medicine in the pediatric intensive care unit (PICU) can be stressful. Through semistructured interviews ( n  = 16), this study explored the emotions, perceptions, and motivations of pediatric medicine (PM) and emergency medicine (EM) residents, as they prepared for their first PICU rotation. Qualitative data were collected and analyzed using the grounded theory method. Three resultant themes emerged: (1) residents entered the PICU with a range of intense emotions and heightened expectations; (2) they experienced prior history of psychologically traumatic learning events (adverse learning experiences or ALEs); and (3) informed by ALEs, residents prepared for their rotation by focusing heavily on their most basic level of physiological needs and adopting a survival mindset prior to the start of the rotation. These three themes led to a substantive, or working, theory that ALE-associated events may affect how residents approach upcoming learning opportunities. Consequently, adapting a trauma-informed approach as a component of medical education may improve resident learning experiences in the PICU and beyond.

Knowledge about Palliative Care and Attitudes toward Care of the Dying among Primary Care Nurses in Spain

Objective: To analyze the knowledge in palliative care and the attitudes toward caring for the dying of nurses who carry out their professional activity in primary care in Spain. Design: A cross-sectional descriptive observational study was carried out among Spanish primary care centers. Participants: A total of 244 nurses who had completed their primary care work and agreed to participate in this study were included. Main measurements: The level of knowledge in palliative care was analyzed using the PCQN-SV scale, and attitudes toward care of the dying were measured with the FATCOD-S scale, both of which are instruments that are validated in Spain. Results: Regarding the level of knowledge in palliative care, at a global level, the results revealed that 60% of the answers in the PCQN-SV were correct, with different results for each of the three subscales that compose it. When analyzing the attitudes of primary care nurses toward the care of the dying, an average of 132.21 out of 150 was obtained, representing a positive attitude. On the other hand, when analyzing these results in terms of knowledge and attitudes according to the population’s characteristics, we see that participants with both experience and training in palliative care present a better level of knowledge and a higher score regarding their attitudes toward care of the dying. However, the differences are only significant regarding the level of knowledge in palliative care. When analyzing the data from the two scales together, it is noteworthy that the participants with the most positive attitudes (highest scores on the FATCOD-S) also have the highest percentages of correct answers on the PCQN-SV.

Learning needs assessments in continuing professional development: A scoping review

BACKGROUND

A rigorous learning needs assessment (LNA) is a crucial initial step in the Continuing Professional Development (CPD) process. This scoping review aimed to collate, summarize, and categorize the reported LNA approaches adopted to inform healthcare professional CPD and highlight the gaps for further research.

METHOD

In August 2020, nine bibliographic databases were searched for studies conducted with any health professional grouping, reporting the utilized LNA to inform CPD activities. Two reviewers independently screened the articles for eligibility and charted the data. A descriptive analytical approach was employed to collate, summarize, and categorize the literature.

RESULTS

151 studies were included in the review; the majority adopted quantitative methods in the form of self-assessment surveys. Mixed-methods approaches were reported in only 35 studies. Descriptions of LNA development lacked detail of measures taken to enhance their rigor or robustness.

DISCUSSION

These findings do not reflect recommendations offered by the CPD literature. Further investigations are required to evaluate more recently advocated LNA approaches and add to their limited evidence-base. Similarly, the existing support afforded to CPD developers warrants further study in order to identify the necessary resource, infrastructure and expertise essential to design and deliver effective CPD programs.

From Targeted Needs Assessment to Course Ready for Implementation-A Model for Curriculum Development and the Course Results

This article contributes guidance on how to approach the development of a course curriculum in general and presents a specific example from medical research education. The purpose of this study is to discuss a model for translating needs assessments of targeted learners into a course curriculum. The model employs established methods for data collection, such as different interview approaches and surveys. The authors argue that there is value in going from exploratory in-depth qualitative data collection methods to more conclusive rigorous quantitative methods when developing a course curriculum. In this way, the model is especially sensitive to the needs of targeted learners in the initial phase and at the same time offers a systematic and practical approach to curriculum development. The model is presented step-by-step with the aid of an empirical example of how to assess the needs of medical doctors in the publication process and develop an introductory course in writing an initial manuscript for publication. The article concludes that the proposed model gives curriculum developers a unique opportunity to explore the needs of targeted learners in depth, while systematically aiming towards conclusive decisions on curriculum content ready for implementation.

Veterinary Students' Use of Learning Objectives

Learning objectives (LO) are the foundation of a competency-based curriculum, but no studies assess how students use LO for exam preparation and/or their general attitudes toward LO. Therefore, the objectives were to evaluate how much veterinary students use LO to study, assess student attitudes toward simple and expanded LO, and determine if LO type impacts grade performance. An alternative-treatment design with pre-test and nonrandom groups was used. Veterinary students in the Endocrine Systems course in the 2019 spring (n = 89) and fall (n = 86) semesters were invited to participate and provided with simple and expanded LO, respectively. After an examination, participants completed an online survey before and after receiving their grade. Overall, 114 students (65%) responded. The percentage of students using simple versus expanded LO was not statistically different (χ² = 1.874, df = 1, p = .171). Fifty-five students did not use LO; the majority (76.4%) preferred other study methods. Independent samples t-tests found no significant differences in student perceptions of helpfulness (t(30) = -1.118, p = .272), format (t(29) = 0.813, p = .423), or relevance (t(30) = 0.326, p = .747) between simple and expanded LO. Students agreed that LO were helpful (M = 3.33) and well formatted (M = 3.42) and that the provided information was relevant and detailed (M = 3.36). An ANOVA tested whether exam grade differed between students using simple versus expanded LO and for students who did not use LO; no significant differences were found (F(2,78) = .087, p = .917). In conclusion, students did not prefer more detailed LO and LO use did not impact grade performance.

Integration intrapreneurship: implementing innovation in a public healthcare organization

AIM

As global events impact the way organizations operate and innovate in response to regional, workforce and consumer needs, the concept of intrapreneurism is attracting growing interest from policymakers and executives, particularly within the healthcare sector. The aim of this study was to capture the key learnings from the implementation of a telementoring pilot, to understand how intrapreneurship can embed innovation within an established organization to effect more integrated healthcare.

PURPOSE

A qualitative approach was used with a phenomenological lens to explore the key learnings of the Project ECHO^® (Extension for Community Healthcare Outcomes) pilot implementation to provide an understanding of what the project team's strategies and tactics were during the process of embedding a new business innovation. The implementation and piloting of Project ECHO^®, a telementoring model, in a large-scale public healthcare organization in Queensland, Australia, was investigated as an exemplar of integration intrapreneurship.

FINDINGS

Through an inductive approach, this qualitative study found the implementation of the Project ECHO^® pilot had specific dimensions and strategies/tactics which were exemplars of intrapreneurism. The organizational context and workforce characteristics described in this study presented new knowledge of how intrapreneurs implemented an innovation to address fragmentation of healthcare service delivery, professional isolation and instances of low-value care. This research contributes to a better understanding of the strategic and tactical approaches to implementing intrapreneurial innovations within a public healthcare organization, with learnings that can be adapted by intrapreneurs in other contexts.

A novel multimodal needs assessment to inform the longitudinal education program for an international interprofessional critical care team

BACKGROUND

The current global pandemic has caused unprecedented strain on critical care resources, creating an urgency for global critical care education programs. Learning needs assessment is a core element of designing effective, targeted educational interventions. In theory, multimodal methods are preferred to assess both perceived and unperceived learning needs in diverse, interprofessional groups, but a robust design has rarely been reported. Little is known about the best approach to determine the learning needs of international critical care professionals.

METHOD

We conducted multimodal learning needs assessment in a pilot group of critical care professionals in China using combined quantitative and qualitative methods. The assessments consisted of three phases: 1) Twenty statements describing essential entrustable professional activities (EPAs) were generated by a panel of critical care education experts using a Delphi method. 2) Eleven Chinese critical care professionals participating in a planned education program were asked to rank-order the statements according to their perceived learning priority using Q methodology. By-person factor analysis was used to study the typology of the opinions, and post-ranking focus group interviews were employed to qualitatively explore participants' reasoning of their rankings. 3) To identify additional unperceived learning needs, daily practice habits were audited using information from medical and nursing records for 3 months.

RESULTS

Factor analysis of the rank-ordered statements revealed three learning need patterns with consensual and divergent opinions. All participants expressed significant interest in further education on organ support and disease management, moderate interest in quality improvement topics, and relatively low interest in communication skills. Interest in learning procedure/resuscitation skills varied. The chart audit revealed suboptimal adherence to several evidence-based practices and under-perceived practice gaps in patient-centered communication, daily assessment of antimicrobial therapy discontinuation, spontaneous breathing trial, and device discontinuation.

CONCLUSIONS

We described an effective mixed-methods assessment to determine the learning needs of an international, interprofessional critical care team. The Q survey and focus group interviews prioritized and categorized perceived learning needs. The chart audit identified additional practice gaps that were not identified by the learners. Multimodal methods can be employed in cross-cultural scenarios to customize and better target medical education curricula.

Teachers' perceptions of using virtual reality technology in classrooms: A large-scale survey

High-immersion virtual reality (VR) technology is often associated with gaming. Yet, it is increasingly popular in educational contexts due to its potential to engage and motivate learners. Prior to VR technology integration in the classroom, the acceptance or resistance toward VR needs to be explored. This paper reports the results obtained from a large-scale (N = 20,876) survey on teachers' attitudes toward the use of VR for education. The survey explored the relationships between the teachers' VR integration level and their instructional approaches, as well as the frequency of VR use. Furthermore, the survey yielded answers on the relationship between the availability of information technology (IT) personnel and the frequency of VR use. Overall, teachers had moderately positive perceptions of the use of VR in education. There was no strong correlation between instructional approaches and the level of VR integration, but lower levels of VR integration were associated with more traditional teaching approaches. The results revealed a positive correlation between the level of VR integration and the frequency of VR use. However, the VR frequency use had a weak correlation with the availability of IT personnel.

Paradigm shift in medical education due to the COVID-19 pandemic: guidelines for developing a blended learning curriculum in medical education

Background: The coronavirus disease 2019 (COVID-19) pandemic has transformed the world's economy, health and education in a blink of an eye. Almost 1 billion learners have been affected across the globe. This has resulted in a paradigm shift to blended learning. Therefore, it was felt necessary to provide practical guidelines for the development of blended curriculum in medical education. It would help to overcome the challenges faced due to unprecedented transformation of medical education on account of pandemic. Methods: Guidelines based on personal experience of the authors and literature search were developed using the complex adapted blended learning system (CALBS) framework. Seven experts developed these guidelines using the nominal group technique. The consent form and literature for CABLS framework was shared with experts. The experts developed the guidelines independently during phase one of the technique. After a given time, phase 2 started with moderator mediated discussion about the individual guidelines developed by the experts. After discussion and mutual consensus four types of guideline ideas were developed. During the third phase the experts ranked the guideline ideas on a scale of 1 to 5. The guideline idea that ranked highest was selected as a final guideline for developing a blended learning curriculum. Results: The group consensus resulted in developing seven guidelines for a blended course or curriculum in medical education. These guidelines are based on a conceptual framework supplemented by expert's own personal experience and current evidence from literature. Conclusions: These guidelines would provide a comprehensive and systematic approach to develop a blended learning curriculum in medical education.

Paradigm shift in medical education due to the COVID-19 pandemic: guidelines for developing a blended learning curriculum in medical education

Background: The coronavirus disease 2019 (COVID-19) pandemic has transformed the world's economy, health and education in a blink of an eye. Almost 1 billion learners have been affected across the globe. This has resulted in a paradigm shift to blended learning. Therefore, it was felt necessary to provide practical guidelines for the development of blended curriculum in medical education. It would help to overcome the challenges faced due to unprecedented transformation of medical education on account of pandemic. Methods: Guidelines based on personal experience of the authors and literature search were developed using the complex adapted blended learning system (CALBS) framework. Seven experts developed these guidelines using the nominal group technique. The consent form and literature for CABLS framework was shared with experts. The experts developed the guidelines independently during phase one of the technique. After a given time, phase 2 started with moderator mediated discussion about the individual guidelines developed by the experts. After discussion and mutual consensus four types of guideline ideas were developed. During the third phase the experts ranked the guideline ideas on a scale of 1 to 5. The guideline idea that ranked highest was selected as a final guideline for developing a blended learning curriculum. Results: The group consensus resulted in developing seven guidelines for a blended course or curriculum in medical education. These guidelines are based on a conceptual framework supplemented by expert's own personal experience and current evidence from literature. Conclusions: These guidelines would provide a comprehensive and systematic approach to develop a blended learning curriculum in medical education.

Measuring the Success of a Project ECHO Implementation: Results from an International e-Delphi Study

There is an increasing global need for organisations to utilise high-quality telementoring models to support workforce development and mentorship. Project ECHO is a validated telementoring model that has been adopted by over 700 organisations globally across multiple sectors. To date there is no consolidated list of success indicators by which organisational teams can assess or benchmark their implementation of Project ECHO across sectors. An e-Delphi methodology was adopted to facilitate a comprehensive means of identifying indicators that could be used to assess the implementations of Project ECHO globally. This paper presents a consolidated framework of indicators that support teams to assess their implementation of Project ECHO. These indicators have been derived by an international panel of experts across the healthcare, education, and university sectors. The final framework identified 54 distinct indicators across four domains: (1) spoke participant engagement, (2) ECHO Hub/teleECHO Network design and operation, (3) ECHO Hub team engagement and (4) Local Impact. This paper highlights that Project ECHO implementation indicators can vary between being dynamic, static, and iterative, depending on the phase of implementation. These findings are significant because they are generalisable to any organisation/sector implementing Project ECHO or similar telementoring models.

Supplementary Information

The online version contains supplementary material available at 10.1007/s43477-022-00050-7.

Navigating Design Options for Large-Scale Interprofessional Continuing Palliative Care Education: Pallium Canada's Experience

To be effective, palliative care education interventions need to be informed, among others, by evidence and best practices related to curriculum development and design. Designing palliative care continuing professional development (CPD) courses for large-scale, national deployment requires decisions about various design elements, including competencies and learning objectives to be addressed, overall learning approaches, content, and courseware material. Designing for interprofessional education (IPE) adds additional design complexity. Several design elements present themselves in the form of polarities, resulting in educators having to make choices or compromises between the various options. This article describes the learning design decisions that underpin Pallium Canada's interprofessional Learning Essential Approaches to Palliative Care (LEAP) courses. Social constructivism provides a foundational starting point for LEAP course design, as it lends itself well to both CPD and IPE. We then explore design polarities that apply to the LEAP courseware development. These include, among others, which professions to target and how to best support interprofessional learning, class sizes, course length and content volume, courseware flexibility, regional adaptations, facilitator criteria, and learning methods. In some cases, compromises have had to be made between optimal perfect design and pragmatism.

Design and Implementation of a Distant-Learning Clinical Research Mentorship Program: The Accra-Toronto Collaboration

PURPOSE

For many oncology training programs in low- and middle-income countries, dedicated time for research education and mentorship of trainees is limited. Here, we report a 1-year-long collaboration between a cancer center in Canada and one in Ghana with the aim of imparting clinical research skills and mentoring the research of radiation oncology residents.

METHODS

On the basis of a needs assessment conducted in Ghana, we designed a curriculum consisting of 13 weekly seminars delivered via videoconference, followed by a 1-year-long mentorship program to support research projects. The primary outcome was the feasibility of the program from seminars to manuscript preparation. We used multiple secondary outcomes to capture the learning experience with study-specific questionnaires. We evaluated critical thinking ability using the Berlin questionnaire. Funding was made available for research and travel to international conferences.

RESULTS

Five Ghanaian trainees submitted research proposals. Nine Canadian faculty members delivered the seminars and two served as methodology mentors, and two Ghanaian faculty acted as local supervisors. Feedback questionnaires from all participants showed that they agreed strongly that they would recommend the sessions to another resident (75%), that the objectives were clear (71%), and that the topics were useful for their training (73%). At the end of the program, two Ghanaian trainees finalized their manuscripts and one was published.

CONCLUSION

Here, we report on the implementation of a mentorship program focused on research methods and evidence-based medicine in sub-Saharan Africa. The program was successful in the drafting and publication of abstracts and manuscripts by local trainees.

Third-Year Medical Students' Self-perceived Knowledge About Health Disparities and Community Medicine

INTRODUCTION

Medical providers' attitudes about caring for vulnerable populations have significant implications for persistent health disparities. Therefore, assessing medical students' self-perceived knowledge about community-based medicine and care for underserved populations can provide insights for improving health care delivery to achieve health equity. We evaluated third-year medical students' perceptions of their knowledge and attitudes about community medicine, and addressing health care needs of vulnerable populations.

METHODS

From October 2, 2017 to July 12, 2019, third-year medical students at a private, urban medical school were asked to complete an assessment survey during their family medicine clerkship orientation. The anonymous survey assessed students' self-perceived knowledge and attitudes regarding community medicine and care of vulnerable populations. We examined differences in survey responses by student demographics.

RESULTS

A total of 401 students participated in the survey; 50.5% of respondents agreed that they had knowledge to assess health literacy of the patient, while only 22.2% of students agreed that they had knowledge about how to identify a community and conduct a community health needs assessment. Additionally, students agreed with being most comfortable providing care to adolescents (73.0%) and the elderly (69.5%), and that they were least comfortable caring for incarcerated individuals (31.7%) and immigrants/refugees (44.1%).

CONCLUSION

Assessment of learners' self-perceived knowledge can help highlight areas for educational interventions. Our findings suggest the need for improving medical student knowledge in areas of community health and health care for specific vulnerable populations.

A Proposed Framework to Develop, Describe and Evaluate Peer-Assisted Learning Programs

PHENOMENON

Peer-assisted learning (PAL) is increasingly used in different fields of education, including medical education, due to its established advantages. However, there are scarce data about the best practice guidelines for PAL program evaluation. The aim of this work was to develop a framework that can describe and develop PAL programs and consequently provide a tool for evaluation and comparison of PAL programs among different institutions.

APPROACH

A thorough literature review was made for assessment of different PAL programs development and implementation strategies, and PAL leaders at the University of Umm Al-Qura in Saudi Arabia were interviewed for development and revision of a framework for PAL program development, description and evaluation.

FINDINGS

A framework of four sections was developed ie context, theory, implementation processes and outcomes, and emergence. The context includes the learning objectives and the logistics. The theory includes the content nature, program design, number of tutees and tutors, participation, program orientation, program duration and timing, tutor recruitment and preparation and faculty involvement. Implementation process and outcome section includes the feedback collection and the pre- and post-intervention students' assessment. The emergence includes tracking the program evolution.

INSIGHTS

Development of a clear well-defined framework for description, implementation and evaluation of a PAL educational program can provide a foundation to unify the terms organizations use to communicate the parameters of PAL programs and overcome the jargon about PAL in the literature. It also can provide comparisons between the programs in an attempt to set best practice guidelines in the future for PAL program developing and implementation.

London calling Gaza: The role of international collaborations in the globalisation of postgraduate burn care education

Burn injuries represent a significant epidemiological problem, with the vast majority occurring in low- to middle-income countries. These regions also represent areas where lack of socioeconomic growth and geopolitical instability pose additional barriers not only to healthcare provision but also to the acquisition of continuing professional development. Long-distance, web-based learning programmes ('tele-education') have been identified as a successful and powerful means of propagating up-to-date medical education and training in poor-resource, isolated or conflict-ridden regions. This report evaluates the role of tele-education in delivering a distance-learning Master's degree in Burn Care to a group of 11 healthcare professionals working in the occupied Palestinian territories (OPT), which was funded as part of a collaboration between Queen Mary University of London and IMET-Pal (International Medical Education Trust - Palestine). We present our experience in delivering the programme in a conflict-ridden part of the world, which includes the specific adaptations to tailor the programme to regional needs as well the unique challenges faced by students and faculty in enhancing the educational value of this unique initiative. The academic achievements of this group of healthcare professionals were found to be comparable to historical student cohorts from privileged socioeconomic backgrounds and the majority of students felt that participation in the programme contributed to a direct improvement to their daily burn care practices. The successful outcomes achieved by our students support the constantly emerging evidence that targeted, well-delivered, long-distance learning programmes can become powerful tools in combating inequalities in global healthcare and health education.

Relationship of Lifestyle with Academic Achievement in Nursing Students

INTRODUCTION

A healthy lifestyle is one of the main factor in maintaining the health of people in society. With regard to the role of youth and students in public health, they must complete and follow a training program on lifestyle related factors. One of the main aim of the training centres is to improve the academic achievement of students.

AIM

This study was designed to determine the correlation of lifestyle with academic achievement in nursing students.

MATERIALS AND METHODS

This was a cross-sectional study, wherein all nursing students of School of Borujen Nursing were selected by census sampling. Data gathering tool was Walker's lifestyle questionnaire which was modified for the purpose of the study. To evaluate the educational status of students, final grade point average was considered as an indicator of academic achievement. To analyze the data, SPSS version 16.0, and descriptive and analytical tests were used.

RESULTS

The results indicated that most subjects (61.01%) displayed moderate levels of lifestyle. Pearson's correlation coefficient showed the significant positive relationship between lifestyle and academic achievement (p=0.03 and r=0.628).

CONCLUSION

To improve the academic achievement of students, in addition to the cognitive abilities-perception, their lifestyle should also be considered. Therefore, it is suggested to incorporate lifestyle education in the curriculum of nursing students so as to improve their lifestyle.

Unmet Learning Needs of Physicians in Specialty Training in Palliative Care: A Japanese Nationwide Study

BACKGROUND

Despite the urgent need for a quality training system in palliative care, learning needs among physicians in palliative care specialty training have not been systematically explored in Japan.

AIM

To clarify unmet learning needs among Japanese physicians in specialty training in palliative care and the potential solutions they favor to meet those needs.

DESIGN

A Japanese nationwide survey.

SETTING/PARTICIPANTS

Participants were physicians in specialty training in palliative care. The questionnaire included unmet learning needs and potential solutions. Factor analysis was performed to identify underlying subscales of unmet needs.

RESULTS

In total, 253 of 735 institutions (34%) responded; of 284 physicians, 253 (89%) responded and 229 were eligible. The most prevalent unmet needs included the following: "to learn areas other than medicine" (89%), "to obtain research support from a data center" (87%), and "to learn ways to educate students and residents about palliative medicine" (87%). The potential solutions most participants favored to meet those needs included the following: "to develop a comprehensive training program" (74%), "to develop systems which reflect trainees' opinions on the improvement of training programs" (71%), and "to increase the number of training institutions" (69%).

CONCLUSION

Physicians in palliative care specialty training had markedly unmet needs regarding training on comprehensive contents, education, and research support; they considered increasing the number of comprehensive quality training programs as a potential solution. Our findings may help physicians in palliative care training, faculty physicians, training programs, academic societies, and the government to develop collaborative efforts to fulfill the unmet needs of trainees.

A students' survey of cultural competence as a basis for identifying gaps in the medical curriculum

BACKGROUND

Assessing the cultural competence of medical students that have completed the curriculum provides indications on the effectiveness of cultural competence training in that curriculum. However, existing measures for cultural competence mostly rely on self-perceived cultural competence. This paper describes the outcomes of an assessment of knowledge, reflection ability and self-reported culturally competent consultation behaviour, the relation between these assessments and self-perceived cultural competence, and the applicability of the results in the light of developing a cultural competence educational programme.

METHODS

392 medical students, Youth Health Care (YHC) Physician Residents and their Physician Supervisors were invited to complete a web-based questionnaire that assessed three domains of cultural competence: 1) general knowledge of ethnic minority care provision and interpretation services; 2) reflection ability; and 3) culturally competent consultation behaviour. Additionally, respondents graded their overall self-perceived cultural competence on a 1-10 scale.

RESULTS

86 medical students, 56 YHC Residents and 35 YHC Supervisors completed the questionnaire (overall response rate 41%; n= 177). On average, respondents scored low on general knowledge (mean 46% of maximum score) and knowledge of interpretation services (mean 55%) and much higher on reflection ability (80%). The respondents' reports of their consultation behaviour reflected moderately adequate behaviour in exploring patients' perspectives (mean 64%) and in interaction with low health literate patients (mean 60%) while the score on exploring patients' social contexts was on average low (46%). YHC respondents scored higher than medical students on knowledge of interpretation services, exploring patients' perspectives and exploring social contexts. The associations between self-perceived cultural competence and assessed knowledge, reflection ability and consultation behaviour were weak.

CONCLUSION

Assessing the cultural competence of medical students and physicians identified gaps in knowledge and culturally competent behaviour. Such data can be used to guide improvement efforts to the diversity content of educational curricula. Based on this study, improvements should focus on increasing knowledge and improving diversity-sensitive consultation behaviour and less on reflection skills. The weak association between overall self-perceived cultural competence and assessed knowledge, reflection ability and consultation behaviour supports the hypothesis that measures of sell-perceived competence are insufficient to assess actual cultural competence.

A novel approach to needs assessment in curriculum development: going beyond consensus methods

BACKGROUND

Needs assessment should be the starting point for curriculum development. In medical education, expert opinion and consensus methods are commonly employed.

AIM

This paper showcases a more practice-grounded needs assessment approach.

METHODS

A mixed-methods approach, incorporating a national survey, practice audit, and expert consensus, was developed and piloted in thrombosis medicine; Phase 1: National survey of practicing consultants, Phase 2: Practice audit of consult service at a large academic centre and Phase 3: Focus group and modified Delphi techniques vetting Phase 1 and 2 findings.

RESULTS

Phase 1 provided information on active curricula, training and practice patterns of consultants, and volume and variety of thrombosis consults. Phase 2's practice audit provided empirical data on the characteristics of thrombosis consults and their associated learning issues. Phase 3 generated consensus on a final curricular topic list and explored issues regarding curriculum delivery and accreditation.

CONCLUSIONS

This approach offered a means of validating expert and consensus derived curricular content by incorporating a novel practice audit. By using this approach we were able to identify gaps in training programs and barriers to curriculum development. This approach to curriculum development can be applied to other postgraduate programs.

Description of a teaching method for research education for palliative care healthcare professionals

OBJECTIVE

Despite the rapidly growing availability of palliative care services, there is still much to be done in order to better support clinicians who are starting research programs. Among the barriers identified in the literature, methodological issues and lack of research training programs are often reported. Our aim was to describe an educational research method for healthcare professionals working in palliative care and to report the result of a survey conducted among a three-year sample of students.

METHOD

The course was provided for a multidisciplinary group and was open to all healthcare professionals involved in palliative care. It took place over a single session during a full day. We used a 20-question e-survey to assess student outcomes (e.g., satisfaction, current status of their project).

RESULTS

We received answers from 83 of the 119 students (70%) who took the course. The majority were physicians (n = 62, 75%), followed by nurses (n = 17, 21%). During the class, students assessed the role of the teacher as an information provider (n = 51, 61%), role model (n = 36, 43%), and facilitator (n = 33, 40%), and considered all of these roles as suitable, with a score of 3.9-4.7 out of 5. Participants reported a high level of support from the teacher, with a mean score of 8.2 (SD, 1.7) out of 10, and good overall satisfaction with a mean score of 7.6 (1.8). Finally, 51 participants (77%) were able to start their research project after the class, 27 (41%) to complete it, and 8 (12%) to submit their research to a journal or conference.

SIGNIFICANCE OF RESULTS

Our results suggest that newer teaching methods such as roleplay, group work, and target acquisition are feasible and effective in a palliative research curriculum. Additional studies are needed to confirm the objective outputs of educational interventions, including research outputs.

Palliative care education in U.S. medical schools

CONTEXT

Medical educators in the U.S.A. perceive the teaching of palliative care competencies as important, medical students experience it as valuable and effective, and demographic and societal forces fuel its necessity. Although it is encouraged by the Association of American Medical Colleges, the only palliative care-related mandate in U.S. medical schools is the Liaison Committee on Medical Education directive that end-of-life (EoL) care be included in medical school curricula, reinforcing the problematic conflation of EoL and palliative care.

FINDINGS

A review of US medical school surveys about the teaching of palliative and EoL care reveals varied and uneven approaches, ranging from 2 hours in the classroom on EoL to weeks of palliative care training or hospice-based clinical rotations.

IMPLICATIONS

Palliative care competencies are too complex and universally important to be relegated to a minimum of classroom time, random clinical exposures, and the hidden curriculum.

RECOMMENDATIONS

Given the reality of overstrained medical school curricula, developmentally appropriate, basic palliative care competencies should be defined and integrated into each year of the medical school curriculum, taking care to circumvent the twin threats of curricular overload and educational abandonment.