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O'Callaghan C, Sandars J, Brown J, Sherratt C. The Value of Master's Degree Programmes in Health Professions Education: A Scoping Review. CLINICAL TEACHER 2024; 21:e13758. [PMID: 38643984 DOI: 10.1111/tct.13758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Accepted: 02/06/2024] [Indexed: 04/23/2024]
Abstract
INTRODUCTION There are increasing numbers of Master's Degree Programmes in Health Professions Education (MHPE), and the value to their students and graduates is not well understood. We conducted a scoping review to explore what is known about the value of MHPE programmes to their students and graduates. METHODS A scoping review was conducted using Arksey and O'Malley's five-stage framework. PubMed, CINAHL, Cochrane, BEI, ERIC and EThOs databases were searched in addition to cited reference searching. Original research with an evaluation and published in the English language were included. RESULTS Nineteen studies were included. Studies were based in a variety of locations on five continents, and included in-person, distance and blended learning. Students and graduates of MHPE programmes self-reported development of their pedagogical knowledge, confidence and credibility in their role as an educator, and educational scholarship. Enhanced career opportunities and opportunities for collegial interactions and networks were also reported. Important barriers included struggling with the time and financial commitments required for studying on a MHPE programme. CONCLUSIONS There are a variety of dimensions of value of MHPE programmes to their students and graduates. Important practical recommendations for MHPE programme providers and employers include providing opportunities for the development of networks and supporting the time and financial commitments required for studying.
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Affiliation(s)
| | - John Sandars
- Medical School, Edge Hill University, Ormskirk, UK
| | - Jeremy Brown
- Medical School, Edge Hill University, Ormskirk, UK
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Heck AJ, Arja S, Bauler LD, Eldeeb K, Huggett KN, Newell AD, Quesnelle KM, Sadik A, Saks N, Smith PJW, Wisco JJ. Evaluation of an Educational Scholarship Fellowship Program for Health Professions Educators. MEDICAL SCIENCE EDUCATOR 2024; 34:831-846. [PMID: 39099850 PMCID: PMC11296987 DOI: 10.1007/s40670-024-02036-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/01/2024] [Indexed: 08/06/2024]
Abstract
Introduction Historically, the requirement to produce scholarship for advancement has challenged health professions educators heavily engaged in teaching. As biomedical scientists or healthcare practitioners, few are trained in educational scholarship, and related faculty development varies in scope and quality across institutions. Currently, there is a need for faculty development and mentoring programs to support the development of these skills. Methods The International Association of Medical Science Educators (IAMSE) established the Medical Educator Fellowship (MEF) Program to foster health professions educational scholarship. MEF addresses the following: curriculum design, teaching methods and strategies, assessment, educational scholarship, and leadership. Participants receive mentorship and faculty development, and complete an educational scholarship project. Using a logic model, we conducted a retrospective program evaluation with data from Program records, database searches, graduate surveys, and focus groups. Results Over 14 years, MEF graduated 61 participants with diverse terminal degrees from five continents and six academic program areas. Graduate survey responses indicated enhanced post-Program skills in all focus areas, that the majority would recommend MEF to a colleague, and that mentorship, networking, and professional development were strengths. Focus group outcomes indicated professional growth, increased confidence, and increased sense of community. Conclusion MEF addresses health professions educators' need for faculty development and mentorship in educational scholarship. Evaluation outcomes suggest that MEF effectively enhanced perceived skills across focus areas. Similar programs are essential to support faculty who dedicate significant time to teaching. Organizations like IAMSE can demonstrate the value of educational scholarship and positively impact health professions educator careers by supporting such programs.
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Affiliation(s)
- Amber J. Heck
- University of North Texas Health Science Center, 3500 Camp Bowie Blvd, Fort Worth, TX 76107 USA
| | - Sateesh Arja
- Avalon University School of Medicine, Willemstad, Curaçao
| | - Laura D. Bauler
- Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI USA
| | - Khalil Eldeeb
- Campbell University Jerry M. Wallace School of Osteopathic Medicine, Lillington, NC USA
| | - Kathryn N. Huggett
- Larner College of Medicine at the University of Vermont, Burlington, VT USA
| | | | - Kelly M. Quesnelle
- University of South Carolina School of Medicine Greenville, Greenville, SC USA
| | - Amina Sadik
- Touro University Nevada, College of Osteopathic Medicine, Henderson, NV USA
| | - Norma Saks
- Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ USA
| | - Paula J. W. Smith
- Edinburgh Medical School at the University of Edinburgh, Edinburgh, Scotland
| | - Jonathan J. Wisco
- Boston University Aram V. Chobanian & Edward Avedisian School of Medicine, Boston, MA USA
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Santen SA, Smith J, Shockley J, Cyrus JW, Lomis KD, Pusic M, Mejicano GC, Lawson L, Allen BL, Skochelak S. Social network analysis of publication collaboration of accelerating change in MedEd consortium. MEDICAL TEACHER 2022; 44:276-286. [PMID: 34686101 DOI: 10.1080/0142159x.2021.1985096] [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: 06/13/2023]
Abstract
INTRODUCTION The American Medical Association formed the Accelerating Change in Medical Education Consortium through grants to effect change in medical education. The dissemination of educational innovations through scholarship was a priority. The objective of this study was to explore the patterns of collaboration of educational innovation through the consortium's publications. METHOD Publications were identified from grantee schools' semi-annual reports. Each publication was coded for the number of citations, Altmetric score, domain of scholarship, and collaboration with other institutions. Social network analysis explored relationships at the midpoint and end of the grant. RESULTS Over five years, the 32 Consortium institutions produced 168 publications, ranging from 38 papers from one institution to no manuscripts from another. The two most common domains focused on health system science (92 papers) and competency-based medical education (30 papers). Articles were published in 54 different journals. Forty percent of publications involved more than one institution. Social network analysis demonstrated rich publishing relationships within the Consortium members as well as beyond the Consortium schools. In addition, there was growth of the network connections and density over time. CONCLUSION The Consortium fostered a scholarship network disseminating a broad range of educational innovations through publications of individual school projects and collaborations.
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Affiliation(s)
- Sally A Santen
- Senior Associate Dean, Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Jeff Smith
- School of Business, Virginia Commonwealth University, Richmond, VA, USA
| | - Jeff Shockley
- School of Business, Virginia Commonwealth University, Richmond, VA, USA
| | - John W Cyrus
- Virginia Commonwealth University Medical Center Tomkins-McCaw Library, Richmond, VA, USA
| | | | - Martin Pusic
- Pediatrics and Emergency Medicine, Harvard Medical School, Boston, MA, USA
| | - George C Mejicano
- Senior Associate Dean for Education, School of Medicine, Oregon Health & Science University, Portland, OR, USA
| | - Luan Lawson
- Emergency Medicine, East Carolina University Brody School of Medicine, Greenville, NC, USA
| | - Bradley L Allen
- Clinical Medicine and Infectious Diseases, Indiana University School of Medicine, Indianapolis, IN, USA
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Khrystenko OM, Vykhrushch AV, Fedoniuk LY, Oliinyk NY. PERSONAL VALUES OF FUTURE DOCTORS. WIADOMOSCI LEKARSKIE (WARSAW, POLAND : 1960) 2022; 75:2020-2025. [PMID: 36129089 DOI: 10.36740/wlek202208214] [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: 06/15/2023]
Abstract
OBJECTIVE The aim: To analyse the value priorities of first-year medical students and outline areas of educational work to develop a system of professional values of future doctors who are able to work in circumstances of challenges of the time, as well as military conflicts. PATIENTS AND METHODS Materials and methods: The method of questionnaires involving the students of Ternopil National Medical University from Ukraine and India was used, as well as the method of content analysis of students' creative work. At the final stage of the study, essays written by Ukrainian first-year students on the day of the beginning of the war in Ukraine on February 24, 2022 were analysed. RESULTS Results: The desire to help people was the motive to enter a medical university for the majority of both Ukrainian and international students. Besides, Ukrainians identified civic values that are important in wartime: unity, national consciousness, struggle. In their opinion, the first day of the war determined the splash of anti-values: panic, fear, confusion. However, a similar study conducted ten days after the start of the war showed increase of confidence in victory, the levelling of negative emotions among Ukrainians. Therefore, the issue of the dynamics of values in wartime should be studied more. CONCLUSION Conclusions: Institutions of higher medical education should maintain a high intrinsic motivation of students in their altruistic striving to serve people, and improve the adaptation of first-year students, especially international ones. In wartime, it is necessary to intensify the educational work regarding ethical and spiritual development for strengthening the psychological well-being of students.
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Affiliation(s)
- Olga M Khrystenko
- I. HORBACHEVSKY TERNOPIL NATIONAL MEDICAL UNIVERSITY, TERNOPIL, UKRAINE
| | | | | | - Nadiia Ya Oliinyk
- I. HORBACHEVSKY TERNOPIL NATIONAL MEDICAL UNIVERSITY, TERNOPIL, UKRAINE
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Cantillon P, De Grave W, Dornan T. Uncovering the ecology of clinical education: a dramaturgical study of informal learning in clinical teams. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2021; 26:417-435. [PMID: 32951128 PMCID: PMC8041675 DOI: 10.1007/s10459-020-09993-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 09/08/2020] [Indexed: 05/28/2023]
Abstract
Off-the-job faculty development for clinical teachers has been blighted by poor attendance, unsatisfactory sustainability, and weak impact. The faculty development literature has attributed these problems to the marginalisation of the clinical teacher role in host institutions. By focusing on macro-organisational factors, faculty development is ignoring the how clinical teachers are shaped by their everyday participation in micro-organisations such as clinical teams. We set out to explore how the roles of clinical teacher and graduate learner are co-constructed in the context of everyday work in clinical teams. Using an ethnographic study design we carried out marginal participant observation of four different hospital clinical teams. We assembled a dataset comprising field notes, participant interviews, images, and video, which captured day-to-day working and learning encounters between team members. We applied the dramaturgical sensitising concepts of impression management and face work to a thematic analysis of the dataset. We found that learning in clinical teams was largely informal. Clinical teachers modelled, but rarely articulated, an implicit curriculum of norms, standards and expectations. Trainees sought to establish legitimacy and credibility for themselves by creating impressions of being able to recognise and reproduce lead clinicians' standards. Teachers and trainees colluded in using face work strategies to sustain favourable impressions but, in so doing, diminished learning opportunities and undermined educational dialogue. These finding suggest that there is a complex interrelationship between membership of clinical teams and clinical learning. The implication for faculty development is that it needs to move beyond its current emphasis on the structuring effects of institutional context to a deeper consideration of how teacher and learner roles are co-constructed in clinical teams.
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Affiliation(s)
- Peter Cantillon
- Discipline of General Practice, National University of Ireland, Galway, Republic of Ireland.
| | - Willem De Grave
- School of Health Professions Education, Maastricht University, Maastricht, The Netherlands
| | - Tim Dornan
- School of Medicine, Dentistry and Biomedical Sciences, Queens University Belfast, Belfast, UK
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Triemstra JD, Iyer MS, Hurtubise L, Poeppelman RS, Turner TL, Dewey C, Karani R, Fromme HB. Influences on and Characteristics of the Professional Identity Formation of Clinician Educators: A Qualitative Analysis. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2021; 96:585-591. [PMID: 33177319 DOI: 10.1097/acm.0000000000003843] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PURPOSE Professional identity formation is the process of internalizing the ideals, values, and beliefs of a profession. In recent years, research on clinician-educator (CE) identity formation has expanded, yet gaps exist in understanding initial influences on an educator identity, sustainment throughout a career, and development of successful pathways for early CEs. This study explored the initial influences on and characteristics of the professional identity formation of CEs in an age-diverse, multispecialty population in the United States. METHOD This was a cross-sectional qualitative study of a purposive sample of medical educators at 6 institutions across the United States between 2018 and 2019. Focus groups were conducted to obtain participants' perspectives on their career choice and subsequent formation of their professional identity as CEs. The authors used a thematic analysis of focus group data to identify themes and domains through an iterative process. RESULTS Twelve focus groups were conducted with a total of 93 participants. Responses were categorized into 5 domains: community supportive of medical education, culture of institution and training, personal characteristics, facilitators, and professionalization of medical education. Themes highlighted the importance of role models and mentors, an affinity and aptitude for teaching and education, specific facilitators for entry into a career in medical education, the evolution from a layperson, importance of formalized training programs, and a supportive academic community. CONCLUSIONS Clinicians experienced a variety of factors that influenced their initial career choice in medical education and subsequent professional identity formation as a CE. This study confirms and expands the current understanding of this process in an age-diverse, multispecialty population of CEs. Educators and administrators designing career development programs across the continuum of medical education should consider these aspects as they mentor and support their learners and faculty.
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Affiliation(s)
- Justin D Triemstra
- J.D. Triemstra is assistant professor of pediatrics and human development, and associate program director, Pediatric Residency Program, Department of Pediatrics and Human Development, Helen DeVos Children's Hospital, Michigan State University College of Human Medicine, Grand Rapids, Michigan
| | - Maya S Iyer
- M.S. Iyer is assistant professor of clinical pediatrics and director, pediatric emergency medicine faculty development, Nationwide Children's Hospital and The Ohio State University College of Medicine, Columbus, Ohio
| | - Larry Hurtubise
- L. Hurtubise is director, Office of Educational Innovation and Scholarship, College of Pharmacy, The Ohio State University, Columbus, Ohio
| | - Rachel Stork Poeppelman
- R.S. Poeppelman is a pediatric critical care fellow, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio
| | - Teri Lee Turner
- T.L. Turner is professor of pediatrics, and vice chair of education, Section of Academic General Pediatrics, Baylor College of Medicine, Houston, Texas
| | - Charlene Dewey
- C. Dewey is professor of medicine and medical education and administration; assistant dean of educator development; and director, Center for Professional Health, Vanderbilt University Medical School/Vanderbilt University Medical Center, Nashville, Tennessee
| | - Reena Karani
- R. Karani is professor of medicine and medical education; senior associate dean of medical education and curricular affairs; and director, Institute for Medical Education, Icahn School of Medicine at Mt. Sinai, New York, New York
| | - H Barrett Fromme
- H.B. Fromme is professor of pediatrics and associate dean for faculty development in medical education, The University of Chicago Pritzker School of Medicine, Chicago, Illinois
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van Lankveld T, Thampy H, Cantillon P, Horsburgh J, Kluijtmans M. Supporting a teacher identity in health professions education: AMEE Guide No. 132. MEDICAL TEACHER 2021; 43:124-136. [PMID: 33153338 DOI: 10.1080/0142159x.2020.1838463] [Citation(s) in RCA: 42] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
This guide provides an understanding of what teacher identity is and how it can be developed and supported. Developing a strong teacher identity in the context of health professions education is challenging, because teachers combine multiple roles and the environment usually is more supportive to the identity of health practitioner or researcher than to that of teacher. This causes tensions for those with a teaching role. However, a strong teacher identity is important because it enhances teachers' intention to stay in health professions education, their willingness to invest in faculty development, and their enjoyment of the teaching role. The guide offers recommendations on how to establish workplace environments that support teacher identity rather than marginalise it. Additionally, the guide offers recommendations for establishing faculty development approaches that are sensitive to teacher identity issues. Finally, the guide provides suggestions for individual teachers in relation to what they can do themselves to nurture it.
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Affiliation(s)
- Thea van Lankveld
- Department of Education, Utrecht University, Utrecht, The Netherlands
| | | | - Peter Cantillon
- Discipline of General Practice, School of Medicine, Galway, Ireland
| | - Jo Horsburgh
- Centre for Higher Education Research and Scholarship, Imperial College, South Kensington, London
| | - Manon Kluijtmans
- Center for Education, University Medical Center Utrecht, Utrecht, The Netherlands
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McDonald JA, Lai CJ, Lin MYC, O'Sullivan PS, Hauer KE. "There Is a Lot of Change Afoot": A Qualitative Study of Faculty Adaptation to Elimination of Tiered Grades With Increased Emphasis on Feedback in Core Clerkships. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2021; 96:263-270. [PMID: 32909998 DOI: 10.1097/acm.0000000000003730] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PURPOSE Medical schools responding to challenges with fairness, equity, learning environments, and student wellness have reconsidered clerkship grades. This study used the Concerns-Based Adoption Model (CBAM) to explore how faculty responded to a change in the approach to assessment from focus on grades toward focus on feedback. METHOD This qualitative study used an inductive approach to analyze data from semistructured interviews with teaching faculty and education leaders at University of California, San Francisco, School of Medicine 6 months following the elimination of traditional tiered clerkship grades. Participants were recruited in 2019 using purposive sampling. Interview questions addressed participants' perceptions of the new approach to assessment and grading that emphasizes assessment for learning, including advantages and concerns. The authors analyzed data using thematic analysis informed by sensitizing concepts from CBAM. RESULTS Nineteen faculty participated (11 medicine, 8 surgery). Faculty expressed optimism about the impact of the change on their clinical educator roles and sought faculty development to enhance feedback and assessment skills. Perceived benefits to students addressed learning and wellness, with concern for students' motivation and professional development. Faculty shared uncertainty about their roles and larger systemic consequences involving the residency match and institutional reputation. Participants acknowledged that traditional grading is imperfect, yet felt a departure from this system represented significant culture change. CONCLUSIONS Faculty perceptions of the assessment and grade change in 2 large departments demonstrated tensions around grading. Their descriptions of change as an ongoing process aligned with CBAM and required them to consider new approaches and perspectives. While discourse about assessment and grading frequently focuses on learners, these findings support institutional consideration of the impact of changes in assessment on teaching faculty.
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MESH Headings
- Clinical Clerkship/standards
- Clinical Clerkship/statistics & numerical data
- Clinical Competence/statistics & numerical data
- Education, Medical/standards
- Education, Medical/statistics & numerical data
- Education, Medical, Undergraduate/standards
- Education, Medical, Undergraduate/statistics & numerical data
- Educational Measurement/methods
- Faculty, Medical/statistics & numerical data
- Faculty, Medical/trends
- Feedback
- Female
- Humans
- Leadership
- Learning/physiology
- Male
- Perception
- Qualitative Research
- San Francisco/epidemiology
- Schools, Medical/organization & administration
- Students, Medical/psychology
- Surveys and Questionnaires
- Thematic Apperception Test/statistics & numerical data
- Universities/organization & administration
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Affiliation(s)
- Jordan A McDonald
- J.A. McDonald is a third-year medical student, University of California, San Francisco, School of Medicine, San Francisco, California
| | - Cindy J Lai
- C.J. Lai is director of internal medicine clerkships and professor, Department of Medicine, University of California, San Francisco, School of Medicine, San Francisco, California
| | - Matthew Y C Lin
- M.Y.C. Lin is director of surgery clerkships and associate professor, Department of Surgery, University of California, San Francisco, School of Medicine, San Francisco, California
| | - Patricia S O'Sullivan
- P.S. O'Sullivan is director of research and development in medical education and professor, Department of Medicine and Department of Surgery, University of California, San Francisco, School of Medicine, San Francisco, California
| | - Karen E Hauer
- K.E. Hauer is associate dean for competency assessment and professional standards and professor, Department of Medicine, University of California, San Francisco, School of Medicine, San Francisco, California
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Buckley H, Nimmon L. Learning in Faculty Development: The Role of Social Networks. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2020; 95:S20-S27. [PMID: 32769458 DOI: 10.1097/acm.0000000000003627] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
PURPOSE Faculty development is increasingly acknowledged as an important aspect of health professions education. Its conceptualization has evolved from an individual skills training activity to contemporary notions that draw on an organizational model. This organizational model recognizes relationships and networks as important mediators of knowledge mobilization. Although such conceptual advancements are critical, we lack empirical evidence and robust insights into how social networks function to shape learning in faculty development. The purpose of this study was to understand how informal professional social networks influence faculty development learning in the health professions. METHOD This study used a qualitative social network approach to explore how teaching faculty's relationships influenced their learning about teaching. The study was conducted in 2018 in an undergraduate course at a Canadian medical school. Eleven faculty participants were recruited, and 3 methods of data collection were employed: semistructured interviews, participant-drawn sociograms, and demographic questionnaires. RESULTS The social networks of faculty participants influenced their learning about teaching in the following 4 dimensions: enabling and mobilizing knowledge acquisition, shaping identity formation, expressing vulnerability, and scaffolding learning. CONCLUSIONS Faculty developers should consider faculty's degree of social embeddedness in their professional social networks, as our study suggests this may influence their learning about teaching. The findings align with recent calls to conceptually reorient faculty development in the health professions as a dynamic social enterprise.
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Affiliation(s)
- Heather Buckley
- H. Buckley is clinical assistant professor, Department of Family Practice, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Laura Nimmon
- L. Nimmon is scientist, Center for Health Education Scholarship, and associate professor, Department of Occupational Science and Occupational Therapy, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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Time to develop more clinician-educators in allergy and immunology. J Allergy Clin Immunol 2020; 145:456-462. [DOI: 10.1016/j.jaci.2019.12.008] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Revised: 12/11/2019] [Accepted: 12/12/2019] [Indexed: 01/24/2023]
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Sheu L, Hauer KE, Schreiner K, van Schaik SM, Chang A, O'Brien BC. "A Friendly Place to Grow as an Educator": A Qualitative Study of Community and Relationships Among Medical Student Coaches. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2020; 95:293-300. [PMID: 31348059 DOI: 10.1097/acm.0000000000002900] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
PURPOSE The rise of coaching programs in medical education sparks questions about ways to support physician coaches in learning new educational practices specific to coaching. How coaches learn from one another is of particular interest considering the potential value of social learning. Using communities of practice as a conceptual framework, the authors examine the sense of community and relationships among coaches in a new medical student coaching program, the value of this community, and the facilitators and barriers influencing community development. METHOD In this qualitative study, investigators conducted 34 interviews with physician coaches at 1 institution over 2 years (2017-2018) and observed 36 coach meetings. Investigators analyzed interview transcripts using thematic analysis and used observation field notes for context and refinement of themes. RESULTS Coaches described a sense of community based on regular interactions; shared commitment to medical education; and new roles with similar experiences, joys, and challenges. They valued the sense of camaraderie and support, learning from one another, and opportunities for professional growth that strengthened their identities as educators and enhanced job satisfaction. Facilitators of community included regular meetings, leadership and administrative support, and informal opportunities to interact outside of meetings. Barriers included time constraints and geographic challenges for coaches at off-site locations. CONCLUSIONS The sense of community among coaches was a valued and beneficial part of their coaching experience. Coaches' interactions and relationships promoted skill acquisition, knowledge transfer, professional development, and career satisfaction. Thus, incorporating support for social learning in coaching programs promotes coach faculty development.
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Affiliation(s)
- Leslie Sheu
- L. Sheu is assistant professor of medicine, Department of Medicine, University of California, San Francisco, School of Medicine, San Francisco, California. K.E. Hauer is associate dean for assessment and professor of medicine, Department of Medicine, University of California, San Francisco, School of Medicine, San Francisco, California. K. Schreiner is a medical student, George Washington University School of Medicine, Washington, DC. S.M. van Schaik is Baum Presidential Chair of Experiential Learning and professor of pediatrics, Department of Pediatrics, University of California, San Francisco, School of Medicine, San Francisco, California. A. Chang is professor of medicine, Department of Medicine, University of California, San Francisco, School of Medicine, San Francisco, California. B.C. O'Brien is associate professor of medicine, Department of Medicine, and education scientist, Center for Faculty Educators, University of California, San Francisco, School of Medicine, San Francisco, California
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O'Sullivan PS. What Questions Guide Investing in Our Faculty? ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2019; 94:S11-S13. [PMID: 31365404 DOI: 10.1097/acm.0000000000002910] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Affiliation(s)
- Patricia S O'Sullivan
- P.S. O'Sullivan is professor, Medicine and Surgery, University of California, San Francisco School of Medicine, San Francisco, California
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13
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Olasoji HO, Mu’azu AB, Garba MH. A study of clinical teachers' attitude to teaching and perceived learning needs in a medical college in Nigeria. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2019; 10:605-617. [PMID: 31496862 PMCID: PMC6697644 DOI: 10.2147/amep.s171550] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/18/2018] [Accepted: 06/30/2018] [Indexed: 06/10/2023]
Abstract
BACKGROUND AND PURPOSE Debates on medical educational reform initiatives in Nigeria have gradually shifted from access to medical colleges to improving learning quality. Understandably, clinical teachers are being encouraged to acquire basic teaching pedagogical knowledge through learning activities. Considering the fact that the concept of faculty development for medical teachers' is still evolving in Sub-Saharan Africa, this study aims to explore clinical teachers' attitude to teaching and perceptions of continuing education in teaching knowledge and skills in a medical college in Nigeria. METHODS Using a mixed-method research approach, quantitative data were collected from a sample of teachers through survey questionnaires, and qualitative data were obtained through face-to-face individual semi-structured interviews of teachers from the same institution. RESULTS Sixty-one survey questionnaires (response rate of 88%) and 10 interviews were completed and analyzed. Findings revealed that teachers' derived satisfaction from teaching and maintain a strong commitment to teaching. Bedside teachings (64%) and lectures (21%) were reported to be the most frequent mode of teaching. Although four out of every five respondents (80%) reported not having previous training in teaching, a large proportion (97%) self-assessed their teaching abilities to be average or above average, with most indicating that the experience of teaching observed during undergraduate medical training may be sufficient preparation for their teaching roles. The majority of the teachers' were of the opinion that there is a need to improve their individual teaching skill. However, in the absence of formal faculty development programs in the college, most of the teachers indicated that their teaching skills are currently being improved through sporadic informal community of practice involving interested colleagues and modeling identified good teachers. CONCLUSION A catalyst of learning by teachers' may come from their belief and self-rating of teaching ability. In this under-resourced context, explicit classifications of existing informal learning opportunities coupled with greater institutional support could improve teaching and teachers' development.
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Affiliation(s)
- HO Olasoji
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, College of Medical Sciences, University of Maiduguri, Maiduguri, Borno State, Nigeria
| | - Ahmad Bilyamini Mu’azu
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, College of Medical Sciences, University of Maiduguri, Maiduguri, Borno State, Nigeria
| | - Mairo Hassan Garba
- Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, College of Medical Sciences, University of Maiduguri, Maiduguri, Borno State, Nigeria
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Philibert I. The International Literature on Teaching Faculty Development in English-Language Journals: A Scoping Review and Recommendations for Core Topics. J Grad Med Educ 2019; 11:47-63. [PMID: 31428259 PMCID: PMC6697281 DOI: 10.4300/jgme-d-19-00174] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Revised: 05/01/2019] [Accepted: 05/23/2019] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND With increasing physician mobility, there is interest in how medical schools and postgraduate medical education institutions across the world develop and maintain the competence of medical teachers. Published reviews of faculty development (FD) have predominantly included studies from the United States and Canada. OBJECTIVE We synthesized the international FD literature (beyond the US and Canada), focusing on FD type, intended audience, study format, effectiveness, differences among countries, and potential unique features. METHODS We identified English-language publications that addressed FD for medical faculty for teaching and related activities, excluding US and Canadian publications. RESULTS A search of 4 databases identified 149 publications, including 83 intervention studies. There was significant growth in international FD publications for the most recent decade, and a sizable number of studies were from developing economies and/or resulted from international collaborations. Focal areas echo those in earlier published reviews, suggesting the international FD literature addresses similar faculty needs and organizational concerns. CONCLUSIONS The growth in publications in recent years and a higher proportion of reporting on participant reactions, coupled with less frequent reporting of results, transfer to practice, and impact on learners and the organization, suggest this is an evolving field. To enhance international FD, educators and researchers should focus on addressing common needs expressed by faculty, including curriculum design and evaluation, small group teaching, assessing professionalism and providing feedback. Future research should focus on approaches for developing comprehensive institutional FD programs that include communities of learning and practice and evaluating their impact.
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Artino AR, Phillips AW, Utrankar A, Ta AQ, Durning SJ. "The Questions Shape the Answers": Assessing the Quality of Published Survey Instruments in Health Professions Education Research. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2018; 93:456-463. [PMID: 29095172 DOI: 10.1097/acm.0000000000002002] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
PURPOSE Surveys are widely used in health professions education (HPE) research, yet little is known about the quality of the instruments employed. Poorly designed survey tools containing unclear or poorly formatted items can be difficult for respondents to interpret and answer, yielding low-quality data. This study assessed the quality of published survey instruments in HPE. METHOD In 2017, the authors performed an analysis of HPE research articles published in three high-impact journals in 2013. They included articles that employed at least one self-administered survey. They designed a coding rubric addressing five violations of established best practices for survey item design and used it to collect descriptive data on the validity and reliability evidence reported and to assess the quality of available survey items. RESULTS Thirty-six articles met inclusion criteria and included the instrument for coding, with one article using 2 surveys, yielding 37 unique surveys. Authors reported validity and reliability evidence for 13 (35.1%) and 8 (21.6%) surveys, respectively. Results of the item-quality assessment revealed that a substantial proportion of published survey instruments violated established best practices in the design and visual layout of Likert-type rating items. Overall, 35 (94.6%) of the 37 survey instruments analyzed contained at least one violation of best practices. CONCLUSIONS The majority of articles failed to report validity and reliability evidence, and a substantial proportion of the survey instruments violated established best practices in survey design. The authors suggest areas of future inquiry and provide several improvement recommendations for HPE researchers, reviewers, and journal editors.
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Affiliation(s)
- Anthony R Artino
- A.R. Artino Jr is professor of medicine and deputy director of graduate programs in health professions education, Department of Medicine, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland; ORCID: http://orcid.org/0000-0003-2661-7853. A.W. Phillips is adjunct clinical professor of emergency medicine, Department of Emergency Medicine, University of North Carolina, Chapel Hill, North Carolina. A. Utrankar is a fourth-year medical student, Vanderbilt University School of Medicine, Nashville, Tennessee. A.Q. Ta is a second-year medical student, University of Illinois College of Medicine, Chicago, Illinois. S.J. Durning is professor of medicine and pathology and director of graduate programs in health professions education, Department of Medicine, F. Edward Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland
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van den Berg JW, Verberg CPM, Scherpbier AJJA, Jaarsma ADC, Lombarts KMJMH. Is being a medical educator a lonely business? The essence of social support. MEDICAL EDUCATION 2017; 51:302-315. [PMID: 28084019 DOI: 10.1111/medu.13162] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2016] [Revised: 04/25/2016] [Accepted: 07/27/2016] [Indexed: 05/27/2023]
Abstract
CONTEXT Social support helps prevent burnout and promotes its positive opposite, work engagement. With higher work engagement performance increases. The context-specific aspects of social support for medical educators, in their educator role, are unknown. To help facilitate social support our study describes the essential elements of social support and their meaning for medical educators. METHODS We held interviews with medical educators purposefully sampled for diverse backgrounds and working circumstances and who spent a considerable amount of time on education. Both clinicians and basic scientists participated. The Pictor technique guided the interviews. Participants were invited to talk about the breadth of social support and elaborate on meaningful experiences. Template analysis was used for a descriptive phenomenological approach. RESULTS Thirteen medical educators were interviewed. We identified four themes: (i) sources of support and their intent (e.g. a superior with the intent to stimulate personal growth); (ii) the materialisation of support (e.g. sought or offered); (iii) its manifestation (e.g. the act of providing protected time); and (iv) the overarching effect of social support, both in terms of practical effects and the meaning of support. We identified three sorts of meanings of social support for educators. Receiving support could lead to (i) feeling reassured and confident; (ii) feeling encouraged and determined and (iii) a sense of relatedness and acknowledgement of the educator role. CONCLUSION Support for education comes from a wide range of sources because it is both sought and offered beyond the boundaries of the educational role. The resulting differences in support provided necessitate that educational leaders and policymakers consider the sources available to each educator, connecting educators where necessary. When facilitating or designing social support it is important that the need to feel reassured, encouraged or related is met.
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Affiliation(s)
- Joost W van den Berg
- Center for Evidence-Based Education Professional Performance Research Group, Academic Medical Center (AMC-UvA), University of Amsterdam, Amsterdam, the Netherlands
| | | | - Albert J J A Scherpbier
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - A Debbie C Jaarsma
- Center for Education Development and Research in Health Professions, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Kiki M J M H Lombarts
- Center for Evidence-Based Education Professional Performance Research Group, Academic Medical Center (AMC-UvA), University of Amsterdam, Amsterdam, the Netherlands
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Cantillon P, D'Eath M, De Grave W, Dornan T. How do clinicians become teachers? A communities of practice perspective. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2016; 21:991-1008. [PMID: 26961285 DOI: 10.1007/s10459-016-9674-9] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/04/2015] [Accepted: 03/03/2016] [Indexed: 05/12/2023]
Abstract
There is widespread acceptance that clinical educators should be trained to teach, but faculty development for clinicians is undermined by poor attendance and inadequate learning transfer. As a result there has been growing interest in situating teacher development initiatives in clinical workplaces. The relationship between becoming a teacher and clinical workplace contexts is under theorised. In response, this qualitative research set out to explore how clinicians become teachers in relation to clinical communities and institutions. Using communities of practice (CoP) as a conceptual framework this research employed the sensitising concepts of regimes of competence and vertical (managerial) and horizontal (professional) planes of accountability to elucidate structural influences on teacher development. Fourteen hospital physicians completed developmental timelines and underwent semi-structured interviews, exploring their development as teachers. Despite having very different developmental pathways, participants' descriptions of their teacher identities and practice that were remarkably congruent. Two types of CoP occupied the horizontal plane of accountability i.e. clinical teams (Firms) and communities of junior doctors (Fraternities). Participants reproduced teacher identities and practice that were congruent with CoPs' regimes of competence in order to gain recognition and legitimacy. Participants also constructed their teacher identities in relation to institutions in the vertical plane of accountability (i.e. hospitals and medical schools). Institutions that valued teaching supported the development of teacher identities along institutionally defined lines. Where teaching was less valued, clinicians adapted their teacher identities and practices to suit institutional norms. Becoming a clinical educator entails continually negotiating one's identity and practice between two potentially conflicting planes of accountability. Clinical CoPs are largely conservative and reproductive of teaching practice whereas accountability to institutions is potentially disruptive of teacher identity and practice.
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Affiliation(s)
- P Cantillon
- Discipline of General Practice, NUI Galway, Galway, UK.
| | - M D'Eath
- Discipline of General Practice, NUI Galway, Galway, UK
| | - W De Grave
- School of Health Professionals Education, Maastricht University, Maastricht, Netherlands
| | - T Dornan
- School of Health Professionals Education, Maastricht University, Maastricht, Netherlands
- Centre for Medical Education, Queens University, Belfast, UK
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van Loon KA, Teunissen PW, Driessen EW, Scheele F. The Role of Generic Competencies in the Entrustment of Professional Activities: A Nationwide Competency-Based Curriculum Assessed. J Grad Med Educ 2016; 8:546-552. [PMID: 27777665 PMCID: PMC5058587 DOI: 10.4300/jgme-d-15-00321.1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
BACKGROUND Entrustable professional activities (EPAs) seek to translate essential physician competencies into clinical practice. Until now, it is not known whether EPA-based curricula offer enhanced assessment and feedback to trainees. OBJECTIVE This study examined program directors' and senior residents' justifications for entrustment decisions and what role generic, cross-specialty competencies (such as communication skills, collaboration, and understanding health care systems) play in these decisions. METHODS Entrustment decisions for all Dutch obstetrics and gynecology residents between January 2010 and April 2014 were retrieved from their electronic portfolios. Justifications for entrustment were divided into 4 categories: the resident's experience, his or her technical performance, the presence of a generic competency, and training. Template analysis was used to analyze in depth the types of justifications, which play a role in entrustment decisions. RESULTS A total of 5139 entrustment decisions for 375 unique residents were extracted and analyzed. In 59% of all entrustment decisions, entrusting a professional task to a resident was justified by the experience of the resident. Generic competencies were mentioned in 0.5% of all entrustment decisions. Template analysis revealed that the amount of exposure and technical skills are leading factors, while the quality of the performance was not reported to be of any influence. CONCLUSIONS Entrustment decisions only rarely are based on generic competencies, despite the introduction of competency frameworks and EPAs. For program directors, a leading factor in entrustment decisions is a resident's exposure to an activity, and the quality of a resident's performance appears to play only a minor role.
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Affiliation(s)
- Karsten A. van Loon
- Corresponding author: Karsten A. van Loon, MSc, OLVG West, Jan Tooropstraat 164, 1061 AE, Amsterdam, the Netherlands,
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Steinert Y, Mann K, Anderson B, Barnett BM, Centeno A, Naismith L, Prideaux D, Spencer J, Tullo E, Viggiano T, Ward H, Dolmans D. A systematic review of faculty development initiatives designed to enhance teaching effectiveness: A 10-year update: BEME Guide No. 40. MEDICAL TEACHER 2016; 38:769-86. [PMID: 27420193 DOI: 10.1080/0142159x.2016.1181851] [Citation(s) in RCA: 297] [Impact Index Per Article: 37.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
BACKGROUND This review, which focused on faculty development initiatives designed to improve teaching effectiveness, synthesized findings related to intervention types, study characteristics, individual and organizational outcomes, key features, and community building. METHODS This review included 111 studies (between 2002 and 2012) that met the review criteria. FINDINGS Overall satisfaction with faculty development programs was high. Participants reported increased confidence, enthusiasm, and awareness of effective educational practices. Gains in knowledge and skills, and self-reported changes in teaching behaviors, were frequently noted. Observed behavior changes included enhanced teaching practices, new educational initiatives, new leadership positions, and increased academic output. Organizational changes were infrequently explored. Key features included evidence-informed educational design, relevant content, experiential learning, feedback and reflection, educational projects, intentional community building, longitudinal program design, and institutional support. CONCLUSION This review holds implications for practice and research. Moving forward, we should build on current success, broaden the focus beyond individual teaching effectiveness, develop programs that extend over time, promote workplace learning, foster community development, and secure institutional support. We should also embed studies in a theoretical framework, conduct more qualitative and mixed methods studies, assess behavioral and organizational change, evaluate transfer to practice, analyse key features, and explore the role of faculty development within the larger organizational context.
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Affiliation(s)
- Yvonne Steinert
- a Centre for Medical Education, Faculty of Medicine , McGill University , Montreal , Canada
| | - Karen Mann
- b Division of Medical Education, Faculty of Medicine , Dalhousie University , Halifax , Canada
| | - Brownell Anderson
- c International Programs , National Board of Medical Examiners , Philadelphia, PA , USA
| | - Bonnie Maureen Barnett
- d Department of Integrated Studies in Education, Faculty of Education , McGill University , Montreal , Canada
| | - Angel Centeno
- e Faculty of Biomedical Sciences , Austral University , Buenos Aires , Argentina
| | - Laura Naismith
- f HoPingKong Centre for Excellence in Education and Practice and The Wilson Centre , University Health Network , Toronto , Canada
| | - David Prideaux
- g Prideaux Centre for Research in Health Professions Education , School of Medicine, Flinders University , Adelaide , Australia
| | - John Spencer
- h School of Medical Education, Faculty of Medical Sciences , Newcastle University , Newcastle upon Tyne , UK
| | - Ellen Tullo
- i Newcastle NIHR Biomedical Research Centre in Ageing and Chronic Disease and Institute of Health and Society , Newcastle University , Newcastle upon Tyne , UK
| | | | - Helena Ward
- k Medicine Learning and Teaching Unit, School of Medicine , The University of Adelaide , Adelaide , Australia
| | - Diana Dolmans
- l School of Health Professions Education (SHE) , Maastricht University , Maastricht , The Netherlands
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Sexton JM, Lord JA, Brenner CJ, Curry CE, Shyn SI, Cowley DS. Peer Mentoring Process for Psychiatry Curriculum Revision: Lessons Learned from the "Mod Squad". ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2016; 40:436-440. [PMID: 25876089 DOI: 10.1007/s40596-014-0274-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/01/2014] [Accepted: 11/27/2014] [Indexed: 06/04/2023]
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Lefroy J, Watling C, Teunissen PW, Brand P. Guidelines: the do's, don'ts and don't knows of feedback for clinical education. PERSPECTIVES ON MEDICAL EDUCATION 2015; 4:284-299. [PMID: 26621488 PMCID: PMC4673072 DOI: 10.1007/s40037-015-0231-7] [Citation(s) in RCA: 182] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/09/2023]
Abstract
INTRODUCTION The guidelines offered in this paper aim to amalgamate the literature on formative feedback into practical Do's, Don'ts and Don't Knows for individual clinical supervisors and for the institutions that support clinical learning. METHODS The authors built consensus by an iterative process. Do's and Don'ts were proposed based on authors' individual teaching experience and awareness of the literature, and the amalgamated set of guidelines were then refined by all authors and the evidence was summarized for each guideline. Don't Knows were identified as being important questions to this international group of educators which if answered would change practice. The criteria for inclusion of evidence for these guidelines were not those of a systematic review, so indicators of strength of these recommendations were developed which combine the evidence with the authors' consensus. RESULTS A set of 32 Do and Don't guidelines with the important Don't Knows was compiled along with a summary of the evidence for each. These are divided into guidelines for the individual clinical supervisor giving feedback to their trainee (recommendations about both the process and the content of feedback) and guidelines for the learning culture (what elements of learning culture support the exchange of meaningful feedback, and what elements constrain it?) CONCLUSION Feedback is not easy to get right, but it is essential to learning in medicine, and there is a wealth of evidence supporting the Do's and warning against the Don'ts. Further research into the critical Don't Knows of feedback is required. A new definition is offered: Helpful feedback is a supportive conversation that clarifies the trainee's awareness of their developing competencies, enhances their self-efficacy for making progress, challenges them to set objectives for improvement, and facilitates their development of strategies to enable that improvement to occur.
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Affiliation(s)
- Janet Lefroy
- Keele University School of Medicine, Clinical Education Centre RSUH, ST4 6QG, Staffordshire, UK.
| | - Chris Watling
- Schulich School of Medicine and Dentistry, Western University, Ontario, Canada
| | - Pim W Teunissen
- Maastricht University and VU University Medical Center, Amsterdam, The Netherlands
| | - Paul Brand
- Isala Klinieken, Zwolle, The Netherlands
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Warman SM, Laws EJ, Crowther E, Baillie S. Initiatives to improve feedback culture in the final year of a veterinary program. JOURNAL OF VETERINARY MEDICAL EDUCATION 2014; 41:162-171. [PMID: 24686719 DOI: 10.3138/jvme.1013-142r] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Despite the recognized importance of feedback in education, student satisfaction with the feedback process in medical and veterinary programs is often disappointing. We undertook various initiatives to try to improve the feedback culture in the final clinical year of the veterinary program at the University of Bristol, focusing on formative verbal feedback. The initiatives included E-mailed guidelines to staff and students, a faculty development workshop, and a reflective portfolio task for students. Following these initiatives, staff and students were surveyed regarding their perceptions of formative feedback in clinical rotations, and focus groups were held to further explore issues. The amount of feedback appeared to have increased, along with improved recognition of feedback by students and increased staff confidence and competence in the process. Other themes that emerged included inconsistencies in feedback among staff and between rotations; difficulties with giving verbal feedback to students, particularly when it relates to professionalism; the consequences of feedback for both staff and students; changes and challenges in students' feedback-seeking behavior; and the difficulties in providing accurate, personal end-of-rotation assessments. This project has helped improve the feedback culture within our clinics; the importance of sustaining and further developing the feedback culture is discussed in this article.
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