Conceptualization and Reporting of Context in the North American Continuing Medical Education Literature: A Scoping Review Protocol

Developing an evaluation framework for assessing the impact of recovery colleges: protocol for a participatory stakeholder engagement process and cocreated scoping review

INTRODUCTION

Recovery colleges (RCs) are mental health centres aimed at equipping people with skills to live a meaningful life despite the presence of mental distress. Unique to them is the aspect of cocreation; RCs are designed collaboratively with people of lived experiences of mental health and addictions and care providers. Despite established benefits, there remains a lack of empirical evidence on how RCs work and on their impact.

AIMS

We aim to address this gap by designing a cocreated evaluation framework for RCs. This will be accomplished by engaging RC student/facilitators to provide perspectives on RCs/RC evaluation and cocreate a scoping review identifying evaluation gaps in the literature. Themes identified through these processes will form the evaluation framework.

METHODS AND ANALYSIS

Two methodologies will be used to explore RC evaluation: student/facilitator engagement and a scoping review of current published and grey literature on RC evaluation. Engagement will be achieved using a participatory action research approach consisting of informant interviews of ~25 RC students/facilitators across Canada, which will be thematically analysed. The scoping review will follow methodology described by Arksey and O'Malley modified to support cocreation. Concurrent conducting of the engagement process and scoping review will allow RC students and peer facilitators the opportunity to shape RC evaluations, address gaps in the literature and codesign an evaluation framework focused on recovery-oriented processes and outcomes mattering most to RCs students/facilitators.

ETHICS AND DISSEMINATION

Ethics approval was received for the RC student/facilitator engagement component from the Centre for Addictions and Mental Health Research Ethics Board (#042-2020) and Ontario Shores Centre for Mental Health Sciences (#20-013-B). Scoping review results will be copresented through national and international medical education conferences and published in open-access peer-reviewed journals. Furthermore, a dissemination strategy on evaluation for the national RC community will be created.

A Unified Theoretical Framework of Learning Theories to Inform and Guide Public Health Continuing Medical Education Research and Practice

Continuing medical education (CME) emerged at the start of the 20th century as a means of maintaining clinical competence among health care practitioners. However, evidence indicates that CME is often poorly developed and inappropriately used. Consequently, there has been increasing interest in the literature in evaluating wider contexts at play in CME development and delivery. In this article, the authors present a unified theoretical framework, grounded in learning theories, to explore the role of contextual factors in public health CME for health care practitioners. Discussion with pedagogical experts together with a narrative review of learning theories within medical and social science literature informed the framework's development. The need to consider sociocultural theories of learning within medical education restricted suitable theories to those that recognized contexts beyond the individual learner; adopted a systems approach to evaluate interactions between contexts and learner; and considered learning as more than mere acquisition of knowledge. Through a process of rigorous critical analysis, two theoretical models emerged as contextually appropriate: Biggs principle of constructive alignment and Bronfenbrenner bioecological model of human development. Biggs principle offers theoretical clarity surrounding interactive factors that encourage lifelong learning, whereas the Bronfenbrenner model expands on these factor's roles across multiple system levels. The authors explore how unification into a single framework complements each model while elaborating on its fundamental and practical applications. The unified theoretical framework presented in this article addresses the limitations of isolated frameworks and allows for the exploration of the applicability of wider learning theories in CME research.

Conceptualization of Competency-Based Medical Education Terminology in Family Medicine Postgraduate Medical Education and Continuing Professional Development: A Scoping Review

PURPOSE

To examine the extent, range, and nature of how competency-based medical education (CBME) implementation terminology is used (i.e., the conceptualization of CBME-related terms) within the family medicine postgraduate medical education (PGME) and continuing professional development (CPD) literature.

METHOD

This scoping review's methodology was based on Arksey and O'Malley's framework and subsequent recommendations by Tricco and colleagues. The authors searched 5 databases and the gray literature for U.S. and Canadian publications between January 2000 and April 2017. Full-text English-language articles on CBME implementation that focused exclusively on family medicine PGME and/or CPD programs were eligible for inclusion. A standardized data extraction form was used to collect article demographic data and coding concepts data. Data analysis used mixed methods, including quantitative frequency analysis and qualitative thematic analysis.

RESULTS

Of 470 unique articles identified, 80 (17%) met the inclusion criteria and were selected for inclusion in the review. Only 12 (15%) of the 80 articles provided a referenced definition of the coding concepts (i.e., referred to an article/organization as the definition's source), resulting in 19 highly variable-and 12 unique- referenced definitions of key terms used in CBME implementation (competence, competency, competency-based medical education). Thematic analysis of the referenced definitions identified 15 dominant themes, among which the most common were (1) a multidimensional and dynamic concept that encompasses a variety of skill components and (2) being able to use communication, knowledge, technical skills, clinical reasoning, judgment, emotions, attitudes, personal values, and reflection in practice.

CONCLUSIONS

The construction and dissemination of shared definitions is essential to CBME's successful implementation. The low number of referenced definitions and lack of consensus on such definitions suggest more attention needs to be paid to conceptual rigor. The authors recommend those involved in family medicine education work with colleagues across medical specialties to develop a common taxonomy.

Psychosocial and quality of life impact of scars in the surgical, traumatic and burn populations: a scoping review protocol

INTRODUCTION

Despite the fact that millions of scars affect individuals annually, little is known about their psychosocial impact and overall quality of life (QOL) on individuals. Scars from multiple aetiologies may cause psychiatric and emotional disturbances, can limit physical functioning and increase costs to the healthcare system. The purpose of this protocol is to describe the methodological considerations that will guide the completion of a scoping review that will summarise the extent, range and nature of psychosocial health outcomes and QOL of scars of all aetiologies.

METHODS AND ANALYSIS

A modified Arksey and O'Malley (2005) framework will be completed, namely having ongoing consultation between experts from the beginning of the process, then (1) identifying the research question/s, (2) identifying the relevant studies from electronic databases and grey literature, with (3) study selection and (4) charting of data by two independent coders, and (5) collating, summarising and reporting data. Experts will include a health information specialist (TAW), scar expert (JSF), scoping review consultant (SCK), as well as at least two independent coders (NZ, AM).

ETHICS AND DISSEMINATION

Ethics approval will not be sought for this scoping review. We plan to disseminate this research through publications, presentations and meetings with relevant stakeholders.