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Bogaty C, Frambach J. The CanMEDS Competency Framework in laboratory medicine: a phenomenographic study exploring how professional roles are applied outside the clinical environment. CANADIAN MEDICAL EDUCATION JOURNAL 2024; 15:26-36. [PMID: 38528898 PMCID: PMC10961121 DOI: 10.36834/cmej.77140] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 03/27/2024]
Abstract
Background The CanMEDS Competency Framework is an internationally recognized model used to outline the proficiencies of a physician. It has predominantly been studied in clinical environments but not all medical specialties take part in direct patient contact. In laboratory medicine, the role of the physician is to promote and enhance patient diagnostics by managing and overseeing the functions of a diagnostic laboratory. Methods This phenomenographic study explores the lived experiences of biochemistry, microbiology, and pathology residency program directors to better understand how they utilize the CanMEDS competencies. Eight laboratory medicine program directors from across Canada were individually interviewed using a semi-structured interview, and the data was analysed using inductive thematic analysis. Results The findings show that the current framework is disconnected from the unique context of laboratory medicine with some competencies appearing unrelatable using the current standardized definitions and expectations. Nevertheless, participants considered the framework to be an appropriate blueprint of the competencies necessary for their professional environment, but to make it accessible more autonomy is required to adapt the framework to their needs. Conclusion Newer renditions of the CanMEDS Competency Framework should better consider the realities of non-clinical disciplines.
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Affiliation(s)
- Chloe Bogaty
- Service de microbiologie et d'infectiologie, Centre hospitalier affilié universitaire Hôtel-Dieu de Lévis, Quebec, Canada
- School of Health Professions Education (SHE), Maastricht University, Maastricht, The Netherlands
| | - Janneke Frambach
- School of Health Professions Education (SHE), Maastricht University, Maastricht, The Netherlands
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Janssens O, Embo M, Valcke M, Haerens L. When theory beats practice: the implementation of competency-based education at healthcare workplaces : Focus group interviews with students, mentors, and educators of six healthcare disciplines. BMC MEDICAL EDUCATION 2023; 23:484. [PMID: 37386406 DOI: 10.1186/s12909-023-04446-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 06/13/2023] [Indexed: 07/01/2023]
Abstract
BACKGROUND Work-integrated learning constitutes a large part of current healthcare education. During the last decades, a competency-based educational (CBE) approach has been introduced to reduce the theory-practice gap and to promote continuous competency development. Different frameworks and models have been developed to support CBE implementation in practice. Although CBE is now well-established, implementation at healthcare workplaces remains complex and controversial. This study aims to explore how students, mentors, and educators from different healthcare disciplines perceive the implementation of CBE at the workplace. The six-step model of Embo et al. (2015) was used as a base: (1) competency selection, (2) formulating learning goals, (3) self-monitoring performance, (4) self-assessing competency development, (5) summative assessment of individual competencies, and (6) summative assessment of global professional competence. METHODS Three semi-structured focus group interviews were conducted with (1) five students, (2) five mentors, and (3) five educators. We recruited participants from six different educational programs: audiology, midwifery, nursing (associate degree and bachelor), occupational therapy, or speech therapy. We used thematic analysis combining an inductive and deductive approach. RESULTS An overview of the predefined competencies was hard to find which complicated CBE implementation and resulted in a lack of consistency between the steps; e.g., the link between the selection of relevant competencies (step 1) and the formulation of learning goals based on these selected competencies (step 2) was absent. Furthermore, the analysis of the data helped identifying seven barriers for CBE implementation: (1) a gap between the educational program and the workplace, (2) a lacking overview of predefined competencies, (3) a major focus on technical competencies at the expense of generic competencies, (4) weak formulation of the learning goals, (5) obstacles related to reflection, (6) low feedback quality, and (7) perceived subjectivity of the assessment approach. CONCLUSION The present barriers to CBE implementation lead to a fragmentation of current work-integrated learning. In this way, theory beats practice when it comes to CBE implementation as the theory of CBE is not effectively implemented. However, the identification of these barriers might help to find solutions to optimize CBE implementation. Future research seems critical to optimize CBE so that theory can meet practice and the opportunities of CBE optimize healthcare education.
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Affiliation(s)
- Oona Janssens
- Department of Educational Studies, Faculty of Psychology and Educational Sciences, Ghent University, H. Dunantlaan 2, Ghent, 9000, Belgium.
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, 9000, Belgium.
| | - Mieke Embo
- Department of Educational Studies, Faculty of Psychology and Educational Sciences, Ghent University, H. Dunantlaan 2, Ghent, 9000, Belgium
- Expertise Network Health and Care, Artevelde University of Applied Sciences, Voetweg 66, Ghent, 9000, Belgium
| | - Martin Valcke
- Department of Educational Studies, Faculty of Psychology and Educational Sciences, Ghent University, H. Dunantlaan 2, Ghent, 9000, Belgium
| | - Leen Haerens
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Ghent, 9000, Belgium
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Andreou V, Peters S, Eggermont J, Embo M, Michels NR, Schoenmakers B. Fitness-for-purpose of the CanMEDS competencies for workplace-based assessment in General Practitioner's Training: a Delphi study. BMC MEDICAL EDUCATION 2023; 23:204. [PMID: 37005633 PMCID: PMC10067520 DOI: 10.1186/s12909-023-04207-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 03/28/2023] [Indexed: 06/19/2023]
Abstract
BACKGROUND In view of the exponential use of the CanMEDS framework along with the lack of rigorous evidence about its applicability in workplace-based medical trainings, further exploring is necessary before accepting the framework as accurate and reliable competency outcomes for postgraduate medical trainings. Therefore, this study investigated whether the CanMEDS key competencies could be used, first, as outcome measures for assessing trainees' competence in the workplace, and second, as consistent outcome measures across different training settings and phases in a postgraduate General Practitioner's (GP) Training. METHODS In a three-round web-based Delphi study, a panel of experts (n = 25-43) was asked to rate on a 5-point Likert scale whether the CanMEDS key competencies were feasible for workplace-based assessment, and whether they could be consistently assessed across different training settings and phases. Comments on each CanMEDS key competency were encouraged. Descriptive statistics of the ratings were calculated, while content analysis was used to analyse panellists' comments. RESULTS Out of twenty-seven CanMEDS key competencies, consensus was not reached on six competencies for feasibility of assessment in the workplace, and on eleven for consistency of assessment across training settings and phases. Regarding feasibility, three out of four key competencies under the role "Leader", one out of two competencies under the role "Health Advocate", one out of four competencies under the role "Scholar", and one out of four competencies under the role "Professional" were deemed as not feasible for assessment in a workplace setting. Regarding consistency, consensus was not achieved for one out of five competencies under "Medical Expert", two out of five competencies under "Communicator",one out of three competencies under "Collaborator", one out of two under "Health Advocate", one out of four competencies under "Scholar", one out of four competencies under "Professional". No competency under the role "Leader" was deemed to be consistently assessed across training settings and phases. CONCLUSIONS The findings indicate a mismatch between the initial intent of the CanMEDS framework and its applicability in the context of workplace-based assessment. Although the CanMEDS framework could offer starting points, further contextualization of the framework is required before implementing in workplace-based postgraduate medical trainings.
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Affiliation(s)
- Vasiliki Andreou
- Academic Centre for General Practice, Department of Public Health and Primary Care, KU Leuven, Box 7001, Kapucijnenvoer 7, Leuven, 3000, Belgium.
| | - Sanne Peters
- Academic Centre for General Practice, Department of Public Health and Primary Care, KU Leuven, Box 7001, Kapucijnenvoer 7, Leuven, 3000, Belgium
- School of Health Sciences, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia
| | - Jan Eggermont
- Department of Cellular and Molecular Medicine, KU Leuven, Leuven, Belgium
| | - Mieke Embo
- Department of Educational Studies, Faculty of Psychology and Educational Sciences, University of Ghent, Ghent, Belgium
- Health and Care Research, Artevelde University of Applied Sciences, Ghent, Belgium
| | - Nele R Michels
- Center for General Practice, Department of Family Medicine and Population Health, University of Antwerp, Antwerp, Belgium
| | - Birgitte Schoenmakers
- Academic Centre for General Practice, Department of Public Health and Primary Care, KU Leuven, Box 7001, Kapucijnenvoer 7, Leuven, 3000, Belgium
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Tellier PP, Ataman R, Zaccagnini M, Gore G, Rodriguez C. Adolescent medicine training in postgraduate family medicine education: a scoping review. Int J Adolesc Med Health 2023; 35:119-129. [PMID: 36584348 DOI: 10.1515/ijamh-2022-0087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 12/07/2022] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Adolescents and young adults require age-appropriate healthcare services delivered by clinicians with expertise in adolescent medicine. However, resident family physicians report a low perceived self-efficacy and under-preparedness to deliver adolescent medical care. We conducted a scoping review to map the breadth and depth of the current evidence about adolescent medicine training for family medicine residents. CONTENT We followed Arksey and O'Malley's framework and searched seven electronic databases and key organizations' webpages from inception to September 2020. Informed by the CanMEDS-FM, we analyzed the extracted data concerning basic document characteristics, competencies and medical topics using numerical and qualitative content analysis. SUMMARY We included 41 peer-reviewed articles and six adolescent health competency frameworks (n=47). Most competencies taught in family medicine programs were organized under the roles of family medicine expert (75%), communicator (11.8%), and professional roles (7.9%). Health advocate and leader were rarely included (1.3%), and never scholar. OUTLOOK The omission of multiple competency roles in family medicine resident education on adolescents is insufficient for family physicians to deliver optimal care to adolescents. The combined efforts of family medicine stakeholders to address adolescent medicine competency gaps may positively impact the perceived competence reported by family medicine residents.
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Affiliation(s)
| | - Rebecca Ataman
- The School of Physical and Occupational Therapy, McGill University, Montréal, QC, Canada.,The Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal, Laval, QC, Canada
| | - Marco Zaccagnini
- The School of Physical and Occupational Therapy, McGill University, Montréal, QC, Canada.,The Centre for Interdisciplinary Research in Rehabilitation of Greater Montréal, Laval, QC, Canada
| | - Geneviève Gore
- McGill Schulich Library of Physical Sciences, Life Sciences and Engineering, McGill University, Montréal, QC, Canada
| | - Charo Rodriguez
- Department of Family Medicine, McGill University, Montréal, QC, Canada.,The Institute of Health Sciences Education, McGill University, Montréal, QC, Canada
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Blanchette V, Andoulsi Y, Brousseau M, Leblanc C, Guillemette F, Hue O. Competency Framework for Podiatric Medicine Training in Canada: An Adapted Delphi Study. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2022; 13:1207-1241. [PMID: 36212705 PMCID: PMC9533777 DOI: 10.2147/amep.s372324] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 09/13/2022] [Indexed: 06/16/2023]
Abstract
PURPOSE Podiatrists are generally defined as professionals with high-level skills in the prevention and management of local foot conditions that are not systemic diseases. Across countries, different academic trainings are implemented due to the specific context and practice of podiatric medicine. It is thus essential to support country-specific podiatry education for the development of highly skilled podiatrists. Therefore, we report the development of a podiatric medicine competency framework to support training in Canada. PARTICIPANTS AND METHODS A Delphi process was conducted by 12 stakeholders (including 8 podiatry experts) from the University of Québec at Trois-Rivières which is the only university offering the degree of Doctor of Podiatric Medicine (DPM) in Canada. The developed framework is (1) based on the seven key roles of the Canadian medical education directives of specialists (CanMEDs) and, (2) closely aligned with the requirement of the College of Podiatrists of Québec which sets the standards of entry to practice in Québec. RESULTS The developed framework represents the state of the development process and the consensus of the podiatry experts. It reflects the expected profile of the institution's DPM graduates based on seven key roles (podiatry expert, communicator, collaborator, health advocate, leader and manager, scholar, and professional). This developed framework is an arborescence of complex skills defined in tangible indicators that characterize each expected part of a core competency. Twenty-four core competencies have been determined and divided into 84 enabling competencies and 288 observable indicators. CONCLUSION This competency framework has been designed to support high-quality education and to develop podiatry. Next steps include: (1) validation of this framework by external experts, (2) development of rigorous evaluation methods and, (3) concrete actions for its implementation and assessment. This framework would help to define the scope of practice and capabilities of podiatric medicine, both in Canada and internationally.
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Affiliation(s)
- Virginie Blanchette
- Department of Human Kinetics and Podiatric Medicine, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Yassin Andoulsi
- Department of Human Kinetics and Podiatric Medicine, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Martine Brousseau
- Occupational Therapy Department, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Céline Leblanc
- Bureau de pédagogie et de formation à distance (Pedagogy and Distance Education Office), Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - François Guillemette
- Education Department, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
| | - Olivier Hue
- Department of Human Kinetics and Podiatric Medicine, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
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Li P, Jiang F, Yin L, Chen YQ, Shao L, Li Y, Gao YJ, Lu MH. Perceptions of the CanMEDS Competencies of Faculty and Students in Different Curriculum Systems of a Medical School in China. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2022; 13:1061-1070. [PMID: 36132622 PMCID: PMC9484775 DOI: 10.2147/amep.s367129] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/19/2022] [Accepted: 09/06/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION The Ottawa-Shanghai Joint School of Medicine (OSJSM) has adopted the uOttawa's undergraduate medical education (UGME) program vertically integrated (VI) curriculum.However, limited information is available regarding whether the VI and non-VI curricula foster different perspectives on necessary competencies. METHODS This study included 167 undergraduate medical students and 142 faculty members from different curricula at the Shanghai Jiao Tong University School of Medicine. Participants completed a questionnaire, rating the importance of competencies relating to the seven CanMEDS roles. RESULTS The cognitive level regarding the competencies required to be a successful clinician was significantly higher among participants from VI versus non-VI curricula. All participants gave the highest ratings to the Medical Expert and Professional roles, and rated the Health Advocate role as least important. Competency ratings did not significantly differ between students from VI versus non-VI curricula. Ratings between VI and non-VI faculty showed only one significant difference, namely the competence of"Constantly update clinical knowledge and professional skills" was ranked significantly higher by faculty of non-VI curricula. In the top rated 10 competencies, the Communicator role was considered more important by participants from VI versus non-VI curricula. CONCLUSION The cognitive level regarding the competencies was related to the curriculum system. The Communicator role seemed to be paid more attention in VI curricula, however, other competencies was not demonstrated to be related to the curriculum system.
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Affiliation(s)
- Pingping Li
- Department of Medical Teaching, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
| | - Fan Jiang
- Department of Developmental and Behavior Pediatrics, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
| | - Lei Yin
- Department of Nephrology, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
| | - Yi Qi Chen
- School of Pediatrics, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Li Shao
- Office of Educational Administration, Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Yi Li
- School of Clinical Medicine, Renji Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, People’s Republic of China
| | - Yi Jin Gao
- Department of Hematology/Oncology, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
| | - Mei Hua Lu
- Department of Medical Teaching, Shanghai Children’s Medical Center, School of Medicine, Shanghai Jiao Tong University, Shanghai, People’s Republic of China
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LoGiudice AB, Sibbald M, Monteiro S, Sherbino J, Keuhl A, Norman GR, Chan TM. Intrinsic or Invisible? An Audit of CanMEDS Roles in Entrustable Professional Activities. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2022; 97:1213-1218. [PMID: 35507461 DOI: 10.1097/acm.0000000000004731] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
PURPOSE Postgraduate medical education in Canada has quickly transformed to a competency-based model featuring new entrustable professional activities (EPAs) and associated milestones. It remains unclear, however, how these milestones are distributed between the central medical expert role and 6 intrinsic roles of the larger CanMEDS competency framework. A document review was thus conducted to measure how many EPA milestones are classified under each CanMEDS role, focusing on the overall balance between representation of intrinsic roles and that of medical expert. METHOD Data were extracted from the EPA guides of 40 Canadian specialties in 2021 to measure the percentage of milestones formally linked to each role. Subsequent analyses explored for differences when milestones were separated by stage of postgraduate training, weighted by an EPA's minimum number of observations, or sorted by surgical and medical specialties. RESULTS Approximately half of all EPA milestones (mean = 48.6%; 95% confidence interval [CI] = 45.9, 51.3) were classified under intrinsic roles overall. However, representation of the health advocate role was consistently low (mean = 2.95%; 95% CI = 2.49, 3.41), and some intrinsic roles-mainly leader, scholar, and professional-were more heavily concentrated in the final stage of postgraduate training. These findings held true under all conditions examined. CONCLUSIONS The observed distribution of roles in EPA milestones fits with high-level descriptions of CanMEDS in that intrinsic roles are viewed as inextricably linked to medical expertise, implying both are equally important to cultivate through curricula. Yet a fine-grained analysis suggests that a low prevalence or late emphasis of some intrinsic roles may hinder how they are taught or assessed. Future work must explore whether the quantity or timing of milestones shapes the perceived value of each role, and other factors determining the optimal distribution of roles throughout training.
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Affiliation(s)
- Andrew B LoGiudice
- A.B. LoGiudice is a postdoctoral research fellow, MacPherson Institute for Leadership, Innovation and Excellence in Teaching, McMaster University, Hamilton, Ontario, Canada; ORCID: https://orcid.org/0000-0003-3527-4389
| | - Matthew Sibbald
- M. Sibbald is educational scientist, director, Cardiology Residency Program, and associate dean, Undergraduate Medical Education, McMaster University, Hamilton, Ontario, Canada; ORCID: https://orcid.org/0000-0002-0022-2370
| | - Sandra Monteiro
- S. Monteiro is associate professor, Department of Medicine, and director of scholarship, Centre for Simulation-Based Learning, McMaster University, Hamilton, Ontario, Canada; ORCID: http://orcid.org/0000-0001-8723-5942
| | - Jonathan Sherbino
- J. Sherbino is professor of medicine and assistant dean of health professions education, McMaster University, Hamilton, Ontario, Canada; ORCID: https://orcid.org/0000-0003-0344-8057
| | - Amy Keuhl
- A. Keuhl is project officer, McMaster Education Research, Innovation and Theory Program, McMaster University, Hamilton, Ontario, Canada
| | - Geoffrey R Norman
- G.R. Norman is professor emeritus, Department of Health Research Methods, Evidence, and Impact, McMaster University, Hamilton, Ontario, Canada
| | - Teresa M Chan
- T.M. Chan is associate dean, Continuing Professional Development, Faculty of Health Sciences, McMaster University, associate professor, Divisions of Education and Innovation and Emergency Medicine, Department of Medicine, McMaster University, and clinician scientist, McMaster Education Research, Innovation, and Theory (MERIT), McMaster University, Hamilton, Ontario, Canada; ORCID: http://orcid.org/0000-0001-6104-462X
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Schneider A, Messerer DAC, Kühn V, Horneffer A, Bugaj TJ, Nikendei C, Kühl M, Kühl SJ. Randomised controlled monocentric trial to compare the impact of using professional actors or peers for communication training in a competency-based inverted biochemistry classroom in preclinical medical education. BMJ Open 2022; 12:e050823. [PMID: 35618331 PMCID: PMC9137345 DOI: 10.1136/bmjopen-2021-050823] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
OBJECTIVE In medical education, biochemistry topics are usually knowledge based, and students often are unaware of their clinical relevance. To improve students' awareness of the relevance, we integrated communication skills training into biochemistry education. No studies before have examined the difference between peer and standardised patient (SP) role plays where students explain the biochemical background of a disease in patient-centred language. Therefore, we evaluated whether students' self-perceived competency in Canadian Medical Education Directives for Specialists (CanMEDS) roles and their opinion of the quality of role play differ if the layperson is played by peers or SPs. METHODS We randomly assigned medical students in a preclinical semester to one of the two groups. The groups used predefined scripts to role play a physician-parent consultation with either a peer (peer group) or an SP (SP group) in the parent role. Students then assessed the activity's effects on their competency in CanMEDS roles and motivation and the relevance of the role play. To determine whether students achieved biochemistry learning goals, we evaluated results of a biochemistry exam. RESULTS Students' self-perceived competency improved in both groups. The SP group rated their competency in the roles 'Scholar' and 'Professional' significantly higher than the peer group did. The peer group rated their competency in the role of 'Medical Expert' significantly higher if they played the role of the parent rather than physician or observer. The SP group agreed more that they were motivated by the role play and wanted to receive more role play-based teaching. The SP group perceived the role play as being realistic and rated the feedback discussion as more beneficial. The examination results were the same in both groups. CONCLUSION We showed that role plays in a biochemistry seminar improve students' self-perceived competency. The use of SPs has some advantages, such as being more realistic.
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Affiliation(s)
- Achim Schneider
- Institute of Biochemistry and Molecular Biolog, Ulm University, Ulm, Germany
- Office of the Dean of Studies, Medical Faculty, Ulm University, Ulm, Germany
| | - David Alexander Christian Messerer
- Institute of Clinical and Experimental Trauma Immunology, Ulm University, Ulm, Germany
- Department of Transfusion Medicine and Hemostaseology, Friedrich-Alexander University Erlangen-Nuremberg, University Hospital Erlangen, Erlangen, Germany
| | - Veronika Kühn
- Office of the Dean of Studies, Medical Faculty, Ulm University, Ulm, Germany
| | - Astrid Horneffer
- Office of the Dean of Studies, Medical Faculty, Ulm University, Ulm, Germany
| | - Till Johannes Bugaj
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Christoph Nikendei
- Department of General Internal Medicine and Psychosomatics, University Hospital Heidelberg, Heidelberg, Germany
| | - Michael Kühl
- Institute of Biochemistry and Molecular Biolog, Ulm University, Ulm, Germany
| | - Susanne Julia Kühl
- Institute of Biochemistry and Molecular Biolog, Ulm University, Ulm, Germany
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Janssens O, Embo M, Valcke M, Haerens L. An online Delphi study to investigate the completeness of the CanMEDS Roles and the relevance, formulation, and measurability of their key competencies within eight healthcare disciplines in Flanders. BMC MEDICAL EDUCATION 2022; 22:260. [PMID: 35399059 PMCID: PMC8994879 DOI: 10.1186/s12909-022-03308-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 03/25/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Several competency frameworks are being developed to support competency-based education (CBE). In medical education, extensive literature exists about validated competency frameworks for example, the CanMEDS competency framework. In contrast, comparable literature is limited in nursing, midwifery, and allied health disciplines. Therefore, this study aims to investigate (1) the completeness of the CanMEDS Roles, and (2) the relevance, formulation, and measurability of the CanMEDS key competencies in nursing, midwifery, and allied health disciplines. If the competency framework is validated in different educational programs, opportunities to support CBE and interprofessional education/collaboration can be created. METHODS A three-round online Delphi study was conducted with respectively 42, 37, and 35 experts rating the Roles (n = 7) and key competencies (n = 27). These experts came from non-university healthcare disciplines in Flanders (Belgium): audiology, dental hygiene, midwifery, nursing, occupational therapy, podiatry, and speech therapy. Experts answered with yes/no (Roles) or on a Likert-type scale (key competencies). Agreement percentages were analyzed quantitatively whereby consensus was attained when 70% or more of the experts scored positively. In round one, experts could also add remarks which were qualitatively analyzed using inductive content analysis. RESULTS After round one, there was consensus about the completeness of all the Roles, the relevance of 25, the formulation of 24, and the measurability of eight key competencies. Afterwards, key competencies were clarified or modified based on experts' remarks by adding context-specific information and acknowledging the developmental aspect of key competencies. After round two, no additional key competencies were validated for the relevance criterion, two additional key competencies were validated for the formulation criterion, and 16 additional key competencies were validated for the measurability criterion. After adding enabling competencies in round three, consensus was reached about the measurability of one additional key competency resulting in the validation of the complete CanMEDS competency framework except for the measurability of two key competencies. CONCLUSIONS The CanMEDS competency framework can be seen as a grounding for competency-based healthcare education. Future research could build on the findings and focus on validating the enabling competencies in nursing, midwifery, and allied health disciplines possibly improving the measurability of key competencies.
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Affiliation(s)
- Oona Janssens
- Department of Educational Studies, Faculty of Psychology and Educational Sciences, Ghent University, H. Dunantlaan 2, 9000, Ghent, Belgium.
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, Ghent, 9000, Belgium.
| | - Mieke Embo
- Department of Educational Studies, Faculty of Psychology and Educational Sciences, Ghent University, H. Dunantlaan 2, 9000, Ghent, Belgium
- Expertise Network Health and Care, Artevelde University of Applied Sciences, Voetweg 66, Ghent, 9000, Belgium
| | - Martin Valcke
- Department of Educational Studies, Faculty of Psychology and Educational Sciences, Ghent University, H. Dunantlaan 2, 9000, Ghent, Belgium
| | - Leen Haerens
- Department of Movement and Sports Sciences, Faculty of Medicine and Health Sciences, Ghent University, Watersportlaan 2, Ghent, 9000, Belgium
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Grün FC, Heibges M, Westfal V, Feufel MA. "You Never Get a Second Chance": First Impressions of Physicians Depend on Their Body Posture and Gender. Front Psychol 2022; 13:836157. [PMID: 35386902 PMCID: PMC8978719 DOI: 10.3389/fpsyg.2022.836157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 02/11/2022] [Indexed: 11/13/2022] Open
Abstract
A first impression matters, in particular when encounters are brief as in most doctor-patient interactions. In this study, we investigate how physicians’ body postures impact patients’ first impressions of them and extend previous research by exploring posture effects on the perception of all roles of a physician – not just single aspects such as scholarly expertise or empathy. In an online survey, 167 participants ranked photographs of 4 physicians (2 female, 2 male) in 4 postures (2 open, 2 closed). The results show that male physicians were rated more positively when assuming open rather than closed postures with respect to all professional physician roles. Female physicians in open postures were rated similarly positive for items related to medical competence, but they tended to be rated less favorably with respect to social skills (such as the ability to communicate with and relate to the patient). These findings extend what is known about the effects of physicians’ body postures on the first impressions patients form to judge physicians’ medical versus social competencies. We discuss practical implications and the need for more research on interaction effects of body postures and physician gender on first impressions.
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Affiliation(s)
- Felix C Grün
- Department of Psychology and Ergonomics (IPA), Division of Ergonomics, Technische Universität Berlin, Berlin, Germany
| | - Maren Heibges
- Department of Psychology and Ergonomics (IPA), Division of Ergonomics, Technische Universität Berlin, Berlin, Germany
| | - Viola Westfal
- Department of Psychology and Ergonomics (IPA), Division of Ergonomics, Technische Universität Berlin, Berlin, Germany
| | - Markus A Feufel
- Department of Psychology and Ergonomics (IPA), Division of Ergonomics, Technische Universität Berlin, Berlin, Germany
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Boone A, Roelants M, Hoppenbrouwers K, Vandermeulen C, Du Bois M, Godderis L. Perceived team roles of medical students: a five year cross-sectional study. BMC MEDICAL EDUCATION 2022; 22:198. [PMID: 35317804 PMCID: PMC8941808 DOI: 10.1186/s12909-022-03263-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Accepted: 03/16/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION Despite the increasing importance of teamwork in healthcare, medical education still puts great emphasis on individual achievements. The purpose of this study is to examine medical students' team role preferences, including the association with gender and specialty; and to provide implications for policy makers and medical educators. METHODS We used an exploratory methodology, following a cross-sectional design. Data was collected from first year master students in medicine (n = 2293) during five consecutive years (2016-2020). The Belbin Team Role Self Perception Inventory (BTRSPI) was used to measure medical students' self-perceptions of their team role. RESULTS The Team Worker was the most preferred team role among medical students (35.8%), regardless of gender or specialty. Female and male students had similar team role patterns, although female students scored higher on Team Worker (40.4% vs. 29.1%, P < .001) and Completer-Finisher (14.0% vs. 8.0%, P < .001). With regard to specialties, the Team Worker role was more often chosen by general practitioners than by person-centered and technique-oriented specialties (47.1% vs. 41.8% vs. 29.1%, P < .001). CONCLUSIONS Our findings contribute to an increased scientific understanding of how medical students perceive their own team role, and how this is related to gender and specialty. This is valuable due to the increased importance of interdisciplinary teamwork in healthcare. Medical schools should prioritize stimulating teamwork skills through the implementation of different interventions at all stages (i.e. from the admission process to curricula to residency) and all levels (i.e. explicit and implicit curricula).
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Affiliation(s)
- Anke Boone
- Centre for Environment and Health, Department of Public Health and Primary Care, University of Leuven (KU Leuven), Leuven, Belgium.
| | - Mathieu Roelants
- Centre for Environment and Health, Department of Public Health and Primary Care, University of Leuven (KU Leuven), Leuven, Belgium
| | - Karel Hoppenbrouwers
- Centre for Environment and Health, Department of Public Health and Primary Care, University of Leuven (KU Leuven), Leuven, Belgium
| | - Corinne Vandermeulen
- Centre for Environment and Health, Department of Public Health and Primary Care, University of Leuven (KU Leuven), Leuven, Belgium
| | - Marc Du Bois
- Centre for Environment and Health, Department of Public Health and Primary Care, University of Leuven (KU Leuven), Leuven, Belgium
| | - Lode Godderis
- Centre for Environment and Health, Department of Public Health and Primary Care, University of Leuven (KU Leuven), Leuven, Belgium
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12
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Training low-middle-income (LMIC) pediatric surgeons in a high-income country (HIC) program. Pediatr Surg Int 2022; 38:269-276. [PMID: 34591153 DOI: 10.1007/s00383-021-05027-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/26/2021] [Indexed: 01/18/2023]
Abstract
BACKGROUND A popular paradigm to support surgical education for low- and middle-income countries (LMICs) is partnering with high-income country (HIC) surgeons. These relationships may, however, be asymmetric and fail to optimally address the most pressing curricular needs. We explored the effectiveness of our LMIC-HIC educational partnership. METHODS Through a partnership between a HIC (Canada) and a LMIC (Uganda), three candidate surgeons were commissioned for a custom designed 1-year training experience at our HIC accredited pediatric surgical training centre as part of their overall formal education. The training curriculum was developed in collaboration with the LMIC pediatric surgeon and utilized competency-based medical education principles. A Likert and short-answer survey tool was administered to these trainees upon completion of their training. RESULTS All prescribed milestones as well as specialty certification by examination of the College of Surgeons of East, Central and Southern Africa was achieved by participating fellows, each of whom have begun clinical practice, leadership and teaching roles in their home country. Although several obstacles were identified by fellows, all agreed that the experience boosted their clinical and teaching abilities, and was worth the effort. CONCLUSION This endeavour in global pediatric surgical training represents a significant innovation in surgical education partnerships and would be reproducible across different surgical subspecialties and contexts. Such collaborative efforts represent a feasible upskilling opportunity towards addressing global surgical service capacity. LEVEL OF EVIDENCE V.
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Karpinski J, Frank JR. The Role of EPAs in Creating a National System of Time-Variable Competency-Based Medical Education. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2021; 96:S36-S41. [PMID: 34183600 DOI: 10.1097/acm.0000000000004087] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Entrustable professional activities (EPAs) have emerged as a meaningful framework for achieving competency-based medical education (CBME). However, little is known about how to adapt EPAs to large-scale, multispecialty, system-wide implementations. The authors describe the design and experience of creating such a system based on EPAs and the Van Melle Core Components Framework for all accredited training programs under the auspices of the Royal College of Physicians and Surgeons of Canada. The resulting design is a unique configuration and use of EPAs, called Royal College EPAs. Others looking to implement EPAs for large-scale health professions education systems may want to consider this design approach.
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Affiliation(s)
- Jolanta Karpinski
- J. Karpinski is associate director, specialties, Office of Specialty Education, Royal College of Physicians and Surgeons of Canada, and staff physician, Division of Nephrology, Department of Medicine, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada
| | - Jason R Frank
- J.R. Frank is director of specialty education, Office of Specialty Education, Royal College of Physicians and Surgeons of Canada, and vice chair, education, Department of Emergency Medicine, University of Ottawa Faculty of Medicine, Ottawa, Ontario, Canada
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Rieffestahl AM, Risør T, Mogensen HO, Reventlow S, Morcke AM. Ignitions of empathy. Medical students feel touched and shaken by interacting with patients with chronic conditions in communication skills training. PATIENT EDUCATION AND COUNSELING 2021; 104:1668-1673. [PMID: 33376009 DOI: 10.1016/j.pec.2020.12.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 12/11/2020] [Accepted: 12/15/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVE To explore what and how medical students learn from patients with chronic conditions in the context of communication skills training. METHODS Semi-structured interviews and focus groups with 32 medical students. Interviews were recorded, transcribed, analyzed inductively and organized into four main narrative themes. RESULTS Learning from patients provided medical students opportunities to see the world through the patients' eyes, understand the diversity of patients' needs, and recognize the importance of matching patients' and doctors' perspectives. Consequently, students expressed emotional responses on challenges in interactions with the patients related to performing the role as 'medical expert'. Difficulty empathizing became visible in the students' interaction with patients. CONCLUSION The patients' authentic contributions provided the students with unique opportunities to engage with their own emotions and capacity for empathy. However, for students to benefit from this affective practical training, they need guidance to balance professional and personal aspects in encounters. There is a need to introduce the 'doctor as person' in medical education. PRACTICE IMPLICATIONS Patients with chronic conditions strengthen students' learning of empathy as part of transformative learning. Doing so with patients is a challenging way of learning. Thus, faculty and educators must provide explicit guidance for students to benefit.
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Affiliation(s)
- Anne Marie Rieffestahl
- Copenhagen Academy for Medical Education and Simulation, the Capital Region of Denmark, Denmark; Section of General Practice and the Research Unit for General Practice, Department of Public Health, Faculty of Health and Medical Science, University of Copenhagen, Denmark.
| | - Torsten Risør
- Section of General Practice and the Research Unit for General Practice, Department of Public Health, Faculty of Health and Medical Science, University of Copenhagen, Denmark; Department of Community Medicine, Faculty of Health Sciences, UiT The Arctic University of Norway, Norway
| | - Hanne O Mogensen
- Department of Anthropology, Faculty of Social Science, University of Copenhagen, Denmark
| | - Susanne Reventlow
- Section of General Practice and the Research Unit for General Practice, Department of Public Health, Faculty of Health and Medical Science, University of Copenhagen, Denmark
| | - Anne Mette Morcke
- Copenhagen Academy for Medical Education and Simulation, the Capital Region of Denmark, Denmark
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Kalafatis N, Sommerville TE, Gopalan PD. Do South African anaesthesiology graduates consider themselves fit for purpose? A longitudinal study. SOUTHERN AFRICAN JOURNAL OF ANAESTHESIA AND ANALGESIA 2021. [DOI: 10.36303/sajaa.2021.27.3.2479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
- N Kalafatis
- Department of Anaesthesiology and Critical Care, Nelson R Mandela School of Medicine, University of KwaZulu-Natal,
South Africa
| | - TE Sommerville
- Department of Anaesthesiology and Critical Care, Nelson R Mandela School of Medicine, University of KwaZulu-Natal,
South Africa
| | - PD Gopalan
- Department of Anaesthesiology and Critical Care, Nelson R Mandela School of Medicine, University of KwaZulu-Natal,
South Africa
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Agusala K. Seeing the Forest for the Trees: A Medical Education Focused on Concepts. JOURNAL OF MEDICAL EDUCATION AND CURRICULAR DEVELOPMENT 2021; 8:23821205211064439. [PMID: 34926828 PMCID: PMC8671661 DOI: 10.1177/23821205211064439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Accepted: 11/15/2021] [Indexed: 06/14/2023]
Abstract
A pedagogical shift in medical education that emphasizes concepts and skills over memorization and recall will strengthen the broad-based foundation of knowledge unique to physicians and free up time for students to engage important new areas that need physician leaders.
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Affiliation(s)
- Kartik Agusala
- Division of Cardiology, Department of Internal Medicine, UT Southwestern Medical Center, Dallas, TX, USA
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17
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Hadedeya D, Ageely G, Alsaleh N, Aref H, Al-Sharqi O, Al-Horani S, Hamour O. Residents' perspectives: Does the Saudi general surgery residency training program apply CanMEDS competencies and prepare future leaders? CANADIAN MEDICAL EDUCATION JOURNAL 2020; 11:e24-e30. [PMID: 33349751 PMCID: PMC7749697 DOI: 10.36834/cmej.68488] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
BACKGROUND This study investigates leadership skills and Canadian Medical Education Directives for Specialists (CanMEDS) competencies acquisition within the General Surgery Residency Training Program (GSRTP). The Saudi Commission for Health Specialties (SCFHS) incorporates the CanMEDS Competency Framework into its curriculum to prepare the resident for healthcare needs. METHODS This is a descriptive-analytical study. A questionnaire was used to collect data from 117 General Surgery residents (GS) at seven institutes in Jeddah, Saudi Arabia. RESULTS The GS residents reported an acceptable self-perceived level of Clinical Leadership Skills (mean ± standard deviation). The most dominant skill was working with others (1.98 ± 1.03), followed by demonstrating personal qualities (2.07 ± 0.88), the ability to manage services (2.21 ± 1.37), improving services (2.22 ± 1.84) and last, setting directions (2.39 ± 0.95). Regarding the CanMEDS competencies, the respondents showed a generally positive perception with an "agree" level (Mean = 1.83). Of the CanMEDS competency roles, Collaborator ranked first followed by Professional and then Communicator. Leader competency ranked fourth followed by Health Advocate, Medical Expert and last, Scholar. CONCLUSION The GSRTP residents showed satisfactory self-assessed clinical leadership skills and acquirement of the CanMEDS competencies during their training, which will prepare them to lead in the future.
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Affiliation(s)
| | - Ghofran Ageely
- Rabigh Medical College, King Abdulaziz University, Jeddah, Saudi Arabia
| | | | - Hajar Aref
- International Medical Center, Jeddah, Saudi Arabia
| | | | | | - Osman Hamour
- King Faisal Specialist Hospital & Research Center, Jeddah, Saudi Arabia
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18
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Zahid A, Rajan V, Hong J, Young CJ. Surgical Competencies Required in Newly Commencing Colorectal Surgeons: an Educational and Training Spectrum. MEDICAL SCIENCE EDUCATOR 2020; 30:1043-1047. [PMID: 34457766 PMCID: PMC8368516 DOI: 10.1007/s40670-020-01005-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE Surgical training models have changed from master-apprentice to competency-based training. We aimed to determine the relative importance and peak periods of acquiring these competencies in newly commencing colorectal surgeons. METHODS A mailed questionnaire to all current Colorectal Surgical Society of Australia and New Zealand (CSSANZ) members was conducted between October and December 2016 assessing the relative importance of each competency and the period or activity of learning or training contributing most to achieving that competency. RESULTS The response rate was 43% (90/208) with 87% (n = 75) agreed or strongly agreed to the relevance and applicability of the nine RACS competencies. Competencies varied in perceived importance (strongly agreed: judgment-clinical decision-making (JU) 63%, collaboration/teamwork (CT) 53%, technical expertise (TE) 47%, communication (CO) 44%, medical expertise (ME) 34%, scholarship/teaching (ST) 33%, professionalism (PR) 33%/ethics (ET) 24%, health advocacy (HA) 18%, management (MX) 13%/leadership (LE) 17%), and the peak period for acquiring them (registrar: CO 39%, ST 30%; fellow: TE 62%, CT 44%, ME 40%, JU 38%; consultant: MX/LE 52%, HA 48%, PR/ET 33%). CONCLUSION Surgical competencies for colorectal surgeons are accumulated and acquired at varying degrees and periods across a spectrum of continuing registrar, fellow, and consultant education and training. These findings serve as a baseline for further refinement of current and continuing educational and training programs.
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Affiliation(s)
- Assad Zahid
- Institute of Academic Surgery, Royal Prince Alfred Hospital, University of Sydney, Sydney, NSW Australia
- Discipline of Surgery, University of Sydney, Sydney, NSW Australia
| | - Vasant Rajan
- Institute of Academic Surgery, Royal Prince Alfred Hospital, University of Sydney, Sydney, NSW Australia
- Discipline of Surgery, University of Sydney, Sydney, NSW Australia
| | - Jonathan Hong
- Institute of Academic Surgery, Royal Prince Alfred Hospital, University of Sydney, Sydney, NSW Australia
- Department of Colorectal Surgery, Royal Prince Alfred Hospital, University of Sydney, Missenden Rd, Camperdown, Sydney, NSW 2050 Australia
| | - Christopher J. Young
- Institute of Academic Surgery, Royal Prince Alfred Hospital, University of Sydney, Sydney, NSW Australia
- Discipline of Surgery, University of Sydney, Sydney, NSW Australia
- Department of Colorectal Surgery, Royal Prince Alfred Hospital, University of Sydney, Missenden Rd, Camperdown, Sydney, NSW 2050 Australia
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van der Aa JE, Aabakke AJM, Ristorp Andersen B, Settnes A, Hornnes P, Teunissen PW, Goverde AJ, Scheele F. From prescription to guidance: a European framework for generic competencies. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2020; 25:173-187. [PMID: 31451981 PMCID: PMC7018687 DOI: 10.1007/s10459-019-09910-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 08/09/2019] [Indexed: 06/01/2023]
Abstract
In postgraduate medical education, required competencies are described in detail in existing competency frameworks. This study proposes an alternative strategy for competency-based medical education design, which is supported by change management theories. We demonstrate the value of allowing room for re-invention and creative adaptation of innovations. This new strategy was explored for the development of a new generic competency framework for a harmonised European curriculum in Obstetrics and Gynaecology. The generic competency framework was developed through action research. Data were collected by four European stakeholder groups (patients, nurses, midwives and hospital boards), using a variety of methods. Subsequently, the data were analysed further in consensus discussions with European specialists and trainees in Obstetrics and Gynaecology. These discussions ensured that the framework provides guidance, is specialty-specific, and that implementation in all European countries could be feasible. The presented generic competency framework identifies four domains: 'Patient-centred care', 'Teamwork', 'System-based practice' and 'Personal and professional development'. For each of these four domains, guiding competencies were defined. The new generic competency framework is supported by European specialists and trainees in Obstetrics and Gynaecology, as well as by their European stakeholders. According to change management theories, it seems vital to allow room for re-invention and creative adaptation of the competency framework by medical professionals. Therefore, the generic competency framework offers guidance rather than prescription. The presented strategy for competency framework development offers leads for implementation of competency-based medical education as well as for development of innovations in postgraduate medical education in general.
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Affiliation(s)
- Jessica E van der Aa
- Department of Research and Education, OLVG Hospital, Amsterdam, The Netherlands.
- Athena Institute, Faculty of Science, VU, Amsterdam, The Netherlands.
| | - Anna J M Aabakke
- Department of Obstetrics and Gynaecology, Herlev University Hospital, Herlev, Denmark
- European Network of Trainees in Obstetrics and Gynaecology (ENTOG), Brussels, Belgium
| | - Betina Ristorp Andersen
- Department of Gynaecology and Obstetrics, North Zealand Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Annette Settnes
- Department of Gynaecology and Obstetrics, North Zealand Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Peter Hornnes
- Department of Gynaecology and Obstetrics, North Zealand Hospital, University of Copenhagen, Copenhagen, Denmark
- European Board and College of Obstetrics and Gynaecology (EBCOG), Brussels, Belgium
| | - Pim W Teunissen
- Department of Obstetrics and Gynaecology, Amsterdam UMC, VU University Medical Centre, Amsterdam, The Netherlands
- School of Health Professions Education (SHE), Faculty of Health Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Angelique J Goverde
- European Board and College of Obstetrics and Gynaecology (EBCOG), Brussels, Belgium
- Department of Reproductive Medicine and Gynaecology, University Medical Centre, Utrecht, The Netherlands
| | - Fedde Scheele
- Department of Research and Education, OLVG Hospital, Amsterdam, The Netherlands
- Athena Institute, Faculty of Science, VU, Amsterdam, The Netherlands
- European Board and College of Obstetrics and Gynaecology (EBCOG), Brussels, Belgium
- Department of Obstetrics and Gynaecology, Amsterdam UMC, VU University Medical Centre, Amsterdam, The Netherlands
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Bharathan R, Ghai V, Ind T. Obstetrics and gynaecology trainees' perceptions of the CanMEDS expertise model: implications for training from a regional questionnaire study in the United Kingdom. J OBSTET GYNAECOL 2020; 40:1138-1144. [PMID: 31941386 DOI: 10.1080/01443615.2019.1699039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
The CanMEDS expertise model is a multi-domain competency framework for doctors. The aims of this study were to assess the perceived importance of the CanMEDS roles and achievement among obstetrics and gynaecology trainees of all grades with a view to identifying opportunities to enhance training. This study was exempt from formal ethical or institutional registration. The data collection was completed in 2017. Following a video introduction, the trainees completed a questionnaire. For each of the CanMEDS domains, trainees of different tiers perceived them to be equally important. Indeed, the junior and senior cohorts of trainees perceived all domains to be equally important, as signified by the significant degree of score correlation. Age was a significant variable for achievement of competency in the roles of a Medical Expert (p = .01), a Communicator (p = .04), a Collaborator (p = .002), a Scholar (p = .01) and a Professional (p = .03). Grade was significant for the Medical Expert (p = .001) and Leader (p = .001) role. Better alignment of clinical activities with CanMEDS competencies and faculty development will complement the training in leadership skills. Impact statementWhat is already known on this subject? The CanMEDS medical expertise model is a multi-domain framework of seven components. This framework has been utilised to assess the training efficacy of curricula and unlock opportunities for improvement. The research application of the CanMEDS framework within Obstetrics and Gynaecology is limited.What does this study add? Results indicate that all trainees recognise the importance of CanMEDS roles: age and grade are significant variables in the perceived achievement of CanMEDS roles. The study identifies areas for improvement in the current training strategy.What are the implications for clinical practice/future research? Research should formalise the assessment of competencies in non-technical skills. Efforts should focus on identifying the activities which will develop leadership skills.
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Affiliation(s)
- Rasiah Bharathan
- Department of Gynaecological Oncology, Maidstone Hospital, Maidstone, UK
| | - Vishalli Ghai
- Department of Obstetrics and Gynaecology, Epsom General Hospital, Epsom, UK
| | - Thomas Ind
- Department of Obstetrics and Gynaecology, St.Georges University Hospitals NHS Foundation Trust, London, UK
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Kalafatis NK, Sommerville TS, Gopalan PG. Are South African anaesthesiologists fit for purpose? A comparison of opinions of graduates, teachers and examiners. SOUTHERN AFRICAN JOURNAL OF ANAESTHESIA AND ANALGESIA 2020. [DOI: 10.36303/sajaa.2020.26.6.2397] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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McDonald M, Lavelle C, Wen M, Sherbino J, Hulme J. The state of health advocacy training in postgraduate medical education: a scoping review. MEDICAL EDUCATION 2019; 53:1209-1220. [PMID: 31430838 DOI: 10.1111/medu.13929] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/29/2018] [Revised: 02/12/2019] [Accepted: 06/11/2019] [Indexed: 06/10/2023]
Abstract
CONTEXT Health advocacy is an essential component of postgraduate medical education, and is part of many physician competency frameworks such as the Canadian Medical Education Directives for Specialists (CanMEDS) roles. There is little consensus about how advocacy should be taught and assessed in the postgraduate context. There are no consolidated guides to assist in the design and implementation of postgraduate health advocacy curricula. OBJECTIVES This scoping review aims to identify and analyse existing literature pertaining to health advocacy education and assessment in postgraduate medicine. We specifically sought to summarise themes from the literature that may be useful to medical educators to inform further health advocacy curriculum interventions. METHODS MEDLINE, Embase and ERIC were searched using MeSH (medical student headings) and non-MeSH search terms. Additional articles were found using forward snowballing. The grey literature search included Google and relevant stakeholder websites, regulatory bodies, physician associations, government agencies and academic institutions. We followed a stepwise scoping review methodology, followed by thematic analysis using an inductive approach. RESULTS Of the 123 documents reviewed in full, five major themes emerged: (i) conceptions of health advocacy have evolved towards advocating with rather than for patients, communities and populations; (ii) longitudinal curricula were less common but appeared the most promising, often linked to scholarly or policy objectives; (iii) hands-on, immersive opportunities build competence and confidence; (iv) community-identified needs and partnerships are increasingly considered in designing curriculum, and (v) resident-led and motivated programmes appear to engage residents and allow for achievement of stated outcomes. There remain significant challenges to assessment of health advocacy competencies, and assessment tools for macro-level health advocacy were notably absent. CONCLUSIONS There is considerable heterogeneity in the way health advocacy is taught, assessed and incorporated into postgraduate curricula across programmes and disciplines. We consolidated recommendations from the literature to inform further health advocacy curriculum design, implementation and assessment.
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Affiliation(s)
- Madeline McDonald
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Conor Lavelle
- Department of Emergency Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Mei Wen
- Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jonathan Sherbino
- Department of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Jennifer Hulme
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
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Pulkkinen E, de la Ossa PP. Newly qualified chiropractors' perceptions of preparedness for practice: A cross-sectional study of graduates from European training programs. THE JOURNAL OF CHIROPRACTIC EDUCATION 2019; 33:90-99. [PMID: 30475640 PMCID: PMC6759006 DOI: 10.7899/jce-18-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
OBJECTIVE The purpose of this pilot study was to explore chiropractic graduates' perceived preparedness for practice in the 7 key competencies of the Canadian Medical Education Directives for Specialists. METHODS An anonymous 5-point Likert scale electronic questionnaire was distributed to graduates from the 2014-2016 cohorts of 9 European chiropractic colleges accredited by the European Council of Chiropractic Education. For each group under 1 competency role, the mean overall score was calculated. Statistical differences were analyzed using a t test and analysis of variance. Cronbach's alpha was calculated for internal consistency. RESULTS Results of 7 chiropractic colleges were analyzed (n = 121). Differences were found among colleges, competencies, and items. Overall, the graduates who responded scored the lowest in collaborator (3.76) and scholar (3.78) competencies. They scored the highest in professional (4.39) and chiropractic expert (4.13) competencies. In all colleges, a lower level of perceived preparedness was found in collaborator, scholar, and manager competencies. Statistical differences were found that compared the type of employment and cohorts. CONCLUSION Our results show there may be a gap between education and professional practice regarding perceived preparedness, and graduates perceived themselves to be unprepared in some competencies. The preliminary results of this study could be used to improve curricula of chiropractic education.
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Griewatz J, Lammerding-Koeppel M. Intrinsic roles in the crosshair - strategic analysis of multi-site role implementation with an adapted matrix map approach. BMC MEDICAL EDUCATION 2019; 19:237. [PMID: 31248391 PMCID: PMC6598229 DOI: 10.1186/s12909-019-1628-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 05/23/2019] [Indexed: 05/26/2023]
Abstract
BACKGROUND The implementation of competency-based intrinsic roles in undergraduate medical education remains a challenge. Faculties in transition need to be provided with generalizable curricular data in order to facilitate orientation on curricular roles' representation and to decide on steps of curriculum development. Explicit and implicit representation of objectives and multi-site agreement can be viewed as status indicators for the adoption of roles. Our aim was to develop a pragmatic cross-locational approach to capture roles' developmental status in an overview and prioritize strategic recommendations. METHODS Based on the mapping data from six German medical faculties, the relationship between explicit and implicit curricular representation of role' objectives (weighting) and extent of programs' consent (agreement) was calculated. Data was visualized in a role-specific Matrix Map to analyse roles' implicit-explicit relation and risk-value potential. The matrix was combined with Roger's stages of innovation diffusion for differentiated interpretation of the developmental role status. RESULTS Entangling multi-site agreement and curricular weighting, the 4-Field-Matrix allows to assess objectives based on their current localization in a quadrant: "Disregard" (lower left) and "Progress" quadrant (upper left) reveal the diffusion period; "Potential" (lower right) and "Emphasis" quadrant (upper right) indicate the adoption period. The role patterns differ in curricular representation, progression and clarity: (1) Scholar: explicit/implicit - scattered across the matrix; most explicit objectives in "Progress". (2) Health Advocate: explicit - primarily in "Emphasis"; only role in which the explicit representation significantly exceeds the implicit. (3) Collaborator: explicit - mainly "Potential"; implicit - "Progress" or "Emphasis". (4) Professional: explicit - primarily "Potential" but also "Emphasis"; implicit - "Progress" and "Emphasis"; appears better adopted but scattered in weighting; high hidden curricula. (5) Manager: explicit and implicit - exclusively in "Potential", without signs of development. Role patterns correspond to evidences from literature. Exemplified with roles, quadrant-specific strategies and measures are suggested. Framework reviewers may gain information for discussion of critical content. CONCLUSION The Matrix Map enables to catch intuitively the status of intrinsic roles' profiles regarding role pattern, implicit-explicit relation and programs agreement. Thus, interpretation and informed discussions are fostered. Further target-oriented analyses and strategic developments can be conducted to enhance transparency and resource-efficiency.
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Affiliation(s)
- Jan Griewatz
- Eberhard-Karls University of Tuebingen, Competence Centre for University Teaching in Medicine, Baden-Wuerttemberg, Elfriede-Aulhorn-Str. 10, 72076 Tuebingen, Germany
| | - Maria Lammerding-Koeppel
- Eberhard-Karls University of Tuebingen, Competence Centre for University Teaching in Medicine, Baden-Wuerttemberg, Elfriede-Aulhorn-Str. 10, 72076 Tuebingen, Germany
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Bächli P, Meindl-Fridez C, Weiss-Breckwoldt AN, Breckwoldt J. Challenging cases during clinical clerkships beyond the domain of the "medical expert": an analysis of students' case vignettes. GMS JOURNAL FOR MEDICAL EDUCATION 2019; 36:Doc30. [PMID: 31211225 PMCID: PMC6545608 DOI: 10.3205/zma001238] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Revised: 11/23/2018] [Accepted: 02/01/2019] [Indexed: 06/01/2023]
Abstract
Background: During clinical clerkships students experience complex and challenging clinical situations related to problems beyond the domain of the "Medical Expert". Workplace routine may leave little opportunity to reflect on these situations. The University of Zurich introduced a mandatory course directly after the clinical clerkship year (CCY) to work up these situations. Prior to the course each student submitted a vignette on a case he or she had perceived challenging during the CCY and which was not related to the domain of the "Medical Expert" role. In this paper we want to characterize these cases in respect to most prominent themes and related CanMEDS roles. The goal was to inform clinical supervisors about potential teaching demands during the CCY. Methods: All case vignettes submitted by a years' cohort were analysed by three researchers in two ways: for the clinical characteristics and the main theme of the underlying problem and the most prominent CanMEDS roles involved. Themes of the underlying problem were aggregated to overarching topics and subsequently to main categories by pragmatic thematic analysis. Results: 254 case vignettes covered the whole spectrum of clinical disciplines. A wide range of underlying themes could be assigned to five main categories: "communication within team" (23.2%), "communication with patients and relatives" (24.8%), "patient behavior and attitudes" (18.5%), "clinical decision making" (24.0%), and "social and legal issues" (9.4%). Most frequent CanMEDS roles were "Communicator" (26.9%) and "Professional" (23.5%). Conclusions: Cases students perceived as challenging beyond the "Medical Expert" were reported from all clinical disciplines. These were mainly related to communicational and professional issues, mirrored by the CanMEDS roles "Communicator" and "Professional". Therefore, supervisors in clinical clerkships should put an additional teaching focus on communication and professionalism.
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Affiliation(s)
- Patrik Bächli
- Kantonsspital Aarau, Dept. of Anesthesiology, Aarau, Switzerland
| | - Claudine Meindl-Fridez
- University Hospital Zurich, Department of General Internal Medicine, Zurich, Switzerland
| | | | - Jan Breckwoldt
- University Hospital Zurich, Institute of Anesthesiology, Zurich, Switzerland
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Ying Y, Seabrook C. Health Advocacy Competency: Integrating Social Outreach into Surgical Education. JOURNAL OF SURGICAL EDUCATION 2019; 76:756-761. [PMID: 30503762 DOI: 10.1016/j.jsurg.2018.11.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/16/2018] [Revised: 10/09/2018] [Accepted: 11/18/2018] [Indexed: 06/09/2023]
Abstract
OBJECTIVE Being a strong health advocate is recognized as being an important part of being a good surgeon. Residency training programs have struggled with teaching health advocacy beyond didactic sessions, and in a way that encourages trainees to incorporate changes into their practice. This curriculum development aimed to incorporate reflective practice to encourage patient compassion and advocacy. DESIGN Community service was incorporated as a mandatory component of a postgraduate surgical training program. Residents participated in a community service activity, and reflected upon their learning with a presentation to their peers. PARTICIPANTS Mandatory advocacy curriculum for all 67 first and second year surgical residents. Sixty-four residents chose to participate in a community service activity. Forty-six residents completed year end evaluations on the curriculum. RESULTS Seventy percent of outreach activities were medically related, and 30% nonmedical. Most residents felt that the amount of work required to complete this project was reasonable (90%), and learned from their experiences (76%). Residents who participated in medically related projects self-described greater learning from their activity (93%), and from watching their peer presentations (79%). These trainees were also more likely to alter their patient management based on their experiences (68%). Trainees who participated in nonmedically related outreach projects were less likely to self-reflect learning from their experiences. Despite mandatory teaching in health advocacy, trainees are often unaware of this teaching within their curriculum. CONCLUSIONS A mandatory outreach project in residency can encourage trainees to reflect on their volunteer activities as a physician and how it impacts their patient's health. Academic departments should try to encourage volunteerism within their trainees by providing opportunities for residents to participate in outreach activities related to their specialty.
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Affiliation(s)
- Yvonne Ying
- Office of Surgical Education, Department of Surgery, University of Ottawa, Ottawa, Ontario, Canada; Department of Surgery, Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada.
| | - Christine Seabrook
- Office of Surgical Education, Department of Surgery, University of Ottawa, Ottawa, Ontario, Canada.
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Herrmann-Werner A, Loda T, Erschens R, Schneider P, Junne F, Gilligan C, Teufel M, Zipfel S, Keifenheim KE. Face yourself! - learning progress and shame in different approaches of video feedback: a comparative study. BMC MEDICAL EDUCATION 2019; 19:88. [PMID: 30917820 PMCID: PMC6437998 DOI: 10.1186/s12909-019-1519-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/30/2018] [Accepted: 03/13/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Feedback is a crucial part of medical education and with on-going digitalisation, video feedback has been increasingly in use. Potentially shameful physician-patient-interactions might particularly benefit from it, allowing a meta-perspective view of ones own performance from a distance. We thus wanted to explore different approaches on how to deliver specifically video feedback by investigating the following hypotheses: 1. Is the physical presence of a person delivering the feedback more desired, and associated with improved learning outcomes compared to using a checklist? 2. Are different approaches of video feedback associated with different levels of shame in students with a simple checklist likely to be perceived as least and receiving feedback in front of a group of fellow students being perceived as most embarrassing? METHODS Second-year medical students had to manage a consultation with a simulated patient. Students received structured video feedback according to one randomly assigned approach: checklist (CL), group (G), student tutor (ST), or teacher (T). Shame (ESS, TOSCA, subjective rating) and effectiveness (subjective ratings, remembered feedback points) were measured. T-tests for dependent samples and ANOVAs were used for statistical analysis. RESULTS n = 64 students could be included. Video feedback was in hindsight rated significantly less shameful than before. Subjectively, there was no significant difference between the four approaches regarding effectiveness or the potential to arise shame. Objective learning success showed CL to be significantly less effective than the other approaches; additionally, T showed a trend towards being more effective than G or ST. CONCLUSIONS There was no superior approach as such. But CL could be shown to be less effective than G, ST and T. Feelings of shame were higher before watching one's video feedback than in hindsight. There was no significant difference regarding the different approaches. It does not seem to make any differences as to who is delivering the video feedback as long as it is a real person. This opens possibilities to adapt curricula to local standards, preferences, and resource limitations. Further studies should investigate, whether the present results can be reproduced when also assessing external evaluation and long-term effects.
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Affiliation(s)
- Anne Herrmann-Werner
- Department of Psychosomatic medicine and Psychotherapy, University Hospital Tuebingen, Osianderstr. 5, D-72076 Tuebingen, Germany
| | - Teresa Loda
- Department of Psychosomatic medicine and Psychotherapy, University Hospital Tuebingen, Osianderstr. 5, D-72076 Tuebingen, Germany
| | - Rebecca Erschens
- Department of Psychosomatic medicine and Psychotherapy, University Hospital Tuebingen, Osianderstr. 5, D-72076 Tuebingen, Germany
| | - Priska Schneider
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Tuebingen, Osianderstr. 14-16, 72076 Tuebingen, Germany
| | - Florian Junne
- Department of Psychosomatic medicine and Psychotherapy, University Hospital Tuebingen, Osianderstr. 5, D-72076 Tuebingen, Germany
| | - Conor Gilligan
- School of Medicine and Public Health, faculty of Health and Medicine, University of Newcastle, Callaghan, NSW 2308 Australia
| | - Martin Teufel
- Dep. of Psychosomatic Medicine and Psychotherapy, LVR Hospital Essen, University of Duisburg-Essen, Virchowstr. 14, 45147 Essen, Germany
| | - Stephan Zipfel
- Department of Psychosomatic medicine and Psychotherapy, University Hospital Tuebingen, Osianderstr. 5, D-72076 Tuebingen, Germany
| | - Katharina E. Keifenheim
- Department of Psychosomatic medicine and Psychotherapy, University Hospital Tuebingen, Osianderstr. 5, D-72076 Tuebingen, Germany
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Kalafatis N, Sommerville T, Gopalan PD. Defining fitness for purpose in South African anaesthesiologists using a Delphi technique to assess the CanMEDS framework. SOUTHERN AFRICAN JOURNAL OF ANAESTHESIA AND ANALGESIA 2019. [DOI: 10.36303/sajaa.2019.25.2.2193] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Background: Training of South African anaesthesiologists is based on the Canadian Medical Education Directives for Specialists (CanMEDS). However, the applicability of CanMEDS in this context has not been assessed. An expert panel participated in a Delphi process to create an appropriate expanded list of CanMEDS competencies that may be used in the future to assess fitness for purpose of local graduates.
Methods: This descriptive study comprised a representative panel of 16 experts surveyed electronically over three rounds to assess the importance of the existing CanMEDS roles and enabling competencies and suggested additions deemed applicable locally. The primary outcome was the creation of a list of competencies applicable to South Africa.
Results: There was a 100% response rate for all three rounds. Based on the existing seven CanMEDS meta-competencies (Medical Expert, Collaborator, Communicator, Leader, Scholar, Professional and Health Advocate), respondents scored the importance of 89 enabling competencies and 19 additional competencies. Seven CanMEDS enabling competencies did not achieve consensus and were excluded. Nineteen new enabling competencies and two new meta-competencies (Humaneness, Context Awareness) achieved consensus and were added. Median ratings of importance of meta-competencies showed highest scores for Medical Expert and Collaborator and lowest scores for Health Advocate. Weighting of meta-competencies revealed highest scores for Medical Expert and Professional with all others equally weighted.
Conclusion: This study has formulated an adapted CanMEDS list of enabling competencies with the addition of the two new metacompetencies of Context Awareness and Humaneness for use in South African anaesthesiology. This provides a means with which future graduates may be assessed for fitness for purpose.
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McConnell M, Gu A, Arshad A, Mokhtari A, Azzam K. An innovative approach to identifying learning needs for intrinsic CanMEDS roles in continuing professional development. MEDICAL EDUCATION ONLINE 2018; 23:1497374. [PMID: 30010510 PMCID: PMC6052411 DOI: 10.1080/10872981.2018.1497374] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 07/01/2018] [Indexed: 05/23/2023]
Abstract
CONTEXT The CanMEDS framework promotes the development of competencies required to be an effective physician. However, it is still not well understood how to apply such frameworks to CPD contexts, particularly with respect to intrinsic competencies. OBJECTIVE This study explores whether physician narratives around challenging cases would provide information regarding learning needs that could help guide the development of CPD activities for intrinsic CanMEDS competencies. METHODS We surveyed medical and surgical specialists from Southern Ontario using an online survey. To assess perceived needs, participants were asked, 'Describe three CPD topic you would like to learn about in the next 12 months'. To identify learning needs that may have arisen from problems encountered in practice, participants were asked, 'Describe three challenging situations encountered in the past 12 months.' Responses to the two open-ended questions were analyzed using thematic content analysis. RESULTS Responses were received from 411 physicians, resulting in 226 intrinsic CanMEDS codes for perceived learning needs and 210 intrinsic codes for challenges encountered in practices. Discrepancies in the frequency of intrinsic roles were observed between the two questions. Specifically, Leader (28%), Scholar (43%), and Professional (16%) roles were frequently described perceived learning needs, as opposed to challenges in practice (Leader: 3%; Scholar: 2%; and Professional: 8%. Conversely, Communicator 39%, Health Advocate 39%, and to a lesser extent Collaborator 11%) roles were frequently described in narratives surrounding challenges in practice, but appeared in <10% of descriptions of perceived learning needs (Communicator: 4%; Health Advocate 6%; Collaborator: 3%). CONCLUSION The present study provides insight into potential learning needs associated with intrinsic CanMEDS competencies. Discrepancies in the frequency of intrinsic CanMEDS roles coded for perceived learning needs and challenges encountered in practice may provide insight into the selection and design of CPD activities.
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Affiliation(s)
- Meghan McConnell
- Department of Innovation in Medical Education, University of Ottawa, Ottawa, Canada
- Department of Anesthesiology and Pain Medicine, University of Ottawa, Ottawa, Canada
| | - Ada Gu
- Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Aysha Arshad
- Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Arastoo Mokhtari
- Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - Khalid Azzam
- Faculty of Health Sciences, McMaster University, Hamilton, Canada
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van Rossum TR, Scheele F, Sluiter HE, Paternotte E, Heyligers IC. Effects of implementing time-variable postgraduate training programmes on the organization of teaching hospital departments. MEDICAL TEACHER 2018; 40:1036-1041. [PMID: 29385864 DOI: 10.1080/0142159x.2017.1418850] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/24/2023]
Abstract
INTRODUCTION As competency-based education has gained currency in postgraduate medical education, it is acknowledged that trainees, having individual learning curves, acquire the desired competencies at different paces. To accommodate their different learning needs, time-variable curricula have been introduced making training no longer time-bound. This paradigm has many consequences and will, predictably, impact the organization of teaching hospitals. The purpose of this study was to determine the effects of time-variable postgraduate education on the organization of teaching hospital departments. METHODS We undertook exploratory case studies into the effects of time-variable training on teaching departments' organization. We held semi-structured interviews with clinical teachers and managers from various hospital departments. RESULTS The analysis yielded six effects: (1) time-variable training requires flexible and individual planning, (2) learners must be active and engaged, (3) accelerated learning sometimes comes at the expense of clinical expertise, (4) fast-track training for gifted learners jeopardizes the continuity of care, (5) time-variable training demands more of supervisors, and hence, they need protected time for supervision, and (6) hospital boards should support time-variable training. CONCLUSIONS Implementing time-variable education affects various levels within healthcare organizations, including stakeholders not directly involved in medical education. These effects must be considered when implementing time-variable curricula.
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Affiliation(s)
- Tiuri R van Rossum
- a School of Health Professions Education (SHE) , Maastricht University , Maastricht , The Netherlands
| | - Fedde Scheele
- b Athena Institute for Transdisciplinary Research , VU University/VU Medical Centre , Amsterdam , The Netherlands
- c OLVG Teaching Hospital , Amsterdam , The Netherlands
| | - Henk E Sluiter
- d Department of Internal Medicine , Deventer Hospital , Deventer , The Netherlands
| | - Emma Paternotte
- e Department of Gynaecology and Obstetrics , Meander Medical Center , Amersfoort , The Netherlands
| | - Ide C Heyligers
- a School of Health Professions Education (SHE) , Maastricht University , Maastricht , The Netherlands
- f Zuyderland Medical Center , Heerlen , The Netherlands
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Udoh A, Bruno A, Bates I. A survey of pharmacists' perception of foundation level competencies in African countries. HUMAN RESOURCES FOR HEALTH 2018; 16:16. [PMID: 29606133 PMCID: PMC5879617 DOI: 10.1186/s12960-018-0280-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 03/16/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Evidence from published literature in pharmacy practice research demonstrate that the use of competency frameworks alongside standards of practice facilitate improvement in professional performance and aid expertise development. The aim of this study was to evaluate pharmacists' perception of relevance to practice of the competencies and behaviours contained in the FIP Global Competency Framework (GbCF v1). The overall objective of the study was to assess the validity of the GbCF v1 framework in selected countries in Africa. METHODS A cross-sectional survey of pharmacists practicing in 14 countries in Africa was conducted between November 2012 and December 2014. A combination of purposive and snowball sampling method was used. Data was analysed using SPSS v22. RESULTS A total of 469 pharmacists completed the survey questionnaire. The majority (91%) of the respondents were from four countries: Ghana, Kenya, Nigeria and South Africa. The study results showed broad agreement on relevance to practice for 90% of the behaviours contained in the GbCF v1 framework. Observed disagreement was associated with area of pharmacy practice and the corresponding patient facing involvement (p ≤ 0.05). In general, the competencies within the 'pharmaceutical care' and 'pharmaceutical public health' clusters received higher weighting on relevance compared to the research-related competencies which had the lowest. Specific inter-country variability on weighting of relevance was observed in five behaviours in the framework although, this was due to disparity in 'degree of relevance' that was related to sample composition in the respective countries. CONCLUSION The competencies contained in the GbCF v1 are relevant to pharmacy practice in the study population; however, there are some emergent differences between the African countries surveyed. Overall, the findings provide preliminary evidence that was previously lacking on the relevance of the GbCF v1 competencies to pharmacy practice in the countries surveyed.
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Affiliation(s)
- Arit Udoh
- University College London School of Pharmacy, London, United Kingdom
| | - Andreia Bruno
- Faculty of Pharmacy and Pharmaceutical Sciences, Monash University (Parkville Campus), Melbourne, Australia
| | - Ian Bates
- University College London School of Pharmacy, London, United Kingdom
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Lammerding-Koeppel M, Fritze O, Giesler M, Narciss E, Steffens S, Wosnik A, Griewatz J. Benchmarking for research-related competencies - a curricular mapping approach at medical faculties in Germany. MEDICAL TEACHER 2018; 40:164-173. [PMID: 29141480 DOI: 10.1080/0142159x.2017.1395403] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
OBJECTIVES Internationally, scientific and research-related competencies need to be sufficiently targeted as core outcomes in many undergraduate medical curricula. Since 2015, standards have been recommended for Germany in the National Competency-based Learning Objective Catalogue in Medicine (NKLM). The aim of this study is to develop a multi-center mapping approach for curricular benchmarking against national standards and against other medical faculties. METHOD A total of 277 faculty members from four German medical faculties have mapped the local curriculum against the scientific and research-related NKLM objectives, using consented procedures, metrics, and tools. The amount of mapping citations of each objective is used as indicator for its weighting in the local curriculum. Achieved competency levels after five-year education are compared. RESULTS All four programs fulfill the NKLM standards, with each emphasizing different sub-competencies explicitly in writing (Scholar: 17-41% of all courses; Medical Scientific Skills: 14-37% of all courses). Faculties show major or full agreement in objective weighting: Scholar 44%, scientific skills 79%. The given NKLM competency level is met or even outperformed in 78-100% of the courses. CONCLUSIONS The multi-center mapping approach provides an informative dataset allowing curricular diagnosis by external benchmarking and guidance for optimization of local curricula.
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Affiliation(s)
- Maria Lammerding-Koeppel
- a Competence Centre for University Teaching in Medicine Baden-Wuerttemberg, Faculty of Medicine , University of Tuebingen , Tuebingen , Germany
| | - Olaf Fritze
- a Competence Centre for University Teaching in Medicine Baden-Wuerttemberg, Faculty of Medicine , University of Tuebingen , Tuebingen , Germany
| | - Marianne Giesler
- b Competence Centre for Evaluation in Medicine Baden-Wuerttemberg, Medical Faculty , University of Freiburg , Freiburg , Germany
| | - Elisabeth Narciss
- c Competence Centre of Final Year, Medical Faculty Mannheim , University of Heidelberg , Mannheim , Germany
| | - Sandra Steffens
- d Dean's Office for Medical Education , Hannover Medical School , Hannover , Germany
| | - Annette Wosnik
- e Dean's Office of Student Affairs, Faculty of Medicine , University of Tuebingen , Tuebingen , Germany
| | - Jan Griewatz
- a Competence Centre for University Teaching in Medicine Baden-Wuerttemberg, Faculty of Medicine , University of Tuebingen , Tuebingen , Germany
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Udoh A, Bruno A, Bates I, Galbraith K. Transnational comparability of advanced pharmacy practice developmental frameworks: a country-level crossover mapping study. INTERNATIONAL JOURNAL OF PHARMACY PRACTICE 2018; 26:550-559. [DOI: 10.1111/ijpp.12427] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2017] [Accepted: 11/19/2017] [Indexed: 11/28/2022]
Abstract
Abstract
Background
Previous work by the International Pharmaceutical Federation Education Initiative (FIPEd) demonstrates that even though some country-specific variations occur in pharmacy practice, there exists a set of practice-related competencies that are globally applicable. This study aimed to evaluate the transnational comparability of the Royal Pharmaceutical Society Advanced Pharmacy Framework (RPS-APF, Great Britain) and the Advanced Pharmacy Practice Framework for Australia (APPF). The objective was to obtain preliminary data on the transnational applicability of the developmental competencies contained in the two frameworks.
Method
A crossover mapping study involving 42 advanced-level pharmacists from four countries was conducted. Qualitative interview (n = 17) was also carried out to explore practitioners’ perception of the frameworks.
Result
The average postregistration experience of the practitioners in the crossover study was 19 years. Directly observed within-subject agreement per advanced practice competency ranged from 45% to 86%. This agreement was significant for 87% of the competencies evaluated (k ≥ 0.21; P ≤ 0.05). The lowest agreement was in the ‘governance’ competency (k = 0.13; P = 0.21). Wilcoxon sum rank test showed a statistically significant within-subject difference in the ‘collaborative practice’ cluster (P = 0.043). This was not observed in the other five advanced practice clusters. From the qualitative interviews, practitioners generally perceived the two compared advanced-level frameworks as similar in content and indicated they found the described competencies to be useful for clarifying expectations of practice and identifying skills development needs.
Conclusion
These findings provide preliminary evidence of the comparability and transnational applicability of the advanced pharmacy practice competencies contained in the two national competency development frameworks evaluated.
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Affiliation(s)
- Arit Udoh
- FIP Collaborating Centre, UCL School of Pharmacy, London, UK
| | - Andreia Bruno
- Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia
| | - Ian Bates
- FIP Collaborating Centre, UCL School of Pharmacy, London, UK
| | - Kirsten Galbraith
- Faculty of Pharmacy and Pharmaceutical Sciences, Monash University, Melbourne, Australia
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Bugaj TJ, Schmid C, Koechel A, Stiepak J, Groener JB, Herzog W, Nikendei C. Shedding light into the black box: A prospective longitudinal study identifying the CanMEDS roles of final year medical students' on-ward activities. MEDICAL TEACHER 2017; 39:883-890. [PMID: 28413889 DOI: 10.1080/0142159x.2017.1309377] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
INTRODUCTION To our best knowledge, a rigorous prospective analysis of final year medical students' (FY medical students) activity profiles during workplace learning is lacking. The present study investigated the CanMEDS characteristics of all on-ward activities performed by internal medicine FY medical students. We tested the hypotheses that during FY medical student workplace training (I) routine activities are predominantly performed, while supervised, more complex activities are underrepresented with (II) FY medical students performing an insufficient number of autonomous activities and that (III) the CanMEDS roles of the Communicator and the Professional prevail. METHODS During the second and the sixth week of their final year trimester at the University of Heidelberg Medical Hospital, N = 34 FY medical students (73% female; mean age 26.4 ± 2.4) were asked to keep a detailed record of all their on-ward activities and to document the duration, mode of action (active versus passive; independent versus supervised), estimated relevance for later practice, and difficulty-level in specially designed activity logbooks. CanMEDS roles were assigned to the documented activities via post-hoc expert consensus. RESULTS About 4308 activities lasting a total of 2211.4 h were documented. Drawing blood (20.8%) was the most frequently documented medical activity followed by full admission procedures (9.6%). About 14.9% of the time was spent with non-medical activities. About 82.1% of all medical activities performed went unsupervised. The Communicator (42%), the Professional (38%), and the Collaborator (7%) were assigned as the top three CanMEDS roles. CONCLUSIONS The results call for increased efforts in creating more authentic learning experiences for FY medical students shifting towards more complex, supervised tasks, and improved team integration.
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Affiliation(s)
- Till Johannes Bugaj
- a Department of General Internal and Psychosomatic Medicine , University of Heidelberg Medical Hospital , Heidelberg , Germany
| | - Carolin Schmid
- a Department of General Internal and Psychosomatic Medicine , University of Heidelberg Medical Hospital , Heidelberg , Germany
| | - Ansgar Koechel
- b Department of Dermatology , University of Heidelberg Medical Hospital , Heidelberg , Germany
| | - Jan Stiepak
- c Department of Cardiology, Angiology, and Pneumology , University of Heidelberg Medical Hospital , Heidelberg , Germany
| | - Jan B Groener
- d Department of Endocrinology and Metabolism , University of Heidelberg Medical Hospital , Heidelberg , Germany
| | - Wolfgang Herzog
- a Department of General Internal and Psychosomatic Medicine , University of Heidelberg Medical Hospital , Heidelberg , Germany
| | - Christoph Nikendei
- a Department of General Internal and Psychosomatic Medicine , University of Heidelberg Medical Hospital , Heidelberg , Germany
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Hefler J, Ramnanan CJ. Can CanMEDS competencies be developed in medical school anatomy laboratories? A literature review. INTERNATIONAL JOURNAL OF MEDICAL EDUCATION 2017; 8. [PMID: 28650843 PMCID: PMC5511744 DOI: 10.5116/ijme.5929.4381] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
OBJECTIVES The purpose of this literature review was to identify potential ways in which undergraduate medical anatomy education may be relevant to the CanMEDS Roles, a competency-based framework used throughout Canadian medical training. METHODS A scoping review of medical education literature was conducted in March 2017 for English language publications that included key words related to anatomy education and to key competencies formally described for each of the Roles in the CanMEDS 2015 framework. Indicated benefits were then collated, characterized, and synthesized for each CanMEDS Role. RESULTS There were 71 studies identified describing original findings. Perceived benefits of anatomy education were most often identified for competencies related to the Medical Expert Role. Multiple studies also cited benefits related to the Scholar, Professional and Collaborator Roles. There was a lack of literature related to the Health Advocate, Communicator, and Leader Roles. The majority of benefits defined in the literature were limited to student perceptions rather than objectively measured outcomes. CONCLUSIONS There is some evidence to suggest that anatomy education can facilitate the development of core competencies related to several CanMEDS Roles, outside of simply developing medical knowledge in the Medical Expert Role. Future studies need to develop methods to objectively assess outcomes related to these competencies.
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Affiliation(s)
- Joshua Hefler
- Department of Innovation in Medical Education, Faculty of Medicine, University of Ottawa, Canada
| | - Christopher J. Ramnanan
- Department of Innovation in Medical Education, Faculty of Medicine, University of Ottawa, Canada
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Fritze O, Griewatz J, Narciß E, Shiozawa T, Wosnik A, Zipfel S, Lammerding-Koeppel M. How much GK is in the NKLM? A comparison between the catalogues of exam-relevant topics (GK) and the German National Competence-based Learning Objectives Catalogue for Undergraduate Medical Education (NKLM). GMS JOURNAL FOR MEDICAL EDUCATION 2017; 34:Doc9. [PMID: 28293676 PMCID: PMC5327656 DOI: 10.3205/zma001086] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Revised: 09/14/2016] [Accepted: 10/09/2016] [Indexed: 05/31/2023]
Abstract
Background: The German National Competence-Based Learning Objectives for Undergraduate Medical Education (NKLM) being adopted in 2015 is designed to contribute to improve the quality of teaching and learning in medicine with respect to competence orientation. For departments, the coherence between teaching, assessment and the content of the catalogues of exam-relevant topics (GK) is a crucial factor. Before making use of the NKLM seriously in curricular development, many faculties demand more transparency regarding the representation in the NKLM of GK topics and in what aspects the NKLM exceeds the GK. Therefore, the aim of the study was to assign the NKLM competencies and objectives to the systematic GK terms, to reveal gaps in their congruence and to determine the percentage of agreement between GK and NKLM. Additionally, the distribution among the NKLM chapters (chap.), of GK content and further competencies relevant for medical practice were analysed. Methods: The textual comparison of GK and NKLM was done by advanced students that were familiar with the NKLM from previous analyses. The comparison was done independently (keyword search, face validity), afterwards consented and matched with independent ratings of GK-2 and chapter 21 done by experts as well as with cross-references to the GK indicated in chapter 12, 13 and 15 of the NKLM. Detailed data is available online: www.merlin-bw.de/gk-nklm-abgleich.html. Results: The degree of correspondence of the GK's six preclinical parts with the NKLM ranges between 94% and 98%, with the clinical GK the degree of correspondence ranging between 84% and 88%. This demonstrates a consistently very high congruence of content. Only 6-16% of the content per GK part could not be assigned to NKLM equivalents. Regarding the distribution of GK content among NKLM chapters, the chapters with classic medical expertise (chapters 12, 13, 16, 17 as well as 20 and 21) show the highest correspondences. Practical medical skills (chapter 14b) can be found in the clinical GK "Health Disorders". Doctor-patient interaction (chapter 14c) and medical scientific skills (chapter 14a) are represented only marginally in the GK. As expected, there were no equivalents to be found in the GK for the new professional roles for medical doctors (chapter 06-11). Discussion: The results presented provide faculties with a useful and detailed data base to evaluate the NKLM more reliably, especially with respect to its relevance for exams. The increased transparency supports the implementation process of the NKLM by reducing content-related uncertainties of departments, invalidating sweeping arguments against the NKLM resulting from uncertainties and thereby minimizing resistance. At the same time a critical review process of the NKLM is encouraged.
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Affiliation(s)
- Olaf Fritze
- Eberhard-Karls University, Competence Centre for University Teaching in Medicine, Baden-Wuerttemberg, Tuebingen, Germany
| | - Jan Griewatz
- Eberhard-Karls University, Competence Centre for University Teaching in Medicine, Baden-Wuerttemberg, Tuebingen, Germany
| | - Elisabeth Narciß
- University of Heidelberg, Faculty of Medicine Mannheim, Competence Centre of Final Year, Mannheim, Germany
| | - Thomas Shiozawa
- University of Tuebingen, Faculty of Medicine, Institute of Clinical Anatomy and Cell Analysis, Tuebingen, Germany
| | - Annette Wosnik
- University of Tuebingen, Faculty of Medicine, Dean's Office of Student Affairs, Tuebingen, Germany
| | - Stephan Zipfel
- University of Tuebingen, Faculty of Medicine, Dean's Office of Student Affairs, Tuebingen, Germany
| | - Maria Lammerding-Koeppel
- Eberhard-Karls University, Competence Centre for University Teaching in Medicine, Baden-Wuerttemberg, Tuebingen, Germany
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[Medical educational evaluation of the German Pain Congress 2012. In the context of the CanMEDS physician competency framework]. Schmerz 2016; 28:520-7. [PMID: 25245595 DOI: 10.1007/s00482-014-1480-9] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND Professionals in the medical field are expected to participate in continuing medical education in the sense of lifelong learning. The authors took this occasion to evaluate the most important national convention in pain medicine concerning its role in medical education. MATERIAL AND METHODS The participants of the 37th German Pain Congress (17-20 October 2012 in Mannheim) were asked to complete a questionnaire concerning content and design of the convention. The aim of this study was to analyze the distribution of different physician competencies in the program. For this purpose the congress program was analyzed with respect to the various medical role models as defined in the Canadian medical education directions for specialists (CanMEDS) framework. RESULTS The participants considered the quality of the different sessions of the German Pain Congress to be good. The poster sessions were considered to be the second most important educational format in the congress following the live sessions. Concerning the content of the congress the participants wished more emphasis on the role of interprofessional partners, such as nursing and psychotherapy. The CanMEDS physician roles of manager, communicator, health advisor and professional paragon were underrepresented in the congress program in this study. CONCLUSION Regarding content and educational value, the congress design could benefit from additional Praktikerseminaren (practical seminars). The role of interprofessional partners should be more emphasized. In addition the program could become more attractive through a more balanced distribution of the CanMEDS roles.
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Ellaway R. CanMEDS is a theory. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2016; 21:915-917. [PMID: 27878472 DOI: 10.1007/s10459-016-9724-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/11/2016] [Accepted: 10/13/2016] [Indexed: 06/06/2023]
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Griewatz J, Wiechers S, Ben-Karacobanim H, Lammerding-Koeppel M. Medical teachers' perception of professional roles in the framework of the German National Competence-Based Learning Objectives for Undergraduate Medical Education (NKLM)-A multicenter study. MEDICAL TEACHER 2016; 38:1157-1165. [PMID: 27075989 DOI: 10.3109/0142159x.2016.1170777] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
BACKGROUND Based on CanMEDS and others, the German National Competence-Based Learning Objectives for Undergraduate Medical Education (NKLM) were recently consented. International studies recommend integrating national and cultural context when transferring a professional roles framework in different countries. Teachers' misconceptions may establish barriers in role understanding and implementation. OBJECTIVES The aim is to analyze medical teachers' rating and perception of NKLM roles in order to reveal differences to official definitions. METHODS A two-step sequential mixed methods design was used including a survey and focus groups with N = 80 medical teachers from four German universities. RESULTS Most of the teachers highly valued the importance of the role "Medical Expert" and understood comprehensively. The Communicator and the Collaborator were rated fairly and perceived to a large extent. Other intrinsic roles like Health Advocate and Scholar showed more deficits in perception and less importance by the participants. This was seen generally problematic and should be considered carefully. Manager and professional showed one-sided weaknesses either in importance or perception. CONCLUSION Medical teachers considered NKLM roles relevant for medical practice, although their role perception differed considerably. The value and risk matrix visualizes the specific role profile and offers strategic implications for NKLM communication and handling, thus supporting change management.
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Affiliation(s)
- Jan Griewatz
- a Competence Centre for University Teaching in Medicine Baden-Wuerttemberg , University of Tuebingen , Tuebingen , Germany
| | - Steffen Wiechers
- b Department of General Paediatrics, Oncology and Haematology , University Children's Hospital, University of Tuebingen , Tuebingen , Germany
| | - Hadiye Ben-Karacobanim
- a Competence Centre for University Teaching in Medicine Baden-Wuerttemberg , University of Tuebingen , Tuebingen , Germany
| | - Maria Lammerding-Koeppel
- a Competence Centre for University Teaching in Medicine Baden-Wuerttemberg , University of Tuebingen , Tuebingen , Germany
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Wong E, Leslie JJ, Soon JA, Norman WV. Measuring interprofessional competencies and attitudes among health professional students creating family planning virtual patient cases. BMC MEDICAL EDUCATION 2016; 16:273. [PMID: 27756294 PMCID: PMC5069921 DOI: 10.1186/s12909-016-0797-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/01/2016] [Accepted: 10/08/2016] [Indexed: 05/14/2023]
Abstract
BACKGROUND The Virtual Interprofessional Patients-Computer-Assisted Reproductive Health Education for Students (VIP-CARES) Project took place during the summers of 2010-2012 for eight weeks each year at the University of British Columbia (UBC). Undergraduate health care students worked collaboratively to develop virtual patient case-based learning modules on the topic of family planning. The purpose of this study was to evaluate the changes in perception towards interprofessional collaboration (IPC) among the participants, before and after the project. METHODS This study utilized a mixed methods evaluation using self-assessment survey instruments, semi-structured interviews, and reflective essays. Pre- and post- project surveys were adapted from the Canadian Medical Education Determinants (CanMEDS) and Canadian Interprofessional Health Collaborative (CIHC) frameworks, as well as the Memorial University Interprofessional Attitudes (IPA) questionnaire. The survey results were analyzed as mean (M) and standard deviation (SD) on Likert scales. The non-parametric Wilcoxon signed-rank test was used to determine if any significant changes were measured between each participant's differences in score (p ≤ 0.05). Post-project interview transcripts and essays were analyzed using recursive abstraction to elicit any themes. RESULTS Altogether, 26 students in medicine, pharmacy, nursing, midwifery, dentistry, counselling psychology, and computer science participated in VIP-CARES, during the three years. Student attitudes toward IPC were positive before and after the project. At the project's conclusion, there was a statistically significant increase in the participants' self-assessment competency scores in the CanMEDS roles of health advocate (p = 0.05), manager (p = 0.02), and medical expert (p = 0.03), as well as the CIHC domains of interprofessional communication (p = 0.04), role clarification (p = 0.01), team functioning (p = 0.05), and collaborative leadership (p = 0.01). Qualitative evaluations yielded three major themes: communication and respect as key to team functioning, importance of role clarification within the team, and existence of inherent challenges to IPC. From the reflections, students generally felt more comfortable with their improvements in the CIHC domains of interprofessional communication, team functioning, and role clarification. CONCLUSION After working within an interdisciplinary team developing virtual patient learning modules on family planning, the student participants of the VIP-CARES Project indicated general improvement in the skills necessary for effective interprofessional collaboration. Triangulation of the overall data suggests this was especially observed within the areas of interprofessional communication, team functioning, and role clarification.
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Affiliation(s)
- Eric Wong
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, Canada
- Contraception Access Research Team- Groupe de recherche sur l’accessibilité à la contraception (CART/GRAC), Women’s Health Research Institute, British Columbia Women’s Hospital and Health Centre, Provincial Health Services Authority, Vancouver, BC Canada
| | - Jasmine J. Leslie
- Contraception Access Research Team- Groupe de recherche sur l’accessibilité à la contraception (CART/GRAC), Women’s Health Research Institute, British Columbia Women’s Hospital and Health Centre, Provincial Health Services Authority, Vancouver, BC Canada
- Department of Family Practice, Faculty of Medicine, University of British Columbia, 3rd Floor, David Strangway Building, 5950 University Boulevard, Vancouver, BC V6T 1Z3 Canada
| | - Judith A. Soon
- Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, Canada
- Contraception Access Research Team- Groupe de recherche sur l’accessibilité à la contraception (CART/GRAC), Women’s Health Research Institute, British Columbia Women’s Hospital and Health Centre, Provincial Health Services Authority, Vancouver, BC Canada
| | - Wendy V. Norman
- Contraception Access Research Team- Groupe de recherche sur l’accessibilité à la contraception (CART/GRAC), Women’s Health Research Institute, British Columbia Women’s Hospital and Health Centre, Provincial Health Services Authority, Vancouver, BC Canada
- Department of Family Practice, Faculty of Medicine, University of British Columbia, 3rd Floor, David Strangway Building, 5950 University Boulevard, Vancouver, BC V6T 1Z3 Canada
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van der Aa JE, Goverde AJ, Teunissen PW, Scheele F. Paving the road for a European postgraduate training curriculum. Eur J Obstet Gynecol Reprod Biol 2016; 203:229-31. [PMID: 27348846 DOI: 10.1016/j.ejogrb.2016.05.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Revised: 04/19/2016] [Accepted: 05/13/2016] [Indexed: 11/25/2022]
Abstract
The 'Project for Achieving Consensus in Training' has been initiated by the European Board & College of Obstetrics and Gynaecology to harmonise training in Obstetrics and Gynaecology throughout Europe. In this project called the EBCOG-PACT, a state of the art pan-European training curriculum will be developed. Implementation of a pan-European curriculum will enhance harmonisation of both quality standards of women's healthcare practice and standards of postgraduate training. Secondly, it will assure equal quality of training of gynaecologists, promoting mobility throughout Europe. Thirdly, it will enhance cooperation and exchange of best practices between medical specialists and hospitals within Europe. The project is expecting to deliver (1) a description of the core and electives of the curriculum based on previously defined standards of care, (2) a societally responsive competency framework based on input from societal stakeholders and (3) strategies for education and assessment based on the current literature. Also, the project focuses on implementation and sustainability of the curriculum by delivering (4) a SWOT-analysis for the implementation based on insights into transcultural differences, (5) recommendations for implementation, change management and sustainability based on the SWOT analysis (6) and finally a handbook for other specialties initiating European curriculum development. The development and the implementation of this modern pan-European curriculum in Obstetrics and Gynaecology aims to serve as an example for the harmonisation of postgraduate training in Europe.
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Affiliation(s)
- Jessica E van der Aa
- Department of Research and Education, OLVG Hospital, Amsterdam, The Netherlands; Athena Institute, Faculty of Earth and Life Sciences, VU, Amsterdam, The Netherlands.
| | - Angelique J Goverde
- European Board & College of Obstetrics and Gynaecology, Standing Committee of Training and Assessment, Brussels, Belgium; European Board & College of Obstetrics and Gynaecology, Executive Committee, Brussels, Belgium; European Board & College of Obstetrics and Gynaecology, Chair of Project Board of EBCOG-PACT, Brussels, Belgium; Department of Reproductive Medicine and Gynaecology, University Medical Centre, Utrecht, The Netherlands
| | - Pim W Teunissen
- Faculty of Health Medicine and Life Sciences, School of Health Professions Education (SHE), Maastricht University, Maastricht, The Netherlands; VU University Medical Center, Amsterdam, The Netherlands
| | - Fedde Scheele
- Department of Research and Education, OLVG Hospital, Amsterdam, The Netherlands; Athena Institute, Faculty of Earth and Life Sciences, VU, Amsterdam, The Netherlands; European Board & College of Obstetrics and Gynaecology, Standing Committee of Training and Assessment, Brussels, Belgium; VU University Medical Center, Amsterdam, The Netherlands
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Renting N, Dornan T, Gans ROB, Borleffs JCC, Cohen-Schotanus J, Jaarsma ADC. What supervisors say in their feedback: construction of CanMEDS roles in workplace settings. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2016; 21:375-87. [PMID: 26342599 PMCID: PMC4801985 DOI: 10.1007/s10459-015-9634-9] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 08/22/2015] [Indexed: 05/10/2023]
Abstract
The CanMEDS framework has been widely adopted in residency education and feedback processes are guided by it. It is, however, only one of many influences on what is actually discussed in feedback. The sociohistorical culture of medicine and individual supervisors' contexts, experiences and beliefs are also influential. Our aim was to find how CanMEDS roles are constructed in feedback in a postgraduate curriculum-in-action. We applied a set of discourse analytic tools to written feedback from 591 feedback forms from 7 hospitals, including 3150 feedback comments in which 126 supervisors provided feedback to 120 residents after observing their performance in authentic settings. The role of Collaborator was constructed in two different ways: a cooperative discourse of equality with other workers and patients; and a discourse, which gave residents positions of power-delegating, asserting and 'taking a firm stance'. Efficiency-being fast and to the point emerged as an important attribute of physicians. Patients were seldom part of the discourses and, when they were, they were constructed as objects of communication and collaboration rather than partners. Although some of the discourses are in line with what might be expected, others were in striking contrast to the spirit of CanMEDS. This study's findings suggest that it takes more than a competency framework, evaluation instruments, and supervisor training to change the culture of workplaces. The impact on residents of training in such demanding, efficiency-focused clinical environments is an important topic for future research.
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Affiliation(s)
- Nienke Renting
- Center for Educational Development and Research in Health Professions, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands.
| | - Tim Dornan
- Centre for Medical Education, Queen's University Belfast, Belfast, UK
- Department of Education Development and Research, Maastricht University, Maastricht, The Netherlands
| | - Rijk O B Gans
- Department of Internal Medicine, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands
| | - Jan C C Borleffs
- Center for Educational Development and Research in Health Professions, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands
| | - Janke Cohen-Schotanus
- Center for Educational Development and Research in Health Professions, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands
| | - A Debbie C Jaarsma
- Center for Educational Development and Research in Health Professions, University Medical Center Groningen and University of Groningen, Groningen, The Netherlands
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Hautz SC, Hautz WE, Feufel MA, Spies CD. What makes a doctor a scholar: a systematic review and content analysis of outcome frameworks. BMC MEDICAL EDUCATION 2016; 16:119. [PMID: 27103593 PMCID: PMC4841044 DOI: 10.1186/s12909-016-0627-z] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 04/05/2016] [Indexed: 05/03/2023]
Abstract
BACKGROUND Many national outcome frameworks (OF) call for a sound scholarship education and scholarly behaviour of physicians. Educators however are known to interpret the scholar role in markedly different ways and at least one major initiative to unify several national outcome frameworks failed to agree on a common definition of the scholar role. Both circumstances currently limit the development of educational and assessment strategies specific for the scholar role. Given increasing physician mobility together with the global perspective inherent in a doctor's role as a scholar, we were interested in what different OFs define as the scholar role and attempted to identify communalities and differences between them. METHODS We conducted a systematic review for OF in medical education in PubMed and google. After in- and exclusion processes, we extracted all content listed under the scholar role (if present) and categorized it based on Boyer's established model of scholarship. Next, we extracted all content related to scholarship from OFs not explicitly defining a scholar role and used it to validate the categories resulting from step one. RESULTS From 1816 search results, we identified 13 eligible OFs, seven of which explicitly specified a scholar role. The outcomes only partly map onto Boyer's definition of scholarship: Discovery, Integration, Application, and Teaching. We adapted and validated a model extending this definition to contain Common Basics (partly overlapping with Integration and Teaching), Clinical Application (specifying Application), Research (Discovery and partly Integration), Teaching and Education (partly overlapping with Teaching) and Lifelong Learning (no equivalent in Boyer's model). Whereas almost all OFs cover Common Basics, Clinical Application, and Lifelong Learning, fewer and less specific outcomes relate to Research or Teaching. CONCLUSIONS The need to adapt existing models of scholarship may result from the changing demands directed at medical scholars. The considerable differences identified between OFs may explain why educators have difficulties defining the scholar role and why the role is rarely assessed. We may have missed OFs due to our in- and exclusion criteria but the results provide a solid basis on which to build a common understanding of what makes a doctor a scholar.
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Affiliation(s)
- Stefanie C. Hautz
- />Office of the Vice Dean for Teaching and Learning, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
- />Department of Anesthesiology and Intensive Care Medicine, Charité Campus Virchow-Klinikum and Charité Campus Mitte, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Wolf E. Hautz
- />Universitäres Notfallzentrum, Inselspital Bern, Bern, Switzerland
| | - Markus A. Feufel
- />Office of the Vice Dean for Teaching and Learning, Charité-Universitätsmedizin Berlin, Charitéplatz 1, 10117 Berlin, Germany
| | - Claudia D. Spies
- />Department of Anesthesiology and Intensive Care Medicine, Charité Campus Virchow-Klinikum and Charité Campus Mitte, Charité-Universitätsmedizin Berlin, Berlin, Germany
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Wallenburg I, Hopmans CJ, Buljac-Samardzic M, den Hoed PT, IJzermans JNM. Repairing reforms and transforming professional practices: a mixed-methods analysis of surgical training reform. JOURNAL OF PROFESSIONS AND ORGANIZATION 2016. [DOI: 10.1093/jpo/jov012] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
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Bunbury KM, Castanelli DJ. A survey of educator needs to support the implementation of the intrinsic ANZCA Roles in Practice. Anaesth Intensive Care 2015; 43:771-8. [PMID: 26603803 DOI: 10.1177/0310057x1504300616] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The 'Roles in Practice' framework was introduced into the revised ANZCA curriculum in 2013. We conducted an online survey of Supervisors of Training in Australia and New Zealand to assess understanding of this framework, and teaching and perceived value of the non-scholar intrinsic roles within the framework. One hundred and forty-three survey responses were received (response rate 60.8%). The majority of respondents (52.1%) reported only a fair understanding of the framework. Formal teaching of all the roles was consistently reported as infrequent, with most teaching occurring through the informal curriculum. The Communicator, Collaborator and Professional Roles were rated as better taught and more important to teach than the roles of Health Advocate and Manager. The Communicator Role was perceived as being the role for which the development of resources would be most valuable. Respondents overwhelmingly nominated small group teaching as the preferred medium for resource development of all intrinsic roles. Our survey indicates that there is a need to increase both the understanding of the Roles in Practice framework and the teaching resources available in the ANZCA Supervisor of Training community.
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Affiliation(s)
- K M Bunbury
- Department of Anaesthesia and Perioperative Medicine, The Alfred Hospital, Melbourne, Victoria
| | - D J Castanelli
- Department of Anaesthesia and Perioperative Medicine, Monash Medical Centre and Monash University, Clayton, Victoria
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[Learning objectives for psychosomatic medicine and psychotherapy in light of the National Competency-Based Catalogue of Learning Objectives for Medicine (NKLM)]. ZEITSCHRIFT FUR PSYCHOSOMATISCHE MEDIZIN UND PSYCHOTHERAPIE 2015; 61:275-88. [PMID: 26388058 DOI: 10.13109/zptm.2015.61.3.275] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The "National Competency-Based Catalogue of Learning Objectives for Medicine" ("Nationaler Kompetenzbasierter Lernzielkatalog Medizin,"NKLM) is a core curriculum developed for medical training. Here, the classic division by discipline and organ system has been abandoned, which requires each discipline to define its own core curriculum in specific catalogues of learning objectives. This article presents such a catalogue for Psychosomatic Medicine and Psychotherapy. METHOD A two-step DELPHI-method was used to survey faculty representatives for Psychosomatic Medicine and Psychotherapy. It reflected the discipline-specific university catalogues of learning objectives as well as the NKLM. A catalogue of learning objectives was then developed and approved. RESULTS The catalogue consists of two parts: (1) a 12-module core curriculum for Psychosomatic Medicine and Psychotherapy and (2) selected interdisciplinary learning objectives from the NKLM with relevant participation of the discipline in ten modules. DISCUSSION For the first time in Germany, this article presents a catalogue of learning objectives for Psychosomatic Medicine and Psychotherapy that is agreed upon by the relevant representatives. This enables the integration of psychosomatic and psychotherapeutic teaching contents from a department into the overall curriculum as required by the NKLM. In the future, methods should be established to allow regular updating and further development of this catalogue.
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Ng SL, Lingard L, Hibbert K, Regan S, Phelan S, Stooke R, Meston C, Schryer C, Manamperi M, Friesen F. Supporting children with disabilities at school: implications for the advocate role in professional practice and education. Disabil Rehabil 2015; 37:2282-90. [PMID: 25738906 PMCID: PMC4673542 DOI: 10.3109/09638288.2015.1021021] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2014] [Revised: 02/10/2015] [Accepted: 02/16/2015] [Indexed: 11/13/2022]
Abstract
PURPOSE School settings are a common practice context for rehabilitation professionals; health advocacy is a common and challenging practice role for professionals in this context. This study explored how pediatric practitioners advocate for children with disabilities at school. Specifically, we examined everyday advocacy in the context of school-based support for children with disabilities. METHOD Our theoretical framework and methodological approach were informed by institutional ethnography, which maps and makes visible hidden social coordinators of work processes with a view to improving processes and outcomes. We included families, educators, and health/rehabilitation practitioners from Ontario. Of the 37 consented informants, 27 were interviewed and 15 observed. Documents and texts were collected from the micro-level (e.g. clinician reports) and the macro-level (e.g. policies). RESULTS Pediatric practitioners' advocacy work included two main work processes: spotlighting invisible disabilities and orienteering the special education terrain. Practitioners advocated indirectly, by proxy, with common proxies being documents and parents. Unintended consequences of advocacy by proxy included conflict and inefficiency, which were often unknown to the practitioner. CONCLUSIONS The findings of this study provide practice-based knowledge about advocacy for children with disabilities, which may be used to inform further development of competency frameworks and continuing education for pediatric practitioners. The findings also show how everyday practices are influenced by policies and social discourses and how rehabilitation professionals may enact change. Implications for Rehabilitation Rehabilitation professionals frequently perform advocacy work. They may find it beneficial to perform advocacy work that is informed by overarching professional and ethical guidelines, and a nuanced understanding of local processes and structures. Competency frameworks and education for pediatric rehabilitation professionals may be improved by: encouraging professionals to consider how their practices, including their written documents, may affect parental burden, (mis)interpretation by document recipients, and potential unintended consequences. Policies and texts, e.g. privacy legislation and the Diagnostic and Statistical Manual (DSM), influence rehabilitation professionals' actions and interactions when supporting children with disabilities at school. An awareness of the influence of policies and texts may enable practitioners to work more effectively within current systems when supporting individuals with disabilities.
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Affiliation(s)
- Stella L. Ng
- Centre for Faculty Development, St. Michael's Hospital,
Toronto,
Canada
- Centre for Ambulatory Care Education, Women's College Hospital,
Toronto,
Canada
- Department of Speech-Language Pathology, University of Toronto,
Toronto,
Canada
| | - Lorelei Lingard
- Centre for Education Research & Innovation, Schulich School of Medicine & Dentistry, Western University,
London,
Canada
- Department of Medicine, Schulich School of Medicine & Dentistry, Western University,
London,
Canada
| | - Kathryn Hibbert
- Centre for Education Research & Innovation, Schulich School of Medicine & Dentistry, Western University,
London,
Canada
- Faculty of Education, Western University,
London,
Canada
| | - Sandra Regan
- Arthur Labatt Family School of Nursing, Faculty of Health Sciences, Western University,
London,
Canada
| | - Shanon Phelan
- Department of Occupational Therapy, Faculty of Rehabilitation Medicine, University of Alberta,
Edmonton,
Canada
| | | | - Christine Meston
- Centre for Education Research & Innovation, Schulich School of Medicine & Dentistry, Western University,
London,
Canada
- Health & Rehabilitation Sciences, Faculty of Health Sciences, Western University,
London,
Canada
| | - Catherine Schryer
- Department of Professional Communication, Ryerson University,
Toronto,
Canada
| | | | - Farah Friesen
- Centre for Faculty Development, St. Michael's Hospital,
Toronto,
Canada
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Steffen J, Grabbert M, Pander T, Gradel M, Köhler LM, Fischer MR, von der Borch P, Dimitriadis K. Finding the right doctoral thesis - an innovative research fair for medical students. GMS ZEITSCHRIFT FUR MEDIZINISCHE AUSBILDUNG 2015; 32:Doc29. [PMID: 26413167 PMCID: PMC4580439 DOI: 10.3205/zma000971] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/07/2014] [Revised: 04/26/2015] [Accepted: 05/18/2015] [Indexed: 11/30/2022]
Abstract
INTRODUCTION The importance of research, as promoted by the CanMEDS framework, is widely acknowledged. Many medical students in Germany work on a research project as part of their doctoral thesis whilst still going to medical school. However, a significant amount of projects are abandoned unfinished, which leads to substantial wastage of resources. One reason for this is an information deficit concerning undergraduate research projects. PROJECT DESCRIPTION To counteract this, we introduced an annual event at LMU Munich called DoktaMed with more than 600 visitors each year. It combines medical convention and research fair including keynote lectures, workshops and poster sessions as well as an exhibition of research groups and institutes. DoktaMed is a peer-to-peer event organized by a team of 40 students. RESULTS A needs analysis before its implementation underlined the information deficit as a possible cause for the high rate of abandoned projects. In the annual evaluation, visitors of DoktaMed rate the event with an average grade of 2.1 on a six-level Likert scale (n=558, SD=1.06, with "1=very good", "6=poor"). They stated to now feel better informed about the topic and regarded visiting DoktaMed as a worthwhile investment of time. DISCUSSION Students are generally satisfied with the event and feel better informed after visiting DoktaMed. However, many students never visit DoktaMed for various reasons. A possible improvement would be to present a greater number of clinical studies in addition to the laboratory work that DoktaMed focuses on now. CONCLUSION Evaluation after six years of DoktaMed is very promising. Visitors seem to be better informed. Nevertheless there is space for improvement in order to get more students and more faculty members involved. More studies are needed to assess long-term effects.
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Affiliation(s)
- Julius Steffen
- Klinikum der Universität München, Institut für Didaktik und Ausbildungsforschung in der Medizin, München, Deutschland ; Klinikum der Universität München, Medizinische Klinik und Poliklinik I, München, Deutschland
| | - Markus Grabbert
- Klinikum der Universität München, Institut für Didaktik und Ausbildungsforschung in der Medizin, München, Deutschland ; Klinikum der Universität München, Urologische Klinik und Poliklinik, München, Deutschland
| | - Tanja Pander
- Klinikum der Universität München, Institut für Didaktik und Ausbildungsforschung in der Medizin, München, Deutschland
| | - Maximilian Gradel
- Klinikum der Universität München, Institut für Didaktik und Ausbildungsforschung in der Medizin, München, Deutschland
| | - Lisa-Maria Köhler
- Klinikum der Universität München, Institut für Didaktik und Ausbildungsforschung in der Medizin, München, Deutschland
| | - Martin R Fischer
- Klinikum der Universität München, Institut für Didaktik und Ausbildungsforschung in der Medizin, München, Deutschland
| | - Philip von der Borch
- Klinikum der Universität München, Institut für Didaktik und Ausbildungsforschung in der Medizin, München, Deutschland ; Klinikum der Universität München, Medizinische Klinik und Poliklinik IV, München, Deutschland
| | - Konstantinos Dimitriadis
- Klinikum der Universität München, Institut für Didaktik und Ausbildungsforschung in der Medizin, München, Deutschland ; Klinikum der Universität München, Neurologische Klinik und Poliklinik, München, Deutschland
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49
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Jilg S, Möltner A, Berberat P, Fischer MR, Breckwoldt J. How do Supervising Clinicians of a University Hospital and Associated Teaching Hospitals Rate the Relevance of the Key Competencies within the CanMEDS Roles Framework in Respect to Teaching in Clinical Clerkships? GMS ZEITSCHRIFT FUR MEDIZINISCHE AUSBILDUNG 2015; 32:Doc33. [PMID: 26413171 PMCID: PMC4580442 DOI: 10.3205/zma000975] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 04/07/2015] [Accepted: 05/04/2015] [Indexed: 11/30/2022]
Abstract
Background and aim: In German-speaking countries, the physicians’ roles framework of the “Canadian Medical Education Directives for Specialists” (CanMEDS) is increasingly used to conceptualize postgraduate medical education. It is however unclear, whether it may also be applied to the final year of undergraduate education within clinical clerkships, called “Practical Year” (PY). Therefore, the aim of this study was to explore how clinically active physicians at a university hospital and at associated teaching hospitals judge the relevance of the seven CanMEDS roles (and their (role-defining) key competencies) in respect to their clinical work and as learning content for PY training. Furthermore, these physicians were asked whether the key competencies were actually taught during PY training. Methods: 124 physicians from internal medicine and surgery rated the relevance of the 28 key competencies of the CanMEDS framework using a questionnaire. For each competency, following three aspects were rated: “relevance for your personal daily work”, “importance for teaching during PY”, and “implementation into actual PY teaching”. Results: In respect to the main study objective, all questionnaires could be included into analysis. All seven CanMEDS roles were rated as relevant for personal daily work, and also as important for teaching during PY. Furthermore, all roles were stated to be taught during actual PY training. The roles “Communicator”, “Medical Expert”, and “Collaborator” were rated as significantly more important than the other roles, for all three sub-questions. No differences were found between the two disciplines internal medicine and surgery, nor between the university hospital and associated teaching hospitals. Conclusion: Participating physicians rated all key competencies of the CanMEDS model to be relevant for their personal daily work, and for teaching during PY. These findings support the suitability of the CanMEDS framework as a conceptual element of PY training.
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Affiliation(s)
- Stefanie Jilg
- Technische Universität München, Klinikum rechts der Isar, III. Medizinische Klinik für Hämatologie und Internistische Onkologie, München, Deutschland
| | - Andreas Möltner
- Kompetenzzentrum für Prüfungen in der Medizin/Baden-Württemberg, Heidelberg, Deutschland
| | - Pascal Berberat
- Technische Universität München, Fakultät für Medizin, MedizinDidaktisches Centrum für Ausbildungsforschung und Lehre (TUM MeDiCAL), München, Deutschland
| | - Martin R Fischer
- Klinikum der Universität München, Institut für Didaktik und Ausbildungsforschung in der Medizin, München, Deutschland
| | - Jan Breckwoldt
- Universität Zürich, Medizinische Fakultät, Studiendekanat, Zürich, Schweiz
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50
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Hulsman RL, van der Vloodt J. Self-evaluation and peer-feedback of medical students' communication skills using a web-based video annotation system. Exploring content and specificity. PATIENT EDUCATION AND COUNSELING 2015; 98:356-63. [PMID: 25433967 DOI: 10.1016/j.pec.2014.11.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/21/2013] [Revised: 10/16/2014] [Accepted: 11/11/2014] [Indexed: 05/21/2023]
Abstract
OBJECTIVE Self-evaluation and peer-feedback are important strategies within the reflective practice paradigm for the development and maintenance of professional competencies like medical communication. Characteristics of the self-evaluation and peer-feedback annotations of medical students' video recorded communication skills were analyzed. METHOD Twenty-five year 4 medical students recorded history-taking consultations with a simulated patient, uploaded the video to a web-based platform, marked and annotated positive and negative events. Peers reviewed the video and self-evaluations and provided feedback. Analyzed were the number of marked positive and negative annotations and the amount of text entered. Topics and specificity of the annotations were coded and analyzed qualitatively. RESULTS Students annotated on average more negative than positive events. Additional peer-feedback was more often positive. Topics most often related to structuring the consultation. Students were most critical about their biomedical topics. Negative annotations were more specific than positive annotations. Self-evaluations were more specific than peer-feedback and both show a significant correlation. Four response patterns were detected that negatively bias specificity assessment ratings. CONCLUSION Teaching students to be more specific in their self-evaluations may be effective for receiving more specific peer-feedback. PRACTICE IMPLICATIONS Videofragmentrating is a convenient tool to implement reflective practice activities like self-evaluation and peer-feedback to the classroom in the teaching of clinical skills.
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Affiliation(s)
- Robert L Hulsman
- Academic Medical Centre, Department of Medical Psychology, Amsterdam, The Netherlands.
| | - Jane van der Vloodt
- Academic Medical Centre, Department of Medical Psychology, Amsterdam, The Netherlands
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