Avoiding tokenism in health professional education

"We talk teeth": Exploring faculty EDIA (equity, diversity, inclusivity, and access) capacity in dental education

PURPOSE

There are increasing concerns regarding inequitable educational access and experiences for underrepresented populations in health education, prompting dental faculties to recognize EDIA (equity, diversity, inclusivity, and access) capacity as a strategic priority. Faculty members contribute to the establishment and reinforcement of institutionally engrained norms within learning settings with significant influence on the experience of students. Currently, there is limited literature on faculty EDIA capacity within dental education and minimal evidence to inform barriers to development. This study sought to explore how dental faculty members perceive their personal and institutional EDIA capacity and to identify current strengths and weaknesses of EDIA development within the institution of study and dental education.

METHODS

Using a hermeneutic study design, semi-structured interviews were conducted on a convenience sampling of dental faculty members (n = 10) and a thematic, interpretative analysis was applied.

RESULTS

Findings revealed six dominant themes impacting EDIA capacity. Knowledge of EDIA language, interfaculty communication, and institutional messaging are identified as weaknesses, whereas informal, community building events for EDIA development are identified as novel strengths meriting prioritization. Motivation to engage in EDIA by faculty members overall is illuminated in relation to emotionally provocative experiences.

CONCLUSION

Current institutional communication of EDIA is unconsciously restricting capacity building based on hierarchical and prescribed parameters. Developing capacity in dental education requires a redirection of resources to initiatives valuing social bonding over prescribed box-checking. This study reveals a new narrative of EDIA capacity within dental education and sustainable pathways for development with high transferability to other health programs.

Which Learning Activities Enhance Physical Therapist Practice? Part 2: Systematic Review of Qualitative Studies and Thematic Synthesis

OBJECTIVE

Post-professional physical therapy expertise requires career-long participation in learning activities. Understanding physical therapists' lived experience of learning activities provides novel insight into how best to enhance physical therapist practice from the perspective of the learner. The purpose of this study was to explore qualified physical therapists' experiences, beliefs, and perspectives with regard to learning activities and professional development.

METHODS

Eight databases were searched for studies published from inception through December 2018. Study selection included mixed-methods and qualitative studies exploring physical therapists' experiences, perspectives, beliefs, and attitudes. Thematic synthesis was performed, and the GRADE-Confidence in the Evidence from Reviews of Qualitative research was used to assess the level of confidence in the findings. A total 41 studies with 719 participants were included.

RESULTS

The key findings include physical therapists' perceptions that worthwhile post-professional learning requires more than attendance at professional development courses. Physical therapists perceived that worthwhile learning requires connection with others and being "taken out of one's comfort zone." Sufficient time and accessible, trustworthy resources were also valued.

CONCLUSIONS

Moderate- to low-level evidence suggests that the choice of professional development activities and education design for qualified physical therapists should consider the inclusion of connected activities, activities that take participants out of comfort zones, time to practice, and trustworthy resources that are easily accessible. Future research should evaluate the effectiveness of learning activities encompassing these factors, prioritizing those that minimize the barriers of time and distance.

IMPACT

This study adds to the profession's understanding of physical therapists' lived experience of learning activities, providing novel insight into how best to enhance physical therapist practice from the perspective of the learner.

Challenging feedback myths: Values, learner involvement and promoting effects beyond the immediate task

CONTEXT

Research suggests that feedback in the health professions is less useful than we would like. In this paper, we argue that feedback has become reliant on myths that perpetuate unproductive rituals. Feedback often resembles a discrete episode of an educator "telling," rather than an active and iterative involvement of the learner in a future-facing process. With this orientation towards past events, it is not surprising that learners become defensive or disengaged when they are reminded of their deficits.

METHODS

We tackle three myths of feedback: (a) feedback needs praise-criticism balancing rules; (b) feedback is a skill residing within the teacher; and (c) feedback is an input only. For each myth we provide a reframing with supporting examples from the literature.

CONCLUSIONS

Equipping learners to engage in feedback processes may reduce the emotional burden on both parties, rendering techniques such as the feedback sandwich redundant. We also highlight the benefits for learners and teachers of conceptualising feedback as a relational activity, and of tracing the effects of information exchanges. These effects may be immediate or latent, and may manifest in different forms such as changes in learner evaluative judgement or professional identity.

Keeping mum in clinical supervision: private thoughts and public judgements

CONTEXT

The seemingly obvious claim that people prefer to keep mum about undesirable messages - termed 'the MUM effect' - was initially reported in the psychology literature in the 1970s. More recently, it has been discussed in contexts including performance appraisals and the reporting of unsuccessful projects in workplace settings, but only sparsely in educational ones. We wished to review the published literature on the MUM effect in order to understand the implications for clinical assessment.

METHODS

We performed a narrative literature review on the MUM effect and clustered findings together into three themes: those that describe what MUM behaviours look like, those that explore potential reasons for the MUM effect and those that consider factors that can influence MUM behaviours.

RESULTS

This paper summarises the extensive literature on the MUM effect, including its manifestations and modifiers and discusses how the effect may be used to consider issues faced by many clinical supervisors faced with delivering 'negative' assessment messages to trainees.

DISCUSSION

We suggest, that as a pervasive phenomenon, the MUM effect can both help to explain the difficulties that some assessors face when delivering undesirable messages (including feedback or ratings) and offer new insights in how to deal with such issues.

Promoting safety mindfulness: Recommendations for the design and use of simulation-based training in radiation therapy

There is a need to better prepare radiation therapy (RT) providers to safely operate within the health information technology (IT) sociotechnical system. Simulation-based training has been preemptively used to yield meaningful improvements during providers' interactions with health IT, including RT settings. Therefore, on the basis of the available literature and our experience, we propose principles for the effective design and use of simulated scenarios and describe a conceptual framework for a debriefing approach to foster successful training that is focused on safety mindfulness during RT professionals' interactions with health IT.

The influence of a preceptor-student 'Daily Feedback Tool' on clinical feedback practices in nursing education: A qualitative study

BACKGROUND

Feedback in clinical education is essential for the development of competent nurses. When the process is enacted well, it offers measured performance against standards required by the nursing health profession, promoting learning and behavioural change. Despite this, health literature describes numerous barriers to effective feedback processes.

OBJECTIVE

A qualitative descriptive design was used to determine whether the introduction of a Daily Feedback Tool addressing some of the barriers to effective feedback, influenced nursing students and clinical supervisors (preceptors) experiences in nursing clinical education.

METHOD

A total of eight semi-structured focus groups related to student and preceptors reported experiences were completed comprising of preceptor and student groups independently. The data was analysed using aspects of grounded theory including purposive sampling and system analysis informing the subsequent stages of data collection.

RESULTS

Participants reported that the introduction of the Daily Feedback Tool overcame some of the reported barriers, particularly relating to the frequency of feedback occasions, and the traditionally didactic, teacher-led feedback conversations.

CONCLUSION

The Daily Feedback Tool was reported to influence the development of trusting preceptor-student relationships which gave the learner agency to seek feedback promoting learning and overall performance.