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Hammoud MM, Schoppen Z, Berkowitz LR, Marzano D. Redesigning Continuous Professional Development: Aligning Learning Needs With Clinical Practice. Clin Obstet Gynecol 2024; 67:474-482. [PMID: 38881535 DOI: 10.1097/grf.0000000000000878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/18/2024]
Abstract
Continuous professional development (CPD) in health care refers to the process of lifelong learning including the acquisition of new competencies, knowledge, and professional growth throughout the career of a health care professional. Since implementation, there has seen little change or innovation in CPD. This perspective will review the current state of CPD, including the challenges in traditional CPD models, foundations and strategies for redesign to meet the needs of current and future physicians, and suggestions for changes to modernize CPD. Precision education and the use of technology, including artificial intelligence, and their application to CPD will be discussed.
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Affiliation(s)
- Maya M Hammoud
- University of Michigan Medical School, Ann Arbor, Michigan
| | | | | | - David Marzano
- University of Michigan Medical School, Ann Arbor, Michigan
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Sherman L, Aboulsoud S, Leon-Borquez R, Ming K, Yang DYD, Chappell K. An overview of global CME/CPD systems. MEDICAL TEACHER 2024:1-13. [PMID: 39012047 DOI: 10.1080/0142159x.2024.2373879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Accepted: 06/25/2024] [Indexed: 07/17/2024]
Abstract
PURPOSE Engagement in CME/CPD has a positive impact on healthcare professionals' (HCPs) knowledge, skills, and performance, and on patient outcomes, therefore it is critical to better understand the components of CME/CPD systems that foster engagement, high-quality education, and impact. METHODS An assessment of CME/CPD systems was conducted using a mixed-methods approach that included interviews with in-country subject matter experts and qualitative and quantitative data from practicing in-country physicians. RESULTS Results demonstrate areas of consistency in CME/CPD systems across world regions that included: types of educational providers; types of credit; educational formats; self-tracking of participation; high-degree of compliance when education is mandatory; overall satisfaction with available education; strong support for interprofessional education; and lack of alignment or evaluation of engagement in education with population health outcomes. Areas of variation included: whether engagement in education is required as a condition to practice medicine; whether regulations are uniformly applied; if mechanisms to ensure independence existed; and physician perceptions of independence. CONCLUSION Results of this assessment maybe used by a variety of different stakeholders to assess how well country-level CME/CPD systems are meeting the needs of practicing physicians and determine what, if any, changes might need to be implemented to improve outcomes.
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Affiliation(s)
| | | | | | - Kuang Ming
- Zhongshan School of Medicine, First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Da-Ya David Yang
- First Affiliated Hospital, Sun Yat-Sen University, Guangzhou, China
| | - Kathy Chappell
- Accreditation Commission for Education in Nursing, Atlanta, GA, USA
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Habibi Baghi M, Abolghasemi M, Zakerimoghadam M, Rezaiezadeh M, Vahidi Asl M. Unveiling CPR training challenges in nursing education: Pedagogical strategies for success. Nurse Educ Pract 2024; 78:104040. [PMID: 38943760 DOI: 10.1016/j.nepr.2024.104040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Revised: 06/08/2024] [Accepted: 06/17/2024] [Indexed: 07/01/2024]
Abstract
AIM This study explored the challenges nursing students face while learning CPR and identified experiential learning strategies to address these challenges. BACKGROUND Nursing students often experience challenges and anxiety during clinical learning, including CPR training. Given the experimental nature of CPR training, experiential learning models like mARC can significantly enhance the learning experience by addressing these prevalent challenges. DESIGN This study adopts an interpretivist approach within a qualitative methodology and uses a phenomenological design. METHOD Semi-structured interviews and the Delphi method were used to gather firsthand experiences from 37 educational supervisors, nursing professors and nursing students undergoing CPR clinical training at five public medical universities. RESULTS Four main challenges and eighteen sub-challenges of CPR training were identified, elaborated and modeled. Additionally, thirteen experiential learning strategies, based on the mARC experiential learning model (more Authentic, Reflective, Collaborative), were mapped to address these challenges. CONCLUSIONS Among the four main challenges of CPR training identified by this study, the lack of pedagogy appears to be the underlying cause of the other three. This underscores the significance of integrating effective pedagogical approaches into nurse education strategies and initiatives.
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Affiliation(s)
- Masoomeh Habibi Baghi
- Department of Education, Faculty of Education and Psychology, University of Shahid Beheshti, Tehran 1983969411, Iran; Faculty of science, The university of Waterloo, Waterloo N2L 3G1, Canada
| | - Mahmood Abolghasemi
- Department of Education, Faculty of Education and Psychology, University of Shahid Beheshti, Tehran 1983969411, Iran
| | | | - Morteza Rezaiezadeh
- Department of Education, Faculty of Education and Psychology, University of Shahid Beheshti, Tehran 1983969411, Iran; Medical School, College of Life Sciences, University of Leicester, Leicester, UK.
| | - Mojtaba Vahidi Asl
- Department of Software and information systems, University of Shahid Beheshti, Tehran 1416753955, Iran
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Aouad P, Janssen A, Corry S, Spielman K, Gonzalez-Arce V, Bryant E, Simeone R, Shaw T, Maguire S. Educating primary care physicians about eating disorders: Pilot data from a microlearning programme. EUROPEAN EATING DISORDERS REVIEW 2024; 32:687-699. [PMID: 38416595 DOI: 10.1002/erv.3074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2023] [Revised: 01/23/2024] [Accepted: 02/03/2024] [Indexed: 03/01/2024]
Abstract
BACKGROUND Over two-thirds of people present to their primary care physician (or general practitioner; GP) as a first point of contact for mental health concerns. However, eating disorders (EDs) are often not identified in a primary care setting. A significant barrier to early detection and intervention is lack of primary care physician training in EDs; compounded by the significant time commitments required for training by already time-poor general practitioners. The aim of the current study was to pilot and evaluate a microlearning programme that can be delivered to general practitioners with high workloads to help support patients with, or at risk of, developing an ED. METHODS Fifty-one Australian general practitioners aged between 25-to-60 years old were recruited. Participants completed a baseline questionnaire to ascertain their experience working in general practice and with EDs. Participants then completed an online programme consisting of a series of 10 case studies (vignettes) delivered over a 6-10 week period related to various facets of ED care. Following conclusion of the programme, participants were asked to complete an evaluative questionnaire related to the content of the programme; perceived knowledge, confidence, willingness-to-treat, skill change; and their overall experience of microlearning. RESULTS All 51 GPs completed the programme and reached completion criteria for all vignettes, 40 of whom completed the programme evaluation. Participants indicated improved skill, confidence, willingness-to-treat, and knowledge following the completion of the pilot programme. Almost all (97.5%; n = 39) found microlearning to be an effective method to learn about EDs; with 87.5% (n = 35) of participants reporting they felt able to apply what was learnt in practice. Qualitative feedback highlighted the benefit of microlearning's flexibility to train general practitioners to work with complex health presentations, specifically EDs. CONCLUSIONS Findings from the current study lend support to the use of microlearning in medical health professional training; notably around complex mental health concerns. Microlearning appears to be an acceptable and effective training method for GPs to learn about EDs. Given the significant time demands on GPs and the resulting challenges in designing appropriate training for this part of the workforce, this training method has promise. The pre-existing interest in EDs in the current study sample was high; future studies should sample more broadly to ensure that microlearning can be applied at scale.
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Affiliation(s)
- Phillip Aouad
- InsideOut Institute, Faculty of Medicine and Health, Sydney, Australia
| | - Anna Janssen
- Research in Implementation Science and EHealth (RISe) Group (Faculty of Medicine and Health), The University of Sydney, Sydney, Australia
| | - Sally Corry
- InsideOut Institute, Faculty of Medicine and Health, Sydney, Australia
| | - Karen Spielman
- InsideOut Institute, Faculty of Medicine and Health, Sydney, Australia
| | - Veronica Gonzalez-Arce
- InsideOut Institute, Faculty of Medicine and Health, Sydney, Australia
- NSW Health, Sydney, Australia
| | - Emma Bryant
- InsideOut Institute, Faculty of Medicine and Health, Sydney, Australia
| | - Rachel Simeone
- InsideOut Institute, Faculty of Medicine and Health, Sydney, Australia
| | - Tim Shaw
- Research in Implementation Science and EHealth (RISe) Group (Faculty of Medicine and Health), The University of Sydney, Sydney, Australia
| | - Sarah Maguire
- InsideOut Institute, Faculty of Medicine and Health, Sydney, Australia
- NSW Health, Sydney, Australia
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Munyaneza E, Rugwizangoga B, Rusingiza E, Niyibizi JB, Kanyandekwe SR, Byiringiro JC, Masaisa F. Continuing Professional Development Program in Health Facilities in Rwanda: A Qualitative Study on the Perceptions of Health Professionals. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2024; 15:527-542. [PMID: 38860026 PMCID: PMC11164211 DOI: 10.2147/amep.s456190] [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: 12/22/2023] [Accepted: 06/01/2024] [Indexed: 06/12/2024]
Abstract
Background Continuous professional development (CPD) is an important pillar in healthcare service delivery. Health professionals at all levels and disciplines must continuously update their knowledge and skills to cope with increasing professional demands in the context of a continuously changing spectrum of diseases. This study aimed to assess the CPD programs available in healthcare facilities (HFs) in Rwanda. Methodology Semi-structured interviews were conducted using purposive sampling. Accordingly, the respondents belonged to different categories of health professionals, namely nurses, midwives, laboratory technicians, pharmacists, general practitioners, and specialist doctors. Thirty-five participants from district, provincial, and national referral hospitals were interviewed between September and October 2020. A thematic analysis was conducted using Atlas ti.7.5.18, and the main findings for each theme were reported as a narrative summary. Results The CPD program was reported to be available, but not for all HPs and HFs, because of either limited access to online CPD programs or limited HF leaders. Where available, CPD programs have sometimes been reported to be irrelevant to health professionals and patients' needs. Furthermore, the planning and implementation of current CPD programs seldom involves beneficiaries. Some HFs do not integrate CPD programs into their daily activities, and current CPD programs do not accommodate mentorship programs. The ideal CPD program should be designed around HPs and service needs and delivered through a user-friendly platform. The motivators for HPs to engage in CPD activities include learning new things that help them improve their healthcare services and license renewal. Conclusion This study provides an overview of the status and perceptions of the CPD program in HFs in Rwanda and provides HPs' insights on the improvements in designing a standardized and harmonized CPD program in Rwanda.
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Affiliation(s)
- Emmanuel Munyaneza
- Clinical Education and Research Division, University Teaching Hospital of Kigali, Kigali, Rwanda
| | - Belson Rugwizangoga
- Clinical Education and Research Division, University Teaching Hospital of Kigali, Kigali, Rwanda
- School of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Emmanuel Rusingiza
- Clinical Education and Research Division, University Teaching Hospital of Kigali, Kigali, Rwanda
- School of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | | | | | - Jean Claude Byiringiro
- Clinical Education and Research Division, University Teaching Hospital of Kigali, Kigali, Rwanda
- School of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
| | - Florence Masaisa
- Clinical Education and Research Division, University Teaching Hospital of Kigali, Kigali, Rwanda
- School of Medicine and Health Sciences, University of Rwanda, Kigali, Rwanda
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Leon-Larios F, Alonso Llamazares MJ, Mausbach Reisen H, Parra Ribes I, Rey Novoa M, Lahoz-Pascual I. Impact of the hands-on clinical training program for subdermic implant on contraceptive counseling and users' choice in Spain: A 6-month follow-up study. Contraception 2024; 132:110372. [PMID: 38237672 DOI: 10.1016/j.contraception.2024.110372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2023] [Revised: 01/10/2024] [Accepted: 01/11/2024] [Indexed: 01/27/2024]
Abstract
OBJECTIVES The study aimed to evaluate the impact of a structured subdermic implant training program on healthcare providers and its effect on the integration of this contraceptive method into patient counselling. STUDY DESIGN The study was a longitudinal experiment with an intervention group, assessing changes at three points: before the training, immediately after, and six months later. The training consisted of a four-hour session combining theory and practical application, conducted by experts in contraception. RESULTS Out of the participants, 376 healthcare professionals (a 34.3% response rate) completed the training and subsequent questionnaires. Post-training, there was an increase in the inclusion of the implant in contraceptive advice and a rise in the monthly number of implants. Knowledge about the implant, including insertion, positioning, removal, and replacement, significantly improved after six months (p<0.05), particularly among general practitioners. CONCLUSIONS The training program successfully enhanced knowledge and handling of the contraceptive implant, leading to its increased recommendation by healthcare providers and selection by patients. Theoretical and practical training in contraception should be compulsory for healthcare providers involved in contraceptive counselling. IMPLICATIONS A training program that includes lectures, video material, and hands-on demonstrations is effective for developing skills in administering the subdermic implant and its integration into contraceptive counselling. Such training should be regular and required for all healthcare professionals providing contraceptive advice.
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Affiliation(s)
- Fatima Leon-Larios
- Nursing Department, Faculty of Nursing, Physiotherapy and Podiatry, University of Seville, Facultad de Enfermería, Fisioterapia y Podología, Sevilla, España.
| | - Maria Jesus Alonso Llamazares
- Unidad de Salud Sexual y Reproductiva, Distrito Sanitario Málaga-Guadalhorce, Servicio Andaluz de Salud, Málaga, España
| | | | | | - Modesto Rey Novoa
- Departamento de Obstetricia y Ginecología, Complejo Asistencial Universitario de Burgos, Burgos, España
| | - Isabel Lahoz-Pascual
- Departamento de Obstetricia y Ginecología, Hospital Universitario Lozano Blesa, Zaragoza, España
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Carr SG, Clifton JC, Freundlich RE, Fowler LC, Sherwood ER, McEvoy MD, Robertson A, Dunworth B, McCarthy KY, Shotwell MS, Kertai MD. Improving Neuromuscular Monitoring Through Education-Based Interventions and Studying Its Association With Adverse Postoperative Outcomes: A Retrospective Observational Study. Anesth Analg 2024; 138:517-529. [PMID: 38364243 PMCID: PMC10878712 DOI: 10.1213/ane.0000000000006722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2024]
Abstract
BACKGROUND We assessed the association between education-based interventions, the frequency of train-of-four (TOF) monitoring, and postoperative outcomes. METHODS We studied adults undergoing noncardiac surgery from February 1, 2020 through October 31, 2021. Our education-based interventions consisted of 3 phases. An interrupted time-series analysis, adjusting for patient- and procedure-related characteristics and secular trends over time, was used to assess the associations between education-based interventions and the frequency of TOF monitoring, postoperative pulmonary complications (PPCs), 90-day mortality, and sugammadex dosage. For each outcome and intervention phase, we tested whether the intervention at that phase was associated with an immediate change in the outcome or its trend (weekly rate of change) over time. In a sensitivity analysis, the association between education-based interventions and postoperative outcomes was adjusted for TOF monitoring. RESULTS Of 19,422 cases, 11,636 (59.9%) had documented TOF monitoring. Monitoring frequency increased from 44.2% in the first week of preintervention stage to 83.4% in the final week of the postintervention phase. During the preintervention phase, the odds of TOF monitoring trended upward by 0.5% per week (odds ratio [OR], 1.005; 95% confidence interval [CI], 1.002-1.007). Phase 1 saw an immediate 54% increase (OR, 1.54; 95% CI, 1.33-1.79) in the odds, and the trend OR increased by 3% (OR, 1.03; 95% CI, 1.01-1.05) to 1.035, or 3.5% per week (joint Wald test, P < .001). Phase 2 was associated with a further immediate 29% increase (OR, 1.29; 95% CI, 1.02-1.64) but no significant association with trend (OR, 0.96; 95% CI, 0.93-1.01) of TOF monitoring (joint test, P = .04). Phase 3 and postintervention phase were not significantly associated with the frequency of TOF monitoring (joint test, P = .16 and P = .61). The study phases were not significantly associated with PPCs or sugammadex administration. The trend OR for 90-day mortality was larger by 24% (OR, 1.24; 95% CI, 1.06-1.45; joint test, P = .03) in phase 2 versus phase 1, from a weekly decrease of 8% to a weekly increase of 14%. However, this trend reversed again at the transition from phase 3 to the postintervention phase (OR, 0.82; 95% CI, 0.68-0.99; joint test, P = .05), from a 14% weekly increase to a 6.2% weekly decrease in the odds of 90-day mortality. In sensitivity analyses, adjusting for TOF monitoring, we found similar associations between study initiatives and postoperative outcomes. TOF monitoring was associated with lower odds of PPCs (OR, 0.69; 95% CI, 0.55-0.86) and 90-day mortality (OR, 0.79; 95% CI, 0.63-0.98), but not sugammadex dosing (mean difference, -0.02; 95% CI, -0.04 to 0.01). CONCLUSIONS Our education-based interventions were associated with both TOF utilization and 90-day mortality but were not associated with either the odds of PPCs or sugammadex dosing. TOF monitoring was associated with reduced odds of PPCs and 90-day mortality.
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Affiliation(s)
- Shane G. Carr
- Vanderbilt University School of Medicine, Nashville, TN, USA
| | - Jacob C. Clifton
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Robert E. Freundlich
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Leslie C. Fowler
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Edward R. Sherwood
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Matthew D. McEvoy
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Amy Robertson
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Brent Dunworth
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Karen Y. McCarthy
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Matthew S. Shotwell
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Miklos D. Kertai
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN, USA
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Zhiyue L, Dan L. Application of ALSO course in standardized training Resident in Obstetric. BMC MEDICAL EDUCATION 2024; 24:151. [PMID: 38365711 PMCID: PMC10874071 DOI: 10.1186/s12909-024-05126-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 02/02/2024] [Indexed: 02/18/2024]
Abstract
OBJECTIVE To explore the teaching effect of Advanced Life Support in Obstetrics (ALSO) Course in the standardized training resident in obstetric. METHODS 60 residents of obstetrics from January 2021 to December 2022 were randomly divided into two groups, observation group and control group. The experimental group used ALSO teaching method, and the control group used traditional teaching method. The teaching effect was evaluated by theoretical examination, direct observation of procedural skills (DOPS) scale and mini clinical evaluation (Mini-CEX) scale. RESULTS The theoretical achievements of the observation group were significantly higher than that of the control group (P < 0.05). The pre-procedural preparation, safe analgesia, technique of procedure, aseptic technique, seeks help when necessary, post-procedural management, communication skills, humanistic care and overall performance score of the DOPS in the experimental group were higher than those in the control group (P < 0.05). The organization efficiency, humanistic qualities, manipulative skills, clinical judgment, medical interviewing skills and overall clinical competence score of the Mini-CEX in the experimental group were higher than those in the control group (P < 0.05). CONCLUSIONS ALSO teaching method has an ideal effect in the standardization training of residents of obstetrics, indicating the prospect of active in-depth research and expanded application.
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Affiliation(s)
- Li Zhiyue
- Clinical Medical College of Yangzhou University, 225001, Yangzhou, China
| | - Lu Dan
- Clinical Medical College of Yangzhou University, 225001, Yangzhou, China.
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Poyiadji N, Klochko C, Griffith B. Radiology Resident Diagnostic In-Training Exam Scores: Impact of Subspecialty Imaging Volume and Rotation Scheduling. Curr Probl Diagn Radiol 2024; 53:111-113. [PMID: 37704488 DOI: 10.1067/j.cpradiol.2023.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 08/23/2023] [Indexed: 09/15/2023]
Abstract
PURPOSE To determine the relationship between resident imaging volumes and number of subspecialty rotations with Diagnostic Radiology In-Training (DXIT) subspecialty scores. METHODS DXIT-scaled subspecialty scores from a single large diagnostic radiology training program from 2014 to 2020 were obtained. The cumulative number of imaging studies dictated by each resident and specific rotations were mapped to each subspecialty for each year of training. DXIT subspecialty scores were compared against the total subspecialty imaging volume and the total number of rotations in a subspecialty for each resident year. A total of 52 radiology residents were trained during the study period and included in the dataset. RESULTS There was a positive linear relationship between the number of neuro studies and scaled neuro DXIT scores for R1s (Pearson coefficient: 0.29; p-value: 0.034) and between the number of breast studies and the number of neuro studies with DXIT scores for R2s (Pearson coefficients: 0.50 and 0.45, respectively; p-values: 0.001 and 0.003, respectively). Furthermore, a positive significant linear relationship between the total number of rotations in cardiac, breast, neuro, and thoracic subspecialties and their scaled DXIT scores for R2 residents (Pearson coefficients: 0.34, 0.49, 0.33, and 0.32, respectively; p-value: 0.025, 0.001, 0.03, and 0.036, respectively) and between the total number of nuclear medicine rotations with DXIT scores for R3s (Pearson coefficient: 0.41; p-value: 0.016). CONCLUSION Resident subspecialty imaging volumes and rotations have a variable impact on DXIT scores. Understanding the impact of study volume and the number of subspecialty rotations on resident medical knowledge will help residents and program directors determine how much emphasis to place on these factors during residency.
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Affiliation(s)
- Neo Poyiadji
- Department of Radiology, Henry Ford Hospital, Detroit, MI
| | - Chad Klochko
- Department of Radiology, Henry Ford Hospital, Detroit, MI
| | - Brent Griffith
- Department of Radiology, Henry Ford Hospital, Detroit, MI; Michigan State University College of Human Medicine, East Lansing, MI.
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Shiri R, El-Metwally A, Sallinen M, Pöyry M, Härmä M, Toppinen-Tanner S. The Role of Continuing Professional Training or Development in Maintaining Current Employment: A Systematic Review. Healthcare (Basel) 2023; 11:2900. [PMID: 37958044 PMCID: PMC10647344 DOI: 10.3390/healthcare11212900] [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: 08/25/2023] [Revised: 10/13/2023] [Accepted: 10/30/2023] [Indexed: 11/15/2023] Open
Abstract
The impact of continuing job education and professional development on early exit from the labor market is unclear. This systematic review examined how continuing job education or professional development influences the retention of current employment. We searched the PubMed and Embase databases from their start dates to January 2023. Two reviewers screened the full texts of relevant reports and assessed the methodological quality of the included studies using the adapted Effective Public Health Practice Project quality assessment. We qualitatively synthesized the results of the included studies. We screened 7338 publications and included 27 studies consisting of four cohort and 23 cross-sectional studies in the review. The participants of the selected studies were mostly from the health sector (24 studies). There were 19 studies on staying or leaving a current job, six on employee turnover intention, two on job change, one on return to work, one on early retirement, and one on employment. Continuing employee development or training opportunities were associated with increased intention to stay in a current job, decreased intention to leave a current job, decreased employee turnover intention, job change, or early retirement and with faster return to work. One of the two studies that examined the role of age showed that continuing employee development is a more important factor for retaining current employment among younger than older employees. A few studies found that job satisfaction and commitment fully mediated the relationship between employee development and employee intention to leave current employment. This study suggests that participating in professional training/development is related to a lower risk of leaving current employment.
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Affiliation(s)
- Rahman Shiri
- Finnish Institute of Occupational Health, 00032 Helsinki, Finland; (M.S.); (M.P.); (M.H.); (S.T.-T.)
| | - Ashraf El-Metwally
- College of Public Health and Health Informatics, King Saud Bin Abdulaziz University for Health Sciences, Riyadh 14611, Saudi Arabia;
- The Health Sciences Unit, Faculty of Social Sciences, Tampere University, 33720 Tampere, Finland
| | - Mikael Sallinen
- Finnish Institute of Occupational Health, 00032 Helsinki, Finland; (M.S.); (M.P.); (M.H.); (S.T.-T.)
| | - Marjaana Pöyry
- Finnish Institute of Occupational Health, 00032 Helsinki, Finland; (M.S.); (M.P.); (M.H.); (S.T.-T.)
| | - Mikko Härmä
- Finnish Institute of Occupational Health, 00032 Helsinki, Finland; (M.S.); (M.P.); (M.H.); (S.T.-T.)
| | - Salla Toppinen-Tanner
- Finnish Institute of Occupational Health, 00032 Helsinki, Finland; (M.S.); (M.P.); (M.H.); (S.T.-T.)
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Thompson CP, Hughes MA. The Effectiveness of Spaced Learning, Interleaving, and Retrieval Practice in Radiology Education: A Systematic Review. J Am Coll Radiol 2023; 20:1092-1101. [PMID: 37683816 DOI: 10.1016/j.jacr.2023.08.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 08/28/2023] [Accepted: 08/30/2023] [Indexed: 09/10/2023]
Abstract
PURPOSE Radiology is a highly complex field that requires mastery over an ever-expanding body of knowledge. Spaced learning, interleaving, and retrieval practice are evidence-based learning strategies that enhance long-term retention of information. The aim of this systematic review is to assess the effectiveness of these interventions in the setting of radiology education. METHODS The authors searched MEDLINE, Embase, PsycInfo, ERIC, and forward and backward citations for studies published between database inception and February 19, 2023. Eligibility criteria for included studies were randomized and quasi-randomized controlled trials that investigated the impact of spaced, interleaved, or retrieval practice on knowledge retention of medical trainees after education related to medical imaging as assessed by postinterventional examination scores. RESULTS Of 1,316 records reviewed, 8 studies met eligibility criteria. Two studies investigated spaced learning, two studies interleaving, and six studies retrieval practice, including two trials that evaluated interventions incorporating both spaced learning and retrieval practice. Five of eight studies reported statistically significant differences between interventional and control groups on either immediate or delayed postinterventional examinations. CONCLUSIONS Despite extensive evidence in support of spaced, interleaved, and retrieval practice within the broader literature, few studies have examined the effectiveness of these strategies in radiology education. Additional trials are required to evaluate the usefulness of incorporating these techniques into educational programs related to medical imaging.
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Affiliation(s)
- Cole P Thompson
- Department of Radiology, University of California, San Diego, San Diego, California.
| | - Marion A Hughes
- Associate Director of the Diagnostic Radiology Residency Program, Associate Medical Director - Faculty Development, Department of Radiology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania
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Bernson-Leung ME, MacNeill H. Big Assumptions in Online and Blended Continuing Professional Development: Finding Our Way Forward Together. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2023:00005141-990000000-00098. [PMID: 37725495 DOI: 10.1097/ceh.0000000000000528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/21/2023]
Abstract
ABSTRACT Continuing professional development (CPD) providers and faculty face a practice gap between our knowledge of effective practices in CPD and our implementation of them, particularly in online environments. Developmental psychologists Bob Kegan and Lisa Lahey have attributed such knowledge-implementation gaps to an "Immunity to Change" rooted in tacit "Big Assumptions." These Big Assumptions produce fears or worries, reveal competing commitments, and result in actions or inactions that hinder intended change. We sought to understand the barriers to change in online and blended CPD, to support CPD leaders in pursuing their goals for optimal use of technology in CPD. This inquiry arose from the 13th National Continuing Professional Development Accreditation Conference of the Royal College of Physicians and Surgeons of Canada and the College of Family Physicians of Canada, a virtual conference held in October 2022. After introducing the Immunity to Change framework and best practices in online and blended learning, we invited audience members to list Big Assumptions in CPD through chat and polling software. These responses were analyzed and grouped into five interrelated Big Assumptions that suggest a number of key barriers to optimal implementation of online CPD. We present data that counter each Big Assumption along with practical approaches to facilitate desired change for CPD.
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Affiliation(s)
- Miya E Bernson-Leung
- Dr. Bernson-Leung: Associate Director of Continuing Education and Program Director, Child Neurology Residency Training Program, Boston Children's Hospital; Assistant Professor of Neurology, Harvard Medical School, Boston, MA. Dr. MacNeill: Faculty Lead, Educational Technologies, Continuing Professional Development, Associate Professor, Temerty Faculty of Medicine, University of Toronto, and Medical Director of Stroke Rehabilitation, Sinai Health System, Toronto, Ontario, Canada
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Sharifdini M, Evazalipour M, Hesari Z. Virtual spaced-learning method, during COVID-19 for Pharm D students. BMC MEDICAL EDUCATION 2023; 23:605. [PMID: 37620834 PMCID: PMC10463503 DOI: 10.1186/s12909-023-04595-5] [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: 08/13/2022] [Accepted: 08/16/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND The coronavirus (COVID-19) outbreak basically changed teaching methods across the world, and learning was almost replaced by virtual learning during the pandemic. Also, the spacing effect is one of the most well-established phenomena in the science of learning. Using temporal intervals for re-exposing learners to information over time (spaced learning) leads to more effective retention of knowledge compared to having information presented at a single time (massed learning). Hence, we designed a virtual spaced learning method to reap the benefits of virtual learning and spaced learning concomitantly. METHODS/APPROACH An interventional semi- experimental survey among 66 Pharm D students was designed and implemented. Students were divided into two groups (spaced vs mass learning) in the national integrated virtual education platform (NAVID) as the matrix for teaching as well as evaluation. Classes were conducted in the following sequence: 1- answering the pre-test, 2- watching and listening to the educational content (separately for each group), 3- answering the post-test (n = 1). The pre/post-test consisted of 10 four-choice questions based on the Kirkpatrick Model extracted from the educational content. RESULTS/OUTCOMES Findings revealed that the average score was not significantly different between the post-tests of the spaced learning and mass learning (7.26 ± 2.26 vs 6.5 ± 2.5) methods utilizing the independent t- test (p ≥ 0.05). CONCLUSIONS Since no statistically significant improvement was observed in the virtual spaced learning group compared to the control group, it seems that clarifying the significant influence of the spaced learning strategy in pharmacy education requires longer period of study, or study on less complex or skill-based topics for further evaluation.
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Affiliation(s)
- Meysam Sharifdini
- Department of Medical Parasitology and Mycology, School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Mehdi Evazalipour
- Department of Pharmaceutical Biotechnology, School of Pharmacy, Guilan University of Medical Sciences, Rasht, Iran
| | - Zahra Hesari
- Medical Education Research Center, Education Development Center, Guilan University of Medical Sciences, Rasht, Iran.
- Department of Pharmaceutics, School of Pharmacy, Guilan University of Medical Sciences, Rasht, Iran.
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Fraundorf SH, Caddick ZA, Nokes-Malach TJ, Rottman BM. Cognitive perspectives on maintaining physicians' medical expertise: IV. Best practices and open questions in using testing to enhance learning and retention. Cogn Res Princ Implic 2023; 8:53. [PMID: 37552437 PMCID: PMC10409703 DOI: 10.1186/s41235-023-00508-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 07/26/2023] [Indexed: 08/09/2023] Open
Abstract
Although tests and assessments-such as those used to maintain a physician's Board certification-are often viewed merely as tools for decision-making about one's performance level, strong evidence now indicates that the experience of being tested is a powerful learning experience in its own right: The act of retrieving targeted information from memory strengthens the ability to use it again in the future, known as the testing effect. We review meta-analytic evidence for the learning benefits of testing, including in the domain of medicine, and discuss theoretical accounts of its mechanism(s). We also review key moderators-including the timing, frequency, order, and format of testing and the content of feedback-and what they indicate about how to most effectively use testing for learning. We also identify open questions for the optimal use of testing, such as the timing of feedback and the sequencing of complex knowledge domains. Lastly, we consider how to facilitate adoption of this powerful study strategy by physicians and other learners.
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Affiliation(s)
- Scott H Fraundorf
- Learning Research and Development Center, University of Pittsburgh, 3420 Forbes Ave., Pittsburgh, PA, 15260, USA.
- Department of Psychology, University of Pittsburgh, Pittsburgh, USA.
| | - Zachary A Caddick
- Learning Research and Development Center, University of Pittsburgh, 3420 Forbes Ave., Pittsburgh, PA, 15260, USA
- Department of Psychology, University of Pittsburgh, Pittsburgh, USA
| | - Timothy J Nokes-Malach
- Learning Research and Development Center, University of Pittsburgh, 3420 Forbes Ave., Pittsburgh, PA, 15260, USA
- Department of Psychology, University of Pittsburgh, Pittsburgh, USA
| | - Benjamin M Rottman
- Learning Research and Development Center, University of Pittsburgh, 3420 Forbes Ave., Pittsburgh, PA, 15260, USA
- Department of Psychology, University of Pittsburgh, Pittsburgh, USA
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Rottman BM, Caddick ZA, Nokes-Malach TJ, Fraundorf SH. Cognitive perspectives on maintaining physicians' medical expertise: I. Reimagining Maintenance of Certification to promote lifelong learning. Cogn Res Princ Implic 2023; 8:46. [PMID: 37486508 PMCID: PMC10366070 DOI: 10.1186/s41235-023-00496-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Accepted: 06/20/2023] [Indexed: 07/25/2023] Open
Abstract
Until recently, physicians in the USA who were board-certified in a specialty needed to take a summative test every 6-10 years. However, the 24 Member Boards of the American Board of Medical Specialties are in the process of switching toward much more frequent assessments, which we refer to as longitudinal assessment. The goal of longitudinal assessments is to provide formative feedback to physicians to help them learn content they do not know as well as serve an evaluation for board certification. We present five articles collectively covering the science behind this change, the likely outcomes, and some open questions. This initial article introduces the context behind this change. This article also discusses various forms of lifelong learning opportunities that can help physicians stay current, including longitudinal assessment, and the pros and cons of each.
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Affiliation(s)
- Benjamin M Rottman
- Learning Research and Development Center, University of Pittsburgh, 3420 Forbes Ave., Pittsburgh, PA, 15260, USA
- Department of Psychology, University of Pittsburgh, Pittsburgh, USA
| | - Zachary A Caddick
- Learning Research and Development Center, University of Pittsburgh, 3420 Forbes Ave., Pittsburgh, PA, 15260, USA
- Department of Psychology, University of Pittsburgh, Pittsburgh, USA
| | - Timothy J Nokes-Malach
- Learning Research and Development Center, University of Pittsburgh, 3420 Forbes Ave., Pittsburgh, PA, 15260, USA
- Department of Psychology, University of Pittsburgh, Pittsburgh, USA
| | - Scott H Fraundorf
- Learning Research and Development Center, University of Pittsburgh, 3420 Forbes Ave., Pittsburgh, PA, 15260, USA.
- Department of Psychology, University of Pittsburgh, Pittsburgh, USA.
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Goldstein J, Nishiguchi EP, Lipman C, Neville Q, Fiecas M, Wiznitzer M. Daily Dose of Development: Feasibility of an App-Based Curriculum of Normal Child Development for Pediatric Residents. J Grad Med Educ 2023; 15:395-397. [PMID: 37363685 PMCID: PMC10286911 DOI: 10.4300/jgme-d-22-00788.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/28/2023] Open
Affiliation(s)
- Jessica Goldstein
- Associate Professor of Neurology, Associate Program Director, Neurology Residency, University of Minnesota Medical School
| | - Erika Phelps Nishiguchi
- Developmental Behavioral Pediatrics Fellow, Rainbow Babies & Children's Hospital, Case Western Reserve University School of Medicine
| | - Catherine Lipman
- Assistant Professor of Pediatrics, Developmental-Behavioral Pediatrics Rotation Director, Rainbow Babies & Children's Hospital, Case Western Reserve University School of Medicine
| | | | - Mark Fiecas
- Associate Professor, Division of Biostatistics, University of Minnesota
| | - Max Wiznitzer
- Professor of Pediatrics and Neurology, Division Chief, Pediatric Neurology, Rainbow Babies & Children's Hospital, Case Western Reserve University School of Medicine
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Zeri F, Eperjesi F, Woods C, Bandlitz S, Kumar Bhootra A, Joshi MR, Nagra M, Schweizer H, Naroo SA. Evidence-based teaching in contact lenses education: Teaching and learning strategies. Cont Lens Anterior Eye 2023; 46:101822. [PMID: 36804937 DOI: 10.1016/j.clae.2023.101822] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2023] [Accepted: 02/08/2023] [Indexed: 02/17/2023]
Abstract
INTRODUCTION Contact lens (CL) practice is an ever-changing field with clinical knowledge, techniques and equipment continuously evolving. These new developments are backed with clinical trials and research to ensure that practitioners feel confident that there is an evidence base to support these advances. Evidence-based practice is now a crucial part of CL practice, and its importance also filters down to CL education. For example, lectures are one of the most popular tools for an educator but, is standing at the front of a lecture theatre full of students a more effective way of teaching than providing the same material for students to read by themselves? What evidence exists specific to CL education? METHOD An expert panel of educators completed a comprehensive literature review of current evidence of teaching methods in CL training, or if not available then what can be learnt from other health care professional training that could be potentially applicable to CL education. RESULTS Due to the amount of evidence available in the overall subject area relating to healthcare education, the initial plan of compiling evidence into one narrative review paper was discarded in favour of producing two linked papers. Here, the first paper details definitions of terminology, and also teaching methods. The second paper focuses on assessment and specific clinical training required to attain CL practice competency. In this first paper, no direct evidence of the spreading and benefit of new education strategies evidence such as flipped classrooms, spaced learning, test-enhanced learning, group work, CBL, PBL, TBL, and reflective practice in CL education was found. The only technique that was widely used in the CL field was case reports and the group discussion of them. Nevertheless, the authors found a consensus of opinion from other disciplines that are transferable to CL teaching and could help students meet the intended learning outcomes. CONCLUSION There is a small amount of evidence supporting CL education, but most of this seems to be related to the practical element of the training. However, there is a lot of evidence in the field of healthcare education from related disciplines which provides additional but important learning tools that may be effectively implemented in CL education.
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Affiliation(s)
- Fabrizio Zeri
- University of Milano-Bicocca, Department of Materials Science, Milan, Italy; College of Health and Life Sciences, Aston University, UK; International Association of Contact Lens Educators, Canada
| | | | - Craig Woods
- School of Optometry and Vision Science, University of New South Wales, Australia; International Association of Contact Lens Educators, Canada
| | - Stefan Bandlitz
- College of Health and Life Sciences, Aston University, UK; Höhere Fachschule für Augenoptik Köln, Cologne School of Optometry, Cologne, Germany
| | | | - Mahesh R Joshi
- Eye and Vision Research Group, University of Plymouth, UK
| | | | | | - Shehzad A Naroo
- College of Health and Life Sciences, Aston University, UK; International Association of Contact Lens Educators, Canada.
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Ito Suffert SC, Campos LS, Barros N, Bica CG. Impact of a multifaceted strategy in end-of-life care in a tertiary hospital: A quasi-experimental study. Chronic Illn 2023; 19:146-156. [PMID: 34812654 DOI: 10.1177/17423953211058416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
OBJECTIVE To evaluate the impact of a multifaceted strategy for quality end-of-life care in a tertiary public hospital in Brazil. METHODOLOGY The study design was quasi-experimental. The multifaceted strategy was applied between January and June 2017, and involved training the healthcare team in end-of-life discussions, the creation and documentation of advance directives, and consultation with the team specialized in palliative care. The periods analyzed were the pre-test period (Time 1, July 2015 to June 2016) and the post-test period (Time 2, July 2017 to June 2018). RESULTS Time 1 involved 302 deaths, with an average hospital stay of 21 days; Time 2 involved 410 deaths, with an average hospital stay of 16 days. Patients were prescribed morphine (44.04% vs. 36.3% [p = 0.367]), methadone (9.60% vs. 4.39% [p = 0.247]), midazolam (43.05% vs. 47.80% [p = 0.73]), blood transfusions (31.13% vs. 24.63% [p = 0.828]), enteral feeding (56.62% vs. 38.54% [p = 0.59]) and antibiotic therapy (50.73% vs. 50.73% [p = 0.435]). CONCLUSION This study found no changes in the end-of-life care quality indicators after the strategy was implemented. Multimodal educational strategies that develop communication skills in palliative care may enhance the quality of end-of-life care.
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Affiliation(s)
- Soraya Camargo Ito Suffert
- 117303Universidade Federal de Ciências da Saúde de Porto Alegre - Programa de Pósgraduação em Patologia, Porto Alegre, RS, Brazil
| | - Luciana Silveira Campos
- Hospital Nossa Senhora da Conceição Porto Alegre - Brasil, Porto Alegre, RS, Brazil.,26706Insituto de Saúde Pública da Universidade do Porto, Porto, Portugal
| | - Newton Barros
- 125208Hospital Nossa Senhora da Conceição, Porto Alegre, RS, Brasil
| | - Claudia Giuliano Bica
- Universidade Federal de Ciências da Saúde de Porto Alegre - Programa de Pósgraduação em Patologia, Porto Alegre, RS, Brazil
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Al-Ismail MS, Naseralallah LM, Hussain TA, Stewart D, Alkhiyami D, Abu Rasheed HM, Daud A, Pallivalapila A, Nazar Z. Learning needs assessments in continuing professional development: A scoping review. MEDICAL TEACHER 2023; 45:203-211. [PMID: 36179760 DOI: 10.1080/0142159x.2022.2126756] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND A rigorous learning needs assessment (LNA) is a crucial initial step in the Continuing Professional Development (CPD) process. This scoping review aimed to collate, summarize, and categorize the reported LNA approaches adopted to inform healthcare professional CPD and highlight the gaps for further research. METHOD In August 2020, nine bibliographic databases were searched for studies conducted with any health professional grouping, reporting the utilized LNA to inform CPD activities. Two reviewers independently screened the articles for eligibility and charted the data. A descriptive analytical approach was employed to collate, summarize, and categorize the literature. RESULTS 151 studies were included in the review; the majority adopted quantitative methods in the form of self-assessment surveys. Mixed-methods approaches were reported in only 35 studies. Descriptions of LNA development lacked detail of measures taken to enhance their rigor or robustness. DISCUSSION These findings do not reflect recommendations offered by the CPD literature. Further investigations are required to evaluate more recently advocated LNA approaches and add to their limited evidence-base. Similarly, the existing support afforded to CPD developers warrants further study in order to identify the necessary resource, infrastructure and expertise essential to design and deliver effective CPD programs.
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Affiliation(s)
- Muna Said Al-Ismail
- Clinical Pharmacy and Practice Department, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Lina Mohammad Naseralallah
- Department of Pharmacy, Hamad Medical Corporation, Doha, Qatar
- School of Pharmacy, Institute of Clinical Sciences, University of Birmingham, Edgbaston, Birmingham, UK
| | - Tarteel Ali Hussain
- Clinical Pharmacy and Practice Department, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Derek Stewart
- Clinical Pharmacy and Practice Department, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
| | - Dania Alkhiyami
- Department of Pharmacy, Hamad Medical Corporation, Doha, Qatar
| | | | - Alaa Daud
- College of Dental Medicine, QU Health, Qatar University, Doha, Qatar
| | | | - Zachariah Nazar
- Clinical Pharmacy and Practice Department, College of Pharmacy, QU Health, Qatar University, Doha, Qatar
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Bellier A, Kaladzé N, Rabattu PY, Chaffanjon PC, Cavalié G. Analysis of a multifaceted interactive pedagogy program in an upper limb anatomy course: A time series study. ANATOMICAL SCIENCES EDUCATION 2023; 16:116-127. [PMID: 35020269 DOI: 10.1002/ase.2170] [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: 02/16/2021] [Revised: 01/07/2022] [Accepted: 01/08/2022] [Indexed: 06/14/2023]
Abstract
Many new methods have contributed to the learning of anatomy, including several interactive methods, increasing the effectiveness of educational programs. The effectiveness of an educational program involving several interactive learning methods such as problem-based learning and reciprocal peer teaching was researched in this study. A quasi-experimental before-after study on three consecutive groups of second-year students at the Grenoble School of Medicine was conducted. The lectures were replaced by an educational program based on the problem-based learning method and reciprocal peer teaching. The first session was dedicated to reading clinical cases illustrating the medical concept, so that the learning objectives for the second session could be set. Then, after viewing digital courses, the second session was dedicated to a synthetic presentation by the students themselves, followed by an interactive summary with the teacher. The analysis of 630 students showed a significant increase in the theory test results for those who took part in the intervention: 9.71 versus 9.19 (β = 0.57, P = 0.036). Moreover, satisfaction was high after the intervention (mean = 4.5/5), and when comparing the two pedagogical approaches the students showed a clear preference for the program implemented with the concepts highlighted such as interactivity, in-depth work, group work, and autonomy. A multifaceted interactive pedagogy program could have a significant impact on the results of the theoretical concepts presented and on satisfaction as well as increased investment by students in learning anatomy.
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Affiliation(s)
- Alexandre Bellier
- Department of Anatomy, Faculty of Medicine, Grenoble Alpes University, Grenoble, France
- Department of Medical Evaluation, Grenoble Alpes University Hospital, Grenoble, France
- Computational Biology and Mathematics Team, Translational Innovation in Medicine and Complexity Laboratory, Grenoble, France
| | - Noémie Kaladzé
- Department of Anatomy, Faculty of Medicine, Grenoble Alpes University, Grenoble, France
| | - Pierre-Yves Rabattu
- Department of Anatomy, Faculty of Medicine, Grenoble Alpes University, Grenoble, France
| | - Philippe C Chaffanjon
- Department of Anatomy, Faculty of Medicine, Grenoble Alpes University, Grenoble, France
| | - Guillaume Cavalié
- Department of Anatomy, Faculty of Medicine, Grenoble Alpes University, Grenoble, France
- Orthopedic Surgery Service, Grenoble Alpes University Hospital, Grenoble, France
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Optimising fundoscopy practices across the medical spectrum: A focus group study. PLoS One 2023; 18:e0280937. [PMID: 36706098 PMCID: PMC9882965 DOI: 10.1371/journal.pone.0280937] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 01/11/2023] [Indexed: 01/28/2023] Open
Abstract
INTRODUCTION Fundoscopy can be of great clinical value, yet remains underutilised. Educational attempts to improve fundoscopy utilisation have had limited success. We aimed to explore the barriers and facilitators underlying the uptake of clinical direct ophthalmoscopy across a spectrum of medical specialties and training levels. METHODS Ten focus groups were conducted with medical students (n = 42), emergency department doctors (n = 24), basic physician trainees (n = 7), hospital physicians (n = 6) and general practitioners (n = 7). Independent thematic analysis of transcripts was conducted by three investigators. A consensus thematic framework was developed, and transcripts were reanalysed using this framework. RESULTS Thematic analysis identified seven main themes: (1) technical barriers to performing fundoscopy examinations; (2) clinical culture and expectations regarding fundoscopy; (3) the influence of fundoscopy on clinical management; (4) motivation to perform the examination; (5) novel technology including smartphone fundoscopy, and the value of a digital fundus image; (6) training requirements, and; (7) use of limited resources. CONCLUSION Our results build a more nuanced picture of the factors which determine fundoscopy utilisation. As current barriers limit practice by clinicians and medical students, expertise and confidence performing and interpreting fundoscopy are lost. This shifts the balance of perceived clinical utility to futility in changing patient management, and reinforces a cycle of reducing fundoscopy utilisation. We identified important cultural barriers such as accepted incompetence, and misperceptions of senior discouragement. Emerging technologies reduce the technical barriers to fundoscopy. Therefore education should: focus on detecting pathology from digital images; clarify the role of fundoscopy in patient management, and; be targeted at key career progression points.
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Speer J, Conley Q, Thurber D, Williams B, Wasden M, Jackson B. A mixed-methods study of the effectiveness and perceptions of a course design institute for health science educators. BMC MEDICAL EDUCATION 2022; 22:873. [PMID: 36527044 PMCID: PMC9756627 DOI: 10.1186/s12909-022-03910-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 11/21/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Most health care professionals get their start in academics without formal teaching training. As such, institutions encourage participation in opportunities to address gaps in faculty's knowledge of pedagogy and learning theory in order to promote both successful student and patient outcomes. This study aimed to examine the reception of a faculty development program focused on teaching participants the basics of course design. METHODS Applying a mixed-method approach, this retrospective study used pre/post-tests, assignment grades, self-assessment questionnaires, and focus groups to elucidate the impact of the faculty development intervention on course design. The participants (n = 12) were health educators from a private all-graduate level university with campus locations across the United States, including in the Southwest and Midwest. In the Course Design Institute (CDI), the participating faculty learned evidence-based instructional approaches and techniques to implement contemporary teaching practices. RESULTS The data from the pre/post-tests and focus groups suggest that participants learned about topics including instructional alignment, learning goals and objectives, instructional strategies, assessment planning, feedback approaches, communicating expectations, and adult learning theories by participating in this course. The final deliverable scores indicate that the CDI graduates were able to apply a backward design process to plan their own instruction. Data from both the survey and the focus groups suggest that participants were satisfied with the experience and particularly appreciated that the course was relevant to them as educators in the health sciences. CONCLUSIONS The results of this study indicate that the CDI was influential in developing the faculty's knowledge of the course design process, promoted the application of course design and pedagogy skills amongst CDI graduates, and positively impacted self-reported attitudes about their teaching abilities. In addition, feedback from participants indicates that they recognized the value of this program in their own development and they believed it should be a required course for all educators at the institution.
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Skapetis T, Cheema S, El Mustapha M. Evaluation of clinical versus non-clinical continuing education in terms of preferences and value for oral healthcare workers. MEDICAL EDUCATION ONLINE 2022; 27:2125630. [PMID: 36124488 PMCID: PMC9518277 DOI: 10.1080/10872981.2022.2125630] [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: 02/28/2022] [Revised: 06/22/2022] [Accepted: 09/09/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Continuing professional development (clinical) and continuing education (non-clinical) is fundamental to education and self-improvement of all categories of staff within a large healthcare facility. AIM This study sought to examine the attendance preferences and perceived value of clinical and non-clinical oral healthcare workers towards clinical continuing professional development (CPD) and non-clinical, continuing education (CE) activities. METHODS A retrospective cross-sectional survey design was used capturing 8640 self-reported evaluations collected across 8 successive years and 160 CPD and CE activities in a large dental hospital. Analysis was performed using descriptive statistics including mean scores, independent t-test and cross tabulations using chi-square. RESULTS A strongly significant association (p < 0.001) was found between attendee position type (clinical or non-clinical) and attendance preference to either clinical or non-clinical education. Dental assistants, compared to Dentist/Specialist (p < 0.001) found the programs more accurate, relevant, improved their knowledge, would use what was learned and rated the sessions higher overall. Clinical CPD was deemed more relevant (p = 0.025) and improved knowledge (p = 0.01) while non-clinical CE had higher presenter quality (p < 0.001) and overall mean scores (p = 0.015). CONCLUSION There was a preference towards attending clinical CPD over non-clinical CE, by not only clinical, but also non-clinical oral healthcare workers. Non-clinical CE was scored higher by both clinical and non-clinical participants and should therefore be considered for inclusion in CPD education programs with similar settings.
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Affiliation(s)
- Tony Skapetis
- Sydney Dental School, Faculty of Medicine and Health, University of Sydney, Westmead Campus, Sydney, NSW, Australia
- Division of Oral Health, Western Sydney Local Health District, Sydney, NSW, Australia
| | - Simran Cheema
- Sydney Dental School, Faculty of Medicine and Health, University of Sydney, Westmead Campus, Sydney, NSW, Australia
| | - Mariam El Mustapha
- Sydney Dental School, Faculty of Medicine and Health, University of Sydney, Westmead Campus, Sydney, NSW, Australia
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Zeitlin BD, Sadhak ND. Attitudes of an international student cohort to the Quizlet study system employed in an advanced clinical health care review course. EDUCATION AND INFORMATION TECHNOLOGIES 2022; 28:3833-3857. [PMID: 36210912 PMCID: PMC9529323 DOI: 10.1007/s10639-022-11371-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/03/2022] [Accepted: 09/22/2022] [Indexed: 06/16/2023]
Abstract
UNLABELLED Computer-based learning applications and mobile technology have transformed many aspects of the educational experience over the last decade, producing software aimed at improving learning efficiency and streamlining the presentation of course materials. One such class of software, purpose-created to take advantage of spaced learning and spaced testing principles, are electronic flashcard applications. We provide a perspective on the novel use of the Quizlet flashcard application in a tertiary educational setting. To reduce cognitive load for international graduate dental students taking a pharmacology review course, we implemented Quizlet, which integrates both spaced learning and self-testing, to improve the student learning experience. This study assessed students' perceptions of the Quizlet flashcard system in a student cohort comprised of two consecutive years' classes (n = 51 students in total). Results indicated broad acceptance of Quizlet based on ease of use of the software and ease of study of the material. Our data provide insight into the use of this common software in a professional healthcare tertiary education setting and further demonstrate the successful application of electronic flashcards for a mixed international student cohort. Further research should include an assessment of the impact of flashcard on long-term knowledge retention in this setting. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s10639-022-11371-3.
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Affiliation(s)
- Benjamin D. Zeitlin
- Arthur A. Dugoni School of Dentistry, University of the Pacific, CA 94103 San Francisco, USA
| | - Nishanth D. Sadhak
- Arthur A. Dugoni School of Dentistry, University of the Pacific, CA 94103 San Francisco, USA
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Van Hoof TJ, Sumeracki MA, Madan CR. Science of Learning Strategy Series: Article 3, Interleaving. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2022; 42:265-268. [PMID: 35170479 DOI: 10.1097/ceh.0000000000000418] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Interleaving is an evidence-based, learning-science strategy that is relevant to the planning and implementation of continuing professional development (CPD). Mixing related but different areas of study forces the brain to reconcile the relationship between the areas while understanding each area well. By doing so, interleaving increases the likelihood of mastery and memory. Research from cognitive psychology and neuroscience provides the rationale for interleaving, and examples of its implementation in health profession education have begun to appear in the literature. If utilized appropriately, some common CPD interventions can leverage interleaving. Through increased understanding, CPD participants can benefit from interleaving by making more-informed educational choices, and CPD planners can benefit in efforts to improve educational activities.
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Affiliation(s)
- Thomas J Van Hoof
- Dr. Van Hoof: Associate Professor, University of Connecticut School of Nursing, Storrs, and Associate Professor, Department of Community Medicine and Health Care, University of Connecticut School of Medicine, Farmington, CT. Dr. Sumeracki: Associate Professor, Department of Psychology, Rhode Island College, Providence, Rhode Island. Dr. Madan: Assistant Professor, School of Psychology, University of Nottingham, Nottingham, United Kingdom
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Alhassan AI. Implementing Faculty Development Programs in Medical Education Utilizing Kirkpatrick's Model. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2022; 13:945-954. [PMID: 36039186 PMCID: PMC9419723 DOI: 10.2147/amep.s372652] [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: 04/28/2022] [Accepted: 07/18/2022] [Indexed: 06/15/2023]
Abstract
Since the 1970s, the definition of faculty development has evolved from improving teaching skills and classroom performance to a full range of activities involving teaching, leadership, mentorship of students, and impacting institutional culture. Unfortunately, in many educational programs, the focus of faculty development is still on classroom performance and research activities. This is troubling given the increased competitive nature of higher education in general, and even medical education, to attract the best students. The purpose of this article is to demonstrate how the Kirkpatrick model can be used as a framework for the development, implementation, and management of a comprehensive faculty development program. An important gap exists within the academic literature regarding a lack of discussion and analysis about how faculty development can be implemented in a way that helps healthcare faculty improve their skills in all areas of academic performance. At the same time, there is a lack of discussion and analysis about the need for medical schools to align faculty development with larger institutional goals and outcomes. The discussion included in this article serves to begin the process of filling that gap within the academic literature by demonstrating that the Kirkpatrick model can be used to implement and manage faculty development programs in which there is an institutional focus rather than an individual focus. By focusing on faculty development that is aligned with larger institutional goals, medical schools can be more competitive and better serve the future healthcare professionals they are training.
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Affiliation(s)
- Abdulaziz I Alhassan
- Department of Medical Education, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
- King Abdullah International Medical Research Center, Riyadh, Saudi Arabia
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Bundle-of-care interventions to improve self-management of patients with urinary catheters: Study protocol. Collegian 2022. [DOI: 10.1016/j.colegn.2021.08.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
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León-Arce HG, Chávez Chávez J, Mogollón-Pérez AS, Vargas I, Vázquez ML. Implementing joint training sessions of general practitioners and specialists aimed at improving clinical coordination in Colombia: Contributions from participatory action research. J Health Serv Res Policy 2022; 27:261-268. [PMID: 35603753 DOI: 10.1177/13558196221094676] [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: 11/17/2022]
Abstract
OBJECTIVE To analyse the contribution of participatory action research (PAR) in designing and implementing joint training sessions as a means to improve clinical coordination in a public health care network in Bogotá, Colombia. METHODS A qualitative, descriptive-interpretative study using semi-structured individual interviews and focus groups with 40 professionals (GPs, specialists, members of the local steering committee (LSC) and network middle managers) involved in designing and implementing joint training sessions to improve cross-level clinical coordination. The intervention consisted of two forms of joint training sessions for GPs and specialists, implemented through two PAR cycles. RESULTS The PAR approach in designing and implementing joint training sessions led to greater awareness of clinical coordination problems and helped adapting sessions to the local health care context. Study participants highlighted the role of LSC leadership during the PAR process and the importance of ensuring the necessary resources for adopting the intervention. Limited institutional support and differences between joint training sessions affected doctors' participation and reduced the time available to conduct the sessions. The use of a reflexive method was essential in enhancing doctors' participation, along with session duration, the facilitator's role and session content. CONCLUSIONS The study provides evidence regarding the contribution of a PAR process to designing and implementing joint training sessions for improving clinical coordination. The findings can inform similar approaches in other health systems.
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Affiliation(s)
- Heisel G León-Arce
- Junior researcher at the School of Medicine and Health Sciences, 25807Universidad del Rosario, Bogotá, Colombia.,PhD Student, Department of Paediatrics, Obstetrics & Gynaecology and Preventative Medicine, Universitat Autònoma de Barcelona, Spain
| | - Josefina Chávez Chávez
- Junior researcher at the School of Medicine and Health Sciences, 25807Universidad del Rosario, Bogotá, Colombia
| | | | - Ingrid Vargas
- Senior researcher, Health Policy and Health Services Research Group Health Policy Research Unit, Consortium for Health Care and Social Services of Catalonia, Barcelona, Spain
| | - María-Luisa Vázquez
- Head, Health Policy and Health Services Research Group, Health Policy Research Unit, Consortium for Health Care and Social Services of Catalonia, Barcelona, Spain
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Mallon D, Fei L, Farrell M, Anderson JB, Klein M. Randomized Controlled Trial of Interactive Spaced Education to Support Constipation Management by Pediatric Primary Care Providers. J Pediatr Gastroenterol Nutr 2022; 74:568-574. [PMID: 35149642 DOI: 10.1097/mpg.0000000000003405] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
INTRODUCTION Integrating continuing medical education and quality improvement (QI) initiatives is challenging. We aimed to compare one method, Interactive Spaced Education (ISE/QI), with standard (sTD/Qi) education embedded within a constipation management Qi initiative. METHODS We conducted a randomized, controlled study to compare ISE/QI and STD/QI education. Pediatric primary care providers (PCPs) were recruited from a network of local private practices. The QI initiative was implemented with all providers before education interventions. ISE/QI participants received questions by email weekly, provided answers, received feedback, and repeated questions over a 4-month period. The STD/QI group received a Power Point with the same educational content. Pre- and post-surveys evaluated usability, self-assessed confidence, and practice changes while quizzes evaluated knowledge. Process control charts tracked subsequent visits to gastroenterology (GI). RESULTS Of the 212 eligible PCPs, 101 (48%) enrolled, with 49 PCPs in the ISE/QI arm and 52 in STD/QI education arm. Quiz scores improved in the ISE/QI arm with a strong effect size (Cohen d 1.76). Mean increase in confidence managing difficult cases was higher in the ISE/QI group (1.84 vs 1.21, P = 0.030). ISE/QI participants were more likely to rate the activity better than most online education (odds ratio [OR] 18.1, P < 0.0001) and incorporate practice changes (OR 3.35, P = 0.0152). Visits to GI decreased among the entire population, but the effect on GI visits within each education arm was mixed. CONCLUSIONS ISE/QI improved knowledge and confidence managing difficult cases. ISE/QI participants reported higher likelihood to change practice, but no differences were seen in GI referrals.
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Affiliation(s)
- Daniel Mallon
- Department of Pediatrics, Division of Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center/University of Cincinnati College of Medicine
| | - Lin Fei
- Department of Pediatrics, Division of Biostatistics
| | - Michael Farrell
- Department of Pediatrics, Division of Pediatric Gastroenterology, Hepatology and Nutrition, Cincinnati Children's Hospital Medical Center/University of Cincinnati College of Medicine
| | - Jeffrey B Anderson
- Department of Pediatrics, University of Cincinnati College of Medicine, Heart Institute, Cincinnati Children's Hospital Medical Center
| | - Melissa Klein
- Department of Pediatrics, Division of General and Community Pediatrics, Cincinnati Children's Hospital Medical Center/University of Cincinnati College of Medicine, Cincinnati, OH
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Janjigian M, Dembitzer A, Srisarajivakul-Klein C, Mednick A, Hardower K, Cooke D, Zabar S, Sauthoff H. Design and comparison of a hybrid to a traditional in-person point-of-care ultrasound course. Ultrasound J 2022; 14:12. [PMID: 35278145 PMCID: PMC8917361 DOI: 10.1186/s13089-022-00261-x] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Accepted: 02/25/2022] [Indexed: 11/25/2022] Open
Abstract
Background Traditional introductory point-of-care ultrasound (POCUS) courses are resource intensive, typically requiring 2–3 days at a remote site, consisting of lectures and hands-on components. Social distancing requirements resulting from the COVID-19 pandemic led us to create a novel hybrid course curriculum consisting of virtual and in-person components. Methods Faculty, chief residents, fellows and advanced practice providers (APPs) in the Department of Medicine were invited to participate in the hybrid curriculum. The course structure included 4 modules of recorded lectures, quizzes, online image interpretation sessions, online case discussions, and hands-on sessions at the bedside of course participant’s patients. The components of the course were delivered over approximately 8 months. Those participants who completed a minimum of 3 modules over the year were invited for final assessments. Results from the hybrid curriculum cohort were compared to the year-end data from a prior traditional in-person cohort. Results Participant knowledge scores were not different between traditional (n = 19) and hybrid (n = 24) groups (81% and 84%, respectively, P = 0.9). There was no change in POCUS skills as measured by the hands-on test from both groups at end-of-course (76% and 76%, respectively, P = 0.93). Confidence ratings were similar across groups from 2.73 traditional to 3.0 hybrid (out of possible 4, P = 0.46). Participants rated the course highly, with an average overall rating of 4.6 out 5. Conclusions A hybrid virtual and in-person POCUS course was highly rated and as successful as a traditional course in improving learner knowledge, hands-on skill and confidence at 8 months after course initiation. These results support expanding virtual elements of POCUS educational curricula. Supplementary Information The online version contains supplementary material available at 10.1186/s13089-022-00261-x.
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Affiliation(s)
- Michael Janjigian
- Department of Medicine, New York University Grossman School of Medicine, NYC Health & Hospitals/Bellevue, Bellevue Hospital Center, New York, USA.
| | - Anne Dembitzer
- Department of Medicine, New York University Grossman School of Medicine, NY Harbor Healthcare System, New York, USA
| | - Caroline Srisarajivakul-Klein
- Department of Medicine, New York University Grossman School of Medicine, NYC Health & Hospitals/Bellevue, Bellevue Hospital Center, New York, USA
| | - Aron Mednick
- Department of Medicine, New York University Grossman School of Medicine, NYU Langone Health, New York, USA
| | - Khemraj Hardower
- Department of Medicine, New York University Grossman School of Medicine, NYU Langone Health, New York, USA
| | - Deborah Cooke
- Department of Medicine, New York University Grossman School of Medicine, NYU Langone Health, New York, USA
| | - Sondra Zabar
- Department of Medicine, New York University Grossman School of Medicine, NYU Langone Health, New York, USA
| | - Harald Sauthoff
- Department of Medicine, New York University Grossman School of Medicine, NY Harbor Healthcare System, New York, USA
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Virtual Reality as a Learning Tool for Trainees in Unicompartmental Knee Arthroplasty: A Randomized Controlled Trial. J Am Acad Orthop Surg 2022; 30:84-90. [PMID: 34520419 DOI: 10.5435/jaaos-d-20-01357] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2020] [Accepted: 08/11/2021] [Indexed: 02/01/2023] Open
Abstract
INTRODUCTION The efficacy of virtual reality (VR) as a teaching augment for arthroplasty has not been well examined for unfamiliar multistep procedures such as unicompartmental knee arthroplasty (UKA). This study sought to determine whether VR improves surgical competence over traditional procedural preparation when performing a UKA. METHODS Twenty-two orthopaedic surgery trainees were randomized to two surgical preparation cohorts: (1) "Guide" group (control) with access to manufacture's technique guide and surgical video and (2) "VR" group with access to an immersive commercially available VR learning module. Surgical performance of UKA on a SawBone model was assessed through time and the Objective Structured Assessment of Technical Skills (OSATS) validated rating system. RESULTS Participants were equally distributed among all training levels and previous exposure to UKA. No difference in mean surgical times was observed between Guide and VR groups (Guide = 42.4 minutes versus VR = 43.0 minutes; P = 0.9) or mean total OSATS (Guide = 15.7 versus VR = 14.2; P = 0.59). Most trainees felt VR would be a useful tool for resident education (77%) and would use VR for case preparation if available (86.4%). CONCLUSION In a randomized controlled trial of trainees at a single, large academic center performing a complex, multistep, unfamiliar procedure (UKA), VR training demonstrated equivalent surgical competence compared with the use of traditional technique guides, as measured by surgical time and OSATS scores. Most of the trainees found the VR technology beneficial. This study suggests that VR technology may be considered as an adjunct to traditional surgical preparation/training methods.
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Lam LT, Lam MK, Reddy P, Wong P. Efficacy of a Workplace Intervention Program With Web-Based Online and Offline Modalities for Improving Workers' Mental Health. Front Psychiatry 2022; 13:888157. [PMID: 35711597 PMCID: PMC9192949 DOI: 10.3389/fpsyt.2022.888157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 04/25/2022] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE This study aims to examine the efficacy of the Workplace Web-based blended psychoeducation mental health intervention program. Of particular interest is the short-term effect of the intervention on workplace burnout, stress, quality of life, and the mental health literacy of workers. METHODS AND MATERIALS The study focused on employees (n = 456) in specific industries with high levels of work-related stress, adopting a phase III wait-listed cluster randomized controlled trial. Work-related burnout was assessed by the Maslach Burnout Inventory (MBI) and stress was measured using the stress subscale of the Depression, Anxiety, and Stress scale (DASS). Quality of Life was evaluated by the European Quality of Life-5 Dimensions (EQ-5D-5L) and Mental Health Literacy was assessed using the Australian National Mental Health Literacy and Stigma Survey. Data were analyzed as a trial with intention-to-treat analysis and adjustment for the clustering effect of work sites. RESULTS Significant differences between intervention and control groups were found on all outcome measures except the self-rated quality of life. The intervention group displayed a significant reduction in the weighted mean score of about 1.0 units (s.e. = 0.4) on the stress scale (p = 0.015) and an increase in the weighted mean score of 1.9 units (s.e. = 0.9) in the professional accomplishment domain of the MBI (p = 0.035). Significant increases were found in the weighted mean scores in the intervention group for correct recognition of the mental problems, help-seeking, and stigmatization, in comparison to the control group who scored 0.2 (s.e. = 0.1), 0.9 (s.e. = 0.2), 1.8 (s.e. = 0.4), respectively. CONCLUSIONS The results obtained from a comparison of the outcome measures between the intervention and control groups were statistically significant, indicating that the intervention group performed better on most measures. The study demonstrates that, in the short term. the on-and-offline modalities of the Web-based blended psychoeducation intervention program is efficacious in reducing workplace burnout and stress and promoting mental health literacy at the workplace.
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Affiliation(s)
- Lawrence T Lam
- Eastern Health Clinical School, Monash University, Melbourne, VIC, Australia.,Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Mary K Lam
- School of Health and Biomedical Sciences, RMIT University, Melbourne, VIC, Australia
| | - Prasuna Reddy
- Faculty of Science & Technology, Swinburne University of Technology, Melbourne, VIC, Australia
| | - Prudence Wong
- The Mental Health Association Hong Kong, Kowloon, Hong Kong SAR, China
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Dunnack HJ, Van Hoof TJ, Banfi V, Polifroni EC. Scoping Review of Distributed Practice in Nursing Education. Nurs Educ Perspect 2021; 42:E22-E25. [PMID: 34352852 DOI: 10.1097/01.nep.0000000000000858] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
AIM The aim of this study was to describe the status of distributed practice in research of nursing education. BACKGROUND The science of learning has compiled evidence-based strategies that should be integral to nursing education. One long-standing strategy, distributed practice, involves spacing, placing cognitive breaks between study or practice sessions with priority information. METHOD Reviewing literature published over 20 years at every level of nursing education, the authors conducted a scoping review to determine the extent to which research of nursing education includes attention to distributed practice. RESULTS In the 13 articles meeting criteria, distributed practice was most common in continuing professional development, with an emphasis in learning psychomotor skills. Study authors used a variety of terms and descriptions in referring to the strategy. CONCLUSION By way of research, distributed practice appears underutilized in nursing education, especially at prelicensure and graduate levels, and could benefit from clear and consistent use of terminology.
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Affiliation(s)
- Hayley J Dunnack
- About the Authors Hayley J. Dunnack, BS, RN, CMSRN, OCN, is a PhD student, School of Nursing, University of Connecticut, Storrs, Connecticut. Thomas J. Van Hoof, MD, EdD, FACMQ, is an associate professor and director of teaching and learning, School of Nursing, University of Connecticut, and associate professor, Department of Public Health Sciences, School of Medicine, University of Connecticut. Valori Banfi, MSLS, is a sciences librarian, University of Connecticut. E. Carol Polifroni, EdD, RN, CNE, NEA-BC, ANEF, is a professor, School of Nursing, University of Connecticut. For more information, contact Hayley J. Dunnack at
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Scott SA, Van Eyk N, Eva K. Using Individual Residents' Learning Trajectories to Better Understand the Impact of Gaps in Practice. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2021; 96:S158-S163. [PMID: 34348388 DOI: 10.1097/acm.0000000000004264] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE To optimize learning, health professional training programs need to achieve the right balance between depth of practice (gaining more experience with particular skills) and breadth of practice (spreading experience across an array of activities). Better understanding how training for a particular skill set is impacted by periods of focus on a different skill set would allow improved curriculum and assessment design, thereby enhancing the efficiency of training and effectiveness of care. To this end, learning curves were used to compare performance in surgery after prolonged periods of practice to performance after gaps in surgical training. METHOD Daily operative assessments from the Dalhousie obstetrics and gynecology program were analyzed retrospectively and learning curves were generated. In addition to examining the variability in learning trajectories, the impact of gaps was systematically assessed by comparing resident scores after 2 successive months in which they were not assessed operatively to those collected after 2 successive months in which they were assessed at least once. RESULTS Four thousand four hundred sixteen scores for 33 residents over a 10-year period were analyzed. Trajectories and peak performances were identified. Residents performed better during their third sequential month of being assessed (mean = 4.40, 95% CI = 4.33-4.46) relative to during months following a period of being away from the operating room for at least 2 months (mean = 4.21, 95% CI = 4.13-4.29; P < .01; d = 0.7). However, maximum performance achieved was more strongly related to the number of times residents experienced a gap in training (r = 0.50) than to the number of times residents experienced 3 consecutive months of training (r = 0.25). CONCLUSIONS Distinct patterns of development exist for individual residents. Time away from surgical practice and assessment negatively impacted short-term performance, but may improve long-term learning trajectories. This speaks to the value of spaced education and is important for the design of longitudinal skills-based training programs.
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Affiliation(s)
- Stephanie A Scott
- S.A. Scott is assistant professor and surgical skills coordinator, Department of Obstetrics and Gynecology, Clinical Gynecologic Oncologist, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Nancy Van Eyk
- N. Van Eyk is associate professor and clinical obstetrician and gynecologist, Department of Obstetrics and Gynecology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Kevin Eva
- K. Eva is associate director, Centre for Health Education Scholarship, and professor and director of educational research and scholarship, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
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Awan OA. How to Become a Great Teacher? Acad Radiol 2021; 28:1639-1640. [PMID: 34782151 DOI: 10.1016/j.acra.2021.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2021] [Accepted: 02/11/2021] [Indexed: 11/17/2022]
Affiliation(s)
- Omer A Awan
- University of Maryland School of Medicine, 655 W Baltimore Street, Baltimore, MD 21201.
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Barrett TW, McEvoy MD, Fowler LC, Shotwell MS, Shi Y, Costello M, Rogers D, Slayton J, Edwards DA. Impact of an Asynchronous Spaced Education Learning Intervention on Emergency Medicine Clinician Opioid Prescribing. Cureus 2021; 13:e18165. [PMID: 34707949 PMCID: PMC8530747 DOI: 10.7759/cureus.18165] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/21/2021] [Indexed: 11/14/2022] Open
Abstract
Introduction Opioid prescribing has contributed to the opioid crisis and education has focused on improved opioid stewardship. We aimed to evaluate the impact of an asynchronous high-quality education to change emergency medicine (EM) clinician opioid prescribing. Methods We conducted a retrospective cohort study of a spaced-education intervention in EM clinicians who work at an urban, university-affiliated academic medical center emergency department. We developed opioid prescribing educational content and investigated whether prescriber participation in a novel asynchronous educational program, QuizTime, was associated with a change in EM clinician opioid prescribing practices and whether those prescribing practice changes would be maintained. The primary outcome was the frequency of opioid prescriptions by attributable emergency department discharges. We compared the frequency during the post-intervention period, 24 months following QuizTime education (July 2018 - June 2020) to the baseline period (November 2016 - March 2018). The secondary outcomes were total morphine milligram equivalent (MME) and the number of tablets dispensed per prescription. We analyzed the outcomes by EM clinicians’ level of participation in QuizTime education. Results During the study period, there was an overall reduction in opioid prescribing per attributable emergency department discharge (p < 0.001). Among the 45 prescribers who enrolled in QuizTime, there was a significant reduction of 4.3 (95% CI: 3.9, 4.6, p < 0.001) opioid prescriptions per 100 ED discharges in the post-intervention period compared to baseline. Among the 11 non-enrollees, there was a significant reduction of 2.4 (95% CI: 1.7, 3.1, p < 0.001) opioid prescriptions per 100 emergency department discharges in the post-intervention period compared to baseline. The prescribers enrolled in QuizTime had a significantly larger reduction in prescriptions compared to those who did not enroll (p < 0.001). A decreasing trend of total MME and the number of tablets dispensed was observed (p < 0.001). However, there was insufficient evidence to show a reduction in the number of tablets dispensed or MME per day. Conclusion EM clinician participation in the QuizTime Pain Management educational program was associated with a nearly two-fold decrease in opioid prescriptions per emergency department discharge compared to peers who chose not to enroll.
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Affiliation(s)
- Tyler W Barrett
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, USA
| | - Matt D McEvoy
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, USA
| | - Leslie C Fowler
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, USA
| | - Matthew S Shotwell
- Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, USA
| | - Yaping Shi
- Department of Biostatistics, Vanderbilt University School of Medicine, Nashville, USA
| | - Michael Costello
- Department of Quality, Safety and Risk Prevention, Vanderbilt University Medical Center, Nashville, USA
| | - Devin Rogers
- Department of Emergency Medicine, PeaceHealth Sacred Heart Medical Center University District, Eugene, USA
| | - Jennifer Slayton
- Department of Quality, Safety and Risk Prevention, Vanderbilt University Medical Center, Nashville, USA
| | - David A Edwards
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, USA
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Simulation Versus Interactive Mobile Learning for Teaching Extracorporeal Membrane Oxygenation to Clinicians: A Randomized Trial. Crit Care Med 2021; 50:e415-e425. [PMID: 34678847 DOI: 10.1097/ccm.0000000000005376] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Extracorporeal membrane oxygenation has become integral to critical care. Data informing optimal extracorporeal membrane oxygenation education modalities are lacking. We aimed to compare the effect of high-fidelity simulation versus interactive mobile learning on extracorporeal membrane oxygenation knowledge acquisition and retention among clinicians. DESIGN Observer-blinded, randomized controlled trial. SETTING A single academic medical center. SUBJECTS Forty-four critical care clinicians with limited extracorporeal membrane oxygenation experience. INTERVENTIONS Participants were randomized to receive: 1) simulation: three high-fidelity training scenarios, 2) QuizTime: 15 total multiple-choice questions delivered over 3 weeks via mobile device, or 3) experiential: no formal training. Participants completed a survey, written knowledge examination, and simulation assessment prior to randomization, immediately following the intervention, and 4 month postintervention. MEASUREMENTS AND MAIN RESULTS The primary outcome was knowledge about extracorporeal membrane oxygenation assessed by score on the immediate postintervention written examination. Secondary outcomes included performance in extracorporeal membrane oxygenation simulation postintervention and 4 months later assessed by a rater blinded to group assignment. Clinicians randomized to simulation (n = 15), QuizTime (n = 14), and experiential (n = 15) had similar baseline characteristics. Adjusting for baseline knowledge, postintervention examination scores were higher in the simulation group (90.0%; interquartile range, 85.0-90.0%) than the QuizTime group (70.0%; interquartile range, 65.0-80.0%; p = 0.0003) and the experiential group (75.0%; interquartile range, 65.0-80.0%; p = 0.001). Scores did not differ between the groups at 4 months (p > 0.05 in all analyses). In postintervention extracorporeal membrane oxygenation simulations, the simulation group demonstrated shorter time to critical action compared with QuizTime (80.0 s [interquartile range, 54.0-111.0 s] vs 300.0 s [interquartile range 85.0-300.0 s]; p = 0.02) and compared with both QuizTime (45.0 s [interquartile range, 34.0-92.5 s] vs 255.5 s [interquartile range, 102.0-300.0 s]; p = 0.008) and experiential (300.0 s [interquartile range, 58.0-300.0 s]; p = 0.009) at 4 months. CONCLUSIONS Simulation was superior to QuizTime and experiential learning with regard to extracorporeal membrane oxygenation knowledge acquisition. Further studies are needed to ascertain the effect of these interventions on knowledge retention, clinical performance, and patient outcomes.
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Awan OA. How to Appeal to a Diverse Array of Learners? Acad Radiol 2021; 28:1445-1446. [PMID: 34563334 DOI: 10.1016/j.acra.2021.02.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2021] [Accepted: 02/07/2021] [Indexed: 10/20/2022]
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Grad R, Leger D, Kaczorowski J, Schuster T, Adler S, Aman M, Archibald D, Beaulieu MC, Chmelicek J, Cornelissen E, Delleman B, Hadj-Mimoune S, Horvey S, Macaluso S, Mintsioulis S, Murdoch S, Ng B, Papineau A, Rangwala S, Rousseau M, Rudkin T, Schabort I, Schultz K, Snow P, Wong E, Wu P, Brailovsky C. Does spaced education improve clinical knowledge among Family Medicine residents? A cluster randomized controlled trial. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2021; 26:771-783. [PMID: 33389233 PMCID: PMC8338813 DOI: 10.1007/s10459-020-10020-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 12/14/2020] [Indexed: 06/12/2023]
Abstract
UNLABELLED Spaced education is a learning strategy to improve knowledge acquisition and retention. To date, no robust evidence exists to support the utility of spaced education in the Family Medicine residency. We aimed to test whether alerts to encourage spaced education can improve clinical knowledge as measured by scores on the Canadian Family Medicine certification examination. METHOD We conducted a cluster randomized controlled trial to empirically and pragmatically test spaced education using two versions of the Family Medicine Study Guide mobile app. 12 residency training programs in Canada agreed to participate. At six intervention sites, we consented 335 of the 654 (51%) eligible residents. Residents in the intervention group were sent alerts through the app to encourage the answering of questions linked to clinical cases. At six control sites, 299 of 586 (51%) residents consented. Residents in the control group received the same app but with no alerts. Incidence rates of case completion between trial arms were compared using repeated measures analysis. We linked residents in both trial arms to their knowledge scores on the certification examination of the College of Family Physicians of Canada. RESULTS Over 67 weeks, there was no statistically significant difference in the completion of clinical cases by participants. The difference in mean exam scores and the associated confidence interval did not exceed the pre-defined limit of 4 percentage points. CONCLUSION Further research is recommended before deploying spaced educational interventions in the Family Medicine residency to improve knowledge.
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Affiliation(s)
- Roland Grad
- Herzl Family Practice Centre, McGill University, 3755 Cote Ste Catherine Road, Montreal, H3T 1E2, Canada.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Brian Ng
- University of British Columbia, Vancouver, Canada
| | | | | | | | - Teresa Rudkin
- Family Medicine, McGill University, Montreal, Canada
| | | | | | - Pamela Snow
- Memorial University of Newfoundland, St. John's, Canada
| | | | - Pearson Wu
- Herzl Family Practice Centre, McGill University, 3755 Cote Ste Catherine Road, Montreal, H3T 1E2, Canada
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Gates MC, McLachlan I, Butler S, Weston JF. Building Veterinarians beyond Veterinary School: Challenges and Opportunities for Continuing Professional Development in Veterinary Medicine. JOURNAL OF VETERINARY MEDICAL EDUCATION 2021; 48:383-400. [PMID: 34161200 DOI: 10.3138/jvme.2019-0148] [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] [Indexed: 06/13/2023]
Abstract
Continuing professional development (CPD) is an important mechanism for veterinarians to acquire, maintain, and enhance their capability to perform competently in their chosen practice area over their career. Although most licensing bodies require veterinarians to complete a minimum number of CPD hours each registration cycle, there are known issues with verifying that these activities are having the desired effects of ensuring professional competence and improving outcomes for patients, owners, and veterinarians. In this review, we summarize the literature across different health care professions to highlight three key challenges for veterinary CPD programs. These are (a) defining what it means to be professionally competent across different career stages from graduation to retirement, (b) delivering CPD activities that are effective in promoting evidence-based medicine and behavioral change in practice, and (c) developing reliable and sustainable systems to formally assess the continued professional competence of veterinarians. A common theme across all challenges was the importance of interacting with colleagues as an opportunity to receive external feedback on their professional strengths and weaknesses and to develop stronger support networks for managing common stressors in clinical practice. There was also a recognized need to develop more transparent outlines of the available and acceptable options for managing different animal health concerns as a first step toward identifying new opportunities for the veterinary profession to elevate the level of care provided. Based on these findings, we propose a new framework for defining, delivering, and evaluating CPD that promotes stronger collaboration between veterinarians to improve professional and personal well-being.
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Roland D, Thoma B, Tagg A, Woods J, Chan TM, Riddell J. What Are the Real-World Podcast-Listening Habits of Medical Professionals? Cureus 2021; 13:e16240. [PMID: 34373803 PMCID: PMC8345330 DOI: 10.7759/cureus.16240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/06/2021] [Indexed: 11/05/2022] Open
Abstract
Introduction Educational podcasts are increasingly being utilized by health professionals for continuing education, but how they are being used remains poorly understood. Given their extensive reach, they represent a phenomenal opportunity for researchers to engage in knowledge translation of their scholarly works. The design, study, and effectiveness of these resources should be informed by a deeper understanding of their pragmatic usage. We aimed to prospectively determine the pragmatic, real-world listening habits of health professionals. Methods We performed a prospective observational study of a broad, interprofessional sample of participants (medical students, residents, physicians, nurses, physician assistants, and paramedics) recruited through a multimodal social media (Twitter and Facebook) campaign. Recruitment materials included an infographic and study website. Participants listened to eight podcasts and described their use of each in subsequent questionnaires. Results A total of 393 participants enrolled in the study, and 241 completed the survey for all eight podcasts. Listening behaviors were consistent across the podcasts with the majority selecting a normal speed of playback and engaging in concomitant activities such as driving. One-third of participants paused the podcasts due to interruption. Conclusion We describe the prospective use of medical podcasts by a cohort of health professionals. This work should inform the role of podcasts in the communication of medical research.
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Affiliation(s)
- Damian Roland
- Children's Emergency Medicine, Leicester University and Hospitals, Leicester, GBR
| | - Brent Thoma
- Emergency Medicine, University of Saskatchewan, Saskatoon, CAN
| | - Andrew Tagg
- Emergency Medicine, Footscray Hospital, University of Melbourne, Melbourne, AUS
| | - Jason Woods
- Emergency Medicine, University of Colorado School of Medicine, Aurora, USA
| | - Teresa M Chan
- Emergency Medicine, McMaster University, Hamilton, CAN
| | - Jeffrey Riddell
- Emergency Medicine, University of Southern California Keck School of Medicine, Los Angeles, USA
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Newton WP, O'Neill TR, Price DW. THE EVOLUTION OF KNOWLEDGE ASSESSMENT: ABFM'S STRATEGY GOING FORWARD. Ann Fam Med 2021; 19:377-379. [PMID: 34264843 PMCID: PMC8282299 DOI: 10.1370/afm.2726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
- Warren P Newton
- American Board of Family Medicine, Department of Family Medicine, University of North Carolina
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Samuel A, Cervero RM, Durning SJ, Maggio LA. Effect of Continuing Professional Development on Health Professionals' Performance and Patient Outcomes: A Scoping Review of Knowledge Syntheses. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2021; 96:913-923. [PMID: 33332905 DOI: 10.1097/acm.0000000000003899] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
PURPOSE Continuing professional development (CPD) programs, which aim to enhance health professionals' practice and improve patient outcomes, are offered to practitioners across the spectrum of health professions through both formal and informal learning activities. Various knowledge syntheses (or reviews) have attempted to summarize the CPD literature; however, these have primarily focused on continuing medical education or formal learning activities. Through this scoping review, the authors seek to answer the question, What is the current landscape of knowledge syntheses focused on the impact of CPD on health professionals' performance, defined as behavior change and/or patient outcomes? METHOD In September 2019, the authors searched PubMed, Embase, CINAHL, Scopus, ERIC, and PsycINFO for knowledge syntheses published between 2008 and 2019 that focused on independently practicing health professionals and reported outcomes at Kirkpatrick's level 3 and/or 4. RESULTS Of the 7,157 citations retrieved from databases, 63 satisfied the inclusion criteria. Of these 63 syntheses, 38 (60%) included multicomponent approaches, and 29 (46%) incorporated eLearning interventions-either standalone or in combination with other interventions. While a majority of syntheses (n = 42 [67%]) reported outcomes affecting health care practitioners' behavior change and/or patient outcomes, most of the findings reported at Kirkpatrick level 4 were not statistically significant. Ten of the syntheses (16%) mentioned the cost of interventions though this was not their primary focus. CONCLUSIONS Across health professions, CPD is an umbrella term incorporating formal and informal approaches in a multicomponent approach. eLearning is increasing in popularity but remains an emerging technology. Several of the knowledge syntheses highlighted concerns regarding both the financial and human costs of CPD offerings, and such costs are being increasingly addressed in the CPD literature.
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Affiliation(s)
- Anita Samuel
- A. Samuel is assistant professor, Department of Medicine and Center for Health Professions Education, Uniformed Services University of the Health Sciences, Bethesda, Maryland; ORCID: https://orcid.org/0000-0001-9488-9565
| | - Ronald M Cervero
- R.M. Cervero is professor, Department of Medicine, and deputy director, Center for Health Professions Education, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Steven J Durning
- S.J. Durning is professor, Department of Medicine, and director, Center for Health Professions Education, Uniformed Services University of the Health Sciences, Bethesda, Maryland
| | - Lauren A Maggio
- L.A. Maggio is associate professor, Department of Medicine, and associate director, Center for Health Professions Education, Uniformed Services University of the Health Sciences, Bethesda, Maryland; ORCID: https://orcid.org/0000-0002-2997-6133
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Minter DJ, Geha R, Manesh R, Dhaliwal G. The Future Comes Early for Medical Educators. J Gen Intern Med 2021; 36:1400-1403. [PMID: 32875502 PMCID: PMC7462356 DOI: 10.1007/s11606-020-06128-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 07/31/2020] [Accepted: 08/10/2020] [Indexed: 11/29/2022]
Abstract
Many experts have foretold of a digital transformation in medical education. Yet, until recently, day-to-day practices for frontline clinician-educators, who cherish close physical and intellectual contact between the patient, learner, and teacher, have remained largely unchanged. The COVID-19 pandemic disrupted that model and is forcing teachers to pursue new ways to reach learners. We provide a roadmap for educators to start their transformation from an analog to a digital approach by harnessing existing tools including podcasts, social media, and videoconferencing. Teachers will need to enhance the same pedagogical and interpersonal practices that underpin effective in-person education while they learn new skills as they become curators, creators, and moderators in the digital space. This adaptation is essential, as many of the changes in medical education spurred by COVID-19 will likely far outlast the pandemic.
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Affiliation(s)
- Daniel J Minter
- Department of Medicine, University of California, San Francisco , San Francisco, CA, USA.
| | - Rabih Geha
- Department of Medicine, University of California, San Francisco , San Francisco, CA, USA.,Medical Service, San Francisco VA Medical Center , San Francisco, CA, USA
| | - Reza Manesh
- Division of Hospital Medicine, Northwestern University Feinberg School of Medicine , Chicago, IL, USA
| | - Gurpreet Dhaliwal
- Department of Medicine, University of California, San Francisco , San Francisco, CA, USA.,Medical Service, San Francisco VA Medical Center , San Francisco, CA, USA
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Van Hoof TJ, Madan CR, Sumeracki MA. Science of Learning Strategy Series: Article 2, Retrieval Practice. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2021; 41:119-123. [PMID: 34057909 DOI: 10.1097/ceh.0000000000000335] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Retrieval practice is an evidence-based, science of learning strategy that is relevant to the planning and implementation of continuing professional development (CPD). Retrieval practice requires one to examine long-term memory to work with priority information again in working memory. Retrieval practice improves learning in two ways. It improves memory for the information itself (direct benefit), and retrieval practice provides feedback about what needs additional effort (indirect). Both benefits contribute significantly to durable learning. Research from cognitive psychology and neuroscience provides the rationale for retrieval practice, and examples of its implementation in health professions education are increasingly available in the literature. Through appropriate utilization, CPD participants can benefit from retrieval practice by making more-informed educational choices, and CPD planners can benefit in efforts to improve educational activities.
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Affiliation(s)
- Thomas J Van Hoof
- Mr. Thomas J. Van Hoof, MD, EdD: Associate Professor, University of Connecticut School of Nursing, Storrs, and Associate Professor, Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, CT. Mr. Christopher R. Madan, PhD: Assistant Professor, School of Psychology, University of Nottingham, Nottingham, United Kingdom. Ms. Megan A. Sumeracki, PhD: Assistant Professor, Department of Psychology, Rhode Island College, Rhode Island, United Kingdom
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Pollock D, Davies EL, Peters MDJ, Tricco AC, Alexander L, McInerney P, Godfrey CM, Khalil H, Munn Z. Undertaking a scoping review: A practical guide for nursing and midwifery students, clinicians, researchers, and academics. J Adv Nurs 2021; 77:2102-2113. [PMID: 33543511 PMCID: PMC8049063 DOI: 10.1111/jan.14743] [Citation(s) in RCA: 211] [Impact Index Per Article: 70.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Revised: 12/02/2020] [Accepted: 12/14/2020] [Indexed: 02/06/2023]
Abstract
AIM The aim of this study is to discuss the available methodological resources and best-practice guidelines for the development and completion of scoping reviews relevant to nursing and midwifery policy, practice, and research. DESIGN Discussion Paper. DATA SOURCES Scoping reviews that exemplify best practice are explored with reference to the recently updated JBI scoping review guide (2020) and the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Scoping Review extension (PRISMA-ScR). IMPLICATIONS FOR NURSING AND MIDWIFERY Scoping reviews are an increasingly common form of evidence synthesis. They are used to address broad research questions and to map evidence from a variety of sources. Scoping reviews are a useful form of evidence synthesis for those in nursing and midwifery and present opportunities for researchers to review a broad array of evidence and resources. However, scoping reviews still need to be conducted with rigour and transparency. CONCLUSION This study provides guidance and advice for researchers and clinicians who are preparing to undertake an evidence synthesis and are considering a scoping review methodology in the field of nursing and midwifery. IMPACT With the increasing popularity of scoping reviews, criticism of the rigour, transparency, and appropriateness of the methodology have been raised across multiple academic and clinical disciplines, including nursing and midwifery. This discussion paper provides a unique contribution by discussing each component of a scoping review, including: developing research questions and objectives; protocol development; developing eligibility criteria and the planned search approach; searching and selecting the evidence; extracting and analysing evidence; presenting results; and summarizing the evidence specifically for the fields of nursing and midwifery. Considerations for when to select this methodology and how to prepare a review for publication are also discussed. This approach is applied to the disciplines of nursing and midwifery to assist nursing and/or midwifery students, clinicians, researchers, and academics.
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Affiliation(s)
- Danielle Pollock
- JBIFaculty of Health and Medical SciencesThe University of AdelaideAdelaideSAAustralia
| | - Ellen L. Davies
- Adelaide Nursing SchoolFaculty of Health and Medical SciencesThe University of AdelaideAdelaideSAAustralia
| | - Micah D. J. Peters
- Adelaide Nursing SchoolFaculty of Health and Medical SciencesThe University of AdelaideAdelaideSAAustralia
- Rosemary Bryant AO Research CentreClinical & Health SciencesUniversity of South AustraliaAdelaideSAAustralia
- The Centre for Evidence‐based Practice South Australia (CEPSA): A JBI Centre of ExcellenceAdelaideSAAustralia
| | - Andrea C. Tricco
- Li Ka Shing Knowledge Institute of St. Michael's HospitalUnity Health TorontoTorontoONCanada
- Epidemiology Division and Institute of Health Management, Policy, and EvaluationDalla Lana School of Public HealthUniversity of TorontoTorontoONCanada
- Queen's Collaboration for Health Care Quality: A JBI Centre of ExcellenceKingstonONCanada
| | - Lyndsay Alexander
- School of Health SciencesRobert Gordon UniversityAberdeenUK
- The Scottish Centre for Evidence‐based Multi‐professional Practice: A JBI Centre of ExcellenceAberdeenUK
| | - Patricia McInerney
- Faculty of Health SciencesUniversity of the WitwatersrandJohannesburgSouth Africa
- The Wits‐JBI Centre for Evidence‐Based Practice: A JBI Affiliated GroupJohannesburgSouth Africa
| | - Christina M. Godfrey
- Queen's Collaboration for Health Care Quality: A JBI Centre of ExcellenceKingstonONCanada
- School of NursingQueen's UniversityKingstonONCanada
| | - Hanan Khalil
- School of Psychology and Public HealthDepartment of Public HealthLa Trobe UniversityMelbourneVicAustralia
| | - Zachary Munn
- JBIFaculty of Health and Medical SciencesThe University of AdelaideAdelaideSAAustralia
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Gough BL, Gerges M, Weinberger J. Spaced Education With ABSITE Quest Resulting in Improved American Board of Surgery In-Training Examination Performance. JOURNAL OF SURGICAL EDUCATION 2021; 78:597-603. [PMID: 32958421 DOI: 10.1016/j.jsurg.2020.07.039] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/25/2020] [Accepted: 07/25/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE The American Board of Surgery In-Training Examination (ABSITE) is an annual exam taken by general surgery residents as a cognitive assessment of the knowledge gained throughout each year of training. Several question banks are available for ABSITE preparation. However, ABSITE Quest (AQ) utilizes a method called spaced education which has been demonstrated to help with retaining information longer and improve exam performance. This study hypothesizes that using this method will help residents improve their ABSITE performance. DESIGN Retrospective survey data was collected from residents who participated in AQ, including postgraduate year (PGY) level, as well as 2019 and 2020 ABSITE percentiles. AQ user data was used to match respondent's total number of questions completed and daily engagement level to the survey data. Paired, single-tailed student's t test was used to evaluate the significance of ABSITE percentile change between 2019 and 2020 among AQ users. SETTING ChristianaCare, Newark, DE, United States. Nonclinical. PARTICIPANTS All ABSITE Quest users were surveyed (n = 390), of which 104 responded. 21 responses were from PGY1 residents and were excluded, resulting in a total of 83 responses. RESULTS The mean percentile difference of AQ users from 2019 to 2020 was +15.8 (p < 0.00001). When categorizing by the total number of questions completed, high users demonstrated a mean percentile difference of +15.3 (p = 0.00002), average users had a difference of +19.1 (p = 0.00029), and low users showed a percentile difference of +1.2 (p = 0.45244). When categorizing by daily engagement level, high users demonstrated a mean percentile difference of +17.9 (p < 0.00001), low users had a mean percentile difference of +15.3 (p = 0.00124), and minimal users showed a mean percentile change of -5.7. CONCLUSIONS The use of the spaced education method with ABSITE Quest, especially in users with a greater number of questions completed and high levels of daily engagement, correlated with a significant improvement on ABSITE performance.
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Affiliation(s)
| | - Michael Gerges
- University of Texas Health Science Center San Antonio, Department of Surgery, San Antonio, Texas
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Sevenhuysen SL, Kent F, Wright C, Williams C, Bowles KA, Matthews K, Ayton D, Maloney S. "Why have you done it that way?" Educator perceptions of student-initiated conversations about perceived deviations from evidence-based clinical practice. NURSE EDUCATION TODAY 2021; 98:104768. [PMID: 33485160 DOI: 10.1016/j.nedt.2021.104768] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Revised: 12/17/2020] [Accepted: 01/06/2021] [Indexed: 06/12/2023]
Abstract
Students on clinical placement may encounter practice that deviates from what they perceive to be evidence-based. However, queries by students about the evidence-base of their clinical educators decision-making and practice can be a challenging conversation to initiate. It is unclear how these conversations occur, and what impact engaging in these challenging conversations may have on practice, the learning experience, and the relationship with the educator. This study sought to explore clinical educators' experiences of student-initiated discussions that question the evidence-base of their clinical practice. And to identify their preferred approaches for students to initiate these conversations. Individual interviews were conducted with 23 clinical educators from five professions at three different hospitals in Victoria, Australia. Semi-structured interviewing techniques were employed to identify participants' context and experiences. Participants described student-initiated conversations about deviations from evidence-based practice as challenging encounters with potential for positive or negative impact on clinical educators, students and patients. They noted that the perceived appropriateness of the discussion could be influenced by the method utilised by students to initiate the conversation. Elements identified by clinical educators as barriers or enablers to support students to appropriately initiate conversations about clinical practice may be utilised by education and health providers to enhance opportunities for learning conversations to occur.
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Affiliation(s)
- Samantha L Sevenhuysen
- Department of Physiotherapy, Monash University, McMahons Road, Frankston, Victoria, Australia.
| | - Fiona Kent
- Faculty Medicine, Nursing Health Sciences at Monash University, Clayton, Victoria, Australia
| | - Caroline Wright
- Department of Medical Imaging and Radiation Sciences, Monash University, Wellington Road, Clayton, Victoria, Australia; School of Primary and Allied Health Care, Monash University, Wellington Road, Clayton, Victoria, Australia
| | - Cylie Williams
- Department of Physiotherapy, Monash University, McMahons Road, Frankston, Victoria, Australia; Peninsula Health, Hastings Road, Frankston, Victoria, Australia
| | - Kelly-Ann Bowles
- Department of Paramedicine, Monash University, McMahons Road, Frankston, Victoria, Australia
| | - Kristie Matthews
- Department of Medical Imaging and Radiation Sciences, Monash University, Wellington Road, Clayton, Victoria, Australia; Peter MacCallum Cancer Centre, Australia
| | - Darshini Ayton
- School of Primary and Allied Health Care, Monash University, Wellington Road, Clayton, Victoria, Australia
| | - Stephen Maloney
- School of Primary and Allied Health Care, Monash University, Wellington Road, Clayton, Victoria, Australia
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Van Hoof TJ, Sumeracki MA, Madan CR. Science of Learning Strategy Series: Article 1, Distributed Practice. THE JOURNAL OF CONTINUING EDUCATION IN THE HEALTH PROFESSIONS 2021; 41:59-62. [PMID: 33044392 DOI: 10.1097/ceh.0000000000000315] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Distributed practice is an evidence-based, learning-science strategy that is relevant to the planning and implementation of continuing professional development (CPD). Spacing-out study or practice over time allows the brain multiple opportunities to process new and complex information in an efficient way, thus increasing the likelihood of mastery and memory. Research from cognitive psychology and neuroscience provide the rationale for distributed practice, and examples of its implementation in health professions education have begun to appear in the literature. If used appropriately or extended creatively, some common CPD interventions can fully leverage distributed practice. Through increased understanding, CPD planners can benefit from distributed practice in efforts to improve educational activities, and CPD participants can benefit by making more informed educational choices.
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Affiliation(s)
- Thomas J Van Hoof
- Dr. Van Hoof: Associate Professor, University of Connecticut School of Nursing, Storrs, CT and Associate Professor, Department of Public Health Sciences, University of Connecticut School of Medicine, Farmington, CT. Dr. Sumeracki: Associate Professor, Department of Psychology, Rhode Island College. Dr. Madan: Assistant Professor, School of Psychology, University of Nottingham, Nottingham, United Kingdom
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Gupta S, Ojeh N, Sa B, Majumder MAA, Singh K, Adams OP. Use of an Adaptive e-Learning Platform as a Formative Assessment Tool in the Cardiovascular System Course Component of an MBBS Programme. ADVANCES IN MEDICAL EDUCATION AND PRACTICE 2020; 11:989-996. [PMID: 33363427 PMCID: PMC7752734 DOI: 10.2147/amep.s267834] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 10/18/2020] [Indexed: 05/31/2023]
Abstract
BACKGROUND Technology-enhanced learning includes the adaptive e-learning platform, a data-driven method with computer algorithms, providing customised learning enhancing critical thinking of individual learners. "Firecracker" - an online adaptive e-learning platform, and assessment software, promotes critical thinking, helps prepare students for courses and high-stakes examinations, and evaluates progress relative to co-learners. The objectives of this study were to determine the usage rates of Firecracker, examine the performance of Firecracker formative quizzes, identify the correlation between Firecracker use and performance with that of performance at summative course assessments, and assess students' satisfaction with Firecracker usage. METHODS Study participants were Year-2 MBBS (Bachelor of Medicine, Bachelor of Surgery) students (n=91) of the Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Barbados. The Firecracker Administrator uploaded quizzes covering basic science content in the Cardiovascular System course. Access, usage, and performance on Firecracker formative quizzes were retrieved from the Firecracker dashboard. A questionnaire sought the views of study participants. RESULTS Seven sets of quizzes were administered over nine weeks, with weekly student completion rates ranging from 53% to 73%. Mean quiz scores ranged from 52% to 72%. Students completing >4 quiz sessions compared to those completing ≤4 demonstrated significantly better performance in Firecracker quizzes (P<0.01), final examinations (P<0.01) and in-course assessment plus final examination (P<0.05) scores. Correlations between overall Firecracker performance and in-course assessment marks (P<0.05); between total overall Firecracker performance and final examination (P<0.01); and overall Firecracker performance and total course marks (P<0.01) were all significant. Most students (70%) were happy using Firecracker and felt it complemented coursework (78%) and prepared them for course exams (58%) (P<0.01). CONCLUSION Overall, Firecracker was perceived very positively and welcomed by the students. Students were satisfied with the Firecracker as a formative assessment tool, and its use correlated with improved performance in the course examinations.
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Affiliation(s)
- Subir Gupta
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
| | - Nkemcho Ojeh
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
| | - Bidyadhar Sa
- Centre for Medical Sciences Education, Faculty of Medical Sciences, The University of the West Indies, St. Augustine Campus, St Augustine, Trinidad and Tobago
| | - Md Anwarul Azim Majumder
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
| | - Keerti Singh
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
| | - Oswald Peter Adams
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
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