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Wisener K, Driessen E, Tan A, Cuncic C, Eva K. From constructive to critical and everywhere in between: education leaders' decision-making related to harsh feedback from learners about their teachers. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2024:10.1007/s10459-024-10367-7. [PMID: 39222274 DOI: 10.1007/s10459-024-10367-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2024] [Accepted: 08/26/2024] [Indexed: 09/04/2024]
Abstract
Feedback from learners is important to support faculty development, but negative feedback can harm teachers' motivation, engagement, and retention. Leaders of educational programs, therefore, need to balance enabling students' voices to be heard with maintaining teachers' enthusiasm and commitment to teaching. Given the paucity of research to explain or guide this struggle, we explored why and how education leaders grapple with negative learner feedback received about their teachers. Using an Interpretive Description methodology, 11 education leaders participated in semi-structured interviews. Discussion was stimulated by showing participants learner narratives they had previously asked to be deleted because they perceived the narrative to be overly critical. Transcripts were iteratively analyzed as codes were developed, refined, and combined into themes. Education leaders interpreted the scope, framing, and focus of the feedback to decide whether it was overly critical. Such determinations were combined with contextual considerations such as the teacher's personal circumstances, the learning environment and how the teacher might react to think through what potential damage the feedback might do to the teacher. Throughout the process, leaders struggled with whether protecting teachers risked not protecting learners and remained unsure about the ethics of censoring student voices. Our study offers direction regarding how to optimize feedback to teachers while minimizing risks inherent in sharing negative feedback with them. Implications include that there is value in: (1) extending feedback interpretation support to teachers, education leaders and learners; (2) situating upward feedback in a coaching dialogue; and, (3) applying the same principles recommended for the provision of feedback to learners, to teachers.
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Affiliation(s)
- Katherine Wisener
- Faculty Development, Faculty of Medicine, University of British Columbia, Vancouver, Canada.
- Faculty of Health, Medicine and Life Sciences, School of Health Professions Education (SHE), Maastricht University, Maastricht, The Netherlands.
| | - Erik Driessen
- Faculty of Health, Medicine and Life Sciences, School of Health Professions Education (SHE), Maastricht University, Maastricht, The Netherlands
| | - Amy Tan
- Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Cary Cuncic
- Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Kevin Eva
- Department of Medicine, Faculty of Medicine, University of British Columbia, Vancouver, Canada
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Roberts LW. Recognizing the Academic Contributions of Clinician Educators. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2024; 99:587-588. [PMID: 38809069 DOI: 10.1097/acm.0000000000005702] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2024]
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Maggio LA, Costello JA, Kolars JC, Cervero RM, Jackson KM, Durning SJ, Ma T. In Search of a "Metric System" for Measuring Faculty Effort: A Qualitative Study on Educational Value Units at U.S. Medical Schools. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2024; 99:445-451. [PMID: 38266197 DOI: 10.1097/acm.0000000000005635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Abstract
PURPOSE Faculty at academic health centers (AHCs) are charged with engaging in educational activities. Some faculty have developed educational value units (EVUs) to track the time and effort dedicated to these activities. Although several AHCs have adopted EVUs, there is limited description of how AHCs engage with EVU development and implementation. This study aimed to understand the collective experiences of AHCs with EVUs to illuminate benefits and barriers to their development, use, and sustainability. METHOD Eleven faculty members based at 10 AHCs were interviewed between July and November 2022 to understand their experiences developing and implementing EVUs. Participants were asked to describe their experiences with EVUs and to reflect on benefits and barriers to their development, use, and sustainability. Transcripts were analyzed using thematic analysis. RESULTS EVU initiatives have been designed and implemented in a variety of ways, with no AHCs engaging alike. Despite differences, the authors identified shared themes that highlighted benefits and barriers to EVU development and implementation. Within and between these themes, a series of tensions were identified in conjunction with the ways in which AHCs attempted to mitigate them. Related to barriers, the majority of participants abandoned or paused their EVU initiatives; however, no differences were identified between those AHCs that retained EVUs and those that did not. CONCLUSIONS The collective themes identified suggest that AHCs implementing or sustaining an EVU initiative would need to balance benefits and barriers in light of their unique context. Study findings align with reviews on EVUs and provide additional nuance related to faculty motivation to engage in education and the difficulties of defining EVUs. The lack of differences observed between those AHCs that retained EVUs and those that did not suggests that EVUs may be challenging to implement because of the complexity of AHCs and their faculty.
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Zhao FF. Teaching behaviours of clinical teachers and professional commitment among nursing students: A moderated mediation model of optimism and psychological well-being. NURSE EDUCATION TODAY 2023; 125:105774. [PMID: 36921540 DOI: 10.1016/j.nedt.2023.105774] [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: 09/17/2022] [Revised: 12/23/2022] [Accepted: 02/26/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Understanding the paths that influence professional commitment among nursing students is important for helping students continue the nursing profession after graduation. The paths between the teaching behaviours of clinical teachers (TBCT) and professional commitment were unknown. OBJECTIVES This study aimed to examine whether psychological well-being mediated the relationships between the teaching behaviours of clinical teachers and professional commitment of nursing students. Moreover, we investigated whether the mediating effects of psychological well-being were moderated by optimism. DESIGN A cross-sectional design was conducted. SETTING AND PARTICIPANTS A total of 318 students from 24 hospitals in 13 cities in northern, north-eastern, and eastern China were included in the study. METHODS The instruments used in this study included the scale of teaching behaviours of clinical teachers, a brief inventory of thriving (measuring psychological well-being), a life orientation test (measuring optimism), and a professional commitment scale. The PROCESS macro for SPSS was used to perform mediation analysis and moderated mediation analyses. RESULTS Psychological well-being of nursing students partially mediated the relationships between the teaching behaviours of clinical teachers and professional commitment of nursing students. Also, optimism moderated the indirect effect of this mediation model. The indirect effect of clinical teachers' teaching behaviours was stronger for nursing students with low levels of optimism. CONCLUSION The findings suggest that the teaching behaviours of clinical teachers and psychological well-being promote professional commitment. In addition, the mediation of psychological well-being between the teaching behaviours of clinical teachers and professional commitment was conditional on different levels of optimism. Clinical teachers should pay special attention to students with low levels of optimism because teaching behaviours of clinical teachers exert more influence on those students' professional commitment.
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Affiliation(s)
- Fang-Fang Zhao
- Department of Nursing Science, School of Medicine, Nantong University, Nantong, China.
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Young R, McEntee MF, Bennett D. Radiographers' perspectives on clinical supervision of students in Ireland. Radiography (Lond) 2023; 29:291-300. [PMID: 36640584 DOI: 10.1016/j.radi.2022.12.009] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Revised: 11/17/2022] [Accepted: 12/23/2022] [Indexed: 01/15/2023]
Abstract
INTRODUCTION Optimising clinical education in radiography is crucial to ensure competent graduates provide safe and effective patient care. Radiographers play a vital role in student supervision undertaken in the complex clinical environment. A greater understanding of factors influencing their ability to undertake this role effectively is needed. The study aimed to explore radiographers' attitudes and perceptions of confidence in undertaking clinical supervision and perceived barriers in a 'real-life' clinical department. METHODS The lens of Bandura's social-cognitive theory was utilised to assist the exploration of the desired constructs. An anonymous online survey was developed and circulated among qualified radiographers in Ireland. Descriptive (frequencies and percentages) and inferential statistical testing was undertaken. Thematic analysis was conducted on optional free-text comments. RESULTS 217 responses were received. Although most radiographers reported a positive attitude (73.3%), a significant minority reported not being confident across survey items related to the tasks required (ranging from 20.7%-29.1%). Time pressures from clinical workload, perceived lack of organisational support, and lack of guidance on expectations were highlighted challenges. CONCLUSION The survey has enabled first-hand identification of some challenges radiographers encounter in undertaking students' clinical supervision. Radiographers must be supported to optimise the clinical learning environment where both students and educators are valued. IMPLICATIONS FOR PRACTICE The findings highlight impact on educational support, practice, policy and future research. Effective clinical supervision is dependent on collaborative engagement and support being evident at all levels, including the clinical department, academic and healthcare institutions, and national organisations.
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Affiliation(s)
- R Young
- Discipline of Medical Imaging and Radiation Therapy, School of Medicine, University College Cork, Ireland.
| | - M F McEntee
- Discipline of Medical Imaging and Radiation Therapy, School of Medicine, University College Cork, Ireland.
| | - D Bennett
- Medical Education Unit, School of Medicine, University College Cork, Ireland.
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The nature and prevalence of threats to medical student placement capacity in primary care: a survey of East of England GP practices. BJGP Open 2022; 6:BJGPO.2022.0127. [PMID: 36270672 PMCID: PMC9904789 DOI: 10.3399/bjgpo.2022.0127] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2022] [Revised: 08/28/2022] [Accepted: 10/10/2022] [Indexed: 10/31/2022] Open
Abstract
BACKGROUND GP practices deliver vital medical student teaching in the face of increasingly challenging circumstances. AIM To understand the nature and scale of threats to medical student teaching capacity in primary care. DESIGN & SETTING An electronic survey of a predefined population of 120 East of England GP practices that host medical student placements. METHOD The survey was completed on behalf of the practice by the GP lead for medical student teaching. They were asked to pick (from a list of 16) the four main challenges they faced delivering medical student teaching placements, then explain their selection and suggest solutions. Thematic analysis of free-text responses was undertaken from an activity theory perspective. RESULTS Responses were received from 114 of the 120 practices in the study population (95% response rate). The most commonly selected challenges to delivering placements were clinical/practice workload (picked by 92 practices), and lack of space in the practice (picked by 63 practices). Thematic analysis produced a model whereby a practice's decision to continue hosting students was influenced by level of motivation and burden of teaching, but only if a certain level of resource enablement is present. Analysis of free-text responses suggested that space pressures were perceived as being exacerbated by the need to accommodate more clinicians, especially advanced practitioners employed by primary care networks (PCNs) under the additional roles reimbursement scheme (ARRS). CONCLUSION This study provides much-needed quantitative evidence to support the view that lack of space in GP premises is a major threat to the future of undergraduate general practice.
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Chen B, Jin X, Zhou J, Chen Y, Wang H. Satisfaction of Clinical Teachers on Standardized Residency Training Program (SRTP) in China: A Cross-Sectional Survey. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19095676. [PMID: 35565071 PMCID: PMC9101658 DOI: 10.3390/ijerph19095676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/27/2022] [Accepted: 04/29/2022] [Indexed: 12/10/2022]
Abstract
BACKGROUND The Standardized Residency Training Program (SRTP) is a significant initiative to deepen health systems and medical education in developing countries like China. Despite the promotion of the SRTP nationwide and its implementation with various improvements, Chinese continuous medical education is still in its infancy. Compared with the residents, little is known about clinical teachers under the SRTP in China. However, clinical teachers effectively determine the training quality as critical disseminators of knowledge, skills, and values in medical practice. Thus, the study aims to analyze critical factors affecting their cognitive job satisfaction and provide continuous improvements for SRTP. METHODS From 1 December 2018 to 31 May 2019, we conducted a self-designed questionnaire with 13 SRTPs (including both training bases and professional bases) in Shaoxing city to evaluate clinical teachers' satisfaction. Altogether, 574 clinical teachers responded to the survey expressing generally high overall satisfaction. We adopted a Chi-square test and Fisher's Exact Test to evaluate the single impact factors affecting the satisfaction of clinical teachers. The multiple factors analysis applied the logistic regression model. RESULTS The male clinical teachers had significant differences in satisfaction with the teaching content (OR: 0.675, [95% CI: 0.477~0.953]), conflicts between study and work (OR: 0.542, [95%CI: 0.371~0.791]), the attention of leaders (OR: 0.403, [95%CI: 0.252~0.645]), and the subsidies of teachers (OR: 0.527, [95%CI: 0.347~0.805]). Compared with internal medicine, clinical teachers from surgery (OR: 2.396, [95%CI: 1.365-4.206]) and other departments (OR: 2.409, [95%CI: 1.406-4.129]) were more satisfied when they considered that residents have high motivation to attend training. In addition, compared with the attending physicians, the deputy chief physicians (OR: 0.493, [95%CI: 0.310-0.783]) and the chief physicians (OR: 0.683, [95%CI: 0.471-0.991]) disagreed more regarding the residents' wage being good enough. CONCLUSION Clinical teachers widely recognize the SRTP. However, teachers' satisfaction varied due to different genders, working departments, and professional titles. The study also discussed possible reasons and strategy implications behind these findings, which combined unique Chinese society characteristics. Further, we believe the analysis and interpretations remind us of the applications of residency training methods from other Western countries, which should also consider the unique socio-cultural challenges.
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Affiliation(s)
- Boyan Chen
- Department of Social Medicine of School of Public Health and Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China; (B.C.); (X.J.); (J.Z.); (Y.C.)
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
| | - Xiaoyuan Jin
- Department of Social Medicine of School of Public Health and Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China; (B.C.); (X.J.); (J.Z.); (Y.C.)
| | - Jie Zhou
- Department of Social Medicine of School of Public Health and Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China; (B.C.); (X.J.); (J.Z.); (Y.C.)
| | - Ying Chen
- Department of Social Medicine of School of Public Health and Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China; (B.C.); (X.J.); (J.Z.); (Y.C.)
| | - Hongmei Wang
- Department of Social Medicine of School of Public Health and Department of Pharmacy of the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou 310058, China; (B.C.); (X.J.); (J.Z.); (Y.C.)
- Correspondence:
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Fantaye AW, Kitto S, Hendry P, Wiesenfeld L, Whiting S, Gnyra C, Fournier K, Lochnan H. Attributes of excellent clinician teachers and barriers to recognizing and rewarding clinician teachers' performances and achievements: a narrative review. CANADIAN MEDICAL EDUCATION JOURNAL 2022; 13:57-72. [PMID: 35572019 PMCID: PMC9099178 DOI: 10.36834/cmej.73241] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
BACKGROUND Over the last 31 years, there have been several institutional efforts to better recognize and reward clinician teachers. However, the perception of inadequate recognition and rewards by clinician teachers for their clinical teaching performance and achievements remains. The objective of this narrative review is two-fold: deepen understanding of the attributes of excellent clinician teachers considered for recognition and reward decisions and identify the barriers clinician teachers face in receiving recognition and rewards. METHODS We searched OVID Medline, Embase, Education Source and Web of Science to identify relevant papers published between 1990 and 2020. After screening for eligibility, we conducted a content analysis of the findings from 43 relevant papers to identify key trends and issues in the literature. RESULTS We found the majority of relevant papers from the US context, a paucity of relevant papers from the Canadian context, and a declining international focus on the attributes of excellent clinician teachers and barriers to the recognition and rewarding of clinician teachers since 2010. 'Provides feedback', 'excellent communication skills', 'good supervision', and 'organizational skills' were common cognitive attributes considered for recognition and rewards. 'Stimulates', 'passionate and enthusiastic', and 'creates supportive environment', were common non-cognitive attributes considered for recognition and rewards. The devaluation of teaching, unclear criteria, and unreliable metrics were the main barriers to the recognition and rewarding of clinician teachers. CONCLUSIONS The findings of our narrative review highlight a need for local empirical research on recognition and reward issues to better inform local, context-specific reforms to policies and practices.
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Affiliation(s)
| | - Simon Kitto
- Office of Continuing Professional Development, University of Ottawa, Ontario, Canada
- Department of Innovation in Medical Education, University of Ottawa, Ontario, Canada
| | - Paul Hendry
- Office of Continuing Professional Development, University of Ottawa, Ontario, Canada
- University of Ottawa Heart Institute, Ontario, Canada
| | - Lorne Wiesenfeld
- Department of Emergency Medicine, University of Ottawa, Ontario, Canada
- Postgraduate Medical Education, University of Ottawa, Ontario, Canada
| | - Sharon Whiting
- Children's Hospital of Eastern Ontario, Ontario, Canada
- Office of Faculty of Affairs, University of Ottawa, Ontario, Canada
| | | | - Karine Fournier
- Health Sciences Library, University of Ottawa, Ontario, Canada
| | - Heather Lochnan
- Office of Continuing Professional Development, University of Ottawa, Ontario, Canada
- Department of Medicine, The Ottawa Hospital, Ottawa, Ontario
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Snook AG, Schram AB, Arnadottir SA. “I am a teacher” – exploring how to support teacher identity formation in physical therapists. PHYSICAL THERAPY REVIEWS 2021. [DOI: 10.1080/10833196.2021.2000809] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
| | - Asta B. Schram
- School of Health Sciences, University of Iceland, Reykjavik, Iceland
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Han JJ, Soegaard Ballester JM, Aarons CB. Finding alignment between numbers and values in medical education. MEDICAL EDUCATION 2021; 55:553-555. [PMID: 33619742 DOI: 10.1111/medu.14479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Accepted: 02/15/2021] [Indexed: 06/12/2023]
Affiliation(s)
- Jason J Han
- Department of Surgery, Hospital of the University of Pennsylvania, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Cary B Aarons
- Department of Surgery, Hospital of the University of Pennsylvania, University of Pennsylvania, Philadelphia, PA, USA
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