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Verhees MJM, Landstra AM, Engbers R, Koksma JJ, Laan RFJM. Exploring workplace-based learning in distributed healthcare settings: a qualitative study. BMC MEDICAL EDUCATION 2024; 24:78. [PMID: 38254144 PMCID: PMC10804752 DOI: 10.1186/s12909-024-05053-6] [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: 04/11/2023] [Accepted: 01/11/2024] [Indexed: 01/24/2024]
Abstract
BACKGROUND Distributed healthcare settings such as district hospitals, primary care, and public health facilities are becoming the real-life settings for workplace-based learning required to educate the future healthcare workforce. Therefore, a major focus should be on designing and developing workplace-based learning in these learning environments. Healthcare professionals and educational policymakers play a significant role in these settings as role models in workplace-based learning, and as leaders in integrating learning into their work environments. It is relevant to explore their beliefs, attitudes, and behaviors towards workplace-based learning in their own settings, in order to provide context-relevant recommendations that can assist in shaping workplace-based learning environments. METHODS We used individual interviews to understand professionals' experiences with workplace-based learning in distributed healthcare settings. We - three clinicians, an educationalist, and a philosopher - thematically analyzed transcripts of 13 interviews with healthcare professionals and educational policymakers from different healthcare settings who were involved in the clinical phase of undergraduate medical education. RESULTS Clustering and categorizing of the data led to the construction of five overarching themes: Identification with and attitude towards medical education, Sense of ownership, Perceived time and space, Mutual preconceptions and relations, and Curriculum for a changing profession. CONCLUSIONS These themes accentuate aspects relevant to the development of workplace-based learning in distributed healthcare settings on the individual, team, or organizational level. We highlight the significance of individual professionals in the development of workplace-based learning and emphasize the need for recognition and support for those occupying the 'broker' role at the intersection of education and practice. For future research and educational practice, we recommend prioritizing initiatives that build on good-practices in workplace-based learning and involve dedicated individuals in distributed healthcare settings.
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Affiliation(s)
- Myrthe J M Verhees
- Radboudumc Health Academy, Radboudumc, Gerard van Swietenlaan 2, Nijmegen, 6525 GB, the Netherlands.
| | - Anneke M Landstra
- Radboudumc Health Academy, Radboudumc, Gerard van Swietenlaan 2, Nijmegen, 6525 GB, the Netherlands
- Rijnstate, Arnhem, the Netherlands
| | - Rik Engbers
- Radboudumc Health Academy, Radboudumc, Gerard van Swietenlaan 2, Nijmegen, 6525 GB, the Netherlands
| | - Jur J Koksma
- Radboudumc Health Academy, Radboudumc, Gerard van Swietenlaan 2, Nijmegen, 6525 GB, the Netherlands
| | - Roland F J M Laan
- Radboudumc Health Academy, Radboudumc, Gerard van Swietenlaan 2, Nijmegen, 6525 GB, the Netherlands
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Culp WC, Hedin RJ, Watkins DW, Lilie CJ, Tippett JC, Garmon EH, Bittenbinder TM, McAllister RK. Changing the Culture: Increasing and Sustaining Anesthesiology Resident Physician Publication Rates. THE JOURNAL OF EDUCATION IN PERIOPERATIVE MEDICINE : JEPM 2024; 26:E720. [PMID: 38516146 PMCID: PMC10954044 DOI: 10.46374/volxxvi_issue1_culp] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/23/2024]
Abstract
Background Academic inquiry is foundational to the advancement of medicine and resident training and must be demonstrated to the Accreditation Council for Graduate Medical Education. Past attempts at increasing publication rates have failed to identify educational best practice models. Our aim was to increase resident publication rates via culture and value changes that are universally implementable, affordable, effective, and sustainable. Methods In 2018, a multifaceted initiative was implemented to shift departmental values and foster a culture of academic productivity. This culture change stressed the value of scientific publication through frequent, consistent messaging from department leaders. In addition, residents were provided the freedom to choose their scholarly activities. In this retrospective cohort innovation, resident authors were identified for 4 academic years before and after the intervention and publication rates were determined (2014-2018 vs 2018-2022). Resident authors and publications per resident per year were compared using descriptive statistics and Student t test. Results The pre- and postintervention groups included 38 and 37 residents, respectively. Resident-authored publications increased from 7 preintervention to 24 postintervention, representing 343% of baseline. Mean ± SD publications per resident per year similarly increased 357% from 0.183 ± 0.16 to 0.654 ± 0.11 postintervention. Unpaired t test analysis demonstrated a significant difference in total publications per year (P = .002) and authorship rate (P = .003). Conclusions A multifaceted academic initiative resulted in a threefold increase in resident publication rates. This initiative demonstrates that local advocacy by leaders, freedom of choice for authors, and supportive departmental culture are driving factors in publication rates.
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Affiliation(s)
- William C. Culp
- The authors are at the Department of Anesthesiology, Baylor Scott & White Medical Center, Temple, TX. The following authors are also at the Baylor College of Medicine-Temple, TX: William C. Culp, Jr., is Professor of Anesthesiology and Vice Chair of Academic Affairs; Craig J. Lilie is Assistant Professor and Associate Program Director; J. Clint Tippett is Clinical Associate Professor and Residency Program Director; Russell K. McAllister is Chair of Anesthesiology and Professor of Anesthesiology. The following authors are also at Texas A&M University College of Medicine, Temple, TX: Riley J. Hedin and Daniel W. Watkins are Cardiothoracic Anesthesiology Fellows; Emily H. Garmon is Clinical Associate Professor; Timothy M. Bittenbinder is Chair, Scott & White Board of Directors, Senior Vice President Baylor Scott & White Healthcare, and Associate Professor; and Russell K. McAllister is Chair of Anesthesiology and Professor of Anesthesiology
| | - Riley J. Hedin
- The authors are at the Department of Anesthesiology, Baylor Scott & White Medical Center, Temple, TX. The following authors are also at the Baylor College of Medicine-Temple, TX: William C. Culp, Jr., is Professor of Anesthesiology and Vice Chair of Academic Affairs; Craig J. Lilie is Assistant Professor and Associate Program Director; J. Clint Tippett is Clinical Associate Professor and Residency Program Director; Russell K. McAllister is Chair of Anesthesiology and Professor of Anesthesiology. The following authors are also at Texas A&M University College of Medicine, Temple, TX: Riley J. Hedin and Daniel W. Watkins are Cardiothoracic Anesthesiology Fellows; Emily H. Garmon is Clinical Associate Professor; Timothy M. Bittenbinder is Chair, Scott & White Board of Directors, Senior Vice President Baylor Scott & White Healthcare, and Associate Professor; and Russell K. McAllister is Chair of Anesthesiology and Professor of Anesthesiology
| | - Daniel W. Watkins
- The authors are at the Department of Anesthesiology, Baylor Scott & White Medical Center, Temple, TX. The following authors are also at the Baylor College of Medicine-Temple, TX: William C. Culp, Jr., is Professor of Anesthesiology and Vice Chair of Academic Affairs; Craig J. Lilie is Assistant Professor and Associate Program Director; J. Clint Tippett is Clinical Associate Professor and Residency Program Director; Russell K. McAllister is Chair of Anesthesiology and Professor of Anesthesiology. The following authors are also at Texas A&M University College of Medicine, Temple, TX: Riley J. Hedin and Daniel W. Watkins are Cardiothoracic Anesthesiology Fellows; Emily H. Garmon is Clinical Associate Professor; Timothy M. Bittenbinder is Chair, Scott & White Board of Directors, Senior Vice President Baylor Scott & White Healthcare, and Associate Professor; and Russell K. McAllister is Chair of Anesthesiology and Professor of Anesthesiology
| | - Craig J. Lilie
- The authors are at the Department of Anesthesiology, Baylor Scott & White Medical Center, Temple, TX. The following authors are also at the Baylor College of Medicine-Temple, TX: William C. Culp, Jr., is Professor of Anesthesiology and Vice Chair of Academic Affairs; Craig J. Lilie is Assistant Professor and Associate Program Director; J. Clint Tippett is Clinical Associate Professor and Residency Program Director; Russell K. McAllister is Chair of Anesthesiology and Professor of Anesthesiology. The following authors are also at Texas A&M University College of Medicine, Temple, TX: Riley J. Hedin and Daniel W. Watkins are Cardiothoracic Anesthesiology Fellows; Emily H. Garmon is Clinical Associate Professor; Timothy M. Bittenbinder is Chair, Scott & White Board of Directors, Senior Vice President Baylor Scott & White Healthcare, and Associate Professor; and Russell K. McAllister is Chair of Anesthesiology and Professor of Anesthesiology
| | - J. Clint Tippett
- The authors are at the Department of Anesthesiology, Baylor Scott & White Medical Center, Temple, TX. The following authors are also at the Baylor College of Medicine-Temple, TX: William C. Culp, Jr., is Professor of Anesthesiology and Vice Chair of Academic Affairs; Craig J. Lilie is Assistant Professor and Associate Program Director; J. Clint Tippett is Clinical Associate Professor and Residency Program Director; Russell K. McAllister is Chair of Anesthesiology and Professor of Anesthesiology. The following authors are also at Texas A&M University College of Medicine, Temple, TX: Riley J. Hedin and Daniel W. Watkins are Cardiothoracic Anesthesiology Fellows; Emily H. Garmon is Clinical Associate Professor; Timothy M. Bittenbinder is Chair, Scott & White Board of Directors, Senior Vice President Baylor Scott & White Healthcare, and Associate Professor; and Russell K. McAllister is Chair of Anesthesiology and Professor of Anesthesiology
| | - Emily H. Garmon
- The authors are at the Department of Anesthesiology, Baylor Scott & White Medical Center, Temple, TX. The following authors are also at the Baylor College of Medicine-Temple, TX: William C. Culp, Jr., is Professor of Anesthesiology and Vice Chair of Academic Affairs; Craig J. Lilie is Assistant Professor and Associate Program Director; J. Clint Tippett is Clinical Associate Professor and Residency Program Director; Russell K. McAllister is Chair of Anesthesiology and Professor of Anesthesiology. The following authors are also at Texas A&M University College of Medicine, Temple, TX: Riley J. Hedin and Daniel W. Watkins are Cardiothoracic Anesthesiology Fellows; Emily H. Garmon is Clinical Associate Professor; Timothy M. Bittenbinder is Chair, Scott & White Board of Directors, Senior Vice President Baylor Scott & White Healthcare, and Associate Professor; and Russell K. McAllister is Chair of Anesthesiology and Professor of Anesthesiology
| | - Timothy M. Bittenbinder
- The authors are at the Department of Anesthesiology, Baylor Scott & White Medical Center, Temple, TX. The following authors are also at the Baylor College of Medicine-Temple, TX: William C. Culp, Jr., is Professor of Anesthesiology and Vice Chair of Academic Affairs; Craig J. Lilie is Assistant Professor and Associate Program Director; J. Clint Tippett is Clinical Associate Professor and Residency Program Director; Russell K. McAllister is Chair of Anesthesiology and Professor of Anesthesiology. The following authors are also at Texas A&M University College of Medicine, Temple, TX: Riley J. Hedin and Daniel W. Watkins are Cardiothoracic Anesthesiology Fellows; Emily H. Garmon is Clinical Associate Professor; Timothy M. Bittenbinder is Chair, Scott & White Board of Directors, Senior Vice President Baylor Scott & White Healthcare, and Associate Professor; and Russell K. McAllister is Chair of Anesthesiology and Professor of Anesthesiology
| | - Russell K. McAllister
- The authors are at the Department of Anesthesiology, Baylor Scott & White Medical Center, Temple, TX. The following authors are also at the Baylor College of Medicine-Temple, TX: William C. Culp, Jr., is Professor of Anesthesiology and Vice Chair of Academic Affairs; Craig J. Lilie is Assistant Professor and Associate Program Director; J. Clint Tippett is Clinical Associate Professor and Residency Program Director; Russell K. McAllister is Chair of Anesthesiology and Professor of Anesthesiology. The following authors are also at Texas A&M University College of Medicine, Temple, TX: Riley J. Hedin and Daniel W. Watkins are Cardiothoracic Anesthesiology Fellows; Emily H. Garmon is Clinical Associate Professor; Timothy M. Bittenbinder is Chair, Scott & White Board of Directors, Senior Vice President Baylor Scott & White Healthcare, and Associate Professor; and Russell K. McAllister is Chair of Anesthesiology and Professor of Anesthesiology
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Hazelton L, da Luz Dias R, Esliger M, Tibbo P, Sinha N, Njoku A, Satyanarayana S, Siddhartha S, Alexiadis-Brown P, Rahman F, Maguire H, Gray G, Bosma M, Parker D, Connolly O, Raji A, Manning A, Bagnell A, Israel Opoku Agyapong V. Exploring Current Practices, Needs, and Barriers for Expanding Distributed Medical Education and Scholarship in Psychiatry: Protocol for an Environmental Scan Using a Formal Information Search Approach and Explanatory Design. JMIR Res Protoc 2023; 12:e46835. [PMID: 38010790 DOI: 10.2196/46835] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Revised: 08/25/2023] [Accepted: 09/23/2023] [Indexed: 11/29/2023] Open
Abstract
BACKGROUND Distributed medical education (DME) offers manifold benefits, such as increased training capacity, enhanced clinical learning, and enhanced rural physician recruitment. Engaged faculty are pivotal to DME's success, necessitating efforts from the academic department to promote integration into scholarly and research activities. Environmental scanning has been used to gather, analyze, and apply information for strategic planning purposes. It helps organizations identify current practices, assess needs and barriers, and respond to emerging risks and opportunities. There are process models and conceptual frameworks developed for environmental scanning in the business and educational sectors. However, the literature lacks methodological direction on how to go about designing and implementing this strategy to guide research and practice in DME, especially in the psychiatry field. OBJECTIVE This paper presents a protocol for an environmental scanning that aims to understand current practices and identify needs and barriers that must be addressed to facilitate the integration of psychiatrists from the Dalhousie University Faculty of Medicine's distributed education sites in Nova Scotia and New Brunswick into the Department of Psychiatry, contributing for the expansion of DME in both provinces and informing strategic planning and decision-making within the organization. METHODS This protocol adopts an innovative approach combining a formal information search and an explanatory design that includes quantitative and qualitative data. About 120 psychiatrists from 8 administrative health zones of both provinces will be invited to complete an anonymous web-based survey with questions about demographics, participants' experience and interest in undergraduate, postgraduate, and continuing medical education, research and scholarly activities, quality improvement, and knowledge translation. Focus group sessions will be conducted with a purposive sample of psychiatrists to collect qualitative data on their perspectives on the expansion of DME. RESULTS Results are expected within 6 months of data collection and will inform policy options for expanding Dalhousie University's psychiatry residency and fellowship programs using the infrastructure and human resources at distributed learning sites, leveraging opportunities regionally, especially in rural areas. CONCLUSIONS This paper proposes a comprehensive environmental scan procedure adapted from existing approaches. It does this by collecting important characteristics that affect psychiatrists' desire to be involved with research and scholarly activities, which is crucial for the DME expansion. Furthermore, its concordance with the literature facilitates interpretation and comparison. The protocol's new method also fills DME information gaps, allowing one to identify insights and patterns that may shape psychiatric education. This environmental scan's results will answer essential questions about how training programs could involve therapists outside the academic core and make the most of training experiences in semiurban and rural areas. This could help other psychiatry and medical units outside tertiary care establish residency and fellowship programs. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/46835.
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Affiliation(s)
- Lara Hazelton
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Raquel da Luz Dias
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Mandy Esliger
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Philip Tibbo
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Nachiketa Sinha
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Saint John, NB, Canada
| | - Anthony Njoku
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Saint John, NB, Canada
| | | | - Sanjay Siddhartha
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Saint John, NB, Canada
| | - Peggy Alexiadis-Brown
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Saint John, NB, Canada
| | - Faisal Rahman
- Mental Health and Addictions Program, Nova Scotia Health, Antigonish, NS, Canada
| | - Hugh Maguire
- Mental Health and Addictions Program, Nova Scotia Health, Truro, NS, Canada
| | - Gerald Gray
- Mental Health and Addictions Program, Nova Scotia Health, Kentville, NS, Canada
| | - Mark Bosma
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Deborah Parker
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Owen Connolly
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Adewale Raji
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Alexandra Manning
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
- Child and Adolescent Psychiatry, IWK Health, Halifax, NS, Canada
| | - Alexa Bagnell
- Department of Psychiatry, Faculty of Medicine, Dalhousie University, Halifax, NS, Canada
- Child and Adolescent Psychiatry, IWK Health, Halifax, NS, Canada
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Bell A, Khemani E, Weera S, Henderson C, Chambers LW. Energizing scholarly activity in a regional medical campus. CANADIAN MEDICAL EDUCATION JOURNAL 2022; 13:99-101. [PMID: 35291455 PMCID: PMC8909830 DOI: 10.36834/cmej.72593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Medical education is increasingly delivered at distributed sites away from Academic Health Sciences Centres. The Council of Ontario Faculties of Medicine recommends schools develop resources and metrics to foster regional campus scholarly activity. Opportunities for distributed program trainees must support learning core skills in research and critical appraisal to comply with medical school accreditation standards and to develop their interests and skills in scholarly work for their future medical careers. We describe a scholarly activity program that is a template for distributed campuses or regional teaching sites seeking to increase learner and faculty engagement and research productivity.
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Affiliation(s)
- Amanda Bell
- Niagara Regional Campus, Michael G. DeGroote School of Medicine, Faculty of Health Sciences, McMaster University, Ontario, Canada
| | - Ekta Khemani
- Niagara Regional Campus, Michael G. DeGroote School of Medicine, Faculty of Health Sciences, McMaster University, Ontario, Canada
| | - Seddiq Weera
- Niagara Regional Campus, Michael G. DeGroote School of Medicine, Faculty of Health Sciences, McMaster University, Ontario, Canada
| | - Chris Henderson
- Niagara Regional Campus, Michael G. DeGroote School of Medicine, Faculty of Health Sciences, McMaster University, Ontario, Canada
| | - Larry W Chambers
- Niagara Regional Campus, Michael G. DeGroote School of Medicine, Faculty of Health Sciences, McMaster University, Ontario, Canada
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Laupland KB, Edwards F, Dhanani J. Determinants of research productivity during postgraduate medical education: a structured review. BMC MEDICAL EDUCATION 2021; 21:567. [PMID: 34753470 PMCID: PMC8579624 DOI: 10.1186/s12909-021-03010-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 10/29/2021] [Indexed: 05/28/2023]
Abstract
BACKGROUND Although formal participation in research is an integral and often mandatory component of clinical training programs, resulting productivity is highly variable. The objective of this review was to identify determinants of successful research performance among graduate medical education trainees. METHODS A structured review of the published literature was performed by searching PubMed, CINAHL, and EMBASE from inception through to 7 April, 2021. Articles examining graduate medical education trainee research productivity evidenced by publications in peer-reviewed journals were included. RESULTS Eighty-five articles were included of which most (66; 78%) were reported from the USA or Canada (10; 12%). A wide range of disciplines were represented with the most common being general surgery, internal medicine, orthopedic surgery, and pediatrics. Themes (number of reports) included trainee characteristics (n = 24), project characteristics (n = 8), mentoring/supervision (n = 11), and programmatic aspects (n = 57). Although variable results were observed, research productivity tended to be higher with prior research experience, later years of training, male gender, and pursuit of a postgraduate degree. Few project related aspects of success were identified. Trainee publication was associated with mentors with higher rank, publication productivity, and supportive academic environments. Training programs with organised programs/curricula including protection of time for research were associated with increased productivity as were provision of incentives or rewards but not mandatory requirements. CONCLUSION This review identifies several trainee characteristics, project and mentor aspects, and programmatic aspects associated with increased productivity that may serve as a useful resource for trainees and graduate medical education training programs.
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Affiliation(s)
- Kevin B Laupland
- Department of Intensive Care Services, Royal Brisbane and Women's Hospital, Level 3 Ned Hanlon Building, Butterfield Street, Brisbane, Queensland, 4029, Australia.
- Queensland University of Technology (QUT), Brisbane, Queensland, Australia.
| | - Felicity Edwards
- Queensland University of Technology (QUT), Brisbane, Queensland, Australia
| | - Jayesh Dhanani
- Department of Intensive Care Services, Royal Brisbane and Women's Hospital, Level 3 Ned Hanlon Building, Butterfield Street, Brisbane, Queensland, 4029, Australia
- Faculty of Medicine, University of Queensland, Brisbane, Queensland, Australia
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