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Adkins DA, Aucoin JW. Failure to fail - Factors affecting faculty decisions to pass underperforming nursing students in the clinical setting: A quantitative study. Nurse Educ Pract 2021; 58:103259. [PMID: 34856470 DOI: 10.1016/j.nepr.2021.103259] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 10/26/2021] [Accepted: 11/15/2021] [Indexed: 11/29/2022]
Abstract
AIM The purpose of the study was to explore the relationship between face-implicating factors and faculty's likelihood of failing students in the clinical setting who do not meet passing criteria. BACKGROUND Clinical nursing faculty members struggle to assign failing grades to underperforming students in the clinical setting; this is known as failure to fail. Qualitative literature has revealed common factors for failure to fail; however, quantitative studies are required to determine the extent to which those factors affect faculty's decision-making process. DESIGN A quantitative, descriptive design was used. METHODS Snowball sampling was used to recruit participants from CCNE- and ACEN-accredited nursing programs to complete an online survey. There were 353 responses to the survey (a 30% return rate) and 327 usable responses. Eligibility criteria included pre-licensure nursing faculty members who had taught in the clinical setting within the past three years. The tool used for the study was adapted from Dibble's (2014) tool, which explored face-implicating factors' impact on the transmission of bad news. RESULTS Respondents who did not commit failure to fail (F2FN) disagreed more strongly with every survey item than those who committed failure to fail (F2FY). The differences in mean scores were compared and 64% of those differences were statistically significant (p < 0.05). Respondents who did not commit failure to fail were less affected by the face-implicating factors than those who committed failure to fail. CONCLUSIONS the null hypothesis was rejected; a direct connection was found between face-implicating factors and faculty's likelihood of passing students in the clinical setting who do not meet passing criteria.
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O'donovan A, Halford WK, Walters B. Towards Best Practice Supervision of Clinical Psychology Trainees. AUSTRALIAN PSYCHOLOGIST 2020. [DOI: 10.1111/j.1742-9544.2011.00033.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Michael Shanahan E, van der Vleuten C, Schuwirth L. Conflict between clinician teachers and their students: the clinician perspective. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2020; 25:401-414. [PMID: 31641944 DOI: 10.1007/s10459-019-09933-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Accepted: 10/14/2019] [Indexed: 06/10/2023]
Abstract
The relationship between clinician teachers and their students is of major importance in medical education. However, there is little known about the effects on clinicians when conflict occurs with their students. What do clinicians perceive to be major causes of these conflicts? How do they react when and after conflict occurs? A phenomenological inquiry exploring the lived experience of 12 clinician teachers in medical schools was performed. The clinicians were selected using purposeful sampling and snowballing techniques. The interviews revolved around discussions based on episodes of conflict with medical students that the clinicians considered significant. The analysis and emergent themes were partially constructed around and informed by theories of conflict, and conflict management. A number of themes emerged from this study. Clinicians experienced that significant psychological and behavioural problems of students had a dominant impact on the likelihood and severity of conflict; these conflicts had a significant emotional impact on clinicians; though the responses to conflict varied, "avoidance" was a mechanism commonly used by clinicians and thus the assessment of attitudinal and behavioural professional issues in the workplace was problematic. This study shows how the clinician perspective to challenging student/clinician encounters impacts on the quality of education they are able to provide. We recommend medical schools consider these issues when designing their programs in order to develop and maintain clinician-teacher engagement and participation.
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Affiliation(s)
- Ernst Michael Shanahan
- Flinders University and the South Australian Health Service Adelaide, Bedford Park, SA, 5042, Australia.
| | - Cees van der Vleuten
- Department of Educational Development, Maastricht University, PO Box 616, 6200 MD, Maastricht, The Netherlands
| | - Lambert Schuwirth
- Flinders University and the South Australian Health Service Adelaide, Bedford Park, SA, 5042, Australia
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Bowen JL, Boscardin CK, Chiovaro J, Ten Cate O, Regehr G, Irby DM, O'Brien BC. A view from the sender side of feedback: anticipated receptivity to clinical feedback when changing prior physicians' clinical decisions-a mixed methods study. ADVANCES IN HEALTH SCIENCES EDUCATION : THEORY AND PRACTICE 2020; 25:263-282. [PMID: 31552531 DOI: 10.1007/s10459-019-09916-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Accepted: 08/30/2019] [Indexed: 05/23/2023]
Abstract
When physicians transition patients, the physician taking over may change the diagnosis. Such a change could serve as an important source of clinical feedback to the prior physician. However, this feedback may not transpire if the current physician doubts the prior physician's receptivity to the information. This study explored facilitators of and barriers to feedback communication in the context of patient care transitions using an exploratory sequential, qualitative to quantitative, mixed methods design. Twenty-two internal medicine residents and hospitalist physicians from two teaching hospitals were interviewed and data were analyzed thematically. A prominent theme was participants' reluctance to communicate diagnostic changes. Participants perceived case complexity and physical proximity to facilitate, and hierarchy, unfamiliarity with the prior physician, and lack of relationship to inhibit communication. In the subsequent quantitative portion of the study, forty-one hospitalists completed surveys resulting in 923 total survey responses. Multivariable analyses and a mixed-effects model were applied to survey data with anticipated receptivity as the outcome variable. In the mixed-effects model, four factors had significant positive associations with receivers' perceived receptivity: (1) feedback senders' time spent on teaching services (β = 0.52, p = 0.02), (2) receivers' trustworthiness and clinical credibility (β = 0.49, p < 0.001), (3) preference of both for shared work rooms (β = 0.15, p = 0.006), and (4) receivers being peers (β = 0.24, p < 0.001) or junior colleagues (β = 0.39, p < 0.001). This study suggests that anticipated receptivity to feedback about changed clinical decisions affects clinical communication loops. Without trusting relationships and opportunities for low risk, casual conversations, hospitalists may avoid such conversations.
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Affiliation(s)
- Judith L Bowen
- Department of Medical Education and Clinical Sciences, Spokane Academic Center, Elson S Floyd College of Medicine, Washington State University, 412 E. Spokane Falls Blvd, Spokane, WA, 99202, USA.
- Portland Veterans Affairs Health Care System, Portland, OR, USA.
| | - Christy Kim Boscardin
- Department of Medicine and Center for Faculty Educators, University of California, San Francisco, CA, USA
| | - Joseph Chiovaro
- Portland Veterans Affairs Health Care System, Portland, OR, USA
- Division of General Internal Medicine and Geriatrics, Department of Medicine, Oregon Health and Science University, Portland, OR, USA
| | - Olle Ten Cate
- Department of Medicine and Center for Faculty Educators, University of California, San Francisco, CA, USA
- Center for Research and Development of Education, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Glenn Regehr
- Department of Surgery and Centre for Health Education Scholarship, University of British Columbia, British Columbia, Canada
| | - David M Irby
- Department of Medicine and Center for Faculty Educators, University of California, San Francisco, CA, USA
| | - Bridget C O'Brien
- Department of Medicine and Center for Faculty Educators, University of California, San Francisco, CA, USA
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Guraya SY, van Mook WN, Khoshhal KI. Failure of faculty to fail failing medical students: Fiction or an actual erosion of professional standards? J Taibah Univ Med Sci 2019; 14:103-109. [PMID: 31435399 PMCID: PMC6694968 DOI: 10.1016/j.jtumed.2019.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Revised: 01/06/2019] [Accepted: 01/07/2019] [Indexed: 11/20/2022] Open
Abstract
OBJECTIVES Literature has shown that some assessors assign passing grades to medical students who, in fact, should not have passed. This inability of the faculty to fail underperforming students can jeopardise the reputation of professional programs, be it in the medical field or beyond. Simultaneously, weak students become incompetent physicians and, thus, endanger the community they serve. The impetus for conducting this systematic review was to identify barriers to faculty in failing struggling medical students. METHODS The databases of MEDLINE, Scopus, Wiley online library, Cochrane library, OVID, Taylor and Francis, CINAHL, Springer link, ProQuest, and ISI Web of knowledge were searched using Medical Subject Headings (MeSH) terms 'Faculty failure' AND 'Failing students' AND 'Failure to fail' OR 'Assessment'. The data were synthesised, and the results were analysed. RESULTS This search showed a wealth of barriers to faculty contributing to a 'failure to fail' such as their concerns about legal action and an appeals process; the stress of failing students; a lack of knowledge about proper documentation; unavailability of support, resources, and offices for faculty; absence of administrative guidelines; and complex dismissal procedures discouraging the faculty from failing students. CONCLUSION Institutional faculty development programs and training workshops should facilitate the education of supervisors and assessors for timely evaluation and regular documentation of trainee assessment. The provision of legal advice in cases of appeal and professional support by the resource and support office is emphasised.
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Affiliation(s)
- Salman Y. Guraya
- Clinical Sciences Department, College of Medicine University of Sharjah, Sharjah, United Arab Emirates
| | - Walther N.K.A. van Mook
- Department of Intensive Care, Faculty of Health, Medicine and Life Sciences (FHML), Maastricht University Medical Centre, the Netherlands
| | - Khalid I. Khoshhal
- Department of Orthopedics, College of Medicine Taibah University, Almadinah Almunawwarah, KSA
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So OW, Shaw R, O'Rourke L, Woldegabriel JT, Wade B, Quesnel M, Mori B. Clinical Instructors' Experiences Working with and Assessing Students Who Perform below Expectations in Physical Therapy Clinical Internships. Physiother Can 2019; 71:391-399. [PMID: 31762549 PMCID: PMC6855354 DOI: 10.3138/ptc-2018-0081] [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: 11/20/2022]
Abstract
Purpose: Clinical education is an integral component of the curriculum of all physical therapy (PT) entry-to-practice programmes in Canada. The literature indicates that working with and assessing students performing below expectations (SPBE) can be procedurally and emotionally difficult. Our study aimed to explore the experiences of clinical instructors (CIs) and the decision-making process involved when supervising SPBE in PT. Method: A total of 19 in-depth, semi-structured interviews were conducted with CIs, transcribed, and coded using qualitative thematic analysis. Results: Four factors appeared to be important for CIs when they were deciding how to assess SPBE: (1) features of student performance, (2) factors related to the CIs, (3) academic and clinical facility influencers, and (4) strategies and available resources. Concerns about safety and professional behaviour, a student's clinical reasoning skills, and a lack of progression were key factors that CIs considered in recommending a final grade. CIs were more likely to recommend a failing grade if there was a series of repeated incidents rather than an isolated incident. Conclusions: We make several recommendations for the student, CI, and facilities to consider to better support and facilitate the process of working with SPBE in PT clinical education.
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Affiliation(s)
- Olivia W So
- Department of Physical Therapy, University of Toronto, Toronto
| | - Rachael Shaw
- Department of Physical Therapy, University of Toronto, Toronto
| | - Liam O'Rourke
- Department of Physical Therapy, University of Toronto, Toronto
| | | | - Brittany Wade
- Department of Physical Therapy, University of Toronto, Toronto
| | - Martine Quesnel
- Department of Physical Therapy, University of Toronto, Toronto
| | - Brenda Mori
- Department of Physical Therapy, University of Toronto, Toronto
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Wilkins D, Khan M, Stabler L, Newlands F, Mcdonnell J. Evaluating the Quality of Social Work Supervision in UK Children's Services: Comparing Self-Report and Independent Observations. CLINICAL SOCIAL WORK JOURNAL 2018; 46:350-360. [PMID: 30524151 PMCID: PMC6244969 DOI: 10.1007/s10615-018-0680-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Understanding how different forms of supervision support good social work practice and improve outcomes for people who use services is nearly impossible without reliable and valid evaluative measures. Yet the question of how best to evaluate the quality of supervision in different contexts is a complicated and as-yet-unsolved challenge. In this study, we observed 12 social work supervisors in a simulated supervision session offering support and guidance to an actor playing the part of an inexperienced social worker facing a casework-related crisis. A team of researchers analyzed these sessions using a customized skills-based coding framework. In addition, 19 social workers completed a questionnaire about their supervision experiences as provided by the same 12 supervisors. According to the coding framework, the supervisors demonstrated relatively modest skill levels, and we found low correlations among different skills. In contrast, according to the questionnaire data, supervisors had relatively high skill levels, and we found high correlations among different skills. The findings imply that although self-report remains the simplest way to evaluate supervision quality, other approaches are possible and may provide a different perspective. However, developing a reliable independent measure of supervision quality remains a noteworthy challenge.
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Affiliation(s)
| | - Munira Khan
- The Tilda Goldberg Centre for Social Work and Social Care, University of Bedfordshire, Luton, UK
| | | | - Fiona Newlands
- The Tilda Goldberg Centre for Social Work and Social Care, University of Bedfordshire, Luton, UK
| | - John Mcdonnell
- Children’s Services, London Borough of Islington, London, UK
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Cuncic C, Regehr G, Frost H, Bates J. It's all about relationships : A qualitative study of family physicians' teaching experiences in rural longitudinal clerkships. PERSPECTIVES ON MEDICAL EDUCATION 2018; 7:100-109. [PMID: 29532346 PMCID: PMC5889386 DOI: 10.1007/s40037-018-0416-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
INTRODUCTION The relationship between preceptor and trainee is becoming recognized as a critical component of teaching, in particular in the negotiation of feedback and in the formation of professional identity. This paper elaborates on the nature of the relationships between preceptor and student that evolve in the context of rural longitudinal integrated clerkships (LICs). METHODS We drew on constructivist grounded theory for the research approach. We interviewed nine LIC family practice preceptors from three sites at one educational institution. We adapted the interview framework based on early findings. We analyzed the data through a constant comparative process. We then drew on concepts of relationship-based learning as sensitizing concepts in a secondary analysis. RESULTS We constructed three themes from the data. First, preceptors developed trusting professional and personal relationships with students over time. These relationships expanded to include friendship, advocacy, and ongoing contact beyond the clerkship year. Second, preceptors' approach to teaching was anchored in the relationship with an understanding of the individual student. Third, preceptors set learning goals collaboratively with their students, based not only on program objectives, but also with the student as a future physician in mind. DISCUSSION Our findings suggest that rural family medicine preceptors developed engaged and trusting relationships with their students over time. These relationships imbued all activities of teaching and learning with an individual and personal focus. This orientation may be a key factor in supporting the learning outcomes demonstrated for students studying in rural LICs.
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Affiliation(s)
- Cary Cuncic
- Centre for Health Education Scholarship, departments of Medicine, Surgery and Family Medicine, University of British Columbia, Vancouver, BC, Canada.
| | - Glenn Regehr
- Centre for Health Education Scholarship, departments of Medicine, Surgery and Family Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Heather Frost
- Centre for Health Education Scholarship, departments of Medicine, Surgery and Family Medicine, University of British Columbia, Vancouver, BC, Canada
| | - Joanna Bates
- Centre for Health Education Scholarship, departments of Medicine, Surgery and Family Medicine, University of British Columbia, Vancouver, BC, Canada
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Tucker C, Choby B, Moore A, Parker RS, Zambetti BR, Naids S, Scott J, Loome J, Gaffney S, Cianciolo AT, Hoffman LA, Kohn JR, O'Sullivan PS, Trowbridge RL. Teachers as Learners: Developing Professionalism Feedback Skills via Observed Structured Teaching Encounters. TEACHING AND LEARNING IN MEDICINE 2017; 29:373-377. [PMID: 29020524 DOI: 10.1080/10401334.2017.1365001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This Conversations Starter article presents a selected research abstract from the 2017 Association of American Medical Colleges Southern Region Group on Educational Affairs annual spring meeting. The abstract is paired with the integrative commentary of 4 experts who shared their thoughts stimulated by the study. These thoughts explore the value of the Observed Structured Teaching Encounter in providing structured opportunities for medical students to engage with the complexities of providing peer feedback on professionalism.
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Affiliation(s)
- Constance Tucker
- a Office of the Provost , Oregon Health & Science University , Portland , Oregon , USA
| | - Beth Choby
- b Department of Medical Education , University of Tennessee Health Sciences Center , Memphis , Tennessee , USA
| | - Andrew Moore
- c Graduate Medical Education , University of Tennessee ; Memphis , Tennessee , USA
| | - Robert Scott Parker
- d University of Tennessee College of Medicine , Chattanooga , Tennessee , USA
| | - Benjamin R Zambetti
- e Department of Cardiovascular Surgery , University of Tennessee Health Science Center , Memphis , Tennessee , USA
| | - Sarah Naids
- c Graduate Medical Education , University of Tennessee ; Memphis , Tennessee , USA
| | - Jillian Scott
- f Department of Surgery , University of Tennessee College of Medicine , Chattanooga , Tennessee , USA
| | - Jennifer Loome
- c Graduate Medical Education , University of Tennessee ; Memphis , Tennessee , USA
| | - Sierra Gaffney
- g Department of Health Policy and Management , Emory University , Atlanta , Georgia , USA
| | - Anna T Cianciolo
- h Department of Medical Education , Southern Illinois University School of Medicine , Springfield , Illinois , USA
| | - Leslie A Hoffman
- i Department of Anatomy and Cell Biology , Indiana University School of Medicine , Fort Wayne , Indiana , USA
| | - Jaden R Kohn
- j Baylor College of Medicine , Houston , Texas , USA
| | - Patricia S O'Sullivan
- k Office of Medical Education , University of California San Francisco , San Francisco , California , USA
| | - Robert L Trowbridge
- l Department of Medicine , Tufts University School of Medicine , Portland , Maine , USA
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Terry J, Gonsalvez C, Deane FP. Brief Online Training with Standardised Vignettes Reduces Inflated Supervisor Ratings of Trainee Practitioner Competencies. AUSTRALIAN PSYCHOLOGIST 2017; 52:130-139. [PMID: 30122787 PMCID: PMC6084334 DOI: 10.1111/ap.12250] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2016] [Revised: 07/17/2016] [Accepted: 08/30/2016] [Indexed: 11/26/2022]
Abstract
Objective Supervisor assessments of trainee competence are integral to ensuring that clinical psychology trainees reach competency benchmarks. The commonly used Clinical Psychology Practicum Competencies Rating Scale (CΨPRS) has been shown to elicit inflated ratings of competency. Hence, the aim of this study is to examine whether brief supervisor training reduces ratings by providing objective criteria with which supervisors can assess trainee competency. Method The ratings included were of 124 psychology trainees from nine Australian university clinical programmes. Of 170 supervisors, 32 completed the online training immediately prior to commencing the CΨPRS. Training required supervisors to rate the competency level described in five standardised vignettes (Beginner through to Competent). Vignette ratings, as determined by a panel of expert supervisors, were provided as feedback. A sixth calibration vignette was also rated (no feedback provided). Firstly, CΨPRS ratings from the trained and untrained supervisors were compared. Secondly, the difference between supervisor and expert ratings of the calibration vignettes were compared across trained and untrained groups. Results Trained supervisors provided lower CΨPRS ratings than untrained supervisors. In addition, trained supervisors (vs untrained supervisors) provided ratings of the calibration vignette that more accurately matched the ratings provided by the expert panel. Conclusions Brief online training using standardised vignettes was associated with lower CΨPRS ratings. The standardised vignettes helped calibrate supervisors’ ratings and likely attuned supervisors to the skills and competency levels that are expected at particular developmental stages. As a consequence, training appeared to reduce ratings, arguably resulting in more accurate assessments of trainee performance.
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Affiliation(s)
- Josephine Terry
- School of Social Sciences and Psychology Western Sydney University
| | - Craig Gonsalvez
- School of Social Sciences and Psychology Western Sydney University
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Ybrandt H, Sundin EC, Capone G. Trainee therapists’ views on the alliance in psychotherapy and supervision: a longitudinal study. BRITISH JOURNAL OF GUIDANCE & COUNSELLING 2016. [DOI: 10.1080/03069885.2016.1153037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Calvert FL, Crowe TP, Grenyer BFS. Dialogical reflexivity in supervision: An experiential learning process for enhancing reflective and relational competencies. CLINICAL SUPERVISOR 2016. [DOI: 10.1080/07325223.2015.1135840] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Norman KE. Clinician's Commentary on Dawes et al.(1.). Physiother Can 2014; 66:177-8. [PMID: 24799755 DOI: 10.3138/ptc.2013-26-cc] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Qadan L, Al-Ozairi E, Ayed A, Huang G. Avoiding honest feedback: discordance between formal evaluations and candid assessments of Kuwaiti PBL students. MEDICAL TEACHER 2013; 35:459-464. [PMID: 23477472 DOI: 10.3109/0142159x.2013.774337] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
BACKGROUND Problem-based learning (PBL) allows faculty to observe students interact and solve problems. Thus, it represents a prime opportunity to provide authentic feedback on learners' knowledge, skills, and attitudes. However, we are concerned that PBL faculty do not accurately convey feedback to students. METHODS To assess the difference between formal evaluations and candid assessments of student performance, we conducted a study of 178 preclinical medical students at Kuwait University. We quantitatively compared PBL evaluations of students with candid assessments of students' competence as obtained from structured interviews with 19 PBL facilitators. We also compared facilitators' comments on the module evaluations with candid comments solicited during the interviews. RESULTS We did not find a strong quantitative or qualitative correlation between faculty feedback and their candid impressions of student performance. Thematic analysis of the comments disclosed multiple factors that influenced the accuracy and specificity of faculty feedback. CONCLUSIONS Systematic discrepancies between feedback given to students and actual assessments of their performance can result in false reassurance of competence, which undermines our curricular efforts and prevents the trainee from achieving his or her full potential.
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Affiliation(s)
- Laila Qadan
- Faculty of Medicine, Kuwait University, Safat, Kuwait.
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Larocque S, Luhanga FL. Exploring the issue of failure to fail in a nursing program. Int J Nurs Educ Scholarsh 2013; 10:/j/ijnes.2013.10.issue-1/ijnes-2012-0037/ijnes-2012-0037.xml. [PMID: 23735436 DOI: 10.1515/ijnes-2012-0037] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
A study using a qualitative descriptive design was undertaken to explore the issue of "failure to fail" in a nursing program. Individual in-depth interviews were conducted with nursing university faculty members, preceptors, and faculty advisors (n=13). Content analysis was used to analyze the data. Results indicate that: (a) failing a student is a difficult process; (b) both academic and emotional support are required for students and preceptors and faculty advisors; (c) there are consequences for programs, faculty, and students when a student has failed a placement; (d) at times, personal, professional, and structural reasons exist for failing to fail a student; and (e) the reputation of the professional program can be diminished as a result of failing to fail a student. Recommendations for improving assessment, evaluation, and intervention with a failing student include documentation, communication, and support. These findings have implications for improving the quality of clinical experiences.
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Affiliation(s)
- Sylvie Larocque
- Laurentian University of Sudbury, Greater Sudbury, ON P3E 2C6, Canada.
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Brown-Rice KA, Furr S. Preservice Counselors' Knowledge of Classmates' Problems of Professional Competency. JOURNAL OF COUNSELING AND DEVELOPMENT 2013. [DOI: 10.1002/j.1556-6676.2013.00089.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
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Cleland JA, Knight LV, Rees CE, Tracey S, Bond CM. Is it me or is it them? Factors that influence the passing of underperforming students. MEDICAL EDUCATION 2008; 42:800-9. [PMID: 18715477 DOI: 10.1111/j.1365-2923.2008.03113.x] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
CONTEXT Research has found that clinical assessments do not always accurately reflect medical student performance. Barriers to failing underperformance in students have been identified in other vocational settings. Is 'failure to fail' an issue for medical educators in the UK, and, if so, what are its determinants? METHODS We carried out a qualitative focus group study exploring the views of medical educators (general practitioners, hospital doctors and non-clinical tutors) from two different UK medical schools. To make sense of a potential multitude of factors impacting on failure to fail, we selected the integrative model of behavioural prediction to underpin our data collection and analysis. RESULTS Ten focus groups were carried out with 70 participants. Using both theory and data-driven framework analysis, we identified six main themes relevant to the integrative model of behavioural prediction. These are: tutor attitudes towards an individual student; tutor attitudes towards failing a student; normative beliefs and motivation to comply; efficacy beliefs (self-efficacy); skills and knowledge, and environmental constraints. DISCUSSION Many different factors impact on medical educators' failure to report underperformance in students. There are conflicts between these factors and the need to report competence accurately (i.e. duty to protect the public). Although some of the barriers identified are similar to those found in previous studies, using a theory-based approach added value in that it facilitated a richer exploration of failure to fail. Insights offered in this study will be used to plan a questionnaire study and subsequent intervention to support medical educators in accurately reporting underperformance in students.
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Affiliation(s)
- Jennifer A Cleland
- Department of General Practice and Primary Care, University of Aberdeen, Aberdeen, UK.
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