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Zoukar I, Dashash M. Using a Modified Delphi Method for Identifying Competencies in a Syrian Undergraduate Neonatology Curriculum. Matern Child Health J 2023; 27:1921-1929. [PMID: 37289293 DOI: 10.1007/s10995-023-03719-z] [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] [Accepted: 05/21/2023] [Indexed: 06/09/2023]
Abstract
OBJECTIVES There is a global shift toward competency-based medical education (CBME) to equip medical students with essential competencies required to meet healthcare needs. Syrian medical faculties lack a formal competency-based neonatology curriculum for undergraduate medical students. Therefore, our study aimed to develop a national consensus on the required competencies for undergraduate neonatology curricula in Syria. METHODS This study took place at the Syrian Virtual University between October 2021 and November 2021. The authors used a modified Delphi method to determine neonatal medicine competencies. A focus group of three neonatologists and one medical education professional identified initial competencies. In the first Delphi round, 75 pediatric clinicians rated the competencies on a 5-point Likert scale. After formulating the results, a second Delphi round was conducted with 15 neonatal medicine experts. To reach an agreement, 75% of participants must score a competency as 4 or 5. Correlation coefficients were used to compare clinicians' first Delphi ratings with experts' second Delphi ratings. Competencies with a weighted response greater than 4.2 were considered essential. RESULTS A list of 37 competencies (22 knowledge, 6 skills, and 9 attitudes) was identified after the second Delphi round, of which 24 were considered core competencies (11 knowledge, 5 skills, and 8 attitudes). The correlation coefficient for knowledge, skills, and attitudes competencies was 0.90, 0.96, and 0.80, respectively. CONCLUSIONS Neonatology competencies have been identified for medical undergraduates. These competencies aim to help students achieve the required skills and enable decision-makers to implement CBME in Syria and similar countries.
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Affiliation(s)
- Imad Zoukar
- Department of Pediatrics, Mediclinic Al Noor Hospital, Abu Dhabi, UAE.
- Syrian Virtual University, Damascus, Syria.
| | - Mayssoon Dashash
- Syrian Virtual University, Damascus, Syria
- Pediatric Dentistry Department, Faculty of Dentistry, Damascus University, Damascus, Syria
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Yartsev A, Yang F. Intensive Care Unit Critical Incident Analysis as an Objective Tool to Select Content for a Simulation Curriculum. Simul Healthc 2023; 18:279-282. [PMID: 35405717 DOI: 10.1097/sih.0000000000000661] [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: 11/26/2022]
Abstract
INTRODUCTION The intensive care unit (ICU) offers a unique environment where emergency events are frequent, high-stakes, and carefully documented, which makes it an ideal setting to research the specific technical skills, which are deployed during such events. This study aimed to describe a method of objectively identifying skills and scenarios, which should be prioritized for inclusion in a simulation curriculum. METHOD A retrospective audit of all available critical incident data (11 months) from a 36-bed tertiary ICU was performed. Code blue events were analyzed. Data were coded according to a rubric based on Le Guen and Costa-Pinto ( Intern Med J. 2020;51(8):1298-1303) tallying the occurrence of common ICU scenarios and skills.Documentation of each event was analyzed. The frequency with which a skill or scenario appeared in these events was considered as "high frequency" if it occurred in more than 20% of the events.The trainees' confidence in a particular skill was assessed by means of a self-assessment survey questionnaire (based on an anchored 6-item rating scale). RESULTS One hundred twenty-one incidents were analyzed. Sixteen were eliminated because of insufficient documentation. The most common skills during these emergency events were familiarity with the advanced life support trolley (34% of events), electrocardiogram (ECG) rhythm strip interpretation (32.4%), and the operation of an external defibrillator (29.5%).Most trainees surveyed are preparing to undergo training in anesthesia (58%) or intensive care (28%). Specialized areas of expertise (troubleshooting an extra-corporeal membrane oxygenation (ECMO) circuit or intra-aortic balloon pump) had the lowest confidence scores (average scores of 0.81 and 0.72). CONCLUSIONS We highlighted a novel, reproducible, and objective methodology by which critical incident data can be integrated with trainee self-assessment to generate a targeted simulation curriculum.
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Affiliation(s)
- Alex Yartsev
- From the Westmead Intensive Care Unit, Westmead Hospital, University of Sydney, Sydney, Australia
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3
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Mitsuyama T, Son D, Eto M, Kikukawa M. Competency lists for urban general practitioners/family physicians using the modified Delphi method. BMC PRIMARY CARE 2023; 24:21. [PMID: 36653776 PMCID: PMC9849100 DOI: 10.1186/s12875-023-01984-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/18/2022] [Accepted: 01/16/2023] [Indexed: 01/20/2023]
Abstract
BACKGROUND In recent years, the growing global urbanization and urban population have resulted in the emergence of various health problems unique to urban areas. Therefore, training general practitioners and family physicians who can tackle the complex health problems of urban areas and improve the health of urban people is one of the most important issues of our time. However, findings on competencies for urban general practitioners (GP) and family physicians (FP) were limited. This study aimed to identify their comprehensive and content-validated list of competencies. METHODS We used the modified Delphi method to develop a content-validated competency list. First, we analyzed and synthesized the competencies extracted from the literature review using qualitative thematic analysis methods to create an initial competency list of 34 items. We then assembled 39 expert panelists in four groups of study participants: physicians, nurses, patients, and medical education specialists. The expert panelists were asked to indicate their level of agreement with the lists and provide revised comments on the description of each competency via a web-based questionnaire. Their responses were analyzed quantitatively and qualitatively by the research team and used to revise the list. These processes were repeated, and the survey was completed when it was determined that consensus had been reached. RESULTS Three rounds of Delphi were conducted. 39 responded in the first round, 38 in the second round, and 36 in the third round. The initial list of competencies was revised and consolidated from 34 to 14 items in the first round, bringing the total to 20 items along with six new items proposed by the panelists. In the second round, it was revised and consolidated into a list of 18 items. In the third round, all 18 items were considered to have been agreed upon by the panelists, so the survey was closed. CONCLUSION We identified a comprehensive 18-item list of competencies for urban GP/FP in a content-validated manner. Several are newly discovered competencies in this study. The findings of this study will be useful for the future training of urban GP/FP and for solving urban health problems.
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Affiliation(s)
- Toshichika Mitsuyama
- grid.26999.3d0000 0001 2151 536XDepartment of Medical Education Studies, International Research Center for Medical Education, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan
| | - Daisuke Son
- grid.26999.3d0000 0001 2151 536XDepartment of Medical Education Studies, International Research Center for Medical Education, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan ,grid.265107.70000 0001 0663 5064Department of Community-based Family Medicine, Faculty of Medicine, Tottori University, Yonago, 683-8503 Japan
| | - Masato Eto
- grid.26999.3d0000 0001 2151 536XDepartment of Medical Education Studies, International Research Center for Medical Education, Graduate School of Medicine, The University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan
| | - Makoto Kikukawa
- grid.177174.30000 0001 2242 4849Department of Medical Education, Faculty of Medical Sciences, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 812-8582 Japan
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Fujikawa H, Mitsuyama T, Son D, Izumiya M, Eto M. Development and Validation of a Performance Assessment Checklist Scale for Vaccine Administration. Intern Med 2022; 61:2295-2300. [PMID: 35598994 PMCID: PMC9424100 DOI: 10.2169/internalmedicine.9268-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objective Vaccination technique is a crucial skill for medical trainees to learn, especially in the current coronavirus disease 2019 pandemic. To this end, validated assessment tools are essential in teaching appropriate techniques. However, valid instruments for assessing vaccine administration skills have not yet been developed. We therefore explored the development and validation of an assessment tool for vaccination techniques based on expert consensus. Methods We implemented a modified Delphi process to develop a vaccination technique assessment tool. We then conducted a validation study to establish the reliability and validity of the tool. Results Two rounds of the modified Delphi process were performed to generate a 19-item, vaccination performance assessment checklist. In the validation study, the linear weighted kappa value for inter-rater reliability of the overall checklist score was 0.725. Spearman's correlation coefficient between the mean checklist score and the global rating was 0.98 (p<0.01). Conclusions This is a pioneering study examining the development and validation of an assessment tool for vaccine administration techniques. The tool will be widely used in vaccination-related education.
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Affiliation(s)
- Hirohisa Fujikawa
- Department of Medical Education Studies, International Research Center for Medical Education, Graduate School of Medicine, the University of Tokyo, Japan
| | - Toshichika Mitsuyama
- Department of Medical Education Studies, International Research Center for Medical Education, Graduate School of Medicine, the University of Tokyo, Japan
| | - Daisuke Son
- Department of Medical Education Studies, International Research Center for Medical Education, Graduate School of Medicine, the University of Tokyo, Japan
- Department of Community-based Family Medicine, Faculty of Medicine, Tottori University, Japan
| | - Masashi Izumiya
- Department of Medical Education Studies, International Research Center for Medical Education, Graduate School of Medicine, the University of Tokyo, Japan
| | - Masato Eto
- Department of Medical Education Studies, International Research Center for Medical Education, Graduate School of Medicine, the University of Tokyo, Japan
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Stollenwerk MM, Gustafsson A, Edgren G, Gudmundsson P, Lindqvist M, Eriksson T. Core competencies for a biomedical laboratory scientist - a Delphi study. BMC MEDICAL EDUCATION 2022; 22:476. [PMID: 35725406 PMCID: PMC9208704 DOI: 10.1186/s12909-022-03509-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Accepted: 05/30/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND After completing university education, biomedical laboratory scientists work in clinical laboratories, in biomedical research laboratories, in biotech, and in pharmaceutical companies. Laboratory diagnostics have undergone rapid development over the recent years, with the pace showing no signs of abatement. This rapid development challenges the competence of the staff and will most certainly influence the education of future staff. This study aimed to examine what was considered the necessary competencies needed to pursue a career as a biomedical laboratory scientist. METHODS A modified Delphi technique was used, with the panel of experts expressing their views in a series of three questionnaire. Consensus was defined as the point which 75 % or more of the panel participants agreed that a particular competency was necessary. RESULTS The study highlights the perceived importance of mostly generic competencies that relate to quality, quality assurance, and accuracy, as well as different aspects of safety, respect, trustworthiness (towards patients/clients and colleagues), and communication skills. The results also stress the significance of self-awareness and professionality. CONCLUSIONS We identified important competencies for biomedical laboratory scientists. Together with complementary information from other sources, i.e., guidelines, laws, and scientific publications, the competencies identified can be used as learning outcomes in a competency-based education to provide students with all the competencies needed to work as professional biomedical laboratory scientists.
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Affiliation(s)
- Maria M Stollenwerk
- Department of Biomedical Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
- Biofilms Research Center for Biointerfaces, Malmö University, Malmö, Sweden
| | - Anna Gustafsson
- Department of Biomedical Science, Faculty of Health and Society, Malmö University, Malmö, Sweden.
- Biofilms Research Center for Biointerfaces, Malmö University, Malmö, Sweden.
| | - Gudrun Edgren
- Center for Teaching and Learning, Faculty of Medicine, Lund University, Lund, Sweden
| | - Petri Gudmundsson
- Department of Biomedical Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
- Biofilms Research Center for Biointerfaces, Malmö University, Malmö, Sweden
| | | | - Tommy Eriksson
- Department of Biomedical Science, Faculty of Health and Society, Malmö University, Malmö, Sweden
- Biofilms Research Center for Biointerfaces, Malmö University, Malmö, Sweden
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Kessoku T, Uneno Y, Urushibara-Miyachi Y, Oya K, Kusakabe A, Nakajima A, Kobayashi N, Ichikawa Y, Miyashita M, Muto M, Mori M, Morita T. Development of a list of competencies and entrustable professional activities for resident physicians during death pronouncement: a modified Delphi study. BMC MEDICAL EDUCATION 2022; 22:119. [PMID: 35193555 PMCID: PMC8861606 DOI: 10.1186/s12909-022-03149-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/13/2021] [Accepted: 01/31/2022] [Indexed: 05/16/2023]
Abstract
BACKGROUND The appropriate delivery of death pronouncements potentially affects bereaved families' wellbeing positively. Although younger physicians need to learn the competencies and entrustable professional activities (EPAs) to conduct death pronouncement independently, both of which have not been clarified. Therefore, this study aimed to develop a list of competencies and EPAs necessary for death pronouncement practice, which resident physicians need to acquire by the end of their residency training (postgraduate year 2). METHODS An anonymous modified Delphi study was conducted with a panel of 31 experts. The experts were invited online from general wards in hospitals with resident physicians across Japan to participate in the study using the purposive and snowball sampling method. A non-anonymous web conference was held with three additional external evaluators to finalize the item list. The consensus criterion was defined as a mean response of at least 4 points on a 5-point Likert scale for each competency and EPA item and a rating of 4 or 5 points by at least 80% of the participants. RESULTS Consensus was achieved, with consistently high levels of agreement across panel members, on 11 competencies and 9 EPA items. Additionally, a correspondence matrix table between competencies and EPAs was developed. CONCLUSIONS This study clarified the standardized educational outcomes as competencies in death pronouncement practice and the unit of professional practice of physicians who can perform this independently (EPAs), serving as a blueprint to aid the development of an educational model and evaluation method for clinical educational institutions and developers of medical school curriculums.
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Affiliation(s)
- Takaomi Kessoku
- Department of Palliative Medicine, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Yu Uneno
- Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan.
| | | | - Kiyofumi Oya
- Department of Transitional and Palliative Care, Aso Iizuka Hospital, Fukuoka, 820-8505, Japan
| | - Akihiko Kusakabe
- Department of General Medicine, Yokohama City University School of Medicine, Yokohama, 236-0004, Japan
| | - Atsushi Nakajima
- Department of Gastroenterology and Hepatology, Yokohama City University Graduate School of Medicine, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
| | - Noritoshi Kobayashi
- Department of Oncology, Yokohama City University Hospital, Yokohama, 236-0004, Japan
| | - Yasushi Ichikawa
- Department of Palliative Medicine, Yokohama City University Hospital, 3-9 Fukuura, Kanazawa-ku, Yokohama, 236-0004, Japan
- Department of Oncology, Yokohama City University Hospital, Yokohama, 236-0004, Japan
| | - Mitsunori Miyashita
- Department of Palliative Nursing, Health Sciences, Tohoku University Graduate School of Medicine, Sendai, 980-8575, Japan
| | - Manabu Muto
- Department of Therapeutic Oncology, Graduate School of Medicine, Kyoto University, Kyoto, 606-8507, Japan
| | - Masanori Mori
- Department of Palliative and Supportive Care, Seirei Mikatahara General Hospital, Hamamatsu, 433-8558, Japan
| | - Tatsuya Morita
- Department of Palliative and Supportive Care, Seirei Mikatahara General Hospital, Hamamatsu, 433-8558, Japan
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Scodras S, Alsbury-Nealy K, Colquhoun H, Yeung E, Jaglal SB, Salbach NM. Methodological approaches for identifying competencies for the physiotherapy profession: a scoping review. DISCOVER EDUCATION 2022; 1:9. [PMID: 35813902 PMCID: PMC9258964 DOI: 10.1007/s44217-022-00008-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 06/13/2022] [Indexed: 02/02/2023]
Abstract
Physiotherapy competencies inform the education and regulation of the profession. Many different methods appear to be used to identify competencies and there is no consensus on optimal methods to identify competencies. The purpose of this review is to synthesize the methodological approaches used to identify competencies for the physiotherapy profession and summarize the nature of those competencies. We searched MEDLINE, EMBASE, CINAHL, and the grey literature from inception to June 2020. Two independent reviewers screened for empirical peer-reviewed articles that aimed to identify professional physiotherapy competencies. General study characteristics, competency characteristics (e.g., target practice area), and methodological characteristics (e.g., study population, data collection and analysis method for each methodological step) were extracted. Descriptive statistics and narrative synthesis were performed. Of the 9529 references screened, 38 articles describing 35 studies published between 1980 and 2020 were included. Orthopaedics (20.0%) was the most commonly targeted area of practice. Studies used one to eight methodological steps whose objective was to generate (16 studies), validate (18 studies), assign value (21 studies), refine (10 studies), or triangulate (3 studies) competencies, or to address multiple objectives (10 studies). The most commonly used methods were surveys to assign value (n = 20, 95%), and group techniques to refine competencies (n = 7, 70%). Physiotherapists with experience in the area of competence was the most commonly consulted stakeholder group (80% of studies). This review can provide methodological guidance to stakeholders such as educators and regulators that aim to identify professional competencies in the future. Supplementary Information The online version contains supplementary material available at 10.1007/s44217-022-00008-9.
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Affiliation(s)
- Stephanie Scodras
- Temerty Faculty of Medicine, Rehabilitation Sciences Institute, University of Toronto, 500 University Avenue, Suite 160, Toronto, ON M5G 1V7 Canada
| | - Kyla Alsbury-Nealy
- Temerty Faculty of Medicine, Rehabilitation Sciences Institute, University of Toronto, 500 University Avenue, Suite 160, Toronto, ON M5G 1V7 Canada
| | - Heather Colquhoun
- Temerty Faculty of Medicine, Rehabilitation Sciences Institute, University of Toronto, 500 University Avenue, Suite 160, Toronto, ON M5G 1V7 Canada ,Department of Occupational Science and Occupational Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON Canada
| | - Euson Yeung
- Temerty Faculty of Medicine, Rehabilitation Sciences Institute, University of Toronto, 500 University Avenue, Suite 160, Toronto, ON M5G 1V7 Canada ,Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON Canada
| | - Susan B. Jaglal
- Temerty Faculty of Medicine, Rehabilitation Sciences Institute, University of Toronto, 500 University Avenue, Suite 160, Toronto, ON M5G 1V7 Canada ,Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON Canada ,University Health Network, KITE Research Institute, Toronto, ON Canada
| | - Nancy M. Salbach
- Temerty Faculty of Medicine, Rehabilitation Sciences Institute, University of Toronto, 500 University Avenue, Suite 160, Toronto, ON M5G 1V7 Canada ,Department of Physical Therapy, Temerty Faculty of Medicine, University of Toronto, Toronto, ON Canada ,University Health Network, KITE Research Institute, Toronto, ON Canada
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Khan T, Mosgrove F, Wass V. Unknown unknowns: can bringing patients' lived experience of long term conditions into curriculum design help our future doctors offer more holistic, socially accountable care? EDUCATION FOR PRIMARY CARE 2021; 32:322-325. [PMID: 34644518 DOI: 10.1080/14739879.2021.1968319] [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: 10/20/2022]
Abstract
Understanding the holistic impact of long-term conditions (LTCs) on a patient, due to their high prevalence, morbidity, mortality and cost, is an important part of the primary care undergraduate medicine curriculum. Increasingly, we set learning outcomes for our students anticipating what the patient would want them to know. But are our expectations congruent with what patients would want them to know? In this leading article, we propose that patient involvement in curriculum design remains inadequate. We base our argument on (1) an existing strong theoretical premise that increasing patient incorporation enhances the delivery of medical education, (2) recommendations from major health organisations, our regulator and leading healthcare educationalists and (3) a growing body of evidence that what is important to physicians may not reflect what is important to patients. We advocate that patient involvement in curriculum design will result in a better understanding of how LTCs affect their physical, psychological and social health and of their journey through health care and community support services. This learning is essential, but unfortunately often overlooked, if we are to ensure that students in their future roles plan patient care using an empathic, holistic, patient-centred and socially accountable approach.
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Affiliation(s)
- Taha Khan
- General Practice and Community Medical Education, University of Aberdeen Medical School, Aberdeen, Scotland
| | - Fiona Mosgrove
- General Practice and Community Medical Education, University of Aberdeen Medical School, Aberdeen, Scotland
| | - Valerie Wass
- General Practice and Community Medical Education, University of Aberdeen Medical School, Aberdeen, Scotland
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Naidoo N, Azar AJ, Khamis AH, Gholami M, Lindsbro M, Alsheikh-Ali A, Banerjee Y. Design, Implementation, and Evaluation of a Distance Learning Framework to Adapt to the Changing Landscape of Anatomy Instruction in Medical Education During COVID-19 Pandemic: A Proof-of-Concept Study. Front Public Health 2021; 9:726814. [PMID: 34568264 PMCID: PMC8460872 DOI: 10.3389/fpubh.2021.726814] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 08/06/2021] [Indexed: 12/23/2022] Open
Abstract
This study presents the design of a DL-framework to deliver anatomy teaching that provides a microfiche of the onsite anatomy learning experience during the mandated COVID-19 lockdown. First, using nominal-group technique, we identified the DL learning theories to be employed in blueprinting the DL-framework. Effectiveness of the designed DL-framework in anatomy teaching was demonstrated using the exemplar of the Head and Neck (H&N) course during COVID-19 lockdown, in the pre-clerkship curriculum at our medical school. The dissemination of the DL-framework in the anatomy course was informed by the Analyse, Design, Develop, Implement, and Evaluate (ADDIE) model. The efficiency of the DL-framework was evaluated using the first two levels of Kirkpatrick's model. Versatility of the DL-framework was demonstrated by aligning its precepts with individual domains of key learning outcomes framework. The framework's blueprint was designed amalgamating principles of: Garrison's community inquiry, Siemens' connectivism and Harasim's online-collaborative-learning; and improved using Anderson's DL-model. Following the implementation of the DL-framework in the H&N course informed by ADDIE, the framework's efficiency was evaluated. In total, 70% students responded to the survey assessing perception toward DL (Kirkpatrick's Level: 1). Descriptive analysis of the survey results showed that the DL-framework was positively received by students and attested that students had an enriched learning experience, which promoted collaborative-learning and student-autonomy. For, Kirkpatrick's Level: 2 i.e., cognitive development, we compared the summative assessment performance in the H&N course across three cohort of students. The results show that the scores of the cohort, which experienced the course entirely through DL modality was statistically higher (P < 0.01) than both the other cohorts, indicating that shift to DL did not have an adverse effect on students' learning. Using Bourdieu's Theory of Practice, we showed that the DL-framework is an efficient pedagogical approach, pertinent for medical schools to adopt; and is versatile as it attests to the key domains of students' learning outcomes in the different learning outcomes framework. To our knowledge this is the first-study of its kind where a rationale and theory-guided approach has been availed not only to blueprint a DL framework, but also to implement it in the MBBS curriculum.
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Affiliation(s)
- Nerissa Naidoo
- College of Medicine and Health Sciences, Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, United Arab Emirates
| | - Aida J. Azar
- College of Medicine and Health Sciences, Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, United Arab Emirates
| | - Amar Hassan Khamis
- College of Medicine and Health Sciences, Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, United Arab Emirates
| | - Mandana Gholami
- College of Medicine and Health Sciences, Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, United Arab Emirates
| | - Marjam Lindsbro
- College of Medicine and Health Sciences, Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, United Arab Emirates
| | - Alawi Alsheikh-Ali
- College of Medicine and Health Sciences, Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, United Arab Emirates
- Dubai Health Authority (DHA) Building, Dubai, United Arab Emirates
| | - Yajnavalka Banerjee
- College of Medicine and Health Sciences, Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU), Dubai, United Arab Emirates
- Centre for Medical Education, University of Dundee, Dundee, United Kingdom
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Tanaka A, Kondo T, Urushibara-Miyachi Y, Maruyama S, Nishigori H. Development of entrustable professional activities for residents rotating nephrology department in a Japanese university hospital: a Delphi study. BMJ Open 2021; 11:e047923. [PMID: 34348951 PMCID: PMC8340278 DOI: 10.1136/bmjopen-2020-047923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
OBJECTIVES Training strategies regarding entrustable professional activities (EPAs) vary from country to country; one such strategy is for residents. However, there are no reports of EPAs developed for residents who rotate to the nephrology departments. We aimed to construct such EPAs, which could be generalised to other institutions. DESIGN Purposive design and a modified Delphi method to build consensus. SETTING The department of nephrology in a university hospital in Aichi Prefecture, Japan. PARTICIPANTS Based on the attainment goals used in our department, an initial list was developed within the research group. The expert panel included 25 nephrologists from our affiliate hospital. Responses were based on a 5-point method and agreement was reached if both (A) and (B) were met: (A) mean≥4 with a SD <1; (B) more than 75% of respondents rated the item 4 or more. With agreement, the item was left for the next round. This round was repeated. RESULTS An initial list of 11 items was developed; after three Delphi rounds and revisions, eight items remained that were then established as the final EPAs. These items can serve as a list of goals to be reached by residents who rotate to the department of nephrology. The results indicated that most of the experts believed residents should be able to perform tasks deemed necessary or urgent for all physicians, such as those that deal with hyperkalaemia and heart failure. CONCLUSIONS The concept of EPAs enabled us to develop goals and evaluation criteria for residents' training in nephrology. This study can serve as a springboard for future discussions and contribute to the development of resident education in nephrology.
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Affiliation(s)
- Akihito Tanaka
- Center for Postgraduate Clinical Training and Career Development, Nagoya University Hospital, Nagoya, Japan
- Department of Nephrology, Nagoya University Hospital, Nagoya, Japan
| | - Takeshi Kondo
- Center for Postgraduate Clinical Training and Career Development, Nagoya University Hospital, Nagoya, Japan
| | | | - Shoichi Maruyama
- Department of Nephrology, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
| | - Hiroshi Nishigori
- Center for Postgraduate Clinical Training and Career Development, Nagoya University Hospital, Nagoya, Japan
- Center for Medical Education, Nagoya University Graduate School of Medicine, Nagoya, Aichi, Japan
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Lukasczik M, Eckel J, Wagner A, Sendig L, Wolf HD, Vogel H. Einsatz von Simulationspersonen in der Lehre und Prüfung psychotherapeutischer Kompetenzen. ZEITSCHRIFT FUR KLINISCHE PSYCHOLOGIE UND PSYCHOTHERAPIE 2021. [DOI: 10.1026/1616-3443/a000643] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Zusammenfassung. Theoretischer Hintergrund: In der Klinischen Psychologie und Psychotherapie werden bislang kaum Simulationspersonen (SPs) in Lehre und kompetenzorientierten Prüfungen eingesetzt. Deren geplante Nutzung etwa im Rahmen von Approbationsprüfungen nach dem neuen Psychotherapeutengesetz ist sinnvoll, jedoch mit inhaltlichen und methodischen Herausforderungen verknüpft. Fragestellung: Machbarkeit des Einsatzes von SPs in Prüfungsszenarien und Ableitung von relevanten therapeutischen Fertigkeiten, die in solchen Szenarien geprüft werden können. Methode: Quantitative Evaluation der Umsetzbarkeit einer SP-basierten Prüfung psychotherapeutischer Kompetenzen (Studie 1) und qualitative Erarbeitung therapeutischer Beziehungsfertigkeiten als Basis für Szenarien in kompetenzorientierten Prüfungen mit SPs (Studie 2). Ergebnisse: Die Evaluation der SP-basierten Prüfungen zeigte eine positive Bewertung hinsichtlich ihrer Machbarkeit durch Ausbildungsteilnehmende ( N = 48) und Prüfende ( N = 2), aber auch eine begrenzte Interrater-Reliabilität. In der zweiten Studie wurden aus Interviews mit Expertinnen und Experten ( N = 12 Psychotherapeutinnen und -therapeuten) Kompetenzen für Beziehungsaufbau und Aufrechterhaltung als Grundlage für SP-basierte Prüfungsszenarien aus den Bereichen Fertigkeiten, Haltung und Wissen abgeleitet. Schlussfolgerungen: SP-basierte Lehr- und Prüfungsformate in Psychotherapie und Klinischer Psychologie sind mit inhaltlichen und methodischen Anforderungen (u. a. Falldarstellung, Interrater-Reliabilität) verbunden, die bei der Implementierung berücksichtigt werden müssen.
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Affiliation(s)
- Matthias Lukasczik
- Arbeitsbereich Medizinische Psychologie und Psychotherapie, Zentrum für Psychische Gesundheit (ZEP), Universitätsklinikum Würzburg, Julius-Maximilians-Universität Würzburg
- Schauspielpatienten-Programm, Dekanat der Medizinischen Fakultät, Universität Würzburg, Julius-Maximilians-Universität Würzburg
| | - Julia Eckel
- Arbeitsbereich Medizinische Psychologie und Psychotherapie, Zentrum für Psychische Gesundheit (ZEP), Universitätsklinikum Würzburg, Julius-Maximilians-Universität Würzburg
- Geschäftsbereich Studium und Lehrentwicklung, Universitätsmedizin Mannheim (UMM), Medizinische Fakultät Mannheim der Universität Heidelberg
| | - Anna Wagner
- Arbeitsbereich Medizinische Psychologie und Psychotherapie, Zentrum für Psychische Gesundheit (ZEP), Universitätsklinikum Würzburg, Julius-Maximilians-Universität Würzburg
| | - Lucie Sendig
- Arbeitsbereich Medizinische Psychologie und Psychotherapie, Zentrum für Psychische Gesundheit (ZEP), Universitätsklinikum Würzburg, Julius-Maximilians-Universität Würzburg
| | - Hans-Dieter Wolf
- Arbeitsbereich Medizinische Psychologie und Psychotherapie, Zentrum für Psychische Gesundheit (ZEP), Universitätsklinikum Würzburg, Julius-Maximilians-Universität Würzburg
| | - Heiner Vogel
- Arbeitsbereich Medizinische Psychologie und Psychotherapie, Zentrum für Psychische Gesundheit (ZEP), Universitätsklinikum Würzburg, Julius-Maximilians-Universität Würzburg
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Urushibara-Miyachi Y, Kikukawa M, Ikusaka M, Otaki J, Nishigori H. Lists of potential diagnoses that final-year medical students need to consider: a modified Delphi study. BMC MEDICAL EDUCATION 2021; 21:234. [PMID: 33892708 PMCID: PMC8066856 DOI: 10.1186/s12909-021-02652-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/13/2020] [Accepted: 03/25/2021] [Indexed: 05/09/2023]
Abstract
BACKGROUND Contrastive learning is known to be effective in teaching medical students how to generate diagnostic hypotheses in clinical reasoning. However, there is no international consensus on lists of diagnostic considerations across different medical disciplines regarding the common signs and symptoms that should be learned as part of the undergraduate medical curriculum. In Japan, the national model core curriculum for undergraduate medical education was revised in 2016, and lists of potential diagnoses for 37 common signs, symptoms, and pathophysiology were introduced into the curriculum. This study aimed to validate the list of items based on expert consensus. METHODS The authors used a modified Delphi method to develop consensus among a panel of 23 expert physician-teachers in clinical reasoning from across Japan. The panel evaluated the items on a 5-point Likert scale, based on whether a disease should be hypothesized by final-year medical students considering given signs, symptoms, or pathophysiology. They also added other diseases that should be hypothesized. A positive consensus was defined as both a 75% rate of panel agreement and a mean of 4 or higher with a standard deviation of less than 1 on the 5-point scale. The study was conducted between September 2017 and March 2018. RESULTS This modified Delphi study identified 275 basic and 67 essential other than basic items corresponding to the potential diagnoses for 37 common signs, symptoms, and pathophysiology that Japanese medical students should master before graduation. CONCLUSIONS The lists developed in the study can be useful for teaching and learning how to generate initial hypotheses by encouraging students' contrastive learning. Although they were focused on the Japanese educational context, the lists and process of validation are generalizable to other countries for building national consensus on the content of medical education curricula.
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Affiliation(s)
| | | | | | | | - Hiroshi Nishigori
- Faculty of Medicine, Kyoto University, Yoshida konoe-cho, Sakyo-ku, Kyoto, 606-8501, Japan
- Nagoya University, Nagoya, Japan
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Embedding Ethics Education in Clinical Clerkships by Identifying Clinical Ethics Competencies: The Vanderbilt Experience. HEC Forum 2020; 32:163-174. [PMID: 32307620 DOI: 10.1007/s10730-020-09410-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The clinical clerkships in medical school are the first formal opportunity for trainees to apply bioethics concepts to clinical encounters. These clerkships are also typically trainees' first sustained exposure to the "reality" of working in clinical teams and the full force of the challenges and ethical tensions of clinical care. We have developed a specialized, embedded ethics curriculum for Vanderbilt University medical students during their second (clerkship) year to address the unique experience of trainees' first exposure to clinical care. Our embedded curriculum is centered around core "ethics competencies" specific to the clerkship: for Medicine, advanced planning and end-of-life discussions; for Surgery, informed consent; for Pediatrics, the patient-family-provider triad; for Obstetrics and Gynecology, women's autonomy, unborn child's interests, and partner's rights; and for Neurology/Psychiatry, decision-making capacity. In this paper, we present the rationale for these competencies, how we integrated them into the clerkships, and how we assessed these competencies. We also review the additional ethical issues that have been identified by rotating students in each clerkship and discuss our strategies for continued evolution of our ethics curriculum.
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Shimizu I, Kikukawa M, Tada T, Kimura T, Duvivier R, van der Vleuten C. Measuring social interdependence in collaborative learning: instrument development and validation. BMC MEDICAL EDUCATION 2020; 20:177. [PMID: 32487067 PMCID: PMC7268626 DOI: 10.1186/s12909-020-02088-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 05/24/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND In health professions education, several collaborative learning approaches have been used. As collaborative learning has a theoretical background of social interdependence theory, a theory informed and valid instrument to measure social interdependence is required to evaluate and compare several learning approaches. The aim of this study was to develop an instrument (the SOcial interdependence in Collaborative learning Scale; SOCS) to measure students' perceived social interdependence in collaborative learning and validate it. METHODS We conducted a modified Delphi procedure among stakeholders to develop the content validity of the instrument. To establish construct validity, we performed a confirmatory factor analysis, and we estimated reliability. RESULTS Two rounds of Delphi were conducted to develop the instrument. Confirmatory factor analysis yielded a three-factor model with 15 items, which provided an excellent fit with CMIN/df = 1.838, GFI = 0.924, CFI = 0.951, RMSEA = 0.061, and PCLOSE = 0.121. Alpha-coefficients for all factors indicated high internal consistency of all the factors. CONCLUSION This study describes the development and construct validation of the SOCS for measuring social interdependence in collaborative learning. This instrument will provide teachers and schools with feedback about their classroom environment.
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Affiliation(s)
- Ikuo Shimizu
- Center for Medical Education and Clinical Training, Shinshu University, 3-1-1 Asahi, Matsumoto, 3908621 Japan
| | - Makoto Kikukawa
- Department of Medical Education, Kyushu University, 3-1-1 Maidashi Higashi-ku, Fukuoka, 8128582 Japan
| | - Tsuyoshi Tada
- Center for Medical Education and Clinical Training, Shinshu University, 3-1-1 Asahi, Matsumoto, 3908621 Japan
| | - Teiji Kimura
- Department of Fundamental Physical Therapy, Shinshu University, 3-1-1 Asahi, Matsumoto, 3908621 Japan
| | - Robbert Duvivier
- Center for Educational Development and Research in Health Sciences (CEDAR), University Medical Center Groningen, Groningen, The Netherlands
- Parnassia Psychiatric Institute, The Hague, The Netherlands
| | - Cees van der Vleuten
- Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Universiteitssingel 60, 6229 ER Maastricht, The Netherlands
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Albarqouni L, Hoffmann T, Straus S, Olsen NR, Young T, Ilic D, Shaneyfelt T, Haynes RB, Guyatt G, Glasziou P. Core Competencies in Evidence-Based Practice for Health Professionals: Consensus Statement Based on a Systematic Review and Delphi Survey. JAMA Netw Open 2018; 1:e180281. [PMID: 30646073 DOI: 10.1001/jamanetworkopen.2018.0281] [Citation(s) in RCA: 182] [Impact Index Per Article: 30.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Evidence-based practice (EBP) is necessary for improving the quality of health care as well as patient outcomes. Evidence-based practice is commonly integrated into the curricula of undergraduate, postgraduate, and continuing professional development health programs. There is, however, inconsistency in the curriculum content of EBP teaching and learning programs. A standardized set of minimum core competencies in EBP that health professionals should meet has the potential to standardize and improve education in EBP. OBJECTIVE To develop a consensus set of core competencies for health professionals in EBP. EVIDENCE REVIEW For this modified Delphi survey study, a set of EBP core competencies that should be covered in EBP teaching and learning programs was developed in 4 stages: (1) generation of an initial set of relevant EBP competencies derived from a systematic review of EBP education studies for health professionals; (2) a 2-round, web-based Delphi survey of health professionals, selected using purposive sampling, to prioritize and gain consensus on the most essential EBP core competencies; (3) consensus meetings, both face-to-face and via video conference, to finalize the consensus on the most essential core competencies; and (4) feedback and endorsement from EBP experts. FINDINGS From an earlier systematic review of 83 EBP educational intervention studies, 86 unique EBP competencies were identified. In a Delphi survey of 234 participants representing a range of health professionals (physicians, nurses, and allied health professionals) who registered interest (88 [61.1%] women; mean [SD] age, 45.2 [10.2] years), 184 (78.6%) participated in round 1 and 144 (61.5%) in round 2. Consensus was reached on 68 EBP core competencies. The final set of EBP core competencies were grouped into the main EBP domains. For each key competency, a description of the level of detail or delivery was identified. CONCLUSIONS AND RELEVANCE A consensus-based, contemporary set of EBP core competencies has been identified that may inform curriculum development of entry-level EBP teaching and learning programs for health professionals and benchmark standards for EBP teaching.
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Affiliation(s)
- Loai Albarqouni
- Centre for Research in Evidence-Based Practice, Bond University, Robina, Queensland, Australia
| | - Tammy Hoffmann
- Centre for Research in Evidence-Based Practice, Bond University, Robina, Queensland, Australia
| | - Sharon Straus
- Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Nina Rydland Olsen
- Department of Health and Functioning, Faculty of Health and Social Sciences, Western Norway University of Applied Sciences, Bergen, Norway
| | - Taryn Young
- Centre for Evidence-based Health Care, Division of Epidemiology and Biostatistics, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
- Cochrane South Africa, South African Medical Research Council, Cape Town, South Africa
| | - Dragan Ilic
- Medical Education Research and Quality Unit, School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Terrence Shaneyfelt
- Department of Veterans Affairs, University of Alabama at Birmingham
- Department of General Internal Medicine, University of Alabama at Birmingham
| | - R Brian Haynes
- Department of Health Research Methods, Evidence and Impact, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Gordon Guyatt
- Department of Health Research Methods, Evidence and Impact, McMaster University Faculty of Health Sciences, Hamilton, Ontario, Canada
| | - Paul Glasziou
- Centre for Research in Evidence-Based Practice, Bond University, Robina, Queensland, Australia
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Green D, Dye AL. How Should We Best Train Clinical Psychology Supervisors? A Delphi Survey. PSYCHOLOGY LEARNING AND TEACHING-PLAT 2016. [DOI: 10.2304/plat.2002.2.2.108] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Although clinical supervision plays a major part in the professional training of clinical psychologists, there are as yet no agreed guidelines for preparing supervisors for this key educational role. This article uses the Delphi approach to see whether an expert panel of UK clinical psychologists could come to a consensus on what the most suitable components of such a supervisor training programme might be.
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van der Gaag A, Davies P. The professional competence of speech therapists. IV: attitude and attribute base. Clin Rehabil 2016. [DOI: 10.1177/026921559200600408] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This paper reports on an empirical study of the attitude and attribute base of speech therapy. This is the final part of a four-part report on a study of the professional competence of speech therapists. The consultative methods used in this study combined the Delphi and Nominal Group techniques with a postal questionnaire survey of specialist clinicians in the UK, the details of which are reported elsewhere. The present discussion of the attitude base of speech therapy concluded that there was a strong consensus of agreement amongst speech therapists on the attitudes and attributes considered essential to professional competence. However, it would appear that these attitudes and attributes are not exclusive to speech therapists, but are common to many professional groups.
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18
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Davies P, van der Gaag A. The professional competence of speech therapists. I: introduction and methodology. Clin Rehabil 2016. [DOI: 10.1177/026921559200600305] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
This paper is the first of a four part report on a study of the professional competence of speech therapists in the United Kingdom. It considers some of the methodological approaches to the study of professional competence, and describes the methods adopted for this study. A combination of consultative and survey techniques were used to determine which knowledge, skills and attitudes were considered essential to the competence of speech therapists working in three specialities; children, learning difficulties, and elderly/adults with acquired neurological disorders. Sixty-eight speech therapy 'experts' were consulted using Delphi and Nominal Group techniques. The items of knowledge, skills and attitudes generated by these experts were then distributed to 657 specialist speech therapists in order that the lists could be validated by a larger sample of clinicians.
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Affiliation(s)
- Philip Davies
- Rehabilitation Research Unit, University of Oxford — Department of Continuing Education, University of Oxford, 1 Wellington Square, Oxford OX12JA, UK
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19
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Mansouri A, Aldakkan A, Badhiwala JH, Taslimi S, Kondziolka D. A Practical Methodological Approach Towards Identifying Core Competencies in Medical Education Based on Literature Trends: A Feasibility Study Based on Vestibular Schwannoma Science. Neurosurgery 2016; 77:594-602; discussion 602-3. [PMID: 26308645 DOI: 10.1227/neu.0000000000000837] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Competency-based medical education (CBME) is gaining momentum in postgraduate residency and fellowship training. While randomized trials, consensus statements, and practice guidelines can help delineate some of the core competencies for CBME, they are not applicable to all clinical scenarios. OBJECTIVE To propose and assess the feasibility of a practical methodology for addressing this issue using radiosurgery for vestibular schwannoma (VS) science as an example. METHODS The Web of Science electronic database was searched using relevant terms. A 3-step review of titles and abstracts was used. Studies were classified independently and in duplicate as either efficacy or effectiveness analyses. Cohen's kappa score was used to assess inter-rater agreement. RESULTS Overall, 1818 surgical and 943 radiosurgical publications were identified. The number of effectiveness studies surpassed that of efficacy studies in the late 1980s for surgical studies, and in the early-to-mid 1990s among radiosurgical studies. The publication rate was higher for radiosurgery in the mid 1990s, but it paralleled that of surgical studies beyond the early 2000s. Variations in this overall trend corresponded to the emergence of studies that assessed the role of endoscopy and the utility of dose reduction in radiosurgery. CONCLUSION We have confirmed the feasibility and accuracy of this objective methodological approach. By understanding how the peer-reviewed literature reflects actual practice interests, educators can tailor curricula to ensure that trainees remain current. While further validation studies are needed, this methodology can serve as a supplemental strategy for identifying additional core competencies in CBME.
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Affiliation(s)
- Alireza Mansouri
- *Division of Neurosurgery, University of Toronto, Toronto, Ontario; ‡Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Ontario; §Division of Neurosurgery, King Saud University, Riyadh, Saudi Arabia; ¶Departments of Neurosurgery and ‖Radiation Oncology, NYU Langone Medical Center, New York University, New York
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Brinkman D, Disselhorst G, Jansen B, Tichelaar J, van Agtmael M, de Vries T, Richir M. What Should Junior Doctors Know about the Drugs they Frequently Prescribe? A Delphi Study among Physicians in the Netherlands. Basic Clin Pharmacol Toxicol 2015; 118:456-61. [PMID: 26506082 DOI: 10.1111/bcpt.12508] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2015] [Accepted: 10/20/2015] [Indexed: 11/28/2022]
Abstract
The aim of this study was to identify the information about commonly prescribed drugs that junior doctors should know in order to prescribe rationally in daily practice, defined as essential drug knowledge (EDK). A two-round Internet Delphi study was carried out involving general practitioners from one practice cluster, and registrars and consultants from two Dutch academic and eight teaching hospitals. A preliminary list of 377 potential EDK items for three commonly prescribed drugs was assessed on a dichotomous scale; an item was considered EDK if at least 80% consensus was reached. The consensus list of EDK items was discussed by the research team to identify similarities between the three drugs, with a view to forming a list of general EDK items applicable to other commonly prescribed drugs. Sixty experts considered 93 of the 377 items (25%) as EDK. These items were then used to form a list of 10 general EDK items. The list of EDK items identified by primary and secondary care doctors could be used in medical curricula and training programmes and for assessing the prescribing competence of future junior doctors. Further research is needed to evaluate the generalizability of this list for other commonly prescribed drugs.
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Affiliation(s)
- David Brinkman
- Research and Expertise Center In Pharmacotherapy Education (RECIPE), Amsterdam, the Netherlands.,Department of Internal Medicine, Section Pharmacotherapy, VU University Medical Center, Amsterdam, the Netherlands
| | - Guus Disselhorst
- Research and Expertise Center In Pharmacotherapy Education (RECIPE), Amsterdam, the Netherlands.,Department of Internal Medicine, Section Pharmacotherapy, VU University Medical Center, Amsterdam, the Netherlands
| | - Bernard Jansen
- Research and Expertise Center In Pharmacotherapy Education (RECIPE), Amsterdam, the Netherlands.,Department of Internal Medicine, Section Pharmacotherapy, VU University Medical Center, Amsterdam, the Netherlands
| | - Jelle Tichelaar
- Research and Expertise Center In Pharmacotherapy Education (RECIPE), Amsterdam, the Netherlands.,Department of Internal Medicine, Section Pharmacotherapy, VU University Medical Center, Amsterdam, the Netherlands
| | - Michiel van Agtmael
- Research and Expertise Center In Pharmacotherapy Education (RECIPE), Amsterdam, the Netherlands.,Department of Internal Medicine, Section Pharmacotherapy, VU University Medical Center, Amsterdam, the Netherlands
| | - Theo de Vries
- Research and Expertise Center In Pharmacotherapy Education (RECIPE), Amsterdam, the Netherlands.,Department of Internal Medicine, Section Pharmacotherapy, VU University Medical Center, Amsterdam, the Netherlands
| | - Milan Richir
- Research and Expertise Center In Pharmacotherapy Education (RECIPE), Amsterdam, the Netherlands.,Department of Internal Medicine, Section Pharmacotherapy, VU University Medical Center, Amsterdam, the Netherlands
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Saito T, Izawa KP, Omori Y, Watanabe S. Functional Independence and Difficulty Scale: Instrument development and validity evaluation. Geriatr Gerontol Int 2015; 16:1127-1137. [DOI: 10.1111/ggi.12605] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/13/2015] [Indexed: 11/27/2022]
Affiliation(s)
- Takashi Saito
- Department of Rehabilitation; Visiting Nursing and Rehabilitation Network; Kawasaki-shi Kanagawa Japan
- Doctoral Course of Gerontology; Kobe University; Kobe Japan
| | | | - Yutaka Omori
- Department of Rehabilitation; Visiting Nursing and Rehabilitation Network; Kawasaki-shi Kanagawa Japan
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Kikukawa M, Stalmeijer RE, Emura S, Roff S, Scherpbier AJJA. An instrument for evaluating clinical teaching in Japan: content validity and cultural sensitivity. BMC MEDICAL EDUCATION 2014; 14:179. [PMID: 25164309 PMCID: PMC4167259 DOI: 10.1186/1472-6920-14-179] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2014] [Accepted: 08/08/2014] [Indexed: 05/24/2023]
Abstract
BACKGROUND Many instruments for evaluating clinical teaching have been developed but almost all in Western countries. None of these instruments have been validated for the Asian culture, and a literature search yielded no instruments that were developed specifically for that culture. A key element that influences content validity in developing instruments for evaluating the quality of teaching is culture. The aim of this study was to develop a culture-specific instrument with strong content validity for evaluating clinical teaching in initial medical postgraduate training in Japan. METHODS Based on data from a literature search and an earlier study we prepared a draft evaluation instrument. To ensure a good cultural fit of the instrument with the Asian context we conducted a modified Delphi procedure among three groups of stakeholders (five education experts, twelve clinical teachers and ten residents) to establish content validity, as this factor is particularly susceptible to cultural factors. RESULTS Two rounds of Delphi were conducted. Through the procedure, 52 prospective items were reworded, combined or eliminated, resulting in a 25-item instrument validated for the Japanese setting. CONCLUSIONS This is the first study describing the development and content validation of an instrument for evaluating clinical teaching specifically tailored to an East Asian setting. The instrument has similarities and differences compared with instruments of Western origin. Our findings suggest that designers of evaluation instruments should consider the probability that the content validity of instruments for evaluating clinical teachers can be influenced by cultural aspects.
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Affiliation(s)
- Makoto Kikukawa
- />Department of Medical Education, Kyushu University, 3-1-1 Maidashi Higashi-ku Fukuoka, 81-8582 Kyushu, Japan
| | - Renee E Stalmeijer
- />Department of Educational Development and Research, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Sei Emura
- />Centre for Graduate Medical Education Development and Research, Saga University Hospital, Saga, Japan
| | - Sue Roff
- />The Centre for Medical Education, Dundee Medical School, Dundee, Scotland
| | - Albert JJA Scherpbier
- />Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
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Gonsalves CL, Ajjawi R, Rodger M, Varpio L. A novel approach to needs assessment in curriculum development: going beyond consensus methods. MEDICAL TEACHER 2014; 36:422-9. [PMID: 24491186 DOI: 10.3109/0142159x.2013.877126] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/18/2023]
Abstract
BACKGROUND Needs assessment should be the starting point for curriculum development. In medical education, expert opinion and consensus methods are commonly employed. AIM This paper showcases a more practice-grounded needs assessment approach. METHODS A mixed-methods approach, incorporating a national survey, practice audit, and expert consensus, was developed and piloted in thrombosis medicine; Phase 1: National survey of practicing consultants, Phase 2: Practice audit of consult service at a large academic centre and Phase 3: Focus group and modified Delphi techniques vetting Phase 1 and 2 findings. RESULTS Phase 1 provided information on active curricula, training and practice patterns of consultants, and volume and variety of thrombosis consults. Phase 2's practice audit provided empirical data on the characteristics of thrombosis consults and their associated learning issues. Phase 3 generated consensus on a final curricular topic list and explored issues regarding curriculum delivery and accreditation. CONCLUSIONS This approach offered a means of validating expert and consensus derived curricular content by incorporating a novel practice audit. By using this approach we were able to identify gaps in training programs and barriers to curriculum development. This approach to curriculum development can be applied to other postgraduate programs.
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Friedman Z, Siddiqui N, Mahmoud S, Davies S. Video-assisted structured teaching to improve aseptic technique during neuraxial block. Br J Anaesth 2013; 111:483-7. [PMID: 23562931 DOI: 10.1093/bja/aet062] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Teaching epidural catheter insertion tends to focus on developing manual dexterity rather than improving aseptic technique which usually remains poor despite increasing experience. The aim of this study was to compare epidural aseptic technique performance, by novice operators after a targeted teaching intervention, with operators taught aseptic technique before the intervention was initiated. METHODS Starting July 2008, two groups of second-year anaesthesia residents (pre- and post-teaching intervention) performing their 4-month obstetric anaesthesia rotation in a university affiliated centre were videotaped three to four times while performing epidural procedures. Trained blinded independent examiners reviewed the procedures. The primary outcome was a comparison of aseptic technique performance scores (0-30 points) graded on a scale task-specific checklist. RESULTS A total of 86 sessions by 29 residents were included in the study analysis. The intraclass correlation coefficient for inter-rater reliability for the aseptic technique was 0.90. The median aseptic technique scores for the rotation period were significantly higher in the post-intervention group [27.58, inter-quartile range (IQR) 22.33-29.50 vs 16.56, IQR 13.33-22.00]. Similar results were demonstrated when scores were analysed for low, moderate, and high levels of experience throughout the rotation. CONCLUSIONS Procedure-specific aseptic technique teaching, aided by video assessment and video demonstration, helped significantly improve aseptic practice by novice trainees. Future studies should consider looking at retention over longer periods of time in more senior residents.
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Affiliation(s)
- Z Friedman
- Department of Anesthesia and Pain Management, Mount Sinai Hospital, University of Toronto, 600 University Avenue, Toronto, ON, M5G1X5, Canada.
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Wijnen-Meijer M, van der Schaaf M, Nillesen K, Harendza S, Ten Cate O. Essential facets of competence that enable trust in graduates: a delphi study among physician educators in the Netherlands. J Grad Med Educ 2013; 5:46-53. [PMID: 24404226 PMCID: PMC3613317 DOI: 10.4300/jgme-d-11-00324.1] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2011] [Revised: 03/20/2012] [Accepted: 05/29/2012] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND There is a need for valid methods to assess the readiness for clinical practice of recently graduated physicians. To develop these methods, it is relevant to know the general features of trainees' performance that facilitate supervisors' trust in their ability to perform critical clinical tasks. OBJECTIVE To discover such essential facets of competence (FOCs), based on the opinion of experienced physician educators. METHODS We conducted a Delphi study, consisting of 2 rounds, among 18 experienced physician educators in the Netherlands. Mean, standard deviation, level of agreement, and skewness were calculated for the importance of FOCs for making entrustment decisions. The study yielded a list of 25 FOCs. RESULTS In the first round, means were between 6.50 and 7.00 on a 7-point Likert scale (SD, 0.42-2.18); in the second round, means ranged from 5.45 to 6.90 (SD, 0.3-2.02). The level of agreement was high for 92% of the FOCs in the first round and 100% of the FOCs in the second round. CONCLUSIONS Our Delphi study found consensus among experts about FOCs that are important for clinical entrustment decisions.
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Ito C, Ota K, Matsuda M. Educational content in nurse education in Japan: A Delphi study. Nurs Ethics 2011; 18:441-54. [DOI: 10.1177/0969733010385530] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The purpose of this study was to clarify the minimum necessary educational content in the area of nursing ethics in a basic nursing education program, and the level of students’ mastery of this content, based on a Delphi study in both educational and clinical settings. A Delphi study was conducted in three rounds with faculty members who teach nursing ethics at all 158 four-year nursing universities in Japan as targeted panelists. In this study the opinions on nursing ethics of nursing instructors responsible for hospital education at all 82 special functioning hospitals were reflected in the panelists’ opinions. Consensus was obtained on 41 items from a total of 63 items in 4 proposed frameworks. There were 20 items related to the Concept of nursing ethics, 7 items related to Ethical codes, 13 items related to Ethical issues and methods to resolve them, and 1 item related to Efforts and issues in practical and educational settings. Consensus as to desired level of mastery was reached on a total of 40 items. This agreed-upon level involved understanding of the concept for 22 items, the ability to explain the concept for 16 items, and the ability to act based on the concept for 2 items.
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Amin HJ, Singhal N, Cole G. Validating objectives and training in Canadian paediatrics residency training programmes. MEDICAL TEACHER 2011; 33:e131-e144. [PMID: 21345052 DOI: 10.3109/0142159x.2011.542525] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
BACKGROUND Changing health care systems and learning environments with reduction in resident work hours raises the question: "Are we adequately training our paediatricians?" AIMS (1) Identify clinical competencies to be acquired during paediatric residency training to enable graduates to practise as consultant paediatricians; (2) Identify gaps in preparedness during training and; (3) Review and validate competencies contained in the Royal College of Physicians and Surgeons of Canada (RCPSC) objectives of training (OTR) for paediatrics. METHODS A questionnaire with 19 classification domains containing 92 clinical competencies was administered to RCPSC certified paediatricians who completed residency training in Canada from June 2004 to June 2008. For each competency, paediatricians were asked to indicate the importance and their degree of preparedness upon entering practice. Gap scores (GSs) between importance and preparedness were calculated. RESULTS Response rate was 43% (187/435); 91.3% (84/92) of competencies in the RCPSC OTR were identified as important. Paediatricians felt less than adequately prepared for 25% (23/92) of competencies; 40 competencies had GSs >10%. CONCLUSIONS The unique approach used in this study is useful in validating OTR as well as the preparation of residents in relation to OTR. The results indicate a potential need for additional training in specific competencies.
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Affiliation(s)
- Harish J Amin
- Department of Paediatrics, University of Calgary, C4-615, Alberta Children's Hospital, 2888 Shaganappi Trail NW, Calgary, Alberta, T3B 6A8, Canada.
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Jelovsek JE, Walters MD, Korn A, Klingele C, Zite N, Ridgeway B, Barber MD. Establishing cutoff scores on assessments of surgical skills to determine surgical competence. Am J Obstet Gynecol 2010; 203:81.e1-6. [PMID: 20417494 DOI: 10.1016/j.ajog.2010.01.073] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2009] [Revised: 10/05/2009] [Accepted: 01/24/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The aim of this study was to establish minimum cutoff scores on intraoperative assessments of surgical skills to determine surgical competence for vaginal hysterectomy. STUDY DESIGN Two surgical rating scales, the Global Rating Scale of Operative Performance and the Vaginal Surgical Skills Index, were used to evaluate trainees while performing vaginal hysterectomy. Cutoff scores were determined using the Modified Angoff method. RESULTS Two hundred twelve evaluations were analyzed on 76 surgeries performed by 27 trainees. Trainees were considered minimally competent to perform vaginal hysterectomy if total absolute scores (95% confidence interval) on Global Rating Scale = 18 (16.5-20.3) and Vaginal Surgical Skills Index = 32 (27.7-35.5). On average, trainees met new cutoffs after performing 21 and 27 vaginal hysterectomies, respectively. With the new cutoffs applied to the same cohort of fourth-year obstetrics and gynecology trainees, all residents achieved competency in performing vaginal hysterectomy by the end of their gynecology rotations. CONCLUSION Standard-setting methods using cutoff scores may be used to establish competence in vaginal surgery.
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Hersey P, Laws D. Defining competence for workplace based assessment - a pragmatic and thorough method. Anaesthesia 2009; 64:1386. [DOI: 10.1111/j.1365-2044.2009.06167_4.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Redman CWE, Dollery E, Jordan JA. Development of the European Colposcopy Core Curriculum: use of the Delphi technique. J OBSTET GYNAECOL 2009; 24:780-4. [PMID: 15763789 DOI: 10.1080/01443610400009519] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
The objective of this study was to develop a European competence-based colposcopy core curriculum using the Delphi technique. Thirty expert colposcopists from 21 countries participated. A four-round iterative questionnaire was used. Competencies were rated using a five-point Likert scale. Competences rated as 4 or more by at least 90% of the respondents were regarded as necessary for the core curriculum. Eighteen participants took part in all four rounds, and 27 were active in each of the last three rounds. Fifty-one core competences were selected from a list of 76 competences collated by the group as a whole. The majority (n = 44) of the selected core competences received a score of 4 or greater in each round. Overall, there was some evidence of increasing consensus but the individual shift in opinion was slight. The Delphi technique was an effective tool for obtaining an expert consensus and enabled group "ownership" of the identified core curriculum.
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Affiliation(s)
- C W E Redman
- The Academic Unit, Maternity Building, North Staffordshire Hospital, Stoke-on-Trent ST4 6QG, UK.
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Abstract
The importance of continuing medical education (CME) as a method of improving the quality of care of children undergoing anesthesia is universally recognized. This article, which is based on a presentation at the FEAPA European Conference on Paediatric Anaesthesia in September 2007 in Amsterdam, gives a theoretical overview of continuing education and introduces some generic educational concepts, such as the CRISIS-criteria and Kirkpatrick's evaluation model, which are as relevant to pediatric anesthesia as to other areas of medical practice. The terms CME and continuing professional develop are described. Some consideration is given to how anesthesiologists can assess the potential worth of an educational activity for their practice. No attempt will be made to judge particular educational activities, as the choice of the most appropriate activity rests primarily with the individual.
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Affiliation(s)
- Nigel McBeth Turner
- Wilhelmina Children's Hospital, University Medical Centre, Utrecht, The Netherlands.
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Paes P, Wee B. A Delphi study to develop the Association for Palliative Medicine consensus syllabus for undergraduate palliative medicine in Great Britain and Ireland. Palliat Med 2008; 22:360-4. [PMID: 18541640 DOI: 10.1177/0269216308090769] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
The Association for Palliative Medicine (APM) produced a previous undergraduate palliative medicine syllabus in 1992. This study describes the process of developing the new APM consensus syllabus against the background of changes in medical education and palliative medicine since 1992. The syllabus was derived by means of a Delphi study carried out amongst experts in palliative medicine across Britain and Ireland. Forty-three participants agreed to take part. Three rounds of the Delphi study took place. Consensus (75% agreement) was achieved in over 90% of the outcomes. The new syllabus is broken down into the following sections: basic principles, physical care, psychosocial care, culture, language, religious and spiritual issues, ethics and legal frameworks. Learning outcomes are categorised as essential or desirable. Using a Delphi study, we have developed a consensus syllabus for undergraduate palliative medicine. This is sufficiently flexible to allow all medical schools to ensure that their students achieve the essential learning outcomes by the time they graduate, whereas those with more generous curricular space will additionally be able to deliver selected desirable learning outcomes.
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Affiliation(s)
- P Paes
- Marie Curie Hospice Newcastle, Northumbria Healthcare NHS Trust, North Tyneside PCT, University of Newcastle, Newcastle upon Tyne, UK.
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Abstract
BACKGROUND Residents are frequently identified by medical students as their most frequent and memorable teachers; residents also teach their peers, junior and senior colleagues, other health professionals, and their patients. Many will teach in their future practice. Developing the skills to become a teacher is an important part of postgraduate education, and warrants a systematic, planned approach that may include many complementary learning opportunities. AIMS Our purpose is to describe one such approach: a 4-week elective experience in medical education offered to postgraduate learners. METHOD The paper describes the background and goals for the elective, and the various steps in planning, implementing, and evaluating such a course, drawing on the literature and mining our own experience for examples. Specifically, we address the following: needs assessment; the determination and selection of content, sequence, and teaching and learning methods; the experiential learning opportunities offered; and the emphasis on the participants' developing self-awareness of themselves as teachers, and as part of a community of teachers. RESULTS The program implementation, program evaluation, and response to feedback received are described. CONCLUSION A 4-week elective experience in medical education was positively received by participants.
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Affiliation(s)
- Karen V Mann
- Division of Medical Education, Dalhousie University, Room C-124, 5849 University Avenue, Halifax, Nova Scotia, Canada B3H 2B3.
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Hall J. The use of an evidence-based portfolio in the management of change in dental practice. ACTA ACUST UNITED AC 2007; 13:142-6. [PMID: 17236569 DOI: 10.1308/135576106778529026] [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: 11/22/2022]
Abstract
In this paper the author gives his opinion about the problems of getting practices to change systems in order to institute clinical governance. There are many reasons why practices need to change and for this change to be monitored. This paper explains the need for change and the use of the evidence-based portfolio, which is produced by candidates for the Membership of the Faculty of General Dental Practice (UK) [MFGDP(UK)] examination. It can also be produced by individuals who are not taking the MFGDP(UK) examination in conjunction with the Faculty of General Dental Practice (UK)'s key skills programme. It provides a mechanism for demonstrating change and for assessing the quality of care provided by a general dental practice. The author concludes that the evidence-based portfolio will enable a practitioner to apply clinical governance in a practical way.
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Edgren G. Developing a competence-based core curriculum in biomedical laboratory science: a Delphi study. MEDICAL TEACHER 2006; 28:409-17. [PMID: 16973452 DOI: 10.1080/01421590600711146] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
In this study the Delphi technique has been used to develop a core curriculum for education of the biomedical scientist. The rapid development in biomedicine and the corresponding changes in methodology in biomedical laboratories demand careful planning of the education of biomedical scientists. The Delphi technique uses an anonymous panel of experts for suggestions and assessments aiming at consensus. Twenty-six experts from different kinds of hospital and university laboratories took part in the investigation. They suggested and assessed necessary competences for a recently graduated biomedical scientist, and if 75% or more of the participants agreed on a competence, it was included in the core curriculum. The final list consisted of 66 competences of varying depth, in three categories. This list contained several generic competences, concerning for example basic laboratory methods, handling of samples, dealing with apparatus and applying relevant rules and laws; basic knowledge in chemistry, preclinical medicine and laboratory methods; and finally attitudes that the panel expected in the recently graduated person. The core was sufficiently restricted to be used in a three-year programme and still leave space for about one year of electives/special study modules. It became rather traditional, e.g. it did not include competences that many recent reports consider important for the future professional.
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Abstract
BACKGROUND The Royal College of Physicians and Surgeons of Canada, through the CanMEDS 2000 project has identified the role of professional as 1 of 7 roles for which physicians are expected to be accountable when dealing with patients. Each specialty is responsible for defining this role relative to their specialty. METHODS The qualities of professionalism for anaesthesiology were defined through a Delphi process involving Canadian anaesthesiology educators. The panellists took part in 3 rounds that identified qualities in 3 distinct areas of professionalism - humanistic qualities, personal development qualities and anaesthesiology meta-competences. RESULTS A total of 23 of 29 anaesthesiologists responded (79%) in round 1, with response rates to rounds 2 and 3 being 72% and 69%, respectively. Of the original 36 qualities, some were combined, definitions were changed in 23, 11 qualities were added and 4 were deleted, leaving a list of 40 qualities. DISCUSSION There is considerable interest in this issue among the Canadian educators in postgraduate anaesthesiology. Consensus on important professional qualities for anaesthesiologists was obtained through the Delphi technique. These qualities will form the basis of identifiable professional behaviours to which anaesthesiologists should aspire.
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Affiliation(s)
- Ramona A Kearney
- University of Alberta, Department of Anesthesiology and Pain Medicine, University of Alberta, Edmonton, Alberta, Canada.
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Carraccio C, Wolfsthal SD, Englander R, Ferentz K, Martin C. Shifting paradigms: from Flexner to competencies. ACADEMIC MEDICINE : JOURNAL OF THE ASSOCIATION OF AMERICAN MEDICAL COLLEGES 2002; 77:361-7. [PMID: 12010689 DOI: 10.1097/00001888-200205000-00003] [Citation(s) in RCA: 526] [Impact Index Per Article: 23.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
Realizing medical education is on the brink of a major paradigm shift from structure- and process-based to competency-based education and measurement of outcomes, the authors reviewed the existing medical literature to provide practical insight into how to accomplish full implementation and evaluation of this new paradigm. They searched Medline and the Educational Resource Information Clearinghouse from the 1960s until the present, reviewed the titles and abstracts of the 469 articles the search produced, and chose 68 relevant articles for full review. The authors found that in the 1970s and 1980s much attention was given to the need for and the development of professional competencies for many medical disciplines. Little attention, however, was devoted to defining the benchmarks of specific competencies, how to attain them, or the evaluation of competence. Lack of evaluation strategies was likely one of the forces responsible for the three-decade lag between initiation of the movement and wide-spread adoption. Lessons learned from past experiences include the importance of strategic planning and faculty and learner buy-in for defining competencies. In addition, the benchmarks for defining competency and the thresholds for attaining competence must be clearly delineated. The development of appropriate assessment tools to measure competence remains the challenge of this decade, and educators must be responsible for studying the impact of this paradigm shift to determine whether its ultimate effect is the production of more competent physicians.
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Affiliation(s)
- Carol Carraccio
- Department of Pediatrics, University of Maryland, Baltimore, 21201, USA.
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Mucklow JC. What knowledge and skills are essential for specialists in Clinical Pharmacology and Therapeutics? Results of a Delphi study. Br J Clin Pharmacol 2002; 53:341-6. [PMID: 11966663 PMCID: PMC1874274 DOI: 10.1046/j.1365-2125.2002.01576.x] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
AIMS To identify the knowledge and skills that should be considered essential for specialists in Clinical Pharmacology and Therapeutics (CPT) with a commitment to the National Health Service (NHS). METHODS A Delphi study using a sample of current specialists. RESULTS Members of the expert panel (20 in all, representative of the Clinical Section membership) identified 78 statements for consideration, in four domains (core of knowledge, therapeutic skills, educative skills, and investigative skills), of which 58 (74.4%) were accepted by more than two-thirds of respondents. Of these, 35 were knowledge items, whereas 23 were skills (11 therapeutic, 4 educative and 8 investigative). The large majority (79.3%) of these statements were endorsed by at least four out of five panel members. CONCLUSIONS Despite the varied work patterns and responsibilities of specialists in CPT, it is possible to identify a core of knowledge and skill that most consider essential for the delivery of their commitment to the NHS. The findings will provide NHS Trusts with a clear idea of what they can expect from these specialists, and will act as a checklist for specialists themselves to direct their Continuing Professional Development within the consultant appraisal process. The results also describe a curriculum for continuing education in CPT, which the BPS Clinical Section can use to develop information resources and training opportunities.
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Affiliation(s)
- J C Mucklow
- Department of Clinical Pharmacology, North Staffordshire Hospital, Stoke-on-Trent, ST4 6QG.
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Debrix I, Flahault A, Becker A, Schwartz L, Kanfer A, Milleron B. Impact of guidelines implemented in a paris university hospital: application to the use of antiemetics by cancer patients. Br J Clin Pharmacol 1999; 48:616-22. [PMID: 10583034 PMCID: PMC2014380 DOI: 10.1046/j.1365-2125.1999.00048.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
AIMS To assess the impact with time of guidelines on antiemetic use in an 850-bed Paris university hospital with a high proportion of cancer patients. METHODS Guidelines on the use of antiemetics available in cancer chemotherapy were drafted according to the Delphi technique. Their implementation was based upon a patient-specific antiemetic prescription form. To assess the impact of guideline implementation over time, discrepancies between current practice and the guidelines were compared before guideline implementation (between March and August 1995) and after implementation (between March and August 1997, and March and August 1998). RESULTS Before the Delphi panel's guidelines were implemented, 5-HT3 antagonists were inappropriately administered in 70% of cases. After guideline implementation, this proportion dropped significantly (P<0.0001, Fisher's exact test) to 22% between March and August 1997 and 28% between March and August 1998. CONCLUSIONS Implementation of guidelines seems to have resulted in significant changes with time, although a causal relationship has not been demonstrated. The development of guidelines by our hospital's multidisciplinary working group helped the various consultants to adjust medical practices to take account of these changes.
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Affiliation(s)
- I Debrix
- Service de Pharmacie-Toxicologie, Hôpital Tenon, Paris, France
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Rivas AL, Deshler JD, Quimby FW, Mohammed HO, Wilson DJ, Gonzalez RN, Lein DH, Bruso P. Interdisciplinary question generation: Synthesis and validity analysis of the 1993–1997 bovine mastitis-related literature. Scientometrics 1998. [DOI: 10.1007/bf02458378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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An interdisciplinary and systems-based evaluation of academic programs: Bovine mastitis-related veterinary research, education and outreach. Scientometrics 1997. [DOI: 10.1007/bf02457437] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Blane CE, Fitzgerald JT, Bowerman RA, Schlesinger AE, Barclay ML, Zelenock GB, McQuillan M, Davis WK. Performance on the radiology component of a critical clinical skills examination. Acad Radiol 1996; 3:958-61. [PMID: 8959187 DOI: 10.1016/s1076-6332(96)80311-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
RATIONALE AND OBJECTIVES Clinical competence certification is now required in some specialties in medicine. A Comprehensive Clinical Assessment (CCA) was created to test mastery of critical skills by students at the end of the 3rd year of medical school. METHODS The CCA is a series of stations that test skills the faculty consider important for all medical students (eg, breast examination, electrocardiogram reading, chest pain assessment, ophthalmology photographs). The radiology station was designed to evaluate imaging skills believed to be taught and learned in the core 3rd-year rotations. RESULTS External measures (National Board Examinations, grade point average, and overall score) of clinical performance of the 608 medical students who completed the CCA examination between 1991 and 1993 were found to be correlated with the radiology station scores. CONCLUSION The radiology station in the CCA examination is a reproducible measure of clinical performance.
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Affiliation(s)
- C E Blane
- Department of Radiology, University of Michigan Medical School, Ann Arbor, USA
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Robinson LA, Spencer JA, Neal DE. Teaching the teachers--a needs assessment of tutors for a new clinical skills course. MEDICAL EDUCATION 1996; 30:208-214. [PMID: 8949555 DOI: 10.1111/j.1365-2923.1996.tb00744.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
There is an increasing trend in undergraduate education towards teaching clinical skills from a community base. A new clinical curriculum was introduced in Newcastle upon Tyne in 1995, beginning with an integrated clinical skills course. Although the attitudes and views of general practitioners (GPs) towards community-based clinical teaching have previously been reported, their perceived training needs have not been formally identified. The aims of this study were to identify the competencies needed by GPs for community-based clinical skills teaching, to compare and contrast these needs with their hospital colleagues, and to use the results to develop a teaching programme for the clinical tutors involved in the new course. In order of priority, the GPs and hospital tutors expressed similar needs: small-group teaching skills, assessing student needs, giving effective feedback and assessment of student performance, with a preference for the teaching to be organized within local teaching units. Most GPs and hospital tutors (73 and 69%, respectively) requested a distance-learning pack to complement the teaching. General practitioners rated resources for improving their individual clinical skills more highly than their hospital colleagues: for example, videotapes demonstrating examination techniques. Forty-six per cent of GP tutors had received some formal training in teaching methods compared to 29% of hospital tutors. The implications of the results for developing a 'Teaching the Teachers' course for clinical tutors are discussed.
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Affiliation(s)
- L A Robinson
- Department of Primary Health Care, Medical School, Newcastle upon Tyne, UK
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Williams PL. A comparison between the roles of part-time and full-time clinical tutors: is there a difference? NURSE EDUCATION TODAY 1994; 14:427-435. [PMID: 7838078 DOI: 10.1016/0260-6917(94)90003-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Recent changes in pre-registration radiographer education required quality issues concerning students' clinical experience to be reviewed. This investigation was undertaken to illuminate one important aspect of clinical education: the way in which clinical tutors spend their time. The study described, quantified and compared the role of part-time tutors with those who are employed full-time. From the data, three main roles for tutors emerged: duties associated with students, duties of a professional nature, and duties which were considered to be developmental. On the basis of the results, it seems reasonable to suggest that, because part-time tutors devote as much time to students as those employed full-time, there is no disadvantage to students. However, further research is required concerning the role and duties of clinical tutors. In addition, recommendations for improving the current methodology are made, if the study is repeated.
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Abstract
The extensive literature in the field of competence and performance is reviewed in this paper, which argues that there is much confusion between these different constructs. It concludes that since nurse pre-registration education is concerned with producing nurses who consistently provide care of a high quality, greater emphasis should be placed upon performance in the real-life clinical setting rather than upon competence.
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Affiliation(s)
- A E While
- Department of Nursing Studies, King's College, London, England
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Abstract
The need for continuing medical education (CME) is now well recognized. The challenge is to make it effective. CRISIS, an acronymn, stands for the criteria which must be met to produce effective CME programmes: convenience, relevance, individualization, self-assessment, interest, speculation and systematic. CRISIS is a practical tool, based on 15 years of experience in the production and evaluation of CME programmes at the Centre for Medical Education, University of Dundee. The application of the CRISIS criteria to a CME programme will highlight any areas needing improvement and will guide programme producers in the creation of new CME materials. It will also help those responsible for planning CME activities to choose from a range of existing programmes.
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Affiliation(s)
- R M Harden
- Centre for Medical Education, University of Dundee, UK
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Laidlaw JM, Harden RM. Impact of technology on the education of health care professionals. Int J Technol Assess Health Care 1986; 3:67-82. [PMID: 10282224 DOI: 10.1017/s0266462300011752] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
A rapid development in health care delivery has been the increasing use of technology. Technology will continue to transform medical practice and all health care workers are involved with technology by accident or design. This has resulted in technology dominating many health policy decisions (4).
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Abstract
This brief practical aid to course or curriculum development cannot replace educational qualifications or experience, but it does examine ten basic questions, any of which may be all too easily neglected. These are: What are the needs in relation to the product of the training programme? What are the aims and objectives? What content should be included? How should the content be organized? What educational strategies should be adopted? What teaching methods should be used? How should assessment be carried out? How should details of the curriculum be communicated? What educational environment or climate should be fostered? How should the process be managed? Each aspect is illustrated through the analogy of car manufacturing. The ten questions are relevant in all situations where a course or curriculum is being planned, including an undergraduate degree course, a short postgraduate course or a 1-hour lecture.
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