The AMEE Research Committee: Initiatives to stimulate research and practice

Harnessing a knowledge translation framework to implement an undergraduate medical education intervention: A longitudinal study

INTRODUCTION

Implementation of evidence-informed educational interventions (EEI) involves applying and adapting theoretical and scientific knowledge to a specific context. Knowledge translation (KT) approaches can both facilitate and structure the process. The purpose of this paper is to describe lessons learned from applying a KT approach to help implement an EEI for clinical reasoning in medical students.

METHODS

Using the Knowledge to Action framework, we designed and implemented an EEI intended to support the development of students' clinical reasoning skills in a renewed medical curriculum. Using mixed-methods design, we monitored students' engagement with the EEI longitudinally through a platform log; we conducted focus groups with students and stakeholders, and observed the unfolding of the implementation and its continuation. Data are reported according to six implementation outcomes: Fidelity, Feasibility, Appropriateness, Acceptability, Adoption, and Penetration.

RESULTS

Students spent a mean of 24 min on the activity (fidelity outcome) with a high completion rate (between 75% and 95%; feasibility outcome) of the entire activity each time it was done. Focus group data from students and stakeholders suggest that the activity was acceptable, appropriate, feasible, adopted and well-integrated into the curriculum.

DISCUSSION

Through the process we observed the importance of having a structuring framework, of working closely and deliberatively with stakeholders and students, of building upon concurrent evaluations in order to adapt iteratively the EEI to the local context and, while taking students' needs into consideration, of upholding the EEI's core educational principles.

Qualitative Research in Veterinary Medical Education: Part 1-Principles of Qualitative Design

Qualitative methodologies are relative newcomers to health sciences education research. While they may look very different to their quantitative counterparts in terms of size and scope, when well-applied they offer a fresh perspective and generate valuable research findings. Although qualitative research is being increasingly conducted in veterinary medical education, there are few contextualized resources to assist those who would like to develop their expertise in this area. In this article, we address this by introducing the principles of qualitative research design in a veterinary medical education context. Drawing from a range of contemporary resources, we explore the types of research goals and questions that are amenable to qualitative inquiry and discuss the process of formulating a worthwhile research question. We explain what research paradigms are and introduce readers to some of the methodological options available to them in qualitative research. Examples from veterinary medical education are used to illustrate key points. In a second companion article, we will focus on the decisions that need to be made regarding data sampling, collection, and analysis. We will also consider how qualitative research is evaluated, and discuss how qualitative findings are applied. Taken together, the two articles build an understanding of qualitative research, illuminate its potential to contribute to the scholarship of teaching and learning in veterinary medical education, and equip readers with an improved capacity to appraise its value.

Building evidence-based practice competencies among rehabilitation students: a qualitative exploration of faculty and preceptors' perspectives

Medical education literature suggests clinically-integrated teaching may be the most effective approach to teach evidence-based practice (EBP). Before implementing this educational best practice in rehabilitation curricula, it is imperative to better understand the current context, barriers and facilitators to teach EBP in rehabilitation from the academic to the clinical setting. The aim of this study was to explore faculty and preceptors' experiences and perceptions of teaching EBP in rehabilitation professions, namely occupational therapy, physical therapy and speech-language pathology. We gathered data from seven focus groups and an individual interview with a sample of 24 faculty and 15 preceptors, i.e., clinical supervisors. Data collected were subjected to inductive thematic content analysis. We identified three overarching themes and corresponding strategies. First, "Recognizing EBP as a multifaceted concept" denoted participants' lack of consensus regarding the meaning and scope of EBP, and their awareness of such discrepancies. Second, "Complexity of EBP is at the core of teaching practices and experiences" referred to participants' perception of EBP as a complex process involving high-level cognitive skills, which influenced their teaching practices and challenged students and themselves. Third, "Connections and divides between research and practice" represented the limited and delicate connection between faculty and preceptors, the factors either bridging or maintaining the gap between them, and the impacts of such connections and divides on teaching. Improving collaboration between faculty and preceptors constitutes an essential first step towards more effective EBP training programs in rehabilitation that could be facilitated through online communities of practice or integrated knowledge translation research projects.

Leveraging knowledge translation and implementation science in the pursuit of evidence informed health professions education

Evidence informed approaches to health professions education can ensure accountability to learners and society in providing meaningful and effective education and helping resource strained systems via streamlined and cost-efficient practices. Knowledge translation and implementation science are two areas of study originally developed in clinical medicine in response to concerns that health care practices were incongruent with the scientific evidence. Two decades of research have led to important advances in our understanding of the nature and magnitude of research-practice gaps, the factors that support or impede adoption of evidence in clinical decision-making, and in the design and evaluation of theory driven interventions to reduce gaps. This paper borrows concepts from knowledge translation and implementation science to further our thinking about how health professions education can 'truly' be evidence informed. The article is organised in four sections: a discussion of the impetus for the evidence informed health professions education movement; a description of the origins of knowledge translation and implementation science; a discussion on how knowledge translation and implementation science can be leveraged to advance the evidence informed health professions education agenda; and suggestions for future discussion and research. An example is used to illustrate the application of the underpinning principles of knowledge translation and implementation science. The authors suggest a theory driven, staged and systematic approach that integrates knowledge translation principles and processes and involves key stakeholders interested in promoting the application of educational research of evidence.

Use of evidence in health professions education: Attitudes, practices, barriers and supports

Introduction: Health professions educators are increasingly called upon to apply an evidence-informed approach to teaching and assessment practices. There is scant empirical research exploring educators' attitudes, practices, and perceived barriers and supports to using research evidence in educational practice. Methods: We conducted a survey of AMEE members to explore three domains related to evidence-informed health professions education: (1) attitudes; (2) practices; and (3) supports and barriers. Analyses involved descriptive statistics to characterize participants' responses per domain, exploratory factor analysis, and multivariate regression analyses. Results: Three hundred ninety-six (∼10%) participants representing health professions educators (HPEs) and non HPEs (e.g. PhDs) and different roles (e.g. teacher, administrator) completed the survey. Attitudes toward evidence-informed HPE were generally favorable. Several barriers preclude participants from engaging in evidence-informed approaches to health professions education (HPE). Discussion: This study provides preliminary evidence on the attitudes toward and perceived barriers and supports of research use in HPE from different groups of HP educators, clinicians, and administrators. The findings for each of the three domains require additional exploration using qualitative methodologies. Conclusion: Targeted interventions designed to increase the uptake of research in HPE should consider different stakeholder groups' perceptions regarding these approaches, current vs. best practices, and factors that may impede evidence-informed approaches.

Twelve tips for creating an academic teaching portfolio

An academic teaching portfolio is not only a requirement at many academic teaching institutions, but it is also important in a medical educator's growth and development through documentation, reflection, evaluation, and change. Creating an academic portfolio may appear daunting at first but with careful advanced preparation, organized evidence collection of your educational work, proof of scholarship, and thorough documentation of self-reflection and change, you can produce a successful product that accurately represents your educational beliefs, accomplishments, and growth throughout your career. This article provides medical educators with twelve steps for creating a successful academic teaching portfolio.

Reliability and validity of the multiple mini interview (MMI) for admissions to an occupational therapy professional program

Introduction

Admissions decisions are among the most consequential assessment points in educating occupational therapists. Suboptimal measures of academic achievement and personal characteristics are often used to select candidates. The purpose of the study is to investigate reliability and validity evidence supporting the use of the multiple mini interview for selecting candidates to an occupational therapy master’s level program.

Method

The study used a prospective cohort design. Data sources included both archival data and prospective candidate-generated data (multiple mini interview scores, applicant file review scores and academic performance), analyzed using psychometric and correlational approaches.

Results

Seventy-seven of 80 candidates participated in the prospective component of the study. Overall reliability of a 10-station multiple mini interview was .72. Inter-rater reliability was reasonable. Weak interrelationships were found between multiple mini interview scores and other application components.

Conclusion

Multiple mini interview scores may be probing different attributes than the other components of the application package. Our study findings support the use of the multiple mini interview for selecting applicants to a professional master’s program in occupational therapy; however, future work should continue to investigate the predictive validity of the multiple mini interview.

Knowledge Syntheses in Medical Education: Demystifying Scoping Reviews

An unprecedented rise in health professions education (HPE) research has led to increasing attention and interest in knowledge syntheses. There are many different types of knowledge syntheses in common use, including systematic reviews, meta-ethnography, rapid reviews, narrative reviews, and realist reviews. In this Perspective, the authors examine the nature, purpose, value, and appropriate use of one particular method: scoping reviews. Scoping reviews are iterative and flexible and can serve multiple main purposes: to examine the extent, range, and nature of research activity in a given field; to determine the value and appropriateness of undertaking a full systematic review; to summarize and disseminate research findings; and to identify research gaps in the existing literature. Despite the advantages of this methodology, there are concerns that it is a less rigorous and defensible means to synthesize HPE literature. Drawing from published research and from their collective experience with this methodology, the authors present a brief description of scoping reviews, explore the advantages and disadvantages of scoping reviews in the context of HPE, and offer lessons learned and suggestions for colleagues who are considering conducting scoping reviews. Examples of published scoping reviews are provided to illustrate the steps involved in the methodology.

Occupational Therapy Education Research: Results of a National Survey

OBJECTIVE

Despite a strong tradition of education scholarship in occupational therapy, no systematic evaluation of the amount and nature of research in this arena, or its associated challenges, has been conducted. This study examined the scope and range of education-focused research conducted in Canada and identified perceived supports and barriers for this area of inquiry.

METHOD

An online survey was sent to faculty of all 14 Canadian occupational therapy programs. Descriptive statistics were used to summarize areas of study focus, and qualitative thematic analysis captured respondents' perceptions of personal and environmental factors influencing their engagement in education research.

RESULTS

Respondents (n = 47) reported engagement in education scholarship spanning more than 20 focus areas, often with limited resources.

CONCLUSION

Strategies are proposed to promote the viability of education research in occupational therapy and to improve resources and other supports for this type of research.

Evidence shaped health professional education: can we talk about a new paradigm?

This commentary accompanies the publication of several Best Evidence Medical Education systematic reviews together with invited discussion papers on issues of key importance to evidence shaped health professional education. The reviews and papers signify positive developments for the still very young movement where practitioners and policy makers use evidence to help their decision making in health professional education. They provide this commentary with exemplar material to highlight some key points about the process of education systematic review and some of the conceptual and methodological issues presently being discussed by colleagues interested in taking the evidence shaped education movement in a forward direction. These include the need for more funded reviews, greater commitment to question-driven research (primary and secondary) and further debate about power, evidence and change. It is hoped that this will lead to a broader debate, a widening of interest and a deepening of scholarship related to evidence shared health professional education.