How does culture affect experiential training feedback in exported Canadian health professional curricula?

Cultural Considerations in the Formal Process of Simulation Curriculum Adaptation: A Scoping Review

SUMMARY STATEMENT

Transborder curriculum partnerships in health professions education have been increasing in numbers in recent years. These partnerships present unique challenges when transferring curricula from one context to another. It has been noted that cultural differences between institutions, faculty, staff, and learners can have profound effects on collaboration. Given the significant need for context and fidelity (especially relative to cultural considerations) in healthcare simulation education, there are gaps that need to be addressed in the transfer of these curricula. A scoping literature review was conducted examining recently published articles with relevance to simulation curriculum design or adaptation in transborder contexts to determine to what extent cultural elements are considered in the design and adaptation of simulation-based education in transborder curriculum partnerships. This review resulted in 19 studies requiring full-text review. Studies represented every region of the world with both near and distant proximity of partnering parties. From the reviewed studies, 8 categories related to curriculum adaptation were identified. These categories, when compared with the themes present in Campinha-Bacote's model of cultural competency, showed complete overlap with the 5 themes of the model plus an additional theme complementary to the model. This scoping review demonstrates that cultural considerations clearly play a role in the adaptation of simulation curricula in transborder healthcare curricular partnerships, but further research is needed to further define the exact nature of that relationship.

Factors influencing clinician-educators' assessment practice in varied Southern contexts: a health behaviour theory perspective

In many contexts, responsibility for exit-level assessment design and implementation in undergraduate medical programmes lies with individuals who convene clinical clerkships. Their assessment practice has significant consequences for students' learning and the patients and communities that graduates will serve. Interventions to enhance assessment must involve these assessors, yet little is known about factors influencing their assessment practice. The purpose of this study was to explore factors that influence assessment practice of clerkship convenors in three varied low-and-middle income contexts in the global South. Taking assessment practice as a behaviour, Health Behaviour Theory (HBT) was deployed as a theoretical framework to explore, describe and explain assessor behaviour. Thirty-one clinician-educators responsible for designing and implementing high-stakes clerkship assessment were interviewed in South Africa and Mexico. Interacting personal and contextual factors influencing clinician-educator assessment intention and action were identified. These included attitude, influenced by impact and response appraisal, and perceived self-efficacy; along with interpersonal, physical and organisational, and distal contextual factors. Personal competencies and conducive environments supported intention to action transition. While previous research has typically explored factors in isolation, the HBT framing enabled a systematic and coherent account of assessor behaviour. These findings add a particular contextual perspective to understanding assessment practice, yet also resonate with and extend existing work that predominantly emanates from high-income contexts in the global North. These findings provide a foundation for the planning of assessment change initiatives, such as targeted, multi-factorial faculty development.

Examining online international health professions education: a mixed methods review of barriers, facilitators, and early outcomes★

BACKGROUND

Access to quality healthcare education across the world is disproportionate. This study explores the potential for Cardiovascular Perfusion education to be delivered online to reach international students.

METHODS

Exploratory mixed methods were used to identify the barriers, facilitators, and early outcomes of online international health professions education.

RESULTS

Qualitative analysis yielded four primary and nine subthemes. Multiple interventions were implemented in the planning of a novel online international Extracorporeal Science (ECS) program based on these themes. Quantitative data from the first semester of the new ECS program was collected along with data from the traditional entry-level program and historic data from previous entry-level cohorts. No significant correlations or differences were found between students. Student satisfaction surveys were determined to be equivalent for each group. Mixed data analysis revealed exceptional student satisfaction in areas where qualitative feedback was incorporated into the program design.

CONCLUSIONS

Online international education may be a viable option in the health professions. Barriers and facilitators to this mode of education were identified and utilized in designing one such program. Early outcomes from the novel ECS program reveal that student performance and satisfaction are equivalent to those of a traditional in-person training program.

A mixed methods evaluation of the effectiveness of an oral health training program for disability care workers in Burkina Faso

BACKGROUND

While efforts to improve the oral health of vulnerable populations have received little attention in general, the situation of children with disabilities in low- income countries (LICs) remains especially challenging. The present study evaluated the effectiveness of an oral health training provided to disability care workers in Ouagadougou, Burkina Faso thereby contributing to closing the knowledge gap in disability research in relation to oral health in LICs.

METHODS

This was a single-arm pre-post study following an embedded mixed methods design using the New World Kirkpatrick training effectiveness evaluation model. For the purposes of this study, three levels of the Kirkpatrick (KP) evaluation were considered: reaction, learning and behaviour.

RESULTS

A total of 44 care workers from 6 disability centres participated in the study. Care worker post-training scores (Md = 17) were significantly higher compared to pre-training scores (Md = 13) [Wilcoxon signed-ranks test: Z= -5.53, p < .001, r = .59.] The median value for care worker confidence in applying training material in their everyday job was 7 out of 10 points (IQR = 3). At the 1-month training follow-up, 3 centres had implemented daily toothbrushing for people with disabilities.

CONCLUSION

These findings suggest that tailored training led to an increase in care worker confidence and motivation to implement oral health activities, in knowledge about oral health and a partial implementation uptake of daily toothbrushing in disability centres. Further long-term evaluations with dental care provision in rural and urban settings are needed to lower the high oral disease burden of people with disabilities in Burkina Faso.