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Ashley H, Gough S, Darlington C, Clark J, Mosley C. Hitting the target and missing the point? A BEME systematic review of evidence regarding the efficacy of statutory and mandatory training in health and care: BEME Guide No. 87. Med Teach 2024:1-10. [PMID: 38599334 DOI: 10.1080/0142159x.2024.2331048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 03/12/2024] [Indexed: 04/12/2024]
Abstract
BACKGROUND Mandatory training is considered fundamental to establishing and maintaining high standards of professional practice. There is little evidence however, of the training either achieving its required learning outcomes, or delivering improvement in outcomes for patients. Whist organisations may be hitting their compliance target for mandatory training, is the purpose missing the point? This systematic review aims to synthesize and evaluate the efficacy of statutory and mandatory training. METHODS PubMed, EMBASE, CNAHL, ERIC and Cochrane Central registers were searched on 23rd May 2023. All research designs were included and reported training had to specify an organisational mandate within a healthcare setting. Data was coded using a modified Kirkpatrick (KP) rating system. Critical appraisal was undertaken using the Modified Medical Education Research Study Quality Instrument, Critical Appraisal Skills Programme Qualitative Studies checklist and Mixed Methods Assessment Tool. RESULTS Twenty-five studies were included, featuring 9132 participants and 1348 patient cases audited. Studies described evaluation of mandatory training according to Kirkpatrick's outcomes levels 1-4b, with the majority (68%) undertaken in the UK and within acute settings. Training duration varied from 5 min to 3 days. There is a lack of consensus regarding mandatory training rationale, core topics, duration, and optimum refresher training period. Currently, mandatory training does not consistently translate to widescale improvements in safe practice or improved patient outcomes. CONCLUSIONS Due to the lack of international consensus regarding the need for mandated training, most papers originated from countries with centrally administered national health care systems. The rationale for mandating training programmes remains undefined. The assumption that mandatory training is delivering safe practice outcomes is not supported by studies included in this review. The findings of this review offer a basis for further research to be undertaken to assist with the design, facilitation, and impact of mandatory training.
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Affiliation(s)
- Helen Ashley
- People and Organisational Development, The University of Manchester, Manchester, UK
| | - Suzanne Gough
- Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Carol Darlington
- Emergency Medicine, Mid Cheshire Hospitals NHS Foundation Trust, Crewe, Cheshire, UK
| | - Justin Clark
- Institute for Evidence-Based Healthcare, Bond University, Robina, Queensland, Australia
| | - Chiara Mosley
- Workforce Transformation, Mid Cheshire Hospitals NHS Foundation Trust, Crewe, Cheshire, UK
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Cleland J, Blitz J, Cleutjens KBJM, Oude Egbrink MGA, Schreurs S, Patterson F. Robust, defensible, and fair: The AMEE guide to selection into medical school: AMEE Guide No. 153. Med Teach 2023; 45:1071-1084. [PMID: 36708606 DOI: 10.1080/0142159x.2023.2168529] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/05/2023]
Abstract
Selection is the first assessment of medical education and training. Medical schools must select from a pool of academically successful applicants and ensure that the way in which they choose future clinicians is robust, defensible, fair to all who apply and cost-effective. However, there is no comprehensive and evidence-informed guide to help those tasked with setting up or rejuvenating their local selection process. To address this gap, our guide draws on the latest research, international case studies and consideration of common dilemmas to provide practical guidance for designing, implementing and evaluating an effective medical school selection system. We draw on a model from the field of instructional design to frame the many different activities involved in doing so: the ADDIE model. ADDIE provides a systematic framework of Analysis (of the outcomes to be achieved by the selection process, and the barriers and facilitators to achieving these), Design (what tools and content are needed so the goals of selection are achieved), Development (what materials and resources are needed and available), Implementation (plan [including piloting], do study and adjust) and Evaluation (quality assurance is embedded throughout but the last step involves extensive evaluation of the entire process and its outcomes).HIGHLIGHTSRobust, defensible and fair selection into medical school is essential. This guide systematically covers the processes required to achieve this, from needs analysis through design, development and implementation, to evaluation of the success of a selection process.
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Affiliation(s)
- J Cleland
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore
| | - J Blitz
- Centre for Health Professions Education, Faculty of Medicine and Health Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - K B J M Cleutjens
- School of Health Professions Education, Maastricht University, the Netherlands
| | - M G A Oude Egbrink
- School of Health Professions Education, Maastricht University, the Netherlands
| | - S Schreurs
- School of Health Professions Education, Maastricht University, the Netherlands
- Centrum for Evidence Based Education, University of Utrecht, the Netherlands
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Kim D, Manzo RD, Montoya M, Nguyen M, Vang KH, Weber L, Yepez M. Medical mentorship deconstructed: an analysis and structural recommendation for high value mentorship. MedEdPublish (2016) 2023; 12:13. [PMID: 37663548 PMCID: PMC10474344 DOI: 10.12688/mep.18944.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/05/2023] Open
Abstract
Background: Mentorship is an important component for young students interested in pursuing a career in medicine. In medically underserved areas, such as rural areas, mentorship can be sparse due to the lack of access to healthcare professionals. The purpose of this project was to gain an understanding of the mentorship received by practicing medical students. Methods: The authors conducted structured, one-on-one interviews with 10 current medical students about their perceptions and experiences with mentorship. Interviews were transcribed, coded, and analyzed for themes and subthemes. Results: Our findings revolve around three time periods of mentorship: 1) Before Obtaining a Mentor; 2) During the Mentorship; and 3) After the Mentorship. In our findings we describe key characteristics such as professional development, personal qualities of the mentor, and professional and personal guidance as important components in guiding the mentee starting from the undergraduate level and continuing to their current level of education. Conclusion: Interviewees' experiences with and perspectives on the mentorship they received were generally positive, though it was evident there are some aspects of the mentee-mentor relationship that can be improved. Building on the results obtained, setting expectations, providing mentor training, and pairing mentors/mentees from similar backgrounds are what we propose to create fulfilling and meaningful relationships between a mentee and mentor.
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Affiliation(s)
- Duane Kim
- School of Medicine, University of California Davis Medical Center, Sacramento, CA, USA
| | - Rosa D. Manzo
- Health Sciences Research Institute, University of California, Merced, Merced, CA, USA
| | - Michael Montoya
- School of Medicine, University of California Davis Medical Center, Sacramento, CA, USA
| | - Marissa Nguyen
- School of Medicine, University of California Davis Medical Center, Sacramento, CA, USA
| | - Kao Houa Vang
- School of Medicine, University of California Davis Medical Center, Sacramento, CA, USA
| | - Lindsey Weber
- School of Medicine, University of California Davis Medical Center, Sacramento, CA, USA
| | - Marisela Yepez
- Health Sciences Research Institute, University of California, Merced, Merced, CA, USA
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4
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Daniel M, Gottlieb M, Wooten D, Stojan J, Haas MRC, Bailey J, Evans S, Lee D, Goldberg C, Fernandez J, Jassal SK, Rudolf F, Guluma K, Lander L, Pott E, Goldhaber NH, Thammasitboon S, Uraiby H, Grafton-Clarke C, Gordon M, Pawlikowska T, Corral J, Partha I, Kolman KB, Westrick J, Dolmans D. Virtual interviewing for graduate medical education recruitment and selection: A BEME systematic review: BEME Guide No. 80. Med Teach 2022; 44:1313-1331. [PMID: 36369939 DOI: 10.1080/0142159x.2022.2130038] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND The COVID-19 pandemic caused graduate medical education (GME) programs to pivot to virtual interviews (VIs) for recruitment and selection. This systematic review synthesizes the rapidly expanding evidence base on VIs, providing insights into preferred formats, strengths, and weaknesses. METHODS PubMed/MEDLINE, Scopus, ERIC, PsycINFO, MedEdPublish, and Google Scholar were searched from 1 January 2012 to 21 February 2022. Two authors independently screened titles, abstracts, full texts, performed data extraction, and assessed risk of bias using the Medical Education Research Quality Instrument. Findings were reported according to Best Evidence in Medical Education guidance. RESULTS One hundred ten studies were included. The majority (97%) were from North America. Fourteen were conducted before COVID-19 and 96 during the pandemic. Studies involved both medical students applying to residencies (61%) and residents applying to fellowships (39%). Surgical specialties were more represented than other specialties. Applicants preferred VI days that lasted 4-6 h, with three to five individual interviews (15-20 min each), with virtual tours and opportunities to connect with current faculty and trainees. Satisfaction with VIs was high, though both applicants and programs found VIs inferior to in-person interviews for assessing 'fit.' Confidence in ranking applicants and programs was decreased. Stakeholders universally noted significant cost and time savings with VIs, as well as equity gains and reduced carbon footprint due to eliminating travel. CONCLUSIONS The use of VIs for GME recruitment and selection has accelerated rapidly. The findings of this review offer early insights that can guide future practice, policy, and research.
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Affiliation(s)
- Michelle Daniel
- School of Medicine, University of California, San Diego, San Diego, CA, USA
| | | | - Darcy Wooten
- School of Medicine, University of California, San Diego, San Diego, CA, USA
| | | | - Mary R C Haas
- University of Michigan Medical School, Ann Arbor, MI, USA
| | - Jacob Bailey
- School of Medicine, University of California, San Diego, San Diego, CA, USA
| | - Sean Evans
- School of Medicine, University of California, San Diego, San Diego, CA, USA
| | - Daniel Lee
- School of Medicine, University of California, San Diego, San Diego, CA, USA
| | - Charles Goldberg
- School of Medicine, University of California, San Diego, San Diego, CA, USA
- VA San Diego Healthcare, San Diego, CA, USA
| | - Jorge Fernandez
- School of Medicine, University of California, San Diego, San Diego, CA, USA
| | - Simerjot K Jassal
- School of Medicine, University of California, San Diego, San Diego, CA, USA
- VA San Diego Healthcare, San Diego, CA, USA
| | - Frances Rudolf
- School of Medicine, University of California, San Diego, San Diego, CA, USA
| | - Kama Guluma
- School of Medicine, University of California, San Diego, San Diego, CA, USA
| | - Lina Lander
- School of Medicine, University of California, San Diego, San Diego, CA, USA
| | - Emily Pott
- School of Medicine, University of California, San Diego, San Diego, CA, USA
| | - Nicole H Goldhaber
- School of Medicine, University of California, San Diego, San Diego, CA, USA
| | | | - Hussain Uraiby
- University Hospitals of Leicester NHS Trust, Leicester, UK
| | | | - Morris Gordon
- Biomedical Evidence Synthesis and Translation to Practice (BEST) Unit, School of Medicine, University of Central Lancashire, Preston, UK
| | - Teresa Pawlikowska
- Health Professions Education Centre (HPEC), RCSI University of Medicine and Health Sciences, Dublin, IE
| | - Janet Corral
- University of Nevada School of Medicine, Reno, NV, USA
| | - Indu Partha
- University of Arizona College of Medicine, Tuscon, AZ, USA
| | - Karyn B Kolman
- University of Arizona College of Medicine, Tuscon, AZ, USA
| | | | - Diana Dolmans
- Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
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Khamees D, Peterson W, Patricio M, Pawlikowska T, Commissaris C, Austin A, Davis M, Spadafore M, Griffith M, Hider A, Pawlik C, Stojan J, Grafton-Clarke C, Uraiby H, Thammasitboon S, Gordon M, Daniel M. Remote learning developments in postgraduate medical education in response to the COVID-19 pandemic - A BEME systematic review: BEME Guide No. 71. Med Teach 2022; 44:466-485. [PMID: 35289242 DOI: 10.1080/0142159x.2022.2040732] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Prior reviews investigated medical education developments in response to COVID-19, identifying the pivot to remote learning as a key area for future investigation. This review synthesized online learning developments aimed at replacing previously face-to-face 'classroom' activities for postgraduate learners. METHODS Four online databases (CINAHL, Embase, PsychINFO, and PubMed) and MedEdPublish were searched through 21 December 2020. Two authors independently screened titles, abstracts and full texts, performed data extraction, and assessed risk of bias. The PICRAT technology integration framework was applied to examine how teachers integrated and learners engaged with technology. A descriptive synthesis and outcomes were reported. A thematic analysis explored limitations and lessons learned. RESULTS Fifty-one publications were included. Fifteen collaborations were featured, including international partnerships and national networks of program directors. Thirty-nine developments described pivots of existing educational offerings online and twelve described new developments. Most interventions included synchronous activities (n Fif5). Virtual engagement was promoted through chat, virtual whiteboards, polling, and breakouts. Teacher's use of technology largely replaced traditional practice. Student engagement was largely interactive. Underpinning theories were uncommon. Quality assessments revealed moderate to high risk of bias in study reporting and methodology. Forty-five developments assessed reaction; twenty-five attitudes, knowledge or skills; and two behavior. Outcomes were markedly positive. Eighteen publications reported social media or other outcomes, including reach, engagement, and participation. Limitations included loss of social interactions, lack of hands-on experiences, challenges with technology and issues with study design. Lessons learned highlighted the flexibility of online learning, as well as practical advice to optimize the online environment. CONCLUSIONS This review offers guidance to educators attempting to optimize learning in a post-pandemic world. Future developments would benefit from leveraging collaborations, considering technology integration frameworks, underpinning developments with theory, exploring additional outcomes, and designing and reporting developments in a manner that supports replication.
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Affiliation(s)
- Deena Khamees
- McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - William Peterson
- Emergency Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | | | - Teresa Pawlikowska
- Royal College of Surgeons, University of Medicine and Health Sciences, Dublin, Ireland
| | - Carolyn Commissaris
- Emergency Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Andrea Austin
- San Diego School of Medicine, University of California, San Diego, CA, USA
| | - Mallory Davis
- Emergency Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Maxwell Spadafore
- Emergency Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Max Griffith
- Emergency Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Ahmad Hider
- Emergency Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Cameron Pawlik
- Emergency Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Jennifer Stojan
- Emergency Medicine, University of Michigan Medical School, Ann Arbor, MI, USA
| | | | - Hussein Uraiby
- School of Medicine, University of Leicester, Leicester, UK
| | | | - Morris Gordon
- Blackpool Victoria Hospital, Blackpool, UK
- School of Medicine, University of Central Lancashire, Preston, UK
| | - Michelle Daniel
- San Diego School of Medicine, University of California, San Diego, CA, USA
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6
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Stojan J, Haas M, Thammasitboon S, Lander L, Evans S, Pawlik C, Pawilkowska T, Lew M, Khamees D, Peterson W, Hider A, Grafton-Clarke C, Uraiby H, Gordon M, Daniel M. Online learning developments in undergraduate medical education in response to the COVID-19 pandemic: A BEME systematic review: BEME Guide No. 69. Med Teach 2022; 44:109-129. [PMID: 34709949 DOI: 10.1080/0142159x.2021.1992373] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
BACKGROUND The COVID-19 pandemic spurred an abrupt transition away from in-person educational activities. This systematic review investigated the pivot to online learning for nonclinical undergraduate medical education (UGME) activities and explored descriptions of educational offerings deployed, their impact, and lessons learned. METHODS The authors systematically searched four online databases and conducted a manual electronic search of MedEdPublish up to December 21, 2020. Two authors independently screened titles, abstracts and full texts, performed data extraction and assessed risk of bias. A third author resolved discrepancies. Findings were reported in accordance with the STORIES (STructured apprOach to the Reporting in healthcare education of Evidence Synthesis) statement and BEME guidance. RESULTS Fifty-six articles were included. The majority (n = 41) described the rapid transition of existing offerings to online formats, whereas fewer (n = 15) described novel activities. The majority (n = 27) included a combination of synchronous and asynchronous components. Didactics (n = 40) and small groups (n = 26) were the most common instructional methods. Teachers largely integrated technology to replace and amplify rather than transform learning, though learner engagement was often interactive. Thematic analysis revealed unique challenges of online learning, as well as exemplary practices. The quality of study designs and reporting was modest, with underpinning theory at highest risk of bias. Virtually all studies (n = 54) assessed reaction/satisfaction, fewer than half (n = 23) assessed changes in attitudes, knowledge or skills, and none assessed behavioral, organizational or patient outcomes. CONCLUSIONS UGME educators successfully transitioned face-to-face instructional methods online and implemented novel solutions during the COVID-19 pandemic. Although technology's potential to transform teaching is not yet fully realized, the use of synchronous and asynchronous formats encouraged virtual engagement, while offering flexible, self-directed learning. As we transition from emergency remote learning to a post-pandemic world, educators must underpin new developments with theory, report additional outcomes and provide details that support replication.
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Affiliation(s)
- Jennifer Stojan
- Internal Medicine and Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Mary Haas
- Internal Medicine and Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Satid Thammasitboon
- Department of Pediatrics, Texas Children's Hospital and Baylor College of Medicine, Houston, TX, USA
| | - Lina Lander
- Family Medicine and Public Health, University of California San Diego School of Medicine, La Jolla, CA, USA
| | - Sean Evans
- Family Medicine and Public Health, University of California San Diego School of Medicine, La Jolla, CA, USA
| | - Cameron Pawlik
- Internal Medicine and Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA
| | | | - Madelyn Lew
- Internal Medicine and Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Deena Khamees
- McGovern Medical School, University of Texas Health Science Center, Houston, TX, USA
| | - William Peterson
- Internal Medicine and Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Ahmad Hider
- Internal Medicine and Pediatrics, University of Michigan Medical School, Ann Arbor, MI, USA
| | | | - Hussein Uraiby
- School of Medicine, University of Leicester, Leicester, UK
| | - Morris Gordon
- Blackpool Victoria Hospital, Blackpool, UK
- School of Medicine, University of Central Lancashire, Preston, UK
| | - Michelle Daniel
- Family Medicine and Public Health, University of California San Diego School of Medicine, La Jolla, CA, USA
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Kolomitro K, Hamilton J, Leslie K, Hazelton L, Veerapen K, Kelly-Turner K, Keegan D. Viewing faculty development through an organizational lens: Sharing lessons learned. Med Teach 2021; 43:894-899. [PMID: 34057867 DOI: 10.1080/0142159x.2021.1931078] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Faculty Development (FD) plays a key role in supporting education, especially during times of change. The effectiveness of FD often depends upon organizational factors, indicating a need for a deeper appreciation of the role of institutional context. How do organizational factors constrain or enhance the capacity of faculty developers to fulfil their mandates? METHODS Using survey research methodology, data from a survey of FD leaders at Canadian medical schools were analyzed using Bolman and Deal's four frames: Symbolic, Political, Structural, and Human Resource (HR). RESULTS In the Symbolic frame, FD leaders reported lack of identity as a FD unit, which was seen as a constraining factor. Within the Political frame, developing visibility was seen as an enhancing factor, though it did not always ensure being valued. In the Structural frame, expanding scope of practice was seen as an enhancing factor, though it could also be a constraining factor if not accompanied by increased resources. In the HR frame, a sense of instability due to changing leadership and uncertainty about human resources was seen as a constraining factor. CONCLUSION While broadening the mandate of FD can generally be considered as positive, it is imperative that it is appropriately resourced and accompanied by recognition of FD as a valued contributor to the educational mission.
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Affiliation(s)
- Klodiana Kolomitro
- Office of Professional Development and Educational Scholarship, Faculty of Health Sciences, Queens University, Kingston, Canada
| | - Joanne Hamilton
- Office of Educational and Faculty Development, University of Manitoba, Winnipeg, Canada
| | - Karen Leslie
- Department of Paediatrics, University of Toronto, Toronto, Canada
| | - Lara Hazelton
- Department of Psychiatry, Dalhousie University, Halifax, Canada
| | - Kiran Veerapen
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | | | - David Keegan
- School of Medicine, University of Calgary, Calgary, Canada
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Chen W, Sandars J, Reeves TC. Navigating complexity: The importance of design-based research for faculty development. Med Teach 2021; 43:475-477. [PMID: 32530727 DOI: 10.1080/0142159x.2020.1774530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Despite the importance of evidence-based medical education, navigating the complexity of its implementation can be frustrating. Faculty development that engages and supports medical educators in Design-Based Research is one promising approach to respond to this challenge. An essential aspect of this process is to expand faculty's Zone of Generativity and thus foster their individual and collective capabilities to navigate the complexity of implementing evidence-based medical education.
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Affiliation(s)
- Weichao Chen
- Office of Medical Education, School of Medicine, University of Virginia, Charlottesville, VA, USA
| | - John Sandars
- Health Research Institute, Edge Hill University, Ormskirk, UK
| | - Thomas C Reeves
- College of Education, The University of Georgia, Athens, GA, USA
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Daniel M, Gordon M, Patricio M, Hider A, Pawlik C, Bhagdev R, Ahmad S, Alston S, Park S, Pawlikowska T, Rees E, Doyle AJ, Pammi M, Thammasitboon S, Haas M, Peterson W, Lew M, Khamees D, Spadafore M, Clarke N, Stojan J. An update on developments in medical education in response to the COVID-19 pandemic: A BEME scoping review: BEME Guide No. 64. Med Teach 2021; 43:253-271. [PMID: 33496628 DOI: 10.1080/0142159x.2020.1864310] [Citation(s) in RCA: 110] [Impact Index Per Article: 36.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
Abstract
BACKGROUND COVID-19 has fundamentally altered how education is delivered. Gordon et al. previously conducted a review of medical education developments in response to COVID-19; however, the field has rapidly evolved in the ensuing months. This scoping review aims to map the extent, range and nature of subsequent developments, summarizing the expanding evidence base and identifying areas for future research. METHODS The authors followed the five stages of a scoping review outlined by Arskey and O'Malley. Four online databases and MedEdPublish were searched. Two authors independently screened titles, abstracts and full texts. Included articles described developments in medical education deployed in response to COVID-19 and reported outcomes. Data extraction was completed by two authors and synthesized into a variety of maps and charts. RESULTS One hundred twenty-seven articles were included: 104 were from North America, Asia and Europe; 51 were undergraduate, 41 graduate, 22 continuing medical education, and 13 mixed; 35 were implemented by universities, 75 by academic hospitals, and 17 by organizations or collaborations. The focus of developments included pivoting to online learning (n = 58), simulation (n = 24), assessment (n = 11), well-being (n = 8), telehealth (n = 5), clinical service reconfigurations (n = 4), interviews (n = 4), service provision (n = 2), faculty development (n = 2) and other (n = 9). The most common Kirkpatrick outcome reported was Level 1, however, a number of studies reported 2a or 2b. A few described Levels 3, 4a, 4b or other outcomes (e.g. quality improvement). CONCLUSIONS This scoping review mapped the available literature on developments in medical education in response to COVID-19, summarizing developments and outcomes to serve as a guide for future work. The review highlighted areas of relative strength, as well as several gaps. Numerous articles have been written about remote learning and simulation and these areas are ripe for full systematic reviews. Telehealth, interviews and faculty development were lacking and need urgent attention.
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Affiliation(s)
- Michelle Daniel
- Emergency Medicine, School of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Morris Gordon
- Blackpool Victoria Hospital, Blackpool, UK
- School of Medicine, University of Central Lancashire, Lancashire, UK
| | | | - Ahmad Hider
- University of Michigan Medical School, Ann Arbor, MI, USA
| | - Cameron Pawlik
- University of Michigan Medical School, Ann Arbor, MI, USA
| | | | | | - Sebastian Alston
- Division of Clinical Sciences, Alabama College of Osteopathic Medicine, Dothan, AL, USA
| | - Sophie Park
- Primary Care and Population Health, University College London Medical School, London, UK
| | - Teresa Pawlikowska
- Health Professions Education Centre (HPEC), Royal College of Surgeons University of Medicine and Health Sciences, Dublin, Ireland
| | - Eliot Rees
- Primary Care and Population Health, University College London Medical School, London, UK
- School of Medicine, Keele University, Keele, UK
| | - Andrea Jane Doyle
- Health Professions Education Centre (HPEC), Royal College of Surgeons University of Medicine and Health Sciences, Dublin, Ireland
| | - Mohan Pammi
- Department of Pediatrics, Texas Children's Hospital, Houston, TX, USA
| | - Satid Thammasitboon
- Department of Pediatrics, Texas Children's Hospital, Houston, TX, USA
- Baylor College of Medicine, Houston, TX, USA
| | - Mary Haas
- University of Michigan Medical School, Ann Arbor, MI, USA
| | | | - Madelyn Lew
- University of Michigan Medical School, Ann Arbor, MI, USA
| | - Deena Khamees
- University of Michigan Medical School, Ann Arbor, MI, USA
| | | | - Nicola Clarke
- Primary Care and Population Health, University College London Medical School, London, UK
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Gordon M, Patricio M, Horne L, Muston A, Alston SR, Pammi M, Thammasitboon S, Park S, Pawlikowska T, Rees EL, Doyle AJ, Daniel M. Developments in medical education in response to the COVID-19 pandemic: A rapid BEME systematic review: BEME Guide No. 63. Med Teach 2020; 42:1202-1215. [PMID: 32847456 DOI: 10.1080/0142159x.2020.1807484] [Citation(s) in RCA: 149] [Impact Index Per Article: 37.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
BACKGROUND The novel coronavirus disease (COVID-19) was declared a pandemic in March 2020. This rapid systematic review synthesised published reports of medical educational developments in response to the pandemic, considering descriptions of interventions, evaluation data and lessons learned. METHODS The authors systematically searched four online databases and hand searched MedEdPublish up to 24 May 2020. Two authors independently screened titles, abstracts and full texts, performed data extraction and assessed risk of bias for included articles. Discrepancies were resolved by a third author. A descriptive synthesis and outcomes were reported. RESULTS Forty-nine articles were included. The majority were from North America, Asia and Europe. Sixteen studies described Kirkpatrick's outcomes, with one study describing levels 1-3. A few papers were of exceptional quality, though the risk of bias framework generally revealed capricious reporting of underpinning theory, resources, setting, educational methods, and content. Key developments were pivoting educational delivery from classroom-based learning to virtual spaces, replacing clinical placement based learning with alternate approaches, and supporting direct patient contact with mitigated risk. Training for treating patients with COVID-19, service reconfiguration, assessment, well-being, faculty development, and admissions were all addressed, with the latter categories receiving the least attention. CONCLUSIONS This review highlights several areas of educational response in the immediate aftermath of the COVID-19 pandemic and identifies a few articles of exceptional quality that can serve as models for future developments and educational reporting. There was often a lack of practical detail to support the educational community in enactment of novel interventions, as well as limited evaluation data. However, the range of options deployed offers much guidance for the medical education community moving forward and there was an indication that outcome data and greater detail will be reported in the future.
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Affiliation(s)
- Morris Gordon
- Blackpool Victoria Hospital, Blackpool, UK
- School of Medicine, University of Central Lancashire, Preston, UK
| | | | | | | | | | - Mohan Pammi
- Texas Children's Hospital and Baylor College of Medicine, Houston, TX, USA
| | | | - Sophie Park
- UCL Medical School, University College London, London, UK
| | | | - Eliot L Rees
- UCL Medical School, University College London, London, UK
- School of Medicine, Keele University, UK
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Gordon M, Patricio M, Horne L, Muston A, Alston SR, Pammi M, Thammasitboon S, Park S, Pawlikowska T, Rees EL, Doyle AJ, Daniel M. Developments in medical education in response to the COVID-19 pandemic: A rapid BEME systematic review: BEME Guide No. 63. Med Teach 2020; 43:243. [PMID: 32847456 DOI: 10.1080/0142159x.2020.1800615] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
BACKGROUND The novel coronavirus disease (COVID-19) was declared a pandemic in March 2020. This rapid systematic review synthesised published reports of medical educational developments in response to the pandemic, considering descriptions of interventions, evaluation data and lessons learned. METHODS The authors systematically searched four online databases and hand searched MedEdPublish up to 24 May 2020. Two authors independently screened titles, abstracts and full texts, performed data extraction and assessed risk of bias for included articles. Discrepancies were resolved by a third author. A descriptive synthesis and outcomes were reported. RESULTS Forty-nine articles were included. The majority were from North America, Asia and Europe. Sixteen studies described Kirkpatrick's outcomes, with one study describing levels 1-3. A few papers were of exceptional quality, though the risk of bias framework generally revealed capricious reporting of underpinning theory, resources, setting, educational methods, and content. Key developments were pivoting educational delivery from classroom-based learning to virtual spaces, replacing clinical placement based learning with alternate approaches, and supporting direct patient contact with mitigated risk. Training for treating patients with COVID-19, service reconfiguration, assessment, well-being, faculty development, and admissions were all addressed, with the latter categories receiving the least attention. CONCLUSIONS This review highlights several areas of educational response in the immediate aftermath of the COVID-19 pandemic and identifies a few articles of exceptional quality that can serve as models for future developments and educational reporting. There was often a lack of practical detail to support the educational community in enactment of novel interventions, as well as limited evaluation data. However, the range of options deployed offers much guidance for the medical education community moving forward and there was an indication that outcome data and greater detail will be reported in the future.
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Affiliation(s)
- Morris Gordon
- Blackpool Victoria Hospital, Blackpool, UK
- School of Medicine, University of Central Lancashire, Preston, UK
| | | | | | | | | | - Mohan Pammi
- Texas Children's Hospital and Baylor College of Medicine, Houston, TX, USA
| | | | - Sophie Park
- UCL Medical School, University College London, London, UK
| | | | - Eliot L Rees
- UCL Medical School, University College London, London, UK
- School of Medicine, Keele University, UK
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Emami SAH, Khankeh H, Motlagh MK, Zarghi N, Shirazi M. Exploring experience of Iranian medical sciences educators about Best Evidence Medical Education: A content analysis. J Educ Health Promot 2019; 8:247. [PMID: 32002419 PMCID: PMC6967127 DOI: 10.4103/jehp.jehp_428_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Accepted: 09/15/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND AND OBJECTIVE Applying the Best Evidence Medical Education (BEME) in real educational arena is a necessity in medical education. As to the literature, there are enough evidence; however, their application by educators and policymakers has been still failed. Therefore, this study conducted to explore the experience of educators about applying BEME in Iranian context. MATERIALS AND METHODS Qualitative approach using content analysis method was utilized for exploring 25 participants involved with medical education in different levels, introduced the study using purposeful sampling. Data were collected through a semi-structured interview by which they answered to researcher's questions in around 45 min about how they apply evidence in their educational setting. To make more clarification, probing questions were used. Interviews were recorded and transcribed and then analyzed by coding paradigm immediately. RESULTS Three categories were emerged as: applying different levels of evidence, substitution of evidence-based medicine for BEME, and variation of understanding BEME. The first category includes subcategories of using personal experience, textbooks, and filtered papers. The second contains lack of knowledge about BEME elements, time and motivation as well as no priority for applying available medical education evidence; and third, using different terminology and having some problems in applying process, based on individual understanding and using papers with or without modification. DISCUSSION For effective evidence application, it is necessary to operationalize BEME terminology and overcome any ambiguity surrounded it. It is also important to suggest educators to apply the appraised evidence as well as teach them how they search and appraise evidence independently. Certainly, in the first steps, supervision and providing a proper context for BEME applications are crucial.
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Affiliation(s)
- Seyed Amir Hossein Emami
- Department of Medical Oncology, Imam Khomeini Hospital, Cancer Institute, Tehran, Iran
- Department of Medical Education, Tehran University of Medical Sciences, Tehran, Iran
| | - Hamidreza Khankeh
- Department of Nursing, University of Social Welfare and Rehabilitation, Tehran, Iran
- Department of Clinical Science and Education, Soder Hospital, Karolinska Institute, Stockholm, Sweden
| | | | - Nazila Zarghi
- Department of Medical Education, Tehran University of Medical Sciences, Tehran, Iran
| | - Mandana Shirazi
- Department of Medical Education, Tehran University of Medical Sciences, Tehran, Iran
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Sanson-Fisher R, Hobden B, Carey M, Mackenzie L, Hyde L, Shepherd J. Interactional skills training in undergraduate medical education: ten principles for guiding future research. BMC Med Educ 2019; 19:144. [PMID: 31092235 PMCID: PMC6521390 DOI: 10.1186/s12909-019-1566-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 04/22/2019] [Indexed: 05/10/2023]
Abstract
BACKGROUND High-quality healthcare requires practitioners who have technical competence and communication skills. Medical practitioners need interpersonal skills for gathering and transferring information to their patients, in addition to general consultation skills. Appropriate information gathering increases the likelihood of an accurate diagnosis. Transferring information should be performed in a way that promotes patient understanding and increases the probability of adherence to physician recommendations. This applies to: (i) primary prevention such as smoking cessation; (ii) secondary prevention including preparation for potentially threatening interventions; and (iii) tertiary care, including breaking bad news regarding treatment and prognosis. DISCUSSION This debate paper delineates factors associated with undergraduate medical communication skills training where robust research is needed. Ten key principles are presented and discussed, which are intended to guide future research in this field and ensure high quality studies with methodological rigour are conducted. The literature on communication skills training for medical school undergraduates continues to grow. A considerable portion of this output is represented by commentaries, descriptive studies or poorly designed interventions. As with any field of healthcare, quality research interventions are required to ensure practice is grounded in high-level evidence.
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Affiliation(s)
- Rob Sanson-Fisher
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Level 4 West, HRMI Building, Callaghan, NSW 2308 Australia
- Priority Research Centre for Health Behaviour, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales 2308 Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales Australia
| | - Breanne Hobden
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Level 4 West, HRMI Building, Callaghan, NSW 2308 Australia
- Priority Research Centre for Health Behaviour, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales 2308 Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales Australia
| | - Mariko Carey
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Level 4 West, HRMI Building, Callaghan, NSW 2308 Australia
- Priority Research Centre for Health Behaviour, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales 2308 Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales Australia
| | - Lisa Mackenzie
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Level 4 West, HRMI Building, Callaghan, NSW 2308 Australia
- Priority Research Centre for Health Behaviour, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales 2308 Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales Australia
| | - Lisa Hyde
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Level 4 West, HRMI Building, Callaghan, NSW 2308 Australia
- Priority Research Centre for Health Behaviour, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales 2308 Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales Australia
| | - Jan Shepherd
- Health Behaviour Research Collaborative, School of Medicine and Public Health, Faculty of Health and Medicine, University of Newcastle, Level 4 West, HRMI Building, Callaghan, NSW 2308 Australia
- Priority Research Centre for Health Behaviour, Faculty of Health and Medicine, University of Newcastle, Callaghan, New South Wales 2308 Australia
- Hunter Medical Research Institute, New Lambton Heights, New South Wales Australia
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