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Turner A, Gopakumar S, Minard C, Guffey D, Allen N, Kuo D, Poszywak K, Pillow MT. Development of an integrated milestone assessment tool across multiple early-adopter programs for breaking bad news: a pilot project. BMC Med Educ 2024; 24:313. [PMID: 38509520 PMCID: PMC10953138 DOI: 10.1186/s12909-023-04715-1] [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] [Received: 06/10/2022] [Accepted: 09/22/2023] [Indexed: 03/22/2024]
Abstract
BACKGROUND The transition of the Accreditation Council for Graduate Medical Education (ACGME) to milestone assessment creates opportunities for collaboration and shared assessments across graduate medical programs. Breaking bad news is an essential communication skill that is a common milestone across almost every medical specialty. The purpose of this study was to develop and pilot an integrated milestone assessment (IMA) tool for breaking bad news using ACGME milestone criteria and to compare the IMA tool with the existing SPIKES protocol. METHODS The IMA tool was created using sub-anchors in professionalism and interpersonal communication skills that are applicable to every specialty and to the ability to break bad news. Two cases of breaking bad news, designed to be "easy" and "intermediate" in difficulty, were used to assess basic skills in breaking bad news in first-year medical residents from six residency specialties. Eight standardized patients were trained to portray the cases in sessions held in November 2013 and May 2014. Standardized patients completed an assessment checklist to evaluate each resident's performance in breaking bad news based on their use of the SPIKES protocol and IMA tool. Residents answered post-encounter questions about their training and comfort in breaking bad news. The association between SPIKES and IMA scores was investigated by simple linear regression models and Spearman rank correlations. RESULTS There were 136 eligible medical residents: 108 (79.4%) participated in the first session and 97 (71.3%) participated in the second session, with 96 (70.6%) residents participating in both sessions. Overall, we were able to identify residents that performed at both extremes of the assessment criteria using the integrated milestone assessment (IMA) and the SPIKES protocol. Interestingly, residents rated themselves below "comfortable" on average. CONCLUSION We developed an integrated milestone assessment (IMA) that was better than the SPIKES protocol at assessing the skill of breaking bad news. This collaborative assessment tool can be used as supplement tool in the era of milestone transformation. We aim assess our tool in other specialties and institutions, as well as assess other shared milestones across specialties.
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Affiliation(s)
- Anisha Turner
- Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA.
| | | | - Charles Minard
- Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, TX, USA
| | - Danielle Guffey
- Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, TX, USA
| | - Nathan Allen
- Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA
| | - Dick Kuo
- Department Chair of Emergency Medicine at Baylor College of Medicine, Houston, TX, USA
| | - Kelly Poszywak
- Simulation and Standardized Patient Program at Baylor College of Medicine, Houston, TX, USA
| | - M Tyson Pillow
- Baylor College of Medicine, One Baylor Plaza, Houston, TX, 77030, USA
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Krishna LKR, Pisupati A, Ong YT, Teo KJH, Teo MYK, Venktaramana V, Quek CWN, Chua KZY, Raveendran V, Singh H, Wong SLCH, Ng VWW, Loh EKY, Yeoh TT, Owyong JLJ, Chiam M, Ong EK, Phua GLG, Hill R, Mason S, Ong SYK. Assessing the effects of a mentoring program on professional identity formation. BMC Med Educ 2023; 23:799. [PMID: 37880728 PMCID: PMC10601320 DOI: 10.1186/s12909-023-04748-6] [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] [Received: 02/20/2023] [Accepted: 10/04/2023] [Indexed: 10/27/2023]
Abstract
BACKGROUND Medical education has enjoyed mixed fortunes nurturing professional identity formation (PIF), or how medical students think, feel and act as physicians. New data suggests that structured mentoring programs like the Palliative Medicine Initiative (PMI) may offer a means of developing PIF in a consistent manner. To better understand how a well-established structured research mentoring program shapes PIF, a study of the experiences of PMI mentees is proposed. METHODOLOGY Acknowledging PIF as a sociocultural construct, a Constructivist approach and Relativist lens were adopted for this study. In the absence of an effective tool, the Ring Theory of Personhood (RToP) and Krishna-Pisupati Model (KPM) model were used to direct this dual Systematic Evidence-Based Approach (Dual-SEBA) study in designing, employing and analysing semi-structured interviews with PMI mentees and mentoring diaries. These served to capture changes in PIF over the course of the PMI's mentoring stages. Transcripts of the interviews and mentoring diaries were concurrently analysed using content and thematic analysis. Complementary themes and categories identified from the Split Approach were combined using the Jigsaw Approach and subsequently compared with mentoring diaries in the Funnelling Process. The domains created framed the discussion. RESULTS A total of 12 mentee interviews and 17 mentoring diaries were analysed, revealing two domains-PMI as a Community of Practice (CoP) and Identity Formation. The domains confirmed the centrality of a structured CoP capable of facilitating longitudinal mentoring support and supporting the Socialisation Process along the mentoring trajectory whilst cultivating personalised and enduring mentoring relationships. CONCLUSION The provision of a consistent mentoring approach and personalised, longitudinal mentoring support guided along the mentoring trajectory by structured mentoring assessments lay the foundations for more effective mentoring programs. The onus must now be on developing assessment tools, such as a KPM-based tool, to guide support and oversight of mentoring relationships.
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Affiliation(s)
- Lalit Kumar Radha Krishna
- Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore, Singapore.
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore.
- Division of Cancer Education, National Cancer Centre Singapore, Singapore, Singapore.
- Duke-NUS Medical School, Singapore, Singapore.
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore.
- Health Data Science, University of Liverpool, 200 London Road, Liverpool, UK.
- Palliative Care Institute Liverpool, Cancer Research Centre, University of Liverpool, 200 London Rd, L3 9TA, Liverpool, UK.
- The Palliative Care Centre for Excellence in Research and Education, PalC C/O Dover Park Hospice, 10 Jalan Tan Tock Seng, Singapore, 308436, Singapore.
- Centre for Biomedical Ethics, National University of Singapore, Singapore, Singapore.
| | - Anushka Pisupati
- Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, Singapore, Singapore
| | - Yun Ting Ong
- Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, Singapore, Singapore
| | - Kelly Jia Hui Teo
- Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, Singapore, Singapore
| | - Mac Yu Kai Teo
- Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, Singapore, Singapore
| | - Vaishnavi Venktaramana
- Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, Singapore, Singapore
| | - Chrystie Wan Ning Quek
- Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, Singapore, Singapore
| | - Keith Zi Yuan Chua
- Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, Singapore, Singapore
| | - Vijayprasanth Raveendran
- Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, Singapore, Singapore
| | - Harpreet Singh
- Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, Singapore, Singapore
| | - Sabine Lauren Chyi Hui Wong
- Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, Singapore, Singapore
| | - Victoria Wen Wei Ng
- Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, Singapore, Singapore
| | - Eleanor Kei Ying Loh
- Yong Loo Lin School of Medicine, National University of Singapore, 10 Medical Dr, Singapore, Singapore
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, Singapore, Singapore
| | - Ting Ting Yeoh
- Division of Oncology Pharmacy, National Cancer Centre Singapore, Singapore, Singapore
| | | | - Min Chiam
- Division of Cancer Education, National Cancer Centre Singapore, Singapore, Singapore
| | - Eng Koon Ong
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Division of Cancer Education, National Cancer Centre Singapore, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
- Assisi Hospice, Singapore, Singapore
- Office of Medical Humanities, SingHealth Medicine Academic Clinical Programme, Singapore, Singapore
| | - Gillian Li Gek Phua
- Division of Supportive and Palliative Care, National Cancer Centre Singapore, Singapore, Singapore
- Lien Centre for Palliative Care, Duke-NUS Medical School, Singapore, Singapore
| | - Ruaraidh Hill
- Health Data Science, University of Liverpool, 200 London Road, Liverpool, UK
| | - Stephen Mason
- Palliative Care Institute Liverpool, Cancer Research Centre, University of Liverpool, 200 London Rd, L3 9TA, Liverpool, UK
| | - Simon Yew Kuang Ong
- Division of Cancer Education, National Cancer Centre Singapore, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
- Division of Medical Oncology, National Cancer Centre Singapore, Singapore, Singapore
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Almansour M, AlMehmadi BA, Zeb NG, Matbouly G, Sami W, Badahdah AM. Promising score for teaching and learning environment: an experience of a fledgling medical college in Saudi Arabia. BMC Med Educ 2023; 23:479. [PMID: 37370058 DOI: 10.1186/s12909-023-04357-3] [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: 01/31/2023] [Accepted: 05/15/2023] [Indexed: 06/29/2023]
Abstract
BACKGROUND Professional competency of graduates of an institute reflects its teaching and learning environment (TLE). This study aimed to provide a preliminary assessment of the TLE at the College of Medicine at Majmaah University. METHODS A cross-sectional survey was conducted during the 2019-20 academic year among students at the College. A validated scoring tool "the Experience of Teaching and Learning Questionnaire" (available at https://bit.ly/3sVBuEw ) was used. The mean score of each section and statement, the difference between the mean scores of different demographic groups, and correlations between sections were analysed. RESULTS A total of 234 (72.2%) enrolled students participated in this survey, with a male-to-female ratio and a ratio of participants from basic to clinical years being 2:1 and 1:1, respectively. Most participants reported a GPA of above 3/5. The overall mean score was 3.52/5 points. Section one "approaches to learning and studying" has the highest mean score (3.68), and no section scored a mean below three, though section three "demands made by the course" scored a borderline mean of 3.08. Students in clinical years had a significantly higher overall mean score compared to their counterparts (3.66 vs. 3.39, p < 0.001). CONCLUSIONS Students at the College had a positive perception of the TLE, but face challenges in coping with the demands of acquiring knowledge and subject-based skills, and in appreciating the TLE especially during basic science years, highlighting the need for an atmosphere that allows them to meet demands and develop greater appreciation.
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Affiliation(s)
- Mohammed Almansour
- Department of Medical Education, College of Medicine, King Saud University, Riyadh, 11461, Saudi Arabia
| | - Bader A AlMehmadi
- Department of Internal Medicine, College of Medicine, Majmaah University, Al Majmaah, 15341, Saudi Arabia
| | - Nida Gulzar Zeb
- Department of Basic Medical Sciences, College of Medicine, Majmaah University, Al Majmaah, 15341, Saudi Arabia
| | - Ghassan Matbouly
- Department of Medical Education, College of Medicine, Majmaah University, Al Majmaah, 15341, Saudi Arabia
| | - Waqas Sami
- College of Nursing, QU Health, Qatar University, P.O Box 2713, Doha, Qatar
| | - Al-Mamoon Badahdah
- Department of Family and Community Medicine, Faculty of Medicine in Rabigh, King Abdulaziz University, Jeddah, 22252, Saudi Arabia.
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Chambers J, Mistry K, Spink J, Tsigarides J, Bryant P. Online medical education using a Facebook peer-to-peer learning platform during the COVID-19 pandemic: a qualitative study exploring learner and tutor acceptability of Facebook as a learning platform. BMC Med Educ 2023; 23:293. [PMID: 37127642 PMCID: PMC10150675 DOI: 10.1186/s12909-023-04268-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 04/17/2023] [Indexed: 05/03/2023]
Abstract
BACKGROUND In recent years, higher education institutions have been moving teaching online, accelerated by the pandemic. The Remote Learning Project (RLP), based at the Norwich Medical School (NMS) in the United Kingdom (U.K.), was a peer-to-peer teaching program developed to supplement medical school teaching during the pandemic. The teaching was delivered through Facebook using peer-to-peer teaching. Tutors were final year medical students, teaching medical student learners in lower years. Tutors and learners perception of peer-to-peer online learning delivered through the Facebook Social Media (SoMe) platform was investigated. METHODS This qualitative study recruited tutor and learner participants from NMS by email, participation in the study was voluntary. Online semi-structured interviews of both tutors and learners in the remote learning project were conducted. The data was analysed using thematic analysis. RESULTS Seven participants were interviewed. Five themes were identified; education (learning/teaching), productivity, data security, professionalism, and usability of the platform. Learners enjoyed the asynchronous nature of the platform and both learners and tutors enjoyed the peer-to-peer nature of the RLP, including the ability to immediately and easily answer on Facebook comments. Some learners felt distracted on Facebook, whilst others enjoyed the reminders. The mix of social and professional on the platform was met with caution from tutors. Both learners and tutors enjoyed the familiarity of the platform. CONCLUSIONS The study found that SoMe may be a credible platform to deliver online peer-to-peer teaching. Educators should consider the ergonomics of SoMe platforms when designing online curriculums. Guidelines for educators should be developed to better guide educators on the effective and safe use of SoMe as a learning tool.
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Affiliation(s)
- Joshua Chambers
- Norwich Medical School, University of East Anglia, Norwich, UK.
| | - Khaylen Mistry
- Norwich Medical School, University of East Anglia, Norwich, UK
- Norfolk and Norwich University Hospital, Norwich, UK
| | - Joel Spink
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - Jordan Tsigarides
- Norwich Medical School, University of East Anglia, Norwich, UK
- Norfolk and Norwich University Hospital, Norwich, UK
| | - Pauline Bryant
- Norwich Medical School, University of East Anglia, Norwich, UK
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5
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Cheu HF, Sameshima P, Strasser R, Clithero-Eridon AR, Ross B, Cameron E, Preston R, Allison J, Hu C. Teaching compassion for social accountability: A parallaxic investigation. Med Teach 2023; 45:404-411. [PMID: 36288735 DOI: 10.1080/0142159x.2022.2136516] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 06/16/2023]
Abstract
BACKGROUND In an arts integrated interdisciplinary study set to investigate ways to improve social accountability (SA) in medical education, our research team has established a renewed understanding of compassion in the current SA movement. AIM This paper explores the co-evolution of compassion and SA. METHODS The study used an arts integrated approach to investigate people's perceptions of SA in four medical schools across Australia, Canada, and the USA. Each school engaged approximately 25 participants who partook in workshops and in-depth interviews. RESULTS We began with a study of SA and the topic of compassion emerged out of our qualitative data and biweekly meetings within the research team. Content analysis of the data and pedagogical discussion brought us to realize the importance of compassion in the practice of SA. CONCLUSIONS The cultivation of compassion needs to play a significant role in a socially accountable medical educational system. Medical schools as educational institutions may operate themselves with compassion as a driving force in engaging partnership with students and communities. Social accountability without compassion is not SA; compassion humanizes institutional policy by engaging sympathy and care.
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Affiliation(s)
- Hoi F Cheu
- Department of English, Laurentian University, Sudbury, Canada
| | | | - Roger Strasser
- The Centre for Social Accountability, Northern Ontario School of Medicine University, Thunder Bay and Sudbury, Canada
- Te Huataki Waiora School of Health, University of Waikato, Hamilton, New Zealand
| | - Amy R Clithero-Eridon
- Family and Community Medicine, Health Sciences, University of New Mexico, Albuquerque, NM, USA
| | - Brian Ross
- The Centre for Social Accountability, Northern Ontario School of Medicine University, Thunder Bay and Sudbury, Canada
| | - Erin Cameron
- The Centre for Social Accountability, Northern Ontario School of Medicine University, Thunder Bay and Sudbury, Canada
| | - Robyn Preston
- Public Health, School of Health, Medical and Applied Sciences, CQUniversity, Rockhampton, Australia
- James Cook University, Townsville, Australia
| | - Jill Allison
- Faculty of Medicine, Memorial University of NewfoundlandSt. John's, Canada
| | - Connie Hu
- Family and Community Medicine, Health Sciences, University of New Mexico, Albuquerque, NM, USA
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Castaldi MT, Palmer M, Felsenreich DM, Con J, Bergamaschi R. Robotic-assisted surgery training (RAST) program: module 1 of a three-module program. Assessment of patient cart docking skills and educational environment. Updates Surg 2023:10.1007/s13304-023-01485-9. [PMID: 36862353 DOI: 10.1007/s13304-023-01485-9] [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] [Received: 11/09/2022] [Accepted: 02/23/2023] [Indexed: 03/03/2023]
Abstract
There is currently no standardized robotic surgery training program in General Surgery Residency. RAST involves three modules: ergonomics, psychomotor, and procedural. This study aimed to report the results of module 1, which assessed the responsiveness of 27 PGY (postgraduate year) 1-5 general surgery residents (GSRs) to simulated patient cart docking, and to evaluate the residents' perception of the educational environment from 2021 to 2022. GSRs prepared with pre-training educational video and multiple-choice questions test (MCQs). Faculty provided one-on-one resident hands-on training and testing. Nine proficiency criteria (deploy cart; boom control; driving cart; docking camera port; targeting anatomy; flex joints; clearance joints; port nozzles; emergency undocking) were assessed with five-point Likert scale. A validated 50-item Dundee Ready Educational Environment Measure (DREEM) inventory was used by GSRs to assess the educational environment. Mean MCQ scores: (90.6 ± 16.1 PGY1), (80.2 ± 18.1PGY2), (91.7 ± 16.5 PGY3) and (PGY4, 86.8 ± 18.1 PGY5) (ANOVA test; p = 0.885). Hands-on docking time decreased at testing when compared to base line: median 17.5 (range 15-20) min vs. 9.5 (range 8-11). Mean hands-on testing score was 4.75 ± 0.29 PGY1; 5.0 ± 0 PGY2 and PGY3, 4.78 ± 0.13 PGY4, and 4.93 ± 0.1 PGY5 (ANOVA test; p = 0.095). No correlation was found between pre-course MCQ score and hands-on training score (Pearson correlation coefficient = - 0.359; p = 0.066). There was no difference in the hands-on scores stratified by PGY. The overall DREEM score was 167.1 ± 16.9 with CAC = 0.908 (excellent internal consistency). Patient cart training impacted the responsiveness of GSRs with 54% docking time reduction and no differences in hands-on testing scores among PGYs with a highly positive perception.
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Affiliation(s)
- Maria Teresa Castaldi
- Department of Surgery, Westchester Medical Center, Taylor Pavilion, Suite D-361, 100 Woods Road, Valhalla, NY, 10595, USA
- Department of Surgery, New York Medical College, Taylor Pavilion, Suite D-361, 100 Woods Road, Valhalla, NY, 10595, USA
| | - Mathias Palmer
- Department of Surgery, New York Medical College, Taylor Pavilion, Suite D-361, 100 Woods Road, Valhalla, NY, 10595, USA
| | - Daniel Moritz Felsenreich
- Department of Surgery, New York Medical College, Taylor Pavilion, Suite D-361, 100 Woods Road, Valhalla, NY, 10595, USA
| | - Jorge Con
- Department of Surgery, Westchester Medical Center, Taylor Pavilion, Suite D-361, 100 Woods Road, Valhalla, NY, 10595, USA
- Department of Surgery, New York Medical College, Taylor Pavilion, Suite D-361, 100 Woods Road, Valhalla, NY, 10595, USA
| | - Roberto Bergamaschi
- Department of Surgery, Westchester Medical Center, Taylor Pavilion, Suite D-361, 100 Woods Road, Valhalla, NY, 10595, USA.
- Department of Surgery, New York Medical College, Taylor Pavilion, Suite D-361, 100 Woods Road, Valhalla, NY, 10595, USA.
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Abstract
PURPOSE In 2020, medical schools across the U.S. were called to task by students who demanded a response to structural racism in medicine. Many medical schools made anti-racism declarations and pledged to promote more inclusive learning environments. Much of the focus was on changing the pre-clinical curriculum and less on the everyday interactions that occur in clinical settings. As medical educators, we have an obligation to reinforce statements of solidarity by role modeling behaviors that demonstrate anti-racism in clinical practice. METHODS This article proposes a framework that provides practical steps for role modeling anti-racism in the clinical learning environment. These steps are drawn from a review of the literature on role modeling, constructs from Social Cognitive Learning Theory, and anti-racism praxis. RESULTS The resulting framework uses the acronym R.E.A.C.T to describe practical steps that include Reflecting on implicit biases, Educating ourselves on historical and current forms of structural racism, Assessing the use of race in clinical practice and asking how racism is impacting a clinical interaction, Calling out behaviors that perpetuate racism, and Treating everyone with dignity and respect. CONCLUSIONS The R.E.A.C.T framework is of value to medical educators because it provides practical steps on role modeling anti-racism in the clinical learning environment. The framework calls medical educators not to merely passively 'react,' but to be introspective, proactive, and intentional in their response to racism. Examples are provided on how each step can be actualized and adapted for different learning environments.
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Affiliation(s)
- Carla Boutin-Foster
- Department of Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
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Rupani N, Evans A, Iqbal M. A quantitative cross-sectional study assessing the surgical trainee perception of the operating room educational environment. BMC Med Educ 2022; 22:764. [PMID: 36344964 PMCID: PMC9640905 DOI: 10.1186/s12909-022-03825-6] [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] [Figures] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Accepted: 10/04/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Limited hours and service provision are diminishing training opportunities, whilst increasing standards of surgical proficiency is being sought. It is imperative to maximise the value of each educational event. An objective measure of higher surgical trainee perception of the operating room environment in England has not been performed before and this can steer future change in optimising educational events in theatre. The Operating Room Educational Environment Measure (OREEM) evaluates each component of the learning environment to enable optimisation of these educational events. However, the OREEM has not yet been assessed for reliability in higher surgical trainees in England. The aim of the current study was to explore areas of strength and weakness in the educational environment in the operating room as perceived by surgical trainees' in one English region. The secondary aim was to assess the reliability of the OREEM. METHODS Using a quantitative approach, data was collected over one month from surgical trainees in England using the OREEM. RESULTS Fifty-four surgical trainees completed the questionnaire. The OREEM had good internal consistency (α = 0.906, variables = 40). The mean OREEM score was 79.16%. Areas for improvement included better learning opportunities (average subscale score = 72.9%) and conducting pre- and post-operative teaching (average score = 70.4%). Trainees were most satisfied with the level of supervision and workload (average subscale score = 82.87%). The learning environment favoured senior trainees (p = 0.017). There was a strong correlation between OREEM and the global satisfaction score (p < 0.001). CONCLUSIONS The OREEM was shown to be a reliable measure of the educational environment. It can be used to identify areas of improvement and as an audit tool. The current perception of the education environment is satisfactory, however, areas of improvement include reducing service provision, empowering trainees to plan lists, improving teamwork and using tools to optimise the educational value of each operation. There is a favourable attitude regarding the use of improvement tools, especially for dissatisfied trainees.
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Affiliation(s)
- Neal Rupani
- Nuffield Orthopaedic Centre, University of Oxford, Windmill Road, Oxford, OX3 7LD, UK.
| | - Ashish Evans
- Nuffield Orthopaedic Centre, University of Oxford, Windmill Road, Oxford, OX3 7LD, UK
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9
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Chatterjee K, Edmonds VS, Girardo ME, Vickers KS, Hathaway JC, Stonnington CM. Medical students describe their wellness and how to preserve it. BMC Med Educ 2022; 22:510. [PMID: 35764972 PMCID: PMC9241274 DOI: 10.1186/s12909-022-03552-y] [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] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2022] [Accepted: 06/07/2022] [Indexed: 06/15/2023]
Abstract
BACKGROUND Despite widespread efforts to create wellness programming in medical schools, there is a paucity of literature examining students' perception of wellness and perceptions of these programs. With the inaugural class at the Arizona campus of Mayo Clinic Alix School of Medicine (MCASOM-AZ), an opportunity arose to establish an empirically evaluated wellness curriculum that most inclusively and effectively enables medical students to flourish for years to come. The initial wellness offerings included mental health, academic success, and disability services, curriculum-embedded seminars, wellness committee driven programming, and student-proposed wellness activities. We aimed to improve the relevance and impact of medical school wellness curricula by soliciting in-depth and longitudinal perspectives of medical students themselves. As MCASOM-AZ opened in 2017, the student body at the time of study consisted of first- and second-year medical students. METHODS Employing a mixed methods analysis of qualitative and longitudinal quantitative data, first- and second-year students at a MCASOM-AZ were invited to respond to an anonymous, online year-long survey (baseline, six months and 12 months) during the 2018-2019 academic year and participate in a structured, in-depth and in-person, peer-to-peer interview about their conceptions of wellness and the MCASOM-AZ wellness curriculum and resources. Qualitative data was coded for themes using thematic analysis strategies by independent raters. RESULTS Nearly half of eligible students completed the baseline survey,1/3 completed all 3 time-points, and 1/5 participated in an in-depth interview. Participant age, gender, and year of school were representative of the larger student body. Although individual conceptions varied, Wellness was consistently highly valued. Family, Academic Performance, and Friends emerged as most important to well-being across time-points. Academic work arose as the largest barrier to wellness. Analysis of qualitative data revealed five themes. Despite individual differences in approaches to wellness, wellbeing was interrelated to the learning environment; mandatory wellness efforts that didn't address the medical culture met with skepticism. CONCLUSIONS Interview responses provided understanding and context by which to interpret questionnaire responses. Academics was critical to students' identity and wellness, while also the largest barrier. Suggested curricular improvements include restructuring academic work, seamlessly integrating wellness within coursework, and offering optional individualized approaches.
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Affiliation(s)
- Krishanu Chatterjee
- Mayo Clinic Alix School of Medicine, Mayo Clinic, Scottsdale, AZ, USA.
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA.
| | - Victoria S Edmonds
- Mayo Clinic Alix School of Medicine, Mayo Clinic, Scottsdale, AZ, USA
- Department of Urology, Mayo Clinic, AZ, Phoenix, USA
| | - Marlene E Girardo
- Department of Quantitative Heath Sciences, Mayo Clinic, Phoenix, AZ, USA
| | - Kristin S Vickers
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, USA
| | - Julie C Hathaway
- Office of Patient Education Research, Mayo Clinic College of Medicine and Science, Rochester, MN, USA
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Lundholm MD, Simpson KP, Ozark L. A medical escape room to build intern workplace social capital in an internal medicine residency program. Med Teach 2022; 44:546-550. [PMID: 34822314 DOI: 10.1080/0142159x.2021.2005243] [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: 06/13/2023]
Abstract
PURPOSE Trainee well-being is a growing focus in graduate medical education. One emerging area in occupational literature is the psychosocial environment of the workplace, of which a large component is workplace social capital (WSC). WSC encompasses how well a group connects to one another. Medical escape rooms (MERs) recently have been studied in various healthcare settings and are one proposed intervention to increase WSC. METHODS This is a single-center before-and-after survey study at the Loyola University Medical Center in 2021 to measure the effect of a MER on WSC amongst interns. Our Chief Resident created a 1-hour MER. WSC scores were measured using a modified version of a validated WSC scale. Scores were analyzed with paired t-test analysis and chi-square analysis. Open-ended feedback was also collected. RESULTS Of 52 eligible intern residents, 51 (98%) participated in the MER, and 41 (80%) completed the pre- and post-activity survey. All six survey statements had a greater percentage of positive responses following the MER. The average score across all participants and questions was 4.66 out of 5 on the pre-survey, and 4.90 on the post-survey (p < 0.001). CONCLUSIONS The MER significantly improved intern resident WSC scores, and proved a valuable addition to our curriculum.
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Affiliation(s)
- Michelle D Lundholm
- Department of Internal Medicine, Loyola University Medical Center, Maywood, IL, USA
| | - Kevin P Simpson
- Department of Internal Medicine, Loyola University Medical Center, Maywood, IL, USA
| | - Laura Ozark
- Department of Internal Medicine, Loyola University Medical Center, Maywood, IL, USA
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Davis K, Lo HY, Lichliter R, Wallin K, Elegores G, Jacobson S, Doughty C. Twelve tips for creating an escape room activity for medical education. Med Teach 2022; 44:366-371. [PMID: 33872114 DOI: 10.1080/0142159x.2021.1909715] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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: 06/12/2023]
Abstract
Communication, teamwork, and resilience all require active practice by healthcare teams. Games such as escape rooms can add variety, interactivity, and value to teaching sessions. Escape room activities typically include a variety of sequential puzzles that lead participants to break free of a room, or can be adapted into an 'escape box' challenge where participants work to successfully unlock a box. Escape room or escape box exercises can help healthcare teams develop and enhance team skills, as well as reinforce medical knowledge. We developed an escape box session to teach and reinforce organizational Safety II principles and the resilience potentials: monitor, respond, learn, and anticipate. We report 12 tips to effectively organize and develop an escape room or escape box activity for multidisciplinary healthcare teams.
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Affiliation(s)
- Kasey Davis
- Department of Pediatrics, Division of Pediatric Critical Care Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Huay-Ying Lo
- Department of Pediatrics, Division of Pediatric Hospital Medicine, Baylor College of Medicine, Houston, TX, USA
| | | | - Kelly Wallin
- The Simulation Center, Texas Children's Hospital, Houston, TX, USA
| | - Gemma Elegores
- The Simulation Center, Texas Children's Hospital, Houston, TX, USA
| | | | - Cara Doughty
- Department of Pediatrics, Division of Pediatric Emergency Medicine, Baylor College of Medicine, Houston, TX, USA
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12
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Boukhris K, Zedini C, El Ghardallou M. Nurse students' perception of the academic learning environment in Tunisian institutes of nursing sciences: A multisite cross-sectional study. Nurse Educ Today 2022; 111:105316. [PMID: 35287064 DOI: 10.1016/j.nedt.2022.105316] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 02/17/2022] [Accepted: 02/23/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND A learning environment is an important determinant of students' learning behaviours, professional competencies, and academic performances. It is also an essential indicator of the quality of teaching programmes. To date, there is not a Tunisian study, that analysed nurse students' perceptions of the educational environment. AIMS This study aimed to assess the perception of Tunisian higher nursing institutes students regarding the quality of the learning environment, and identify the factors associated with it. DESIGN Multi-site cross-sectional survey. SETTING Five universities of nursing sciences in Tunisia. PARTICIPANTS Undergraduate nursing students (n = 736). METHODS A cross-sectional descriptive study was conducted during the academic year 2019-2020. The Dundee Ready Educational Environment Measure (DREEM) questionnaire was used to describe the students' perceptions of the learning environment. The participants were recruited using a convenience sampling method. Statistical analyses were performed using SPSS version 20. One-way analysis of variance and t-test were used to compare the DREEM scores and socio-demographic/academic characteristics. A p-value of less than 0.05 was considered significant. RESULTS The mean overall DREEM score was 110.92 ± 20.55, indicating a positive perception of the learning environment. The year of study was significantly associated with total DREEM scores, with first-year students scoring higher than third- and second-year students (p = 0.035). The perception of the learning environment varied significantly among the five institutes (p < 10-3). Demotivated atmosphere, lack of a support system, poor timetable organisation, and teacher-centred learning were revealed as problematic areas that needed improvement (individual score < 2). Our adapted version of the DREEM obtained acceptable internal consistency (Cronbach's alpha coefficient of 0.881). CONCLUSIONS The study reported positive perceptions of the students regarding their academic learning environment. However, the DREEM scores reflected a traditional learning environment. It is essential to re-engineer the curriculum and shift the teaching paradigm towards 'student-centred curriculum' to enhance both the effectiveness and the efficiency of the learning environment.
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Affiliation(s)
- Khouloud Boukhris
- University of Sousse, Higher Institute of Techniques and Health Sciences of Sousse (Tunisia), Street Tadjikistan-Sahloul II, Sousse 4054, Tunisia; Laboratory of Research LR12ES03 «Qualité des soins et management des services de santé maternelle», Tunisia.
| | - Chekib Zedini
- University of Sousse, Faculty of Medicine of Sousse (Tunisia), Department of Community and Family Health, Tunisia; Laboratory of Research LR12ES03 «Qualité des soins et management des services de santé maternelle», Tunisia
| | - Mariem El Ghardallou
- University of Sousse, Faculty of Medicine of Sousse (Tunisia), Department of Community and Family Health, Tunisia; Laboratory of Research LR12ES03 «Qualité des soins et management des services de santé maternelle», Tunisia
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Norman HH, Hadie SNH, Yaacob NM, Kasim F. The Association Between Preclinical Medical Students' Perceptions of the Anatomy Education Environment and Their Learning Approaches. Med Sci Educ 2022; 32:399-409. [PMID: 35528310 PMCID: PMC9055004 DOI: 10.1007/s40670-022-01517-w] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/28/2022] [Indexed: 06/14/2023]
Abstract
This study aimed to measure medical students' perceptions of the anatomy education environment and determine its association with their learning approaches. First- and second-year undergraduate medical students (N = 234) completed the Anatomy Education Environment Measurement Inventory and the Approaches and Study Skills Inventory for Students. Results revealed that the students' perceptions of all the factors in the anatomy education environment were positive except for two areas-the anatomy learning resources and quality of histology learning facilities. The majority of students in the first year (62.3%) and second year (43.7%) adopted a deep learning approach. There was no significant association between most of the factors in the anatomy education environment and the students' learning approaches, except for the students' intrinsic interest in learning anatomy factor (p = 0.032). The anatomy education environment was positive for the medical students, and there was a prevalence of a deep learning approach among them. However, most of the factors in the anatomy education environment did not influence the students' learning approach. Given that the students' learning approach is a multifactorial construct, investigating the relationship between these two variables in longitudinal time points would provide better insight into the association between the anatomy educational climate and students' learning approaches.
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Affiliation(s)
- Haziq Hazman Norman
- Anatomy Unit, Management and Science University, University Drive, Off Persiaran Olahraga, Seksyen 13, Shah Alam, Selangor 40100 Malaysia
| | - Siti Nurma Hanim Hadie
- Department of Anatomy, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu, Kelantan 16150 Malaysia
| | - Najib Majdi Yaacob
- Biostatistics and Research Methodology Unit, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu, Kelantan Malaysia
| | - Fazlina Kasim
- Department of Anatomy, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu, Kelantan 16150 Malaysia
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Herzog LS, Wright SR, Pennington JJ, Richardson L. The KAIROS Blanket Exercise: Engaging Indigenous ways of knowing to foster critical consciousness in medical education. Med Teach 2021; 43:1437-1443. [PMID: 34369238 DOI: 10.1080/0142159x.2021.1956679] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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
PURPOSE Indigenous Peoples across Turtle Island (North America) experience ongoing health disparities tied to the effects of colonization and persistent racism toward Indigenous Peoples. Educating future clinicians to develop a critical consciousness is an important way to work toward cultural safety and improve the health care experiences of Indigenous patients. The present study evaluated the ability of the KAIROS Blanket Exercise (KBE) to foster critical consciousness. METHODS Two hundred thirteen medical students at the University of Toronto participated in the KBE. Subsequently, 174 students completed a paper evaluation, designed to capture concepts of cultural safety and critical consciousness. Data were analyzed using quantitative and qualitative methods to identify shifts in perspectives. RESULTS The majority of students reported the exercise altered the way they viewed those from backgrounds different from their own, and comments regarding bias, power and privilege were highlighted throughout the responses. Engaging in critical reflection through dialogue and revealing the complex sociopolitical context of Indigenous Peoples' history were emphasized as central to this transformation. CONCLUSIONS Following participation in the KBE, medical students demonstrated a shift in their perspectives. This suggests that creating curricular space for critical pedagogy may be effective in fostering critical consciousness, ultimately encouraging reflexive practice and social action.
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Affiliation(s)
- Lindsay S Herzog
- Mount Sinai Hospital, Department of Family and Community Medicine, University of Toronto, Toronto, Canada
| | - Sarah R Wright
- Michael Garron Hospital, Department of Family and Community Medicine, University of Toronto, Toronto, Canada
- Wilson Centre for Research in Education, University Health Network, University of Toronto, Toronto, Canada
| | | | - Lisa Richardson
- Wilson Centre for Research in Education, University Health Network, University of Toronto, Toronto, Canada
- Department of Medicine, University of Toronto, Toronto, Canada
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15
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Abstract
It is essential that medical education should be equally representative of our society and subsequently the population that we will be serving as practicing physicians. As doctors, we have a duty of care to all members of our community. To align with these values, medical teaching should prepare future physicians to be able to treat patients from all backgrounds and ethnicities. After reflecting on medical education in the current global climate it is evident that there is unfortunately still a lack of ethnically diverse examples of clinical case presentations in medical education resources. This leads to students being ill-prepared in diagnosing certain illnesses in BAME patients which could result in a delay of treatment. It also causes BAME medical students to feel less included and acknowledged in the medical curriculum and can manifest in feelings of isolation and reduced self-worth.
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Affiliation(s)
- Simran Bedi
- Faculty of Biology, Medicine and Health, University of Manchester, Manchester, UK
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16
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Ellawala A, Marasinghe RB. Measuring the educational environment in a Sri Lankan medical school following curricular revision. BMC Med Educ 2021; 21:187. [PMID: 33773578 PMCID: PMC8005235 DOI: 10.1186/s12909-021-02625-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 03/19/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND In 2007, the Faculty of Medical Sciences, University of Sri Jayewardenepura revised its medical curriculum from discipline-based to one that was student-centered and integrated. This study aimed to evaluate the perceptions of students regarding the educational environment and compare them to those prior to curricular revision. METHODS The Dundee Ready Education Environment Measure (DREEM) questionnaire was administered to all volunteering students enrolled in the medical degree programme at the time of the study (n = 595). Results were compared to DREEM scores obtained prior to curricular revision. RESULTS The overall DREEM score and sub-scale scores were positive and showed improvement compared to previous scores. The score for Students' Perceptions of Atmosphere showed progression from 'there are many issues which need changing' to the next highest category 'a more positive attitude'. The mean scores in pre-clinical, para-clinical and clinical phases also showed an improvement. 'The teachers are knowledgeable' was the highest rated item overall and within each phase of learning. All sub-scales were rated highest by pre-clinical students and lowest by para-clinical students, in contrast to previous results where such patterns were not observed. Certain items, especially those related to teaching/learning, received exclusively low scores in particular student subsets. CONCLUSIONS Students' perceptions towards the educational environment overall, have improved following curricular revision. However, certain negative areas warranting further evaluation were highlighted.
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Affiliation(s)
- Amaya Ellawala
- Department of Medical Education, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka.
| | - Rohana B Marasinghe
- Department of Medical Education, Faculty of Medical Sciences, University of Sri Jayewardenepura, Nugegoda, Sri Lanka
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17
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Brand G, Collins J, Bedi G, Bonnamy J, Barbour L, Ilangakoon C, Wotherspoon R, Simmons M, Kim M, Schwerdtle PN. "I teach it because it is the biggest threat to health": Integrating sustainable healthcare into health professions education. Med Teach 2021; 43:325-333. [PMID: 33181038 DOI: 10.1080/0142159x.2020.1844876] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [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
BACKGROUND Steering planetary and human health towards a more sustainable future demands educated and prepared health professionals. AIM This research aimed: to explore health professions educators' sustainable healthcare education (SHE) knowledge, attitudes, self-efficacy and teaching practices across 13 health professions courses in one Australian university. METHODS Utilising a sequential mixed-methods design: Phase one (understanding) involved an online survey to ascertain educators' SHE knowledge, attitudes, self-efficacy and teaching practices to inform phase two (solution generation), 'Teach Green' Hackathon. Survey data was descriptively analysed and a gap analysis performed to promote generation of solutions during phase two. Results from the hackathon were thematically analysed to produce five recommendations. RESULTS Regarding SHE, survey data across 13 health professions disciplines (n = 163) identified strong content knowledge (90.8%); however, only (36.9%) reported confidence to 'explain' and (44.2%) to 'inspire' students. Two thirds of participants (67.5%) reported not knowing how best to teach SHE. Hackathon data revealed three main influencing factors: regulatory, policy and socio-cultural drivers. CONCLUSIONS The five actionable recommendations to strengthen interdisciplinary capacity to integrate SHE include: inspire multi-level leadership and collaboration; privilege student voice; develop a SHE curriculum and resources repository; and integrate SHE into course accreditation standards.
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Affiliation(s)
- Gabrielle Brand
- School of Nursing and Midwifery, Monash University, Frankston, Australia
- Monash Centre for Scholarship in Health Education, Monash University, Clayton, Australia
| | - Jorja Collins
- Department of Nutrition, Dietetics & Food, Monash University Australia, Notting Hill, Australia
- Dietetics Department, Eastern Health, Box Hill, Australia
| | - Gitanjali Bedi
- Monash Sustainable Development Institute, Monash University, Clayton, Australia
| | - James Bonnamy
- School of Nursing and Midwifery, Monash University, Frankston, Australia
| | - Liza Barbour
- Department of Nutrition, Dietetics & Food, Monash University Australia, Notting Hill, Australia
| | - Chanika Ilangakoon
- School of Nursing and Midwifery, Monash University, Frankston, Australia
| | - Rosie Wotherspoon
- School of Nursing and Midwifery, Monash University, Frankston, Australia
| | | | - Misol Kim
- Faculty of Engineering, Monash University, Clayton, Australia
| | - Patricia Nayna Schwerdtle
- School of Nursing and Midwifery, Monash University, Frankston, Australia
- Heidelberg Institute of Global Health, Heidelberg University, Heidelberg, Germany
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18
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Hammoud MM, Appelbaum NP, Wallach PM, Burrows HL, Kochhar K, Hemphill RR, Daniel M, Clery MJ, Santen SA. Incidence of resident mistreatment in the learning environment across three institutions. Med Teach 2021; 43:334-340. [PMID: 33222573 DOI: 10.1080/0142159x.2020.1845306] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 06/11/2023]
Abstract
INTRODUCTION Mistreatment in the learning environment is associated with negative outcomes for trainees. While the Association of American Medical Colleges (AAMC) annual Graduation Questionnaire (GQ) has collected medical student reports of mistreatment for a decade, there is not a similar nationally benchmarked survey for residents. The objective of this study is to explore the prevalence of resident experiences with mistreatment. METHODS Residents at three academic institutions were surveyed using questions similar to the GQ in 2018. Quantitative data were analyzed based on frequency and Mann-Whitney U tests to detect gender differences. RESULTS Nine hundred ninety-six of 2682 residents (37.1%) responded to the survey. Thirty-nine percent of residents reported experiencing at least one incident of mistreatment. The highest reported incidents were public humiliation (23.7%) and subject to offensive sexist remarks/comments (16.0%). Female residents indicated experiencing significantly more incidents of public embarrassment, public humiliation, offensive sexist remarks, lower evaluations based on gender, denied opportunities for training or rewards, and unwanted sexual advances. Faculty were the most frequent instigators of mistreatment (66.4%). Of trainees who reported experiencing mistreatment, less than one-quarter reported the behavior. CONCLUSION Mistreatment in the academic learning environment is a concern in residency programs. There is increased frequency among female residents.
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Affiliation(s)
- Maya M Hammoud
- Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Nital P Appelbaum
- Virginia Commonwealth University School of Medicine, Richmond, VA, USA
- Baylor College of Medicine, Houston, TX, USA
| | - Paul M Wallach
- Family Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Heather L Burrows
- Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Komal Kochhar
- Family Medicine, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Robin R Hemphill
- Virginia Commonwealth University School of Medicine, Richmond, VA, USA
| | - Michelle Daniel
- Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Michael J Clery
- Obstetrics and Gynecology, University of Michigan Medical School, Ann Arbor, MI, USA
- Emergency Medicine, Emory University School of Medicine, Atlanta, GA, USA
| | - Sally A Santen
- Virginia Commonwealth University School of Medicine, Richmond, VA, USA
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Archibald D, Eyre A, Szczepanik D, Burns JK, Laroche L. Capturing the impact of cultural differences in residency. BMC Med Educ 2021; 21:115. [PMID: 33602186 PMCID: PMC7890890 DOI: 10.1186/s12909-021-02548-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Accepted: 01/28/2021] [Indexed: 05/29/2023]
Abstract
BACKGROUND Postgraduate training is a period in which residents develop both their medical competency and their professional identity in an environment of apprenticeship. As situated learning suggests, a critical dimension of such apprenticeship is the mode through which trainees can legitimately participate in the practice before they become experts, in this case physicians. One source of barriers to participation is cultural difference between learner and the clinical environment. OBJECTIVE To assess the extent cultural differences create barriers for residents, particularly but not exclusively for international medical graduates (IMGs). METHODS In 2014-15 a questionnaire was developed with subscales assessing areas such as sense of hierarchy, individuality versus teamwork, and risk tolerance. We refined the instrument by subjecting it to a review panel of experts in postgraduate education followed by "think aloud" sessions with residents. RESULTS Piloting this instrument yielded a Cronbach's alpha of 0.675. When administered to a larger group of residents and faculty representing many specialties, the Impact of Cultural Differences on Residency Experiences (ICDRE) questionnaire revealed a few items for which the Canadian Medical Graduates and International Medical Graduates differed in their mean opinion. The groups were not substantially different overall, but we did observe an interesting diversity of cultural beliefs within each group. CONCLUSIONS We suggest that the ICDRE may be useful in identifying beliefs which may present challenges to an individual resident or in capturing trends in a resident population so that a specialty program can address the trends proactively. The instrument also provides language with which to anchor preceptors' evaluations of residents' professionalism and may serve as an interventional coaching tool.
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Affiliation(s)
- Douglas Archibald
- Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada.
- Bruyère Research Institute, Ottawa, Ontario, Canada.
| | - Alison Eyre
- Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | - Dorota Szczepanik
- Department of Family Medicine, University of Ottawa, Ottawa, Ontario, Canada
| | | | - Lionel Laroche
- MultiCultural Business Solutions Inc., Markham, Ontario, Canada
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Muller D, Parkas V, Amiel J, Anand S, Cassese T, Cunningham T, Kang Y, Nosanchuk J, Soriano R, Zbar L, Karani R. Guiding principles for undergraduate medical education in the time of the COVID-19 pandemic. Med Teach 2021; 43:137-141. [PMID: 33142072 DOI: 10.1080/0142159x.2020.1841892] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 06/11/2023]
Abstract
As the early epicenter of the COVID-19 pandemic, New York City's medical schools experienced dramatic disruptions in every aspect of medical education. Remote learning was created, seemingly overnight, clerkships were disrupted, licensing examinations were cancelled, teaching faculty were redeployed, student volunteers rallied, and everyone was required to shelter at home. Seismic changes were required to adapt the authors' educational programs to a constantly evolving, unpredictable, and ever-worsening public health crisis. Entirely new communication strategies were adopted and thousands of decisions had to be made, often with little time to carefully reflect on the consequences of those decisions. What allowed each school to navigate these treacherous waters was a set of guiding principles that were used to ground each conversation, and inform every decision. While the language varied somewhat between schools, the core principles were universal and framed a way forward at a time when information, data, precedent, and best practices did not exist. The authors share these guiding principles in the hope that colleagues at other medical schools will find them to be a useful framework as we all continue to cope with the impact of COVID-19 on the future of medical education.
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Affiliation(s)
- David Muller
- Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Valerie Parkas
- Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Infectious Diseases, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jonathan Amiel
- Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Shashi Anand
- Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Todd Cassese
- Medical Education, Albert Einstein College of Medicine, New York, NY, USA
| | - Tara Cunningham
- Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Yoon Kang
- Weill Cornell Medical College, New York, NY, USA
| | - Joshua Nosanchuk
- Medical Education, Albert Einstein College of Medicine, New York, NY, USA
| | - Rainier Soriano
- Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Geriatrics and Palliative Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Lori Zbar
- Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Medical Education and Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Reena Karani
- Medical Education, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Abstract
Purpose: Medical education is undergoing curricular reform driven by internal needs and external pressures. Concurrently, medical students are changing. More diverse student bodies, particularly those from underrepresented minorities, bring different skill sets, needs and priorities to their medical school education. Here we present their voices.Methods: In order to explore the stories, needs and motivations of future physicians, we conducted a small-scale study of students from diverse backgrounds in US medical schools. Our interviews revealed two core themes about medical school: (1) that medical school is an extreme physical and emotional challenge for all students, and (2) that medical school education consists of multiple conflicting goals. Combining the two themes provides a descriptive topology of student's motivations and strategies for getting through medical school. Using this framework, we deconstruct the experience of medical school to reveal the gaps and misalignments between the traditional system of medical education and what medical students want, expect and need to be successful.Conclusions: We discuss the implications of our research and this framework for curricula and the learning environment with a particular focus on (1) cooperative learning and social interdependence theory and (2) an expanded understanding of diversity and the needs of under-represented students.
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Affiliation(s)
| | - Lindsay Mazotti
- Department of Clinical Sciences, Kaiser Permanente School of Medicine, University of California, San Francisco, CA, USA
| | - Michael S Wilkes
- Department of Medicine and Global Health, School of Medicine, University of California, Davis, CA, USA
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22
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Smith-Han K, Collins E, Asil M, Blakey AG, Anderson L, Berryman E, Wilkinson TJ. Measuring exposure to bullying and harassment in health professional students in a clinical workplace environment: Evaluating the psychometric properties of the clinical workplace learning NAQ-R scale. Med Teach 2020; 42:813-821. [PMID: 32286111 DOI: 10.1080/0142159x.2020.1746249] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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: 06/11/2023]
Abstract
Background: Instruments that measure exposure to bullying and harassment of students learning in a clinical workplace environment (CWE) that contain validity evidence are scarce. The aim of this study was to develop such a measure and provide some validity evidence for its use.Method: We took an instrument for detecting bullying of employees in the workplace, called the Negative Acts Questionnaire - Revised (NAQ-R). Items on the NAQ-R were adapted to align with our context of health professional students learning in a CWE and added two new factors of sexual and ethnic harassment. This new instrument, named the Clinical Workplace Learning NAQ-R, was distributed to 540 medical and nursing undergraduate students and we undertook a Confirmatory Factor Analysis (CFA) to investigate its construct validity and factorial structure.Results: The results provided support for the construct validity and factorial structure of the new scale comprising five factors: workplace learning-related bullying (WLRB), person-related bullying (PRB), physically intimidating bullying (PIB), sexual harassment (SH), and ethnic harassment (EH). The reliability estimates for all factors ranged from 0.79 to 0.94.Conclusion: This study provides a tool to measure the exposure to bullying and harassment in health professional students learning in a CWE.
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Affiliation(s)
- Kelby Smith-Han
- Department of Anatomy and Otago Medical School, University of Otago, Dunedin, New Zealand
| | - Emma Collins
- School of Nursing, Otago Polytechnic, Dunedin, New Zealand
| | - Mustafa Asil
- Educational Assessment Research Unit (EARU), College of Education, University of Otago, Dunedin, New Zealand
| | | | - Lynley Anderson
- Department of Bioethics Centre, University of Otago, Dunedin, New Zealand
| | | | - Tim J Wilkinson
- Dean's Department and Department of Medicine, Otago Medical School, University of Otago, Christchurch, New Zealand
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Fleit HB, Lu WH, Olvet DM, Chandran L. Medical students' perception of behaviors in the clinical learning environment evolve with increasing clinical exposure as measured with situational video vignettes. Med Teach 2020; 42:822-827. [PMID: 32401093 DOI: 10.1080/0142159x.2020.1759790] [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
This cross-sectional study involved matriculating, mid-level and graduating medical students (n = 723) who participated in specific transition courses in our medical school curriculum between August 2016 and March 2019. We used a mixed-methods approach (survey and analysis of narrative comments) to study the evolution in perception of the learning environment by medical students with increasing clinical exposure using four different video vignettes. Differences in student perceptions of mistreatment exists at various levels of training. Compared to graduating students, matriculating students were more likely to perceive reprimanding a student on being late as appropriate behavior (80.5% vs 53.3%, p = 0.001), whereas a significantly higher proportion of the graduating students (15.3%, p = 0.001) perceived it as mistreatment. A majority of the matriculating students (84%, p = 0.001) considered the case of an eager student as mistreatment, while a significantly higher proportion of the graduating students (59.5%, p = 0.001) did not think it was mistreatment. Qualitative analysis of comments from students at different stages of training displayed an increased appreciation of their professional responsibilities and nuanced appreciation of body language and tone as contributing factors in determining whether a situation represented inappropriate behavior. Our results demonstrate that students' perceptions of inappropriate behaviors evolve with increased clinical exposure.
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Affiliation(s)
- Howard B Fleit
- Renaissance School of Medicine at Stony, Brook University, Stony Brook, NY, USA
| | - Wei-Hsin Lu
- Renaissance School of Medicine at Stony, Brook University, Stony Brook, NY, USA
| | - Doreen M Olvet
- Renaissance School of Medicine at Stony, Brook University, Stony Brook, NY, USA
| | - Latha Chandran
- Renaissance School of Medicine at Stony, Brook University, Stony Brook, NY, USA
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Li H, Novack DH, Duke P, Gracely E, Cestone C, Davis T. Predictors of medical students' ethical decision-making: A pilot study using the Theory of Interpersonal Behavior. Patient Educ Couns 2020; 103:S0738-3991(20)30292-5. [PMID: 32540095 DOI: 10.1016/j.pec.2020.05.026] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2019] [Revised: 05/15/2020] [Accepted: 05/20/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To understand medical students' (MS) ethical decision-making using the Theory of Interpersonal Behavior (TIB). METHODS We conducted two rounds of focus groups to develop a TIB-based questionnaire by eliciting students' perspectives on an ethical dilemma they will encounter in a standardized patient (SP) station, in which an SP "surgeon" asked them to intubate a sedated patient whom the student knew had requested no student involvement. We administrated questionnaires to 241 third-year MS following this SP station, asking for their decisions in the SP station and if a surgeon made the same request in their clerkship. Confirmatory factor analysis (CFA) was used to test whether observed data fit the proposed TIB-based model. RESULTS The CFA provided an acceptable fit to the a priori proposed model. Fifty-five percent of students indicated they would intubate in an actual situation versus 18% in the SP station (p < 0.05). Using logistic regression, TIB domains affect and facilitating factors reported significant association with students' decisions in both the SP and hypothesized actual situations. CONCLUSIONS The TIB appears to be an effective theoretical framework for explaining students' ethical decision-making. PRACTICE IMPLICATIONS The TIB may guide design and assessment of educational programs for professional formation.
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Affiliation(s)
- Honghe Li
- Institute for International Health Professions Education and Research, China Medical University, Shenyang, China; Cambridge Health Alliance, Harvard Medical School, Cambridge, USA.
| | - Dennis H Novack
- Office of Educational Affairs, Drexel University College of Medicine, Philadelphia, USA
| | - Pamela Duke
- Office of Educational Affairs, Drexel University College of Medicine, Philadelphia, USA
| | - Edward Gracely
- Family Community and Preventive Medicine, Drexel University College of Medicine, Philadelphia, USA
| | - Christina Cestone
- Office of Educational Affairs, Drexel University College of Medicine, Philadelphia, USA
| | - Tiffany Davis
- Office of Educational Affairs, Drexel University College of Medicine, Philadelphia, USA
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Viggers S, Østergaard D, Dieckmann P. How to include medical students in your healthcare simulation centre workforce. Adv Simul (Lond) 2020; 5:1. [PMID: 31921465 PMCID: PMC6947995 DOI: 10.1186/s41077-019-0117-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Accepted: 10/22/2019] [Indexed: 12/20/2022] Open
Abstract
Running simulation centre activities requires a substantial amount of human resources. Here we present ideas on how medical students can be integrated into the simulation centre workforce to support the goal of delivering simulation-based education. The ideas are centred around the many different roles the students can fulfil and how this can be applied in other centres interested in integrating medical students into the workforce. The ideas are based on the experience from a regional Danish simulation centre, the Copenhagen Academy for Medical Education and Simulation (CAMES), where the work of medical students appears to be beneficial for both students, teaching and research faculty, and the growth of the simulation centre.
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Affiliation(s)
- Sandra Viggers
- 1Copenhagen Academy for Medical Education and Simulation, Copenhagen, Capital Region of Denmark Denmark
| | - Doris Østergaard
- 1Copenhagen Academy for Medical Education and Simulation, Copenhagen, Capital Region of Denmark Denmark.,2Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark
| | - Peter Dieckmann
- 1Copenhagen Academy for Medical Education and Simulation, Copenhagen, Capital Region of Denmark Denmark.,2Faculty of Health and Medical Sciences, Copenhagen University, Copenhagen, Denmark
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Sanchez DJ, Strauman TJ, Compton S. Impact of Student Perceptions of the Educational Program on Burnout in Medical School. Med Sci Educ 2019; 29:1077-1087. [PMID: 34457586 PMCID: PMC8368313 DOI: 10.1007/s40670-019-00812-3] [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] [Indexed: 06/13/2023]
Abstract
INTRODUCTION Burnout is considered to be at the opposite end of the continuum from engagement. People who experience burnout first go through various intermediate patterns that lead to burnout, which in medical students is associated with reduced empathy, intention to leave school, and suicidal ideation. Thus, understanding how to mitigate burnout is of primary importance. In this study, we investigate if students' positive perceptions of the educational program's alignment with adult education principles decreased symptoms suggestive of typical patterns of intermediate burnout. METHODS We conducted a cross-sectional survey study of all currently enrolled Duke-NUS Medical School students in Singapore (n = 238). An electronic questionnaire contained demographic questions and additional measures for factors known to be associated with burnout, including depression, anxiety, social support, and workload. In addition, we measured students' perceptions of how well the educational program aligned with adult learning principles by using a modified version of the Andragogical Practices Inventory (API) to suit medical education. An intermediate pattern of burnout was measured using the Maslach Burnout Inventory (MBI). Using logistic regression, we then assessed the unique association between the presence of an intermediate pattern of burnout with students' perceptions of the educational program's alignment with adult learning principles. RESULTS The survey response rate was 52%. Overall, 76% (95% CI 67-84%) displayed symptoms suggestive of an intermediate pattern of burnout. Perceptions of the educational program's alignment with adult learning principles were found to be inversely related to the pattern of burnout after controlling for depression, anxiety, and subjective workload. DISCUSSION AND CONCLUSION Though adult learning theory is the subject of rich debate, the results of this study suggest that promoting educational activities that are aligned with adult learning principles may help to ultimately reduce the risk of burnout in medical school students.
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Affiliation(s)
- Daniel J. Sanchez
- Office of Education, Duke-NUS Medical School, 8 College Rd, Singapore, 169857 Singapore
| | - Timothy J. Strauman
- Office of Education, Duke-NUS Medical School, 8 College Rd, Singapore, 169857 Singapore
- Department of Psychology and Neuroscience, Duke University, 417 Chapel Dr, Durham, NC 27708 USA
| | - Scott Compton
- Office of Education, Duke-NUS Medical School, 8 College Rd, Singapore, 169857 Singapore
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Quiroga-Marabolí P, Antúnez-Riveros MA, Aguirre-Jerez M, Saldaña AB, Peralta-Camposano J, Bahillo MPRDG. Perceptions of the educational environment among undergraduate physical therapy students in a competency-based curriculum at the University of Chile. J Educ Eval Health Prof 2019; 16:9. [PMID: 31064046 PMCID: PMC6545526 DOI: 10.3352/jeehp.2019.16.9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Accepted: 04/29/2019] [Indexed: 05/31/2023]
Abstract
PURPOSE This study aimed to assess the educational environment (EE) among students in a physical therapy undergraduate program, to identify patterns in EE perceptions among the students by year, and to determine issues that should be addressed. METHODS The Dundee Ready Education Environment Measure (DREEM) questionnaire was used to explore the relationships among the total mean score, subscales, and items in a competency-based curriculum in the physical therapy program at the University of Chile. The DREEM questionnaire was filled out by 166 of 244 students (68.03%), of whom 56.6% were men and 43.4% were women, with 75.9% between 19 and 23 years of age. RESULTS The total mean score (120.9/200) indicated that the EE was perceived as 'more positive than negative.' There were significant differences (P<0.05) between first-year students (113.41), who reported the lowest total mean score, and fourth-year students (126.60), who had the highest total mean score. Students rated their EE favorably on each subscale except social self-perceptions, which second-year students rated as 'not too bad,' and for which first-, third-, and fourth-year students gave a rating corresponding to 'not a nice place.' On the perceptions of teachers subscale, there were significant differences (P<0.05) between first-year students (28.05/44) and fourth-year students (32.24/44) and between second-year students (28.72/44) and fourth-year students (32.24/44). On the academic self-perceptions subscale, there were significant differences (P<0.05) between first-year students (18.12/32) and second-year (21.68/32), third-year (22.33/32), and fourth-year students (21.87/32). CONCLUSION Physical therapy students at the University of Chile had positive perceptions of their EE. First-year students rated the largest number of items as problematic. Improvements are required across the program in the specific subscales mentioned above.
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Affiliation(s)
- Pablo Quiroga-Marabolí
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile
| | | | - Marcela Aguirre-Jerez
- Laboratory for Scientific Image Analysis, Center for Medical Informatics and Telemedicine Program of Anatomy and Developmental Biology, Biomedical Science Institute, Faculty of Medicine, University of Chile, Santiago, Chile
| | - Alvaro Besoain Saldaña
- Department of Physical Therapy, Faculty of Medicine, University of Chile, Santiago, Chile
| | | | - María Pilar Ruiz de Gauna Bahillo
- Department of Theory and History of Education, Faculty of Philosophy and Educational Sciences, Basque Country University, UPV/EHU, Bilbao, Spain
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Burke E, Teeling M, Hennessy M. Introduction of an academic internship in Ireland: views of undergraduate medical students. Ir J Med Sci 2018; 188:1025-1032. [PMID: 30341635 DOI: 10.1007/s11845-018-1917-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2018] [Accepted: 10/11/2018] [Indexed: 10/28/2022]
Abstract
INTRODUCTION A combined academic and clinical training programme for junior doctors in Ireland, the academic track for internship, has recently been launched. The academic track offers newly graduated doctors protected time within the working week to undertake a research project in addition to funding, an academic supervisor, and additional training in research skills. This study seeks to investigate the views of undergraduate medical students. METHODS The study population was undergraduate medical students at Trinity College Dublin in their penultimate year of study. An online questionnaire was designed and disseminated via a gatekeeper. Descriptive statistics were used to carry out data analysis on students' responses. RESULTS The response rate was 50/203 (24.6%). All respondents indicated that protected time would be 'very important' or 'important'. The most frequently cited reason for participating in the academic track was 'To progress my career in a particular specialty' (28/42). The most frequently cited anticipated achievement was research publication (39/42). The most common response when asked what concerns (if any) students had about participating in the programme was 'I am not sure I could achieve all the clinical competencies of an intern in addition to research' (58%). DISCUSSION There was a significant interest in the academic track for internship, and it is perceived by students as being of benefit to their careers. The value of protected time and an academic supervisor were recognised, and a research publication was the most frequently cited anticipated outcome. The data gathered in this questionnaire will help inform curriculum development and the identification of suitable learning outcomes.
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Affiliation(s)
- Elaine Burke
- School of Medicine, Trinity College Dublin, The University of Dublin, Pearse Street, Dublin 2, Ireland.
| | - Mary Teeling
- School of Medicine, Trinity College Dublin, The University of Dublin, Pearse Street, Dublin 2, Ireland
| | - Martina Hennessy
- School of Medicine, Trinity College Dublin, The University of Dublin, Pearse Street, Dublin 2, Ireland
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Chhabra S, Misra A, Shah S, Kole T. Survey of student perception of medical education environment among emergency medicine residents of an academic medical centre in Northern India. Int J Emerg Med 2016; 9:5. [PMID: 26894893 DOI: 10.1186/s12245-016-0098-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2015] [Accepted: 01/28/2016] [Indexed: 11/27/2022] Open
Abstract
Background The specialty of emergency medicine is in its infancy state in the long history of the Indian health sciences education system. Little analytical published data is available at the moment in India regarding the quality of medical education as perceived by the students. Roff et al. (Med Teach 19: 295–299, 1997) developed a methodology using a Delphi panel to standardize the measurement of medical education known as the Dundee Ready Education Environment Measure (DREEM), which is widely utilized. The purpose of this survey is to investigate student perceptions of medical education environment among emergency medicine residents of an academic medical centre in Northern India using the DREEM tool. Methods The DREEM questionnaire was administered to the students undergoing 3-year post-graduate emergency medicine training in our residency programme. A total of 35 students enrolled from all 3 years of the residency programme completed the survey in May 2013. The results were analysed using STATA 9.0. Results The reliability coefficient which was calculated using Cronbach’s alpha for the totality of items of this study was 0.92, which indicates high internal consistency. The mean (95 % CI) for the overall DREEM was 139.8 (133.3, 146.2), which showed excellent educational environment among the medical students. Conclusions The DREEM score is a universal tool for assessment of education provided by health science institutes. With a total score of 139.8, the study conducted at our institute showed comparable results to the original DREEM study conducted by Roff et al. The good scores in all the five subscales reveal an excellent educational programme and learning environment as perceived by the students enrolled at our institution.
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