PharmaCORE: Optimizing medical pharmacology education with an innovative instructional dashboard

WHAT WAS THE EDUCATIONAL CHALLENGE?

Diminishing emphasis on pharmacology education in medical schools has resulted in a concerning lack of prescribing knowledge among physician graduates. These concerns mirror our graduates' expressed dissatisfaction with the structure and quality of pharmacology educational experiences over the past 5 years.

WHAT WAS THE SOLUTION?

PharmaCORE, a web-based instructional dashboard, was developed as an interactive faculty development tool to enhance integration and instruction of pharmacology content in pre-clinical curriculum at a US medical school.

HOW WAS THE SOLUTION IMPLEMENTED?

PharmaCORE was introduced in Spring 2022 for instructors teaching pharmacology in the pre-clinical curriculum. Instructors used the dashboard to assess coverage of specific drug topics throughout the curriculum and to apply tailored, learner-centered teaching strategies to optimize learner engagement and comprehension.

WHAT LESSONS WERE LEARNED THAT ARE RELEVANT TO A WIDER GLOBAL AUDIENCE?

The initial assessment indicated that the dashboard was user-friendly and positively influenced instructor awareness of pharmacology content and learner-centered teaching. This faculty development approach underscores the importance of skill-based mapping and maintaining learner-centered teaching standards to address other integrated subjects and broader curricular challenges.

WHAT ARE THE NEXT STEPS?

This study lays the foundation for the broader applicability of instructional dashboards in tracking and addressing curricular challenges across pharmacology and other science subjects. Future steps include more personalized feedback for instructors, creating a student-accessible version, and ongoing monitoring of maintenance measures like milestone exams.

Twelve tips for creating a longitudinal quality improvement and safety education for early health professions students

Despite the numerous calls for integrating quality improvement and patient safety (QIPS) curricula into health professions education, there are limited examples of effective implementation for early learners. Typically, pre-clinical QIPS experiences involve lectures or lessons that are disconnected from the practice of medicine. Consequently, students often prioritize other content they consider more important. As a result, they may enter clinical settings without essential QIPS skills and struggle to incorporate these concepts into their early professional identity formation. In this paper, we present twelve tips aimed at assisting educators in developing QIPS education early in the curricula of health professions students. These tips address various key issues, including aligning incentives, providing longitudinal experiences, incorporating real-world care outcomes, optimizing learning environments, communicating successes, and continually enhancing education and care delivery processes.

A mixed-methods SWOT analysis of a medical student Balint group programme

BACKGROUND

Balint groups use case-based discussions to explore, reflect on, and enhance the clinician-patient relationship. They facilitate the development of empathy and reflective practice and reduce burnout. This study aimed to explore how the benefits of a traditional Balint group format can be accessed and optimised for medical students during a one-year pilot programme.

METHODS

Eight medical student Balint groups ran for six weeks during 2022-2023, with 90 students participating. Themes were identified from student feedback using qualitative content analysis. Group leaders kept reflective session notes and used these alongside student feedback to undertake a strengths, weaknesses, opportunities, and threats analysis.

RESULTS

Strengths of the programme were emotional containment, learning to reflect, and community identity. Weaknesses were themed as strange situations, dragging along, and facilitator as an object. Opportunities were identified in expanding the scope and sharpening focus. Psychological defences and the engagement dilemma threatened the future success of the Balint group programme.

DISCUSSION

Medical student Balint groups provide a unique space to combine learning and emotional support with personal, professional and community development. However, the traditional Balint group format may need adapting to be widely accessible to undergraduate learners. Sustainably integrating Balint groups into the medical school curriculum requires ongoing engagement work at both an individual and organisational level.

Learning strategies for the advanced trainee in specialist training

BACKGROUND

A significant factor of clinicians' learning is based on their ability to effectively transfer acquired knowledge, skills, and attitudes from specialty-specific clinical courses to their working environment.

MATERIAL AND METHOD

We conducted semi-structured interviews with 20 anaesthesiologist trainees (i.e. residents) in four group and five individual interviews using SRL principles as sensitizing concepts. Data were collected and analyzed iteratively using thematic analysis.

RESULTS

Advanced trainees are highly motivated to explore what they have learned in specialty-specific courses, but they often face several barriers in implementing their learning in the workplace environment. Four themes emerged from the interview data: 'Be ready to learn', "Take the 'take-home-messages' home', "Be ready to create your own opportunities', and "Face it, it's not entirely up to you'. Understanding the challenges regarding transferring knowledge from courses to the working environment is an important lesson for assisting trainees set their learning goals, monitor their progress, and re-evaluate their SRL processes.

CONCLUSION

Even for advanced trainees, successfully transferring knowledge from specialty-specific courses often requires adequate commitment and support. Medical supervisors and other relevant stakeholders must be aware of their shared responsibility for creating individual environments that support opportunities for trainees to self-regulate their learning.

Twelve tips for practical clinical skills coaching

Coaching is rapidly evolving in clinical medicine, including for clinical skills (CS) learning. Yet a schema is needed for how to coach students in the many CS that are pivotal to the practice of medicine. These twelve tips aim to provide practical strategies for teachers and educators to coach students for CS learning. The tips cover many important aspects of CS coaching, including establishing a safe space, ways to prepare to coach, setting goals, guiding a coaching relationship, fostering coaching conversations, and in-person or virtual approaches. Together, the tips align as seven key steps of an overall coaching process. The twelve tips apply equally to coaching struggling students and all students seeking to improve CS and offer a guide for coaching at an individual or program level.

Approaches to integrating online videos into health professions curricula: educators' perspectives from multiple institutions

Background: The COVID-19 pandemic has accelerated a transition from lecture-based classes to blended and online learning, increasing the need to integrate publicly available online educational videos. Although online videos are widely available, it is challenging for educators to effectively integrate them into a curriculum. Years before the pandemic, educators from different institutions integrated videos from a library of microbiology and immunology resources into different curricula. Their experiences may inform current educators on the approach to incorporating external resources into their unique curricula. Methods: We interviewed US health professions instructors or course directors who had previously requested access to online microbiology and immunology videos. Using thematic analysis, we organized prominent themes into an existing framework for curriculum development. We then reflected on the meaning of the themes using the same conceptual framework. Results: We found that educators from different schools were able to integrate the same publicly available videos into varying contexts. Most used them as preparation for interactive sessions. For integrating videos, educators felt success when the following actions occurred. 1) Educators integrated videos as a tool to enhance active-learning activities. 2) Educators created activities that focused on clinical applications of knowledge, taught critical thinking, and developed enthusiasm for the subject. 3) They tested students on knowledge application and major concepts rather than solely on content for high-stakes exams. 4) Educators worked with administrators who understood the goals of integrating external videos and supported educators with time and resources to develop effective blended learning. Conclusion: Our study suggests that educators integrating external resources into their curricula may benefit from first establishing their goals and aspirations for their students. These goals then become the anchor for other curricular elements, including external videos, in-class activities, and assessments. Our study highlights the need for dedicated time to develop experienced and enthusiastic educators.

Ethnicity-related stereotypes and their impacts on medical students: A critical narrative review of health professions education literature

BACKGROUND

Stereotypes are oversimplified beliefs about groups of people. Social psychology concepts and theories describing ethnicity-related stereotypes are well reported in non-medical educational settings. In contrast, the full impact of stereotyping on medical students, and the extent to which they were represented in health professions education (HPE) is less well-described. Using the lens of social psychological theory, this review aimed to describe ethnicity-related stereotypes about medical students portrayed in HPE literature and the impacts of those stereotypes.

METHODS

A critical narrative approach was undertaken. Social psychology concepts and theories were used as a framework through which to review the impacts of ethnicity-related stereotypes on medical students as described in HPE literature. A database search of Ovid MEDLINE, JSTOR, Project Muse, and PsychINFO was conducted to identify both theoretical and empirical articles relating to this topic in the HPE literature. Data was synthesised using thematic analysis, giving particular care to appraise the evidence from perspectives in social psychology.

FINDINGS

In HPE, the experiences and impact of stereotyping on learners from minority ethnic groups was explained by social psychology concepts such as stereotype threat, stereotype reactance, attributional ambiguity, self-fulfilling prophecy, stereotype boost, stereotype lift, and stereotype masking. Stereotype boost and stereotype lift were particularly described among students who identified as White, whereas stereotype threat was described more commonly among students from minority ethnics groups. The impact of stereotyping is not just on assessment, but may be across all teaching and learning activities at medical school.

INTERPRETATION

Social psychology concepts and theories can be used to describe the experience and impact of ethnicity-related stereotypes in HPE. Educators can better support learners from minority ethnic groups by self-reflecting over assumptions about individuals from minority ethnic groups, as well as minimise the impact of stereotyping and bias to create more inclusive learning environments.

Education curriculum for surgical interns that improves stress management and grit levels

INTRODUCTION

Overwhelming stress or burnout has been observed in medical students, including 69% of surgical interns. This study aimed to assess the stress levels of fifth-year medical students during surgical training. An education curriculum with both clinical and research sessions was evaluated for its effect on the interns' stress and grit levels.

METHOD

A blinded, prospective study was conducted to evaluate the efficacy of an educational program on the recognition and management of stress. The State-Trait Anxiety Inventory (STAI) was used to assess anxiety. The Grit Scale was used to quantify the interns' grit, conscientiousness, and self-control.

RESULTS

The STAI survey results showed that the STAI state scores but not the trait scores were significantly lower in the intervention group than in the control group (p < 0.05). Additionally, the postintervention STAI score and the change in the STAI score were both lower in the intervention group (p < 0.05). There was a significant increase in grit among the medical students in the intervention group from baseline to post-intervention (p < 0.001). The scores of the consistency and perseverance subscales of the Grit Scale also increased significantly from baseline to post-intervention (both p < 0.001).

CONCLUSION

The education curriculum can improve interns' stress management and grit levels. We believe this curriculum needs to be implemented in medical education, and we plan to continue the program.

Using audio-diaries for research and education: AMEE Guide No. 144

For this AMEE Guide, we explore the process and application of an evolved tool known as the audio diary. Diaries are a type of qualitative method that has long been advocated for in healthcare education practice and research. However, this tool has been typically underestimated as an approach to capturing how individuals' experiences change over time. In particular, this longitudinal method can nurture a stronger partnership between the researcher and participant, which can empower participants to share their reflections as they make sense of their identities and experiences. There is a wider issue concerning how to use and implement audio diaries in medical education research, this guide outlines a foundational process by which all levels of researchers can use to ensure the purpose, application and use of the audio diary tool is done with quality, rigour and ethics in mind. The processes presented are not a prescriptive approach to utilising audio diaries as a longitudinal method. This AMEE Guide serves as an opportunity for researchers and educators to consult this resource in making decisions to decide whether the audio diary tool is fit for their research and/or educational purpose and how audio diaries can be implemented in health profession education projects. This guide discusses and addresses some of the ethical, operational and contextual considerations that can arise from using audio diaries as a tool for longitudinal data collection, critical reflection, or understanding professionalism.

Viewing faculty development through an organizational lens: Sharing lessons learned

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.

Redefining scholarship for health professions education: AMEE Guide No. 142

Scholarship is an integral aspect of academia. It shapes the practice of individuals and the field and is often used to inform career progression decisions and policies. This makes it high stakes. Yet it is complex, and ambiguous. Definitions vary and the term does not necessarily translate well across contexts. In this AMEE guide, our aim is to establish a contemporary definition of scholarship which is appropriate to health professions education (HPE). Our specific objectives are to provide guidance to support colleagues in their career development as professional educators and to challenge biases and assumptions about scholarship which may still exist in educational systems and structures. Ultimately, we hope that this work will advance the stature/standing of scholarship in the field. We provide a general definition of scholarship and how this relates to the scholarship of teaching (and learning) (SoT[L]) and scholarly teaching. Drawing on Boyer's seminal work, we describe different types of scholarship and reflect on how these apply to HPE, before moving on to describe different types of engagement with scholarship in HPE, including scope of contribution and influence. Using cases and examples, we illustrate differences in scholarly engagement across stages of a career, contexts, and ways of engaging. We provide guidance on how to assess 'quality' of scholarship. We offer practical advice for health professions' educators seeking academic advancement. We advocate that institutional leaders consider their systems and structures, so that these align with faculty work patterns, and judge teaching and professional practice appropriately. We conclude by offering a new definition of scholarship in HPE.

Transfer of knowledge, skills and confidence from a faculty development programme for health professions educators into practice

BACKGROUND

Faculty development programmes should incorporate the transfer of knowledge, skills, and confidence from the training to educational practice. However, there is a risk that transfer may fail due to inadequate integration of knowledge, skills, and confidence. The study evaluated transfer levels, guided by learned principles from a faculty development programme.

METHOD

The submitted self-reports on a pedagogical intervention of 92 out of 190 health professions educators who participated in a mandatory teaching and learning training programme, were analysed by a mixed-method approach guided by a structured conceptual framework.

RESULTS

Overall 93.4% reported the successful transfer of learning. Participants incorporated sustainable changed practice (level A, 57.6%), showed reflection on the impact of changed practice (level B, 21.7%), and performed effect analysis (level C, 14.1%). The rest planned application of learning (level D, 4.4%) and identified gaps in current practice or developed an idea for educational intervention but did not implement (level E, 2.2%).

CONCLUSION

The majority of participants transferred their learning. Faculty development programmes must ensure successful transfer of knowledge, skills, and confidence from the training to educational practice to ensure sustainable development of teaching and learning practices.

Mixed reality as a time-efficient alternative to cadaveric dissection

Objectives: The extent of medical knowledge increases yearly, but the time available for students to learn is limited, leading to administrative pressures to revise and reconfigure medical school curricula. The goal of the present study is to determine whether the mixed reality platform HoloAnatomy represents an effective and time-efficient modality to learn anatomy when compared to traditional cadaveric dissection.Methods: This was a prospective, longitudinal study of medical students completing a musculoskeletal anatomy course at Case Western Reserve University School of Medicine. Participants were divided into two groups based on learning platform (HoloAnatomy versus traditional cadaveric dissection) and content area (upper limb versus lower limb anatomy). Time spent in lab and end of course practical exam scores were compared between groups.Results: The average study time of 48 medical students who completed study requirements was 4.564 h using HoloAnatomy and 7.318 h in the cadaver lab (p = 0.001). No significant difference was found between exam scores for HoloAnatomy and cadaver learners (p = 0.185).Conclusions: Our results indicate that HoloAnatomy may decrease the time necessary for anatomy didactics without sacrificing student understanding of the material.

Academic Anesthesiologists Perceive Significant Internal Barriers to Intraoperative Teaching in a Cross-Sectional Survey

BACKGROUND

Academic anesthesiologists have numerous demands on their time, and this can erode teaching quality. Reducing barriers to teaching may ameliorate this. The primary aim of this study is to evaluate the learning environment and identify barriers to clinical teaching using a multicenter survey approach.

METHODS

Anesthesiologists at four academic centers were surveyed to understand barriers to clinical teaching. Demographic data and time spent teaching were collected. Faculty attitudes regarding teaching, resident physician perceptions of their teaching, supportiveness of departmental and operating room leadership, whether they enjoyed teaching, and the perceived quality of their own teaching ("self-efficacy") were assessed using Likert scales. Principal component analysis was performed to identify themes in these data. Pearson correlation, t test, and linear regression analyses were used to evaluate interactions between themes.

RESULTS

The response rate was 40.6% (230/566). Responding faculty expressed a high level of engagement with the teaching role. Clinical production pressure was a common theme. Faculty who spent more time teaching reported greater enjoyment of teaching, feeling better about their teaching, and were better prepared to teach. Enjoyment of teaching was not independently associated with more time spent teaching. Regression analysis revealed that perceptions of environmental factors (including production pressure) had no independent effect on time spent teaching or on self-efficacy in teaching quality. Faculty self-efficacy was positively related to enjoyment of teaching as well as making teaching a higher priority.

CONCLUSIONS

Improving perceptions of the learning environment might be best achieved by mitigating production pressure and improving faculty self-efficacy in their teaching.