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Koelewijn G, Hennus MP, Kort HSM, Frenkel J, van Houwelingen T. Games to support teaching clinical reasoning in health professions education: a scoping review. Med Educ Online 2024; 29:2316971. [PMID: 38394053 PMCID: PMC10896137 DOI: 10.1080/10872981.2024.2316971] [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: 10/27/2023] [Accepted: 02/06/2024] [Indexed: 02/25/2024]
Abstract
INTRODUCTION Given the complexity of teaching clinical reasoning to (future) healthcare professionals, the utilization of serious games has become popular for supporting clinical reasoning education. This scoping review outlines games designed to support teaching clinical reasoning in health professions education, with a specific emphasis on their alignment with the 8-step clinical reasoning cycle and the reflective practice framework, fundamental for effective learning. METHODS A scoping review using systematic searches across seven databases (PubMed, CINAHL, ERIC, PsycINFO, Scopus, Web of Science, and Embase) was conducted. Game characteristics, technical requirements, and incorporation of clinical reasoning cycle steps were analyzed. Additional game information was obtained from the authors. RESULTS Nineteen unique games emerged, primarily simulation and escape room genres. Most games incorporated the following clinical reasoning steps: patient consideration (step 1), cue collection (step 2), intervention (step 6), and outcome evaluation (step 7). Processing information (step 3) and understanding the patient's problem (step 4) were less prevalent, while goal setting (step 5) and reflection (step 8) were least integrated. CONCLUSION All serious games reviewed show potential for improving clinical reasoning skills, but thoughtful alignment with learning objectives and contextual factors is vital. While this study aids health professions educators in understanding how games may support teaching of clinical reasoning, further research is needed to optimize their effective use in education. Notably, most games lack explicit incorporation of all clinical reasoning cycle steps, especially reflection, limiting its role in reflective practice. Hence, we recommend prioritizing a systematic clinical reasoning model with explicit reflective steps when using serious games for teaching clinical reasoning.
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Affiliation(s)
- Gilbert Koelewijn
- Research Group Technology for Healthcare Innovations, Research Centre for Healthy and Sustainable Living, University of Applied Sciences Utrecht, Utrecht, the Netherlands
- Department of Pediatrics, Wilhelmina Children's Hospital/University Medical Center Utrecht, Utrecht, the Netherlands
| | - Marije P Hennus
- Department of Pediatrics, Wilhelmina Children's Hospital/University Medical Center Utrecht, Utrecht, the Netherlands
- Center for Research and Development of Health Professions Education, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Helianthe S M Kort
- Research Group Technology for Healthcare Innovations, Research Centre for Healthy and Sustainable Living, University of Applied Sciences Utrecht, Utrecht, the Netherlands
- Building Healthy Environments for Future Users Group, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Joost Frenkel
- Department of Pediatrics, Wilhelmina Children's Hospital/University Medical Center Utrecht, Utrecht, the Netherlands
| | - Thijs van Houwelingen
- Research Group Technology for Healthcare Innovations, Research Centre for Healthy and Sustainable Living, University of Applied Sciences Utrecht, Utrecht, the Netherlands
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Bains M, Kaliski DZ. Assessing the benefits of an online prematriculation anatomy workshop on knowledge acquisition and anatomy competency in a Doctor of Physical Therapy program. Adv Physiol Educ 2024; 48:347-355. [PMID: 38625130 DOI: 10.1152/advan.00053.2023] [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: 04/07/2023] [Revised: 03/04/2024] [Accepted: 03/04/2024] [Indexed: 04/17/2024]
Abstract
Preparing students for the transition to graduate-level education with greater learning demands in a condensed time frame is a challenging process for health professions educators and incoming students. Prematriculation programs offer a solution for exposing students to the foundational sciences in preparation for the academic rigor of a doctoral program. This retrospective study assessed whether incoming students enrolled across 3 yr of a 2-day online anatomy workshop, offered in July and August before the start of their first semester resulted in improved anatomy knowledge. Whether this acquired knowledge translated to improved anatomy outcomes in the first semester of a Doctor of Physical Therapy program was also assessed, while also accounting for variables of gender, ethnicity, and grade-point average. Knowledge acquired during both days of the workshop resulted in statistically significant improvements in anatomy postquiz scores compared to the baseline prequiz (P < 0.001). Multivariate regression analyses demonstrated statistically significant relationships between the first-semester anatomy practical score and workshop participation (P = 0.04) as well as a predictive value of gender (P = 0.01). Evaluating a timing effect on the predictive value of the online anatomy workshop demonstrated statistically significant effects of the prematriculation workshop on both first-semester anatomy practicals for August (P = 0.03 for practical 1; P = 0.04 for practical 2) but not July workshop participants. Findings from this study support the utility of an online prematriculation anatomy workshop to prepare students for graduate-level anatomy learning expectations in a doctoral allied health program.NEW & NOTEWORTHY This paper presents the findings of a retrospective study examining the effectiveness of an online prematriculation anatomy workshop on knowledge acquisition and first-semester anatomy competency following the success of a previously offered peer-led onsite workshop. To our knowledge, this is the first report of an online prematriculation program that successfully introduces graduate-level learning expectations and access to anatomical resources leading to improved anatomy competency in an allied health professional program.
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Affiliation(s)
- Mona Bains
- School of Physical Therapy, The University of the Incarnate Word, San Antonio, Texas, United States
| | - Debora Z Kaliski
- School of Physical Therapy, The University of the Incarnate Word, San Antonio, Texas, United States
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Desselle SP, McDonagh G, O'Dea M, Schoen I. A comprehensive program in academic health professions to enhance faculty recruitment, mentoring, productivity, and retention: The case of RCSI's StAR program. Res Social Adm Pharm 2024; 20:539-546. [PMID: 38346916 DOI: 10.1016/j.sapharm.2024.01.014] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2024] [Revised: 01/24/2024] [Accepted: 01/25/2024] [Indexed: 04/01/2024]
Abstract
Top faculty talent recruitment, mentoring, productivity, and retention are paramount for organizational success among institutions of higher learning. Programs would do well to treat these various aspects of faculty management/development as inextricably linked to one another, rather than viewing recruitment or retention in a vacuum. The Strategic Academic Recruitment (StAR) program at the Royal College of Surgeons in Ireland (RCSI) University of Medicine and Health Sciences in Dublin was founded to bear these things, along with best practices in faculty development, in mind to enhance organizational effectiveness. This paper provides some background, description, and outcomes of the program thus far, revealing positive trends in scholarly productivity, teaching, program faculty commitment, and the development of future leaders for the institution, even while further evaluation and continued quality improvement for the StAR initiative are called for. It is hoped that the details provided here can be helpful for other academic organizations as they consider any of various initiatives aimed to attract high-quality labor capital, position those faculty for success, and enhance organizational effectiveness and reputation.
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Affiliation(s)
- Shane P Desselle
- College of Pharmacy, Touro University California, Vallejo, CA, 94952, USA.
| | - Gráinne McDonagh
- Insights & Planning Office, Royal College of Surgeons in Ireland, 121 St Stephen's Green, Dublin 2, Ireland
| | - Mark O'Dea
- Department of Human Resources, Royal College of Surgeons in Ireland, 121 St. Stephen's Green, Ireland
| | - Ingmar Schoen
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, 123 St. Stephen's Green, Dublin 2, Ireland
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Cahn PS, Watkins Liu C, Hobbs M. Using narrative to integrate anti-oppression into interprofessional collaborative practice competencies. J Interprof Care 2024; 38:583-586. [PMID: 38219266 DOI: 10.1080/13561820.2024.2303498] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 01/04/2024] [Indexed: 01/16/2024]
Abstract
Many institutions of higher education have designed curricula for health professions learners based on the Interprofessional Education Collaborative (IPEC) core competencies for interprofessional collaborative practice. As part of a periodic cycle of revision, in 2023, IPEC released revised competencies that, for the first time, explicitly embedded concepts of anti-oppressive practice. Curriculum designers seeking to revise their interprofessional learning activities to map onto the new competencies can benefit from the experience of a health professions graduate school in Boston, MA. Since 2021, faculty members and experts in justice, equity, diversity, and inclusion have revamped a required interprofessional education curriculum to include anti-oppression competencies. They targeted narrative elements of the courses like a common reading, case studies, and simulation scenarios for revision. By using narrative to introduce anti-oppression competencies like recognizing bias, analyzing systems of power, and intervening to mitigate microaggressions, course designers encouraged learners to cultivate reflection about their relationship to the care team, the patient, and the community.
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Affiliation(s)
- Peter S Cahn
- Office of the Provost, MGH Institute of Health Professions, Boston, MA, USA
| | - Callie Watkins Liu
- Office of Justice, Equity, Diversity, and Inclusion, MGH Institute of Health Professions, Boston, MA, USA
| | - Midge Hobbs
- Office of the Provost, MGH Institute of Health Professions, Boston, MA, USA
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Allvin R, Thompson C, Edelbring S. Variations in measurement of interprofessional core competencies: a systematic review of self-report instruments in undergraduate health professions education. J Interprof Care 2024; 38:486-498. [PMID: 37589390 DOI: 10.1080/13561820.2023.2241505] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 06/27/2023] [Indexed: 08/18/2023]
Abstract
Educating health care professionals for working in interprofessional teams is a key preparation for roles in modern healthcare. Interprofessional teams require members who are competent in their roles. Self-assessment instruments measuring interprofessional competence (IPC) are widely used in educational preparation, but their ability to accurately and reliably measure competence is unknown. We conducted a systematic review to identify variations in the characteristics and use of self-report instruments measuring IPC. Following a systematic search of electronic databases and after applying eligibility criteria, 38 articles were included that describe 8 IPC self-report instruments. A large variation was found in the extent of coverage of IPC core competencies as articulated by the Interprofessional Education Collaborative. Each instrument's strength of evidence, psychometric performance and uses varied. Rather than measuring competency as "behaviours", they measured indirect proxies for competence, such as attitudes towards core interprofessional competencies. Educators and researchers should identify the most appropriate and highest-performing IPC instruments according to the context in which they will be used.Systematic review registration: Open Science Framework (https://archive.org/details/osf-registrations-vrfjn-v1).
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Affiliation(s)
- Renée Allvin
- Clinical Skills Centre, Örebro University Hospital, Örebro, Sweden
- School of Health Sciences, Örebro University, Örebro, Sweden
| | - Carl Thompson
- School of Healthcare, University of Leeds, Leeds, UK
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Majumder MAA, Bharatha A, Kumar S, Chatterjee M, Gupta S, Harewood H, Singh K, Johnson WMS, Rajasundaram A, Dutta SB, Prasad SV, Rahman S, Kabir R, Parsa AD, Gaur U, Rabbi AMF, Krishnamurthy K, Mohammad S, Chode V, Haque M, Campbell MH. Self-reported side effects of COVID-19 vaccines among health professions students in India. PeerJ 2024; 12:e17083. [PMID: 38590705 PMCID: PMC11000642 DOI: 10.7717/peerj.17083] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Accepted: 02/19/2024] [Indexed: 04/10/2024] Open
Abstract
Studies focusing on the safety and common side effects of vaccines play a crucial role in enhancing public acceptance of vaccination. Research is scarce regarding the usage of COVID-19 vaccines and the side effects experienced by health professions students in India and other countries. This study aimed to document self-reported side effects associated with COVID-19 vaccination among medical and dental students of six medical and dental colleges and teaching hospitals in four states (Tamil Nadu, Madhya Pradesh, Gujarat, and West Bengal) of India. A cross-sectional survey using purposive sampling of medical and dental students was conducted from 26 April to 26 May 2021. Data was collected using a Google Forms questionnaire capturing information regarding receiving COVID-19 vaccines, side effects and symptoms, onset and duration of symptoms, use of treatment to alleviate symptoms, awareness of haematologic risks associated with vaccination, and side effects from previous (non-COVID-19) vaccinations. The majority (94.5%) of participants received both doses of the Covishield/AstraZeneca COVID-19 vaccine. Among participants (n = 492), 45.3% (n = 223) reported one or more side effects. The most frequently reported side effects were soreness of the injected arm (80.3%), tiredness (78.5%), fever (71.3%), headache (64.1%), and hypersomnia (58.7%). The two most common severe symptoms were fever (14.8%) and headache (13%). Most side effects appeared on the day of vaccination: soreness of the injection site (57%), fever (43.1%), and tiredness (42.6%). Most reported symptoms persisted for one to three days-soreness of the injection site (53%), fever (47.1%), and headache (42.6%). Logistic regression showed that women were almost 85% less likely to report side effects. The study's findings corroborate the safety of the Covishield/AstraZeneca vaccine's first dose, evidenced by the relatively minor and transient nature of the side effects. However, the study underscores the necessity for ongoing research to assess the long-term impacts of COVID-19 vaccines, especially in the context of booster doses, thereby contributing to the global understanding of vaccine safety and efficacy.
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Affiliation(s)
- Md Anwarul Azim Majumder
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
- Public Health Foundation of Bangladesh, Dhaka, Bangladesh
| | - Ambadasu Bharatha
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
| | | | - Madhuri Chatterjee
- Shri Ramkrishna Institute of Medical Science, Durgapur, West Bengal, India
| | - Subir Gupta
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
| | - Heather Harewood
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
| | - Keerti Singh
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
| | - WMS Johnson
- Sree Balaji Medical College and Hospital, Chennai, Tamil Nadu, India
| | | | - Sudeshna Banerjee Dutta
- Department of Medical Surgical Nursing (Critical care nursing), Shri Anand Institute of Nursing, Rajkot, Gujarat, India
| | | | - Sayeeda Rahman
- American University of Integrative Sciences (AUIS), Bridgetown, Barbados
| | - Russell Kabir
- Anglia Ruskin University, Chelmsford, Essex, United Kingdom
| | | | - Uma Gaur
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
| | | | - Kandamaran Krishnamurthy
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
| | - Shegufta Mohammad
- Health Education Department, Empower Me First College, Geneva, Switzerland
| | | | - Mainul Haque
- National Defence University of Malaysia, Kuala Lumpur, Malaysia
| | - Michael H. Campbell
- Faculty of Medical Sciences, The University of the West Indies, Cave Hill Campus, Bridgetown, Barbados
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Judkins DR, Durham G. Using Ecometric Data to Explore Sources of Cross-Site Impact Variance in Multi-Site Trials. Eval Rev 2024; 48:274-311. [PMID: 37306100 DOI: 10.1177/0193841x231175549] [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
In 2003, Bloom, Hill, and Riccio (BHR) published an influential paper introducing novel methods for explaining the variation in local impacts observed in multi-site randomized control trials of socio-economic interventions in terms of site-level mediators. This paper seeks to improve upon this previous work by using student-level data to measure site-level mediators and confounders. Development of asymptotic behavior backed up with simulations and an empirical example. Students and training providers. Two simulations and an empirical application to data from an evaluation of the Health Professions Opportunity Grants (HPOG) Program. This empirical analysis involved roughly 6600 participants across 37 local sites. We examine bias and mean square error of estimates of mediation coefficients as well as the true coverage of nominal 95-percent confidence intervals on the mediation coefficients. Simulations suggest that the new methods generally improve the quality of inferences even when there is no confounding. Applying this methodology to the HPOG study shows that program-average FTE months of study by month six was a significant mediator of both career progress and long-term degree/credential receipt. Evaluators can robustify their BHR-style analyses by the use of the methods proposed here.
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Affiliation(s)
| | - Gabriel Durham
- Statistician, University of Michigan, Ann Arbor, MI, USA
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Balizzakiwa T, Achanga P, Ahaisibwe B, Kerry V, Duhaga IA, Semakula D, Sewankambo N, Masood KM. Ensuring Continuity of Health Professions Training Amid a Global Pandemic: Lessons From the Uganda Safe Schools Initiative. Acad Med 2024; 99:395-401. [PMID: 38039980 DOI: 10.1097/acm.0000000000005570] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Abstract
ABSTRACT Uganda experienced 2 COVID-19 waves that challenged health professional education. All health professions training institutions (HPTIs) in Uganda closed in March 2020. Cognizant of the threat to quality education and the frontline workforce, the National Council for Higher Education (NCHE) and Seed Global Health partnered to examine the risks and benefits of HPTI reopening through the Safe Schools Initiative (SSI). This article described the processes to unify stakeholders in health professions education and the outcomes from these discussions during the COVID-19 pandemic in Uganda.During the first COVID-19 wave, the SSI conducted consultative meetings with key stakeholders. The SSI developed guidelines around student welfare and issued standard operating procedures (SOPs) for HPTI reopening. The NCHE recommended in-person learning for final-year students and online learning for junior years, resulting in HPTIs being the first academic institutions to reopen in the country. During the second COVID-19 wave, schools closed again. The SSI utilized recently published literature and quantitative data to inform decision making in addition to expert consensus. The NCHE recommended immediate phased reopening for students in clinical years, blended learning for nonclinical years, and prioritizing health professions education in future lockdowns. Consequently, HPTIs reopened within a month of closure. The SSI demonstrated that national advocacy for health professions education can be effective when engaging stakeholders to build consensus around difficult decisions.Key lessons learned from the SSI include the following: (1) collaborating across sectors in health professions education can amplify change, (2) occupational health guidelines must include health professions students, (3) investing in online education and simulation has value in outbreak-prone areas, and (4) systemic inequities in health professions education will require persistence and advocacy to correct. Future pandemic preparedness must prioritize HPTIs to ensure quality education and continuity of a frontline workforce.
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Tavares W, Pearce J. Attending to Variable Interpretations of Assessment Science and Practice. Teach Learn Med 2024; 36:244-252. [PMID: 37431929 DOI: 10.1080/10401334.2023.2231923] [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: 11/03/2022] [Accepted: 05/31/2023] [Indexed: 07/12/2023]
Abstract
Issue: The way educators think about the nature of competence, the approaches one selects for the assessment of competence, what generated data implies, and what counts as good assessment now involve broader and more diverse interpretive processes. Broadening philosophical positions in assessment has educators applying different interpretations to similar assessment concepts. As a result, what is claimed through assessment, including what counts as quality, can be different for each of us despite using similar activities and language. This is leading to some uncertainty on how to proceed or worse, provides opportunities for questioning the legitimacy of any assessment activity or outcome. While some debate in assessment is inevitable, most have been within philosophical positions (e.g., how best to minimize error), whereas newer debates are happening across philosophical positions (e.g., whether error is a useful concept). As new ways of approaching assessment have emerged, the interpretive nature of underlying philosophical positions has not been sufficiently attended to. Evidence: We illustrate interpretive processes of assessment in action by: (a) summarizing the current health professions assessment context from a philosophical perspective as a way of describing its evolution; (b) demonstrating implications in practice using two examples (i.e., analysis of assessment work and validity claims); and (c) examining pragmatism to demonstrate how even within specific philosophical positions opportunities for variable interpretations still exist. Implications: Our concern is not that assessment designers and users have different assumptions, but that practically, educators may unknowingly (or insidiously) apply different assumptions, and methodological and interpretive norms, and subsequently settle on different views on what serves as quality assessment even for the same assessment program or event. With the state of assessment in health professions in flux, we conclude by calling for a philosophically explicit approach to assessment, and underscore assessment as, fundamentally, an interpretive process - one which demands the careful elucidation of philosophical assumptions to promote understanding and ultimately defensibility of assessment processes and outcomes.
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Affiliation(s)
- Walter Tavares
- The Wilson Centre for Health Professions Education Research, and Post-Graduate Medical Education, Toronto, Canada
- Temerty Faculty of Medicine, University Health Network and University of Toronto, Toronto, Canada
- Department of Health and Society, University of Toronto, Toronto, Canada
- York Region Paramedic Services, Community Health Services, Regional Municipality of York, Newmarket, Canada
| | - Jacob Pearce
- Tertiary Education, Australian Council for Educational Research, Camberwell, Australia
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Neshastesaz Kashi H, Goharinezhad S, Soleimanpour S, Mohammadi AH. Mapping student engagement in health professions education policy and decision-making: a scoping review. BMC Med Educ 2024; 24:325. [PMID: 38519931 PMCID: PMC10960467 DOI: 10.1186/s12909-024-05283-8] [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: 10/02/2023] [Accepted: 03/11/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND "Student engagement" (SE) is gaining momentum as an approach to improve the performance of health professions education (HPE). Nevertheless, despite the broad studies about the role of students in various areas, little is known about the role of SE in policy and decision-making activities. This study aimed to map SE in policy and decision-making regarding terms and definitions, engagement models, influencing factors, outcomes and achievements, and the interconnection between the influencing factors. METHOD Five databases (PubMed, Scopus, ProQuest, Web of Science, and ERIC) were systematically searched from Jan 1, 1990, to Nov 12, 2022. The review was followed according to the Arksey and O'Malley framework for scoping reviews and reported according to the PRISMA-ScR guidelines. We included articles published in English focusing on HPE policy and decision-making. The authors summarized and synthesized the findings into themes, subthemes, tables, and models. RESULTS Of the 22 articles included in the full-text review, terms and definitions were tabled, and three themes were extracted: 1. models of SE, in which 10 studies (45.5%) presented the highly structured formal models as Organizations, 5 studies (22.7%) reported less-structured community and group as Programs, and 7 studies (31.8%) engaged students only in surveys or interviews as Perspective; 2. Factors influencing SE, that were categorized into 7 subthemes: structural, environmental, and motivational factors, member characteristics, training and mentoring, member relationships, valuing and recognizing. 3. Outcomes and achievements of SE related to systems and members. The interconnection between influencing factors is also demonstrated as a conceptual model. DISCUSSION There are various SE models in HPE policy and decision-making, which are mapped and categorized depending on the degree of formality, structuredness, and level of engagement. In our study, three more common SE models in HPE policy and decision-making were investigated. Additionally, these collaborative methods emphasized curriculum development and quality assurance and employed students in these activities. It is worth mentioning that to make SE models more efficient and sustainable, several influencing factors and their interconnections should be considered.
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Affiliation(s)
- Hanieh Neshastesaz Kashi
- Centre for Educational Research in Medical Sciences (CERMS), Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Salime Goharinezhad
- School of Health, Wellbeing and Social Care, Faculty of Wellbeing, Education and Language Studies, The Open University, Walton Hall, Kents Hill, Milton Keynes, MK7 6AA, UK, England
| | - Samira Soleimanpour
- Education Development Center (EDC), Iran University of Medical Sciences, Tehran, Iran
| | - Ali Haji Mohammadi
- Centre for Educational Research in Medical Sciences (CERMS), Faculty of Medicine, Iran University of Medical Sciences, Tehran, Iran.
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Mukurunge E, Nyoni CN, Hugo L. Assessment approaches in undergraduate health professions education: towards the development of feasible assessment approaches for low-resource settings. BMC Med Educ 2024; 24:318. [PMID: 38509579 PMCID: PMC10956342 DOI: 10.1186/s12909-024-05264-x] [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: 08/21/2023] [Accepted: 03/05/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND Feasible and effective assessment approaches to measuring competency in health sciences are vital in competency-based education. Educational programmes for health professions in low- and middle-income countries are increasingly adopting competency-based education as a strategy for training health professionals. Importantly, the organisation of assessments and assessment approaches must align with the available resources and still result in the fidelity of implementation. A review of existing assessment approaches, frameworks, models, and methods is essential for the development of feasible and effective assessment approaches in low-resource settings. METHODS Published literature was sourced from 13 electronic databases. The inclusion criteria were literature published in English between 2000 and 2022 about assessment approaches to measuring competency in health science professions. Specific data relating to the aims of each study, its location, population, research design, assessment approaches (including the outcome of implementing such approaches), frameworks, models, and methods were extracted from the included literature. The data were analysed through a multi-step process that integrated quantitative and qualitative approaches. RESULTS Many articles were from the United States and Australia and reported on the development of assessment models. Most of the articles included undergraduate medical or nursing students. A variety of models, theories, and frameworks were reported and included the Ideal model, Predictive Learning Assessment model, Amalgamated Student Assessment in Practice (ASAP) model, Leadership Outcome Assessment (LOA) model, Reporter-Interpreter-Manager-Educator (RIME) framework, the Quarter model, and the model which incorporates four assessment methods which are Triple Jump Test, Essay incorporating critical thinking questions, Multistation Integrated Practical Examination, and Multiple Choice Questions (TEMM) model. Additional models and frameworks that were used include the Entrustable Professional Activities framework, the System of Assessment framework, the Reporter-Interpreter-Manager-Educator (RIME) framework, the Clinical Reasoning framework (which is embedded in the Amalgamated Student Assessment in Practice (ASAP) model), Earl's Model of Learning, an assessment framework based on the Bayer-Fetzer Kalamazoo Consensus Statement, Bloom's taxonomy, the Canadian Medical Education Directions for Specialists (CanMEDS) Framework, the Accreditation Council for Graduate Medical Education (ACGME) framework, the Dreyfus Developmental Framework, and Miller's Pyramid. CONCLUSION An analysis of the assessment approaches, frameworks, models, and methods applied in health professions education lays the foundation for the development of feasible and effective assessment approaches in low-resource settings that integrate competency-based education. TRIAL REGISTRATION This study did not involve any clinical intervention. Therefore, trial registration was not required.
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Affiliation(s)
- Eva Mukurunge
- School of Nursing, Faculty of Health Sciences, University of the Free State, P.O. Box 339, Bloemfontein, 9300, South Africa.
| | - Champion N Nyoni
- School of Nursing, Faculty of Health Sciences, University of the Free State, P.O. Box 339, Bloemfontein, 9300, South Africa
| | - Lizemari Hugo
- School of Nursing, Faculty of Health Sciences, University of the Free State, P.O. Box 339, Bloemfontein, 9300, South Africa
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Elyoseph Z, Levkovich I. Comparing the Perspectives of Generative AI, Mental Health Experts, and the General Public on Schizophrenia Recovery: Case Vignette Study. JMIR Ment Health 2024; 11:e53043. [PMID: 38533615 PMCID: PMC11004608 DOI: 10.2196/53043] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2023] [Revised: 01/24/2024] [Accepted: 02/11/2024] [Indexed: 03/28/2024] Open
Abstract
Background The current paradigm in mental health care focuses on clinical recovery and symptom remission. This model's efficacy is influenced by therapist trust in patient recovery potential and the depth of the therapeutic relationship. Schizophrenia is a chronic illness with severe symptoms where the possibility of recovery is a matter of debate. As artificial intelligence (AI) becomes integrated into the health care field, it is important to examine its ability to assess recovery potential in major psychiatric disorders such as schizophrenia. Objective This study aimed to evaluate the ability of large language models (LLMs) in comparison to mental health professionals to assess the prognosis of schizophrenia with and without professional treatment and the long-term positive and negative outcomes. Methods Vignettes were inputted into LLMs interfaces and assessed 10 times by 4 AI platforms: ChatGPT-3.5, ChatGPT-4, Google Bard, and Claude. A total of 80 evaluations were collected and benchmarked against existing norms to analyze what mental health professionals (general practitioners, psychiatrists, clinical psychologists, and mental health nurses) and the general public think about schizophrenia prognosis with and without professional treatment and the positive and negative long-term outcomes of schizophrenia interventions. Results For the prognosis of schizophrenia with professional treatment, ChatGPT-3.5 was notably pessimistic, whereas ChatGPT-4, Claude, and Bard aligned with professional views but differed from the general public. All LLMs believed untreated schizophrenia would remain static or worsen without professional treatment. For long-term outcomes, ChatGPT-4 and Claude predicted more negative outcomes than Bard and ChatGPT-3.5. For positive outcomes, ChatGPT-3.5 and Claude were more pessimistic than Bard and ChatGPT-4. Conclusions The finding that 3 out of the 4 LLMs aligned closely with the predictions of mental health professionals when considering the "with treatment" condition is a demonstration of the potential of this technology in providing professional clinical prognosis. The pessimistic assessment of ChatGPT-3.5 is a disturbing finding since it may reduce the motivation of patients to start or persist with treatment for schizophrenia. Overall, although LLMs hold promise in augmenting health care, their application necessitates rigorous validation and a harmonious blend with human expertise.
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Affiliation(s)
- Zohar Elyoseph
- Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, United Kingdom
- The Center for Psychobiological Research, Department of Psychology and Educational Counseling, Max Stern Yezreel Valley College, Emek Yezreel, Israel
| | - Inbar Levkovich
- Faculty of Graduate Studies, Oranim Academic College, Kiryat Tiv'on, Israel
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Shah S, Mahboob U, Junaid SM, Siddiqui S, Jamil B, Rehman S. Challenges faced by teachers of postgraduate health professions blended learning programs: a qualitative analysis. BMC Med Educ 2024; 24:251. [PMID: 38454399 PMCID: PMC10921785 DOI: 10.1186/s12909-024-05213-8] [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: 08/19/2023] [Accepted: 02/22/2024] [Indexed: 03/09/2024]
Abstract
INTRODUCTION Blended learning, which integrates classroom face-to-face teaching with both asynchronous and synchronous online learning elements, has swiftly gained acceptance in educational environments. However, the implementation of blended learning presents challenges that impact all stakeholders, necessitating thoughtful consideration. Teachers play a central role in shaping the instructional experience among these stakeholders. To fully realize the potential of comprehensive blended learning, it is imperative to identify the challenges faced by these teachers and develop strategies that sensibly address and overcome them. METHODOLOGY A qualitative exploratory study was conducted with twelve teachers involved in the postgraduate blended learning health professions program at Khyber Medical University, Peshawar in 2022. One-on-one semi-structured Interviews were conducted via WhatsApp/ZOOM, transcribed by Otter AI, coded on NVivo & analyzed using Braun/Clarke's Thematic Analysis. RESULTS Three themes of challenges faced by teachers of postgraduate blended learning programs were constructed namely (1) Skills, such as (i) digital, (ii) instructional, and (iii) online class management, and (2) Administrative barriers in terms of (iv) resources (iv) training, and (3) Faculty resistance. CONCLUSION This study provides profound insights into the daunting challenges that postgraduate blended learning program teachers encounter in terms of skills, administrative barriers, and faculty resistance. These findings offer a valuable opportunity for program directors to identify the critical requirements of these faculties in their pursuit of effective teaching and learning, ultimately transforming the landscape of blended education. This study emphasizes the need for ongoing faculty development and institutional support to address the identified challenges and improve the quality of postgraduate blended-learning programs.
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Affiliation(s)
- Sana Shah
- Islam Medical College, Sialkot, Pakistan
| | | | | | - Sana Siddiqui
- National University of Medical Sciences, Rawalpindi, Pakistan
| | | | - Saadia Rehman
- Abbottabad International Medical Institute, Abbottabad, Pakistan
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Quilliam C, Green E, Rasiah RL, Sheepway L, Seaton C, Moore L, Bailie J, Matthews KM, Ferns J, Debenham J, Taylor C, Fitzgerald K, Ridd M. University staff perspectives on determinants of high-quality health professions student placements in regional, rural and remote Australia: protocol for a mixed-method study. BMJ Open 2024; 14:e077079. [PMID: 38448071 PMCID: PMC10916158 DOI: 10.1136/bmjopen-2023-077079] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Accepted: 02/13/2024] [Indexed: 03/08/2024] Open
Abstract
INTRODUCTION In rural areas, work-integrated learning in the form of health student placements has several potential benefits, including contributing to student learning, enhancing rural health service capacity and attracting future rural health workforce. Understanding what constitutes a high-quality rural placement experience is important for enhancing these outcomes. There is no current standardised definition of quality in the context of rural health placements, nor is there understanding of how this can be achieved across different rural contexts. This study is guided by one broad research question: what do university staff believe are the determinants of high-quality health professions student placements in regional, rural and remote Australia? METHODS AND ANALYSIS This study will adopt a convergent mixed-method design with two components. Component A will use explanatory sequential mixed methods. The first phase of component A will use a survey to explore determinants that contribute to the development of high-quality health student placements from the perspective of university staff who are not employed in University Departments of Rural Health and are involved in the delivery of health student education. The second phase will use semistructured interviews with the same stakeholder group (non-University Department of Rural Health university staff) to identify the determinants of high-quality health student placements. Component B will use a case study Employing COnceptUal schema for policy and Translation Engagement in Research mind mapping method to capture determinants that contribute to the development of high-quality health student placements from the perspective of University Department of Rural Health university staff. ETHICS AND DISSEMINATION The University of Melbourne Human Ethics Committee approved the study (2022-23201-33373-5). Following this, seven other Australian university human research ethics committees provided external approval to conduct the study. The results of the study will be presented in several peer-review publications and summary reports to key stakeholder groups.
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Affiliation(s)
- Claire Quilliam
- Department of Rural Health, The University of Melbourne, Shepparton, Victoria, Australia
| | - Elyce Green
- Charles Sturt University, Wagga Wagga, New South Wales, Australia
| | - Rohan L Rasiah
- Western Australian Centre for Rural Health, The University of Western Australia, Karratha, Western Australia, Australia
| | - Lyndal Sheepway
- La Trobe Rural Health School, La Trobe University, Wodonga, Victoria, Australia
| | - Catherine Seaton
- Centre for Rural and Remote Health, James Cook University, Mount Isa, Queensland, Australia
| | - Leigh Moore
- Flinders University Rural and Remote Health, Flinders University, Darwin, Northern Territory, Australia
| | - Jodie Bailie
- University Centre for Rural Health, The University of Sydney, Lismore, New South Wales, Australia
- School of Public Health, The University of Sydney, Sydney, New South Wales, Australia
| | - Kylie Maree Matthews
- Majarlin Kimberley Centre for Remote Health, The University of Notre Dame Australia, Broome, Western Australia, Australia
| | - Jane Ferns
- Department of Rural Health, The University of Newcastle, Taree, New South Wales, Australia
| | - James Debenham
- Majarlin Kimberley Centre for Remote Health, The University of Notre Dame Australia, Broome, Western Australia, Australia
| | - Carolyn Taylor
- La Trobe Rural Health School, La Trobe University, Bendigo, Victoria, Australia
| | - Kathryn Fitzgerald
- Western Australian Centre for Rural Health, The University of Western Australia, Geraldton, Western Australia, Australia
| | - Melissa Ridd
- Flinders University Rural and Remote Health, Flinders University, Darwin, Northern Territory, Australia
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He L, Wang L, He Z, Pang CH, Tang B, Wu A, Li J. Strategies for utilizing covalent organic frameworks as host materials for the integration and delivery of bioactives. Mater Horiz 2024; 11:1126-1151. [PMID: 38112198 DOI: 10.1039/d3mh01492d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2023]
Abstract
Covalent organic frameworks (COFs), a new and developing class of porous framework materials, are considered a type of promising carrier for the integration and delivery of bioactives, which have diverse fascinating merits, such as a large specific surface area, designable and specific porosity, stable and orderly framework structure, and various active sites. However, owing to the significant differences among bioactives (including drugs, proteins, nucleic acid, and exosomes), such as size, structure, and physicochemical properties, the interaction between COFs and bioactives also varies. In this review, we firstly summarize three strategies for the construction of single or hybrid COF-based matrices for the delivery of cargos, including encapsulation, covalent binding, and coordination bonding. Besides, their smart response release behaviors are also categorized. Subsequently, the applications of cargo@COF biocomposites in biomedicine are comprehensively summarized, including tumor therapy, central nervous system (CNS) modulation, biomarker analysis, bioimaging, and anti-bacterial therapy. Finally, the challenges and opportunities in this field are briefly discussed.
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Affiliation(s)
- Lulu He
- Ningbo Key Laboratory of Biomedical Imaging Probe Materials and Technology, Zhejiang International Cooperation Base of Biomedical Materials Technology and Application, Chinese Academy of Sciences (CAS) Key Laboratory of Magnetic Materials and Devices, Ningbo Cixi Institute of Biomedical Engineering, Zhejiang Engineering Research Center for Biomedical Materials, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, 315201, China.
- Department of Chemical and Environment Engineering, The University of Nottingham Ningbo China, Ningbo, 315100, China.
- Advanced Energy Science and Technology Guangdong Laboratory, Huizhou, 516000, China
| | - Le Wang
- Ningbo Key Laboratory of Biomedical Imaging Probe Materials and Technology, Zhejiang International Cooperation Base of Biomedical Materials Technology and Application, Chinese Academy of Sciences (CAS) Key Laboratory of Magnetic Materials and Devices, Ningbo Cixi Institute of Biomedical Engineering, Zhejiang Engineering Research Center for Biomedical Materials, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, 315201, China.
- Advanced Energy Science and Technology Guangdong Laboratory, Huizhou, 516000, China
| | - Zhen He
- Ningbo Key Laboratory of Biomedical Imaging Probe Materials and Technology, Zhejiang International Cooperation Base of Biomedical Materials Technology and Application, Chinese Academy of Sciences (CAS) Key Laboratory of Magnetic Materials and Devices, Ningbo Cixi Institute of Biomedical Engineering, Zhejiang Engineering Research Center for Biomedical Materials, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, 315201, China.
| | - Cheng Heng Pang
- Department of Chemical and Environment Engineering, The University of Nottingham Ningbo China, Ningbo, 315100, China.
| | - Bencan Tang
- Department of Chemical and Environment Engineering, The University of Nottingham Ningbo China, Ningbo, 315100, China.
| | - Aiguo Wu
- Ningbo Key Laboratory of Biomedical Imaging Probe Materials and Technology, Zhejiang International Cooperation Base of Biomedical Materials Technology and Application, Chinese Academy of Sciences (CAS) Key Laboratory of Magnetic Materials and Devices, Ningbo Cixi Institute of Biomedical Engineering, Zhejiang Engineering Research Center for Biomedical Materials, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, 315201, China.
- Advanced Energy Science and Technology Guangdong Laboratory, Huizhou, 516000, China
| | - Juan Li
- Ningbo Key Laboratory of Biomedical Imaging Probe Materials and Technology, Zhejiang International Cooperation Base of Biomedical Materials Technology and Application, Chinese Academy of Sciences (CAS) Key Laboratory of Magnetic Materials and Devices, Ningbo Cixi Institute of Biomedical Engineering, Zhejiang Engineering Research Center for Biomedical Materials, Ningbo Institute of Materials Technology and Engineering, Chinese Academy of Sciences, Ningbo, 315201, China.
- Advanced Energy Science and Technology Guangdong Laboratory, Huizhou, 516000, China
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Sussman S, Sinclair DL, Clifasefi SL, Collins SE. Commentary: Similarities and Differences Between Harm-Reduction and Substitute Addiction-- Implications for the Health Professions. Eval Health Prof 2024; 47:75-80. [PMID: 38247290 DOI: 10.1177/01632787241227225] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
"Substitute addiction" refers to the process of achieving abstinence or resolution of one addictive behavior and subsequently engaging in one or more additional addictive behaviors in its place. Substitute addiction, a concept in the abstinence-based recovery field for decades, is viewed as a cause for concern because resolving one addictive behavior might not fully remove harm or ensure recovery. Conversely, "harm-reduction treatment" refers to a counseling orientation that focuses on helping service users reduce substance-related harm and improve their quality of life without necessarily requiring abstinence or use reduction. Harm-reduction treatment assesses a constellation of addictive behaviors in the larger context of a person's life to holistically reduce harm in that constellation. In this commentary, we define and compare both constructs and point out their implications for addictions treatment.
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Dell’Aiera L, Fitzgerald D, Fisher D, Gill NW. Examining online international health professions education: a mixed methods review of barriers, facilitators, and early outcomes★. J Extra Corpor Technol 2024; 56:2-9. [PMID: 38488712 PMCID: PMC10941829 DOI: 10.1051/ject/2023044] [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: 08/16/2023] [Accepted: 10/25/2023] [Indexed: 03/17/2024]
Abstract
BACKGROUND Access to quality healthcare education across the world is disproportionate. This study explores the potential for Cardiovascular Perfusion education to be delivered online to reach international students. METHODS Exploratory mixed methods were used to identify the barriers, facilitators, and early outcomes of online international health professions education. RESULTS Qualitative analysis yielded four primary and nine subthemes. Multiple interventions were implemented in the planning of a novel online international Extracorporeal Science (ECS) program based on these themes. Quantitative data from the first semester of the new ECS program was collected along with data from the traditional entry-level program and historic data from previous entry-level cohorts. No significant correlations or differences were found between students. Student satisfaction surveys were determined to be equivalent for each group. Mixed data analysis revealed exceptional student satisfaction in areas where qualitative feedback was incorporated into the program design. CONCLUSIONS Online international education may be a viable option in the health professions. Barriers and facilitators to this mode of education were identified and utilized in designing one such program. Early outcomes from the novel ECS program reveal that student performance and satisfaction are equivalent to those of a traditional in-person training program.
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Affiliation(s)
- Laura Dell’Aiera
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Medical University of South Carolina, Division of Cardiovascular Perfusion Charleston SC 29425 United States
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George Washington University, School of Medicine and Health Sciences, Department of Health Human Function and Rehabilitation Washington DC 20052 United States
| | - David Fitzgerald
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Medical University of South Carolina, Division of Cardiovascular Perfusion Charleston SC 29425 United States
| | - David Fisher
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Medical University of South Carolina Hospital Authority, Department of Cardiovascular Perfusion Charleston SC 29425 United States
| | - Norman W. Gill
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George Washington University, School of Medicine and Health Sciences, Department of Health Human Function and Rehabilitation Washington DC 20052 United States
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Levinsohn E, Herschkopf M. What Should Health Professions Students Know About Countertransference in Inpatient Psychiatric Environments? AMA J Ethics 2024; 26:E232-236. [PMID: 38446728 DOI: 10.1001/amajethics.2024.232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
Inpatient psychiatric units are heavily regulated physical environments designed around the twin aims of treatment and containment. Less formally regulated but no less important are emotional norms and tones that also contribute significantly to psychiatric care environments. Inpatient psychiatric units are co-created by patients and clinicians, but clinicians have authority that patients do not. This means that clinicians' management of their own transference and reactions is clinically and ethically important. This article defines transference reactions and draws on case examples to canvass how positive and negative transference reactions can influence inpatient care of patients who are suicidal.
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Affiliation(s)
- Erik Levinsohn
- Consultation-liaison psychiatrist at the West Roxbury VA Medical Center in Massachusetts
| | - Marta Herschkopf
- Psychiatrist on the consultation-liaison service at Beth Israel Deaconess Medical Center in Boston, Massachusetts
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Marais DL. It's very difficult to set the boundaries, it's human nature to want to respond: exploring health professions educators' responses to student mental health difficulties through a positioning theory lens. Adv Health Sci Educ Theory Pract 2024; 29:67-88. [PMID: 37296198 PMCID: PMC10252173 DOI: 10.1007/s10459-023-10254-7] [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: 11/14/2022] [Accepted: 06/04/2023] [Indexed: 06/12/2023]
Abstract
By virtue of their teaching role and contact with students, health professions (HP) educators are often the first point of connection for students who are experiencing mental health difficulties. Educators are increasingly expected to include some form of pastoral care in their role. Mental health-related interactions with students may have a negative emotional impact on educators, particularly when roles and expectations are not clearly defined and where boundaries are not managed effectively. Using positioning theory as a lens, this study explored how educators experienced such interactions and how this manifested in positions, storylines, and speech acts. Interviews were conducted with 27 HP educators at a faculty of medicine and health sciences. Reflexive thematic analysis using inductive coding identified themes corresponding to the nearing, weighted, ambivalent, and distancing positions participants adopted in relation to students with mental health difficulties. There was fluidity in and between positions, and more than one position could be occupied simultaneously; participants each moved through different positions in response to different relational situations. Multiple storylines informed these positions, representing how moral- and care-informed responsibility intersected with responsiveness to make certain actions possible or impossible. Normative and personal value narratives were evident in storylines, in many cases underscored by care or justice ethics. The value of positioning theory in facilitating reflective faculty development initiatives for educators engaged in these interactions is discussed.
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Affiliation(s)
- Debra L Marais
- Research and Internationalisation Development and Support, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa.
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Barber C, van der Vleuten C, Chahine S. Validity evidence and psychometric evaluation of a socially accountable health index for health professions schools. Adv Health Sci Educ Theory Pract 2024; 29:147-172. [PMID: 37347458 DOI: 10.1007/s10459-023-10248-5] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2021] [Accepted: 05/28/2023] [Indexed: 06/23/2023]
Abstract
There is an expectation that health professions schools respond to priority societal health needs. This expectation is largely based on the underlying assumption that schools are aware of the priority needs in their communities. This paper demonstrates how open-access, pan-national health data can be used to create a reliable health index to assist schools in identifying societal needs and advance social accountability in health professions education. Using open-access data, a psychometric evaluation was conducted to examine the reliability and validity of the Canadian Health Indicators Framework (CHIF) conceptual model. A non-linear confirmatory factor analysis (CFA) on 67 health indicators, at the health-region level (n = 97) was used to assess the model fit of the hypothesized 10-factor model. Reliability analysis using McDonald's Omega were conducted, followed by Pearson's correlation coefficients. Findings from the non-linear CFA rejected the original conceptual model structure of the CHIF. Exploratory post hoc analyses were conducted using modification indices and parameter constraints to improve model fit. A final 5-factor multidimensional model demonstrated superior fit, reducing the number of indicators from 67 to 32. The 5-factors included: Health Conditions (8-indicators); Health Functions (6-indicators); Deaths (5-indicators); Non-Medical Health Determinants (7-indicators); and Community & Health System Characteristics (6-indicators). All factor loadings were statistically significant (p < 0.001) and demonstrated excellent internal consistency ( ω >0.95). Many schools struggle to identify and measure socially accountable outcomes. The process highlighted in this paper and the indices developed serve as starting points to allow schools to leverage open-access data as an initial step in identifying societal needs.
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Affiliation(s)
- Cassandra Barber
- School of Health Professions Education (SHE), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.
| | - Cees van der Vleuten
- School of Health Professions Education (SHE), Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Saad Chahine
- Faculty of Education, Queen's University, Kingston, ON, Canada
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Jenkins G, Palermo C, Clark AM, Costello L. Communities of practice to facilitate change in health professions education: A realist synthesis. Nurse Educ Today 2024; 134:106091. [PMID: 38241962 DOI: 10.1016/j.nedt.2024.106091] [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: 07/17/2023] [Revised: 12/14/2023] [Accepted: 01/04/2024] [Indexed: 01/21/2024]
Abstract
BACKGROUND Communities of practice could contribute to transformations in health professions education to meet complex and emerging challenges. However, little is known about the underlying mechanisms of communities of practice in this setting, and how context influences outcomes. OBJECTIVE To understand when, why and how communities of practice with health professions education faculty work to facilitate higher education change. DESIGN A realist synthesis according to the RAMESES standards and steps described by Pawson and colleagues. REVIEW METHODS Early scoping of the literature informed the development of an initial program theory to describe underlying assumptions about how communities of practice in higher education, implemented with health professions education faculty, were likely to work. The theory was tested and further refined through a realist synthesis. A systematic search for evidence using search terms 'faculty', 'communities of practice' and 'higher education' and related terms was supplemented with citation tracking and hand searching of significant authors and journals. Following study appraisal, data were extracted and synthesised from 21 manuscripts describing 16 communities of practice. The realist synthesis focused on identifying patterns in context-mechanism-outcome interactions, and the alignment with substantive theory. RESULTS From the included manuscripts, ten context-mechanism-outcome configurations were identified that describe a range of individual, interpersonal and institutional outcomes of communities of practice with health professions education faculty and context-mechanism interactions that contribute to achieving these outcomes. CONCLUSIONS This study expands theoretical understandings of how and why communities of practice work. There is value in communities of practice in the higher education sector, primarily in the field of health professions education. Communities of practice implemented in the context of complex change with participants who have a desire to participate can facilitate change in health professions education, including institutional level changes, through reflection, experiential learning and creating a shared agenda for change. Findings from this study can be used by policy and decision-makers within health education to best apply communities of practice to achieve meaningful outcomes.
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Affiliation(s)
- Gemma Jenkins
- School of Medical and Health Sciences, Nutrition and Health Innovation Research Institute, Edith Cowan University, Joondalup, Australia.
| | - Claire Palermo
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Clayton, Australia
| | | | - Leesa Costello
- School of Medical and Health Sciences, Nutrition and Health Innovation Research Institute, Edith Cowan University, Joondalup, Australia
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Kalocsai C, Agrawal S, de Bie L, Beder M, Bellissimo G, Berkhout S, Johnson A, McNaughton N, Rodak T, McCullough K, Soklaridis S. Power to the people? A co-produced critical review of service user involvement in mental health professions education. Adv Health Sci Educ Theory Pract 2024; 29:273-300. [PMID: 37247126 DOI: 10.1007/s10459-023-10240-z] [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: 06/30/2022] [Accepted: 05/07/2023] [Indexed: 05/30/2023]
Abstract
Meaningful service user involvement in health professions education requires integrating knowledge held by "lay" people affected by health challenges into professional theories and practices. Involving service users redefines whose knowledge "counts" and implies a shift in power. Such a shift is especially significant in the mental health field, where power imbalances between health professionals and service users are magnified. However, reviews of the literature on service user involvement in mental health professional education do little to explore how power manifests in this work. Meanwhile critical and Mad studies scholars have highlighted that without real shifts in power, inclusion practices can lead to harmful consequences. We conducted a critical review to explore how power is addressed in the literature that describes service user involvement in mental health professions education. Our team used a co-produced approach and critical theories to identify how power implicitly and explicitly operates in this work to unearth the inequities and power structures that service user involvement may inadvertently perpetuate. We demonstrate that power permeates service user involvement in mental health professional education but is rarely made visible. We also argue that by missing the opportunity to locate power, the literature contributes to a series of epistemic injustices that reveal the contours of legitimate knowledge in mental health professions education and its neoliberal underpinnings. Ultimately, we call for a critical turn that foregrounds power relations to unlock the social justice-oriented transformative potential of service user involvement in mental health professions education and health professions education more broadly.
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Affiliation(s)
- Csilla Kalocsai
- Sunnybrook Health Sciences Centre, 2075 Bayview Avenue, Toronto, ON, M4N 3M5, Canada.
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
| | - Sacha Agrawal
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Lee de Bie
- Centre for Clinical Ethics, Unity Health Toronto, Toronto, ON, Canada
- Department of Family and Community Medicine, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Michaela Beder
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Unity Health Toronto, Toronto, ON, Canada
| | - Gail Bellissimo
- Independent service user educator researcher, Toronto, ON, Canada
| | - Suze Berkhout
- University Health Network, Toronto, ON, Canada
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Andrew Johnson
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Nancy McNaughton
- Wilson Centre for Research in Education at University Health Network and University of Toronto, Toronto, ON, Canada
- Michener Institute of Education at University Health Network, Toronto, ON, Canada
| | - Terri Rodak
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Kim McCullough
- Department of Social Work, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Sophie Soklaridis
- Department of Psychiatry, Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
- Centre for Addiction and Mental Health, Toronto, ON, Canada
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Meeuwissen SNE, Steinert Y, Konopasky AW, Stalmeijer RE. How Theory Can Inform Practice: A Case of Easing Transition Into Residency. Acad Med 2024; 99:344. [PMID: 37332190 DOI: 10.1097/acm.0000000000005301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
Health professions educators aim to optimally prepare trainees for future practice; educational theory can help reach this goal. Below we present an authentic case, I Just Need to Speak With My Eyes, that displays the significant struggles of transitioning into residency training. Using this case, we show how the application of 4 learning mechanisms described in Lave and Wenger's 1,2 theories of situated learning and communities of practice can help ease the transition into residency by addressing issues like self-questioning and emotional turmoil (see the colored boxes below). Situated learning refers to learning in everyday practice and highlights its fundamentally social nature as well as the progressive participation of the learner. 1 Communities of practice builds on the notion of people learning from each other, viewing learning as a shared enterprise among a group of people with a common purpose. 2.
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Beagan BL, Bizzeth SR, Sibbald KR, Etowa JB. Epistemic racism in the health professions: A qualitative study with Black women in Canada. Health (London) 2024; 28:203-215. [PMID: 36475974 PMCID: PMC10900862 DOI: 10.1177/13634593221141605] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
Systemic racism within health care is increasingly garnering critical attention, but to date attention to the racism experienced by health professionals themselves has been scant. In Canada, anti-Black racism may be embodied in structures, policies, institutional practices and interpersonal interactions. Epistemic racism is an aspect of systemic racism wherein the knowledge claims, ways of knowing and 'knowers' themselves are constructed as invalid, or less credible. This critical interpretive qualitative study examined the experiences of epistemic racism among 13 healthcare professionals across Canada who self-identified as Black women. It explores the ways knowledge claims and expert authority are discredited and undermined, despite the attainment of professional credentials. Three themes were identified: 1. Not being perceived or portrayed as credible health professionals; 2. Requiring invisible labour to counter professional credibility 'deficit'; and 3. Devaluing knowledge while imposing stereotypes. The Black women in our study faced routine epistemic racism. They were not afforded the position of legitimate knower, expert, authority, despite their professional credentials as physicians, nurses and occupational therapists. Their embodied cultural and community knowledges were disregarded in favour of stereotyped assumptions. Adopting the professional comportment of 'Whiteness' was one way these health care providers strived to be perceived as credible professionals. Their experiences are characteristic of 'misogynoir', a particular form of racism directed at Black women. Anti-Black epistemic racism constitutes one way Whiteness is perpetuated in health professions institutions.
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Katial JM. Contention and collaboration: the tenuous encounter of modern Ayurveda and Western medicine in the twentieth and twenty-first centuries. Med Humanit 2024; 50:185-190. [PMID: 37696601 DOI: 10.1136/medhum-2023-012617] [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] [Accepted: 08/17/2023] [Indexed: 09/13/2023]
Abstract
Complementary medicine systems are ascending to rapid popularity as the twenty-first century progresses. Often adapted from ancient systems of healing such as Ayurveda, these modern alternative medical movements reappraise millennia-old health traditions that found their inception at the confluence of religious philosophy and herbal healing. Naturally, contemporary global economic forces and a desire to market traditional medicine products in an enticing fashion have characterised how historic traditional medicine systems are presented in the modern context. By establishing a vision of complementary medicine born from ancient traditions, it becomes clear how traditional methods of healing can contend with Western biomedicine-the prevailing standard of care around the globe. The claims made by both sides parry along a line of scientific validity, efficacy and regulatory purview. India, the birthplace of Ayurveda and an epicentre of contemporary medical education, is a prime arena to study the friction between biomedicine and traditional medicine. In this piece, I focus on the modernisation of Ayurveda and how it has found conflict with allopathic medicine. I posit that Ayurveda has re-emerged since the early twentieth century as a key tenet of Indian modernity: and in doing so has found contention with Western medicine. I furthermore argue that despite existing discord, the two medical traditions are not inherently antithetical. They can be synergistic, so long as healthcare delivery and education recognise the limits of each and focus on coaction rather than contradiction.
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Pai H. Presidential address 2024: the expansion of computer-based testing to numerous health professions licensing examinations in Korea, preparation of computer-based practical tests, and adoption of the medical metaverse. J Educ Eval Health Prof 2024; 21:2. [PMID: 38373801 PMCID: PMC10948918 DOI: 10.3352/jeehp.2024.21.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 02/10/2024] [Indexed: 02/21/2024]
Affiliation(s)
- Hyunjoo Pai
- President, Korea Health Personnel Licensing Examination Institute, Seoul, Korea
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Lapchmanan LM, Hussin DA, Mahat NA, Ng AH, Bani NH, Hisham S, Teh WS, A Aziz MA, Maniam S, Dollah P, Hasbullah NA, Manimaran S, Hassan H, Zulkernain F. Developing criteria for a profession to be considered as profession of allied health in Malaysia: a qualitative study from the Malaysian perspective. BMC Health Serv Res 2024; 24:165. [PMID: 38308291 PMCID: PMC10835829 DOI: 10.1186/s12913-024-10569-0] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 01/05/2024] [Indexed: 02/04/2024] Open
Abstract
BACKGROUND The Malaysian Allied Health Profession Act (Act 774) regulates the practice of allied health practitioners in Malaysia, with two described professions viz. allied health profession (AHP) and profession of allied health (PAH). While AHPs have been clearly identified by the law, comprehensive implementation of the act requires development of specific criteria in defining any profession as PAH in the Malaysian context. Hence, the research aims to explore and identify the criteria for defining such professions for healthcare policy direction in Malaysia. METHODS This research utilised two methods of qualitative research (document review and focus group discussions (FGDs) involving 25 participants from four stakeholders (higher education providers, employers, associations and regulatory bodies). Both deductive and inductive thematic content analysis were used to explore, develop and define emergent codes, examined along with existing knowledge on the subject matter. RESULTS Sixteen codes emerged from the FGDs, with risk of harm, set of competency and skills, formal qualification, defined scope of practice, relevant training and professional working within the healthcare team being the six most frequent codes. The frequencies for these six codes were 62, 46, 40, 37, 36 and 18, correspondingly. The risk of harm towards patients was directly or indirectly involved with patient handling and also relates to the potential harms that may implicate the practitioners themselves in performing their responsibilities as the important criterion highlighted in the present research, followed by set of competency and skills. CONCLUSIONS For defining the PAH in Malaysia, the emerged criteria appear interrelated and co-exist in milieu, especially for the risk of harm and set of competency and skills, with no single criterion that can define PAH fully. Hence, the integration of all the empirically identified criteria must be considered to adequately define the PAH. As such, the findings must be duly considered by policymakers in performing suitable consolidation of healthcare governance to formulate the appropriate regulations and policies for promoting the enhanced framework of allied health practitioners in Malaysia.
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Affiliation(s)
| | - Duratul Ain Hussin
- Allied Health Sciences Division, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Naji Arafat Mahat
- Department of Chemistry, Faculty of Science, Universiti Teknologi Malaysia, Johor Bahru, Johor, Malaysia
- Centre for Sustainable Nanomaterials, Ibnu Sina Institute for Scientific and Industrial Research, Universiti Teknologi Malaysia, Johor Bahru, Johor, Malaysia
- Centre of Research for Fiqh Forensics and Judiciary, Faculty of Syariah and Law, Universiti Sains Islam Malaysia, Nilai, Negeri Sembilan, Malaysia
| | - Aik Hao Ng
- Faculty of Medicine, Universiti Malaya, Kuala, Lumpur, Malaysia
| | - Nurul Huda Bani
- Audiology Unit, Department of Rehabilitation Medicine, Cheras Rehabilitation Hospital, Kuala Lumpur, Malaysia
| | - Salina Hisham
- Department of Forensic Medicine, Hospital Sultan Idris Shah Serdang, Selangor, Malaysia
| | - Wai Siew Teh
- Nutrition Division, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Mohd Azmarul A Aziz
- School of Health Sciences, Universiti Sains Malaysia, Kubang Kerian, Kelantan, Malaysia
| | - Saravanakumar Maniam
- Allied Health Sciences Division, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Pauzilah Dollah
- Allied Health Sciences Division, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Nur Atiqah Hasbullah
- Allied Health Sciences Division, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Salini Manimaran
- Allied Health Sciences Division, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Hazirah Hassan
- Allied Health Sciences Division, Ministry of Health Malaysia, Putrajaya, Malaysia
| | - Farina Zulkernain
- Allied Health Sciences Division, Ministry of Health Malaysia, Putrajaya, Malaysia
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Papanagnou D, Corliss S, Richards JB, Artino AR, Schwartzstein R. Progression of Self-Directed Learning in Health Professions Education: Clarifying Terms and Processes. Acad Med 2024; 99:236. [PMID: 36812060 DOI: 10.1097/acm.0000000000005191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
As the complexity ofmedical knowledge and clinical practice continues to grow, physicians and physicians-intrainingmust learn to identify gaps in their knowledge and understand and engage in self-directed learning (SDL) in pursuit of academic goals and improved clinical performance. There is a lack of consensus, however, on the precise definition of SDL and how it relates to self-regulated learning (SRL) and co-regulated learning (CRL). We propose a conceptual framework for understanding the progression of a self-directed learner in the health professions and describe the interplay of SRL and CRL.
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Hampton AC, Ogbonna KC, Pontinha VM, Holdford D. Leadership development in health professions. Curr Pharm Teach Learn 2024; 16:132-143. [PMID: 38171980 DOI: 10.1016/j.cptl.2023.12.011] [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: 03/11/2022] [Revised: 09/26/2023] [Accepted: 12/18/2023] [Indexed: 01/05/2024]
Abstract
BACKGROUND AND PURPOSE Despite changing clinical care dynamics, health professions education has been slow in addressing gaps in leadership development as teaching and assessment of clinical care-related knowledge, skills, and attitudes remain central across curricula. While accreditation standards across health professions programs acknowledge the importance of leadership development within curricula, it remains an underrepresented aspect of health professions training. EDUCATIONAL ACTIVITY AND SETTING Given the varied approach to leadership training, we set out to develop a tailored approach to leadership development that integrated the Center for the Advancement of Pharmacy Education (CAPE) outcomes and was based on self-awareness, skill-building, and application. This pilot included three cohorts of doctor of pharmacy students and measured their knowledge, skills, and self-awareness as they progressed through this year-long program. It also measured leadership competency attainment using a pre- and post-assessment in one cohort. FINDINGS Participant satisfaction was assessed using session and program evaluations, while self-perception of growth and leadership competency attainment was assessed using a survey that was administered before and after program participation. Participants found the program to be beneficial in meeting stated objectives and in creating a conducive learning environment. Results of the pre- and post-assessment indicated growth in all dimensions of self-perception of knowledge, skills, and self-awareness, as well as attainment of leadership competency personal leadership commitment and leadership knowledge. SUMMARY Offering co-curricular leadership development programs based on CAPE outcomes and leadership competencies provided students with the opportunity to develop leadership skills and acquire knowledge needed to be effective healthcare leaders.
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Affiliation(s)
- Alena C Hampton
- Academic Affairs and Student Success, Rehabilitation Counseling, Virginia Commonwealth University, College of Health Professions, 900 E. Leigh Street, P.O. Box 980233, Richmond, VA, United States.
| | - Kelechi C Ogbonna
- Virginia Commonwealth University School of Pharmacy, 410 N 12th Street, P.O. Box 980581, Richmond, VA 23298-0533, United States.
| | - Vasco M Pontinha
- Department of Pharmacotherapy & Outcomes Science, Virginia Commonwealth University School of Pharmacy, United States.
| | - David Holdford
- Department of Pharmacotherapy & Outcomes Science, International Programs, Virginia Commonwealth University School of Pharmacy, United States.
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Chen AMH, Kleppinger EL, Churchwell MD, Rhoney DH. Examining Competency-Based Education Through the Lens of Implementation Science: A Scoping Review. Am J Pharm Educ 2024; 88:100633. [PMID: 38092089 DOI: 10.1016/j.ajpe.2023.100633] [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: 12/13/2022] [Revised: 11/15/2023] [Accepted: 12/06/2023] [Indexed: 01/12/2024]
Abstract
OBJECTIVES This study aimed to identify evidence for the implementation and assessment of competency-based education (CBE) in health professions curricula using an implementation science framework. FINDINGS Using the PRISMA framework, a systematic review of the literature applying a prespecified and piloted search strategy from 2017 to the present in PubMed and CINAHL was performed. References identified from the search strategy were imported into Covidence for title and abstract screening and full-text review by 2 researchers. A third researcher resolved discrepancies. Data were extracted and synthesized to identify key elements from the article related to implementation science, with a quality appraisal. A total of 25 studies out of 304 initially identified records were included. The studies covered a broad range of health professions and countries. Key findings were limited use of implementation science elements, including variability in CBE implementation, limited fidelity assessment, and partial examination of the process continuum. Programs with a more robust implementation approach have a team-based strategy to lead, implement, and support CBE. Motivation and training of faculty are also key components of successful CBE implementation. SUMMARY Competency-based education is implemented differently across institutions, with variation among programs in their choice of elements of implementation science used. Further research is needed to examine CBE from an implementation science perspective and address remaining questions.
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Affiliation(s)
- Aleda M H Chen
- Cedarville University, School of Pharmacy, Cedarville, OH, USA.
| | | | - Mariann D Churchwell
- University of Toledo, College of Pharmacy and Pharmaceutical Sciences, Toledo, OH, USA
| | - Denise H Rhoney
- University of North Carolina at Chapel Hill, Eshelman School of Pharmacy, Chapel Hill, NC, USA
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Nimmon L, Stenlund S. Interpersonal energy: New and bold directions in palliative care health professions education research. Palliat Med 2024; 38:166-169. [PMID: 38268060 PMCID: PMC10865756 DOI: 10.1177/02692163231219949] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2024]
Affiliation(s)
- Laura Nimmon
- The University of British Columbia, Faculty of Medicine, Centre for Health Education Scholarship, Department of Occupational Science and Occupational Therapy, Vancouver, BC, Canada
| | - Säde Stenlund
- The University of British Columbia, Faculty of Medicine, School of Population and Public Health, Vancouver, BC, Canada
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Tavares W, Sockalingam S, Valanci S, Giuliani M, Davis D, Campbell C, Silver I, Charow R, Jeyakumar T, Younus S, Wiljer D. Performance Data Advocacy for Continuing Professional Development in Health Professions. Acad Med 2024; 99:153-158. [PMID: 37824840 DOI: 10.1097/acm.0000000000005490] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/14/2023]
Abstract
ABSTRACT Efforts to optimize continuing professional development (CPD) are ongoing and include advocacy for the use of clinician performance data. Several educational and quality-based frameworks support the use of performance data to achieve intended improvement outcomes. Although intuitively appealing, the role of performance data for CPD has been uncertain and its utility mainly assumed. In this Scholarly Perspective, the authors briefly review and trace arguments that have led to the conclusion that performance data are essential for CPD. In addition, they summarize and synthesize a recent and ongoing research program exploring the relationship physicians have with performance data. They draw on Collins, Onwuegbuzie, and Johnson's legitimacy model and Dixon-Woods' integrative approach to generate inferences and ways of moving forward. This interpretive approach encourages questioning or raising of assumptions about related concepts and draws on the perspectives (i.e., interpretive work) of the research team to identify the most salient points to guide future work. The authors identify 6 stimuli for future programs of research intended to support broader and better integration of performance data for CPD. Their aims are to contribute to the discourse on data advocacy for CPD by linking conceptual, methodologic, and analytic processes and to stimulate discussion on how to proceed on the issue of performance data for CPD purposes. They hope to move the field from a discussion on the utility of data for CPD to deeper integration of relevant conceptual frameworks.
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Wolcott MD, McLaughlin JE. Exploring user experience (UX) research methods in health professions education. Curr Pharm Teach Learn 2024; 16:144-149. [PMID: 38158330 DOI: 10.1016/j.cptl.2023.12.010] [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: 06/22/2023] [Revised: 08/22/2023] [Accepted: 12/18/2023] [Indexed: 01/03/2024]
Abstract
OUR ISSUE Researchers often design interventions or experiences to meet the needs of a specific user. However, the user's perspective is often excluded in the process, which can minimize effectiveness due to a lack of understanding about the user, their perspective, and/or their needs. User experience (UX) research methods offer an opportunity to capture additional information about the user that can inform the design of these solutions. METHODOLOGICAL LITERATURE REVIEW UX research became prominent during the 1990s to describe the complexity of human interactions with technological solutions. UX research methods emerged in other disciplines as strategies for describing user perspectives, needs, challenges, and potential impact of proposed solutions-these may be useful in health professions education research. OUR RECOMMENDATIONS AND THEIR APPLICATIONS Those interested in UX research methods should define the user, establish focused research questions, and select applicable strategies cognizant of time and resource constraints. UX research often requires a clear outline of research activities, how they address the questions, and techniques to engage representative users for data collection. Researchers can optimize data collection by creating inclusive spaces that emphasize active listening. Researchers should compile insights regularly and remember UX research emphasizes an iterative approach to design. POTENTIAL IMPACT UX research can support deeper insights into users, their perspectives, their needs, and offers opportunities to co-construct solutions with their experiences in mind. These methods may help educators design impactful experiences that better achieve targeted outcomes in collaboration with their users (e.g., learners, faculty, teams).
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Affiliation(s)
- Michael D Wolcott
- Workman School of Dental Medicine, High Point University, One University Parkway, High Point, NC 27268, United States; Eshelman School of Pharmacy, The University of North Carolina at Chapel Hill, 301 Pharmacy Lane - Beard Hall 321, Chapel Hill, NC 27599, United States.
| | - Jacqueline E McLaughlin
- Eshelman School of Pharmacy, The University of North Carolina at Chapel Hill, 301 Pharmacy Lane - Beard Hall 321, Chapel Hill, NC 27599, United States.
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Rueda-Medina B, Reina-Cabello JC, Buendía-Castro M, Aguilar-Ferrándiz ME, Gil-Gutiérrez R, Tapia-Haro RM, Casas-Barragán A, Correa-Rodríguez M. Effectiveness of video-assisted debriefing versus oral debriefing in simulation-based interdisciplinary health professions education: A randomized trial. Nurse Educ Pract 2024; 75:103901. [PMID: 38277804 DOI: 10.1016/j.nepr.2024.103901] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 01/15/2024] [Accepted: 01/17/2024] [Indexed: 01/28/2024]
Abstract
AIM We aimed to compare the debriefing experience, simulation assessment, reflection, anxiety and simulation satisfaction of using oral debriefing versus video-assisted debriefing after a simulated clinical session in an interdisciplinary cohort of health sciences students. BACKGROUND Debriefing is a reflective process that takes place after a clinical simulation and that can be performed either in a traditional way (oral) or using video-assisted debriefing. DESIGN A randomized controlled trial was conducted in 143 health sciences students (35.7% male, 61.5% female). METHODS The simulation scenario was designed to evaluate the procedure for donning and doffing personal protective equipment. Differences in debriefing experience, simulation assessment, reflection, anxiety and satisfaction were assessed. RESULTS Regarding debriefing experience, significant differences were observed for the category "learning" (34.9 (6.13) vs. 36.7 (3.89); p = 0.039). For simulation assessment, significantly higher scores for all categories were identified in video-assisted debriefing compared with oral debriefing (p<0.001). There were also significant differences between the oral debriefing versus video-assisted debriefing for the overall score of reflection ability (86.97 (10.55) vs. 90.74 (9.67); p=0.028) as well as for the category "reflective communication" (24.72 (3.77) vs 26.04 (4.07); p=0.047). Perceived satisfaction was significantly higher in the video-assisted debriefing group compared with oral debriefing group (p <0.001). For anxiety, no significant differences were observed between debriefing groups. CONCLUSION Video-assisted debriefing after a simulated clinical session improves debriefing experience, simulation assessment, reflection and simulation satisfaction, but does not increase anxiety compared with oral debriefing among health sciences students.
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Affiliation(s)
- Blanca Rueda-Medina
- Department of Nursing, Faculty of Health Sciences, University of Granada, Granada 18016, Spain; Instituto de Investigación Biosanitaria ibs. GRANADA, Granada, Spain
| | - José Carlos Reina-Cabello
- Functional Area of Health and Social Policy, Subdelegation of the Government of Almería, Almería, Spain
| | - Miriam Buendía-Castro
- Department of Translation and Interpreting, Faculty of Translation and Interpreting, University of Granada, Granada 18003, Spain
| | - María Encarnación Aguilar-Ferrándiz
- Instituto de Investigación Biosanitaria ibs. GRANADA, Granada, Spain; Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada 18016, Spain
| | - Rocío Gil-Gutiérrez
- Department of Nursing, Faculty of Health Sciences, University of Granada, Granada 18016, Spain; Instituto de Investigación Biosanitaria ibs. GRANADA, Granada, Spain; Sport and Health University Research Institute (iMUDS), University of Granada, Granada 18016, Spain.
| | - Rosa María Tapia-Haro
- Instituto de Investigación Biosanitaria ibs. GRANADA, Granada, Spain; Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada 18016, Spain
| | - Antonio Casas-Barragán
- Instituto de Investigación Biosanitaria ibs. GRANADA, Granada, Spain; Department of Physical Therapy, Faculty of Health Sciences, University of Granada, Granada 18016, Spain
| | - María Correa-Rodríguez
- Department of Nursing, Faculty of Health Sciences, University of Granada, Granada 18016, Spain; Instituto de Investigación Biosanitaria ibs. GRANADA, Granada, Spain
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Fukui N, Partain DK, Yeow ME, Farfour HN, Prokop L, Barwise A. Learning to collaborate with medical interpreters in health professions education: A systematic review of training programs. Med Teach 2024; 46:258-272. [PMID: 37625438 DOI: 10.1080/0142159x.2023.2249211] [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: 08/27/2023]
Abstract
BACKGROUND Working effectively with medical interpreters is an increasingly valuable skill for clinicians to provide high-quality medical care. We aimed to assess the effectiveness of existing training programs that teach optimal collaboration practices between clinicians and interpreters during patient encounters. METHODS We searched MEDLINE, EMBASE, Scopus, and Cochrane Central for studies published from 1945 through June 21, 2022. RESULTS Out of the 1689 studies screened, we identified 19 studies that met inclusion criteria. Participants were from diverse professions, medical specialities, and training levels. Interpreter involvement in the development or delivery of the program was mentioned in 63% of the evaluated studies. There was substantial variability in training design, assessment methods, and reported outcomes. Only 10 of the programs included an objective knowledge or skills assessment. Only one study conducted a longitudinal assessment of skill maintenance over time. The training programs were generally well received. CONCLUSIONS There is a critical need for structured programs to train clinicians to effectively collaborate with medical interpreters to reduce healthcare disparities. An effective training program should involve interpreters in the development and delivery of the program, practical skills development through interactive activities, structured clinical skill assessment, and both in-person and virtual components.
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Affiliation(s)
- Natsu Fukui
- Division of Palliative Medicine, Mayo Clinic, Phoenix, AZ, USA
| | - Daniel K Partain
- Division of Community Internal Medicine, Geriatrics and Palliative Care, Mayo Clinic, Rochester, MN, USA
| | - Mei-Ean Yeow
- Division of Community Internal Medicine, Geriatrics and Palliative Care, Mayo Clinic, Rochester, MN, USA
| | | | - Larry Prokop
- Mayo Clinic Libraries, Mayo Clinic, Rochester, MN, USA
| | - Amelia Barwise
- Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA
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Rosser JI, Lavery OX, Christofferson RC, Nasoro J, Mutuku FM, LaBeaud AD. Top 5 Things Health Professions Students Should Know About Ecology and Waste Management. AMA J Ethics 2024; 26:E132-141. [PMID: 38306203 PMCID: PMC10894046 DOI: 10.1001/amajethics.2024.132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2024]
Abstract
The environments in which we live affect individual and community risk for disease transmission and illness severity. Communities' and neighborhoods' waste stream management designs and health care organizations' spatial and structural architecture also influence individuals' and communities' pathogenic vulnerabilities and how well health sector industrial hygiene practices support them. This article describes a One Health approach to planetary environmental health and suggests strategies for implementing a One Health or Planetary Health approach in the context of climate change.
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Affiliation(s)
- Joelle I Rosser
- Infectious disease physician-researcher and epidemiologist at Stanford University in Stanford, California
| | - Orion X Lavery
- Aspiring architect interested in the impact of the built environment and housing construction on human health
| | - Rebecca C Christofferson
- Associate professor of infectious diseases and epidemiology at the School of Veterinary Medicine at Louisiana State University in Baton Rouge
| | - Juma Nasoro
- Program manager of the Health and Environmental Research Institute
| | - Francis M Mutuku
- Public health entomologist, field epidemiologist, and senior lecturer in the Department of Environment and Health Sciences at the Technical University of Mombasa in Kenya
| | - A Desiree LaBeaud
- Professor in the Division of Pediatric Infectious Diseases at the Stanford University School of Medicine in Stanford, California
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Elliott SA, Schermerhorn J, Durning S, Costello J, Norton C, Meyer H. Striking up a Conversation: Exploring Advising in Graduate Programs in Health Professions Education. Mil Med 2024; 189:e21-e26. [PMID: 37074123 DOI: 10.1093/milmed/usad116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 03/10/2023] [Accepted: 03/28/2023] [Indexed: 04/20/2023] Open
Abstract
INTRODUCTION Advising is happening across the medical education continuum, within non-medical graduate education programs, and is central to the advancement of said learners. This suggests that advising should play a role in graduate health progressions education (HPE) programs. MATERIALS AND METHODS To explore advising curricula among HPE programs, we conducted a website review of all published HPE programs on the Foundation for Advancement of International Medical Education and Research's website. RESULTS We recognized the lack of information published on advisory roles in graduate HPE programs. This prompted a literature review, which revealed a similar gap. CONCLUSIONS Advising serves to benefit a student, advisor, and program thus carrying importance and need for discussion. This article is intended to kick-start a scholarly discussion about advising within graduate HPE programs.
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Affiliation(s)
| | - Janse Schermerhorn
- Orthopedic Surgery, Walter Reed National Military Medical Center, Bethesda, MD 20889, USA
| | - Steven Durning
- Department of Medicine and Pathology, Uniformed Services University of the Health Sciences, Bethesda, MD 20814, USA
| | - Joseph Costello
- Department of Library Services, Uniformed Services University of the Health Sciences, HPE, Bethesda, MD 20814-4712, USA
| | - Candace Norton
- Department of Library Services, Uniformed Services University of the Health Sciences, Bethesda, MD 20814-4712, USA
| | - Holly Meyer
- Department of Medicine, Division of HPE, F. Edward Hebert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD 20814-4712, USA
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Xu X, Li Z, Mackay L, Li N, Zhang Y, Wu Y, Zhang Y. The state of health professions students' self-directed learning ability during online study and the factors that influence it. BMC Med Educ 2024; 24:25. [PMID: 38178042 PMCID: PMC10768216 DOI: 10.1186/s12909-023-04876-z] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 11/14/2023] [Indexed: 01/06/2024]
Abstract
BACKGROUND Universities have widely switched from traditional face-to-face classes to online instruction as a result of the epidemic. Self-directed learning is becoming the new norm for university students' learning styles. The ability of health professions students to learn independently during online study directly impacts the effectiveness of online medical education. The ability to learn on their own initiative may be affected by health professions students' professional identities, defined as their positive perceptions, evaluations, emotional experiences, and identity as professionals related to medicine. This study aimed to look into the current status and the factors that influence health professions students' self-directed learning ability (SDLA) during online study and its relationship with professional identity. METHODS This study was conducted from September to November 2022 at a medical school in East China. An online questionnaire was used to collect participants' status of online learning, self-directed learning ability (SDLA), and professional identity. RESULTS One thousand two hundred ninety-eight health professions students demonstrated intermediate self-directed learning ability during online study. In terms of teacher-student interaction (F = 14.778, P < 0.001), student-student interaction (F = 15.713, P < 0.001), and learning concentration (F = 13.424, P < 0.001), there were significant differences in health professions students' self-directed learning ability. Professional identity and self-directed learning ability positively correlated (r = 0.589-0.802, P < 0.01). Academic atmosphere and professional identity were significant predictors. CONCLUSIONS The self-directed learning ability of health professions students while receiving instruction online is at an intermediate level and is influenced by several factors. Developing health professions students' professional identities can enhance their ability for self-directed learning.
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Affiliation(s)
- Xiaoyue Xu
- School of Anesthesiology, Xu Zhou Medical University, Xuzhou, Jiangsu Province, China
| | - Ziyi Li
- School of Anesthesiology, Xu Zhou Medical University, Xuzhou, Jiangsu Province, China
| | - Louisa Mackay
- School of International Education, Xu Zhou Medical University, Xuzhou, Jiangsu Province, China
| | - Na Li
- School of Nursing, Xu Zhou Medical University, Xuzhou, Jiangsu Province, China
| | - Yaheng Zhang
- School of Nursing, Xu Zhou Medical University, Xuzhou, Jiangsu Province, China
| | - Yujie Wu
- School of Nursing, Xu Zhou Medical University, Xuzhou, Jiangsu Province, China
| | - Yang Zhang
- School of Anesthesiology, Xu Zhou Medical University, Xuzhou, Jiangsu Province, China.
- School of International Education, Xu Zhou Medical University, Xuzhou, Jiangsu Province, China.
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Xirau-Probert P, Lai T, Black E, Fanfan D, Blue A, Rush CC, Powers R, Stacciarini JMR. Perceived Success After Participation in the Summer Health Professions Education Program. JAMA Netw Open 2024; 7:e2352440. [PMID: 38277148 PMCID: PMC10818219 DOI: 10.1001/jamanetworkopen.2023.52440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 11/20/2023] [Indexed: 01/27/2024] Open
Abstract
Importance The number of active health care professionals has not kept pace with the increasing number of minoritized individuals in the US. The Summer Health Professions Education Program (SHPEP) was developed to alleviate this underrepresentation in the health workforce. Objective To evaluate students' changes in perceived barriers and motivators for entering and succeeding in professional school after SHPEP participation. Design, Setting, and Participants For this cohort study, anonymous electronic surveys were sent to the 2017 to 2021 SHPEP participants at an academic health center at a large university in the southern US. Participants were first- and second-year undergraduates interested in the health professions and enrolled in the SHPEP. Program participants were invited to complete the study. Exposures An anonymous electronic survey was administered before and immediately after program completion. Main Outcomes and Measures The SHPEP Career Barriers Survey (SCBS) is composed of 22 questions on motivators and 20 questions on barriers to entering and succeeding in health professional school. Students responded using a 5-point Likert scale, with 1 indicating strongly disagree and 5 indicating strongly agree. Mixed analysis of variance was used to analyze the program's latent factors. Results Of all 402 SHPEP participants (mean [SD] age, 19.32 [0.88] years) from 2017 to 2021, 325 completed the preprogram survey and 259 also completed the postprogram survey. Of the 325 initial participants, 4 identified as American Indian or Alaska Native, Native Hawaiian, or Pacific Islander (1.2%); 12 as Asian (3.7%); 188 as Black (57.8%); 95 as Hispanic or Latino (29.2%); 7 as White (2.2%); and 16 as multiracial (4.9%). Two hundred twelve participants were female (65.2%), and 226 were first-generation college students (69.5%). Results of the SCBS indicate that the SHPEP had a significant small to moderate association on perceived motivators (mean [SD] x̅ = 84.60 [9.67] vs 80.95 [8.93]; P = .001) and decreases in perceived barriers (mean [SD] x̅ = 48.02 [13.20] vs 51.72 [11.39]; P = .008). There was no significant difference in program success between studied years. Conclusions and Relevance In this cohort study, the SHPEP appeared to provide essential support for underrepresented students as measured by improved perceived motivators and reduced perceived barriers to entering professional education. Knowledge from this study can assist educators and health care professionals who wish to implement similar enrichment programs.
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Affiliation(s)
| | - Tram Lai
- College of Dentistry, University of Florida Gainesville
| | - Erik Black
- College of Nursing, University of Florida Gainesville
| | - Dany Fanfan
- College of Nursing, University of Florida Gainesville
| | - Amy Blue
- College of Public Health and Health Professions, University of Florida Gainesville
| | - Caronne C. Rush
- Office of Interprofessional Education, University of Florida, Gainesville
| | - Rachel Powers
- College of Dentistry, University of Florida Gainesville
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Hovland C, Gergis M, Milliken B, DeBoth Foust K, Niederriter J. The value of learning virtual interprofessional collaboration during a pandemic and the future "new normal": health professions students share their experiences. J Interprof Care 2024; 38:87-94. [PMID: 37422881 DOI: 10.1080/13561820.2023.2232401] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Revised: 05/15/2023] [Accepted: 06/26/2023] [Indexed: 07/11/2023]
Abstract
This exploratory study looked at the experiences of social work, occupational therapy, and nursing students who participated in an interprofessional simulation that was offered virtually due to the impact of COVID-19. The simulation was a one-day event that introduced advanced care planning to the students through an IPE team approach and incorporated various learning and teaching modalities. Using conventional content analysis of the post-program survey data from 255 students (35 occupational therapy; 87 social work; and 133 nursing), three primary themes were identified for the value of learning virtual interprofessional collaboration during a pandemic: (1) catalyst for telehealth education; (2) patient, family & professional safety; and (3) connection and continuity of care. In addition, students identified four primary themes that were learned and perceptions of what could lie ahead beyond the simulation: (1) patient & family convenience and inclusion; (2) expand interprofessional team involvement; (3) alleviate disparities/increase access; and (4) the "new normal" of virtual IP Collaboration.
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Affiliation(s)
- Cynthia Hovland
- School of Social Work, College of Health, Cleveland State University, Cleveland, OH, USA
| | - Mary Gergis
- School of Nursing, College of Health, Cleveland State University, Cleveland, OH, USA
| | - Barbara Milliken
- Occupational Therapy Program, College of Health, Cleveland State University, Cleveland, OH, USA
| | - Kelle DeBoth Foust
- Occupational Therapy Program, College of Health, Cleveland State University, Cleveland, OH, USA
| | - Joan Niederriter
- School of Nursing, College of Health, Cleveland State University, Cleveland, OH, USA
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Caloudas AB, Arredondo K, Godwin KM, Watts BV, Croom T, O'Brien B, Topor DR, Battistone MJ, Edens EL, Singh MK, Horstman MJ. Development of Health Professions Education Competencies for a National Fellowship Program: A Group Consensus Process. Acad Med 2024; 99:40-46. [PMID: 38149865 DOI: 10.1097/acm.0000000000005468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2023]
Abstract
ABSTRACT Health professions educators need knowledge, skills, and attitudes to provide high-quality education within dynamic clinical learning environments. Although postgraduate training opportunities in health professions education (HPE) have increased significantly, no shared competencies exist across the field. This article describes the systematic development of postgraduate HPE competencies for the Health Professions Education, Evaluation, and Research (HPEER) Advanced Fellowship, a 2-year, interprofessional, post-master's degree and postdoctoral HPE training program funded through the Department of Veterans Affairs' Office of Academic Affiliations. Using a modified RAND/University of California at Los Angeles Appropriateness Method, the authors developed competencies from March 2021 to August 2021 that were informed by current practices and standards in HPE. Literature reviews were conducted of published literature from November 2020 to February 2021 and gray literature from February to March 2021, identifying 78 and 274 HPE training competencies, respectively. These competencies were combined with 71 competencies submitted by program faculty from 6 HPEER fellowship sites, resulting in 423 initial competencies. Competencies were organized into 6 primary domains and condensed by deleting redundant items and combining overlapping concepts. Eight subject matter experts completed 3 Delphi surveys and met during 2 nominal group technique meetings. The final 25 competencies spanned 6 domains: teaching methods and learning theories; educational assessment and program evaluation; educational research methods; diversity, equity, and inclusion; interprofessional practice and team science; and leadership and management. In addition to informing the national HPEER curriculum, program evaluation, and learner assessment, these advanced competencies describe the knowledge, skills, and attitudes health professions educators need to provide high-quality education with an emphasis on the global and societal impact of HPE. These competencies represent a step toward leveraging HPE expertise to establish competencies to drive HPE program changes. Other programs should report their competencies and competency development processes to spur further dialog and progress.
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Jain V, Krishnan L. Critical Pedagogies in Health Professions Education. AMA J Ethics 2024; 26:E3-5. [PMID: 38180852 DOI: 10.1001/amajethics.2024.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2024]
Affiliation(s)
- Vinayak Jain
- Resident physician in the Department of Internal Medicine at Washington Hospital Center in Washington, DC
| | - Lakshmi Krishnan
- Founding faculty director of the Medical Humanities Initiative at Georgetown University in Washington, DC
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Onuoha C, Tsai J, Khazanchi R. Using Critical Pedagogy to Advance Antiracism in Health Professions Education. AMA J Ethics 2024; 26:E36-47. [PMID: 38180857 DOI: 10.1001/amajethics.2024.36] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2024]
Abstract
This article draws on Paulo Freire's Pedagogy of the Oppressed to model how health professions education can advance health equity. It first introduces 3 well-known frameworks that can be meaningfully applied as critical pedagogy: structural competency, critical race theory, and participatory action research. It then highlights applications of these frameworks that can prepare trainees for reflection and action that motivate health equity.
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Affiliation(s)
- Chioma Onuoha
- Third-year medical student at the University of California, San Francisco School of Medicine
| | - Jennifer Tsai
- Emergency medicine physician in the Department of Emergency Medicine at the Yale School of Medicine in New Haven, Connecticut
| | - Rohan Khazanchi
- Resident physician in the Harvard Combined Internal Medicine and Pediatrics Residency Program at Brigham and Women's Hospital, Boston Children's Hospital, and Boston Medical Center in Boston, Massachusetts
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Smeltz L, Havercamp SM, Meeks L. Aspiring to Disability Consciousness in Health Professions Training. AMA J Ethics 2024; 26:E54-61. [PMID: 38180859 DOI: 10.1001/amajethics.2024.54] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2024]
Abstract
Lack of disability-competent health care contributes to inequitable health outcomes for the largest minoritized population in the world: persons with disabilities. Health care professionals hold implicit and explicit bias against disabled people and report receiving inadequate disability training. While disability competence establishes a baseline standard of care, health professional educators must prepare a disability conscious workforce by challenging ableist assumptions and promoting holistic understanding of persons with disabilities. Future clinicians must recognize disability as an aspect of diversity, express respect for disabled patients, and demonstrate flexibility about how to care for disabled patients' needs. These skills are currently undervalued in medical training, specifically. This article describes how integrating disability consciousness into health professions training can improve health equity for patients with disabilities.
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Affiliation(s)
- Lydia Smeltz
- Medical student at Penn State College of Medicine in Hershey, Pennsylvania
| | - Susan M Havercamp
- Professor of psychiatry and behavioral health at the Ohio State University Nisonger Center in Columbus
| | - Lisa Meeks
- Clinical associate professor at the University of Michigan Medical School in Ann Arbor
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Naidu T, Ramani S. Transforming global health professions education for sustainability. Med Educ 2024; 58:129-135. [PMID: 37350281 DOI: 10.1111/medu.15149] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Revised: 05/19/2023] [Accepted: 05/26/2023] [Indexed: 06/24/2023]
Abstract
BACKGROUND Health professions education (HPE) must keep pace with rapid shifts in learning and societal contexts, control of resources, knowledge and environmental concerns. Sustainability is increasingly seen as complex, balancing the three pillars of economy, society and the environment and addressing the current generation's needs without compromising future generations' needs. We aim to orient three-pillar sustainability in (HPE) from a decolonial global perspective. CONFERENCES AS TRUTH-REGIMES Future-proofing imperatives compel HPE to respond to sustainability calls in contexts of globalisation and internationalisation. International conferences are sites of power in knowledge production and dissemination because themes and invited speakers determine who experts in the field are and what knowledge is important. Scholarly communities, dominating the discourse, determine the nature of reality or 'truth' (ontology), theoretical foundations of that reality and approaches to knowing (epistemology). Using one international conference as a case study, we found few scholarly presentations on sustainability, especially economic disparities. Discourse in HPE is still dominated by Global North 'experts'. IMPLICATIONS Conferences are important discursive spaces for knowledge production and exchange. Increasing attention to social justice and planetary health must include a global perspective on three-pillar sustainability. Historical and contemporary perspectives about disparities on health should exceed Eurocentric epistemologies alone. These are areas ripe for innovative research in HPE. Promisingly, there is increasing attention to curricula around health equity, disparities and clinical rotations in rural and underserved communities among educational institutions around the world. CONCLUSIONS Future-proofing HPE requires addressing three sustainability pillars simultaneously. Conferences as influential knowledge production spaces are mostly characterised by Global North to South flow of knowledge. Global North-dominated discourse fails to reflect on the impact of historical disparities including colonialism that thwart equivalence. Transforming HPE can occur through a sustainability perspective that advances three-pillar global approaches for inclusive global legitimacy in HPE narratives and standards.
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Affiliation(s)
- Thirusha Naidu
- College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa
| | - Subha Ramani
- Department of Medicine, Brigham and Women's Hospital, Boston, Massachusetts, USA
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Horbacewicz J, Molinsky R. Promoting Interprofessional Collaboration-Related Competencies in Students from Seven Health Professions. J Allied Health 2024; 53:19-24. [PMID: 38430492] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 09/11/2023] [Indexed: 03/03/2024]
Abstract
Health professions students in their final year of the mental health counseling (MHC), nursing, occupational therapy (OT), pharmacy, physical therapy, physician assistant, and speech/language pathology programs at Touro University participated in a virtual interprofessional education (IPE) symposium designed to promote interprofessional collaboration. The students worked as an interprofessional team with a faculty facilitator to first create a plan of care and later a discharge plan for a fictitious patient. At the completion of the symposium, 281 out of 311 students completed the Interprofessional Collaborative Competency Attainment Survey (ICCAS), a tool that assesses competency in collaborative practice. Results demonstrated a significant increase in every collaboration-related competency for all participants as a group (p < 0.001), as well as significant differences between professions (F = 2.99, p = 0.007). For example, students from OT rated themselves lowest at the start and showed the greatest gains, and students from MHC showed the smallest gains but had the fewest participants. This virtual symposium resolved some common logistical challenges and was effective at improving interprofessional collaborative competency. Including a wide variety of health professions in this IPE activity facilitated a broad reach and applicability to the interprofessional teams that students will encounter in the future.
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Affiliation(s)
- Jill Horbacewicz
- Dep. of Physical Therapy, Touro University School of Health Sciences, 3 Times Square, New York, NY 10036, USA. Tel 646 777 9678.
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Kazley AS, Andresen C, Mund A, Wager KA, Blankenship C, Segal R. Perceptions of Cheating Among Students of Health Professions. J Allied Health 2024; 53:25-31. [PMID: 38430493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Accepted: 03/09/2023] [Indexed: 03/03/2024]
Abstract
For many decades, academic cheating has been prevalent across many institutions and majors. This problem has been exacerbated by new technology that has increased opportunities for students to access and use information dishonestly. There is fear amongst faculty that dishonesty in the academic world could negatively impact professionals in their future careers. The greater prevalence of cheating may be related to students misunderstanding what constitutes cheating. To better understand students' perceptions of cheating, a group of faculty surveyed students across 11 academic programs at a college of health professions using a slightly modified version of a validated tool via an online platform. Data about cheating perceptions were collected from more than 400 students. Although most respondents agreed that cheating is wrong, some were open to explanations of innocence related to possible cheating scenarios. Also, most respondents did not agree that a person who cheats is an unethical person. These findings suggest that students believe cheating can occur unintentionally. Although the findings support that more education about academic dishonesty would be valuable, this study can inform efforts to develop more targeted education and interventions to reduce cheating behaviors.
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Affiliation(s)
- Abby S Kazley
- Dep. of Health Care Leadership and Management, Medical University of South Carolina, 151 Rutledge Ave Box 962, Charleston, SC 29425, USA. Tel 843-792-0012.
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Hanson MD, Pang C, Springall E, Kulasegaram K, Eva KW. Patient Engagement in Medical Trainee Selection: A Scoping Review. Acad Med 2024; 99:98-105. [PMID: 37683264 DOI: 10.1097/acm.0000000000005450] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/10/2023]
Abstract
PURPOSE The stakes of medical trainee selection are high, making it ironic and somewhat paradoxical that patients and the public often get little say in selection practices. The authors sought to undertake a knowledge synthesis to uncover what is known about patient engagement across the medical trainee selection continuum. METHOD The authors conducted a scoping review aimed at exploring the current state of practice and research on patient engagement in medical trainee selection in 2017-2021. MeSH headings and keywords were used to capture patient, community, and standardized patient engagement in selection processes across multiple health professions. The authors employed broad inclusion criteria and iteratively refined the corpus, ultimately, limiting study selection to those reporting engagement of actual patients in selection within medicine, but maintaining a broad focus on any patient contributions across the entire selection continuum. The Cambridge Framework was adapted and used to organize the included studies. RESULTS In total, 2,858 abstracts were reviewed, and ultimately, 28 papers were included in the final corpus. The included studies were global but nascent. Most of the literature on this topic appears in the form of individual projects advocating for patient engagement in selection rather than cohesive programs with empirical exploration of patient engagement in selection. Job analysis methodology was particularly prominent for incorporating the patient voice into identifying competencies of relevance to selection. Direct patient engagement in early selection activities allowed the patient voice to assist candidates in determining their fit for medicine. CONCLUSIONS Patient engagement has not been made a specific focus of study in its own right, leading the authors to encourage researchers to turn their lens more directly on patient engagement to explore how it complements the professional voice in medical trainee selection.
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Vovides Y, Mathew J. Which Priorities Should Guide Design of Online Health Professions Capability-Based Curricula? AMA J Ethics 2024; 26:E26-35. [PMID: 38180856 DOI: 10.1001/amajethics.2024.26] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2024]
Abstract
Inquiry-based learning instructional design methods support online health professions capability-based curricula. This article proposes which instructional design priorities should guide development of inclusive, accessible online curricula and learning experiences.
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Affiliation(s)
- Yianna Vovides
- Senior director at the Center for New Designs in Learning and Scholarship and a professor in the Program in Learning, Design, and Technology at Georgetown University in Washington, DC
| | - Jimson Mathew
- Assistant director for online learning in the College of Population Health at Thomas Jefferson University in Philadelphia, Pennsylvania
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Hodge DR, Turner PR, Huang CK. The 100 Leading Contributors to English-Language Gerontological Journals: An International Study of Scholarly Impact. J Gerontol Soc Work 2024; 67:3-18. [PMID: 37488929 DOI: 10.1080/01634372.2023.2236670] [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: 01/11/2023] [Accepted: 07/11/2023] [Indexed: 07/26/2023]
Abstract
The two aims of this study were to: 1) identify the 100 most impactful contributors to English-language gerontological journals, and 2) map their respective disciplinary affiliations to help illuminate the perspectives shaping gerontological discourse. Toward that end, we conducted a secondary data analysis of a publicly available database of the world's leading scientists. After extracting all scientists in the gerontological category, we rank ordered them according to a composite measure of scholarly impact that controls for self-citations and author order while also calculating other bibliometric statistics. Disciplinary affiliations were assigned based upon the Classification of Instructional Programs codes developed by the National Center for Education Statistics at the United States Department of Education. The results reveal the mean contributor to the gerontological literature published 241.15 (SD = 203.95) papers and - after correcting for self-citations - had an h-index of 50.05 (SD = 25.00), and an hm-index 23.67 (SD = 7.50). A diverse array of professional affiliations characterized the contributors with a plurality being located in the health professions category, followed by the biological and biomedical science, and social sciences categories. The results reveal that gerontology is home to some of the world's leading scientists. Leveraging their expertise can help advance the field's collective knowledge development.
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Affiliation(s)
- David R Hodge
- School of Social Work, Arizona State University, AZ, USA
- Program for Research on Religion and Urban Civil Society, University of Pennsylvania, PA, USA
| | | | - Chao-Kai Huang
- School of Social Work, Arizona State University, AZ, USA
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