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Li YJ, Orlosky J, Jirau-Rosaly W, Brown S, Rockich-Winston N. Immersing healthcare students in a virtual reality Parkinson's disease experience. Int J Med Educ 2024; 15:34-36. [PMID: 38554134 DOI: 10.5116/ijme.65f5.725c] [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] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 03/16/2024] [Indexed: 04/01/2024]
Affiliation(s)
- Yi Joy Li
- Kennesaw State University, Department of Software Engineering & Game Development, Marietta, Georgia, USA
| | - Jason Orlosky
- Augusta University, Department of Computer & Cyber Sciences, Augusta, Georgia, USA, and Osaka University, Cybermedia Center, Toyonaka, Japan
| | - Wanda Jirau-Rosaly
- Medical College of Georgia at Augusta University, Department of Medicine, Augusta, Georgia, USA
| | - Shilpa Brown
- Medical College of Georgia at Augusta University, Department of Medicine, Augusta, Georgia, USA
| | - Nicole Rockich-Winston
- Medical College of Georgia at Augusta University, Department of Pharmacology and Toxicology, Augusta, Georgia, USA
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McLaughlin JE, Fassett KT, Wolcott M, Rockich-Winston N, Harpe S. Methodological Challenges in Studies of Personal and Professional Identity Formation. Am J Pharm Educ 2023; 87:100583. [PMID: 37562708 DOI: 10.1016/j.ajpe.2023.100583] [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: 06/24/2022] [Revised: 12/05/2022] [Accepted: 07/28/2023] [Indexed: 08/12/2023]
Abstract
Demographic information about the identities of faculty, staff, students, and trainees is frequently collected in pharmacy education. A wide range of identities and characteristics can influence the choices and experiences of students as they progress through curricula and develop their professional goals. Understanding personal and professional identity formation within dynamic and complex environments is critical to promoting the success of pharmacy education and practice. Emerging research efforts highlight the importance of considering identity development from varying perspectives, and offer new methods for collecting and analyzing data. The objective of this commentary is to reflect on the methodological challenges of identity formation research in pharmacy education and offer recommendations for those interested in this work.
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Affiliation(s)
- Jacqueline E McLaughlin
- University of North Carolina Eshelman, School of Pharmacy, Center for Innovative Pharmacy Education and Research, Chapel Hill, NC, USA.
| | - Kyle T Fassett
- University of North Carolina at Chapel Hill, Diversity, Equity, and Inclusion, Institutional Research and Assessment, Chapel Hill, NC, USA
| | - Michael Wolcott
- High Point University Workman School of Dental Medicine, Curriculum Innovation and Assessment, High Point, NC, USA; University of North Carolina Eshelman, School of Pharmacy, Chapel Hill, NC, USA
| | - Nicole Rockich-Winston
- Medical College of Georgia at Augusta University, Curriculum: Foundations of Medicine, Augusta, GA, USA
| | - Spencer Harpe
- Midwestern University, College of Pharmacy, Pharmacy Administration, Downers Grove, IL, USA
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Zaidi Z, Rockich-Winston N, Chow C, Martin PC, Onumah C, Wyatt T. Whiteness theory and the (in)visible hierarchy in medical education. Med Educ 2023; 57:903-909. [PMID: 37199083 DOI: 10.1111/medu.15124] [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] [Received: 06/24/2022] [Revised: 04/13/2023] [Accepted: 04/29/2023] [Indexed: 05/19/2023]
Abstract
CONTEXT The theory of whiteness in medical education has largely been ignored, yet its power continues to influence learners within our medical curricula and our patients and trainees within our health systems. Its influence is even more powerful given the fact that society maintains a 'possessive investment' in its presence. In combination, these (in)visible forces create environments that favour White individuals at the exclusion of all others, and as health professions educators and researchers, we have the responsibility to uncover how and why these influences continue to pervade medical education. PROPOSAL To better understand how whiteness and the possessive investment in its presence create (in)visible hierarchies, we define and explore the origin of whiteness by examining whiteness studies and how we have come to have a possessive investment in its presence. Next, we provide ways in which whiteness can be studied in medical education so that it can be disruptive. CONCLUSION We encourage health profession educators and researchers to collectively 'make strange' our current hierarchical system by not just recognising the privileges afforded to those who are White but also recognising how these privileges are invested in and maintained. As a community, we must develop and resist established power structures to transform the current hierarchy into a more equitable system that supports everyone, not just those who are White.
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Affiliation(s)
- Zareen Zaidi
- George Washington School of Medicine & Health Sciences, George Washington University, Washington, District of Columbia, USA
| | | | - Candace Chow
- Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, Utah, USA
| | - Paolo C Martin
- Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
| | - Chavon Onumah
- George Washington School of Medicine & Health Sciences, George Washington University, Washington, District of Columbia, USA
| | - Tasha Wyatt
- Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
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Rockich-Winston N, Robinson A, Arif SA, Steenhof N, Kellar J. The Influence of Intersectionality on Professional Identity Formation among Underrepresented Pharmacy Students. Am J Pharm Educ 2023; 87:100108. [PMID: 37597916 DOI: 10.1016/j.ajpe.2023.100108] [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] [Revised: 01/18/2023] [Accepted: 02/15/2023] [Indexed: 08/21/2023]
Abstract
OBJECTIVE The objective of this study is to explore professional identity formation (PIF) among student pharmacists from underrepresented groups (URGs). METHODS In this qualitative study, 15 student pharmacists from the University of Georgia and Midwestern University Colleges of Pharmacy were recruited for interviews to explore the influence of intersectionality of race, ethnicity, and gender on PIF. Interview data were analyzed using constructivist grounded theory to identify themes and then further analyzed using Crenshaw's theory of intersectionality, namely structural, political, and representational intersectionality. RESULTS Intersectionality of identities created situations where participants expressed advantages belonging to certain social categories, while simultaneously being disadvantaged belonging to other social categories. This awareness led to strategies to overcome these collective obstacles for themselves and their communities. Participants then described ways to shift perceptions of how society depicts pharmacists and the pharmacy profession. The results depict these processes and how intersectionality influences PIF for URG student pharmacists. CONCLUSION The sociocultural aspects of race, ethnicity, and gender influence the PIF of student pharmacists who belong to URGs. Intersectionality helps us better understand the ways in which inequality compounds itself, and this results in URG student pharmacists creating opportunities for belongingness and representation. Resultantly, URGs create opportunities for inclusivity and representation. To continue to facilitate this it is essential for educators and university systems to promote ways to foster and incorporate PIF in student pharmacists.
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Affiliation(s)
| | | | - Sally A Arif
- Midwestern University College of Pharmacy, Downers Grove, IL, USA
| | - Naomi Steenhof
- University of Toronto, Leslie Dan Faculty of Pharmacy, Toronto, Canada
| | - Jamie Kellar
- University of Toronto, Leslie Dan Faculty of Pharmacy, Toronto, Canada
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Wooten RL, Gillette C, Wyatt TR, Rockich-Winston N, Crandall S. Exploring the Professional Identity Formation of Racial/Ethnic Minoritized Physician Assistants. J Physician Assist Educ 2023; 34:98-103. [PMID: 37083571 DOI: 10.1097/jpa.0000000000000497] [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: 04/22/2023]
Abstract
INTRODUCTION The purpose of this article is to (1) describe how professional identity intersects with physician assistants' (PAs') and PA students' racial and ethnic identities and cultural backgrounds; (2) examine how sociohistorical contexts shape professional identity in racial/ethnic minoritized PAs and PA students; and (3) identify the role of PA program administrators and faculty to address the needs of racial/ethnic minoritized PAs and PA students. METHODS This study draws on elements of constructivist grounded theory to investigate the professional identity formation (PIF) experiences of 45 PA students and alumni from 3 institutions. Participants were recruited using a snowball method and identified as 23 Black/African American, 12 Hispanic/Latino, 6 mixed race, and 4 Native American/Indigenous. Interview data were analyzed using sociocultural theory as an analytic framework. RESULTS The results suggest that participants felt that their racial/ethnic identity was an important part of their identity, yet many indicated they experienced frequent micro- and macroaggressions from fellow students, faculty, lecturers, administrators, preceptors, patients, and supervisors. Additionally, they indicated that they need more support from their programs than what is currently provided. DISCUSSION The results of this study suggest that social experiences before, during, and after PA training strongly influence PIF development in racial/ethnic minoritized PAs. Administrators and professional PA organizations should evaluate methods to support those individuals who identify as a racial/ethnic minority throughout their careers.
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Affiliation(s)
- Robert L Wooten
- Robert L. Wooten, MS, PA-C, is an assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Chris Gillette, PhD, is an associate professor and director of research and scholarship, Department of PA Studies, Wake Forest School of Medicine, and associate professor, Department of Epidemiology and Prevention, Winston-Salem, North Carolina
- Tasha R. Wyatt, PhD, is an associate professor, Department of Medicine, Center for Health Professions Education, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- Nicole Rockich-Winston, PharmD, EdD, MS, is an assistant professor, Department of Pharmacology and Toxicology, Medical College of Georgia, Augusta, Georgia
- Sonia Crandall, PhD, MS, is a professor emeritus, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Chris Gillette
- Robert L. Wooten, MS, PA-C, is an assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Chris Gillette, PhD, is an associate professor and director of research and scholarship, Department of PA Studies, Wake Forest School of Medicine, and associate professor, Department of Epidemiology and Prevention, Winston-Salem, North Carolina
- Tasha R. Wyatt, PhD, is an associate professor, Department of Medicine, Center for Health Professions Education, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- Nicole Rockich-Winston, PharmD, EdD, MS, is an assistant professor, Department of Pharmacology and Toxicology, Medical College of Georgia, Augusta, Georgia
- Sonia Crandall, PhD, MS, is a professor emeritus, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Tasha R Wyatt
- Robert L. Wooten, MS, PA-C, is an assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Chris Gillette, PhD, is an associate professor and director of research and scholarship, Department of PA Studies, Wake Forest School of Medicine, and associate professor, Department of Epidemiology and Prevention, Winston-Salem, North Carolina
- Tasha R. Wyatt, PhD, is an associate professor, Department of Medicine, Center for Health Professions Education, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- Nicole Rockich-Winston, PharmD, EdD, MS, is an assistant professor, Department of Pharmacology and Toxicology, Medical College of Georgia, Augusta, Georgia
- Sonia Crandall, PhD, MS, is a professor emeritus, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Nicole Rockich-Winston
- Robert L. Wooten, MS, PA-C, is an assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Chris Gillette, PhD, is an associate professor and director of research and scholarship, Department of PA Studies, Wake Forest School of Medicine, and associate professor, Department of Epidemiology and Prevention, Winston-Salem, North Carolina
- Tasha R. Wyatt, PhD, is an associate professor, Department of Medicine, Center for Health Professions Education, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- Nicole Rockich-Winston, PharmD, EdD, MS, is an assistant professor, Department of Pharmacology and Toxicology, Medical College of Georgia, Augusta, Georgia
- Sonia Crandall, PhD, MS, is a professor emeritus, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Sonia Crandall
- Robert L. Wooten, MS, PA-C, is an assistant professor, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
- Chris Gillette, PhD, is an associate professor and director of research and scholarship, Department of PA Studies, Wake Forest School of Medicine, and associate professor, Department of Epidemiology and Prevention, Winston-Salem, North Carolina
- Tasha R. Wyatt, PhD, is an associate professor, Department of Medicine, Center for Health Professions Education, Uniformed Services University of the Health Sciences, Bethesda, Maryland
- Nicole Rockich-Winston, PharmD, EdD, MS, is an assistant professor, Department of Pharmacology and Toxicology, Medical College of Georgia, Augusta, Georgia
- Sonia Crandall, PhD, MS, is a professor emeritus, Department of PA Studies, Wake Forest School of Medicine, Winston-Salem, North Carolina
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Wyatt TR, Rockich-Winston N, Crandall S, Wooten R, Gillette C. A comparison of professional identity experiences among minoritized medical professionals. J Natl Med Assoc 2022; 114:456-464. [PMID: 35728993 DOI: 10.1016/j.jnma.2022.05.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 05/24/2022] [Accepted: 05/30/2022] [Indexed: 11/16/2022]
Abstract
OBJECTIVE Professional identity formation (PIF) is considered a fundamental process in the development of healthcare providers. In medical education, the PIF literature has historically centered on medicine's socialization practices involving white male physicians. However, recently researchers have begun to reveal how larger socio-historical contexts influence PIF in minoritized physicians. To better understand what influences Black/African American physicians' PIF, this study compares their PIF experiences to a group of minoritized physician assistants (PAs). In comparing Black physicians' experiences to another provider, this study explored what PIF experiences may be attributed to participants' minoritized status and what might be attributed to the culture of medicine. METHODS In this cross-case analysis, 45 minoritized PA students and practicing PAs were recruited from several Southeastern universities. The PA participants included 23 Black/African Americans, 12 Latinx, 4 Indigenous/Native, and 6 of mixed races/ethnicities. Interview data were then compared to previously collected data from 41 Black/African American medical trainees and physicians. Using constant comparative method, similarities and differences in PIF were explored. RESULTS Similarities between the two groups included the importance of participants' racial/ethnic identity to patient care, experiences on-going microaggressions from patients and peers, and a desire to engage in racial uplift. However, one marked difference was found, namely that PAs felt they could bring their entire selves to the profession, whereas physicians described feeling splintered early in their training. CONCLUSIONS Several possibilities that might explain why Black physicians and minoritized PAs have this one marked difference in their PIF experience, including identity threat, internalization of different discourses, and length of training for physicians. While this study was not designed to answer this question, it is clear that there is something in the culture of medicine and the training of physicians that signals to Black physicians that they cannot bring their whole selves to the profession.
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Affiliation(s)
- T R Wyatt
- Uniformed Services University of the Health Sciences, Department of Medicine, Bethesda, Maryland, United States
| | - N Rockich-Winston
- Medical College of Georgia at Augusta University, Department of Pharmacology and Toxicology, 1120 15th Street, Augusta, Georgia 30912, United States.
| | - S Crandall
- Wake Forest School of Medicine, Department of PA Studies, Winston-Salem, NC, United States
| | - R Wooten
- Wake Forest School of Medicine, Department of PA Studies, Winston-Salem, NC, United States
| | - C Gillette
- Wake Forest School of Medicine, Department of PA Studies, Winston-Salem, NC, United States
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Rockich-Winston N, Taylor TR, Richards JA, White D, Wyatt TR. "All Patients Are Not Treated as Equal": Extending Medicine's Social Contract to Black/African American Communities. Teach Learn Med 2022; 34:238-245. [PMID: 33934678 DOI: 10.1080/10401334.2021.1902816] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
PHENOMENON The social contract is an implicit agreement that governs medicine's values, beliefs, and practices in ways that uphold the profession's commitment to society. While this agreement is assumed to include all patients, historical examples of medical experimentation and mistreatment suggest that medicine's social contract has not been extended to Black patients. We suggest that is because underlying medicine's contract with society is another contract; the racial contract, which favors white individuals and legitimizes the mistreatment of those who are nonwhite. When Black/African American physicians enter medicine, they enter into the social contract as an agreement with society, but must navigate the realities of the racial contract in ways that have yet to be acknowledged. This study examines how Black/African American physicians interpret and enact the social contract in light of the country's racial contract by investigating the ways in which Black/African American physicians discuss their interactions with Black patients. APPROACH This qualitative study reexamines cross-sectional data previously collected in 2018-2019 examining the professional identity formation (PIF) experiences of Black/African American trainees and physicians in the Southern part of the U.S. The goal of the larger study was to explore participants' professional identity formation experiences as racialized individuals within a predominantly white profession. The current study examines these data in light of medicine's social contract with society and Mill's (1997) theory of the racial contract to understand how Black physicians interpret and enact the social contract. Participants included 10 Black/African American students, eight residents, and nine attending physicians. FINDINGS The findings show that Black/African American physicians and trainees are aware of the country's racial contract, which has resulted in Black patients being historically excluded from what has been described in the social contract that governs all physicians. As such, they are actively working to extend the social contract so that it includes Black patients and their communities. Specifically, they engage in trust building with the Black community to make sure all patients are included. Building trust includes ensuring a consistent stream of new Black/African American trainees, and equipping Black trainees and patients with the skills needed to improve the healthcare within the Black/African American community. INSIGHTS While it been has assumed that all patients are included in the social contract between medicine and society, historical examples of medical mistreatment and experimentation demonstrate this is inaccurate; Black/African American communities have not been included. In an effort to dismantle systemic racism in the U.S., medical education must teach about its racist past and divulge how some communities have been historically excluded, providing new ways to think about how to include everyone in medicine's social contract.
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Affiliation(s)
- Nicole Rockich-Winston
- Department of Pharmacology and Toxicology, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
| | - Taryn R Taylor
- Department of Pediatrics and Emergency Medicine, School of Medicine, Emory University, Atlanta, Georgia, USA
| | - Joslyn A Richards
- Educational Innovation Institute, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
| | - DeJuan White
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Emory University, Atlanta, Georgia, USA
| | - Tasha R Wyatt
- Educational Innovation Institute, Medical College of Georgia, Augusta University, Augusta, Georgia, USA
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Wyatt TR, Taylor TR, White D, Rockich-Winston N. "When No One Sees You as Black": The Effect of Racial Violence on Black Trainees and Physicians. Acad Med 2021; 96:S17-S22. [PMID: 34348386 DOI: 10.1097/acm.0000000000004263] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
PURPOSE The United States has an implicit agreement known as the racial contract that exists between white and non-white communities. Recently, the racial contract has produced much tension, expressed in racial violence and police brutality. This study explores how this racial violence and police brutality have affected the practice and education of Black trainees and physicians who are members of the racial community being targeted. METHOD This qualitative cross-sectional study interviewed 7 Black trainees and 12 physicians from 2 Southern medical schools in 2020. Interview data were collected using aspects of constructivist grounded theory, and then analyzed using the concept of racial trauma; a form of race-based stress minoritized individuals experience as a result of inferior treatment in society. Data were then organized by the causes participants cited for feeling unsafe, conditions they cited as producing these feelings, and the consequences these feelings had on their education and practice. RESULTS The results show that even though participants were not direct victims of racial violence, because their social identity is linked to the Black community, they experienced these events vicariously. The increase in racial violence triggered unresolved personal and collective memories of intergenerational racial trauma, feelings of retraumatization after more than 400 years of mistreatment, and an awakening to the fact that the white community was unaware of their current and historical trauma. These events were felt in both their personal and professional lives. CONCLUSIONS As more minoritized physicians enter medicine and medical education, the profession needs a deeper understanding of their unique experiences and sociohistorical contexts, and the effect that these contexts have on their education and practice. While all community members are responsible for this, leaders play an important role in creating psychologically safe places where issues of systemic racism can be addressed.
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Affiliation(s)
- Tasha R Wyatt
- T.R. Wyatt is associate professor, Department of Medicine, Center for Health Professions Education, Uniformed Services University, Bethesda, Maryland; ORCID: https://orcid.org/0000-0002-0071-5298
| | - Taryn R Taylor
- T.R. Taylor is assistant professor of pediatrics and emergency medicine, Emory University School of Medicine, Atlanta, Georgia; ORCID: https://orcid.org/0000-0001-8099-900X
| | - DeJuan White
- D. White is assistant professor of psychiatry and director of psychiatric emergency services, Emory University School of Medicine, Atlanta, Georgia; ORCID: https://orcid.org/0000-0003-0637-1294
| | - Nicole Rockich-Winston
- N. Rockich-Winston is assistant professor of pharmacology, Medical College of Georgia, Augusta, Georgia; ORCID: https://orcid.org/0000-0002-2898-4393
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Wyatt TR, Rockich-Winston N. Antiracist work in uncharted waters. Clin Teach 2021; 18:474-476. [PMID: 33835706 DOI: 10.1111/tct.13352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 03/01/2021] [Accepted: 03/10/2021] [Indexed: 11/28/2022]
Affiliation(s)
- Tasha R Wyatt
- Uniformed Services University of the Health Sciences, Bethesda, Maryland, USA
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Wyatt TR, Rockich-Winston N, White D, Taylor TR. "Changing the narrative": a study on professional identity formation among Black/African American physicians in the U.S. Adv Health Sci Educ Theory Pract 2021; 26:183-198. [PMID: 32572728 DOI: 10.1007/s10459-020-09978-7] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Accepted: 06/15/2020] [Indexed: 06/11/2023]
Abstract
Professional identity formation (PIF) is considered a key process in physician development. However, early PIF research may have inadvertently left out experiences from ethnically/racially minoritized physicians. As a result, the PIF literature may have forwarded dominant perspectives and assumptions about PIF that does not reflect those of minoritized physicians. This study used a cross-sectional study design, in which interview data was initially collected using constructivist grounded theory and then analyzed using critical lenses. Participants included 14 Black/African American students, 10 residents, and 17 attending physicians at two Southern medical schools in the U.S. Coding included the both/and conceptual framework developed out of Black feminist scholarship, and further analyzed using medicine's culture of Whiteness. These lenses identified assumptions made in the dominant PIF literature and how they compared to the experiences described by Black physicians. The results show that medical education's historical exclusion of minoritized physicians in medical education afforded a culture of Whiteness to proliferate, an influence that continues to frame the PIF research. Black physicians described their professional identity in terms of being in service to their racial/ethnic community, and the interconnectedness between personal/professional identities and context. Their professional identity was used to challenge larger social, historical, and cultural mistreatment of Black Americans, findings not described in the dominant PIF research. Black physicians' experiences as minoritized individuals within a culture of Whiteness reveals that the PIF literature is limited, and the current framings of PIF may be inadequate to study minoritized physicians.
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Affiliation(s)
- Tasha R Wyatt
- Educational Innovation Institute, Medical College of Georgia at Augusta University, Augusta, GA, USA
| | - Nicole Rockich-Winston
- Pharmacology and Toxicology Department, Medical College of Georgia at Augusta University, 1120 15th Street, Augusta, GA, 30912, USA.
| | - DeJuan White
- Emory University School of Medicine, Atlanta, GA, USA
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Wyatt TR, Balmer D, Rockich-Winston N, Chow CJ, Richards J, Zaidi Z. 'Whispers and shadows': A critical review of the professional identity literature with respect to minority physicians. Med Educ 2021; 55:148-158. [PMID: 33448459 DOI: 10.1111/medu.14295] [Citation(s) in RCA: 49] [Impact Index Per Article: 16.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 06/28/2020] [Accepted: 07/16/2020] [Indexed: 06/12/2023]
Abstract
OBJECTIVES Professional identity formation (PIF) is a growing area of research in medical education. However, it is unclear whether the present research base is suitable for understanding PIF in physicians considered to be under-represented in medicine (URM). This meta-ethnography examined the qualitative PIF literature from 2012 to 2019 to assess its capacity to shine light on the experiences of minoritised physicians. METHODS Data were gathered using a search of six well-known medical education journals for the term 'professional identit*' in titles, keywords, abstracts and subheadings, delineated with the date range of 2012-2019. All non-relevant abstracts were removed and papers were then further reduced to those that focused only on learners' experiences. This left 67 articles in the final dataset, which were analysed using a collaborative approach among a team of researchers. The team members used their professional expertise as qualitative researchers and personal experiences as minoritised individuals to synthesise and interpret the PIF literature. RESULTS Four conceptual categories were identified as impacting PIF: Individual versus Sociocultural Influences; the Formal versus the Hidden Curriculum; Institutional versus Societal Values; and Negotiation of Identity versus Dissonance in Identity. However, a major gap was identified; only one study explored experiences of PIF in URM physicians and there was an almost complete absence of critical stances used to study PIF. Combined, these findings suggest that PIF research is building on existing theories without questioning their validity with reference to minoritised physicians. CONCLUSIONS From a post-colonial perspective, the fact that race and ethnicity have been largely absent, invisible or considered irrelevant within PIF research is problematic. A new line of inquiry is needed, one that uses alternative frameworks, such as critical theory, to account for the ways in which power and domination influence PIF for URM physicians in order to foreground how larger sociohistorical issues influence and shape the identities of minoritised physicians.
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Affiliation(s)
- Tasha R Wyatt
- Educational Innovation Institute, Medical College of Georgia, Augusta, Georgia, USA
| | - Dorene Balmer
- Department of Paediatrics, Children's Hospital of Pennsylvania, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Nicole Rockich-Winston
- Department of Pharmacology and Toxicology, Medical College of Georgia, Augusta, Georgia, USA
| | - Candace J Chow
- Division of General Internal Medicine, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, Utah, USA
| | - Joslyn Richards
- Educational Innovation Institute, Medical College of Georgia, Augusta, Georgia, USA
| | - Zareen Zaidi
- Department of Medicine, College of Medicine, University of Florida, Gainesville, Florida, USA
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Wyatt TR, Rockich-Winston N, Taylor TR, White D. What Does Context Have to Do With Anything? A Study of Professional Identity Formation in Physician-Trainees Considered Underrepresented in Medicine. Acad Med 2020; 95:1587-1593. [PMID: 32079956 DOI: 10.1097/acm.0000000000003192] [Citation(s) in RCA: 54] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
PURPOSE Research on professional identity formation has largely ignored how race, ethnicity, and the larger sociohistorical context work to shape medical students' professional identity. Researchers investigated how physician-trainees considered underrepresented in medicine (URM) negotiate their professional identity within the larger sociohistorical context that casts them in a negative light. METHOD In this qualitative study, 14 black/African American medical students were recruited from the Medical College of Georgia at Augusta University and Emory University College of Medicine between September 2018 and April 2019. Using constructive grounded theory and Swann's model of identity negotiation, the authors analyzed interview data for how students negotiate their racial and professional identities within medical education. RESULTS The results indicated that URM students were aware of the negative stereotypes ascribed to black individuals and the potential for the medical community to view them negatively. In response, students employed identity cues and strategies to bring the community's perceptions in line with how they perceived themselves-black and a physician. Specifically, students actively worked to integrate their racial and professional identities by "giving back" to the African American community. Community-initiated mentoring from non-URM physicians helped to reify students' hope that they could have a racialized professional identity. CONCLUSIONS Race, ethnicity, and the larger sociohistorical context is often overlooked in professional identity formation research, and this omission has resulted in an underappreciation of the challenges URM physicians' experience as they develop a professional identity. Within the context of this study, findings demonstrated that black/African American physicians negotiated the formation of professional identity within a challenging sociohistorical context, which should be given greater consideration in related research.
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Affiliation(s)
- Tasha R Wyatt
- T.R. Wyatt is associate professor, Educational Innovation Institute, Medical College of Georgia at Augusta University, Augusta, Georgia; ORCID: https://orcid.org/0000-0002-0071-5298
| | - Nicole Rockich-Winston
- N. Rockich-Winston is assistant professor of pharmacology, Medical College of Georgia at Augusta University, Augusta, Georgia; ORCID: https://orcid.org/0000-0002-2898-4393
| | - Taryn R Taylor
- T.R. Taylor is assistant professor of pediatrics and emergency medicine, Emory University School of Medicine, Atlanta, Georgia
| | - DeJuan White
- D. White is assistant professor of psychiatry and director of psychiatric emergency services, Emory University School of Medicine, Atlanta, Georgia
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13
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Vaizer R, Aslam S, Pearson Jr WG, Rockich-Winston N. What does it mean to be a physician? Exploring social imaginaries of first-year medical students. Int J Med Educ 2020; 11:76-80. [PMID: 32221044 PMCID: PMC7246111 DOI: 10.5116/ijme.5e30.8f73] [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: 11/18/2019] [Accepted: 01/28/2020] [Indexed: 06/10/2023]
Abstract
OBJECTIVES To explore if community embedded discussions with local community members reshape the social imaginary of medicine among students and contribute positively to their professional identity. METHODS This explorative, qualitative study involved 35 first-year medical students who volunteered to attend a 2-hour forum at a local church to ask community members about their experiences with doctors and healthcare systems. Student participants were asked to reflect on five structured questions. The written reflections were submitted for analysis, de-identified, and analyzed using Glaser's classic grounded theory, constant comparative analysis, and Taylor's model of modern social imaginaries as an analytical lens. RESULTS The results indicate that student participants identified seven main themes regarding what community members expect from their doctors, including active listening (n=22), physical touch (n=18), and compassion (n=16). Responses also indicated that only 5.6% of the students felt that the preclinical curriculum was adequately preparing them for what local community members identified as important to patient care. However, students recognized that two aspects of the curriculum, Physical Diagnosis (n=12) and volunteering/community engagement (n=9), were congruent with the expectations of future patients. CONCLUSIONS The results suggest that students identified educational experiences that were congruent with the social imaginary of patients. However, patient expectations were discordant to some aspects of the medical imaginary of medical students. The experience and subsequent reflections may be salient to contributing to each student's professional identity and provide a model for other medical schools to explore how the curriculum is fulfilling the community's perception of ideal patient care.
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Affiliation(s)
| | - Sanah Aslam
- Medical College of Georgia, Augusta University, USA
| | - William G. Pearson Jr
- The Human Flourishing Program, Institute for Quantitative Social Science, Harvard University, USA
| | - Nicole Rockich-Winston
- Department of Pharmacology and Toxicology, Medical College of Georgia, Augusta University, USA
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14
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Jirau-Rosaly W, Brown SP, Wood EA, Rockich-Winston N. Integrating an Interprofessional Geriatric Active Learning Workshop Into Undergraduate Medical Curriculum. J Med Educ Curric Dev 2020; 7:2382120520923680. [PMID: 32548306 PMCID: PMC7271265 DOI: 10.1177/2382120520923680] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Accepted: 04/08/2020] [Indexed: 06/11/2023]
Abstract
PURPOSE The aging population in the United States poses a substantial challenge to our health care system, and particularly affects the training of physicians in geriatric care. To introduce undergraduate medical students to a variety of clinical skills and concepts emphasized in geriatrics, we created an interprofessional geriatric workshop and examined changes in student perceptions of working in interprofessional teams, knowledge regarding geriatric concepts, perceptions of the pre-work material, and suggestions for curricular improvement to enhance the workshop for future students. METHODS Second-year medical students participated in a 4-hour workshop with tasks that emphasized activities of daily living, geriatric physical assessment, end-of-life discussions, Beers Criteria, and a home health assessment. Pre- and post-surveys were administered including the Students Perceptions of Interprofessional Clinical Education-Revised (SPICE-R) survey and a knowledge assessment. Student perceptions of pre-work and overall program assessment were captured after the workshop. Descriptive statistics and paired t tests assessed for significant differences. Emerging themes were analyzed using the Glaser constant comparative method. RESULTS Of the 186 medical student participants, 178 students completed the SPICE-R survey, demonstrating significant increases in students' perceptions of the value of interprofessional education (P < .001). In addition, 111 students completed the pre- and post-test for the knowledge assessment, demonstrating significant gains in geriatric concepts (P < .001). Overall, most students perceived the pre-work as useful and felt prepared to evaluate geriatric patients. Open-ended question analysis supported results, in which 34 students indicated that they felt most comfortable performing a home health assessment and emphasized the usage of the home health simulation. CONCLUSIONS Introducing medical students to a variety of geriatric assessments and concepts in an interprofessional environment early in their career positively influences their perceptions of working as an interprofessional team member to deliver comprehensive care to older adults.
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Affiliation(s)
- Wanda Jirau-Rosaly
- Department of Medicine, Medical College
of Georgia, Augusta University, Augusta, GA, USA
| | - Shilpa P Brown
- Department of Medicine, Medical College
of Georgia, Augusta University, Augusta, GA, USA
| | - Elena A Wood
- Department of Medicine, Medical College
of Georgia, Augusta University, Augusta, GA, USA
- Educational Innovation Institute,
Augusta University, Augusta, GA, USA
| | - Nicole Rockich-Winston
- Department of Pharmacology and
Toxicology, Medical College of Georgia, Augusta University, Augusta, GA, USA
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15
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Abstract
Objective. In the course of daily teaching responsibilities, pharmacy educators collect rich data that can provide valuable insight into student learning. This article describes the qualitative data analysis method of content analysis, which can be useful to pharmacy educators because of its application in the investigation of a wide variety of data sources, including textual, visual, and audio files. Findings. Both manifest and latent content analysis approaches are described, with several examples used to illustrate the processes. This article also offers insights into the variety of relevant terms and visualizations found in the content analysis literature. Finally, common threats to the reliability and validity of content analysis are discussed, along with suitable strategies to mitigate these risks during analysis. Summary. This review of content analysis as a qualitative data analysis method will provide clarity and actionable instruction for both novice and experienced pharmacy education researchers.
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Affiliation(s)
- A J Kleinheksel
- The Medical College of Georgia at Augusta University, Augusta, Georgia
| | | | - Huda Tawfik
- Central Michigan University, College of Medicine, Mt. Pleasant, Michigan
| | - Tasha R Wyatt
- The Medical College of Georgia at Augusta University, Augusta, Georgia
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16
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Rockich-Winston N, Wyatt TR. The Case for Culturally Responsive Teaching in Pharmacy Curricula. Am J Pharm Educ 2019; 83:7425. [PMID: 31831909 PMCID: PMC6900830 DOI: 10.5688/ajpe7425] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2018] [Accepted: 05/29/2019] [Indexed: 05/22/2023]
Abstract
Cultural diversity training in pharmacy education has evolved from standalone lectures to longitudinal courses, service-learning initiatives, rotation experiences and global health opportunities. Cultural competency frameworks have served as the scaffold for cultural diversity training, yet educators in other health care disciplines have called into question the utility of such frameworks and offered cultural humility as an alternative to foster development and lifelong learning. In order to implement and assess outcomes tied to cultural diversity successfully, this commentary discusses the five elements of culturally responsive teaching that will provide the tools necessary to integrate cultural humility across pharmacy curricula. In addition, we address how to approach faculty development to avoid common maladaptations in pedagogical movements and conclude with addressing the salient objectives to evaluate gains in student, institutional, and societal outcomes.
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Affiliation(s)
| | - Tasha R Wyatt
- Medical College of Georgia at Augusta University, Augusta, Georgia
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17
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Rangachari P, May KR, Stepleman LM, Tingen MS, Looney S, Liang Y, Rockich-Winston N, Rethemeyer RK. Measurement of Key Constructs in a Holistic Framework for Assessing Self-Management Effectiveness of Pediatric Asthma. Int J Environ Res Public Health 2019; 16:E3060. [PMID: 31443605 PMCID: PMC6747253 DOI: 10.3390/ijerph16173060] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Revised: 08/14/2019] [Accepted: 08/19/2019] [Indexed: 11/29/2022]
Abstract
The 2007 U.S. National Institutes of Health EPR-3 guidelines emphasize the importance creating a provider-patient partnership to enable patients/families to monitor and take control of their asthma, so that treatment can be adjusted as needed. However, major shortfalls continue to be reported in provider adherence to EPR-3 guidelines. For providers to be more engaged in asthma management, they need a comprehensive set of resources for measuring self-management effectiveness of asthma, which currently do not exist. In a previously published article in the Journal of Asthma and Allergy, the authors conducted a literature review, to develop a holistic framework for understanding self-management effectiveness of pediatric asthma. The essence of this framework, is that broad socioecological factors can influence self-agency (patient/family activation), to impact self-management effectiveness, in children with asthma. A component of socio-ecological factors of special relevance to providers, would be the quality of provider-patient/family communication on asthma management. Therefore, the framework encompasses three key constructs: (1) Provider-patient/family communication; (2) Patient/family activation; and (3) Self-management effectiveness. This paper conducts an integrative review of the literature, to identify existing, validated measures of the three key constructs, with a view to operationalizing the framework, and discussing its implications for asthma research and practice.
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Affiliation(s)
- Pavani Rangachari
- Department of Interdisciplinary Health Sciences, College of Allied Health Sciences, Augusta University, Augusta, GA 30912, USA.
| | - Kathleen R May
- Division of Allergy-Immunology and Pediatric Rheumatology, Department of Pediatrics, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Lara M Stepleman
- Department of Psychiatry & Health Behavior, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Martha S Tingen
- Georgia Prevention Institute, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Stephen Looney
- Department of Population Health Sciences, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - Yan Liang
- Department of Interdisciplinary Health Sciences, College of Allied Health Sciences, Augusta University, Augusta, GA 30912, USA
| | - Nicole Rockich-Winston
- Department of Pharmacology & Toxicology, Medical College of Georgia, Augusta University, Augusta, GA 30912, USA
| | - R Karl Rethemeyer
- Rockefeller College of Public Affairs & Policy, University at Albany, State University of New York, Albany, NY 12222, USA
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18
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Gillette C, Rockich-Winston N. Response to Standardized Colleagues in Pharmacy Education. Am J Pharm Educ 2018; 82:7275. [PMID: 30181682 PMCID: PMC6116880 DOI: 10.5688/ajpe7275] [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] [Indexed: 06/08/2023]
Affiliation(s)
- Chris Gillette
- Wingate University School of Pharmacy, Wingate, North Carolina
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19
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Gillette C, Rudolph M, Kimble C, Rockich-Winston N, Smith L, Broedel-Zaugg K. A Meta-Analysis of Outcomes Comparing Flipped Classroom and Lecture. Am J Pharm Educ 2018; 82:6898. [PMID: 30013248 PMCID: PMC6041496 DOI: 10.5688/ajpe6898] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 02/15/2018] [Indexed: 05/25/2023]
Abstract
Objective. To examine the evidence of the effectiveness of flipped classroom compared to traditional lecture. Methods. Experimental and observational studies were included and obtained through searches of PubMed, Education Resources Information Center (ERIC), and Google Scholar. Publications from January 1, 2000 through July 1, 2017 were included. Studies were eligible for this research if: (a) the study compared student outcomes using flipped classroom versus lecture and (b) at least one outcome measure was final examination score or final course score. This analysis used a random effects model with weighted mean difference (WMD) as the outcome. Results. Six studies were included in the qualitative synthesis and five were included in the quantitative synthesis. To date, there has only been one prospective randomized comparison of flipped classroom to lecture in student pharmacist education. When comparing final examination scores, there was no significant difference between flipped classroom and lecture based instruction. Only two studies examined the effect of flipped classroom compared to lecture on final course score. This analysis also found no significant difference. Conclusion. Despite a lack of prospective randomized studies, findings from this meta-analysis suggest that flipped classroom may be associated with minimal gains in student knowledge compared to lecture. These findings are important because previous research has estimated that the flipped classroom requires more time to develop and implement. Future studies using prospective randomized designs need to be conducted before widespread adoption.
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Affiliation(s)
- Chris Gillette
- Wingate University School of Pharmacy, Wingate, North Carolina
| | | | - Craig Kimble
- Marshall University School of Pharmacy, Huntington, West Virginia
| | | | - Lisa Smith
- Wingate University School of Pharmacy, Wingate, North Carolina
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20
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21
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Rockich-Winston N, Train BC, Rudolph MJ, Gillette C. Faculty motivations to use active learning among pharmacy educators. Curr Pharm Teach Learn 2018; 10:277-284. [PMID: 29764630 DOI: 10.1016/j.cptl.2017.11.015] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 08/21/2017] [Accepted: 11/27/2017] [Indexed: 06/08/2023]
Abstract
INTRODUCTION Faculty motivations to use active learning have been limited to surveys evaluating faculty perceptions within active learning studies. Our objective in this study was to evaluate the relationship between faculty intrinsic motivation, extrinsic motivation, and demographic variables and the extent of active learning use in the classroom. METHODS An online survey was administered to individual faculty members at 137 colleges and schools of pharmacy across the United States. The survey assessed intrinsic and extrinsic motivations, active learning strategies, classroom time dedicated to active learning, and faculty development resources. Bivariate associations and multivariable stepwise linear regression were used to analyze the results. RESULTS In total, 979 faculty members completed the questionnaire (23.6% response rate). All motivation variables were significantly correlated with percent active learning use (p < 0.001). Intrinsic motivation demonstrated the highest correlation (r = 0.447) followed by current extrinsic motivations (r = 0.245) and ideal extrinsic motivations (r = 0.291). Variables associated with higher intrinsic motivation included the number of resources used (r = 0.233, p < 0.001) and the number of active learning methods used in the last year (r = 0.259, p < 0.001). Years of teaching experience was negatively associated with intrinsic motivation (r = -0.177, p < 0.001). Regression analyses confirmed the importance of intrinsic and extrinsic motivations in predicting active learning use. DISCUSSION AND CONCLUSIONS Our results suggest that faculty members who are intrinsically motivated to use active learning are more likely to dedicate additional class time to active learning. Furthermore, intrinsic motivation may be positively associated with encouraging faculty members to attend active learning workshops and supporting faculty to use various active learning strategies in the classroom.
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Affiliation(s)
- Nicole Rockich-Winston
- Department of Pharmacology and Toxicology, Medical College of Georgia at Augusta University, 1120 15th Street, Augusta, GA 30912, United States.
| | - Brian C Train
- Department of Pharmaceutical Science and Research, Marshall University School of Pharmacy, Huntington, WV, United States
| | - Michael J Rudolph
- Department of Pharmacy Practice, Administration, and Research, Marshall University School of Pharmacy, Huntington, WV, United States
| | - Chris Gillette
- Wingate University School of Pharmacy, Wingate, NC, United States
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22
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Gillette C, Stanton RB, Rockich-Winston N, Rudolph M, Anderson HG. Cost-Effectiveness of Using Standardized Patients to Assess Student-Pharmacist Communication Skills. Am J Pharm Educ 2017; 81:6120. [PMID: 29367775 PMCID: PMC5774195 DOI: 10.5688/ajpe6120] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [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: 10/21/2016] [Accepted: 12/19/2016] [Indexed: 05/31/2023]
Abstract
Objective. To explore the cost-effectiveness of including standardized patients (SP) in the didactic curriculum for application and assessment of students' pharmacist-patient communication skills. Methods. Five role play/case study (RP/CS) activities from a communication skills curriculum were replaced with five SP encounters. Communication was assessed using a rubric. This study developed an economic model to examine the costs and effectiveness of replacing RP/CS events with SP events in knowledge-application and communication assessment. Costs consisted of SP hourly wages for training and delivery of SP events. Outcomes examined were the incremental cost-effectiveness ratio (ICER) per student. Results. The ICER comparing SP to RP/CS was $100.93 higher per student on first-attempt pass rates and $9.04 per one-point increase in the mean score. Conclusion. SP was more effective and more costly than RP/CS. Further research into students' willingness to pay needs to occur before determining if using SPs is cost-effective in teaching communication skills.
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Affiliation(s)
- Chris Gillette
- Wingate University School of Pharmacy, Wingate, North Carolina
| | | | | | - Michael Rudolph
- Marshall University School of Pharmacy, Huntington, West Virginia
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23
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Gillette C, Rockich-Winston N, Shepherd M, Flesher S. Children with asthma and their caregivers help improve written asthma action plans: A pilot mixed-method study. J Asthma 2017; 55:609-614. [PMID: 28759273 DOI: 10.1080/02770903.2017.1355379] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
OBJECTIVE The objectives of this study were to (a) qualitatively examine caregiver and child feedback about a gold standard written asthma action plan (WAAP), and (b) determine whether having an asthma action plan was associated with child and caregiver self-efficacy in managing an exacerbation. METHODS This was a cross-sectional analysis of structured interviews with 22 children with persistent asthma that collected feedback about the WAAP as well as self-efficacy. An analysis of interviews used the constant comparative method to identify themes of child and caregiver statements. Caregivers completed a questionnaire that measured asthma management self-efficacy, barriers to managing asthma, and belief in the treatment efficacy using validated scales. RESULTS Approximately 36% of the caregivers reported having a WAAP for their child from their child's pediatrician. Most caregivers stated that having pictures would improve the WAAP, while most children stated that the layout needed to be improved by adding more space between the sections. Caregivers who reported knowing what the asthma action plan was had greater self-efficacy than caregivers who did not (z = -1.99, p = 0.047). CONCLUSIONS Re-designing the current WAAP layout and including pictures of inhalers may promote patient understanding. Future research needs to examine if a re-designed WAAP improves asthma management of children with asthma and their caregivers.
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Affiliation(s)
- Chris Gillette
- a School of Pharmacy , Wingate University , Wingate , NC , USA
| | - Nicole Rockich-Winston
- a School of Pharmacy , Wingate University , Wingate , NC , USA.,c School of Pharmacy , Marshall University , Huntington , WV , USA
| | - Meagan Shepherd
- b Joan C. Edwards School of Medicine , Marshall University , Huntington , WV , USA
| | - Susan Flesher
- b Joan C. Edwards School of Medicine , Marshall University , Huntington , WV , USA
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Gillette C, Rudolph M, Rockich-Winston N, Stanton R, Anderson HG. Improving Pharmacy Student Communication Outcomes Using Standardized Patients. Am J Pharm Educ 2017; 81:110. [PMID: 28970611 PMCID: PMC5607720 DOI: 10.5688/ajpe816110] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2016] [Accepted: 08/25/2016] [Indexed: 05/25/2023]
Abstract
Objective. To examine whether standardized patient encounters led to an improvement in a student pharmacist-patient communication assessment compared to traditional active-learning activities within a classroom setting. Methods. A quasi-experimental study was conducted with second-year pharmacy students in a drug information and communication skills course. Student patient communication skills were assessed using high-stakes communication assessment. Results. Two hundred and twenty students' data were included. Students were significantly more likely to have higher scores on the communication assessment when they had higher undergraduate GPAs, were female, and taught using standardized patients. Similarly, students were significantly more likely to pass the assessment on the first attempt when they were female and when they were taught using standardized patients. Conclusion. Incorporating standardized patients within a communication course resulted in improved scores as well as first-time pass rates on a communication assessment than when using different methods of active learning.
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Affiliation(s)
- Chris Gillette
- Wingate University School of Pharmacy, Wingate, North Carolina
| | - Michael Rudolph
- Marshall University School of Pharmacy, Huntington, West Virginia
| | | | - Robert Stanton
- Marshall University School of Pharmacy, Huntington, West Virginia
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25
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Rockich-Winston N. Toward a pharmacy curriculum theory: spiral integration for pharmacy education. Int J Med Educ 2017; 8:61-62. [PMID: 28237975 PMCID: PMC5339021 DOI: 10.5116/ijme.58a8.0381] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Accepted: 02/18/2017] [Indexed: 06/06/2023]
Affiliation(s)
- Nicole Rockich-Winston
- Department of Pharmacy Practice, Administration and Research, Marshall University School of Pharmacy, USA
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26
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Gillette C, Rudolph M, Rockich-Winston N, Blough ER, Sizemore JA, Hao J, Booth C, Broedel-Zaugg K, Peterson M, Anderson S, Riley B, Train BC, Stanton RB, Anderson HG. Predictors of student performance on the Pharmacy Curriculum Outcomes Assessment at a new school of pharmacy using admissions and demographic data. Curr Pharm Teach Learn 2017; 9:84-89. [PMID: 29180160 DOI: 10.1016/j.cptl.2016.08.033] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/15/2015] [Revised: 06/13/2016] [Accepted: 08/20/2016] [Indexed: 06/07/2023]
Abstract
OBJECTIVES To characterize student performance on the Pharmacy Curriculum Outcomes Assessment (PCOA) and to determine the significance of specific admissions criteria and pharmacy school performance to predict student performance on the PCOA during the first through third professional years. METHODS Multivariate linear regression models were developed to study the relationships between various independent variables and students' PCOA total scores during the first through third professional years. RESULTS To date, four cohorts have successfully taken the PCOA examination. Results indicate that the Pharmacy College Admissions Test (PCAT), the Health Science Reasoning Test (HSRT), and cumulative pharmacy grade point average were the only consistent significant predictors of higher PCOA total scores across all students who have taken the exam at our school of pharmacy. CONCLUSION The school should examine and clarify the role of PCOA within its curricular assessment program. Results suggest that certain admissions criteria and performance in pharmacy school are associated with higher PCOA scores.
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Affiliation(s)
- Chris Gillette
- Department of Pharmacy Practice Administration, and Research, Marshall University School of Pharmacy, Huntington, WV.
| | - Michael Rudolph
- Department of Pharmaceutical Science and Research, Marshall University School of Pharmacy, Huntington, WV
| | - Nicole Rockich-Winston
- Department of Pharmaceutical Science and Research, Marshall University School of Pharmacy, Huntington, WV
| | - Eric R Blough
- Department of Pharmaceutical Science and Research, Marshall University School of Pharmacy, Huntington, WV
| | - James A Sizemore
- Department of Pharmaceutical Science and Research, Marshall University School of Pharmacy, Huntington, WV
| | - Jinsong Hao
- Department of Pharmaceutical Science and Research, Marshall University School of Pharmacy, Huntington, WV
| | - Chris Booth
- Department of Pharmaceutical Science and Research, Marshall University School of Pharmacy, Huntington, WV
| | - Kimberly Broedel-Zaugg
- Department of Pharmaceutical Science and Research, Marshall University School of Pharmacy, Huntington, WV
| | - Megan Peterson
- Department of Pharmaceutical Science and Research, Marshall University School of Pharmacy, Huntington, WV
| | - Stephanie Anderson
- Department of Pharmaceutical Science and Research, Marshall University School of Pharmacy, Huntington, WV
| | - Brittany Riley
- Department of Pharmaceutical Science and Research, Marshall University School of Pharmacy, Huntington, WV
| | - Brian C Train
- Department of Pharmaceutical Science and Research, Marshall University School of Pharmacy, Huntington, WV
| | - Robert B Stanton
- Department of Pharmaceutical Science and Research, Marshall University School of Pharmacy, Huntington, WV
| | - H Glenn Anderson
- Department of Pharmaceutical Science and Research, Marshall University School of Pharmacy, Huntington, WV
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Babcock C, Rockich-Winston N, Booth C. Bringing naloxone to ground zero: Huntington, West Virginia. J Am Pharm Assoc (2003) 2016; 57:S9-S10. [PMID: 27838389 DOI: 10.1016/j.japh.2016.09.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2016] [Revised: 09/08/2016] [Accepted: 09/25/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Charles Babcock
- Clinical Assistant Professor, Marshall University School of Pharmacy, Huntington, WV.
| | | | - Chris Booth
- Clinical Assistant Professor, Marshall University School of Pharmacy, Huntington, WV
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Gillette C, Rockich-Winston N, Kuhn JA, Flesher S, Shepherd M. Inhaler Technique in Children With Asthma: A Systematic Review. Acad Pediatr 2016; 16:605-15. [PMID: 27130811 DOI: 10.1016/j.acap.2016.04.006] [Citation(s) in RCA: 61] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 04/11/2016] [Accepted: 04/19/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Pediatric asthma is an important public health problem worldwide. The primary methods of medication delivery are inhalation devices. OBJECTIVES This systematic review examined: 1) what is the prevalence of correct inhaler technique among children with asthma, 2) are educational interventions associated with improved rates of correct inhalation technique, and 3) is improved inhaler technique associated with improved asthma outcomes? DATA SOURCES We included experimental and observational studies through searches of PubMed, Cochrane Database of Systematic Reviews, Cochrane Central Register of Controlled Trials, CINAHL Complete, and clinicaltrials.gov. STUDY ELIGIBILITY CRITERIA, PARTICIPANTS, AND INTERVENTIONS Studies were eligible for this review if at least 1 outcome measure of the study included and reported results of child/adolescent inhaler technique. STUDY APPRAISAL AND SYNTHESIS METHODS The following information was extracted from each included study: study design (experimental vs observational), and outcomes data. The Downs and Black checklist was used to appraise study quality. RESULTS Twenty-eight studies were eligible for inclusion. We found that inhaler technique is generally very poor among children, but is better when children use their metered-dose inhalers (MDIs) with spacers. Technique in using turbuhalers and diskus inhalers is better than in MDI, but still poor. Counseling children on correct inhaler technique was associated with improved technique among children in multiple studies. LIMITATIONS We examined articles published in English. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS Inhaler technique in children is generally poor. Physicians and other members of the health care team should instruct children and their caregivers on the proper use of their inhalation devices at every opportunity and correct mistakes when made to ensure effective medication delivery. REGISTRY This systematic review was registered under the Centre for Reviews and Dissemination, PROSPERO CRD42015025070 (http://www.crd.york.ac.uk/PROSPERO/display_record.asp?ID=CRD42015025070).
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Affiliation(s)
- Chris Gillette
- Marshall University School of Pharmacy, Huntington, WVa; Marshall University College of Health Professions, Huntington, WVa.
| | | | - JoBeth A Kuhn
- Marshall University School of Pharmacy, Huntington, WVa
| | - Susan Flesher
- Marshall University Joan C. Edwards School of Medicine, Huntington, WVa
| | - Meagan Shepherd
- Marshall University Joan C. Edwards School of Medicine, Huntington, WVa
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