Dealing with the difficult student in emergency medicine

A Content Analysis of the ACGME Specialty Milestones to Identify Performance Indicators Pertaining to the Development of Residents as Educators

Construct: For curriculum development purposes, this study examined how the development of residents as educators is reflected in the Accreditation Council for Graduate Medical Education (ACGME) Milestones. Background: Residents teach patients, families, medical students, physicians, and other health professionals during and beyond their training. Despite this expectation, it is unclear how the development of residents as educators is reflected in the specialty-specific Milestones. Approach: We performed a textual content analysis of 25 specialty Milestone documents available as downloads from the ACGME website in December 2015. Syntactical units of interest included developmental progressions that describe the development of educators over the course of residency training and 16 key terms identified during the analysis. We then categorized the terms by associated Milestone level, ACGME core competency, and targeted learner(s). Results: We identified 10 developmental progressions and 546 instances of the 16 key terms that describe the development of physician educators. The frequency of terms among specialties was quite variable (5-46 terms per specialty, Mdn = 21). The majority of education-related terms appeared at advanced Milestone levels; there were 139 (26%) such instances in Level 4 and 296 (54%) in Level 5. Education-related terms were identified in all six ACGME core competencies, with greatest frequency in Patient Care (157, 29%). Other residents were the learners most frequently targeted by education-related Milestones (211, 40%). Conclusions: The current ACGME Milestones largely imply that resident teaching is a high-level or aspirational goal, achieved without a clear or consistently assessed developmental progression. These findings run counter to the theoretical basis that underlies the development of the Milestones. Wide variation among specialties indicates lack of consensus around the ideal skill set of the resident educator and limits the utility of these documents for curriculum development in this domain.

Conflict management strategies in coping with students' disruptive behaviors in the classroom: Systematized review

INTRODUCTION

Classroom management is leading the class by setting the class schedule, organizing the procedures, supervising the learners' progress, and predicting and solving their problems. Students' disruptive behaviors and classroom management are the most important challenges and concerns of the teachers. The current review aimed to analyze the classroom management techniques and strategies used to cope with the students' disruptive behaviors.

METHODS

The present study was systematic review. The articles in Science Direct, PubMed and Scopus databases and Google Scholar search engine were searched using the keywords of classroom management, students' disruptive behaviors, difficult students, and confrontation strategies during 2000-2017. A total of 31 articles were included in the study for analysis.

RESULTS

The results showed all the techniques and strategies used and teachers' challenges in dealing with students' disruptive behaviors were included in conflict management strategies, which were classified into three categories, i.e. cooperative and problem solving strategies, avoidance strategies and punishment strategies. Moreover, the studies mostly emphasized the use of cooperative and problem solving strategies, and the most highlighted methods were making effective mutual communication with students to correct their negative behavior, training and preparing the teachers for dealing with the students' disruptive behaviors and using various teaching methods and approaches based on the classroom situation.

CONCLUSION

To cope with the challenges of students' disruptive behaviors, the teachers can use different strategies. Also, sufficient knowledge and skills about teaching, familiarity with the relevant and influential disciplines in dealing with students and making effective communication in the class can be helpful in developing and enjoying more effective skills in classroom management.

Is there a way for clinical teachers to assist struggling learners? A synthetic review of the literature

Struggling medical trainees pose a challenge to clinical teachers, since these learners warrant closer supervision that is time-consuming and competes with time spent on patient care. Clinical teachers' perception that they are ill equipped to address learners' difficulties efficiently may lead to delays or even lack of remediation for these learners. Because of the paucity of evidence to guide best practices in remediation, the best approach to guide clinical teachers in the field remains to be established. We aimed to present a synthetic review of the empirical evidence and theory that may guide clinical teachers in their daily task of supervising struggling learners, reviewing current knowledge on the challenges and solutions that have been identified and explored. A computerized literature search was performed using Medline, Embase, Education Resources Information Center, and Education Source, after which final articles were selected based on relevance. The literature reviewed provided best evidence for clinical teachers to address learners' difficulties, which is presented in the order of the four steps inherent to the clinical approach: 1) detecting a problem based on a subjective impression, 2) gathering and documenting objective data, 3) assessing data to make a diagnosis, and 4) planning remediation. A synthesized classification of pedagogical diagnoses is also presented. This review provides an outline of practical recommendations regarding the supervision and management of struggling learners up to the remediation phase. Our findings suggest that future research and faculty development endeavors should aim to operationalize remediation strategies further in response to specific diagnoses, and to make these processes more accessible to clinical teachers in the field.