Professionalism among paramedic students: achieving the measure or missing the mark?

Scoping reviews in medical education: A scoping review

OBJECTIVES

Over the last two decades, the number of scoping reviews in core medical education journals has increased by 4200%. Despite this growth, research on scoping reviews provides limited information about their nature, including how they are conducted or why medical educators undertake this knowledge synthesis type. This gap makes it difficult to know where the field stands and may hamper attempts to improve the conduct, reporting and utility of scoping reviews. Thus, this review characterises the nature of medical education scoping reviews to identify areas for improvement and highlight future research opportunities.

METHOD

The authors searched PubMed for scoping reviews published between 1/1999 and 4/2020 in 14 medical education journals. The authors extracted and summarised key bibliometric data, the rationales given for conducting a scoping review, the research questions and key reporting elements as described in the PRISMA-ScR. Rationales and research questions were mapped to Arksey and O'Malley's reasons for conducting a scoping review.

RESULTS

One hundred and one scoping reviews were included. On average, 10.1 scoping reviews (SD = 13.1, median = 4) were published annually with the most reviews published in 2019 (n = 42). Authors described multiple reasons for undertaking scoping reviews; the most prevalent being to summarise and disseminate research findings (n = 77). In 11 reviews, the rationales for the scoping review and the research questions aligned. No review addressed all elements of the PRISMA-ScR, with few authors publishing a protocol (n = 2) or including stakeholders (n = 20). Authors identified shortcomings of scoping reviews, including lack of critical appraisal.

CONCLUSIONS

Scoping reviews are increasingly conducted in medical education and published by most core journals. Scoping reviews aim to map the depth and breadth of emerging topics; as such, they have the potential to play a critical role in the practice, policy and research of medical education. However, these results suggest improvements are needed for this role to be fully realised.

Assessment of US Paramedic Professionalism: A Psychometric Appraisal

INTRODUCTION

Professionalism is an essential behavior for paramedic students to demonstrate. In the United States, paramedic accreditation standards require educators to evaluate and document summative affective evaluation on each paramedic student before graduation. The 2009 Emergency Medical Services Education Standards identified the affective behaviors as one of the three learning domains and published a grading tool to help educators recognize professional behaviors. However, little attention was given to the validity or reliability of this tool. Therefore, the aim of this study was to evaluate the psychometric properties of the 5-point Paramedic Affective Domain Tool.

METHODS

This was a retrospective study with educators that completed evaluations on paramedic students from May 2013 to January 2017. A total of 707 cases met inclusion criteria and 131 unique evaluators from 27 different paramedic programs. A Rasch Partial Credit Model was used to analyze the data.

RESULTS

Almost 97% of the paramedic students received passing scores and 28.1% (n=199) received perfect scores. Only 3.5% (n=25) failed the evaluation. Scores ranged from 11 to 55 (M = 46, SD = 9.02) and α = 0.97. Evidence suggests that the tool is not valid and the clustering of scores suggests minimal information can be gleaned from the results.

CONCLUSION

Serious consideration should be made in the continued use of this tool and future research should focus on developing a new tool that is both valid and reliable.

Development and Validation of a Simplified Chinese Version of the Assessment Tool for Students' Perceptions of Medical Professionalism

Professionalism is crucial in all professions and is particularly important in the medical field. Measuring students' perceptions of professionalism can help to form education targeting the enhancement of professionalism. This study aimed to validate an effective assessment tool for the measurement of medical students' perceptions of medical professionalism in mainland China. The cross-sectional survey was conducted in three medical colleges in Guangdong, China. Of the 2103 eligible medical students, 1976 responded, and 1856 questionnaires were deemed valid. Students from clinical medicine in these three medical colleges were randomly selected by cluster sampling. First, a Simplified Chinese Version questionnaire to measure Student's Perception of Medical Professionalism (SCV-SPMP) was constructed. Second, questionnaires from 1856 students majoring in clinical medicine at three medical colleges were included in the analysis. Third, exploratory factor analysis, Cronbach's alpha, item-subscale correlation, and confirmatory factor analysis were conducted to test the validity and reliability of the SCV-SPMP. Nine items were eliminated following exploratory factor analysis, and four subscales were extracted from the analysis. All internal consistency reliability exceeded the minimum standard. The overall Cronbach's alpha was 0.94, and four subscales' alphas were 0.82 (Accountability and excellence), 0.81 (Duty), 0.89 (Honor and integrity), and 0.85 (Practice habits and respect for others), respectively. The model fit was good. The convergent validity and discriminant validity were acceptable. The modified SCV-SPMP was found to be a valid and reliable tool to capture the main features of Chinese students' perceptions of medical professionalism in four dimensions, and it provides a quantitative method for the measurement of the students' perceptions in mainland China..