A Medical Education Research Library: key research topics and associated experts

When clinician-educators and medical education researchers use and discuss medical education research, they can advance innovation in medical education as well as improve its quality. To facilitate the use and discussions of medical education research, we created a prefatory visual representation of key medical education research topics and associated experts. We conducted one-on-one virtual interviews with medical education journal editorial board members to identify what they perceived as key medical education research topics as well as who they associated, as experts, with each of the identified topics. We used content analysis to create categories representing key topics and noted occurrences of named experts. Twenty-one editorial board members, representing nine of the top medical education journals, participated. From the data we created a figure entitled, Medical Education Research Library. The library includes 13 research topics, with assessment as the most prevalent. It also notes recognized experts, including van der Vleuten, ten Cate, and Norman. The key medical education research topics identified and included in the library align with what others have identified as trends in the literature. Selected topics, including workplace-based learning, equity, diversity, and inclusion, physician wellbeing and burnout, and social accountability, are emerging. Once transformed into an open educational resource, clinician-educators and medical education researchers can use and contribute to the functional library. Such continuous expansion will generate better awareness and recognition of diverse perspectives. The functional library will help to innovate and improve the quality of medical education through evidence-informed practices and scholarship.

Developing a framework for promoting interest and engagement of scholarship of teaching and learning for medical students

BACKGROUND

The scholarship of teaching and learning (SoTL) is a field of academic research that focuses on improving learning through reflective and informed teaching. Currently, most SoTL-related work is faculty-driven; however, student involvement in SoTL has been shown to benefit both learners and educators. Our study aims to develop a framework for increasing medical students' interest, confidence, and engagement in SoTL.

METHODS

A student-led SoTL interest group was developed and a year-round program of SoTL was designed and delivered by student leaders of the group under the guidance of a faculty advisor. Individual post-session surveys were administered to evaluate participants' perceptions of each session. Pre- and post-program surveys were administered to evaluate the program impact.

RESULTS

The year-round SoTL program consistently attracted the participation of medical students and faculty. Survey responses indicated strong medical student interest in the program and positive impact of the program. Increased interest and confidence in medical education research were reported by the student participants. The program design provided opportunities for student participants to network and receive ongoing feedback about medical education research they were interested or involved in.

CONCLUSION

Our study provides insights for developing a framework that other institutions can reference and build upon to educate and engage students in SoTL.

What guides student learning in the clinical years: A mixed methods study exploring study behaviours prior to the UK Medical Licensing Assessment (UKMLA)

PURPOSE

Student study behaviours that prioritise the UKMLA content map over the local curriculum are a significant risk for UK medical education. To mitigate this, we describe a student-centred faculty process to improve local curriculum guidance based on an evaluation of student study behaviours, concerns and needs. Responses informed the build of an online curriculum map.

METHODS

A mixed methods approach was adopted, including an online anonymous survey exploring student study behaviours and preferences for curricular guidance. This was followed by student-led focus groups to explore emergent themes further. Qualitative data underwent reflexive thematic analysis.

RESULTS

121 students responded to the survey, of which 12 consented to participate in two student-led focus groups. Five key themes emerged, including motivation for learning, student use of the intended curriculum, student experience of the enacted curriculum, the hidden curriculum, and expectations of an online curriculum map.

CONCLUSIONS

A participatory framework enabled shared aims and responsive outcomes for curricular development in the run up to the UKMLA. Student responses led to clarification of guidance, reorganisation of learning resources and optimal design of an online curriculum map which linked all content in a visible, UKMLA aligned framework, accessible to all students and teachers.

The positive and negative consequences of stress and its relationship with coping in medical students: A qualitative study

Rates of mental health problems among medical students have prompted efforts to reduce stress during medical training. However, stress can be motivating and is a feature of clinical work. This qualitative study explores what makes an experience stressful, and how medical students respond to such experiences. In-depth interviews were conducted with a purposive sample of 15 medical students. Experiences were distressing when they threatened students' self-perception, goals or coping mechanisms, or when they reminded the student of distressing past events. Moderate stress was motivating and could build resilience. Students selected coping mechanisms based on their availability, acceptability, likely outcome and their previous experience of using these mechanisms. Social support, extra-curricular activities and exercise were helpful. High levels of distress, poor self-esteem and course factors, including remote placements, impaired engagement with coping strategies. Perception of stressors as being insurmountable or beyond one's control, led to increasing distress and the adoption of avoidant coping strategies. University strategies need to consider the beneficial effects of stress and seek to bolster coping resources as well as minimising unnecessary sources of stress.

Twelve tips for developing and implementing an effective critical care simulation programme

Simulation training in healthcare settings has become a valuable training tool. It provides an ideal formative assessment for interdisciplinary teaching. It provides a high fidelity and highly immersive environment where healthcare staff and students can practice developing their skills in a safe and controlled manner. Simulation training allows staff to practice skills that better prepare them for clinical emergencies, therefore possibly optimising clinical care. While the benefits of simulation education are well understood, establishing a programme for use by critical care staff is complex. Complexities include the highly specialised scenarios that are not typically encountered in non-critical care areas, as well as the need for advanced monitoring equipment, ventilation equipment etc. These 12 tips are intended to assist healthcare educators in navigating the complexities in the establishment of a critical care simulation programme, providing advice on selecting target audiences, learning outcomes, creating a critical care simulation environment and recommendations on evaluation and development of the programme.

Are serious games seriously good at preparing students for clinical practice?: A randomized controlled trial

PURPOSE

Serious games (SGs) have great potential for pediatric medical education. This study evaluated the efficacy of a SG in improving learner satisfaction, knowledge, and behavior.

MATERIALS AND METHODS

This was an investigator-blinded randomized controlled trial (RCT) comparing a SG against two controls: (i) adaptive tutorial (AT), and (ii) low-stimulus control (LSC). SG is a highly immersive role-playing game in a virtual hospital. AT delivers interactive web-based lessons. LSC is paper-based clinical practice guidelines. Metropolitan senior medical students at UNSW were eligible. A total of 154 enrolled and were block randomized to one intervention. Participants had access to one intervention for 8 weeks which taught pediatric acute asthma and seizure assessment and management. Satisfaction was assessed with Likert-scale responses to 5 statements and 2 free-text comments. Knowledge was assessed with 10 multiple-choice questions (MCQs). Clinical behavior was assessed during a 30-point simulated clinical management scenario (CMS). Primary analysis was performed on a modified intention-to-treat basis and compared: (1) SG vs. AT; and (2) SG vs. LSC.

RESULTS

A total of 118 participants were included in the primary analysis (modified intention-to-treat model). No significant differences in MCQ results between the SG and control groups. SG group outperformed the LSC group in the CMS, with a moderate effect (score out of 30: 20.8 (3.2) vs. 18.7 (3.2), respectively, d = 0.65 (0.2-1.1), p = 0.005). No statistically significant difference between SG and AT groups in the CMS (score: 20.8 (3.2) vs. 19.8 (3.1), respectively, d = 0.31 (-0.1 to 0.8), p = 0.18). A sensitivity analysis (per-protocol model) was performed with similar outcomes.

CONCLUSIONS

This is the first investigator-blinded RCT assessing the efficacy of a highly immersive SG on learner attitudes, knowledge acquisition, and performance in simulated pediatric clinical scenarios. The SG demonstrated improved translation of knowledge to a simulated clinical environment, particularly compared to LSC. SGs show promise in pediatric medical education.

The Impact of Faculty Gender on Resident Evaluations of Faculty Performance in Emergency Medicine

INTRODUCTION

Gender bias impacts the promotion and tenure of female emergency medicine (EM) physicians and limits their ability to advance in academic rank. Many factors influence the promotion and tenure process including research, evaluations, opportunities for leadership, sponsorship, and mentorship. The goal of this study is to determine if resident evaluations of EM faculty differ by faculty gender.

METHODS

A quantitative analysis was used to examine 14,613 teaching evaluations of faculty by residents at a single academic center (The Ohio State University Wexner Medical Center, Columbus) in the years 2017-2019. Anonymized ratings of male and female faculty on a five-point Likert scale were compared using Fischer's exact test and adjusting for multiple comparisons.

RESULTS

Male faculty were more likely to hold the rank of Associate Professor or Professor. When taking both faculty gender and rank into account, male Clinical Instructors and Assistant Professors had significantly higher evaluation scores by residents in the domain of resident autonomy than their female counterparts. Regardless of gender or faculty rank, the majority of faculty received scores greater than four.

CONCLUSION

A significant gender difference was found in resident evaluation scores of faculty in the domain of resident autonomy at the level of Clinical Instructor and Assistant Professor. Resident autonomy refers to the degree of supervision by faculty which evolves over time and is primarily based on level of training. This is important as it demonstrates a gender difference in scores that could be used to determine faculty compensation and promotion. Evaluation tools used for promotion and tenure of academic faculty should be evaluated for implicit bias and appropriate statistical analysis.

A Narrative Review of Key Studies in Medical Education in 2022: Applying the Current Literature to Educational Practice and Scholarship

The expectation of every academic pediatrician is to stay updated on current evidence in their field; this is especially true of pediatric clinician educators who are training the next generation of pediatricians. Since 2016, select members of the Academic Pediatric Association Education Committee have curated educational research articles in order to distill the increasing volume of research related to medical education. The purpose of this narrative review is to summarize 14 articles published in 2022 related to medical education that may impact the work of pediatric clinician educators and educational leadership. These articles are organized into 6 overarching domains: selection and recruitment, promoting learner growth and development, learning environment and wellness, curriculum development, assessment, and educator development.

Student-directed learning in a LIC: How do they find it? An exploration into the medical students' perceptions of the utility of the self-directed component ('white space') of the Longitudinal Integrated Clerkship in the ScotGEM curriculum

BACKGROUND

Scottish Graduate Entry Medicine (ScotGEM) is a new four-year graduate entry medical programme. During the third year, students undertake a Longitudinal Integrated Clerkship (LIC) where they are integrated into one General Practice for two and a half days a week. The remaining time is 'white space', allowing students to undertake placements and portfolio work; while directing their learning.

AIMS

To explore the students' perceptions of the utility of the 'white space' of the ScotGEM LIC. Secondary aims were to explore the positive aspects of this space, the challenges of utilising this space and to explore any difference in the 'white space' between LIC regions.

METHODS

An explorative case study methodology was utilised and semi-structured interviews were conducted with third and fourth-year students. 13 interviews were transcribed for inductive thematic analysis.

FINDINGS

Four themes were established: the students' usage of the 'white space'; the tools they used to guide learning in this space; regional variations in LIC experiences and they offered suggestions to improve the utility of this space.

DISCUSSION AND CONCLUSION

The findings are detailed and integrated with relevant literature to inform recommendations for future LIC practice and suggestions for future research are offered.

Maturing through awareness: An exploratory study into the development of educational competencies, identity, and mission of medical educators

PURPOSE

Faculty development in learning-centred medical education aims to help faculty mature into facilitators of student learning, but it is often ineffective. It is unclear how to support educators' maturation sustainably. We explored how and why medical educators working in learning-centred education, more commonly referred to as student-centred education, mature over time.

METHODS

We performed a qualitative follow-up study and interviewed 21 senior physician-educators at two times, ten years apart. A hierarchical model, distinguishing four educator phenotypes, was employed to deductively examine educators' awareness of the workplace context, their educational competencies, identity, and 'mission,' i.e. their source of personal inspiration. Those educators who grew in awareness, as measured by advancing in educator phenotype, were re-interviewed to inductively explore factors they perceived to have guided their maturation.

RESULTS

A minority of the medical educators grew in awareness of their educational qualities over the 10-year study period. Regression in awareness did not occur. Maturation as an educator was perceived to be linked to maturation as a physician and to engaging in primarily informal learning opportunities.

CONCLUSIONS

Maturation of medical educators can take place, but is not guaranteed, and appears to proceed through a growth in awareness of, successively, educational competencies, identity, and mission. At all stages, maturation is motivated by the task, identity, and mission as a physician.

Implementation of Team-Based Learning for a Clinical Module of the Ethiopian Undergraduate Anesthesia Curriculum and Students' Perspectives: A Pilot Cross-Sectional Study

Introduction

Team-based learning (TBL) is an active learning strategy that gives students the opportunity to apply conceptual information through a series of tasks that incorporate individual effort, team collaboration, and immediate feedback. This study aimed to report baseline TBL implementation in a clinical module of a fourth-year competency-based undergraduate anesthesia curriculum and explore the perspectives of students.

Methods

In April 2023, 18 students participated in two TBL sessions over two weeks, and readiness assurance test results and post-TBL evaluations were analyzed. Week one TBL implementation scores were compared with week two, establishing a longitudinal analysis over two points in time. Students also participated in an online survey to assess their views on the advantages and design of TBL, their perceptions of its best and worst features, and their suggestions for its implementation.

Results

Of 18 students, 16 (89%) responded to the survey. Most students believed that TBL was an effective educational strategy but expressed concern about the amount of time required for TBL preparation and the need for student readiness. The individual readiness assurance test scores did not differ significantly between weeks 1 and 2 (mean difference [MD] = 0.39, P= 0.519, 95% CI: -0.824 to 1.60). However, the students' median [IQR] team readiness assurance test scores increased significantly from week one to week two, from 8 [2] to 10 [1] (p = 0.004). Peer evaluation scores also showed a significant increase in week 2 (MD = 2.4, P = 0.001, 95% CI: -3.760 to -0.996).

Conclusion

TBL was successfully implemented for a clinical module at Dilla University-Ethiopia for the first time. Students perceived it positively, but some criticized its preparation time, workload, and minimal facilitator engagement. We suggest convenient and flexible scheduling personalized for each student's needs when TBL is applied for clinical modules.

Challenges and opportunities of evaluating work based interprofessional learning: insights from a pediatric interprofessional training ward

Introduction

Interprofessional collaboration among healthcare professionals is fostered through interprofessional education (IPE). Work-based IPE has demonstrated effectiveness within interprofessional training wards. We developed the Interprofessional Training Ward in Pediatrics (IPAPED) and employ a combination of established assessment tools and a newly created IPAPED questionnaire, directed at to assess both students' learning experiences and program structure. This paper presents the development and analysis of the psychometric properties of the IPAPED questionnaire.

Methods

Nursing trainees and medical students participated in IPAPED. The IPAPED questionnaire was developed to complement established instruments, based on IPE frameworks. Interprofessional collaboration and communication were represented in subscales in part 1 of the questionnaire. Part 2 focused on the IPAPED program itself. Statistical analyses included calculation of internal consistency for part 1 and exploratory factor analyses for part 2.

Results

All IPAPED participants between November 2017 and November 2022 completed the questionnaire (n = 105). 94 of 105 questionnaires were analyzed. Internal consistency for part 1 was low (Cronbach's α <0.58). Exploratory factor analyses revealed three distinct factors: teaching and learning material, interprofessional learning facilitation and professional guidance by nurses on the ward.

Discussion

Our results illustrate the challenge of performing high quality, theory based evaluation in a work-based setting. However, exploratory factor analyses highlighted the opportunity of focusing on both learning facilitators and staff on the wards to ensure a maximum learning output for participants. Developing program-specific questionnaires to gain insight into local structures has the potential to improve work-based IPE formats.

Robust, defensible, and fair: The AMEE guide to selection into medical school: AMEE Guide No. 153

Selection is the first assessment of medical education and training. Medical schools must select from a pool of academically successful applicants and ensure that the way in which they choose future clinicians is robust, defensible, fair to all who apply and cost-effective. However, there is no comprehensive and evidence-informed guide to help those tasked with setting up or rejuvenating their local selection process. To address this gap, our guide draws on the latest research, international case studies and consideration of common dilemmas to provide practical guidance for designing, implementing and evaluating an effective medical school selection system. We draw on a model from the field of instructional design to frame the many different activities involved in doing so: the ADDIE model. ADDIE provides a systematic framework of Analysis (of the outcomes to be achieved by the selection process, and the barriers and facilitators to achieving these), Design (what tools and content are needed so the goals of selection are achieved), Development (what materials and resources are needed and available), Implementation (plan [including piloting], do study and adjust) and Evaluation (quality assurance is embedded throughout but the last step involves extensive evaluation of the entire process and its outcomes).HIGHLIGHTSRobust, defensible and fair selection into medical school is essential. This guide systematically covers the processes required to achieve this, from needs analysis through design, development and implementation, to evaluation of the success of a selection process.

Exam prediction and the general Practice Registrar Competency Assessment Grid (GPR-CAG)

BACKGROUND

In GP training, identifying early predictors of poor summative examination performance can be challenging. We aimed to establish whether external clinical teaching visit (ECTV) performance, measured using a validated instrument (GP Registrar Competency Assessment Grid, GPR-CAG) is predictive of Royal Australian College of General Practitioners (RACGP) Fellowship examination performance.

METHODS

A retrospective cohort study including GP registrars in New South Wales/Australian Capital Territory with ECTV data recorded during their first training term (GPT1), between 2014 and 2018, who attempted at least one Fellowship examination. Independent variables of interest included the four GPR-CAG factors assessed in GPT1 ('patient-centredness/caring', 'formulating hypotheses/management plans', 'professional responsibilities', 'physical examination skills'). Outcomes of interest included individual scores of the three summative examinations (Applied Knowledge Test (AKT); Key Feature Problem (KFP); and the Objective Structured Clinical Examination (OSCE)) and overall Pass/Fail status. Univariable and multivariable regression analyses were performed.

RESULTS

Univariably, there were statistically significant associations (p < 0.01) between all four GPR-CAG factors and all four summative examination outcomes, except for 'formulating hypotheses/management plans' and OSCE score (p = 0.07). On multivariable analysis, each factor was significantly associated (p < 0.05) with at least one exam outcome, and 'physical examination skills' was significantly associated (p < 0.05) with all four exam outcomes.

DISCUSSION

ECTV performance, via GPR-CAG scores, is predictive of RACGP Fellowship exam performance. The univariable findings highlight the pragmatic utility of ECTVs in flagging registrars who are at-risk of poor exam performance, facilitating early intervention. The multivariable associations of GPR-CAG scores and examination performance suggest that these scores provide predictive ability beyond that of other known predictors.

Using the think aloud protocol in health professions education: an interview method for exploring thought processes: AMEE Guide No. 151

The think aloud protocol (TAP) has two components, the think aloud interview, a technique for verbal data collection, and protocol analysis, a technique for predicting and analyzing verbal data. TAP is a useful method for those attempting to observe, explore, and understand individuals' thoughts, which remain among the most difficult research areas in health professions education. Notably, the long, complex history and heterogeneous implementation of variations of TAP can make it difficult to understand and implement rigorously. In this Guide, we define the TAP and related concepts, describe the origins, outline applications, offer a detailed roadmap for rigorous implementation as a technique for data collection and/or data analysis, and suggest opportunities for adaptation of the traditional TAP. We aim to arm researchers with the tools to implement a rigorous think aloud interview, while explaining its origins to empower them to adapt the traditional TAP intentionally and justifiably to modern health professions education research.

How much is enough? Proposing achievement thresholds for core EPAs of graduating medical students in Canada

PURPOSE

The transition towards Competency-Based Medical Education at the Cumming School of Medicine was accelerated by the reduced clinical time caused by the COVID-19 pandemic. The purpose of this study was to define a standard protocol for setting Entrustable Professional Activity (EPA) achievement thresholds and examine their feasibility within the clinical clerkship.

METHODS

Achievement thresholds for each of the 12 AFMC EPAs for graduating Canadian medical students were set by using sequential rounds of revision by three consecutive groups of stakeholders and evaluation experts. Structured communication was guided by a modified Delphi technique. The feasibility/consequence models of these EPAs were then assessed by tracking their completion by the graduating class of 2021.

RESULTS

The threshold-setting process resulted in set EPA achievement levels ranging from 1 to 8 across the 12 AFMC EPAs. Estimates were stable after the first round for 9 of 12 EPAs. 96.27% of EPAs were successfully completed by clerkship students despite the shortened clinical period. Feasibility was predicted by the slowing rate of EPA accumulation overtime during the clerkship.

CONCLUSION

The process described led to consensus on EPA achievement thresholds. Successful completion of the assigned thresholds was feasible within the shortened clerkship.[Box: see text].

The personal is political in the struggle for equity in global medical education research and scholarship

Medical education research is rooted in a long tradition of objectivity, evidence-based methods, and clinical surety. However, the inexorable confidence, health professions research education, and scholarship have in the manifest supremacy of western science as the foundational epistemology is questionable. Is this bravado legitimate and if so by what authority? How does this dominance of western epistemic frames determine how we are seen and how we see ourselves as health professions educators scholars and researchers? In what ways does western epistemic dominance influence how and why we conduct research? What do we consider as important to research in health professions education (HPE)? The answers are different depending on where we position ourselves or are placed in a hierarchy of scholarly privilege. I pose that the supremacy of Western scientific epistemology in modern medical education, research, and practice blurs differently colored scientific lenses and silences marginalized voices from legitimate contribution to HPE.

Medical mentorship deconstructed: an analysis and structural recommendation for high value mentorship

Background: Mentorship is an important component for young students interested in pursuing a career in medicine. In medically underserved areas, such as rural areas, mentorship can be sparse due to the lack of access to healthcare professionals. The purpose of this project was to gain an understanding of the mentorship received by practicing medical students. Methods: The authors conducted structured, one-on-one interviews with 10 current medical students about their perceptions and experiences with mentorship. Interviews were transcribed, coded, and analyzed for themes and subthemes. Results: Our findings revolve around three time periods of mentorship: 1) Before Obtaining a Mentor; 2) During the Mentorship; and 3) After the Mentorship.  In our findings we describe key characteristics such as professional development, personal qualities of the mentor, and professional and personal guidance as important components in guiding the mentee starting from the undergraduate level and continuing to their current level of education.  Conclusion: Interviewees' experiences with and perspectives on the mentorship they received were generally positive, though it was evident there are some aspects of the mentee-mentor relationship that can be improved. Building on the results obtained, setting expectations, providing mentor training, and pairing mentors/mentees from similar backgrounds are what we propose to create fulfilling and meaningful relationships between a mentee and mentor.

Artificial Hallucinations by Google Bard: Think Before You Leap

One of the critical challenges posed by artificial intelligence (AI) tools like Google Bard (Google LLC, Mountain View, California, United States) is the potential for "artificial hallucinations." These refer to instances where an AI chatbot generates fictional, erroneous, or unsubstantiated information in response to queries. In research, such inaccuracies can lead to the propagation of misinformation and undermine the credibility of scientific literature. The experience presented here highlights the importance of cross-checking the information provided by AI tools with reliable sources and maintaining a cautious approach when utilizing these tools in research writing.

Evaluating the Impact of Early Career Academic Medicine Workshops on Medical Students' Interest

Introduction Academic medicine is an important field that has had a notable decline in physician interest. The aim of this study was to introduce academic medicine to medical students early in their careers with a workshop in the medical school setting, beyond conferences, to promote even greater interest in the field. Methods This workshop consisted of (1) an informational didactic session using a Microsoft PowerPoint presentation, (2) small-group breakout discussion sessions to review case scenarios, and (3) a faculty panel to provide personal anecdotes and advice to students. The authors administered online pre- and post-workshop surveys to the students. One workshop was presented to first-year medical students and another to second-year medical students at California University of Science and Medicine. Data were analyzed using the IBM SPSS Statistics 27.0 for Windows. Pre- and post-workshop survey question means were compared using a paired t-test. Results There were 104 pre-clerkship student attendees, 83 of whom were in their first year and 21 in their second. Within each class year, there was a statistical significance in pre- and post-workshop survey responses for questions one through four (p < 0.001, p < 0.001, p < 0.001, p < 0.001), but question five responses were not statistically significant (p = 0.78). Conclusion Academic medicine workshops held early in medical students' careers are an effective way to foster interest in the field. Implementing academic medicine scholars' programs, in addition to these workshops, can help provide guidance and resources for students who want to pursue a career in academic medicine.

Including patients and caregivers in assessment in the pediatric competence by design curriculum: A national consensus study

Although evidence supports diverse assessment strategies, including patient/caregiver involvement in Competency-Based Medical Education (CBME), few residency programs formally include patients/caregivers in assessment. We aimed to determine the milestones for which patient/caregiver inclusion would be valuable in the Canadian Pediatric Competence By Design (CBD) curriculum.Program directors from 17 Canadian pediatric residency programs were invited to participate in a Delphi study. This Delphi included 209 milestones selected by the study team from the 320 milestones of the draft pediatric CBD curriculum available at the time of the study. In round 1, 16 participants representing 13 institutions rated the value of including patients/caregivers in the assessment of each milestone using a 4-point scale. We obtained consensus for 150 milestones, leaving 59 for re-exposure. In round 2, 14/16 participants rated remaining items without consensus. Overall, 67 milestones met consensus for 'valuable,' of which 11 met consensus for 'extremely valuable.' The majority of these milestones related to communication skills.Patient/caregiver assessment is valuable for 21% of milestones in the draft pediatric CBD curriculum, predominantly those relating to communication skills. This confirms the perceived importance of patient/caregiver assessment of trainees in CBME curricula; formal inclusion may be considered. Future directions could include exploring patients/caregivers' perspectives of their roles in assessment in CBD.

Planetary health and sustainability teaching in UK medical education: A review of medical school curricula

BACKGROUND

The doctors of the future need to be empowered to deliver healthcare sustainably while protecting their patients' health in the context of a degrading environment. This study aimed to objectively review the extent and nature of the teaching of planetary health and sustainability topics in UK medical education.

METHODS

A multi-centre national review of the timetabled teaching sessions in medical courses in the UK during the academic year 2020/2021 against the General Medical Council's adopted 'Educating for Sustainable Healthcare - Priority Learning Outcomes'. Medical students were recruited and reviewed the entirety of their own institution's online teaching materials associated with core teaching sessions using a standardised data collection tool. Learning outcome coverage and estimated teaching time were calculated and used to rank participating medical schools.

RESULTS

45% of eligible UK medical schools were included in the study. The extent of teaching varied considerably amongst courses. Mean coverage of the 13 learning outcomes was 9.9 (SD:2.5) with a mean estimated teaching time of 140 min (SD:139). Courses with dedicated planetary health and sustainability sessions ranked best.

CONCLUSION

There is large disparity in the education that medical students receive on these topics. Teaching may not adequately prioritise sustainability or reflect advances in planetary health knowledge.[Box: see text].

Editing the editors: Aims and priorities of health professions education journals

PURPOSE

Although health professions education (HPE) scholarship has flourished in recent decades, the influence of HPE journals has received little attention. This study examines the editorial policies and priorities of leading HPE journals.

METHODS

Fourteen HPE journals with the highest impact factors were reviewed for their editorial aims, scope, intended readership, and priority topic areas. Text from journal websites was coded using thematic analysis.

RESULTS

10/14 HPE journals included in this study were linked to regional or national education societies. Two focussed predominantly on medicine, one on dentistry, one on nursing, one on nutrition, and the remaining nine on general HPE. Although journals differed in their projected aims and proposed readerships, four overarching editorial themes were identified: (1) methodological and theoretical rigor; (2) impact on practice; (3) global relevance; (4) advancing knowledge.

CONCLUSIONS

Leading HPE journals share a number of priority areas and principles, implying some cohesion and consensus amongst the HPE scholarly community. These journals prioritise impact at the level of individual practitioners. Given the importance of policy level change in the development and reform of HPE around the world, the relative lack of focus on policy impact in HPE journals is worthy of further exploration.

Professional Identity Formation, Professionalism, Leadership and Resilience (PILLAR) in Medical Students: Methodology and Early Results

Objectives

The fundamental role of medical education is the transformation of students to doctors, through a process of education and professional identity formation (PIF), which can be informed by several educational, behavioural and emotional factors. PIF has been deemed to be of equal importance to the acquisition of clinical knowledge and skills and includes constructs such as professionalism, leadership and resilience. We aimed to assess professional identity formation, professionalism, leadership and resilience (PILLAR) in the junior years of medical school in the 2020/2021 academic year and illustrate the potential role of quantitative assessment to demonstrate progression in these areas. In this research, we provide the methods and baseline results for the PILLAR study.

Methods

We implemented a compulsory assessment in pre-clinical years of graduate entry and direct entry medicine at the Royal College of Surgeons in Ireland University of Medicine and Health Sciences, Dublin, Ireland. Validated scales were used to assess students' PILLAR. Descriptive and univariable statistical techniques were used to compare student scores between respective years.

Results

A total of 1311 students (92% response rate) provided their consent for research. For the psychometric scales, there were no evident trends among the years on these assessment measures. Results indicated significant differences in all measures, however, these did not correspond to ascending years of seniority.

Conclusion

The PILLAR methodology provides important information on the challenges of quantitatively assessing medical students in the four key areas of PIF, professionalism, leadership, and resilience. Our cross-sectional results point to cohort effects, without the expected progression per year in the cross-sectional data, or suggest that the chosen quantitative measures may be problematic for these constructs in pre-clinical students. Therefore, while we believe that PILLAR has potential as a progress test for these constructs, this will only truly be elucidated by repeated measures of each cohort over time.

Capacity for wonder among medical students: Assessment and educational implications

OBJECTIVE

The capacity for wonder (CfW) is a personal disposition related to lifelong learning and moral character development, two highly valued characteristics of health professionals. We previously developed and validated a CfW measure among college students. Here we describe how the scale performs among medical students.

METHODS

We invited all students at a top-tier U.S. medical school (N = 477) to participate in an online survey including the CfW measure, year in medical school, and demographics. We performed confirmatory factor analysis on the CfW measure and reassessed its reliability.

RESULTS

276 students completed the survey for an overall response rate of 58%. Factor analysis resulted in a 10-item scale with an alpha of 0.79 and an eigen value of 3.57. Factor loadings ranged from 0.43 to 0.77. The mean total score was 39.3 (SD = 8.9) out of a possible high score of 60. Total scores varied by year in school with significantly lower scores among 2nd year students (32.9 vs. 41.5; p < 0.001).

CONCLUSION

We confirmed the reliability of a 10-item CfW scale in 4 cohorts of medical students. Results suggest that the 2nd year of medical school poses the greatest risk to students' capacity for wonder. Efforts should be made to understand this phenomenon and develop interventions to mitigate it. Future research should explore the validity of the CfW scale, its utility in evaluating interventions designed to cultivate the capacity for wonder, its applicability to other groups of health professionals, and its association with ethical decision-making and practice.

Comparison of two validated evidence-based medicine assessments: Do they correlate?

Evidence-based medicine (EBM) has been defined as a process involving five actions: asking, acquiring, appraising, applying, and assessing. Several attempts have been made to create and validate tools to assess EBM aptitude. The newest testing instrument, the ACE tool, which is a 15-question true/false exam, has not been directly compared to the more established Fresno test, which is composed of 12 in-depth short-answer questions. Although both were designed to test Steps 1-4 of the five-step EBM process, it is unclear whether they examine the same things or whether one is superior. To our knowledge there is not a widely used standard for EBM assessment despite the broad requirements for inclusion of EBM in both undergraduate and graduate medical education.

HYPOTHESES

It was hypothesized that these instruments do not correlate between one another, based on inherent differences between them, including assessment format, grading method, and scoring range. The authors sought to examine whether a correlation between the results of these two instruments exists in a population of U.S. medical students.

METHODS

A retrospective cohort study of 158 fourth-year U.S. medical students in academic year 2018-2019 was conducted. All students were exposed to a focused EBM curriculum, consisting of three guided discussions of separate journal articles clinically relevant to the practice of emergency medicine. Outcomes measured included scores on both the ACE tool and Fresno test using descriptive statistics. Spearman's rho was used to determine the correlation between the ACE and Fresno scores for each student among the entire group. A subgroup analysis was performed to assess for correlations at more extreme data points.

RESULTS

The median scores on the ACE tool and Fresno test were 66.7% and 62.7%. There was no statistically significant correlation between the results of these two assessments (Spearman's rho 0.023, p = 0.774) in our population. The scores from the subgroup of advanced performers on the Fresno test showed a weak statistically significant positive correlation (p = 0.045) to advanced scores on the ACE tool. No other subgroups showed statistically significant correlation.

CONCLUSIONS

In our population of U.S. medical students, the results of two known EBM assessment instruments do not correlate with one another. The assessments may differ in what categories of learning they measure or in generalizability or perhaps in what depth of understanding they test overall. Further study is needed to determine what each instrument is measuring and whether there is demonstrable variation across populations.

The relationship between medical students' empathy, mental health, and burnout: A cross-sectional study

OBJECTIVE

To investigate how medical students' empathy is related to their mental health and burnout.

METHODS

This cross-sectional study included 886 medical students from curriculum years 1-6. The cognitive, affective, and behavioural dimensions of empathy were measured with self-report questionnaires and an emotion recognition test. Regressions were used to test the relationship between the empathy dimensions, depressive symptoms, anxiety, and burnout as well as the influence of curriculum year and gender.

RESULTS

Cognitive and behavioural empathy were significantly related to less mental health issues and burnout, whereas affective empathy was related to more mental health issues and burnout. Students in later curriculum years reported less mental health issues and burnout than students in earlier years, whereas no systematic difference could be observed for empathy. Female students reported more mental health issues and burnout as well as higher empathy, except for behavioural empathy for which male students scored higher.

CONCLUSIONS

The cognitive, affective, and behavioural dimensions of empathy were differently related to the mental health and burnout of medical students. Students presenting mental health issues or burnout might have more difficulty to adapt their behaviour in social situations and keep a certain distance when taking others' perspective.

Understanding online self-directed learning using point of care information systems (POCIS): A plot study using a capability approach perspective

PURPOSE OF THE STUDY

Understanding self-directed learning (SDL) when using point of care information systems (POCIS) can inform educational providers of the usefulness of the system for continuing medical education (CME). Sen's capability approach can offer a unique perspective to understand SDL, which considers the extent to which individual valued learning needs can be achieved. The aim of the study was to pilot the use of a questionnaire informed by the capability approach for understanding SDL when using POCIS in the context of CME.

METHODS

A semi-structured questionnaire aligned to the capability approach (Capability Approach for SDL with POCIS Questionnaire - CA-SPQ) in the context of CME was developed and implemented with 200 users of a POCIS (BMJ Best Practice).

RESULTS

The response rate was 92 and 78% of users considered that their valued outcomes were achieved and that they could apply their new learning to practice. The questionnaire had high content, face, and construct validity.

CONCLUSION

The CA-SPQ can offer a practical instrument to provide data and useful information for understanding SDL, when using POCIS in the context of CME. It also has the potential for adaptation to other areas of medical education.

Micro-Scholarship: An innovative approach for the first steps for Scholarship in Health Professions Education

In this paper, we propose Micro-Scholarship as a new and innovative approach to begin the scholarship journey for Scholarship in Health Professions Education. We introduce Micro-Scholarship as both an outcome and process, with the iterative and progressive development of a variety of micro-assets that can be combined and counted as 'traditional' Scholarship. We highlight the core components and processes that are enabled by a variety of digital technologies and supported by engagement with a community of practice. We also emphasise the importance of reflection throughout the entire journey. Our intention is to offer practical advice that can lower the bar for entry to Scholarship in Health Professions Education, with the potential to increase the sharing of different viewpoints at an early stage of the journey and to build a community of scholars.

'We just did it as a team': Learning and working on a paediatric interprofessional training ward improves interprofessional competencies in the short- and in the long-term

PURPOSE

Interprofessional (IP) education is essential for healthcare professionals to prepare them for future IP collaboration. IP training wards (ITWs) have been established for work-based IP education. Short-term effects of ITW placements have been published but long-term results are scarce. There are no reports on ITWs in paediatrics. We established the Interprofessional Training Ward in Paediatrics (IPAPAED) for paediatric nursing trainees and medical students. The aim of the study is to evaluate both short- and long-term outcomes regarding IP competencies of IPAPAED participants.

METHODS

The study was designed as a prospective, non-randomized trial, using a mixed-methods design. The Interprofessional Socialization and Valuing Scale (ISVS-9A/B) and the Interprofessional Collaboration Scale (ICS) were used for quantitative evaluation, qualitative data were gathered from structured group discussions and free-text comments. Data were collected from 68 IPAPAED participants, before and after the rotation, and 6-34 months later.Results: IPAPAED participants showed increased global scores in the ISVS 9 A/B and rated their communication competencies and their accommodation in IP teams better (ICS). Improvements in communication competency and accommodation persisted at 6-34 months.Conclusions: IP learning and working on IPAPAED had positive short-term effects on interprofessional competencies. Some of these effects persisted on a long-term.

Faculty motivations for leading clinical clerkship electives: A qualitative study

PURPOSE

Faculty are motivated to pursue clinician-educator careers out of a sense of purpose, duty, connectedness, satisfaction, and mastery. Yet, many suffer from burnout due to a lack of funding, resources, and competing clinical demands. Reasons for clinician-educator participation in unfunded educational leadership positions are underexplored. This study examined faculty members' reasons for volunteering and remaining as clerkship elective directors, an unfunded leadership position.

METHODS

In this qualitative study, the authors conducted 17 semi-structured interviews with clerkship elective directors in March 2021. The authors conducted a thematic analysis of deidentified transcripts using motivation theories as a lens.

RESULTS

Directors' motivations to engage in this unfunded educational leadership position stemmed from their existing clinician-educator identity and a sense of purpose and duty. Directors are sustained by the satisfaction derived from witnessing the positive impact they have on learners' career development and skills building, the impact of learners on the clinical environment, as well as personal benefits in the mastery of educator skills and enhanced visibility as educators.

CONCLUSIONS

Unfunded educational leadership positions can advance clinician-educators' commitment to learners and alter the learning environment. Strategies for faculty recruitment and retention in unfunded leadership positions include ensuring meaningful contact with learners, as well as opportunities for personal career development through skills building and enhanced visibility through recognition.

How podcasts teach: A comprehensive analysis of the didactic methods of the top hundred medical podcasts

PURPOSE

Medical podcasts have grown in popularity, but little is known about their didactic methods. This study sought to systemically describe the pedagogical approach employed by the 100 most popular medical podcasts in the United States. This study also aimed to assess factors related to quality control and conflicts of interest in podcasting.

METHODS

The authors averaged the rank positions for Apple podcasts in the Medicine category in the United States from 06/01/18 to 09/30/20 to generate a list of the 100 highest-ranked medical podcasts. They developed and validated a categorization system of didactic methods based on Bloom's taxonomy and collected data on didactic methods, as well as podcast affiliation, target audience, format, advertising, continuing medical education (CME) offerings, and presence of a reference list or review process.

RESULTS

Of the 100 most popular medical podcasts, 91 are educational. Of those, 51 are podcasts intended for physician education (PIPEs) while 40 are intended for other audiences, including the general public, nurses, and physical therapists. Compared with podcasts intended for other audiences, PIPEs engage higher levels of Bloom's taxonomy (p < 0.001). Among PIPEs, 18 (35.2%) are affiliated with an individual, 16 (31.4%) with a company, and 12 (23.5%) with a professional journal. 38 PIPEs (74.5%) are targeted toward all levels of medical learners. PIPEs are significantly more likely to list references or have a peer review process in place (n = 37, 72.5% vs. n = 15, 37.5%, p = 0.001) and offer CME credits (n = 20, 39.2% vs. n = 2, 5.0%, p < 0.001) than podcasts intended for other audiences.

CONCLUSIONS

Medical podcasts employ a variety of didactic methods, including those ranked highly on Bloom's taxonomy. Unlike traditional medical education, PIPEs are commonly produced by individuals or companies and targeted to all levels of medical learners.

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

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

The impact of COVID-19 safety interventions on creating a controlled environment on campus

Objectives

During COVID-19 the re-opening of educational institutes was frequently debated, however with the decline in the number of COVID-19 cases, The Aga Khan University (AKU) in Karachi, Pakistan opened its campus for medical and nursing students after more than 6 months of closure. To ensure gradual resumption of activities on-campus, a combination of interventions was diligently deployed to minimize student infection rates. Scarce literature exists on students' perceptions regarding decisions implemented by university leadership. The aim of the study was to determine the efficacy of these interventions.

Methods

We conducted a convergent, parallel, mixed-methods observational study targeting medical and nursing students. An online questionnaire was disseminated to elicit students' degree of (dis)agreement on a four-point Likert scale. Focused group discussions (FGDs) were conducted to comprehend reasons for (dis)agreement.

Results

Total of 183 students responded to questionnaire (59.0% nursing, 67.8% female), 11 FGDs were conducted with 85 students. Interventions with highest agreement were mandatory face masks policy (94.54%), weekly mandated COVID-testing (92.35%) and students' Academic Bubble (91.26%); highest disagreement was for Sehat Check application (41.53%); and stay strong campaign (40.44%). Four themes emerged from FGDs: Effective safety interventions, Safety interventions with limited effectiveness, Utility of Sehat Check Application and Future recommendations for informing policy.

Conclusion

It is paramount to seek student-feedback at forefront of university re-opening strategy. Clear communication channels are as important as an administrative response system's robustness. Bidirectional communication channels are fundamental and requisite during ever-changing policies and regulations. Engaging student representatives in decision making or implementation processes (such as "pilot" before "roll-out") would allow any potential issues to be managed early on. Gather real-time anonymous feedback and identify key areas that need further promulgation and those that need to be replaced with more effective ones.

Hyperglobalist, sceptical, and transformationalist perspectives on globalization in medical education

PURPOSE

Globalisation has been hotly debated in recent decades and has seemingly had a profound impact on medical education. This review synthesises the medical education literature using key perspectives from globalisation theory by Holton (Making globalisation).

METHODS

Holton (Making globalisation) recognised three key perspectives in globalisation theory-hyperglobalist, sceptical, and transformationalist. This article critically reviews the literature on globalisation in the field of medical education using this theoretical framework.

RESULTS

Hyperglobalist and sceptical perspectives dominated early periods of medical education literature on globalisation, projecting it either as a mainly positive or mainly negative force, respectively. Most forecasts grounded in these perspectives have not materialised in medical education policy and practice. Since 2010, the volume of scholarship about globalisation has increased and has been predominantly transformationalist in perspective, recognising a reality that has both positive and negative consequences.

CONCLUSIONS

The medical education literature has mirrored the broader social science literature, in moving over time from hyperglobalist and sceptical positions, towards a 'third wave' of globalisation thinking that is transformationalist. Medical education practitioners and policymakers should be mindful of these perspectives and trends as they navigate the opportunities and challenges presented by globalisation.

Twelve tips for organising a local or regional e-poster session

E-posters have been increasingly incorporated into medical education conferences over the past few years, but since the disruption to the 'traditional' conference circuit as a result of COVID-19 pandemic in 2020 they have become a necessary tool for larger national and international conferences to support ongoing scholarship dissemination. The authors of this article also recognise the potential for smaller-scale e-poster sessions to be organised at local or regional levels to either continue, or establish new, special interest groups and smaller medical education research networks. Our 12 tips article is designed to offer practical advice to support the implementation of local or regional e-poster sessions to potential organisers and is written from the perspective of two medical educational researchers with experience of designing e-posters and organising virtual conferences which include e-poster presentation sessions.

Technology enhanced assessment: Ottawa consensus statement and recommendations

INTRODUCTION

In 2011, a consensus report was produced on technology-enhanced assessment (TEA), its good practices, and future perspectives. Since then, technological advances have enabled innovative practices and tools that have revolutionised how learners are assessed. In this updated consensus, we bring together the potential of technology and the ultimate goals of assessment on learner attainment, faculty development, and improved healthcare practices.

METHODS

As a material for the report, we used the scholarly publications on TEA in both HPE and general higher education, feedback from 2020 Ottawa Conference workshops, and scholarly publications on assessment technology practices during the Covid-19 pandemic.

RESULTS AND CONCLUSION

The group identified areas of consensus that remained to be resolved and issues that arose in the evolution of TEA. We adopted a three-stage approach (readiness to adopt technology, application of assessment technology, and evaluation/dissemination). The application stage adopted an assessment 'lifecycle' approach and targeted five key foci: (1) Advancing authenticity of assessment, (2) Engaging learners with assessment, (3) Enhancing design and scheduling, (4) Optimising assessment delivery and recording learner achievement, and (5) Tracking learner progress and faculty activity and thereby supporting longitudinal learning and continuous assessment.

A medical escape room to build intern workplace social capital in an internal medicine residency program

PURPOSE

Trainee well-being is a growing focus in graduate medical education. One emerging area in occupational literature is the psychosocial environment of the workplace, of which a large component is workplace social capital (WSC). WSC encompasses how well a group connects to one another. Medical escape rooms (MERs) recently have been studied in various healthcare settings and are one proposed intervention to increase WSC.

METHODS

This is a single-center before-and-after survey study at the Loyola University Medical Center in 2021 to measure the effect of a MER on WSC amongst interns. Our Chief Resident created a 1-hour MER. WSC scores were measured using a modified version of a validated WSC scale. Scores were analyzed with paired t-test analysis and chi-square analysis. Open-ended feedback was also collected.

RESULTS

Of 52 eligible intern residents, 51 (98%) participated in the MER, and 41 (80%) completed the pre- and post-activity survey. All six survey statements had a greater percentage of positive responses following the MER. The average score across all participants and questions was 4.66 out of 5 on the pre-survey, and 4.90 on the post-survey (p < 0.001).

CONCLUSIONS

The MER significantly improved intern resident WSC scores, and proved a valuable addition to our curriculum.

Equity in medical education: Addressing microaggressions and discrimination on the wards

PURPOSE

Existing frameworks to address instances of microaggressions and discrimination in the clinical environment have largely been developed for faculty and resident physicians, creating a lack of resources for medical students.

METHODS

We implemented a workshop to prepare pre-clinical medical/dental students to recognize and respond to microaggressions. Participants in three cohorts from 2018 to 2020 completed pre- and post-workshop surveys assessing the prevalence of exposure to clinical microaggressions and the workshop's effect on mitigating commonly perceived barriers to addressing microaggressions.

RESULTS

Of 461 first-year medical and dental students who participated, 321 (69.6%) provided survey responses. Over 80% of students reported experiencing microaggressions, with women and URM students over-represented. After the workshop, participants reported significant reductions in barriers to addressing microaggressions and discrimination, including recognizing incidents, uncertainty of what to say or do, lack of allies, lack of familiarity with institutional policies, and uncertainty of clinical relevance. The workshop was similarly effective in-person and virtual formats.

CONCLUSIONS

Most medical/dental student respondents reported experiencing microaggressions in the clinical setting, particularly female and URM students. Our workshop mitigated most perceived challenges to responding to microaggressions. Future interventions across institutions should continue to equip students with the tools they need to address and respond to microaggressions.

Twelve tips for students who wish to write and publish

Stepping into the world of research can be an overwhelming task, especially for those with relatively little experience, such as medical students. This article aims to provide students with tips for writing and publishing in all fields. The 12 tips are as follows: (1) find your why; (2) play to your strengths and be realistic; (3) be well read; (4) revisit missed opportunities; (5) talk to the doctors around you; (6) broaden your horizons; (7) get to grips with the submission process early; (8) pay attention to the details; (9) remember that submission is not the end; (10) the process can't be rushed; (11) consider the alternative paths to presenting research; (12) start writing. This writing is derived from personal experience with supporting evidence and is not designed to be encyclopaedic, simply a reference to help students alleviate any concerns and begin their own journey into the world of research.

An Annotated Bibliography of Key Studies in Medical Education in 2020: Applying the Current Literature to Educational Practice and Scholarship

Pediatric medical educators, with their multitude of responsibilities, may have difficulty staying abreast with both medical education and specialty specific medical literature. The body of medical literature is growing at an exponential rate. This annotated bibliography serves as a summary of highlighted medical education literature in the year 2020. The purpose was to identify manuscripts which have the potential to significantly influence a pediatric medical educator's practice. The authors reviewed abstracts from 14 medical education and specialty journals using a two-staged review process. Each stage of review was completed by 2 different authors. A total of 1861 abstracts were reviewed and ultimately 15 key manuscripts were identified. The authors grouped the manuscripts into 6 core domains: diversity and inclusion, faculty development, feedback, learner development, mentorship, and teaching skills. Condensed summaries of each medical education manuscript likely to influence educational practice are provided by the authors in this annotated bibliography.

Exploring the Attitudes and Perceptions of Master of Medical Education Graduates Towards Research Publication in Saudi Arabia

INTRODUCTION

Evidence is lacking to identify what encourages students to conduct research and publish. This study aimed to understand the barriers and facilitators of research and publications from Master of Medical Education student research projects as 15-20% have published their research while 75-80% did not.

METHODS

This study used qualitative in-depth interviews with 17 graduates from the previous 13 batches of the Master of Medical Education program, Saudi Arabia. In-depth interviews were conducted with participants by face to face and Zoom, using a semi-structured interview guide. The interviews were conducted in English, and the recordings were transcribed verbatim. Next, the interview text was read multiple times to familiarize with the data for thematic analysis, where the text was coded inductively. Themes were generated by identifying patterns in the data and merging similar codes. The data were interpreted within the themes and supported with the most relevant quotations.

RESULTS

We identified four distinct but interrelated themes and the first theme, the importance and advantages of conducting research and its publication, explains the participants need to conduct research and publish it to survive and progress in the academic environment. In the second theme, positive experiences of conducting research and its publication, we identify what participants' positive experiences of the research process entail. In the third theme, challenges to conducting research and its publication, we explore the participants' opinions on the barriers to their efforts to undertake and publish their research. In the last theme, facilitators for conducting research and its publication, we summarize various facilitating factors that participants described as necessary to complete the research process successfully to peer-reviewed publication.

CONCLUSION

Masters' student researchers, especially those with demanding projects, need to be supported by providing them with critical supervision, an enabling environment, technical support, and guidance at each step of the research process.

Student-faculty co-creation of experiential learning in health systems science

INTRODUCTION

Health Systems Science (HSS) teaches students critical skills to navigate complex health systems, yet medical schools often find it difficult to integrate into their curriculum due to limited time and student disinterest. Co-developing content with students and teaching through appropriate experiential learning can improve student engagement in HSS coursework.

METHODS

Medical students and faculty co-developed a patient outreach initiative during the early phases of the COVID-19 pandemic and integrated that experience into a new experiential HSS elective beginning May 2020. Students called patients identified as high-risk for adverse health outcomes and followed a script to connect patients to healthcare and social services. Subsequently, this initiative was integrated into the required third-year primary care clerkship.

RESULTS

A total of 255 students participated in HSS experiential learning through the elective and clerkship from May 2020 through July 2021. Students reached 3,212 patients, encountering a breadth of medical, social, and health systems issues; navigated the EMR; engaged interdisciplinary professionals; and proposed opportunities for health systems improvement.

DISCUSSION AND CONCLUSION

This educational intervention demonstrated the opportunity to partner with student-led initiatives, coproducing meaningful educational experiences for the learners within the confines of a busy medical curriculum.

Transitioning preclinical students into clerkships amidst curricular disruptions from the COVID-19 pandemic

The COVID-19 pandemic resulted in significant disruptions to medical education. The patient care space was unavailable as a learning environment, which compounded the complexity of preparing students for clerkships with a traditional transition to clerkship (TTC) curriculum. We developed a multimodal, structured approach to re-introduce students to the clinical space prior to the start of clerkships. 105 second year medical students completed a 4-week clinical enhancement course. A modified Delphi method was used to select core topics, which were then anchored to key Entrustable Professional Activities (EPAs). Students participated in 9 virtual problem-based cases, workshops and multiple supervised patient encounters. Students were surveyed before, during, and after the course; responses were compared with paired t-tests. 25.9% rated the course as excellent, 44.2% as very good, and 19.5% as good. Compared to baseline, self-perceived efficacy grew significantly (P < 0.05) across all EPAs. Improvements in key competencies were sustained when students were surveyed 2 weeks into their first clerkship. This was a well-received, novel course, focused on helping students transition back into the clinical space through a multimodal teaching approach. This framework may be used by other institutions seeking to restructure their TTC initiatives.

An evaluation of two small group learning strategies among third-year medical students at the Faculty of Medicine, Siriraj Hospital, Mahidol University

Small group learning (SGL) is a discussion-based teaching strategy that can improve critical thinking, analytical skills, problem-solving, and interpersonal skills. This study aimed to evaluate student satisfaction in two SGL models among third-year medical students enrolled in a blood and lymphoid systems II course at the Faculty of Medicine Siriraj Hospital, Mahidol University in Bangkok, Thailand. A total of 318 students were divided into 12 groups, and each group had one facilitator. All included students and groups were exposed to both the central summary (CS) model and the individual facilitator summary (IFS) model (both SGLs). A questionnaire was developed to evaluate student rating of learning activities, perceived benefit, timing, workload, and satisfaction. Medical students rated the IFS model superior to the CS model for four of five parameters [confidence in performing and interpreting a laboratory test (83.6% vs. 78.8%), guidance for self-learning (52% vs. 39.5%), increased understanding of a disease (87.7% vs. 72.1%), and application of knowledge (77.4% vs. 70.2%), respectively]. Moreover, the IFS model was rated as having more suitable timing and workload and better satisfaction than the CS model. The results of this study suggest a strong preference for the IFS model over the CS model among medical students.

Beyond advising and mentoring: Competencies for coaching in medical education

BACKGROUND

Coaching supports academic goals, professional development and wellbeing in medical education. Scant literature exists on training and assessing coaches and evaluating coaching programs. To begin filling this gap, we created a set of coach competencies for medical education using a modified Delphi approach.

METHODS

An expert team assembled, comprised of seven experts in the field of coaching. A modified Delphi approach was utilized to develop competencies.

RESULTS

Fifteen competencies in five domains resulted: coaching process and structure, relational skills, coaching skills, coaching theories and models, and coach development.

CONCLUSION

These competencies delineate essential features of a coach in medical education. Next steps include creating faculty development and assessment tools for coaching.

Remote Learning and Its Impact on Newly Matriculated Medical Students

Objective The coronavirus disease 2019 (COVID-19) pandemic has led to massive disruptions in medical education. In the fall of 2020, newly matriculated medical students around the country started medical school in a remote learning setting. The purpose of this study is to assess the impact of remote learning during the COVID-19 pandemic on academic performance and student satisfaction among first-year medical students. Methods The newest cohort of first-year medical students (class of 2024; n = 128) who completed their first basic science course, "Genes, Molecules & Cells (GMC)," using an adapted remote format was compared to the prior year's cohort (class of 2023; n = 122) of first-year medical students who were taught using traditional approaches. The items that were compared were numerical performance on exams and quizzes, study strategies, and course evaluation in GMC. Data were analyzed with a two-sided t-test and Pearson correlation coefficient. Students' perception of remote learning was also reported and results were obtained using a five-point Likert scale through anonymous surveys via E-value. Results No statistical difference was observed in students' performance on the midterm and final examinations between the two cohorts in both multiple-choice and written examinations. Mean multiple-choice question (MCQ) midterm students' performance in remote learning compared to traditional learning cohort was 75.9%, standard deviation (SD) 6.1 to 75.89%, SD 6.49, respectively. Mean MCQ final students' performance was 84%, SD 6.37 (class of 2024) to 85%, SD 8.78 (class of 2023). Students' satisfaction with their learning experience was similar among the two groups (class of 2024: mean = 4.61, SD 0.66; class of 2023: mean = 4.57, SD 0.68). Most students (70%) in the remote learning cohort had a positive opinion of remote learning. Of the students, 17% reported feeling disconnected, isolated, or not actively involved. Conclusions The results of this study demonstrate that not only is remote learning effective but that the students were also resilient in their adaptation to a new learning format. Our experience highlights the importance of including wellness solutions to mitigate the feeling of isolation and disconnection during remote learning.

Twelve Years of Postgraduate Palliative Medicine Training in Finland: How International Guidelines Are Implemented

Background and Objective: The European Association for Palliative Care (EAPC) published recommendations for postgraduate education in palliative medicine in 2009. However, it is currently unknown how the EAPC remommendations are implemented in national programs, as audits of them are lacking. In Finland, the national society of palliative medicine has been organizing postgraduate palliative medicine training for experienced physicians since 2008, but the program has not been audited. The aim of this study was to perform a comprehensive analysis of the program. Design: In 2018-2019, a questionnaire on the Finnish Training Program for Palliative Medicine Competence was sent to past participants and delivered in person to current trainees. Learning outcomes were assessed with validated instruments for received skills and attitudes. All available educational archives were examined as well. Results: Forty-five (32 %) out of 155 specialists and 13 (38 %) out of 34 trainees responded. According to their assessments, the training provided them well with most skills required to work as palliative care specialists, but poorly with research capabilities. However, the Finnish program covers the EAPC guidelines well. Problem-based education, group work, and clinical excursions have been added to the latest curriculum. Maturation through work is needed for administrative and consultant competences. Conclusion: The EAPC guidelines can be included in a national course. The course had an important positive influence on the attitudes and learning of physicians in palliative medicine. The development of the education would benefit from pedagogical consultation. Uniform standards for auditing national programs should be developed.