教育学最新文献

Abstract: Although U.S. medical education has continued to place increased emphasis on defining competency standards and ensuring accountability to the public, health care inequities have persisted, several basic health outcomes have worsened, public trust in the health care system has eroded, and moral distress, burnout, and attrition among practicing physicians have escalated. These opposing trends beg the question of how the "good doctor" concept may be strengthened. In this perspective, the authors argue that revisiting the construct of physician character from an affirmational perspective could meaningfully improve medical education's impact on overall health by more holistically conceptualizing what-and who-a good doctor is. The authors introduce positive psychology's framework of character strengths, probe the distinction between character strengths and medical professionalism, and summarize the role of character strengths in promoting physician engagement and well-being in health care work. They contend that a systems-level approach to cultivating character strengths will foster physician moral agency and well-being and, by extension, transformational change in health care. Consistent with best practice in modern character education, the authors propose that institutions mindfully cultivate moral community among all stakeholders (students, faculty, staff, postgraduate trainees, and patients) and that moral community interaction centers on each member's personal aspirations with respect to living a good life, guided by the character strengths framework and informed by patient perspectives.

Clinical education rotations typically involve an initial training phase followed by supervised clinical practice. However, little research has explored the separate contributions of each component to the development of student confidence and treatment fidelity. The dual purpose of this study was to compare the impact of clinical training format (synchronous vs. asynchronous) and education model (traditional vs. collaborative) on student confidence and treatment fidelity. Thirty-six speech-language pathology graduate students completed this two-phase study during a one-term clinical rotation. Phase 1 investigated the impact of training condition (synchronous, asynchronous guided, asynchronous unguided) on student confidence and treatment fidelity. Phase 2 explored the impact of education model (traditional vs. collaborative) on student confidence and treatment fidelity. Treatment fidelity was measured at the conclusion of Phases 1 and 2. Students rated their confidence at six-time points throughout the study. Our results indicate that training condition did not differentially impact student confidence or treatment fidelity; however, education model did: students in the collaborative education model reported increased confidence compared to students in the traditional education model. Students in the collaborative education model also trended towards having higher treatment fidelity than students in the traditional education model. These results demonstrate that pre-clinical trainings can be effective in several different formats provided they cover the discrete skills needed for the clinical rotation. While preliminary, our results further suggest that students may benefit from working with peers during their clinical rotations.

Medical educators and programs are deeply interested in understanding and projecting the longitudinal developmental trajectories of medical students after these students are matriculated into medical schools so appropriate resources and interventions can be provided to support students' learning and progression during the process. As students have different characteristics and they do not learn and progress at the same pace, it is important to identify student subgroups and address their academic needs to create more equitable learning opportunities. Using latent class growth analysis, this study explored students' developmental trajectories and detected group differences based on their coursework performance in Anatomy within the two years of preclinical education in one medical school. Four subgroups were identified with various intercepts and slopes. There were significant group differences between these subgroups and their standardized scores in MCAT and UCMLE Step 1. The study provides evidence about the heterogeneity of the student population and points out future research directions.

Most students with reading difficulties struggle to read words. We examined intervention effects for students with significant word reading difficulties (SWRD; standard score of 80 on at least one pretest measure of word reading), which includes individuals with or at risk for dyslexia. We investigated: (a) What are the effects of reading interventions for students in Grades 3-12 with SWRD? and (b) What intervention features (i.e., instructional components and elements of dosage) are related to improved reading outcomes for the target population? A meta-analysis of 22 studies and 208 effect sizes revealed a statistically significant, positive, mean effect (g = 0.14, standard error [SE] = 0.04, p = .01, 95% confidence interval [CI]: [0.04, 0.23]) of interventions for the target population. Subset analyses revealed positive, statistically significant intervention effects on measures of pseudoword reading (g = 0.38, SE = 0.07, p = .0003, 95% CI [0.21, 0.54]) and pseudoword reading fluency (g = 0.29, SE = 0.09, p = .010, 95% CI [0.09, 0.49]). Moderator analyses yielded statistically significant, positive effects associated with increased total hours of intervention, β = 0.003, SE = 0.0009, t(8.31) = 3.58, p = .007. Overall, findings indicate a need for interventions that improve generalized real-world reading for the target population.

What was the educational challenge?: Medical students experience high rates of anxiety; frequent examinations are one contributing source. Students may perceive the observed structured clinical examinations (OSCEs) as particularly stressful. Strategies to reduce anxiety during OSCEs have not been described.

What was the solution?: We sought to implement and evaluate a simple, in-the-moment intervention aimed at reducing students' OSCE-related anxiety by making stress-reducing activities available during break stations during a summative pediatric OSCE.

How was the solution implemented?: Three break stations were included in an end-of-rotation, summative OSCE. Students were block-randomized to either control group with standard break stations, or intervention group with stress-reducing activities available in the break room. All participants completed the State-Trait Anxiety Inventory (STAI) before and after the OSCE, and a short questionnaire after OSCE completion.

What lessons were learned that are relevant to a wider global audience?: Third-year medical students have high levels of stress before and after OSCEs. More than half of students in the intervention group felt their anxiety improved with activities. While the inclusion of stress-reducing activities in break stations did not impact exam performance, some students subjectively felt their performance improved. If OSCE break stations are logistically required, they can be employed to allow students to briefly relax during a high-stress exam without negatively impacting performance.

What are the next steps?: Next steps include exploration of opportunities for integration of stress-reducing activities during OSCEs with other learner groups, and identification of other stress-inducing aspects of medical training to provide similar opportunities.

Background: A significant factor of clinicians' learning is based on their ability to effectively transfer acquired knowledge, skills, and attitudes from specialty-specific clinical courses to their working environment.

Material and method: We conducted semi-structured interviews with 20 anaesthesiologist trainees (i.e. residents) in four group and five individual interviews using SRL principles as sensitizing concepts. Data were collected and analyzed iteratively using thematic analysis.

Results: Advanced trainees are highly motivated to explore what they have learned in specialty-specific courses, but they often face several barriers in implementing their learning in the workplace environment. Four themes emerged from the interview data: 'Be ready to learn', "Take the 'take-home-messages' home', "Be ready to create your own opportunities', and "Face it, it's not entirely up to you'. Understanding the challenges regarding transferring knowledge from courses to the working environment is an important lesson for assisting trainees set their learning goals, monitor their progress, and re-evaluate their SRL processes.

Conclusion: Even for advanced trainees, successfully transferring knowledge from specialty-specific courses often requires adequate commitment and support. Medical supervisors and other relevant stakeholders must be aware of their shared responsibility for creating individual environments that support opportunities for trainees to self-regulate their learning.

This multi-case study investigated self-regulation of preservice science teachers’ (PSTs), focusing on their ability to learn from their own teaching experiences and to regulate teaching practices to pose higher-level cognitive questions. The participants were three PSTs enrolled in a certification program for teaching secondary science, representing low, intermediate, and high self-regulated learning (SRL). Data were collected from classroom materials, semi-structured interviews on planning classroom questions, classroom observations, classroom audio recordings, and semi-structured interviews on enacting questions. The findings revealed that while each case exhibited unique characteristics, all PSTs demonstrated improvements in their SRL practices and questioning. The analysis highlighted PSTs’ SRL practices in planning and enacting classroom questions, suggesting ways to enhance PSTs’ questioning skills through the integration of SRL into teacher preparation. Furthermore, the findings underscored the importance of university supervisors and cooperating teachers tailoring their coaching to PSTs based on their initial SRL skills and utilizing well-defined models of SRL development for guidance.

Health professions educators often use social media to share knowledge; however, it is unclear what specific dissemination and knowledge translation (KT) processes are occurring and the implications of this sharing for health professions education (HPE). This study explored how educators have used social media as a mechanism of dissemination and KT in the literature. A critical scoping review methodology, informed by Engeström's Activity Theory, was employed. Twelve databases were searched and studies that: (a) addressed health professions educators; (b) described the use of social media for dissemination or KT; (c) focused on a regulated health profession; (d) focused on undergraduate or graduate education; and (e) were published in English or French between 2011 and 2021 were included. Data were analyzed using numerical and qualitative content analyses. Of the 4859 articles screened, 37 were eligible for inclusion. Social media may facilitate knowledge sharing in HPE, but there is a lack of conceptual clarity on what is meant by 'dissemination' and 'KT'. Who is responsible for sharing knowledge, what knowledge is being shared, and the target audiences are not always clear. Multiple factors (e.g., affordances, opportunity costs) influence how social media is used as a mechanism of dissemination, and it remains unclear whether and how it is used as a mechanism of KT. Concepts like KT and dissemination, which are often borrowed from other disciplines, must be critically evaluated for their relevance and suitability if they are to be appropriately applied to HPE and in particular to social media. Educators looking to use social media to teach students about KT should consider whether this use of technology truly aligns with their stated learning outcomes.