Evaluation & the Health Professions最新文献

Program evaluation is essential for medical schools to demonstrate social accountability and identify areas for improvement in medical education (MEd). Although stakeholder engagement is crucial in program evaluation, no previous review has specifically examined the stakeholders involved in MEd program evaluation. This scoping review addresses this gap by identifying the stakeholders, their roles, and their levels of engagement in evaluating MEd programs, along with the facilitators and barriers to their participation. Through a systematic search across four databases, we identified 53 relevant studies out of 7206 screened. Our findings reveal seven primary stakeholder groups, with students and program directors being the most frequent participants. However, a significant gap exists in the representation of community members and patients, indicating a need for greater inclusion of these key stakeholders. Additionally, we found that stakeholders are primarily engaged as passive participants providing feedback rather than actively shaping the evaluation process. Facilitators and barriers to participation were identified from the participants' perspective, highlighting the need for further research to understand the viewpoints of active stakeholders, such as faculty and administrators. Future studies should also explore the impact of different evaluation approaches on stakeholder engagement to develop more inclusive and effective MEd program evaluations.

This systematic review provides an overview of the unique challenges allied health professions face in the translation and implementation of evidence into practice, which remain relatively under reported and uninformed by a theoretical basis of behaviour change. MEDLINE, EMBASE, CINAHL and Scopus databases from 2010 to 2022 were searched for primary study designs resulting in 21 articles included in this review (PROSPERO: 2022 CRD42022314996). Allied health disciplines reported in the review were mainly from occupational therapy, physiotherapy, dietetics, and speech pathology. The most frequently reported implementation determinants across the Theoretical Domains Framework were identified as 'environmental context and resources', and 'knowledge'. The results also identified a greater influence of 'social influences' and 'beliefs about consequences' in implementation. Implementing evidence into clinical practice is a multifaceted, complex process, and the use of the Theoretical Domains Framework provided a systematic approach to understanding the drivers behind the target behaviours. However, there is a paucity of studies across the allied health professions that describe implementation strategies used and their impact. Many of the studies focused on implementation by the individual clinician rather than the role organizations can play in the translation of evidence into practice.

The goal of maintenance of certification (MOC) activities is to ensure physicians are up to date on current practices and demonstrate the knowledge and skills required to provide patients with optimal care. The program's aim is to promote professional development, lifelong learning and quality assurance for the public and medical community. However, physicians are not happy with the current structure of the program, claiming it to be time-consuming, expensive and ineffective for their practice. The lack of concrete evidence confirming the efficacy of MOC in improving knowledge and clinical outcomes causes many to question how this system can be improved to better serve practitioners and the public. In this commentary, we provide an overview of the current MOC situation for U.S. specialists and highlight the importance of increasing research to inform evidence-based changes that can be applied to clinical situations.

Effective feedback is crucial for educating health professions students. This systematic review investigates the impact of extrinsic feedback on health professions students, encompassing medical, dental, and nursing fields. Through meticulous gathering and analysis of 37 studies, this review highlights verbal and visual feedback as predominant forms, often delivered immediately by instructors and supplemented by peer or simulated input. Notably, technology is increasingly utilised to enhance the provision of feedback. The impacts of feedback span various domains, including surgical skills and patient communication, revealing notable improvements in procedural skills such as suturing and knot-tying, as well as general patient communication proficiency. Meta-analyses underscore significant enhancements in communication skills and provide nuanced insights into chest compression techniques. Overall, the findings provide initial evidence that extrinsic feedback enhances surgical procedural skills and general patient communication proficiency among health professions students. The evolving role of technology in feedback provision is promising. Future studies should assess extrinsic feedback across different health professions to better understand its impacts and alignment with specific educational needs and accreditation standards, thereby enhancing learning outcomes.

This study's purpose was to assess the prevalence and characteristics of highly and poorly rated attending physicians as well as the evaluation's reliability and validity. Medicine residents evaluated attending physicians (2013-2024) on eight teaching domains (clarity, supervision, skills, decision-making, expectations, feedback, approachability and overall effectiveness). Overall teaching effectiveness was dichotomized into "highly rated" (scores of 5) and "poorly rated" (scores of ≤3). We assessed correlates of highly and poorly rated attending physicians using generalized latent and linear and mixed methods. Validity and reliability were assessed using factor analysis, Cronbach's alpha and intra-class correlation coefficients. Among 20,150 evaluations of 668 attending physicians by 814 residents, 67% were rated highly (n = 12,801) and 9% were poorly rated (n = 1,754). Highly rated attendings explained decisions (OR: 5.1, 95% CI: 3.l-7.0), were clear (OR: 3.2, 95% CI: 2.4-4.4), approachable (OR: 2.9, 95% CI: 2.2-3.9) and demonstrated skills (OR: 3.2, 95% CI: 2.4-4.3). Poorly rated attending physicians received multiple poor ratings (74%) and lower scores on all teaching domains. Ratings were reliable and consistent, but had low levels of agreement by residents. We conclude that attending physicians were commonly highly rated. While uncommon, poor ratings are better discriminators of teaching quality than highly rated ones.

Dental education faces a significant challenge in preparing future professionals for a world increasingly driven by Digital Health (DH) innovations. However, it is not known whether or how DH content is being included in the training of future dental teachers in Brazil. This study aimed to evaluate the extent of DH content integration in Brazilian Dentistry Master's programs. From April to June 2023, data from the Sucupira platform and institutional websites were utilized to evaluate all Dentistry Master's programs in Brazil. Statistical analysis assessed the impacts of five factors: geographical location, program type, administrative category, program score, and association with a Teledentistry unit on offering up-to-date content. Out of 92 identified programs, 77 had available documents for analysis. A total of 2,161 courses were found, 1,523 with detailed information. DH curricular content was found in 4 courses. No relationship was observed between the offering of DH and factors like program type (professional or academic) (p = 1.00), university administrative category (public or private) (p = .144), region (p = .638), program quality rating (p = .792), or association with a Teledentistry unit (p = 1.00). These findings highlight a concerning gap in the incorporation of DH-related content into Brazil's dentistry master's programs, underscoring the need to address this deficiency.

The evolving landscape of healthcare necessitates a paradigm shift in professional education, blending clinical expertise with business acumen. This paper delves into the need for healthcare professionals to acquire a comprehensive understanding of both clinical intricacies and business dynamics while examining the emergence of joint degree programs aimed to equip graduates with multifaceted skills required to navigate the complexities our of modern healthcare delivery systems. Drawing from a diverse literature review, this paper highlights the pros and cons of this dual-degree education and the benefits that it brings given today's challenging healthcare landscape. It explores the profound impact of such programs on student outcomes, emphasizing the cultivation of leadership, financial acumen, and strategic thinking alongside clinical competencies. Moreover, it addresses concerns regarding academic rigor and the feasibility of integrating business education into an already demanding healthcare curricula. Analysis of current trends and future projections underscores the growing demand for professionals who possess hybrid skill sets. With healthcare workforce shortages and evolving industry challenges, individuals equipped with both clinical and business proficiencies are poised to lead innovation and drive organizational success.

Self-regulated learning (SRL) plays a pivotal role in medical education. There is a pressing need for a meta-analytical review to comprehensively evaluate the effect sizes of SRL strategies across diverse learning outcomes and levels of medical trainees. A meta-analysis was executed by searching five databases and resulted in 61 studies that met our inclusion criteria. A three-level meta-analysis was performed to examine the association between SRL strategies and various levels of learning outcomes (i.e., affective, cognitive, and behavioral learning outcomes). Moderator analyses were conducted using meta-regression, considering factors such as types of learning outcomes, training levels, SRL subscales, and quality of the studies. The analysis yielded an average effect size of .212, using Pearson's correlation coefficient, demonstrating a positive and significant association between SRL strategies and overall learning outcomes. Although our moderator analyses indicated that SRL subscales and study quality did not significantly influence the relationship between SRL strategies and learning outcomes, SRL strategies had a more pronounced effect on affective outcomes than on test scores, behavioral outcomes, and mental health outcomes. In addition, the association between SRL strategies and learning outcomes were significantly higher among the clerkship phase of undergraduate medical education than the pre-clerkship phase.

Role modelling is important in developing professionalism with a need for reliable, evidence-based tools to assess professionalism in the learning environment (LE). The Learning Environment for Professionalism (LEP) survey is brief, anonymous and balanced assessing medical trainees' and attendings' positive and negative professionalism behaviours that can be tracked longitudinally and identify problem areas in the LE. Seven training programs agreed to facilitate administration of the LEP survey at four hospitals in Ottawa, Canada. The survey was carried out iteratively between 2013 and 2020. A total of 3783 LE ratings of training programs and hospitals were assessed longitudinally using univariate linear regression. A Bonferroni corrected p-value of ≤.0045 was used to account for multiple comparisons. Positive professional behaviours were observed across time with some of the negative behaviors having improved. A negative signal was found, with attendings appearing to be treating patients unfairly because of their financial status, ethnic background, sexual or religious preferences. Applying LEP survey longitudinally across diverse training programs and institutions is feasible and may assist programs to identify areas requiring attention and acknowledging areas of exemplary professionalism. Continuous monitoring of LE to meet requirements of accrediting bodies can also be considered an important quality improvement metric.

The general population struggles to meet physical activity recommendations, risking mental and physical health. Validated, culturally adapted tools are essential for identifying barriers and implementing effective, context-specific strategies to promote exercise participation. Despite its wide use, the cross-cultural equivalence, and psychometric properties of the Barriers to Being Active Quiz (BBAQ) have not been confirmed. The purpose of this study was to validate the BBAQ cross-culturally into European Spanish (BBAQ-ES). Following international guidelines, the BBAQ underwent a systematic four-step process involving a multidisciplinary translation, synthesis, reconciliation, review, and a population-based comprehensibility test. Measurement properties-including structural and construct validity, and internal consistency, measurement error and test-retest reliability-were assessed following COSMIN guidelines on a sample of 589 Spanish University students. The IPAQ-SF was used as comparator instrument during hypothesis testing for construct validity (i.e. convergent, and discriminative validity). The BBAQ-ES demonstrates strong cross-cultural equivalence and good measurement properties (RMSEA = 0.0485, CFI = 0.946; Cronbach's alpha = 0.875; ICC = 0.724 -0.878; confirmed hypotheses testing >75%). The BBAQ-ES is a cross-culturally adapted, reliable and valid measure to assess multidimensional obstacles to physical activity. This study provides valuable new insights for international research and clinical practice.