Pub Date : 2024-12-31Epub Date: 2024-02-07DOI: 10.1080/10872981.2024.2312713
Shahpar Najmabadi, Virginia Valentin, Joanne Rolls, Mary Showstark, Leigh Elrod, Carey Barry, Adam Broughton, Michael Bessette, Trenton Honda
Purpose: Effective communication is critical in patient care. Multilingual medical providers, including Physician Assistants (PAs) can contribute to improved health care among patients with limited English proficiency; however, this is contingent upon matriculating multilingual providers. In this study, the association between prospective applicants' self-reported English as second language (ESL) status and their likelihood of matriculation into a PA program was investigated.
Methods: Participants included applicants to five admission cycles of the Centralized Application Service for Physician Assistant from 2012 to 2020. Logistic regression was utilized to investigate association between applicant ESL status and odds of program matriculation in both bivariate and multivariable regression models. Models were adjusted for citizenship status, undergraduate grade point average, gender, age, race/ethnicity, number of programs applied to, and patient care hours.
Results: In unadjusted and adjusted models, ESL status was associated with a significantly lower odds of matriculation to a PA program across all study years. In adjusted multivariable models, associations were strongest for 2014-2015 where ESL status was associated with a 35% lower odds of matriculation (odds ratio 0.65, 95% confidence interval 0.56, 0.76) when controlling for demographics, citizenship status, patient care experience, and academic achievement. In sensitivity analyses restricting to (a) those with TOEFL scores ≥ 100, and (b) restricting to those ESL applicants without TOEFL scores, we did not observe important changes in our results.
Conclusions: Results indicated that non-native English-speaking applicants have lower odds of PA program matriculation. Decrements in matriculation odds were large magnitude, minimally impacted by adjustment for confounders and persistent across the years. These findings suggest that PA program admission processes may disadvantage non-native English-speaking applicants. While there are potential explanations for the observed findings, they are cause for concern. Matriculating and training PAs who have language concordance with underserved populations are important means of improving patient outcomes.
目的:有效沟通对患者护理至关重要。包括医生助理(PA)在内的多语种医疗服务提供者可以为改善英语水平有限的患者的医疗服务做出贡献;但是,这取决于多语种医疗服务提供者的预科情况。本研究调查了潜在申请者自我报告的英语作为第二语言(ESL)的状况与他们进入助理医师专业学习的可能性之间的关系:参与者包括 2012 年至 2020 年期间五个助理医师集中申请服务录取周期的申请人。在双变量和多变量回归模型中,采用逻辑回归法研究申请者的 ESL 状态与课程预科几率之间的关联。模型根据公民身份、本科平均成绩、性别、年龄、种族/民族、申请的项目数量和病人护理时间进行了调整:在未调整和调整后的模型中,ESL 状态与所有研究年份中较低的 PA 课程入学几率有关。在调整后的多变量模型中,2014-2015 年的相关性最强,在控制人口统计学、公民身份、病人护理经验和学业成绩的情况下,ESL 身份与入学几率降低 35% 相关(几率比 0.65,95% 置信区间 0.56,0.76)。在对(a)托福成绩≥100分的申请者和(b)没有托福成绩的ESL申请者进行的敏感性分析中,我们没有观察到结果的重要变化:结果表明,非英语母语的申请者进入 PA 项目的几率较低。入学几率的下降幅度很大,受混杂因素调整的影响很小,并且在不同年份持续存在。这些研究结果表明,专业录取过程可能会对母语非英语的申请者不利。虽然观察到的结果有可能是有原因的,但也值得关注。培养和培训与服务不足人群语言相通的助理医师是改善患者治疗效果的重要手段。
{"title":"Non-native English-speaking applicants and the likelihood of physician assistant program matriculation.","authors":"Shahpar Najmabadi, Virginia Valentin, Joanne Rolls, Mary Showstark, Leigh Elrod, Carey Barry, Adam Broughton, Michael Bessette, Trenton Honda","doi":"10.1080/10872981.2024.2312713","DOIUrl":"10.1080/10872981.2024.2312713","url":null,"abstract":"<p><strong>Purpose: </strong>Effective communication is critical in patient care. Multilingual medical providers, including Physician Assistants (PAs) can contribute to improved health care among patients with limited English proficiency; however, this is contingent upon matriculating multilingual providers. In this study, the association between prospective applicants' self-reported English as second language (ESL) status and their likelihood of matriculation into a PA program was investigated.</p><p><strong>Methods: </strong>Participants included applicants to five admission cycles of the Centralized Application Service for Physician Assistant from 2012 to 2020. Logistic regression was utilized to investigate association between applicant ESL status and odds of program matriculation in both bivariate and multivariable regression models. Models were adjusted for citizenship status, undergraduate grade point average, gender, age, race/ethnicity, number of programs applied to, and patient care hours.</p><p><strong>Results: </strong>In unadjusted and adjusted models, ESL status was associated with a significantly lower odds of matriculation to a PA program across all study years. In adjusted multivariable models, associations were strongest for 2014-2015 where ESL status was associated with a 35% lower odds of matriculation (odds ratio 0.65, 95% confidence interval 0.56, 0.76) when controlling for demographics, citizenship status, patient care experience, and academic achievement. In sensitivity analyses restricting to (a) those with TOEFL scores ≥ 100, and (b) restricting to those ESL applicants without TOEFL scores, we did not observe important changes in our results.</p><p><strong>Conclusions: </strong>Results indicated that non-native English-speaking applicants have lower odds of PA program matriculation. Decrements in matriculation odds were large magnitude, minimally impacted by adjustment for confounders and persistent across the years. These findings suggest that PA program admission processes may disadvantage non-native English-speaking applicants. While there are potential explanations for the observed findings, they are cause for concern. Matriculating and training PAs who have language concordance with underserved populations are important means of improving patient outcomes.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10851801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139703721","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-31Epub Date: 2024-06-06DOI: 10.1080/10872981.2024.2363006
Guillaume Der Sahakian, Maxime de Varenne, Clément Buléon, Guillaume Alinier, Christian Balmer, Antonia Blanié, Bertrand Bech, Anne Bellot, Hamdi Boubaker, Nadège Dubois, Francisco Guevara, Erwan Guillouet, Jean-Claude Granry, Morgan Jaffrelot, François Lecomte, Fernande Lois, Mohammed Mouhaoui, Ollivier Ortolé, Méryl Paquay, Justine Piazza, Marie Pittaco, Patrick Plaisance, Dan Benhamou, Gilles Chiniara, Etienne Rivière
Background: Simulation-based education in healthcare encompasses a wide array of modalities aimed at providing realistic clinical experiences supported by meticulously designed scenarios. The French-speaking Society for Simulation in Healthcare (SoFraSimS) has developed guidelines to assist educators in the design of scenarios for manikin- or simulated participant- based immersive simulation and procedural simulation, the three mainly used modalities.
Methods: After establishing a French-speaking group of experts within the SoFraSimS network, we performed an extensive literature review with theory-informed practices and personal experiences. We used this approach identify the essential criteria for practice-based scenario design within the three simulation modalities.
Results: We present three comprehensive templates for creating innovative scenarios and simulation sessions, each tailored to the specific characteristics of a simulation modality. The SoFraSimS templates include five sections distributed between the three modalities. The first section contextualizes the scenario by describing the practicalities of the setting, the instructors and learners, and its connection to the educational program. The second section outlines the learning objectives. The third lists all the elements necessary during the preparation phase, describing the educational method used for procedural simulation (such as demonstration, discovery, mastery learning, and deliberate practice). The fourth section addresses the simulation phase, detailing the behaviors the instructor aims to analyze, the embedded triggers, and the anticipated impact on simulation proceedings (natural feedback). This ensures maximum control over the learning experience. Finally, the fifth section compiles elements for post-simulation modifications to enhance future iterations.
Conclusion: We trust that these guidelines will prove valuable to educators seeking to implement simulation-based education and contribute to the standardization of scenarios for healthcare students and professionals. This standardization aims to facilitate communication, comparison of practices and collaboration across different learning and healthcare institutions.
{"title":"The 2024 French guidelines for scenario design in simulation-based education: manikin-based immersive simulation, simulated participant-based immersive simulation and procedural simulation.","authors":"Guillaume Der Sahakian, Maxime de Varenne, Clément Buléon, Guillaume Alinier, Christian Balmer, Antonia Blanié, Bertrand Bech, Anne Bellot, Hamdi Boubaker, Nadège Dubois, Francisco Guevara, Erwan Guillouet, Jean-Claude Granry, Morgan Jaffrelot, François Lecomte, Fernande Lois, Mohammed Mouhaoui, Ollivier Ortolé, Méryl Paquay, Justine Piazza, Marie Pittaco, Patrick Plaisance, Dan Benhamou, Gilles Chiniara, Etienne Rivière","doi":"10.1080/10872981.2024.2363006","DOIUrl":"10.1080/10872981.2024.2363006","url":null,"abstract":"<p><strong>Background: </strong>Simulation-based education in healthcare encompasses a wide array of modalities aimed at providing realistic clinical experiences supported by meticulously designed scenarios. The French-speaking Society for Simulation in Healthcare (SoFraSimS) has developed guidelines to assist educators in the design of scenarios for manikin- or simulated participant- based immersive simulation and procedural simulation, the three mainly used modalities.</p><p><strong>Methods: </strong>After establishing a French-speaking group of experts within the SoFraSimS network, we performed an extensive literature review with theory-informed practices and personal experiences. We used this approach identify the essential criteria for practice-based scenario design within the three simulation modalities.</p><p><strong>Results: </strong>We present three comprehensive templates for creating innovative scenarios and simulation sessions, each tailored to the specific characteristics of a simulation modality. The SoFraSimS templates include five sections distributed between the three modalities. The first section contextualizes the scenario by describing the practicalities of the setting, the instructors and learners, and its connection to the educational program. The second section outlines the learning objectives. The third lists all the elements necessary during the preparation phase, describing the educational method used for procedural simulation (such as demonstration, discovery, mastery learning, and deliberate practice). The fourth section addresses the simulation phase, detailing the behaviors the instructor aims to analyze, the embedded triggers, and the anticipated impact on simulation proceedings (natural feedback). This ensures maximum control over the learning experience. Finally, the fifth section compiles elements for post-simulation modifications to enhance future iterations.</p><p><strong>Conclusion: </strong>We trust that these guidelines will prove valuable to educators seeking to implement simulation-based education and contribute to the standardization of scenarios for healthcare students and professionals. This standardization aims to facilitate communication, comparison of practices and collaboration across different learning and healthcare institutions.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11164058/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141285019","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-31Epub Date: 2024-02-06DOI: 10.1080/10872981.2024.2311481
Julie Blaszczak, Sara Wiener, Melissa Plegue, Dan Shumer, John Shatzer, Anita Hernandez
Background and objectives: It is well established that provider lack of knowledge in the field of transgender and nonbinary health is as ignificant barrier to care and that training in this area is lacking. This study examined how family medicine residents' self-confidence and medical knowledge in providing gender-affirming care changed after completing a novel, online curriculum on transgender and nonbinary care.
Methods: Thirty-nine family medicine residents were invited to complete the curriculum. Change inself-confidence was determined by the difference in scores on a Likert scale on a pre- and post-survey. Change in medical knowledge was assessed by examining the difference between pre- and post-test scores on a novel multiple-choice examination.
Results: Only 7% of current residents agreed that their current training is adequate in order to provide comprehensive primary care to transgender and nonbinary people. After completion of the curriculum, 100% of participants felt at least somewhat confident providing primary care to transgender and nonbinary people, including hormone therapy. Average medical knowledge post-test scores trended higher than the pre-test results (mean (SD) at pre = 11.2 (1.4) vs post = 14.6 (2.8)).
Conclusions: An online, self-directed curriculum on caring for transgender and nonbinary patients in the primary care setting, including management of gender-affirming hormone therapy, has the potential to increase confidence and knowledge in this field, decreasing barriers to care for this population.
{"title":"Evaluating the effectiveness of an online curriculum on caring for transgender and nonbinary patients.","authors":"Julie Blaszczak, Sara Wiener, Melissa Plegue, Dan Shumer, John Shatzer, Anita Hernandez","doi":"10.1080/10872981.2024.2311481","DOIUrl":"10.1080/10872981.2024.2311481","url":null,"abstract":"<p><strong>Background and objectives: </strong> It is well established that provider lack of knowledge in the field of transgender and nonbinary health is as ignificant barrier to care and that training in this area is lacking. This study examined how family medicine residents' self-confidence and medical knowledge in providing gender-affirming care changed after completing a novel, online curriculum on transgender and nonbinary care.</p><p><strong>Methods: </strong>Thirty-nine family medicine residents were invited to complete the curriculum. Change inself-confidence was determined by the difference in scores on a Likert scale on a pre- and post-survey. Change in medical knowledge was assessed by examining the difference between pre- and post-test scores on a novel multiple-choice examination.</p><p><strong>Results: </strong>Only 7% of current residents agreed that their current training is adequate in order to provide comprehensive primary care to transgender and nonbinary people. After completion of the curriculum, 100% of participants felt at least somewhat confident providing primary care to transgender and nonbinary people, including hormone therapy. Average medical knowledge post-test scores trended higher than the pre-test results (mean (SD) at pre = 11.2 (1.4) vs post = 14.6 (2.8)).</p><p><strong>Conclusions: </strong>An online, self-directed curriculum on caring for transgender and nonbinary patients in the primary care setting, including management of gender-affirming hormone therapy, has the potential to increase confidence and knowledge in this field, decreasing barriers to care for this population.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10848997/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139698561","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: In 2020, the American Osteopathic Association merged its residency programs into one system under the Accreditation Council for Graduate Medical Education (ACGME). The effects of this transition on the ophthalmology match is not fully understood. The purpose of this study is to assess the early impact of the transition to ACGME accreditation on MD, DO, and IMG representation in ophthalmology residency programs.
Materials and methods: Information about resident medical degree and resident medical school was gathered from ophthalmology residency program websites from a resident class before and after the Transition. Additionally, the medical degree of residency program directors (PD) was collected to analyze MD vs DO leadership in ophthalmology residency programs and to further stratify resident data to identify any trends in PD preference for different medical graduates.
Results: Data was obtained for 915 ophthalmology residents in 110 residency programs that met the study's inclusion criteria. Of these programs, 102 were allopathic with MD leadership, 1 was allopathic with DO leadership, 3 were osteopathic with MD leadership, and 4 were osteopathic with DO leadership. Overall, MD representation increased while DO and IMG representation decreased although not significantly. For both classes analyzed, DO and IMG representation was disproportionately low.
Discussion: The transition to ACGME accreditation seems to have primarily harmed DO and IMG applicants in the ophthalmology match while benefitting MDs. Various factors such as loss of protected residency positions for DO applicants and the closure of osteopathic ophthalmology residency programs are likely reasons to blame for this decrease in osteopathic representation.
{"title":"Characterizing the initial effects of the single accreditation system merge on the ophthalmology residency match.","authors":"Forrest Bohler, Allison Garden, Christian J Santiago, Lily Bohler, Varna Taranikanti","doi":"10.1080/10872981.2024.2307124","DOIUrl":"10.1080/10872981.2024.2307124","url":null,"abstract":"<p><strong>Introduction: </strong>In 2020, the American Osteopathic Association merged its residency programs into one system under the Accreditation Council for Graduate Medical Education (ACGME). The effects of this transition on the ophthalmology match is not fully understood. The purpose of this study is to assess the early impact of the transition to ACGME accreditation on MD, DO, and IMG representation in ophthalmology residency programs.</p><p><strong>Materials and methods: </strong>Information about resident medical degree and resident medical school was gathered from ophthalmology residency program websites from a resident class before and after the Transition. Additionally, the medical degree of residency program directors (PD) was collected to analyze MD vs DO leadership in ophthalmology residency programs and to further stratify resident data to identify any trends in PD preference for different medical graduates.</p><p><strong>Results: </strong>Data was obtained for 915 ophthalmology residents in 110 residency programs that met the study's inclusion criteria. Of these programs, 102 were allopathic with MD leadership, 1 was allopathic with DO leadership, 3 were osteopathic with MD leadership, and 4 were osteopathic with DO leadership. Overall, MD representation increased while DO and IMG representation decreased although not significantly. For both classes analyzed, DO and IMG representation was disproportionately low.</p><p><strong>Discussion: </strong>The transition to ACGME accreditation seems to have primarily harmed DO and IMG applicants in the ophthalmology match while benefitting MDs. Various factors such as loss of protected residency positions for DO applicants and the closure of osteopathic ophthalmology residency programs are likely reasons to blame for this decrease in osteopathic representation.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10810612/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139543110","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-31Epub Date: 2024-03-06DOI: 10.1080/10872981.2024.2322223
Levent Çetinkaya, I Lke Keser, Serkan Yildirim, Hafize Keser
This mixed-method study aims to determine the effect of the use of mobile virtual patient application with narrated case-based virtual patients as an assistive technology on students' clinical reasoning skills. It makes a notable contribution by exploring the impact of mobile virtual patient applications on healthcare students' clinical skills and their preparation for real-world patient care. In addition, the accuracy of the analysis results regarding the effect on student achievement was analyzed with a second dataset tool, and thus, aiming to increase reliability by verifying the same research question with a different quantitative analysis technique. In the qualitative part of the study, students' views on the implementation were collected through an open-ended questionnaire and the data were subjected to content analysis. An achievement test was also developed to determine the development of students' clinical reasoning skills, which revealed that each of the learning environments had different outcomes regarding students' achievement and that supporting the traditional environment with the mobile virtual patient application yielded better results for increasing students' achievement. Students' opinions about the mobile virtual patient application and the process also support the increase in academic achievement aimed at measuring clinical reasoning skills. The content analysis showed that the students, who generally reported multiple positive factors related to the application, thought that the stories and cases presented created a perception of reality, and they especially highlighted the contribution of the application to learning the story organization. Based on all these results, it can be said that the application supports clinical reasoning, provides practical experience, improves academic achievement, and contributes positively to motivation.
{"title":"The effect of case-based mobile virtual patient application on students' academic achievement in clinical reasoning skills.","authors":"Levent Çetinkaya, I Lke Keser, Serkan Yildirim, Hafize Keser","doi":"10.1080/10872981.2024.2322223","DOIUrl":"10.1080/10872981.2024.2322223","url":null,"abstract":"<p><p>This mixed-method study aims to determine the effect of the use of mobile virtual patient application with narrated case-based virtual patients as an assistive technology on students' clinical reasoning skills. It makes a notable contribution by exploring the impact of mobile virtual patient applications on healthcare students' clinical skills and their preparation for real-world patient care. In addition, the accuracy of the analysis results regarding the effect on student achievement was analyzed with a second dataset tool, and thus, aiming to increase reliability by verifying the same research question with a different quantitative analysis technique. In the qualitative part of the study, students' views on the implementation were collected through an open-ended questionnaire and the data were subjected to content analysis. An achievement test was also developed to determine the development of students' clinical reasoning skills, which revealed that each of the learning environments had different outcomes regarding students' achievement and that supporting the traditional environment with the mobile virtual patient application yielded better results for increasing students' achievement. Students' opinions about the mobile virtual patient application and the process also support the increase in academic achievement aimed at measuring clinical reasoning skills. The content analysis showed that the students, who generally reported multiple positive factors related to the application, thought that the stories and cases presented created a perception of reality, and they especially highlighted the contribution of the application to learning the story organization. Based on all these results, it can be said that the application supports clinical reasoning, provides practical experience, improves academic achievement, and contributes positively to motivation.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10919315/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140040614","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-31Epub Date: 2024-03-22DOI: 10.1080/10872981.2024.2331852
Thomas Soroski, Kuda Hove, Lisa Steblecki, Jaime C Yu
Background: Simulated cases are widely used in medical education to develop clinical reasoning skills and discuss key topics around patient care. Such cases present an opportunity to demonstrate real world encounters with diverse patient and health provider identities, impacts of social and structural determinants of health, and demonstrate a generalist approach to problems. However, despite many calls-to-action for medical schools to better incorporate equity, diversity and inclusion (EDI) and generalism, it remains difficult to evaluate how well these goals are being met.
Methods: A quality improvement project was completed at a single medical school to evaluate the domains of generalism and EDI within simulated cases used in the preclinical curriculum. Generalism was evaluated using the Toronto Generalism Assessment Tool (T-GAT). EDI was evaluated using a locally developed novel tool. Analysis included descriptive statistics and Pearson correlation coefficient.
Results: A total of 49 simulated cases were reviewed. Twelve generalism and 5 EDI items were scored on a 5-point Likert scale, with higher scores indicating better demonstration of generalism or EDI within a case. Average generalism score across all cases was 45.6/60. Average EDI score across all cases was 11.7/25. Only 21/49 cases included representation of one or more diverse identity categories. The most common diverse identity represented was non-white races/ethnicities, and the identity represented the least was diversity in language fluency. Generalism and EDI scores demonstrated a weak positive correlation (R2 = 0.25).
Conclusions: Quantitative evaluation of simulated cases using specific generalism and EDI scoring tools was successful in generating insight into areas of improvement for teaching cases. This approach identified key content areas for case improvement and identities that are currently underrepresented in teaching cases. Similar approaches could be feasibly used by other medical schools to improve generalism and EDI in teaching cases or other curricular materials.
背景:模拟病例被广泛应用于医学教育中,以培养临床推理技能和讨论有关病人护理的关键话题。此类病例提供了一个机会,展示现实世界中不同患者和医疗服务提供者的身份、社会和结构性健康决定因素的影响,并展示解决问题的通才方法。然而,尽管很多人呼吁医学院采取行动,更好地融入公平、多样性和包容性(EDI)以及通才主义,但仍然很难评估这些目标的实现情况:方法:在一所医学院完成了一项质量改进项目,以评估临床前课程模拟病例中的通识性和 EDI 领域。采用多伦多通识评估工具(T-GAT)对通识进行评估。EDI使用当地开发的一种新型工具进行评估。分析包括描述性统计和皮尔逊相关系数:共审查了 49 个模拟病例。12个通性项目和5个EDI项目采用5点李克特量表进行评分,分数越高,表明病例中的通性或EDI表现越好。所有病例的通用性平均得分为 45.6/60。所有案例的平均 EDI 得分为 11.7/25。只有 21/49 个案例包含一个或多个不同身份类别的代表。最常见的多元化身份是非白人种族/族裔,最少的多元化身份是语言流利程度。通用性与 EDI 分数呈弱正相关(R2 = 0.25):使用特定的通用性和 EDI 评分工具对模拟案例进行定量评估,成功地深入了解了案例教学的改进领域。这种方法确定了案例改进的关键内容领域,以及目前在教学案例中代表性不足的身份。其他医学院校也可以采用类似的方法来改进教学病例或其他课程材料中的通识性和EDI。
{"title":"Evaluating the domains of generalism and equity, diversity and inclusion in preclinical simulated cases for targeted curricular improvements.","authors":"Thomas Soroski, Kuda Hove, Lisa Steblecki, Jaime C Yu","doi":"10.1080/10872981.2024.2331852","DOIUrl":"10.1080/10872981.2024.2331852","url":null,"abstract":"<p><strong>Background: </strong>Simulated cases are widely used in medical education to develop clinical reasoning skills and discuss key topics around patient care. Such cases present an opportunity to demonstrate real world encounters with diverse patient and health provider identities, impacts of social and structural determinants of health, and demonstrate a generalist approach to problems. However, despite many calls-to-action for medical schools to better incorporate equity, diversity and inclusion (EDI) and generalism, it remains difficult to evaluate how well these goals are being met.</p><p><strong>Methods: </strong>A quality improvement project was completed at a single medical school to evaluate the domains of generalism and EDI within simulated cases used in the preclinical curriculum. Generalism was evaluated using the Toronto Generalism Assessment Tool (T-GAT). EDI was evaluated using a locally developed novel tool. Analysis included descriptive statistics and Pearson correlation coefficient.</p><p><strong>Results: </strong>A total of 49 simulated cases were reviewed. Twelve generalism and 5 EDI items were scored on a 5-point Likert scale, with higher scores indicating better demonstration of generalism or EDI within a case. Average generalism score across all cases was 45.6/60. Average EDI score across all cases was 11.7/25. Only 21/49 cases included representation of one or more diverse identity categories. The most common diverse identity represented was non-white races/ethnicities, and the identity represented the least was diversity in language fluency. Generalism and EDI scores demonstrated a weak positive correlation (R<sup>2</sup> = 0.25).</p><p><strong>Conclusions: </strong>Quantitative evaluation of simulated cases using specific generalism and EDI scoring tools was successful in generating insight into areas of improvement for teaching cases. This approach identified key content areas for case improvement and identities that are currently underrepresented in teaching cases. Similar approaches could be feasibly used by other medical schools to improve generalism and EDI in teaching cases or other curricular materials.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10962297/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140186002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-31Epub Date: 2024-03-25DOI: 10.1080/10872981.2024.2333618
Ann-Kathrin Schindler, Mareike Schimmel, Melissa Oezsoy, Thomas Rotthoff
Background: Teacher identity is defined as a continuum of a person's self-conviction ('Identity is something I have') and a context-dependent action ('Identity is something I do in a context') (Lankveld et al. 2021). It has been identified a relevant contributor to physicians' teaching commitment. In this study, we further improve the currently only existing questionnaire instrument (37 items) measuring physicians' teacher identity.
Methods: Survey data on 147 clinicians at a German university hospital were (1) analyzed by confirmatory factor analysis (CFA). We tested (a) the model fits of the originally suggested scales and (b) potential for improvement of model fits by item reduction. As this could not reveal satisfactory fits for all scales, we (2) applied a principal axis factoring as an exploratory approach. Last, we combined findings from (1) and (2) with a theoretical item content discussion and suggest (3) reassembled scales which were again checked using CFA.
Findings: (1a) Two scales from the original instrument were successfully confirmed. (1b) Some scales benefited from item reduction. (2) The exploratory analysis identified three factors that explained at least 5% variance. (3) By integrating confirmatory and exploratory findings with a content analysis of the items, we propose a partially rearranged questionnaire instrument, comprising seven scales: (1) Feeling intrinsic satisfaction from teaching; (2) Feeling responsibility to teach; (3) Exchange of teaching experience; (4) Identification and enjoyment of the teaching role; (5) Development of teaching; (6) Teaching self-concept of ability; (7) Desired rewards for teaching. Four items were kept as single items.
Conclusion: We suggest that when assessing teacher identity in physicians, all items should be constructed to allow for responses, even from physicians who are presently not actively involved in teaching. The scales benefited from categorizing items based on the continuum of teacher identity as outlined by van Lankveld et al. (2021).
{"title":"Measuring teacher identity of physicians - a validation study of a questionnaire instrument.","authors":"Ann-Kathrin Schindler, Mareike Schimmel, Melissa Oezsoy, Thomas Rotthoff","doi":"10.1080/10872981.2024.2333618","DOIUrl":"10.1080/10872981.2024.2333618","url":null,"abstract":"<p><strong>Background: </strong>Teacher identity is defined as a continuum of a person's self-conviction ('Identity is something I have') and a context-dependent action ('Identity is something I do in a context') (Lankveld et al. 2021). It has been identified a relevant contributor to physicians' teaching commitment. In this study, we further improve the currently only existing questionnaire instrument (37 items) measuring physicians' teacher identity.</p><p><strong>Methods: </strong>Survey data on 147 clinicians at a German university hospital were (1) analyzed by confirmatory factor analysis (CFA). We tested (a) the model fits of the originally suggested scales and (b) potential for improvement of model fits by item reduction. As this could not reveal satisfactory fits for all scales, we (2) applied a principal axis factoring as an exploratory approach. Last, we combined findings from (1) and (2) with a theoretical item content discussion and suggest (3) reassembled scales which were again checked using CFA.</p><p><strong>Findings: </strong>(1a) Two scales from the original instrument were successfully confirmed. (1b) Some scales benefited from item reduction. (2) The exploratory analysis identified three factors that explained at least 5% variance. (3) By integrating confirmatory and exploratory findings with a content analysis of the items, we propose a partially rearranged questionnaire instrument, comprising seven scales: (1) Feeling intrinsic satisfaction from teaching; (2) Feeling responsibility to teach; (3) Exchange of teaching experience; (4) Identification and enjoyment of the teaching role; (5) Development of teaching; (6) Teaching self-concept of ability; (7) Desired rewards for teaching. Four items were kept as single items.</p><p><strong>Conclusion: </strong>We suggest that when assessing teacher identity in physicians, all items should be constructed to allow for responses, even from physicians who are presently not actively involved in teaching. The scales benefited from categorizing items based on the continuum of teacher identity as outlined by van Lankveld et al. (2021).</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10964827/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140207945","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-31Epub Date: 2023-12-05DOI: 10.1080/10872981.2023.2289262
Rebecca Miller-Kuhlmann, Marzena Sasnal, Carl A Gold, Aussama K Nassar, James R Korndorffer, Sandrijn Van Schaik, Andrea Marmor, Sarah Williams, Rebecca Blankenburg, Caroline E Rassbach
This article provides structure to developing, implementing, and evaluating a successful coaching program that effectively meets the needs of learners. We highlight the benefits of coaching in medical education and recognize that many educators desiring to build coaching programs seek resources to guide this process. We align 12 tips with Kern's Six Steps for Curriculum Development and integrate theoretical frameworks from the literature to inform the process. Our tips include defining the reasons a coaching program is needed, learning from existing programs and prior literature, conducting a needs assessment of key stakeholders, identifying and obtaining resources, developing program goals, objectives, and approach, identifying coaching tools, recruiting and training coaches, orienting learners, and evaluating program outcomes for continuous program improvement. These tips can serve as a framework for initial program development as well as iterative program improvement.
{"title":"Tips for developing a coaching program in medical education.","authors":"Rebecca Miller-Kuhlmann, Marzena Sasnal, Carl A Gold, Aussama K Nassar, James R Korndorffer, Sandrijn Van Schaik, Andrea Marmor, Sarah Williams, Rebecca Blankenburg, Caroline E Rassbach","doi":"10.1080/10872981.2023.2289262","DOIUrl":"10.1080/10872981.2023.2289262","url":null,"abstract":"<p><p>This article provides structure to developing, implementing, and evaluating a successful coaching program that effectively meets the needs of learners. We highlight the benefits of coaching in medical education and recognize that many educators desiring to build coaching programs seek resources to guide this process. We align 12 tips with Kern's Six Steps for Curriculum Development and integrate theoretical frameworks from the literature to inform the process. Our tips include defining the reasons a coaching program is needed, learning from existing programs and prior literature, conducting a needs assessment of key stakeholders, identifying and obtaining resources, developing program goals, objectives, and approach, identifying coaching tools, recruiting and training coaches, orienting learners, and evaluating program outcomes for continuous program improvement. These tips can serve as a framework for initial program development as well as iterative program improvement.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10783821/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138488772","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-31Epub Date: 2024-01-09DOI: 10.1080/10872981.2024.2302231
Yung-Fu Wang, Ya-Fang Hsu, Kwo-Ting Fang, Liang-Tseng Kuo
Background: Gamification has gained popularity in medical education, but key elements have not been formally identified. This study aimed to generate and prioritize a list of key elements of gamification in medical education.
Methods: This study utilized a two-stage approach, including the Delphi method and qualitative interview. Nineteen medical educators with expertise in gamification participated in the Delphi method stage. Experts who had more than three years of experience with gamification in medical education constituted the expert panel. The experts were then asked to rate the gamification elements using the Likert five-point scale through at least two consensus-seeking rounds. Consensus for key elements was predefined as ≥ 51% of respondents rating an element as 'important' or"very important." In the qualitative interview stage, 10 experts provided feedback on the application of these key gamification elements.
Results: Eighteen participants (11 males and 7 females) completed the entire Delphi process for this study. After two rounds of surveys, the consensus was reached on all elements. Thirteen elements scored more than 4 points (37%) and reached the criteria of key elements of gamification in medical education. The top five key elements were integration with instruction objectives, game rules, rapid feedback, fairness, and points/scoring. The thirteen key elements for successful gamification in medical education were further organized into two main categories: (1) gamification design principles and (2) game mechanisms.
Conclusions: Integration with educational objectives, gamification in curriculum design and teaching methods, and balancing between the mechanisms and principles were the three key components for successful gamification. This study explored the gamification key elements, providing practical tips for medical educators in their efforts to gamify medical education. Future studies involving learners could be performed to examine the efficacy of these key elements in gamification.
{"title":"Gamification in medical education: identifying and prioritizing key elements through Delphi method.","authors":"Yung-Fu Wang, Ya-Fang Hsu, Kwo-Ting Fang, Liang-Tseng Kuo","doi":"10.1080/10872981.2024.2302231","DOIUrl":"10.1080/10872981.2024.2302231","url":null,"abstract":"<p><strong>Background: </strong>Gamification has gained popularity in medical education, but key elements have not been formally identified. This study aimed to generate and prioritize a list of key elements of gamification in medical education.</p><p><strong>Methods: </strong>This study utilized a two-stage approach, including the Delphi method and qualitative interview. Nineteen medical educators with expertise in gamification participated in the Delphi method stage. Experts who had more than three years of experience with gamification in medical education constituted the expert panel. The experts were then asked to rate the gamification elements using the Likert five-point scale through at least two consensus-seeking rounds. Consensus for key elements was predefined as ≥ 51% of respondents rating an element as 'important' or\"very important.\" In the qualitative interview stage, 10 experts provided feedback on the application of these key gamification elements.</p><p><strong>Results: </strong>Eighteen participants (11 males and 7 females) completed the entire Delphi process for this study. After two rounds of surveys, the consensus was reached on all elements. Thirteen elements scored more than 4 points (37%) and reached the criteria of key elements of gamification in medical education. The top five key elements were integration with instruction objectives, game rules, rapid feedback, fairness, and points/scoring. The thirteen key elements for successful gamification in medical education were further organized into two main categories: (1) gamification design principles and (2) game mechanisms.</p><p><strong>Conclusions: </strong>Integration with educational objectives, gamification in curriculum design and teaching methods, and balancing between the mechanisms and principles were the three key components for successful gamification. This study explored the gamification key elements, providing practical tips for medical educators in their efforts to gamify medical education. Future studies involving learners could be performed to examine the efficacy of these key elements in gamification.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":null,"pages":null},"PeriodicalIF":4.6,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10778414/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139404821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}