Journal of Continuing Education in the Health Professions最新文献

Introduction: Open-ended feedback from learners offers valuable insights for adapting continuing health education to their needs; however, this feedback is burdensome to analyze with qualitative methods. Natural language processing offers a potential solution, but it is unclear which methods provide useful insights. We evaluated natural language processing methods for analyzing open-ended feedback from continuing professional development training at a psychiatric hospital.

Methods: The data set consisted of survey responses from staff participants, which included two text responses on how participants intended to use the training ("intent to use"; n = 480) and other information they wished to share ("open-ended feedback"; n = 291). We analyzed "intent-to-use" responses with topic modeling, "open-ended feedback" with sentiment analysis, and both responses with large language model (LLM)-based clustering. We examined outputs of each approach to determine their value for deriving insights about the training.

Results: Our results indicated that because the "intent-to-use" responses were short and lacked diversity, topic modeling was not useful in differentiating content between the topics. For "open-ended feedback," sentiment scores did not accurately reflect the valence of responses. The LLM-based clustering approach generated meaningful clusters characterized by semantically similar words for both responses.

Discussion: LLMs may be a useful approach for deriving insights from learner feedback because they capture context, making them capable of distinguishing between responses that use similar words to convey different topics. Future directions involve exploring other methods involving LLMs, or examining how these methods fare on other data sets or types of learner feedback.

Introduction: This study evaluated the impact of F inancial and I nsurance N avigation Assist ance- Train ing - a pilot interprofessional training program to facilitate cost of care (CoC) conversations and address health-harming social determinants of health in a pediatric hematology-oncology clinic.

Methods: A pre-post study design was used to evaluate the impact of F inancial and I nsurance N avigation Assist ance- Train ing on an interprofessional health care team's (clinicians, social workers, financial navigator, and legal advocates) knowledge, attitudes, and behaviors related to CoC conversations and screening, referring, and collaborating with interprofessional team members. Data were collected via surveys administered at baseline/pretraining, immediate post-training, and 12-month post-training.

Results: Most health care team members (n= 21) reported improvement in their knowledge of available financial (66.7%) and legal resources (86.7%) and ability to address social needs (93.3%), financial needs (93.3%), and facilitate CoC conversations with patients and caregivers (66.7%).

Discussion: Improvements in attitudes and behaviors toward engaging in CoC conversations, screenings, and referrals were relatively improved as a result of the training. However, there was a lower positive rate for actual behaviors around routine screening and initiating discussions on out-of-pocket costs, suggesting a need to address barriers. Study findings highlight the importance of interprofessional education in helping health care teams address social determinants of health through effective CoC conversations.

Introduction: Advances in genomics are transforming clinical practice, but there are too few genetics professionals to meet increasing demand. Moreover, many nongeneticist clinicians feel unprepared to incorporate genetics into practice. This study assessed clinicians' unmet genomics educational needs at a single academic institution.

Methods: Qualitative interviews with Department and Division leaders informed a survey distributed to all clinicians at the institution. Survey questions focused on current practices, confidence, and desired educational resources around genetics and genomics. Data were analyzed using descriptive statistics and Fisher exact tests. Results were shared with an expert panel of Genetics-Genomics Champions to help meet educational needs across specialties.

Results: Of the 215 survey respondents, 72% were faculty, 24% were trainees, and 4% were clinical staff, representing 18 departments. Less than half felt confident using genetics in the clinic. About 81% desired more training, which did not differ by role ( P = .27) or department ( P = .98). The Genetics-Genomics Champions proposed delivering just-in-time content via e-consults, online materials, and departmental meetings.

Discussion: This study highlights clinicians' need and desire for more genetics training. It also underscores the importance of consulting genetics-savvy clinicians to identify challenges and solutions for addressing cross-specialty genetics education needs.

Abstract: The science of learning (learning science) is an interprofessional field that concerns itself with how the brain learns and remembers important information. Learning science has compiled a set of evidence-based strategies, such as distributed practice, retrieval practice, interleaving, and elaboration, which are quite relevant to continuing professional development (CPD). Spreading out study and practice separated by cognitive breaks (distributed practice), testing oneself to check mastery and memory of previously learned information (retrieval practice), mixing the learning of separate but associated information (interleaving), and making connections between concepts one is trying to learn and other known concepts (elaboration) represent strategies that are underused in CPD. Participants and planners alike can benefit from learning science recommendations to inform their decisions. Contextual learning, the subject of this article, is another evidence-based strategy that supports the study and practice of important information. By better understanding how the context in which one learns later affects retention and performance, CPD participants and planners can make more informed educational decisions.

Abstract: Academies highlight the educational mission that is often second to clinical and basic science scholarship on health professions campuses. They help bridge the gap between faculty development and continuing professional development. Owing to their popularity, academies have proliferated across the United States and Canada during the past 3 decades. Yet the evidence of the extent to which academies have had impact on their organizations remains largely underdeveloped. In this article, the authors used logic modeling as a framework to align the research mission, programming, and longitudinal goals of the Duke Academy for Health Professions, Education and Academic Development across the span of a decade. Furthermore, we used bibliometric analysis as a program evaluation tool. Through three different case examples, we share how bibliometrics may be used to track faculty publications in health professions education journals and to assess the impact of an academy's investment on its members and the institution at large. Finally, we illustrate that longitudinal implementation of scholarship and grants programming can be an effective strategy for fostering the development of health professions education research and encouraging scholarly innovation.

Introduction: Sex and racial/ethnic disparities in academic medicine are an intractable and inordinate reality. The purpose of our study was to analyze the 56-year trends in sex and racial/ethnic demographics in academic dermatology in the United States.

Methods: Data from the Association of American Medical Colleges Faculty Roster between 1966 and 2021 were analyzed to trend the representation of sex and race/ethnicity by academic ranks, leadership positions, and tenure statuses using linear regression. In addition, differences in representation using 56-year means were assessed using the Mann-Whitney test for sex and Kruskal-Wallis test followed by the Dunn multiple comparisons test for race/ethnicity.

Results: In 2021, academic dermatologists were 66.71% (1072/1607) White, 20.97% (337/1607) Asian, 2.86% (46/1607) Black, and 2.49% (40/1607) Hispanic. From 1966 to 2021, the total number of academic dermatologists increased from 107 to 1607 [mean +26.92 (95% CI 25.15-28.70) per year, P < .001]. Specifically, annual proportional increases for groups were women +0.93 (0.90-0.96)% ( P < .001); Asians +0.38 (0.34-0.42)% ( P < .001); Blacks +0.01 (0.01-0.02)% ( P < .001); and Hispanics +0.01 (0-0.02)% ( P = .001).

Discussion: Despite these increasing trends, in 2021, the most recent year for which data were provided, there remained a far greater proportion of male and/or White physicians in senior academic ranks (65.35% male and 75.85% White professors), leadership positions (79.52% male and 66.27% White chairpersons), and tenure (67.17% male and 77.78% White). Although there have been efforts to improve diversity and inclusion in academic dermatology over the 56-year study period, sex and racial/ethnic disparities persist.

Introduction: Health care providers (HCPs) use reflection to intervene in complex, ambiguous clinical situations. Yet, there is scant evidence about the circumstances when HCPs use reflection and how they perceive reflection within their continuing professional development. We selected a narrative inquiry approach to study how HCPs perceive reflection's role in learning in four health professions.

Methods: We invited 26 health professionals to a narrative interview conducted by a student in one of the four selected professions: medicine, nursing, occupational therapy, and speech-language pathology. The narrative events that make up the stories were analyzed and interpreted using structural analysis based on the narratives' historic-empirical and psycho-semantic dimensions.

Results: Physicians told us that reflection bolsters their clinical performance and confidence. Nurses told us that reflection allowed them to develop resilience as they sought to integrate their work setting and gain autonomy. Occupational therapists spoke of how reflection spurred them to innovate and extend the scope of their practice to advocate for their patients' health better. Speech-language pathologists described how they reflect on "educating" other HCPs about their profession and enhancing their communication skills with patients.

Discussion: The communicative power of storytelling allowed us to fathom what is hard to describe in words: how reflection builds clinical and psychosocial skills and introspective capacity. Hence, findings provide empirical evidence of reflection's perceived role in maintaining professional skills that make HCPs effective in complex, ambiguous situations.

Introduction: Respiratory therapists (RTs) must apply competencies to address the health care needs of the public. Although all competencies are deemed essential, scholarly practice requires that professionals critically assess their practices, integrate evidence-based literature, and enhance the care they deliver to patients. Though scholarly practice is also associated with professional empowerment, role satisfaction, and improved patient care, it is rarely measured. The purpose of this study was to develop, pilot, and generate preliminary validity evidence of a tool designed to measure scholarly practice among RTs.

Methods: We used DeVellis' nine-step scale development process and exploratory factor analysis to develop the tool. The results of a scoping review and qualitative study were used to generate an item pool and pilot test it with 81 RTs across Canada. The refined tool was tested on a larger sample (n = 832) and analyzed using exploratory factor analysis.

Results: Using principal axis factoring with Promax rotation, we retained 18 items across 4 factors, explaining 56.7% of the variance in the data (31.7%, 10.2%, 8.6%, 6.2%): (Factor 1) professional development and credibility, (Factor 2) elements supporting scholarly practice, (Factor 3) the perceived impact of scholarly activities on practice, and (Factor 4) s cholarly practitioner identity and ability. Internal consistency of the final 18-item scale was suitable overall (Cronbach alpha = 0.879) and for each factor (F1 = 0.888; F2 = 0.774; F3 = 0.842; F4 = 0.746).

Discussion: Our results provide preliminary evidence for a scholarly practice tool that can encourage self-reflection and/or foster peer-based reflection. Using the tool with other health care professionals and conducting confirmatory factor analysis could generate additional validity evidence.

Introduction: According to Self-Determination Theory, when health professionals see their continuing professional development (CPD) efforts as aligned with their intrinsic values (eg, helping others), they may develop a more desirable motivational orientation toward CPD. The aim of this cross-sectional study was to investigate the effect of physicians' values on their CPD motivation.

Methods: Practicing physicians in a single Canadian providence were administered an online survey that assessed their motivation for engaging in CPD, the importance they ascribe to three intrinsic and three extrinsic values, and the extent to which engaging in CPD activities is aligned with intrinsic and extrinsic values.

Results: A total of 122 physicians completed the survey. Seeing CPD activities as contributing to helping others was positively associated with intrinsic regulation, identified regulation, and introjected regulation. Seeing CPD activities as contributing to personal growth was positively associated with identified regulation.

Discussion: As predicted by the Self-Determination Theory, physicians who perceived CPD as aligned with intrinsic values tended to report a more desirable motivational orientation toward CPD. CPD providers can support health professionals' motivation by highlighting connections between CPD activities and intrinsic values in promotional materials.