MedEdPublish (2016)最新文献

Virtual reality simulation (VRS) has the potential to disrupt and transform current understandings and practices in simulation-based education in health professions curricula. Recent technological developments, including AI applications, give the learner high levels of immersion into a virtual environment that even more closely mimic the real world than heretofore. At the same time, there are significant obstacles facing educators who strive to integrate VRS into their simulation curricula. We have written a VRS handbook for nurse educators, developed VR scenarios and delivered VRS workshops to undergraduate nursing students. Our twelve tips are aimed at undergraduate curriculum developers and simulation leaders, guiding them on how to support educators in integrating VRS into their curricula. The tips describe key considerations to be addressed in the development and integration of VRS into curricula. The tips are timely, as health professions education is on the cusp of entering technology-enhanced simulation, of which VRS will be a key player.

The assessment of professionalism in healthcare disciplines is a challenging and nuanced topic in medical education. The literature, although continually emerging, remains in its infancy in regards to the role of the assessment of professionalism, appropriate timing for assessment, methods to assess professionalism and the benefits and implications of assessment of professionalism. With emergence of healthcare professionalism in both undergraduate and postgraduate curricula and increasing awareness of professionalism's pertinent role in developing as a healthcare practitioner, the concept of assessing this topic is being discussed regularly in international fora, but as yet there is no consensus decision in how best to proceed. The authors have over a decade of experience researching, promoting and delivering healthcare professionalism education. They presented a roundtable discussion to an international panel of medical educators at an international conference. The attendees represented multiple healthcare disciplines. Breakout rooms and pre-determined introductory questions were used to explore the international consensus on current thinking about assessment in healthcare professionalism. This paper presents these findings as practical tips for educators who are considering introducing or extending their assessment of undergraduate professionalism, all of which were taken from the main themes of the discussion. The aim of the paper is to support educators to think about their stance on this often divisive issue, consider their approaches and focus future research to clarify the remaining unknowns.

Background: The emergence of multiple Severe Acute Respiratory Syndrome-Coronavirus-2 (SARS-CoV-2) variants presented an escalated risk to public health globally and prompted epidemiologic monitoring and classification. Health professionals are vital for patient education regarding Coronavirus Disease 2019 (COVID-19), discussing patient concerns, and providing guidance. Students enrolled in professional healthcare programs benefit from being adept with the evolution and spread of SARS-CoV-2 variants, and a team-based learning module can be helpful for applying foundational concepts to clinical problems.

Methods: This team-based learning (TBL) framework was developed in response to the COVID-19 pandemic and the emergence of viral variants. It was placed at the end of a hematology block within the first semester of year one of the medical school during the academic years 2021-2022. It consists of a 7-question readiness assurance process and a four-question application exercise.

Results: The average score increased from 58.8% (iRAT) to 85.9% (tRAT) (n=104). The post-session survey data showed an increase in students' understanding of the classification of COVID-19 variants and the role of genetic mutations in viral pathogenesis. Qualitative data yielded positive feedback for the session, notably in students' ability to interpret phylogenetic trees and understand the role of variants.

Conclusions: This TBL framework cultivates higher-order thinking skills among medical students and effectively integrates virology, epidemiology, and pathology. Additionally, it provides a framework for developing a robust and up-to-date platform for the discussion of novel variants of COVID-19 or other infectious diseases.

The metaverse is based on immersive technologies such as virtual and augmented reality, body tracking, tactile sensation, etc. A growing number of studies are demonstrating the potential of the metaverse as an attractive resource for learning medicine. However, in practice, medical teachers and students often encounter significant challenges when utilizing the underlying technologies, potentially leading to frustrating learning experiences. A significant part of the teaching time is often devoted to troubleshooting technical issues with the metaverse, and the medical content itself taking a backseat until students become proficient in navigating the metaverse environment. Therefore, it is essential to fit the metaverse's underlying technologies specifically for medical education, minimizing technical hurdles for both teachers and students. In this paper, we deal with this challenge and we present a collection of practical tips that serves as a guide for medical educators making decisions in this emerging field, where they may lack prior experience. Drawing on our observation with a cohort of 776 medical students, we conclude how to effectively identify, design, or implement educational applications tailored for efficient medical learning through the metaverse. Our work may support teachers considering metaverse learning platforms for their classrooms and it is a beneficial reference for the medical education community during the initial stages of implementing the metaverse for teaching.

Introduction: Student centric learning approaches have been reported to be effective in introducing higher order cognitive skills required by the health professionals. However, learners' perceptions must be constructively aligned with new learning interventions to achieve a positive impact on their learning. The aim of this study was to explore the learning experiences of undergraduate dental students with case-based learning in orthodontics.

Methods: A case-based learning model was introduced on orthodontic diagnosis and treatment planning for final year students on a Bachelor of Dentistry programme toward the end of their academic year. A survey was conducted to explore the perceptions and experiences of the participants. The research instrument was based on a previously validated questionnaire and included information on demographics and consisted of 12 items aimed at evaluating the benefits and challenges of cased based learning.

Results: All 67 students in the final-year cohort participated in study, yielding a response rate of 100 percent. Participants across the board perceived CBL to be an effective strategy to learn the subject content and helpful in improving the students' skills in orthodontic diagnosis, treatment planning and team-working. CBL did not pose any significant challenges or barriers to student learning.

Conclusion: Participants reported high acceptance of CBL in orthodontic teaching and learning and a positive impact on their educational experiences. CBL was perceived to be an appropriate strategy to enhance the diagnostic, treatment planning and team-working skills of dental students.

Background: The Occupational English Test (OET) is a globally recognized test for healthcare professionals who speak English as a foreign language (EFL). Although its speaking sub-test criteria are publicly accessible, practical application demands specialized assessor training. The aim of the study was to create a physician-friendly rubric for assessing the English history-taking skills of EFL medical undergraduates inspired by the OET speaking sub-test.

Methods: Informed by the OET criteria, a rubric was tailor-made to assess the English history-taking skills of EFL medical undergraduates studying in Japan. Using this rubric, 14 physicians assessed the English history-taking skills of 134 sixth-year medical undergraduates. We used exploratory factor analysis to ascertain its construct validity, evaluated the instrument's reliability through Cronbach's α and inter-rater reliability with chi-squared tests, and conducted a multiple regression analysis, ensuring adherence to key regression assumptions.

Results: Three key factors were found: linguistic-clinical distinction, communication dynamics, and medical comprehension. The rubric's internal consistency was verified, achieving a Cronbach's α of 0.799. Discrepancies in assessor scores highlighted the need for calibration. Four criteria emerged as vital in assessing the students' performance.

Conclusions: The tailored rubric effectively assesses the English history-taking skills of EFL medical undergraduates.

Introduction: Feedback is an essential component of medical education, enhancing the quality of students' knowledge and skills. However, providing effective feedback, particularly in clinical skills assessments like Objective Structured Clinical Examinations [OSCEs], often poses challenges. This study aimed to evaluate the content of OSCE feedback given to undergraduate medical students over five years.

Methods: A retrospective analysis of 1034 anonymised medical students' OSCE performance was conducted, focusing on written feedback. The written feedback data were randomly selected from OSCE sessions, collected from university assessment records and anonymised for ethical considerations. R software was used to identify the most frequently repeated words in the examiners' feedback text, and word cloud charts were created to visualise the responses.

Results: Word clouds generated from the top 200 most frequently used terms provided visual insights into common descriptive words in feedback comments. The most frequently repeated word over five years was "good," indicative of potentially non-specific feedback.

Discussion: The high frequency of non-specific terms like "good" suggests a need for more specific, constructive feedback. However, such generic terms can offer some positive reinforcement, more than they may be needed to foster significant improvement. As previously proposed in the literature, adopting structured feedback forms may facilitate the delivery of more specific, actionable feedback.

Conclusion: This study emphasises the importance of providing specific, actionable feedback in medical education to facilitate meaningful student development. As medical education continues to evolve, refining feedback processes is crucial for effectively guiding students' growth and skill enhancement. Using structured feedback forms can be a beneficial strategy for improving feedback quality.

Background: Learning outcomes are essential in education, guiding both educators and learners towards desired knowledge, skills, and competencies. The backward design process offers a structured approach to curriculum planning, but its integration with actionable, SMART (Specific, Measurable, Achievable, Relevant, Time-bound) learning outcomes needs further exploration.

Goal: This guide aims to introduce the concept of "A-SMART" learning outcomes and demonstrate their integration into the backward design process, focusing on outcomes that begin with action verbs.

Methods: The guide outlines a three-stage curriculum planning approach: (i) define desired results, (ii) determine acceptable evidence of learning, and (iii) plan learning activities. It emphasizes the importance of starting with action verbs in formulating learning outcomes, aligning with Stage 1 of backward design and facilitating the transition to Stage 2 (assessment development).

Results: By following this guide, educators will acquire tools to develop effective "A-SMART" learning outcomes. This approach immediately advances to Stage 2 of backward design, improving educational practices and ensuring alignment with assessment methods. The guide provides strategies for formulating outcomes that are Action-oriented, Specific, Measurable, Achievable, Relevant, and Time-based.

Conclusions: The integration of A-SMART learning outcomes into the backward design process offers a more cohesive and effective educational framework. This approach enhances clarity for learners, provides guidance for instructors, enables more effective assessments, and improves overall learning experiences. The guide also addresses potential challenges in formulating A-SMART outcomes and suggests solutions, including the use of AI tools for inspiration and critical review.

Purpose: There is a pressing need to address all forms of anti-oppression in medicine, given systemic harm and inequities in care and outcomes for patients and health care professionals from equity-deserving groups. Revising definitions of professionalism used in competency-based education can incorporate new professional competencies for physicians to identify and eliminate the root causes of these inequities. This study redefined the CanMEDS Professionalism definition to centre perspectives of equity-deserving groups.

Methods: In this qualitative study there were two phases. The authors conducted individual semi-structured interviews with participants representing equity-deserving population groups to understand their perspectives on and iteratively build a definition of medical professionalism. Then, the authors undertook a consensus-building process, a modified nominal group technique, using focus groups with community members from equity-deserving groups and healthcare providers to verify findings and arrive at an updated definition of medical professionalism.

Results: Four main themes were identified: 1) healthcare at the margins; 2) equity-oriented domains of professionalism; 3) structural professionalism; and 4) supporting improved professionalism. These themes were incorporated into a consensus-based definition of medical professionalism, with a focus on anti-oppression, anti-racism, accountability, safety, and equity.

Conclusions: The authors propose a new definition of medical professionalism that embeds anti-oppression, including anti-racism, as critical competencies in clinical practice and education.

Despite the Supreme Court's decision on race-based admissions, academic medical centers, medical societies, and accreditation bodies remain committed to recruiting a diverse workforce. Many medical schools and graduate medical education programs created initiatives to expand their census of underrepresented in medicine (UIM) as the key to addressing health care disparities. As a result, an influx of an UIM physician workforce has entered clinical learning environments, often without consideration of the inclusivity of these settings. To create inclusive, safe, and comfortable CLEs, we must first recognize the challenges faced by UIM trainees, students, and faculty and the complex ways in which discrimination manifests. Ultimately, having inclusive CLEs allows all learners, especially those from historically excluded identities, to thrive in their training and working environment, making it essential to retain the diverse workforce necessary. Using case examples, we discuss strategies of inclusivity and ways in which we can maintain clinical learning environments where learners feel safe and supported through their training.