MedEdPublish (2016)最新文献

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.

Background: Despite advocacy from the Association of American Medical Colleges (AAMC) and The Lancet Commission on medicine, Nazism, and the Holocaust, Holocaust education is lacking in medical education. To address this gap, students at Geisinger Commonwealth School of Medicine (GCSOM) viewed an Association of American Medical College (AAMC) webinar about medicine during the Holocaust as part of the required curriculum for first year medical students introduced in 2022.

Methods: As part of their doctoring course, Physician and Patient Centered Care (PPCC), students viewed the AAMC webinar "The legacy of the role of medicine during the Holocaust and its contemporary relevance" and participated in two structured reflections: a written reflection on how webinar topics inform students' professional development and a verbal reflection on learning from the Holocaust to develop a sense of moral courage, advocacy, and activism in medicine. Researchers conducted qualitative analysis of written reflections and analyzed session surveys to determine key themes and impact of the session.

Results: Of the 108 enrolled in PPCC, 59 (54.6%) completed a post session Likert scale survey assessing the impact of the webinar on their personal and professional development. As an average, respondents moderately agreed that the webinar impacted their personal and professional development, with 91% slightly, moderately, or strongly agreeing. Additionally, thematic analysis of required written reflections indicated a majority of students (62.5%) identified the need for additional medical humanities education about the Holocaust and its relevance to medicine.

Conclusion: Holocaust education encourages medical students to bear witness to past medical atrocities and critically assess the profession and their personal-professional growth. Continued structured integration of the Holocaust in medical education supports critical self-reflection and the development of morally courageous physicians who endorse and practice social accountability in medicine.

Mistreatment of students has been historically documented as common in U.S. medical schools, but graduate questionnaire (GQ) data from the Association of American Medical Colleges (AAMC) displays high numbers of students who have experienced mistreatment but not reported the incident. There are many reasons within the literature as to why students do not report their experiences, including fear of academic repercussion or a misunderstanding of what constitutes as mistreatment. Our institution found through GQ data that there was a shortcoming in understanding policies and knowledge of procedures associated with mistreatment, and student focus group responses showed that many students were not confident that their reports would receive follow-up on the part of the institution. These factors led to the formation of a task force to investigate our school's workflow once a report of concern for mistreatment is received and examine measures to increase transparency to the student body that their reports are acted upon. We took measures to place a greater emphasis on communication with students during the mistreatment report workflow, as well as releasing name-blinded data within our weekly student communication emails regarding reports that had been processed and resolved. The results after one year of these efforts saw our GQ percentile data jump from falling between the 10 ^th to 25 ^th percentile to the 90 ^th percentile for student awareness of mistreatment policies and from between the 25 ^th to 50 ^th percentile to between the 75 ^th to 90 ^th percentile for student knowledge of mistreatment procedures. These jumps in GQ figures provide insight for policy changes that could benefit other institutions struggling with building a safe environment for students to confidently report incidents of mistreatment with knowledge that their concerns are important and acted upon.

Interprofessional education is one of the interventions used to increase health care students' motivation for working with older patients. Previous research about such interventions has been conducted without the use of control groups and has given inconclusive results. The objective of the present curricular resource was: Does geriatric paper-based interprofessional education influence students' interest in treating older people? During a one-year period, undergraduate fourth-year medical and third-year nursing students wrote four health care plans for four different paper-based older patient cases. In the intervention group students were paired up in interprofessional couples. In the control group students made the assignment alone. Interest for working with older patients was measured on a 5-point Likert scale before and one year after the intervention. In both groups, no significant change was found. Before-interest score of the interprofessional group was relatively high (3.8) so the non-significant results may be due to a ceiling effect. Nursing students' interest in treating older people at the start of the research was higher than medical students' interest.

Objectives: This study aims to show whether correlation exists between pediatric residency applicants' quantitative scores on the United States Medical Licensing Exam Step 2 Clinical Knowledge examination and their subsequent performance in residency training based on the Accreditation Council for Graduate Medical Education Milestones, which are competency-based assessments that aim to determine residents' ability to work unsupervised after postgraduate training. No previous literature has correlated Step 2 Clinical Knowledge scores with pediatric residency performance assessed by Milestones.

Methods: In this retrospective cohort study, the United States Medical Licensing Exam Step 2 Clinical Knowledge Scores and Milestones data were collected from all 188 residents enrolled in a single categorical pediatric residency program from 2012 - 2017. Pearson correlation coefficients were calculated amongst available test and milestone data points to determine correlation between test scores and clinical performance.

Results: Using Pearson correlation coefficients, no significant correlation was found between quantitative scores on the Step 2 Clinical Knowledge exam and average Milestones ratings (r = -0.1 for post-graduate year 1 residents and r = 0.25 for post-graduate year 3 residents).

Conclusions: These results demonstrate that Step 2 scores have no correlation to success in residency training as measured by progression along competency-based Milestones. This information should limit the importance residency programs place on quantitative Step 2 scores in their ranking of residency applicants. Future studies should include multiple residency programs across multiple specialties to help make these findings more generalizable.

Background: One recent trend in medical education is the integration of humanities into the curriculum, including viewing works of art in museums, with analysis of short-term, but not long-term, impact. We developed a course for medical students, trainees, and faculty at the Icahn School of Medicine at Mount Sinai co-taught by an art historian and a physician/medical historian that features images of great works of art to make connections between art and medical history with the following goals: 1. To encourage the students to make careful and systematic observations, describe what they see to others in the group, and exchange their views respectfully, 2. To sensitize students to the patient's experience of illness by discussing artists' depictions of patients and the impact of their illness on family and friends, and 3. To highlight milestones in medical history by focusing on artworks that epitomize the state of medical care and science at a defined point in time. We have taught the course for more than a decade and so wanted to assess whether participating in the course had a long-term impact.

Methods: We created and deployed a five-question survey to 167 students and received responses from 35 of those students.

Results: 97% of respondents answered that they still think about the course, and large majorities of the respondents indicated that the course, had an impact on how they viewed works of art (91%), their appreciation of the history of medicine (89%), and their observational skills (80%). More than half the students responded that the course sensitized them to the patient's perspective of illness (63%) and had an impact on how they viewed their role as a physician (51%).

Conclusions: Our course has had a long-term impact on the respondents across a wide range of professional and personal characteristics.

There is no unified understanding of the concept of inclusion in the literature. Because of the growing reports of exclusion and marginalization in HPE, and the reports of inequitable health provision in global health, inclusion is currently a widely discussed topic in Health Professions Education (HPE) as well as global health. In this article I explore the concept of inclusion based on the current literature, mainly from the psychological aspect. When I say inclusion, it is not just a sense of belonging, but also the opportunity to participate and contribute meaningfully.

Background: The rapid transition from in-person to online delivery of medical curriculum has facilitated the continuation of medical education during the COVID-19 pandemic. Whilst active learning approaches, including Team-Based Learning (TBL), are generally more supportive of the learner's needs during such transition, it remains elusive how different learning environments affect a learner's motivation, engagement, and perceived learning over a prolonged period. We leveraged on the Self-Determination Theory (SDT) and key learners' characteristics to explore the levels of student's engagement and perceived learning in two TBL learning environments, online and in-person, over an extended period. We hypothesize that students' self-reported perceptions of engagement and learning will be lower in online compared to in-person TBL classes.

Methods: This is a mixed methods study with 49 preclinical graduate medical students completing the same questionnaire twice for each learning environment, online TBL and in-person TBL, over an eight-month period. Quantitative data were collected on learners' characteristics, basic psychological needs satisfaction, motivation, student's engagement and perceived learning. Additionally, the final questionnaire also explored the participants' perception on which learning environment better supported their learning.

Results: We found that autonomy support, perceived competence and needs satisfaction, and perceived learning were higher in-person than online. Additionally, most learners felt that in-person TBL was better for learning, as the concepts of learning space and the community of practice were mediated by being in-person.

Conclusions: TBL, being an active instructional method, can maintain students' engagement because it supports many aspects of SDT constructs and perceived learning. However, online TBL is unable to fully support the students' needs and perceived learning. Hence, we strongly advocate for any in-person opportunities to be included in a course, as in-person classes best support students' engagement and perceived learning.