MedEdPublish (2016)最新文献

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.

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.