Perspectives on Medical Education最新文献_第10页

What about Happiness? A Critical Narrative Review with Implications for Medical Education. 幸福呢?对医学教育意义的批判性叙事评论。

IF 3.6 2区医学

Perspectives on Medical Education Pub Date : 2023-01-01 DOI: 10.5334/pme.856

Fabienne Schwitz, Jacqueline Torti, Lorelei Lingard

{"title":"What about Happiness? A Critical Narrative Review with Implications for Medical Education.","authors":"Fabienne Schwitz, Jacqueline Torti, Lorelei Lingard","doi":"10.5334/pme.856","DOIUrl":"https://doi.org/10.5334/pme.856","url":null,"abstract":"Introduction: Despite abundant scholarship and improvement initiatives, the problem of physician wellbeing persists. One reason might be conceptual: the idea of ‘happiness’ is rare in this work. To explore how it might influence the conversation about physician wellbeing in medical education, we conducted a critical narrative review asking: ‘How does happiness feature in the medical education literature on physician wellbeing at work?’ and ‘How is happiness conceptualized outside medicine?’ Methods: Following current methodological standards for critical narrative review as well as the Scale for the Assessment of Narrative Review Articles, we conducted a structured search in health research, humanities and social sciences, a grey literature search, and consultation with experts. After screening and selection, content analysis was performed. Results: Of 401 identified records, 23 were included. Concepts of happiness from the fields of psychology (flow, synthetic happiness, mindfulness, flourishing), organizational behaviour (job satisfaction, happy-productive worker thesis, engagement), economics (happiness industry, status treadmill), and sociology (contentment, tyranny of positivity, coercive happiness) were identified. The medical education records exclusively drew on psychological concepts of happiness. Discussion and Conclusion: This critical narrative review introduces a variety of conceptualizations of happiness from diverse disciplinary origins. Only four medical education papers were identified, all drawing from positive psychology which orients us to treat happiness as individual, objective, and necessarily good. This may constrain both our understanding of the problem of physician wellbeing and our imagined solutions. Organizational, economical and sociological conceptualizations of happiness can usefully expand the conversation about physician wellbeing at work.","PeriodicalId":48532,"journal":{"name":"Perspectives on Medical Education","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10253238/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9638853","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}

引用次数: 1

A Qualitative Study on How Entrustable Professional Activities Support Medical Students in Their Transitions across Clerkships. 可信赖的专业活动如何支持医学生跨实习过渡的质性研究。

IF 3.6 2区医学

Perspectives on Medical Education Pub Date : 2023-01-01 DOI: 10.5334/pme.825

Anne E Bremer, Larissa I A Ruczynski, Petra Bot, Cornelia R M G Fluit, Marjolein H J van de Pol

{"title":"A Qualitative Study on How Entrustable Professional Activities Support Medical Students in Their Transitions across Clerkships.","authors":"Anne E Bremer, Larissa I A Ruczynski, Petra Bot, Cornelia R M G Fluit, Marjolein H J van de Pol","doi":"10.5334/pme.825","DOIUrl":"https://doi.org/10.5334/pme.825","url":null,"abstract":"Introduction: Medical students regularly transition between clerkships. These transitions can lead to discontinuity in their development because of the need to adapt to a new environment. The use of entrustable professional activities (EPAs) might facilitate less disruptive transitions across clerkships, as they could provide support at the start of a clerkship. This study aims to shed light on how an EPA-based curriculum contributes to medical students' learning processes during transitions.Methods: The authors used a constructivist rapid ethnographic design. They conducted observations and interviews with 11 medical students in their Pediatrics clerkship; six of them were in clerkships not utilizing EPAs, and five were using EPAs. Data collection was followed by template analysis such that all data were coded with a template that was continually updated until the authors all agreed upon a definitive template.Results: Four themes proved important when considering the impact of EPAs during transitions between clerkships: transitions as a learning opportunity, building relationships in context, taking leadership in the landscape of practice and feedback-seeking behavior.Discussion: EPAs smooth clerkship transitions, as they establish continuity in the student's development and facilitate navigating discontinuity in transitions. Students build skills and confidence in order to grow and work with increasing independence within the clerkships. Transitions offer important learning opportunities for students, which can be fully exploited by using EPA guidance.","PeriodicalId":48532,"journal":{"name":"Perspectives on Medical Education","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10237239/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9691927","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}

引用次数: 0

The Art of Revising. 复习的艺术。

IF 3.6 2区医学

Perspectives on Medical Education Pub Date : 2023-01-01 DOI: 10.5334/pme.1073

Chris Watling

引用次数: 0

Understanding and Embracing Culture in International Faculty Development. 在国际教师发展中理解和拥抱文化。

IF 3.6 2区医学

Perspectives on Medical Education Pub Date : 2023-01-01 DOI: 10.5334/pme.31

Sara Mortaz Hejri, Rashmi Vyas, William P Burdick, Yvonne Steinert

{"title":"Understanding and Embracing Culture in International Faculty Development.","authors":"Sara Mortaz Hejri, Rashmi Vyas, William P Burdick, Yvonne Steinert","doi":"10.5334/pme.31","DOIUrl":"https://doi.org/10.5334/pme.31","url":null,"abstract":"Introduction: Research on international faculty development programs (IFDPs) has demonstrated many positive outcomes; however, participants' cultural backgrounds, beliefs, and behaviors have often been overlooked in these investigations. The goal of this study was to explore the influences of culture on teaching and learning in an IFDP.Method: Using interpretive description as the qualitative methodology, the authors conducted semi-structured interviews with 15 Fellows and 5 Faculty of a US-based IFDP. The authors iteratively performed a constant comparative analysis to identify similar patterns and themes. Transformative Learning Theory informed the analysis and interpretation of the results.Results: This research identified three themes related to the influences of culture on teaching and learning. First, cultural differences were not seen as a barrier to learning; instead, they tended to act as a bridge to cultural awareness and network building. Second, some cultural differences produced a sense of unease and uncertainty, which led to adaptations, modifications, or mediation. Third, context mattered, as participants' perspectives were also influenced by the program culture and their professional backgrounds and experiences.Discussion: The cultural diversity of health professions educators in an IFDP did not impede learning. A commitment to future action, together with the ability to reflect critically and engage in dialectical discourse, enabled participants to find constructive solutions to subtle challenges. Implications for faculty development included the value of enhanced cultural awareness and respect, explicit communication about norms and expectations, and building on shared professional goals and experiences.","PeriodicalId":48532,"journal":{"name":"Perspectives on Medical Education","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9997115/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9402188","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}

引用次数: 2

Fairness in Assessment: Identifying a Complex Adaptive System. 评估中的公平性:识别一个复杂的自适应系统。

IF 3.6 2区医学

Perspectives on Medical Education Pub Date : 2023-01-01 DOI: 10.5334/pme.993

Nyoli Valentine, Steven J Durning, Ernst Michael Shanahan, Lambert Schuwirth

{"title":"Fairness in Assessment: Identifying a Complex Adaptive System.","authors":"Nyoli Valentine, Steven J Durning, Ernst Michael Shanahan, Lambert Schuwirth","doi":"10.5334/pme.993","DOIUrl":"https://doi.org/10.5334/pme.993","url":null,"abstract":"Introduction: Assessment design in health professions education is continuously evolving. There is an increasing desire to better embrace human judgement in assessment. Thus, it is essential to understand what makes this judgement fair. This study builds upon existing literature by studying how assessment leaders conceptualise the characteristics of fair judgement.Methods: Sixteen assessment leaders from 15 medical schools in Australia and New Zealand participated in online focus groups. Data collection and analysis occurred concurrently and iteratively. We used the constant comparison method to identify themes and build on an existing conceptual model of fair judgement in assessment.Results: Fairness is a multi-dimensional construct with components at environment, system and individual levels. Components influencing fairness include articulated and agreed learning outcomes relating to the needs of society, a culture which allows for learner support, stakeholder agency and learning (environmental level), collection, interpretation and combination of evidence, procedural strategies (system level) and appropriate individual assessments and assessor expertise and agility (individual level).Discussion: We observed that within the data at fractal, that is an infinite pattern repeating at different scales, could be seen suggesting fair judgement should be considered a complex adaptive system. Within complex adaptive systems, it is primarily the interaction between the entities which influences the outcome it produces, not simply the components themselves. Viewing fairness in assessment through a lens of complexity rather than as a linear, causal model has significant implications for how we design assessment programs and seek to utilise human judgement in assessment.","PeriodicalId":48532,"journal":{"name":"Perspectives on Medical Education","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10377744/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10294638","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}

引用次数: 2

Exploring Medical Students' Learning Around Uncertainty Management Using a Digital Educational Escape Room: A Design-based Research Approach. 利用数字教育逃生室探索医学生围绕不确定性管理的学习:一种基于设计的研究方法。

IF 3.6 2区医学

Perspectives on Medical Education Pub Date : 2023-01-01 DOI: 10.5334/pme.844

Jenny Moffett, Dara Cassidy, Naoise Collins, Jan Illing, Marco Antonio de Carvalho Filho, Harold Bok

{"title":"Exploring Medical Students' Learning Around Uncertainty Management Using a Digital Educational Escape Room: A Design-based Research Approach.","authors":"Jenny Moffett, Dara Cassidy, Naoise Collins, Jan Illing, Marco Antonio de Carvalho Filho, Harold Bok","doi":"10.5334/pme.844","DOIUrl":"https://doi.org/10.5334/pme.844","url":null,"abstract":"Introduction: Medical professionals meet many transitions during their careers, and must learn to adjust rapidly to unfamiliar workplaces and teams. This study investigated the use of a digital educational escape room (DEER) in facilitating medical students' learning around managing uncertainty in transitioning from classroom to clinical placement.Methods: We used design-based research to explore the design, build, and test of a DEER, as well as gain insight into how these novel learning environments work, using Community of Inquiry (CoI) as a guiding conceptual framework. This study represented a mixed methods pilot test of a prototype DEER. Twenty-two medical students agreed to participate, and data were collected through qualitative (i.e., focus groups, game-play observations) and quantitative (i.e., questionnaires) methods.Results: Eighty-two per cent of participants agreed or strongly agreed that the DEER supported their learning around uncertainty. Participants offered diverse examples of how the game had facilitated new insights on, and approaches to, uncertainty. With respect to the learning environment, multiple indicators and examples of the three domains of CoI - cognitive, teaching and social presence - were observed.Discussion: Our findings suggested that DEERs offer a valuable online learning environment for students to engage with complex and emotion-provoking challenges, such as those experienced at transitions. The study also suggested that CoI can be applied to the design, implementation, and evaluation of DEER learning environments, and we have proposed a set of design principles that may offer guidance here.","PeriodicalId":48532,"journal":{"name":"Perspectives on Medical Education","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10038110/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9404048","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}

引用次数: 2

The Use of Art Observation Interventions to Improve Medical Students' Diagnostic Skills: A Scoping Review. 运用艺术观察干预提高医学生的诊断技能:一项范围综述。

IF 3.6 2区医学

Perspectives on Medical Education Pub Date : 2023-01-01 DOI: 10.5334/pme.20

Anjali Mehta, Steven Agius

{"title":"The Use of Art Observation Interventions to Improve Medical Students' Diagnostic Skills: A Scoping Review.","authors":"Anjali Mehta, Steven Agius","doi":"10.5334/pme.20","DOIUrl":"https://doi.org/10.5334/pme.20","url":null,"abstract":"Introduction: Clinical observation skills are fundamental to the practice of medicine. Yet, the skill of looking carefully is rarely taught within the medical curriculum. This may be a contributory factor in diagnostic errors in healthcare. A growing number of medical schools, especially in the United States, have turned to the humanities to offer visual arts-based interventions to foster medical students' visual literacy. This research aims to map the literature on the relationship between art observation training and diagnostic skills of medical students, highlighting effective teaching methodologies.Methods: Based on the Arksey and O'Malley framework, a comprehensive scoping review was conducted. Publications were identified by searching nine databases and hand searching the published and grey literature. Two reviewers independently screened each publication using the pre-designed eligibility criteria.Results: Fifteen publications were included. Significant heterogeneity exists between the study designs and the methods employed to evaluate skill improvement. Nearly all studies (14/15) reported an increase in the number of observations made post-intervention, but none evaluated long-term retention rates. There was an overwhelmingly positive response to the programme, but only one study explored the clinical relevance of the observations made.Discussion: The review establishes improved observational acumen following the intervention, however, uncovers very limited evidence towards improved diagnostic abilities. There is a need for greater rigour and consistency within the experimental designs, through using control groups, randomisation, and a standardised evaluation rubric. Further research on the optimal intervention duration and the application of skills gained to clinical practice, should be performed.","PeriodicalId":48532,"journal":{"name":"Perspectives on Medical Education","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10215995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9564272","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}

引用次数: 0

Learning in Tension: A Case Study Examining What Internal Medicine Residents Learn in the Ambulatory Care Setting. 紧张中的学习:内科住院医师在门诊护理环境中学习的个案研究。

IF 3.6 2区医学

Perspectives on Medical Education Pub Date : 2023-01-01 DOI: 10.5334/pme.443

David C Thomas, Janneke M Frambach, Pim W Teunissen, Tamara Goldberg, Frank W J M Smeenk

{"title":"Learning in Tension: A Case Study Examining What Internal Medicine Residents Learn in the Ambulatory Care Setting.","authors":"David C Thomas, Janneke M Frambach, Pim W Teunissen, Tamara Goldberg, Frank W J M Smeenk","doi":"10.5334/pme.443","DOIUrl":"https://doi.org/10.5334/pme.443","url":null,"abstract":"Introduction: Medical care of patients with complex conditions has shifted to the ambulatory setting, whereas current knowledge of resident learning is primarily based on studies from inpatient settings. Preparing trainees to adapt to this shift necessitates an understanding of what internal medicine (IM) residents currently learn during ambulatory rotations. The aim of this study is to identify what residents learn during their ambulatory care experience.Methods: Using a qualitative instrumental case study design, the authors conducted separate focus groups with IM trainees (n = 15), supervisors (n = 16), and program directors (n = 5) from two IM programs in New York City, USA in 2019. Participants were invited via email, and focus group sessions were complemented by document analysis of ambulatory syllabi.Results: Based on focus group commentary and document analysis, content learned in the ambulatory setting encompassed three domains; 1) patient needs, 2) the resident's role within a healthcare team, and 3) health system opportunities and limitations. Residents also learned about tensions within and between these domains including the skills needed to care for patients versus the skills acquired, a desire for ownership of patient care versus fragmented care, and time allotted versus time required.Discussion: This study revealed two outcomes about what residents learn during their ambulatory care experience. First, learning content largely fell into three domains. Second, residents learned about the tensions between ideal care delivery and the realities of practice. These results highlight the imperative to better align curricula with clinical environments to meet the learning needs of residents.","PeriodicalId":48532,"journal":{"name":"Perspectives on Medical Education","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9997111/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9402192","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}

引用次数: 0

Strategic Paragraphing 2.0: Techniques for Enhancing Inter-Paragraph Coherence. 策略性段落2.0:加强段落间连贯的技巧。

IF 3.6 2区医学

Perspectives on Medical Education Pub Date : 2023-01-01 DOI: 10.5334/pme.727

Yang Yann Foo, Lorelei Lingard

引用次数: 0

Stakes of Assessments in Residency: Influence on Previous and Current Self-Regulated Learning and Co-Regulated Learning in Early Career Specialists. 住院医师评估的风险:对早期职业专家过去和当前自我调节学习和共同调节学习的影响。

IF 3.6 2区医学

Perspectives on Medical Education Pub Date : 2023-01-01 DOI: 10.5334/pme.860

Indra Ganesan, Breana Cham, Pim W Teunissen, Jamiu O Busari

{"title":"Stakes of Assessments in Residency: Influence on Previous and Current Self-Regulated Learning and Co-Regulated Learning in Early Career Specialists.","authors":"Indra Ganesan, Breana Cham, Pim W Teunissen, Jamiu O Busari","doi":"10.5334/pme.860","DOIUrl":"https://doi.org/10.5334/pme.860","url":null,"abstract":"Introduction: Assessments drive learning but the influence of the stakes of the assessments on self-regulated (SRL) during and after residency are unknown. As early career specialists (ECS) must continue learning independently, the answer to this is important as it may inform future assessments with the potential to promote life-long learning after graduation.Methods: We utilized constructivist grounded theory to explore the perspectives of eighteen ECS on the influence of stakes of assessments within residency on their SRL during training and in current practice. We conducted semi-structured interviews.Results: We initially set out to examine the influence of the stakes of assessments on SRL during residency and after graduation. However, it was apparent that learners increasingly engaged with others in co-regulated learning (CRL) as the perceived stakes of the assessments increased. The individual learner's SRL was embedded in CRL in preparation for the various assessments in residency. For low-stakes assessments, the learner engaged in less CRL, taking less cues from others. As stakes increased, the learner engaged in more CRL with peers with similar intellectual level and supervisors to prepare for these assessments. SRL and CRL influenced by assessments in residency had a knock-on effect in clinical practice as ECS in: 1) developing clinical reasoning, 2) improving doctor-patient communication and negotiation skills, and 3) self-reflections and seeking feedback to deal with expectations of self or others.Discussion: Our study supported that the stakes of assessments within residency reinforced SRL and CRL during residency with a continued effect on learning as ECS.","PeriodicalId":48532,"journal":{"name":"Perspectives on Medical Education","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2023-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10275342/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9686022","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}

引用次数: 0