Perspectives on Medical Education最新文献

{"title":"Sharing Is Caring: Helping Institutions and Health Organizations Leverage Data for Educational Improvement.","authors":"Stefanie S Sebok-Syer, Alina Smirnova, Ethan Duwell, Brian C George, Marc M Triola, Christopher A Feddock, Saad Chahine, Jonathan D Rubright, Brent Thoma","doi":"10.5334/pme.1081","DOIUrl":"https://doi.org/10.5334/pme.1081","url":null,"abstract":"<p><p>Competency-based medical education (CBME) has produced large collections of data, which can provide valuable information about trainees and medical education systems. Many organizations continue to struggle with accessing, collecting, governing, analyzing, and visualizing their clinical and/or educational data. This hinders data sharing efforts within and across organizations, which are foundational in supporting system-wide improvements. Challenges to data sharing within medical education include variability in legislation, existing data policies, heterogeneity of data, inadequate data infrastructure, and various intended purposes or uses. In this eye opener, the authors describe four case studies to illustrate some of the aforementioned challenges and characterize the complexity of data sharing within medical education along two dimensions: organizational (single vs. multiple) and data type (clinical and/or educational). With the goal of better supporting data sharing initiatives, the authors introduce an action-oriented blueprint that includes a three-stage process (i.e., preparation, execution, and iteration) to highlight crucial aspects of data sharing. This evidence-informed model incorporates current best practices and aims to support data sharing initiatives within their own organizations and across multiple organizations. Finally, organizations can use this model to conceptually guide and track their progression throughout the data sharing process.</p>","PeriodicalId":48532,"journal":{"name":"Perspectives on Medical Education","volume":"13 1","pages":"486-495"},"PeriodicalIF":4.8,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11468250/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142478064","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}

{"title":"Creating <i>Effects</i> in Your Writing-<i>Tools</i> to 'Use' (or Not).","authors":"Lara Varpio","doi":"10.5334/pme.1540","DOIUrl":"10.5334/pme.1540","url":null,"abstract":"<p><p>We all want our writing to have impact but realizing that goal is difficult. Prompting specific responses from readers takes savvy and the know-how to wield grammatical tools. This Writer's Craft addresses the skill of varying emphasis in academic writing through five grammatical tools: italics, bold, dashes, parentheses, and scare quotes. It describes each of these tools, and illustrates when and how to use them effectively. In the writer's craft section we offer simple tips to improve your writing in one of three areas: Energy, Clarity and Persuasiveness. Each entry focuses on a key writing feature or strategy, illustrates how it commonly goes wrong, teaches the grammatical underpinnings necessary to understand it and offers suggestions to wield it effectively. We encourage readers to share comments on or suggestions for this section on Twitter, using the hashtag: #how'syourwriting?</p>","PeriodicalId":48532,"journal":{"name":"Perspectives on Medical Education","volume":"13 1","pages":"481-485"},"PeriodicalIF":4.8,"publicationDate":"2024-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11451541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382040","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}

{"title":"Gaining Respect and Mitigating Risk: A Qualitative Exploration of How New Attendings Navigate Interpersonal Relationships with Recent Resident Peers.","authors":"Cameryn C Garrett, Hannah Robinson, Jacob David, Brian Utz, Michelle B Azimov","doi":"10.5334/pme.1396","DOIUrl":"10.5334/pme.1396","url":null,"abstract":"<p><strong>Background: </strong>Physicians moving through training experience changes in personal and professional relationships, which can increase stress, uncertainty, and burnout. Social connection can be an important resource but can introduce complexity and conflict. This study aimed to explore how early-career attendings navigate and manage changing organizational and friendship roles with recent resident peers (near-peers) through this critical transition.</p><p><strong>Methods: </strong>We conducted a reflexive thematic analysis of interviews with early-career attendings working with near-peers from the same institution where they trained. Twenty three of 27 (85%) eligible attendings from two United States health systems participated in semi-structured interviews between April and June 2023.</p><p><strong>Results: </strong>Familiarity from working at the same institution where new attendings completed training made it more difficult to command authority. Early-career attendings at times struggled with insecurities about their ability to fulfill their new role and challenges from others in recognizing their new attending identity. These tensions could heighten emotions in the clinical setting and spill over into relationships with residents outside the workplace, impacting social lives and well-being. Early-career attendings engaged in strategies to manage the social realm of their transition with near-peers, including prioritizing their organizational role in the clinical setting and mitigating risks to their professional reputation by creating stronger boundaries between their personal and professional lives.</p><p><strong>Conclusions: </strong>This study provides new insight into how attendings navigate changing personal and professional relationships with recent resident peers and offers strategies on how to manage the social realm of this liminal transition.</p>","PeriodicalId":48532,"journal":{"name":"Perspectives on Medical Education","volume":"13 1","pages":"460-468"},"PeriodicalIF":4.8,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11451548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382041","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}

{"title":"Legitimation Without Argumentation: An Empirical Discourse Analysis of 'Validity as an Argument' in Assessment.","authors":"Benjamin Kinnear, Daniel J Schumacher, Lara Varpio, Erik W Driessen, Abigail Konopasky","doi":"10.5334/pme.1404","DOIUrl":"10.5334/pme.1404","url":null,"abstract":"<p><strong>Introduction: </strong>Validity is frequently conceptualized in health professions education (HPE) assessment as an argument that supports the interpretation and uses of data. However, previous work has shown that many validity scholars believe argument and argumentation are relatively lacking in HPE. To better understand HPE's discourse around argument and argumentation with regard to assessment validity, the authors explored the discourses present in published HPE manuscripts.</p><p><strong>Methods: </strong>The authors used a bricolage of critical discourse analysis approaches to understand how the language in influential peer reviewed manuscripts has shaped HPE's understanding of validity arguments and argumentation. The authors used multiple search strategies to develop a final corpus of 39 manuscripts that were seen as influential in how validity arguments are conceptualized within HPE. An analytic framework drawing on prior research on Argumentation Theory was used to code manuscripts before developing themes relevant to the research question.</p><p><strong>Results: </strong>The authors found that the elaboration of argument and argumentation within HPE's validity discourse is scant, with few components of Argumentation Theory (such as intended audience) existing within the discourse. The <i>validity as an argument</i> discourse was legitimized via authorization (reference to authority), rationalization (reference to institutionalized action), and mythopoesis (narrative building). This legitimation has cemented the <i>validity as an argument</i> discourse in HPE despite minimal exploration of what argument and argumentation are.</p><p><strong>Discussion: </strong>This study corroborates previous work showing the dearth of argument and argumentation present within HPE's validity discourse. An opportunity exists to use Argumentation Theory in HPE to better develop validation practices that support use of argument.</p>","PeriodicalId":48532,"journal":{"name":"Perspectives on Medical Education","volume":"13 1","pages":"469-480"},"PeriodicalIF":4.8,"publicationDate":"2024-10-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11451546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382042","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}

{"title":"Validity in the Next Era of Assessment: Consequences, Social Impact, and Equity.","authors":"Benjamin Kinnear, Christina St-Onge, Daniel J Schumacher, Mélanie Marceau, Thirusha Naidu","doi":"10.5334/pme.1150","DOIUrl":"https://doi.org/10.5334/pme.1150","url":null,"abstract":"<p><p>Validity has long held a venerated place in education, leading some authors to refer to it as the \"sine qua non\" or \"cardinal virtue\" of assessment. And yet, validity has not held a fixed meaning; rather it has shifted in its definition and scope over time. In this Eye Opener, the authors explore if and how current conceptualizations of validity fit a next era of assessment that prioritizes patient care and learner equity. They posit that health profession education's conceptualization of validity will change in three related but distinct ways. First, consequences of assessment decisions will play a central role in validity arguments. Second, validity evidence regarding impacts of assessment on patients and society will be prioritized. Third, equity will be seen as part of validity rather than an unrelated concept. The authors argue that health professions education has the agency to change its ideology around validity, and to align with values that predominate the next era of assessment such as high-quality care and equity for learners and patients.</p>","PeriodicalId":48532,"journal":{"name":"Perspectives on Medical Education","volume":"13 1","pages":"452-459"},"PeriodicalIF":4.8,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11396166/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298929","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}

{"title":"\"The Best Home for This Paper\": A Qualitative Study of How Authors Select Where to Submit Manuscripts.","authors":"Lauren A Maggio, Natascha Chtena, Juan Pablo Alperin, Laura Moorhead, John M Willinsky","doi":"10.5334/pme.1517","DOIUrl":"https://doi.org/10.5334/pme.1517","url":null,"abstract":"<p><strong>Introduction: </strong>For authors, selecting a target journal to submit a manuscript is a critical decision with career implications. In the discipline of medical education, research conducted in 2016 found that authors were influenced by multiple factors such as a journal's prestige and its mission. However, since this research was conducted the publishing landscape has shifted to include a broader variety of journals, an increased threat of predatory journals, and new publishing models. This study updates and expands upon how medical education authors decide which journal to submit to with the aim of describing the motivational factors and journal characteristics that guide authors' decision making.</p><p><strong>Methods: </strong>The authors conducted five qualitative focus groups in which twenty-two medical education authors and editors participated. During the focus groups participants were engaged in a discussion about how they select a journal to submit their manuscripts. Audio from all focus groups was transcribed. Transcripts were analyzed using codebook thematic analysis.</p><p><strong>Results: </strong>Participants considered multiple factors when selecting a target journal. Factors included a journal's impact, the scope of a journal, journal quality, and technical factors (e.g., word limits). Participants also described how social factors influenced their process and that open access plays a role that could both encourage or deter submission.</p><p><strong>Discussion: </strong>The findings describe the motivational factors and influential signals that guide authors in their journal selection decision making. These findings confirm, extend, and update journal selection factors reported in medical education and other disciplines. Notably, these findings emphasize the role of social factors, relationships and personal experiences, which were absent from previous work. Additionally, we observed increased consideration of open acces and a shift away from an emphasis on journal prestige.</p>","PeriodicalId":48532,"journal":{"name":"Perspectives on Medical Education","volume":"13 1","pages":"442-451"},"PeriodicalIF":4.8,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11405847/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298928","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}

{"title":"How Do Trainees Use EPAs to Regulate Their Learning in the Clinical Environment? A Grounded Theory Study.","authors":"Bart P A Thoonen, Nynke D Scherpbier-de Haan, Cornelia R M G Fluit, Renée E Stalmeijer","doi":"10.5334/pme.1403","DOIUrl":"10.5334/pme.1403","url":null,"abstract":"<p><strong>Introduction: </strong>Entrustable Professional Activities (EPAs) can potentially support self-regulated learning in the clinical environment. However, critics of EPAs express doubts as they see potential harms, like checkbox behaviour. This study explores how GP-trainees use EPAs in the clinical environment through the lens of self-regulated learning theory and addresses the question of whether EPAs help or hinder trainees' learning in a clinical environment.</p><p><strong>Methods: </strong>Using constructivist grounded theory methodology, a purposive and theoretical sample of GP-trainees across different years of training were interviewed. Two PICTOR interviews were added to refine and confirm constructed theory. Data collection and analysis followed principles of constant comparative analysis.</p><p><strong>Results and discussion: </strong>Trainees experience both hindering and helping influences of EPAs and self-regulate their learning by balancing these influences throughout GP-placements. Three consecutive stages were constructed each with different use of EPAs: adaptation, taking control, and checking the boxes. EPAs were most helpful in the 'taking control' stage. EPAs hindered self-regulated learning most during the final stage of training as trainees had other learning goals and experienced assessment of EPAs as bureaucratic and demotivating. Regularly discussing EPAs with supervisors helped to focus on specific learning goals, create opportunities for learning, and generate task-oriented feedback.</p><p><strong>Conclusion: </strong>EPAs can both help and hinder self-regulated learning. How trainees balance both influences changes over time. Therefore, placements need to be at least long enough to enable trainees to gain and maintain control of learning. Supervisors and teachers should assist trainees in balancing the hindering and helping influences of EPAs.</p>","PeriodicalId":48532,"journal":{"name":"Perspectives on Medical Education","volume":"13 1","pages":"431-441"},"PeriodicalIF":4.8,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11378707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142156421","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}

{"title":"Widening the Gates: Redefining Excellence in Selection for Health Professions Education for a Diverse Future Workforce.","authors":"Suzanne Fikrat-Wevers, Karen M Stegers-Jager, Walter W Van Den Broek, Andrea M Woltman","doi":"10.5334/pme.1295","DOIUrl":"10.5334/pme.1295","url":null,"abstract":"<p><p>To ensure diversity in the healthcare workforce selection committees must select a cohort of students who collectively possess the wide variety of qualities necessary to serve societal needs. In practice, selection procedures primarily focus on predicting academic outcomes, which are currently based on a limited set of qualities, restricting the definition of excellence in healthcare. The authors propose a shift in the design of selection procedures by including additional considerations - student diversity and applicant perception - to select talented students who can fulfil societal needs. The authors explain the importance of incorporating these considerations into the design of selection procedures and challenges that may arise. To overcome the challenges of incorporating student diversity and applicant perception in the design of selection procedures, a new view on alignment between the profession, training and selection is needed. This starts with redefining excellence in the profession with more explicit attention to equity, diversity and inclusion (EDI). The authors argue that by employing an EDI-adjusted model of alignment, selection procedures can enhance academic outcomes, properly recognize the talents of and acknowledge the needs for a diverse future workforce and be perceived as fair by applicants.</p>","PeriodicalId":48532,"journal":{"name":"Perspectives on Medical Education","volume":"13 1","pages":"423-430"},"PeriodicalIF":4.8,"publicationDate":"2024-08-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11363897/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142113568","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}

{"title":"An Innovative Course on Involving Patients in Health Professions Education.","authors":"Kaylee Eady, Catherine Giroux, Sarah Heath, Katherine A Moreau","doi":"10.5334/pme.1190","DOIUrl":"10.5334/pme.1190","url":null,"abstract":"<p><strong>Background & need for innovation: </strong>Patients can be actively involved in various aspects of health professions education (HPE). However, learners in HPE graduate programs have minimal opportunities to learn how to involve patients in HPE.</p><p><strong>Steps taken for development and implementation of innovation: </strong>We designed, implemented, and evaluated a 12-week asynchronous, online graduate course that provides learners such opportunities. We established an advisory committee of patients, clinician-educators, and professors to guide course development. Using Thomas et al.'s framework, we established the general and targeted need for the course, identified the learning outcomes, determined the learning activities, and implemented and evaluated the course. It is offered within the asynchronous, online Diploma and Master in HPE at the University of Ottawa, Canada.</p><p><strong>Evaluation of innovation: </strong>Forty learners participated in the course between 2020 and 2022. Using a survey with closed- and open-ended items, learners reported satisfaction with all course components, and they valued the patient narrative videos created for the course. After course completion, learners reported that the course is relevant to their professional practice. They also reported confidence in their abilities to actively involve patients in HPE. Based on the culminating assignment assessment data, learners attained course expectations.</p><p><strong>Critical reflection: </strong>Although patients who participated in the narrative videos represented diverse age ranges, health conditions, and experiences in HPE, they were often Caucasian, educated, and from a higher socio-economic background. Also, the level of engagement between patients and learners in the course was limited. We are committed to improving our own patient involvement efforts.</p>","PeriodicalId":48532,"journal":{"name":"Perspectives on Medical Education","volume":"13 1","pages":"417-422"},"PeriodicalIF":4.8,"publicationDate":"2024-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11295902/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141890591","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}

{"title":"Computer Adaptive vs. Non-adaptive Medical Progress Testing: Feasibility, Test Performance, and Student Experiences.","authors":"Elise V Van Wijk, Jeroen Donkers, Peter C J De Laat, Ariadne A Meiboom, Bram Jacobs, Jan Hindrik Ravesloot, René A Tio, Cees P M Van Der Vleuten, Alexandra M J Langers, Andre J A Bremers","doi":"10.5334/pme.1345","DOIUrl":"10.5334/pme.1345","url":null,"abstract":"<p><strong>Background: </strong>Computerized adaptive testing tailors test items to students' abilities by adapting difficulty level. This more efficient, and reliable assessment form may provide advantages over a conventional medical progress test (PT). Prior to our study, a direct comparison of students' performance on a computer adaptive progress test (CA-PT) and a conventional PT, which is crucial for nationwide implementation of the CA-PT, was missing. Therefore, we assessed the correlation between CA-PT and conventional PT test performance and explored the feasibility and student experiences of CA-PT in a large medical cohort.</p><p><strong>Methods: </strong>In this cross-over study medical students (n = 1432) of three Dutch medical schools participated in both a conventional PT and CA-PT. They were stratified to start with either a conventional PT or CA-PT to determine test performance. Student motivation, engagement and experiences were assessed by questionnaires in students from seven Dutch medical schools. Parallel-forms reliability was assessed using the Pearson correlation coefficient.</p><p><strong>Results: </strong>A strong correlation was found (0.834) between conventional PT and CA-PT test performance. The CA-PT was administered without system performance issues and was completed in a median time of 83 minutes (67-102 minutes). Questionnaire response rate was 31.7% (526/1658). Despite a higher experienced difficulty, most students reported persistence, adequate task management and good focus during the CA-PT.</p><p><strong>Conclusions: </strong>CA-PT provides a reliable estimation of students' ability level in less time than a conventional non-adaptive PT and is feasible in students throughout the entire medical curriculum. Despite the strong correlation between PT scores, students found the CA-PT more challenging.</p>","PeriodicalId":48532,"journal":{"name":"Perspectives on Medical Education","volume":"13 1","pages":"406-416"},"PeriodicalIF":4.8,"publicationDate":"2024-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11276406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141789549","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}