Perspectives on Medical Education最新文献

{"title":"Diversity Awareness in Medical Education: An Innovative Training with Visual Reflection Tools.","authors":"Winny Ang,&nbsp;Liesbeth Verpooten,&nbsp;Benedicte De Winter,&nbsp;Katrien Bombeke","doi":"10.5334/pme.1080","DOIUrl":"https://doi.org/10.5334/pme.1080","url":null,"abstract":"<p><p>Dealing with a diverse population is one of the most challenging topics in medicine, with consequences for health disparities as evidenced by poorer health of marginalised groups. An urgent need exists to build a diversity-responsive curriculum in medical education. At the core of such a curriculum are experiential learning and a focus on self-awareness and reflexivity via small group trainings. This Show and Tell paper describes the development and qualitative evaluation of such a training, that was implemented at the University of Antwerp in Belgium, presenting answers to some of the gaps and challenges described in the literature. This training is guided by three visual reflection tools - the kaleidoscope, the iceberg and the communication compass - to inspire learners on how to deal with the diversity of their future patients. The content, method, and educational aim of this hands-on training are described. We discuss some of the challenges the educational methods pose on reflexivity and awareness, looking at the lessons learned based on participants' feedback. While the visual reflection tools offer a dynamic space to broaden the way we look at patients, it remains imperative to create a safe environment for discussing tensions, sharing difficult topics and being aware of different voices. Taking time (space for discussion, small groups, training of faculty) and allowing for continuous reflection of the educators are key in the development of diversity-responsive education.</p>","PeriodicalId":48532,"journal":{"name":"Perspectives on Medical Education","volume":"12 1","pages":"480-487"},"PeriodicalIF":3.6,"publicationDate":"2023-11-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10624131/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71487643","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":"Preparing Medical and Nursing Students for Interprofessional Feedback Dialogues.","authors":"Claudia Tielemans,&nbsp;Renske de Kleijn,&nbsp;Emy van der Valk-Bouman,&nbsp;Sjoukje van den Broek,&nbsp;Marieke van der Schaaf","doi":"10.5334/pme.1069","DOIUrl":"https://doi.org/10.5334/pme.1069","url":null,"abstract":"<p><strong>Background: </strong>In healthcare education, preparing students for interprofessional feedback dialogues is vital. However, guidance regarding developing interprofessional feedback training programs is sparse. In response to this gap, the Westerveld framework, which offers principles for interprofessional feedback dialogue, was developed.</p><p><strong>Approach: </strong>Using the Westerveld framework, we developed and implemented an interprofessional feedback intervention for 4^th-year nursing and 5^th-year medical students. It encompasses two half-day workshops comprising small group sessions, interactive lectures, and a goal-setting assignment for the rotations. This paper describes the intervention and reflects on students' self-reported goals, as learning outcomes, to inform future interprofessional feedback dialogue education.</p><p><strong>Outcomes: </strong>To understand student's learning outcomes, we coded the content and specificity of 288 responses to the goal-setting assignment. Students indicated they mainly aimed to improve their feedback actionability, but contrastingly set - largely unspecific - goals, addressing the initiation of feedback dialogues. To better understand the process of setting these goals, we held three focus groups (N = 11): aside from the Westerveld framework, students used previous experience in rotations, outcome expectations, and personal characteristics as sources in their goal-setting process.</p><p><strong>Reflection: </strong>The contrast between students' aims to improve their actionability and their goals to initiate dialogues, suggests that overcoming practice barriers to initiating dialogues are conditional to developing other feedback dialogue aspects. These and other goal conflicts in the workplace may hinder them setting specific feedback dialogue goals. We recommend explicit discussion of these challenges and conflicts in interprofessional feedback dialogue education.</p>","PeriodicalId":48532,"journal":{"name":"Perspectives on Medical Education","volume":"12 1","pages":"472-479"},"PeriodicalIF":3.6,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10624133/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71487645","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":"Developing Computerized Adaptive Testing for a National Health Professionals Exam: An Attempt from Psychometric Simulations.","authors":"Lingling Xu,&nbsp;Zhehan Jiang,&nbsp;Yuting Han,&nbsp;Haiying Liang,&nbsp;Jinying Ouyang","doi":"10.5334/pme.855","DOIUrl":"https://doi.org/10.5334/pme.855","url":null,"abstract":"<p><strong>Introduction: </strong>The accurate assessment of health professionals' competence is critical for ensuring public health safety and quality of care. Computerized Adaptive Testing (CAT) based on the Item Response Theory (IRT) has the potential to improve measurement accuracy and reduce respondent burden. In this study, we conducted psychometric simulations to develop a CAT for evaluating the candidates' competence of health professionals.</p><p><strong>Methods: </strong>The initial CAT item bank was sourced from the Standardized Competence Test for Clinical Medicine Undergraduates (SCTCMU), a nationwide summative test in China, consisting of 300 multiple-choice items. We randomly selected response data from 2000 Chinese clinical medicine undergraduates for analysis. Two types of analyses were performed: first, evaluating the psychometric properties of all items to meet the requirements of CAT; and second, conducting multiple CAT simulations using both simulated and real response data.</p><p><strong>Results: </strong>The final CAT item bank consisted of 121 items, for which item parameters were calculated using a two-parameter logistic model (2PLM). The CAT simulations, based on both simulated and real data, revealed sufficient marginal reliability (coefficient of marginal reliability above 0.750) and criterion-related validity (Pearson's correlations between CAT scores and aggregate scores of the SCTCMU exceeding 0.850).</p><p><strong>Discussion: </strong>In national-level medical education assessment, there is an increasing need for concise yet valid evaluations of candidates' competence of health professionals. The CAT developed in this study demonstrated satisfactory reliability and validity, offering a more efficient assessment of candidates' competence of health professionals. The psychometric properties of the CAT could lead to shorter test durations, reduced information loss, and a decreased testing burden for participants.</p>","PeriodicalId":48532,"journal":{"name":"Perspectives on Medical Education","volume":"12 1","pages":"462-471"},"PeriodicalIF":3.6,"publicationDate":"2023-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10624130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71487642","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":"Developing Simulated and Virtual Patients in Psychological Assessment - Method, Insights and Recommendations.","authors":"Bartosz Zalewski,&nbsp;Mateusz Guziak,&nbsp;Maciej Walkiewicz","doi":"10.5334/pme.493","DOIUrl":"https://doi.org/10.5334/pme.493","url":null,"abstract":"<p><p>The phenomena of the simulated (SP) and virtual patient (VP) is widely described in the literature. Although it is difficult to find any practical information on developing these methods for teaching psychological assessment. Having conducted a long-term research project regarding this topic, we report the experience gained and retrospectively identify many mistakes. In this article, we present a summary of creating and using both SP and VP methods in clinical psychology and propose some insights and tips for their development, based on our experiences. While the project concerned clinical psychology, we believe the reflections might be applicable to a wider group of educational situations in which students develop competencies to carry out a diagnostic process with a real patient.</p>","PeriodicalId":48532,"journal":{"name":"Perspectives on Medical Education","volume":"12 1","pages":"455-461"},"PeriodicalIF":3.6,"publicationDate":"2023-10-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10607628/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71414842","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":"Effectiveness of Life Goal Framing to Motivate Medical Students During Online Learning: A Randomized Controlled Trial.","authors":"Adam G Gavarkovs,&nbsp;Jeff Crukley,&nbsp;Erin Miller,&nbsp;Rashmi A Kusurkar,&nbsp;Kulamakan Kulasegaram,&nbsp;Ryan Brydges","doi":"10.5334/pme.1017","DOIUrl":"https://doi.org/10.5334/pme.1017","url":null,"abstract":"<p><strong>Introduction: </strong>Educators need design strategies to support medical students' motivation in online environments. Prompting students to frame a learning activity as preparing them to attain their life goals (e.g., helping others) via their clinical practice, a strategy called 'life goal framing', may enhance their autonomous motivation, learning strategy use, and knowledge retention. However, for students with low perceived competence for learning (PCL), life goal framing may have an adverse effect. A randomized controlled trial was conducted to test the effectiveness of life goal framing and the moderating effect of students' PCL.</p><p><strong>Methods: </strong>First- and second-year medical students across four Canadian universities (<i>n</i> = 128) were randomized to receive a version of an online module with an embedded prompt for life goal framing, or one without. Students' motivation, learning strategy use, and knowledge retention were assessed. Differences between conditions on each outcome were estimated using Bayesian regression.</p><p><strong>Results: </strong>Students' PCL was a moderator for autonomous motivation but no other outcomes. The prompt did not have a statistically significant effect on any outcome, even for learners with high PCL, except for a small effect on link-clicking behaviour.</p><p><strong>Discussion: </strong>The results of this study suggest that learners' autonomous motivation is influenced by how they make meaning of instruction in terms of their future life goals <i>and</i> their present confidence. We cannot recommend life goal framing as an effective design strategy at this point, but we point to future work to increase the benefit of life goal framing for learners with high confidence.</p>","PeriodicalId":48532,"journal":{"name":"Perspectives on Medical Education","volume":"12 1","pages":"444-454"},"PeriodicalIF":3.6,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10607565/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71414843","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":"Representation in Health Professions Education: Striving for an Inclusive Health Professions Education Community.","authors":"Zakia Dimassi, Halah Ibrahim","doi":"10.5334/pme.883","DOIUrl":"10.5334/pme.883","url":null,"abstract":"<p><p>Author representation and inclusivity in health professions education (HPE) scholarship is receiving increasing attention in academic medicine, with multiple articles calling for greater equity related to gender, geographic, and institutional affiliations. Despite journal efforts to seek diversity, authors from high-income English-speaking countries are the most highly represented in HPE scholarship. Less attention, however, has been focused on the openness of medical education scholars, themselves, to engaging in international collaborations with authors and institutions from low-and-middle income countries. This eye-opener is inspired by the authors' personal experiences in HPE scholarship from an international medical educator perspective and advocates for the creation of an open and inclusive multinational medical education community. We offer suggestions that can help create opportunities for networking, collaboration, and promoting a sense of belonging among HPE scholars worldwide. As researchers, journal editors and associate editors, and faculty in HPE programs, we can work together to create a welcoming and accommodating environment that embraces non-dominant voices and perspectives, with the ultimate goal of achieving diversity and equity in HPE scholarship.</p>","PeriodicalId":48532,"journal":{"name":"Perspectives on Medical Education","volume":"12 1","pages":"438-443"},"PeriodicalIF":4.8,"publicationDate":"2023-10-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10607562/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71414844","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":"Feedback that Lands: Exploring How Residents Receive and Judge Feedback During Entrustable Professional Activities.","authors":"Natasha Sheikh,&nbsp;Joshua Mehta,&nbsp;Rupal Shah,&nbsp;Ryan Brydges","doi":"10.5334/pme.1020","DOIUrl":"10.5334/pme.1020","url":null,"abstract":"<p><strong>Introduction: </strong>Receiving feedback from different types of assessors (e.g., senior residents, staff supervisors) may impact trainees' perceptions of the quantity and quality of data during entrustable professional activity (EPA) assessments. We evaluated the quality of EPA feedback provided by different assessors (senior residents, chief medical residents/subspecialty residents, and staff) and explored residents' judgements of the value of this feedback.</p><p><strong>Methods: </strong>From a database of 2228 EPAs, we calculated the frequency of contribution from three assessor groups. We appraised the quality of 60 procedure-related EPAs completed between July 2019 and March 2020 using a modified Completed Clinical Evaluation Report Rating (CCERR) tool. Next, we asked 15 internal medicine residents to sort randomly selected EPAs according to their judgements of value, as an elicitation exercise before a semi-structured interview. Interviews explored participants' perceptions of quality of written feedback and helpful assessors.</p><p><strong>Results: </strong>Residents completed over 60% of EPA assessments. We found no difference in modified-CCERR scores between the three groups. When judging EPA feedback value, residents described a process of weighted deliberation, considering perceived assessor characteristics (e.g., credibility, experience with EPA system), actionable written comments, and their own self-assessment.</p><p><strong>Discussion: </strong>Like other recent studies, we found that residents contributed most to procedure-related EPA assessments. To the established list of factors influencing residents' judgements of feedback value, we add assessors' adherence to, and their shared experiences of being assessed within, EPA assessment systems. We focus on the implications for how assessors and leaders can build credibility in themselves and in the practices of EPA assessments.</p>","PeriodicalId":48532,"journal":{"name":"Perspectives on Medical Education","volume":"12 1","pages":"427-437"},"PeriodicalIF":3.6,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10588547/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49693222","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":"Virtues in Competency-Based Assessment Frameworks: A Text Analysis.","authors":"Pleuntje M B Verstegen,&nbsp;J J Jos Kole,&nbsp;A Stef Groenewoud,&nbsp;Frank J A van den Hoogen","doi":"10.5334/pme.996","DOIUrl":"10.5334/pme.996","url":null,"abstract":"<p><strong>Introduction: </strong>Official documentation of specialty training provides comprehensive and elaborate criteria to assess residents. These criteria are commonly described in terms of competency roles and entrustable professional activities (EPA's), but they may also <i>implicitly</i> encompass virtues. Virtues are desirable personal qualities that enable a person, in this case, a medical specialist, to make and act on the right decisions. We articulate these virtues and explore the resulting implied ideal of a medical professional.</p><p><strong>Method: </strong>We applied a two-staged <i>virtue ethical content analysis</i> to analyze documents, specific to the Dutch training program of the Ear, Nose, and Throat (ENT) specialty. First, we identified explicit references to virtues. Next, we articulated implicit virtues through interpretation. The results were categorized into cardinal, intellectual, moral, and professional virtues.</p><p><strong>Results: </strong>Thirty virtues were identified in the ENT- training program. Amongst them, practical wisdom, temperance, and commitment. Furthermore, integrity, curiosity, flexibility, attentiveness, trustworthiness and calmness are often implicitly assumed. Notable findings are the emphasis on efficiency and effectiveness. Together, these virtues depict an ideal of a future medical specialist.</p><p><strong>Conclusion: </strong>Our findings suggest that competency-frameworks and EPA's implicitly appeal to virtues and articulate a specific ideal surgeon. Explicit attention for virtue development and discussion of the role and relevance of implied ideal professionals in terms of virtues could further improve specialty training.</p>","PeriodicalId":48532,"journal":{"name":"Perspectives on Medical Education","volume":"12 1","pages":"418-426"},"PeriodicalIF":3.6,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10588518/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49693125","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":"Teaching AI Ethics in Medical Education: A Scoping Review of Current Literature and Practices.","authors":"Lukas Weidener, Michael Fischer","doi":"10.5334/pme.954","DOIUrl":"10.5334/pme.954","url":null,"abstract":"<p><strong>Introduction: </strong>The increasing use of Artificial Intelligence (AI) in medicine has raised ethical concerns, such as patient autonomy, bias, and transparency. Recent studies suggest a need for teaching AI ethics as part of medical curricula. This scoping review aimed to represent and synthesize the literature on teaching AI ethics as part of medical education.</p><p><strong>Methods: </strong>The PRISMA-SCR guidelines and JBI methodology guided a literature search in four databases (PubMed, Embase, Scopus, and Web of Science) for the past 22 years (2000-2022). To account for the release of AI-based chat applications, such as ChatGPT, the literature search was updated to include publications until the end of June 2023.</p><p><strong>Results: </strong>1384 publications were originally identified and, after screening titles and abstracts, the full text of 87 publications was assessed. Following the assessment of the full text, 10 publications were included for further analysis. The updated literature search identified two additional relevant publications from 2023 were identified and included in the analysis. All 12 publications recommended teaching AI ethics in medical curricula due to the potential implications of AI in medicine. Anticipated ethical challenges such as bias were identified as the recommended basis for teaching content in addition to basic principles of medical ethics. Case-based teaching using real-world examples in interactive seminars and small groups was recommended as a teaching modality.</p><p><strong>Conclusion: </strong>This scoping review reveals a scarcity of literature on teaching AI ethics in medical education, with most of the available literature being recent and theoretical. These findings emphasize the importance of more empirical studies and foundational definitions of AI ethics to guide the development of teaching content and modalities. Recognizing AI's significant impact of AI on medicine, additional research on the teaching of AI ethics in medical education is needed to best prepare medical students for future ethical challenges.</p>","PeriodicalId":48532,"journal":{"name":"Perspectives on Medical Education","volume":"12 1","pages":"399-410"},"PeriodicalIF":4.8,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10588522/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49693224","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":"Leading Change from Within: Student-Led Reforms to Advance Anti-Racism within Medical Education.","authors":"Tyler S Warnock,&nbsp;Priatharsini Sivananthajothy,&nbsp;Whitney Ereyi-Osas,&nbsp;Pamela Roach","doi":"10.5334/pme.1076","DOIUrl":"10.5334/pme.1076","url":null,"abstract":"<p><p>Racism, physician biases against Indigenous, Black, and racialized people, and the resultant poor health outcomes have been the subject of many institutional position statements and calls to action. Across Canada, undergraduate medical education programs have recognized the importance of addressing racism, but material changes to curriculum and learning environments to incorporate anti-racist lenses have yet to be actualized. To bridge a gap seen within the curriculum, the authors of this manuscript led the co-development, organization, and implementation of a student-led anti-racism initiative at the University of Calgary's Cumming School of Medicine. The initiative consisted of a class-wide anti-racism training session and a strategic review of student governance policies, including elections and decision-making processes through an anti-racist lens to advance equity within student learning environments. Anti-racism praxis was embedded within the co-creation of the anti-racism training by incorporating cultural safety and ethical engagement principles along with paid consultations with racialized students and faculty to identify pertinent topics and inform training priorities. Through this initiative, the authors offer an approach for the larger medical community to consider in their own local efforts to advance anti-racism advocacy and curricular change. This initiative highlighted the unique role of students in disrupting the status quo and modeling an anti-racist lens in their actions and self-governance.</p>","PeriodicalId":48532,"journal":{"name":"Perspectives on Medical Education","volume":"12 1","pages":"411-417"},"PeriodicalIF":3.6,"publicationDate":"2023-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10588537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49693223","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}