Advances in Health Sciences Education最新文献

{"title":"Not ready in the ways that count- a qualitative exploration of junior doctor's perceived preparedness for practice using Legitimation Code Theory.","authors":"Stuart Redvers Pattinson, Hans Savelberg, Anique Atherley","doi":"10.1007/s10459-024-10380-w","DOIUrl":"https://doi.org/10.1007/s10459-024-10380-w","url":null,"abstract":"<p><p>Despite demonstrating the required competencies to graduate, many newly qualified doctors find the transition to internship difficult. There is a concern over whether their preparation is aligned with the expectations of the role. This study aimed to gain a better understanding of the competencies needed for legitimate practice as junior doctors and explores their perceived preparedness for practice. A qualitative, descriptive study using focus groups was undertaken with first year internship doctors. Thirty-two junior doctors in their first year of internship took part in five focus groups. The data were analysed using a reflective thematic analysis approach with a subsequent analysis using the Legitimation Code Theory (LCT) specialisation dimension coding framework to aid interpretation. Personal attributes including adaptability, organisation and proactivity form the basis of achievement in internship. While graduates felt ready in some ways, it was not in the ways that counted. Participants felt well prepared in terms of their clinical knowledge and skills, but legitimacy came from being able to take responsibility, communicate effectively and apply knowledge confidently and efficiently to all aspects of patient care, something that they did not feel ready to do. Using LCT has revealed a shift in the basis of achievement between medical school, where individual academic performance is rewarded, and internship, where personal and social competencies are legitimised. There is a clash between what graduates feel well prepared for and the expectations and demands of the internship role, resulting in a difficult and stressful transition from student to doctor.</p>","PeriodicalId":50959,"journal":{"name":"Advances in Health Sciences Education","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142382299","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Predicting undergraduate OSCE performance using traditional and construct-driven situational judgment tests at admission.","authors":"Ina Mielke, Simon M Breil, Johanna Hissbach, Maren Ehrhardt, Mirjana Knorr","doi":"10.1007/s10459-024-10379-3","DOIUrl":"https://doi.org/10.1007/s10459-024-10379-3","url":null,"abstract":"<p><p>Situational Judgement Tests (SJTs) are popular to screen for social skills during undergraduate medical admission as they have been shown to predict relevant study outcomes. Two different types of SJTs can be distinguished: Traditional SJTs, which measure general effective behavior, and construct-driven SJTs which are designed to measure specific constructs. To date, there has been no comparison of the predictive validity of these two types of SJTs in medical admission. With the present research, we examine whether the HAM-SJT, a traditional SJT, and the CD-SJT, a construct-driven SJT with an agentic and a communal scale, administered during undergraduate medical admission can predict OSCE (i.e., objective structured clinical examination) performance in a low-stakes (n_LS = 159) and a high-stakes (n_HS = 160) sample of medical students. Results showed a moderate positive relation between the communal scale of the CD-SJT and performance in OSCE stations with trained patients in the high-stakes sample (r =.20, p =.009). This SJT had also an incremental value in predicting the OSCE performance above and beyond GPA (i.e., grade point average), a science test (i.e., HAM-Nat), and gender (ß = 0.18, 95% CI [0.03; 0.33], p =.020). That is, individuals who chose more communal behavioral responses in the SJT were rated more favorably in interactions with trained patients in the OSCE. A comparable correlation coefficient was observed for the HAM-SJT when controlling for range restriction due to admission (r_raw = 0.14 vs. r_controlled = 0.20). Our research provides a first indication for the predictive validity of construct-driven SJTs in high-stakes undergraduate medical admission.</p>","PeriodicalId":50959,"journal":{"name":"Advances in Health Sciences Education","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331799","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preparedness for practice, competency and skill development and learning in rural and remote clinical placements: A scoping review of the perspective and experience of health students.","authors":"Stevie-Jae Hepburn, Syadani Riyad Fatema, Rikki Jones, Kylie Rice, Kim Usher, Jen Williams","doi":"10.1007/s10459-024-10378-4","DOIUrl":"10.1007/s10459-024-10378-4","url":null,"abstract":"<p><p>When considering health professionals' requirements and responsibilities, competence is a complex concept that extends beyond knowledge to encompass understanding, application, technical skills, problem-solving, and clinical judgment. Rural clinical placements provide a rich learning environment for students to improve their competencies, self-esteem, and preparedness for practice (PFP). This scoping review aimed to identify pre-registration health students' perspectives on rural placement regarding competency and skill development, and enablers and barriers to learning. The methodology outlined by the Joanna Briggs Institute was followed. Out of 1186 records (366 duplicates), 821 were screened by title and abstract, 59 underwent full-text screening and 18 studies were included. Over half the studies included medicine students (n = 11). Reported competencies predominantly focused on self-assessed confidence regarding clinical skills. The reported barriers and enablers to learning highlighted the complexity of the placement experience and the importance of interpersonal factors, learner engagement and the supervisor's role. The review identified a gap in the literature pertaining to student perspectives of competencies and skills not assessed or experienced as well as a lack of standardised measures for PFP. The identified enablers and barriers provide suggestions for rural placement design and emphasise the importance of the student learning experience. Future research could include multiple health disciplines and specific methodologies to identify health students' perspectives regarding the development of competency, relatedness and autonomy, that is how to support health students to think, feel and act like health professionals.</p>","PeriodicalId":50959,"journal":{"name":"Advances in Health Sciences Education","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331800","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating discourses of feedback: developing a pattern system of feedback.","authors":"Catherine Patocka, Lara Cooke, Irene W Y Ma, Rachel H Ellaway","doi":"10.1007/s10459-024-10376-6","DOIUrl":"https://doi.org/10.1007/s10459-024-10376-6","url":null,"abstract":"<p><p>Although feedback is often presented as if it were a well-understood concept in health professions education, in practice it can mean many things. For some, feedback is a conversation about defining and improving performance, while for others it is the information generated by assessments and tools. Indeed, feedback has variously been defined as a process, as data, as a conversation, and as a reflective exercise. As a result, for a concept so central to what educators do, 'feedback' is ambiguous and has multiple meanings. Pattern theory affords opportunities to examine what scholars and practitioners mean when they use the term 'feedback'. Elaborating feedback as a pattern system can connect otherwise disjointed discourses of feedback. In this paper, the authors describe the development of a pattern system of feedback in medical education. Arksey & O'Malley's 5-stages of scoping reviews were adapted to enact a 6-step pattern system development methodology that included (1) Identifying the research question and scope of inquiry; (2) elaborating a strategy for pattern identification; (3) study selection; (4) abductive pattern representation development; (5) pattern system testing; and (6) summarizing and reporting the results. A pattern system of feedback was developed based on review of 218 full text articles and testing against an additional 2833 citations. This pattern system is made up of 36 pattern representations organized under 6 domains: feedback referent, feedback intentions, feedback information, feedback processing, feedback response, and feedback meta. The pattern system was applied to two models of feedback to demonstrate its utility as a lens through which to analyze various instances of feedback and to foreshadow its potential broader applicability as a tool to facilitate knowledge synthesis in the feedback problem space.</p>","PeriodicalId":50959,"journal":{"name":"Advances in Health Sciences Education","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142331798","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A longitudinal study of interprofessional education experiences among health professional graduates.","authors":"S Price, L Van Dam, M Sim, C Andrews, J Gilbert, K Lackie, J Almost, N Kennie-Kaulbach, E Sutton, H Khalili","doi":"10.1007/s10459-024-10374-8","DOIUrl":"https://doi.org/10.1007/s10459-024-10374-8","url":null,"abstract":"<p><p>Effective teamwork and collaboration among health professionals is a well-recognized strategy toward enhancing patient outcomes. However, there is a lack of understanding on how to best prepare health professionals for collaborative practice. The aim of this research is to gain a better understanding of how graduates of five health professions (dentistry, medicine, nursing, pharmacy, physiotherapy) perceive and experience interprofessional education for collaborative practice (IPECP) throughout their health professions journey, with a focus on transition to practice. This longitudinal study employed an interpretive, narrative methodology to understand interprofessional identity development of 24 individuals who had recently graduated from a health professions program (dentistry, medicine, nursing, pharmacy, physiotherapy) at a Canadian university. Participant experiences were analyzed using narrative analysis. Participants' narratives provided insight into the context, factors and curricular experiences needed for interprofessional identity development and preparedness for collaborative practice. Participants identified the importance of socialization and connection with others, collaborative role models and exposure to collaborative experiences and settings for interprofessional practice. Participants expressed some dissatisfaction with their earliest IPECP experiences and most valued their exposure to 'real-life' practice examples and clinical scenarios. Participants desired more authentic experiences of interprofessional collaboration during their programs. Improving health professionals' interprofessional socialization and collaborative experiences within IPECP is critical to improving patient outcomes. Study findings can inform future curricula and IPECP strategies that create conditions to enhance collaborative practice and ensure the preparedness of a future health workforce with a strong collaborative identity.</p>","PeriodicalId":50959,"journal":{"name":"Advances in Health Sciences Education","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142309028","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"How does interprofessional education affect attitudes towards interprofessional collaboration? A rapid realist synthesis.","authors":"Jean Anthony Grand-Guillaume-Perrenoud, Eva Cignacco, Maura MacPhee, Tania Carron, Isabelle Peytremann-Bridevaux","doi":"10.1007/s10459-024-10368-6","DOIUrl":"https://doi.org/10.1007/s10459-024-10368-6","url":null,"abstract":"<p><p>Interprofessional collaboration (IPC) in healthcare is regarded as important by professionals, as it increases the quality of care while decreasing costs. Interprofessional education (IPE) is a prerequisite for IPC and influences learners' attitudes, knowledge, and collaboration skills. Since attitudes shape behavior, understanding how they are formed is crucial for influencing IPC in learners' professional practice. We investigated what kind of IPE works, for which students, how, and in what circumstances to develop positive attitudes towards IPC. Using realist synthesis, we extracted causal mechanisms that produce positive attitude outcomes and the conducive contexts that trigger them. Our analysis resulted in six plausible context-mechanism-outcome configurations that explain positive attitude development. Positive IPC attitudes are more likely to arise in contexts where IPE provides time and facilities for formal and informal interactions, as this allows learners to get to know each other both professionally and personally, fostering trust, respect, and mutual liking. Additionally, positive attitudes are more likely in contexts where the IPE curriculum is perceived as career-relevant and boosts confidence. Key mechanisms of positive attitude development include getting to know the other learners professionally and personally, experiencing positive affect during IPE, and learners experiencing mutual dependence. Sustained positive attitudes are more likely to develop when there is organizational support for IPC and professionals attend IPE on an ongoing basis, allowing the attitudes and values expected in IPC to be positively reinforced and eventually integrated into the learners' personal value system.</p>","PeriodicalId":50959,"journal":{"name":"Advances in Health Sciences Education","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142309029","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring preparedness transitions in medicine and pharmacy: a qualitative longitudinal study to inform multiprofessional learning opportunities.","authors":"Ella Ottrey, Charlotte E Rees, Caitlin Kemp, Kayley M Lyons, Tina P Brock, Michelle Leech, Lynn V Monrouxe, Claire Palermo","doi":"10.1007/s10459-024-10372-w","DOIUrl":"https://doi.org/10.1007/s10459-024-10372-w","url":null,"abstract":"<p><p>Despite extensive preparedness literature, existing studies fail to adequately explore healthcare graduates' feelings of preparedness longitudinally across new graduate transition journeys, nor do they compare different healthcare professions to ascertain what opportunities exist for multiprofessional transition interventions. Therefore, this Australian study, underpinned by temporal theory, explores the preparedness transitions of medicine and pharmacy graduates. Our 6-month qualitative longitudinal study involved 12 medicine and 7 pharmacy learners after purposive sampling. They participated in an entrance interview before starting internship, longitudinal audio-diaries during their first three months of internship, and an exit interview. Framework analysis explored patterns in the data cross-sectionally and longitudinally for the whole cohort (thinking over time), with pen portraits illustrating individuals' journeys (thinking through time). Preparedness and unpreparedness narratives involved practical skills and tasks, interpersonal skills, knowledge, and professional practice for medicine and pharmacy. However, narratives for practical skills and tasks, and professional practice were dominant amongst medicine graduates, while narratives for interpersonal skills and knowledge were dominant amongst pharmacy graduates. We found numerous cohort changes in feelings of preparedness over time, but the illustrative pen portraits demonstrated the complexities and nuances through time, including feelings of preparedness before internship becoming unpreparedness during internship (e.g., cannulas), improving preparedness through time (e.g., cover shifts), and persistent feelings of unpreparedness (e.g., patient interactions). While our cross-sectional findings are reasonably consistent with existing research, our comparative and longitudinal findings are novel. We recommend that educators build learners' preparedness through uniprofessional transition interventions involving practical skills and tasks, and professional practice in medicine, and interpersonal skills and knowledge in pharmacy. More importantly, we recommend multiprofessional transition interventions for medicine and pharmacy learners before internship focusing on knowledge, and during internship focusing on practical skills and tasks.</p>","PeriodicalId":50959,"journal":{"name":"Advances in Health Sciences Education","volume":" ","pages":""},"PeriodicalIF":3.0,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142300189","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the implicit meanings of 'cultural diversity': a critical conceptual analysis of commonly used approaches in medical education.","authors":"Albertine Zanting,Janneke M Frambach,Agnes Meershoek,Anja Krumeich","doi":"10.1007/s10459-024-10371-x","DOIUrl":"https://doi.org/10.1007/s10459-024-10371-x","url":null,"abstract":"Existing approaches to cultural diversity in medical education may be implicitly based on different conceptualisations of culture. Research has demonstrated that such interpretations matter to practices and people concerned. We therefore sought to identify the different conceptualisations espoused by these approaches and investigated their implications for education. We critically reviewed 52 articles from eight top medical education journals and subjected these to a conceptual analysis. Via open coding, we looked for references to approaches, their objectives, implicit notions of culture, and to implementation practices. We iteratively developed themes from the collected findings. We identified several approaches to cultural diversity teaching that used four different ways to conceptualise cultural diversity: culture as 'fixed patient characteristic', as 'multiple fixed characteristics', as 'dynamic outcome impacting social interactions', and as 'power dynamics'. We discussed the assumptions underlying these different notions, and reflected upon limitations and implications for educational practice. The notion of 'cultural diversity' challenges learners' communication skills, touches upon inherent inequalities and impacts how the field constructs knowledge. This study adds insights into how inherent inequalities in biomedical knowledge construction are rooted in methodological, ontological, and epistemological principles. Although these insights carry laborious implications for educational implementation, educators can learn from first initiatives, such as: standardly include information on patients' multiple identities and lived experiences in case descriptions, stimulate more reflection on teachers' and students' own values and hierarchical position, acknowledge Western epistemological hegemony, explicitly include literature from diverse sources, and monitor diversity-integrated topics in the curriculum.","PeriodicalId":50959,"journal":{"name":"Advances in Health Sciences Education","volume":"19 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142265606","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping the complexity of task demands during constant observation of patients with complex health behaviors.","authors":"Julie Broski,Krista Eckels,Michael Blomquist,Naomi King,Matthew Lineberry","doi":"10.1007/s10459-024-10366-8","DOIUrl":"https://doi.org/10.1007/s10459-024-10366-8","url":null,"abstract":"Unlicensed patient care assistants (PCAs) are often tasked with providing constant observation (CO) of patients with complex health behaviors. The unique demands of CO are poorly understood, making it challenging to design effective training. Four-component instructional design theory suggests the tasks associated with CO feature non-recurrent challenges, such that effective, simulation-based deliberate practice must reflect real-life variability. This study aimed to elucidate the variety of challenges PCAs encounter during CO of patients with complex health behaviors. We used a qualitative descriptive design and developed a preliminary framework to code interviews. The data collection framework was designed to support creating numerous realistic scenarios to support generalized and transferable learning. From our interviews with 16 participants, we identified 1,066 statements associated with variations in CO tasks. We grouped our findings by two domains, \"patient factors\" and \"environmental contexts.\" Our results revealed many recurring and non-recurring challenges inherent in CO, requiring a range of skills to maintain patient and staff safety. Instructional design elements may include scenarios incorporating environment and resource assessment, cognitive feedback for non-recurrent tasks, novel methods of self-harm initiated by the patient, and incorporating interdisciplinary staff in which the learner must navigate a complex conversation. This study clarifies the task demands of CO and is useful as a task analysis to guide scenario development for simulation-based experiences. A less systematic approach would risk underrepresenting the difficulties inherent in the task, reinforcing a limited set of behaviors that may not generalize well to the non-recurrent challenges in CO.","PeriodicalId":50959,"journal":{"name":"Advances in Health Sciences Education","volume":"33 1","pages":""},"PeriodicalIF":4.0,"publicationDate":"2024-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142265604","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"What if we consider research teams as teams?","authors":"Meredith Young,&nbsp;Tim Dubé","doi":"10.1007/s10459-024-10375-7","DOIUrl":"10.1007/s10459-024-10375-7","url":null,"abstract":"<div><p>Research teams are an important means by which knowledge is generated in Health Professions Education (HPE). Although funding agencies encourage the formation of interdisciplinary and interprofessional research teams, we know little about how our interdisciplinary and interprofessional research teams are functioning, nor how best to ensure their success. Indeed, while HPE Scholarship Units and research environments have been the object of study, little work has been focused on research teams themselves. In this article, the authors propose that research teams should be studied as unique instantiations of teams where several individuals work together towards a common goal. Considering research teams as a <i>team</i> can encourage attention to how effective teams are built, supported, and celebrated, it can acknowledge that competent individuals may form incompetent teams, and it opens important avenues for future research. Turning our attention to better understanding how and when research teams thrive should support the development of more effective teams; resulting in reduced waste and redundancy, better mobilization of team members’ time and skills, and enhanced knowledge generation. Considering research teams as <i>teams</i>, encourages an understanding that these teams require care, commitment, and effort to sustain them, and it acknowledges that pursuing research in a team context is both a collaborative and a social endeavour.</p></div>","PeriodicalId":50959,"journal":{"name":"Advances in Health Sciences Education","volume":"30 2","pages":"579 - 586"},"PeriodicalIF":3.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142186175","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}