MedEdPublish (2016)最新文献

{"title":"Exploring the construct of anticipatory stress in finding a job after residency training through cognitive interviewing: Implications for learner well-being and health workforce planning.","authors":"Sana Jawad, Megan Thomas, Kent Hecker, Aliya Kassam","doi":"10.12688/mep.19559.1","DOIUrl":"10.12688/mep.19559.1","url":null,"abstract":"<p><p><b>Background:</b> Anticipatory stress (AS) is denoted by concern about future events for which there is little control. Most AS research has been physiological studies such as measuring salivary cortisol levels. Medical learners may experience AS regarding employment after residency, however AS a psychological construct across career stages has not previously been studied. The objective of this study is to explore the psychological construct of employment AS in medical students, residents, and former Program Directors (PDs). <b>Methods:</b> Participants were recruited from a large Canadian medical school via purposive sampling. Semi-structured interviews with n=21 participants (six medical students, nine residents, and six PDs) were transcribed verbatim, and coded by two independent reviewers using thematic analysis. <b>Results:</b> Participants agreed that financial, family, and geographical factors exacerbate AS, and it is mitigated by flexibility, social support, and being proactive. External support, job market saturation, and differences between medical specialities also influence AS. Perspectives unique to participant groups included: medical students reflecting on a hidden curriculum and preoccupation with proximal issues over distal concerns of employment; residents experiencing competing residency program demands; former PDs finding that resident competency, yearly hiring fluctuations, and existing stress impact AS. Consequences of AS include physical and psychological manifestations, performance anxiety, and pursuing additional training. <b>Conclusions:</b> Perceptions of AS vary by medical career stage. Individual, program and systems-level changes can help manage and address the underlying cause of AS: an unreliable job market for physicians. Correcting the mismatch between residency positions and job openings may be a proactive, preventative approach.</p>","PeriodicalId":74136,"journal":{"name":"MedEdPublish (2016)","volume":" ","pages":"25"},"PeriodicalIF":0.0,"publicationDate":"2023-05-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10594048/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44148560","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The challenging reality of the clinical learning environment at Damascus University Faculty of Dental Medicine in Syria: a qualitative study","authors":"Ghaith Alfakhry, Khattab Mustafa, Bashar Jazayerli, K. Alhomsi, I. Jamous","doi":"10.12688/mep.19564.1","DOIUrl":"https://doi.org/10.12688/mep.19564.1","url":null,"abstract":"Introduction: In Syria, specialist dentists undergo five years of undergraduate education and four years of postgraduate education. In the latter, students engage in treating complex cases as part of their professional training. This study aimed to obtain in-depth qualitative understanding of the clinical learning environment at Damascus University Faculty of Dental Medicine, Syria. Methods: Semi-structured interviews were held with eight postgraduate dental students at Damascus University Faculty of Dental Medicine. The faculty has eight clinical departments; therefore, a single participant was purposively sampled from each department. The male-female ratio of the eight interviewed participants was 1:1. Data was analyzed inductively using reflective thematic analysis. Pragmatic saturation was discussed during the analysis and the authors made an interpretative judgement to stop data collection at the eighth interview. Results: Major themes which emerged covered different aspects of the clinical learning environment such as clinical training, social interaction and assessment procedures. Faculty’s negligence of their teaching duties was one of the most recurrent themes. In clinical training and due to faculty inaccessibility, students had to rely on themselves or their senior peers in training. The social climate was perceived negatively and assessment was described as unfair and biased. Discussion: The findings of this study showcased the continuing deterioration of the clinical learning environment at Damascus University. It is hoped that these findings will encourage decision makers to introduce a comprehensive reform that addresses the curriculum, teaching practices and assessment procedures in clinical professional training.","PeriodicalId":74136,"journal":{"name":"MedEdPublish (2016)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42891106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anti-Black racism in clinical supervision: asynchronous simulated encounters facilitate reflective practice.","authors":"Amanda J Calhoun, Andrés Martin, Ayodola Adigun, Shirley D Alleyne, Kammarauche Aneni, Tara Thompson-Felix, Andrea Asnes, Marco A de Carvalho-Filho, Laelia Benoit, Inginia Genao","doi":"10.12688/mep.19487.2","DOIUrl":"10.12688/mep.19487.2","url":null,"abstract":"<p><p>Background Racist interactions in clinical practice remain a pervasive reality for Black healthcare providers. We sought to develop a framework to inform supervisors' actions when confronting racism in clinical practice and protecting trainees under their oversight. Methods We conducted a qualitative study in which experienced supervisors responded to seven short, videotaped interactions between: 1) Black trainees and a simulated patient (SP) in a racist role; 2) the trainees and their respective supervisors; and 3) the trainees and their supervisors together with the SP. The clinical exchanges exemplified different types of racist <i>(entrenching)</i> or antiracist <i>(uprooting)</i> behaviors by the supervisors. After viewing each clip, participants wrote their reflections confidentially; they later joined a structured debriefing together. We used thematic analysis to identify supervisors' behavioral patterns when confronting racist interactions. Results Based on the input of 52 participants recruited into five two-hour-long sessions, we categorized the behaviors of supervisors facing anti-Black racial injuries involving learners under their oversight. We organized supervisor behaviors into five interlocking domains, each with a range of possible themes: 1) <i>Joining</i>: from conciliatory to confrontational in communicating with the aggressor; 2) <i>Explicitness</i>: from avoiding to naming racism; 3) <i>Ownership</i>: from individual to shared responsibility of the event and the response to it; 4) <i>Involving:</i> from excusing to including the aggrieved party when confronting the aggressor; and 5) <i>Stance</i>: from protective to paternalistic in supporting the learner's autonomy. Conclusions Our qualitative findings can provide a framework for facilitated discussion toward reflective practice among healthcare providers who may have experienced, witnessed, or intervened in anti-Black racist interactions. They can also help medical educators to inform faculty development to fight anti-Black racism in clinical practice. The video materials we developed are available for viewing and download and can be used or adapted as springboards for reflective discussion or faculty development activities.</p>","PeriodicalId":74136,"journal":{"name":"MedEdPublish (2016)","volume":"13 ","pages":"4"},"PeriodicalIF":0.0,"publicationDate":"2023-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10140654/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9483398","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ten practical tips for integration of biochemistry topics into systems-based medical school curriculum","authors":"Samuel Kadavakollu, Rosie Kumar, Likitha Aradhyula, Shawn R. White, Reena Lamichhane-Khadka, Edward Merino, B. Boyanovsky","doi":"10.12688/mep.19633.1","DOIUrl":"https://doi.org/10.12688/mep.19633.1","url":null,"abstract":"Biochemistry is implemented in undergraduate medical school from the very beginning of the curriculum. Achieving a high level of competence in this area strongly influences academic success throughout the entire program. Due to the evaporating nature of this subject, medical students struggle to retain biochemistry concepts across the two years of their preclinical courses, especially while preparing for their board examinations. Therefore, the curriculum should be designed strategically to effectively implement the ever-growing field of biochemistry and metabolic pathways across the preclinical years of medical education. We propose a broadened integration of biochemistry by providing clinically correlated metabolic concepts which spiral across multiple domains, thus deepening and solidifying students’ understanding of pathology and etiology. This approach may help medical students retain their subject expertise and understand the complex material in the clinical context to minimize rote memorization. We hope to encourage medical educators, course directors, and curriculum administrators to utilize these tips to augment their biochemistry instruction in medical education.","PeriodicalId":74136,"journal":{"name":"MedEdPublish (2016)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45806633","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring medical educators’ expressions of identity through visual prompts and use of metaphor; a grounded theory study utilising focus groups","authors":"Jordan Napier, M. Moffat","doi":"10.12688/mep.19157.1","DOIUrl":"https://doi.org/10.12688/mep.19157.1","url":null,"abstract":"Background: This project aimed to explore which metaphors, similies, or other forms of imagery medical educators use to express their identity as a ‘medical educator’ and to discuss what these expressions might tell us about their connection to, attitude to, and views of this identity. Medical educators are essential stakeholders in effective learning experiences for our future healthcare workforce and gaining insight into their identity development will be valuable in supporting them in their crucial roles. Methods: Utilising a constructivist grounded theory approach, two focus group/workshop hybrids were carried out with a total of 16 participants in January and February of 2020. The focus group/workshops were used to encourage participant discussion about their educator identity, which included the use of visual prompts to promote use of metaphor in their expressions. Data were analysed using open and then focused coding. Iterative reviews of the literature relating to the study area took place throughout the timeframe of the project. Results: Participants used a range of metaphors for their medical educator identity which fell into the themes of: metaphors around movement, entertainment and environment. The metaphors used included that of a gardener, farmer, role model, traveller, formula 1 pitstop team, and orchestral conductor. When expressing their educator identity, participants spoke of the burden of juggling clinical and educator workload and of the impact of the clinical learning environment upon their ability to do so. Conclusions: Using a creative approach to collect data through metaphors and imagery, our study gave a valuable insight into how medical educators’ view their identity and experiences. It gave insight into the influence of environment upon their identity and the potential role for faculty development in promoting medical educators to converse with each other about the challenges faced when juggling roles and making sense of differing and clashing identities.","PeriodicalId":74136,"journal":{"name":"MedEdPublish (2016)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44763142","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Twelve tips for physicians’ mastering expertise in diagnostic excellence","authors":"Taro Shimizu","doi":"10.12688/mep.19618.1","DOIUrl":"https://doi.org/10.12688/mep.19618.1","url":null,"abstract":"Diagnostic errors, which account for a large proportion of medical errors, are a global medical challenge. The slogan of reducing diagnostic errors has recently shifted to a new strategy of diagnostic excellence, the core of which is the importance of improving the multidisciplinary diagnostic process. Many of the elements and strategies necessary for diagnostic excellence have been presented. In the context of this diagnostic improvement, some reports have been structured to improve the quality of performance of individual physicians as players. Still, surprisingly, only a few reports have focused on specific day-to-day training strategies for the diagnostic thinking process as expertise. This paper focuses on this point and proposes strategies for refining the diagnostic thinking expertise of frontline physicians in the new era, based on the following four elements: knowledge and experience, diagnostic thinking strategies, information management skills, and calibration and reflection.","PeriodicalId":74136,"journal":{"name":"MedEdPublish (2016)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49238679","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Barriers to the utilization of wellness days in graduate medical education","authors":"W. Kinzler, Melissa Mooney, Helen Ding, Kara Scalice, Carole Filangieri, M. Akerman, P. Rekawek","doi":"10.12688/mep.19501.1","DOIUrl":"https://doi.org/10.12688/mep.19501.1","url":null,"abstract":"Background: Personal well-being is an important component of a resilient physician and can reduce the risk of burnout. To address this, our institution implemented a wellness-day policy to promote self-care.  The objectives of this study were to determine the frequency in which house staff (HS) use wellness days and to identify barriers to their utilization. Methods: A questionnaire was administered to all HS at a single sponsoring institution through a secure online survey platform in 2019-2021. Those that took one or both of the wellness days were compared with those that took none using Chi-square. Comparisons across years were made using Cochran-Armitage Trend test, with a P value <0.05 denoting statistical significance. Results: There were 386/878 responses, representing a 44% response rate. Only 31% of HS took both wellness days and 50% took none. Reasons for not taking a wellness day included not wanting to burden the program, having no need for them and being discouraged by the program. HS that took one or both days were more likely to identify as female (60% vs 45%, p=0.007) but not more likely to be married or have children. Interns were less likely (38% vs 51%; p=0.04) and fellows were more likely (61% vs 47%; p=0.03) to take a wellness day.  Conclusions: The utilization of wellness days is variable. Increased utilization can serve to normalize their use and minimize the burden felt by house staff. Education at orientation and leadership buy-in is essential to policy success.","PeriodicalId":74136,"journal":{"name":"MedEdPublish (2016)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42081594","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Wearable point-of-view live streaming technology in a virtual airway management workshop for medical students","authors":"Ashley Zwaiman, Mary Xie, Caleb Tackey, Mark Khoury, L. Wintraub, Bernice Ho, F. Leung, J. Wassermann","doi":"10.12688/mep.19391.1","DOIUrl":"https://doi.org/10.12688/mep.19391.1","url":null,"abstract":"Background: Trauma resuscitation skills are an essential part of medical training. Airway management skills are often learned via simulation-based training, but physical distancing restrictions have forced medical schools to transition their preclinical curricula to a virtual format. A wearable, point-of-view (POV), live streaming tool was piloted in a virtual airway management workshop to preclinical medical students to address limitations in the standard online curriculum. Methods: An anesthesiologist instructor donned a chest-mounted smartphone that captured POV video as it was connected to a Zoom video conference call. Simultaneously, a second camera view from a different angle was streamed from a laptop webcam. Preclinical medical student attendees watched the facilitator demonstrate airway management and resuscitation skills on a simulation mannequin. Student perceptions of the workshop were assessed via standardised course evaluations administered through the online student portal and a questionnaire distributed by the course representative. Results: Qualitative and quantitative course evaluation data showed that although this platform may not completely substitute in-person learning, students appreciated the alternative teaching style, particularly the use of POV video and multiple camera views. Generally, students believed that the learning objectives were achieved. Camera stability, camera positioning, and the distracting nature of the virtual student-instructor interactions were identified as areas for improvement. Conclusions: Moving forward, this innovative workshop format can act as a valuable framework for other institutions that wish to bridge gaps in current virtual education methods and enhance technical skills training in medical learners.","PeriodicalId":74136,"journal":{"name":"MedEdPublish (2016)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44234569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Complex motivations of Japanese medical students to an online medical English course during the COVID-19 pandemic","authors":"Miu Azuma, Osamu Nomura, Takaya Sakuma, Yuki Soma","doi":"10.12688/mep.19042.2","DOIUrl":"https://doi.org/10.12688/mep.19042.2","url":null,"abstract":"<ns4:p><ns4:bold>Background:</ns4:bold> In response to globalism, many East-Asian countries now include a Medical English course in their undergraduate medical education syllabus. Traditional didactic educational culture is a potential barrier for teaching and learning medical English in East-Asian countries. Online technology-based learning has been recognized as an effective instructional strategy for teaching medical English in the East. The purpose of this study was to explore the relationship between the related attribute factors of students' motivation to learn medical English through an online modality.</ns4:p><ns4:p> <ns4:bold>Methods:</ns4:bold> Of 134 eligible fourth-year medical students who participated in an online medical English course at a Japanese medical school, 105 were enrolled in this single cohort study. The participants completed pre- and post-course surveys regarding their motivation during the course, including perceived academic control and task value, and their assignment scores. A structural equation model was used to examine the hypothesized relationship of constructs, based on control-value theory.</ns4:p><ns4:p> <ns4:bold>Results:</ns4:bold> The model showed a good fit for the data (χ <ns4:sup>2</ns4:sup>[df=7] = 1.821, p=0.969, CFI = 1.000, RMSEA < 0.001, SRMR < 0.05, GFI = 0.993, AGFI = 0.980). The latent variables of the perceived course achievement related to the observed variables of academic control and task value scale scores, and negatively predicted willingness for self-study after course completion. In addition, the preference of English as the course language negatively predicted willingness for self-study of medical English.</ns4:p><ns4:p> <ns4:bold>Conclusion:</ns4:bold> Choice of English as the language of instruction and perceived high course achievement negatively predicted students’ motivation for further English self-study after the class. The importance of incorporating the perspective of lifelong learning into the teaching of medical English was recognized.</ns4:p>","PeriodicalId":74136,"journal":{"name":"MedEdPublish (2016)","volume":"172 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135080431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lego® bricks assisted training of the novice debriefers.","authors":"Emanuele Capogna, Pier Luigi Ingrassia, Giorgio Capogna","doi":"10.12688/mep.19314.1","DOIUrl":"10.12688/mep.19314.1","url":null,"abstract":"<p><p>Lego® Serious Play® is a guided workshop in which participants construct Lego creations to represent symbolic and metaphorical ideas in response to assignments. How to encourage inexperienced debriefers to concentrate on dialogue and communications strategies rather than engage in an unstructured debate on technical or behavioral abilities is one of the main challenges in training people to debrief a high-fidelity simulation session. We explore the use of Lego bricks in this study to build straightforward, standardised situations that debriefers in training can use to practice leading discussion. With this method, the different debriefing methodologies may be practiced focusing exclusively on method and dialogue, without getting involved or having to concentrate on the technical aspects.</p>","PeriodicalId":74136,"journal":{"name":"MedEdPublish (2016)","volume":"13 ","pages":"16"},"PeriodicalIF":0.0,"publicationDate":"2023-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10076905/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9273484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}