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Author: Brian S McGowan, PhD

MANUSCRIPT: Summative assessments are more powerful drivers of student learning than resource intensive teaching formats

Abstract
BACKGROUND:Electrocardiogram (ECG) interpretation is a core clinical skill that needs to be acquired during undergraduate medical education. Intensive teaching is generally assumed to produce more favorable learning outcomes, but recent research suggests that examinations are more powerful drivers of student learning than instructional format. This study assessed the differential contribution of teaching format and examination consequences to learning outcome regarding ECG interpretation skills in undergraduate medical students.METHODS:A total of 534 fourth-year medical students participated in a six-group (two sets of three), partially randomized trial. Students received three levels of teaching intensity: self-directed learning (two groups), lectures (two groups) or small-group peer teaching facilitated by more advanced students (two groups). One of the two groups on each level of teaching intensity was assessed in a formative, the other in a summative written ECG examination, which provided a maximum of 1% credit points of the total curriculum. The formative examination provided individual feedback without credit points. Main outcome was the correct identification of [greater than or equal to]3 out of 5 diagnoses in original ECG tracings. Secondary outcome measures were time spent on independent study and use of additional study material.RESULTS:Compared with formative assessments, summative assessments increased the odds of correctly identifying at least three out of five ECG diagnoses (OR 5.14; 95% CI 3.26 to 8.09), of spending at least 2 h/week extra on ECG self-study (OR 4.02; 95% CI 2.65 to 6.12) and of using additional learning material (OR 2.86; 95% CI 1.92 to 4.24). Lectures and peer teaching were associated with increased learning effort only, but did not augment examination performance.CONCLUSIONS:Medical educators need to be aware of the paramount role of summative assessments in promoting student learning. Consequently, examinations within medical schools need to be closely matched to the desired learning outcomes. Shifting resources from implementing innovative and costly teaching formats to designing more high-quality summative examinations warrants further investigation.

via Summative assessments are more powerful drivers of s… [BMC Med. 2013] – PubMed – NCBI.

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ABSTRACT: Exposure to, understanding of, and interest in interventional radiology in american medical students

Abstract
RATIONALE AND OBJECTIVES:
The purposes of this study were to determine the degree to which medical students are exposed to interventional radiology (IR) in medical school, to assess their knowledge of the field, and to gauge their interest in IR as a career choice.
MATERIALS AND METHODS:
An institutional review board-approved survey was generated using the website www.surveymonkey.com. Medical student participation nationwide was elicited by sending e-mails to administrators of medical schools and radiology residency program directors and asking them to distribute the survey link to their students.
RESULTS:
Seven hundred twenty-nine medical students from 21 states responded to the survey. Although 58% of students said they were interested in a hands-on career, only 5.5% of students said they had participated in an IR rotation and only 12.7% were interested in IR. Less than half of the IR domain-related questions used to assess understanding of IR were answered correctly, with greater understanding found among the students who had participated in an IR rotation.
CONCLUSIONS:
Exposure to IR in accredited US medical education programs is inconsistent, although interest in the field is moderate among medical students compared with interest in other hands-on specialties. Understanding of IR is limited among the study population. Improved understanding of the field and recruitment could result from greater exposure.

via Exposure to, understanding of, and interest in i… [Acad Radiol. 2013] – PubMed – NCBI.

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ABSTRACT: Improving resident education in quality improvement: role for a resident quality improvement director

Abstract
RATIONALE AND OBJECTIVES:
As a component of the practice-based core competency of the Accreditation Council for Graduate Medical Education, all residents must receive training to be able to evaluate and improve their patient care practices. To further enhance our overall resident quality improvement (QI) educational experience, and to ensure resident involvement in the many aspects of a quality assurance program, we have established a resident educational leadership role and have appointed a resident as resident QI director.
MATERIALS AND METHODS:
We have designed and implemented a resident leadership position in QI in our department. A senior resident (postgraduate year 4 and above) is provided with dedicated training in QI methods, mentored opportunities to develop professional skills in QI, and didactic teaching in applications of QI to other residents.
RESULTS:
A leadership position in QI for trainees introduces this important concept early in their career. The resident QI director is provided dedicated training, receives a broader perspective of QI and is optimally positioned to introduce the concept to junior residents leading to greater acceptance of QI at a resident level.
CONCLUSION:
The introduction of a resident QI director enhances the importance of QI for trainees, prepares the individual for a strong academic and QI career, and improves acceptance of QI methods among trainees.

via Improving resident education in quality improvem… [Acad Radiol. 2013] – PubMed – NCBI.

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ABSTRACT: Self-evaluation: how well do surgery residents judge performance on a rotation?

Abstract
BACKGROUND:
Surgical trainees are evaluated based on the Accreditation Council for Graduate Medical Education 6 core competencies. The ability for a learner to recognize strengths and weaknesses in these areas allows for critical self-improvement.
METHODS:
Surgery residents rotating on a pediatric surgery rotation for 1 academic year were asked at an exit interview to provide a self-evaluation within the 6 core competencies on a Likert scale from 1 to 5. Self-evaluation scores were compared with a final group consensus attending evaluation. Further analyses included comparing residents as follows: less than R3 (junior residents) versus R3 (senior residents) residents, general surgery versus non-general surgery residents, university versus community residents, residents in the first half of the academic year versus residents in the second half, and top one third- and lowest one third-performing residents. Statistical analysis was performed using Student t tests with significance at P < .05.
RESULTS:
A total of 45 surgical residents (29 junior residents and 16 senior residents) gave overall self-evaluation scores that were lower than attending evaluations (3.4 vs 3.8, P = .0002). This underscoring occurred for most core competencies, especially medical knowledge, operative skills, and practice-based learning but not professionalism or communication. When sorting residents by variables, there was significant underscoring by senior residents, general surgery residents, and highest one third-performing residents compared with junior residents, non-general surgery residents, and lowest one third-performing residents. There were no differences between self-evaluations and attending evaluations when comparing university with community residents and residents in the first half of the academic year with residents in the second half of the academic year.
CONCLUSIONS:
Residents appear to have a more critical self-analysis than attending surgeons, with senior residents, general surgery residents, and highest one third-performing residents being the most critical of their own performance. Poorly performing residents appeared to lack insight into their abilities. This method of self-evaluation helps trainees reflect on their performance and highlights trainees who lack self-awareness and need counseling for improvement.

via Self-evaluation: how well do surgery residents jud… [Am J Surg. 2013] – PubMed – NCBI.

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ABSTRACT: Critical Care Physicians: Attitudes, Beliefs, and Knowledge about Pressure Ulcers.

Abstract
OBJECTIVE: The objective of this study was to determine critical care physicians’ attitudes, beliefs, and knowledge toward pressure ulcer (PrU) prevention and treatment in critical care patients.
DESIGN:  Descriptive, correlational
PARTICIPANTS:  56 critical care physicians
MAIN OUTCOME MEASURES:  Survey instrument developed to collect demographic information and information regarding attitudes and beliefs about PrUs and PrU knowledge.
RESULTS:  The majority of physicians (69%) reported poor to adequate basic medical education training on PrU prevention and treatment. Sixty percent reported never attending a PrU lecture. Most physicians reported their role to be important to very important in the areas of PrU prevention (71.4%) and treatment (67.9%). Physicians’ perceived knowledge regarding PrU prevention and treatment was most frequently reported as adequate (48%) and poor (37%). The mean score on the knowledge test was 18.1 (range, 12-24; SD, 2.26), equating to a percentage score of 75%. No significant relationship was found between physicians’ perceived PrU knowledge and actual knowledge score.
CONCLUSIONS:  Prevalence rates of acquired PrUs in critical care adult patients are cited as the highest among hospitalized patients; thus, critical care physicians encounter patients at risk for or with PrUs regularly in clinical practice. Management of a critically ill patient requires a cohesive, multidisciplinary approach, including prevention and/or management of PrUs. The critical care physician, as a vital member of this team, may benefit from PrU education in an effort to heighten awareness of this phenomenon in critical care patients.

via Critical Care Physicians: Attitudes, Bel… [Adv Skin Wound Care. 2013] – PubMed – NCBI.

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EDITORIAL: Balancing Equivalence and Equipoise in Medical Education Research

Even in randomized controlled trials it is questionable whether students in the control arm will receive less benefit. Evidence has grown over many years that patients in clinical research trials achieve better outcomes regardless of which arm of the trial they are assigned to.4 Could the same be true of medical educational research? If so, how would we find out?

 

http://www.stfm.org/fmhub/fm2012/April/Kieran275.pdf

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RESOURCE: Big Data Use In Healthcare Needs Governance, Education

Healthcare organizations should adopt a standardized framework for data governance if they want to harness the power of big data, says a new report. But governance is but one element in the highly complex world of healthcare information, where many long-held practices must change, says the report, from the Institute for Health Technology Transformation (IHT2), a New York-based research and consulting firm.
Citing a 2011 McKinsey & Co. study, IHT2 said the U.S. healthcare industry could potentially save $300 billion a year with the help of advanced analytics, but healthcare organizations continue to struggle with managing and leveraging the vast stores of data they are building up.

via Big Data Use In Healthcare Needs Governance, Education – Healthcare –.

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RESOURCE: Health Care Quality Measurement for Doctors’ Offices Needs Improvement

In its 2001 report Crossing the Quality Chasm, the Institute of Medicine outlined six domains of quality in medical care: safety, effectiveness, patient-centeredness, timeliness, efficiency and equity. But, Dr. Tara Bishop writes in a new viewpoint article published online March 21, in the Journal of the American Medical Association (JAMA), current quality measures for the outpatient setting do not include all of these domains. As a result, quality measurement and quality improvement efforts in the outpatient setting have neglected critical areas of high quality care.

“The majority of outpatient quality measures focus on preventive care, chronic disease care and, to some extent, timeliness of care and patient centeredness,” says Dr. Bishop, an assistant professor of public health and assistant professor of medicine at Weill Cornell Medical College. Dr. Bishop is also the Nanette Laitman Clinical Scholar in Public Health/Clinical Evaluation and an assistant attending physician at NewYork-Presbyterian Hospital/Weill Cornell Medical Center. “But safety, high-level effectiveness, coordination and efficiency are not captured in the current measures of outpatient quality.”

via News | Weill Cornell Medical College | Cornell University.

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ABSTRACT: Understanding the Group Size Effect in Electronic Brainstorming

A number of studies on electronic brainstorming have found that large electronic groups can facilitate the number of ideas generated relative to control groups of similar numbers of solitary performers (nominal groups). Thus far there is no clear evidence for the basis of this facilitative effect. The most likely explanation is that group members benefit from exposure to the wide range of ideas in large groups. Since most electronic brainstorming studies appear to divide the presented ideas into subfolders to avoid overloading participants with too many ideas, this practice may be important for demonstration of a benefit of exposure to a large number of ideas. The present study was designed to assess the role of number of ideas and number of folders on individual idea generation and to eliminate some alternative interpretations for the group size effect. Participants performed an idea generation task on computers while being exposed to either no ideas, 28 ideas, or 112 ideas. The 28 and 112 ideas were presented in either one, four, or eight folders. The results indicated that only the number of ideas factor was important for facilitating idea generation.

via Understanding the Group Size Effect in Electronic Brainstorming.

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RESOURCE: Infographic: What Role Will Mobile Play in The Future of Higher Learning

A new infographic based on New Media Consoritum’s 12 emerging technologies to watch highlights how mobile technologies will impact the future of higher learning. From smartphones to smart wearable devices, there’s a wide assortment of gadgets and corresponding features that may change how we learn in the coming years.
So what are the 12 technologies to look out for?

via Infographic: What Role Will Mobile Play in The Future of Higher Learning | Mobile Marketing Watch.

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