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Author: Brian S McGowan, PhD

ABSTRACT: Associations between teaching effectiveness scores and characteristics of presentations in hospital medicine continuing education

BACKGROUND:
There is little research regarding characteristics of effective continuing medical education (CME) presentations in hospital medicine (HM). Therefore, we sought to identify associations between validated CME teaching effectiveness scores and characteristics of CME presentations in the field of HM.
DESIGN/SETTING:
This was a cross-sectional study of participants and didactic presentations from a national HM CME course in 2014.
MEASUREMENTS:
Participants provided CME teaching effectiveness (CMETE) ratings using an instrument with known validity evidence. Overall CMETE scores (5-point scale: 1 = strongly disagree; 5 = strongly agree) were averaged for each presentation, and associations between scores and presentation characteristics were determined using the Kruskal-Wallis test. The threshold for statistical significance was set at P < 0.05.
RESULTS:
A total of 277 out of 368 participants (75.3%) completed evaluations for the 32 presentations. CMETE scores (mean [standard deviation]) were significantly associated with the use of audience response (4.64 [0.16]) versus no audience response (4.49 [0.16]; P = 0.01), longer presentations (≥30 minutes: 4.67 [0.13] vs <30 minutes: 4.51 [0.18]; P = 0.02), and larger number of slides (≥50: 4.66 [0.17] vs <50: 4.55 [0.17]; P = 0.04). There were no significant associations between CMETE scores and use of clinical cases, defined goals, or summary slides.
CONCLUSIONS:
To our knowledge, this is the first study regarding associations between validated teaching effectiveness scores and characteristics of effective CME presentations in HM. Our findings, which support previous research in other fields, indicate that CME presentations may be improved by increasing interactivity through the use of audience response systems and allowing longer presentations.

via Associations between teaching effectiveness scores and characteristics of presentations in hospital medicine continuing education. – PubMed – NCBI.

MANUSCRIPT: Improving Participant Feedback to Continuing Medical Education Presenters in Internal Medicine: A Mixed Methods Study

Evaluation and feedback are uniquely different: evaluation is summative and involves judgment, whereas feedback is formative and specifically intended to improve effectiveness.7,8 It is understood that useful feedback is provided in a timely fashion, behavior-specific, and balanced with both positive and constructive elements.7 Behavior-specific feedback is important because, unlike vague or judgmental comments, it identifies tangible actions for learners to improve upon. Feedback that is balanced (e.g., containing both positive and constructive elements) is particularly useful for poor performers, because it makes the overall feedback more acceptable, thus allowing learners to reflect more comfortably on the constructive feedback component. Reflection on feedback is important, because it has been observed that reflection is the critical link between receiving and using assessment feedback.2 Unfortunately, the feedback provided to CME presenters often lacks mention of specific behaviors, thus providing presenters with no means for improvement.

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There has never been a classroom…

It’s been said that, “There has never been a classroom better than its teacher!” in short, I couldn’t agree more!

We have all been in the role of learner, sitting in a lecture or workshop, or participating in some virtual or on-demand learning activity. The classroom may be literal or figurative…but we are excited by the topic, the objectives, the opportunity…the learner settles in and the speaker (or teacher or facilitator) begins….and ugh…learning grinds to a halt.

Just this morning as I listened to one of my favorite podcasts this frustration smacked me right between the ears. I tuned in excited to hear about new research from an Ivy-league trained, fully tenured professor…it was a beautiful morning…the sun shone brightly….the birds chirped…and within seconds of the episode beginning I became distracted. In this case, the renowned, subject matter expert ended the vast majority of her sentences with ‘up speak’ – that thing where every sentence sounds like a question. I struggled to make it through…it was an inefficient learning experience to say the least. Was she uncertain in what she was telling me, was the data in question, what was she really trying to say? From what I could tell the content was everything I would have expected…but the experience was not.

Flashback to a little more than a week ago. I logged into a webinar with an expert in rheumatology exploring his new research…fascinating topic. I was highly motivated to learn more, to consume every last morsel…10 minutes later I was logging off. There are only so many times I can hear someone say ‘next slide’ or ‘on this slide what I wanted to say was that …yada, yada, yada.”

Tell me a story. Structure the content to make it consumable. Speak clearly. Mitigate the extraneous load of learning.

I was moved to write up these recent experiences because I have always been fascinated by how we conflate subject matter expertise or professional titles with the ability to create meaningful educational experiences…and teach.

As much as the educational community needs to fully embrace adult learning theory, instructional design hacks, and even the learning actions research….it seems illogical to apply all of this marvelous, practical research and then forget about the teacher…or to make assumptions about teaching competency.

 

 

 

ABSTRACT: Dis-integration of communication in healthcare education: Workplace learning challenges and opportunities

The purpose of this paper, based on a 2016 Heidelberg International Conference on Communication in Healthcare (ICCH) plenary presentation, is to examine a key problem in communication skills training for health professional learners. Studies have pointed to a decline in medical students’ communication skills and attitudes as they proceed through their education, particularly during their clinical workplace training experiences. This paper explores some of the key factors in this disintegration, drawing on selected literature and highlighting some curriculum efforts and research conducted at the University of Iowa Carver College of Medicine as a case study of these issues. Five key factors contributing to the disintegration of communication skills and attitudes are presented including: 1) lack of formal communication skills training during clinical clerkships; 2) informal workplace teaching failing to explicitly address learner clinical communication skills; 3) emphasizing content over process in relation to clinician-patient interactions; 4) the relationship between ideal communication models and the realities of clinical practice; and 5) clinical teachers’ lack of knowledge and skills to effectively teach about communication in the clinical workplace. Within this discussion, potential practical responses by individual clinical teachers and broader curricular and faculty development efforts to address each of these factors are presented.

via Dis-integration of communication in healthcare education: Workplace learning challenges and opportunities. – PubMed – NCBI.

MANUSCRIPT: An active learning curriculum improves fellows’ knowledge and faculty teaching skills

OBJECTIVES:
Traditional didactic lectures are the mainstay of teaching for graduate medical education, although this method may not be the most effective way to transmit information. We created an active learning curriculum for Brigham and Women’s Hospital (BWH) gastroenterology fellows to maximize learning. We evaluated whether this new curriculum improved perceived knowledge acquisition and knowledge base. In addition, our study assessed whether coaching faculty members in specific methods to enhance active learning improved their perceived teaching and presentation skills.
METHODS:
We compared the Gastroenterology Training Exam (GTE) scores before and after the implementation of this curriculum to assess whether an improved knowledge base was documented. In addition, fellows and faculty members were asked to complete anonymous evaluations regarding their learning and teaching experiences.
RESULTS:
Fifteen fellows were invited to 12 lectures over a 2-year period. GTE scores improved in the areas of stomach (p<0.001), general gastroenterology (p=0.005), esophagus (p<0.001), and small bowel (p=0.001), and the total score (p=0.001) between pre- and postimplementation of the active learning curriculum. Scores in hepatology, as well as biliary and pancreatic study, showed a trend toward improvement (p>0.05). All fellows believed the lectures were helpful, felt more prepared to take the GTE, and preferred the interactive format to traditional didactic lectures. All lecturers agreed that they acquired new teaching skills, improved teaching and presentation skills, and learned new tools that could help them teach better in the future.
CONCLUSION:
An active learning curriculum is preferred by GI fellows and may be helpful for improving transmission of information in any specialty in medical education. Individualized faculty coaching sessions demonstrating new ways to transmit information may be important for an individual faculty member’s teaching excellence.

via An active learning curriculum improves fellows’ knowledge and faculty teaching skills. – PubMed – NCBI.

ABSTRACT: Use of 3D models of vascular rings and slings to improve resident education

OBJECTIVE:
Three-dimensional (3D) printing is a manufacturing method by which an object is created in an additive process, and can be used with medical imaging data to generate accurate physical reproductions of organs and tissues for a variety of applications. We hypothesized that using 3D printed models of congenital cardiovascular lesions to supplement an educational lecture would improve learners’ scores on a board-style examination.
DESIGN AND INTERVENTION:
Patients with normal and abnormal aortic arches were selected and anonymized to generate 3D printed models. A cohort of pediatric and combined pediatric/emergency medicine residents were then randomized to intervention and control groups. Each participant was given a subjective survey and an objective board-style pretest. Each group received the same 20-minutes lecture on vascular rings and slings. During the intervention group’s lecture, 3D printed physical models of each lesion were distributed for inspection. After each lecture, both groups completed the same subjective survey and objective board-style test to assess their comfort with and postlecture knowledge of vascular rings.
RESULTS:
There were no differences in the basic demographics of the two groups. After the lectures, both groups’ subjective comfort levels increased. Both groups’ scores on the objective test improved, but the intervention group scored higher on the posttest.
CONCLUSIONS:
This study demonstrated a measurable gain in knowledge about vascular rings and pulmonary artery slings with the addition of 3D printed models of the defects. Future applications of this teaching modality could extend to other congenital cardiac lesions and different learners.

via Use of 3D models of vascular rings and slings to improve resident education. – PubMed – NCBI.

ABSTRACT: Academic Primer Series: Key Papers About Competency-Based Medical Education

INTRODUCTION:
Competency-based medical education (CBME) presents a paradigm shift in medical training. This outcome-based education movement has triggered substantive changes across the globe. Since this transition is only beginning, many faculty members may not have experience with CBME nor a solid foundation in the grounding literature. We identify and summarize key papers to help faculty members learn more about CBME.
METHODS:
Based on the online discussions of the 2016-2017 ALiEM Faculty Incubator program, a series of papers on the topic of CBME was developed. Augmenting this list with suggestions by a guest expert and by an open call on Twitter for other important papers, we were able to generate a list of 21 papers in total. Subsequently, we used a modified Delphi study methodology to narrow the list to key papers that describe the importance and significance for educators interested in learning about CBME. To determine the most impactful papers, the mixed junior and senior faculty authorship group used three-round voting methodology based upon the Delphi method.
RESULTS:
Summaries of the five most highly rated papers on the topic of CBME, as determined by this modified Delphi approach, are presented in this paper. Major themes include a definition of core CBME themes, CBME principles to consider in the design of curricula, a history of the development of the CBME movement, and a rationale for changes to accreditation with CBME. The application of the study findings to junior faculty and faculty developers is discussed.
CONCLUSION:
We present five key papers on CBME that junior faculty members and faculty experts identified as essential to faculty development. These papers are a mix of foundational and explanatory papers that may provide a basis from which junior faculty members may build upon as they help to implement CBME programs.

via Academic Primer Series: Key Papers About Competency-Based Medical Education. – PubMed – NCBI.

ABSTRACT: Academic Primer Series: Key Papers About Peer Review

INTRODUCTION:
Peer review, a cornerstone of academia, promotes rigor and relevance in scientific publishing. As educators are encouraged to adopt a more scholarly approach to medical education, peer review is becoming increasingly important. Junior educators both receive the reviews of their peers, and are also asked to participate as reviewers themselves. As such, it is imperative for junior clinician educators to be well-versed in the art of peer reviewing their colleagues’ work. In this article, our goal was to identify and summarize key papers that may be helpful for faculty members interested in learning more about the peer-review process and how to improve their reviewing skills.
METHODS:
The online discussions of the 2016-17 Academic Life in Emergency Medicine (ALiEM) Faculty Incubator program included a robust discussion about peer review, which highlighted a number of papers on that topic. We sought to augment this list with further suggestions by guest experts and by an open call on Twitter for other important papers. Via this process, we created a list of 24 total papers on the topic of peer review. After gathering these papers, our authorship group engaged in a consensus-building process incorporating Delphi methods to identify the papers that best described peer review, and also highlighted important tips for new reviewers.
RESULTS:
We found and reviewed 24 papers. In our results section, we present our authorship group’s top five most highly rated papers on the topic of peer review. We also summarize these papers with respect to their relevance to junior faculty members and to faculty developers.
CONCLUSION:
We present five key papers on peer review that can be used for faculty development for novice writers and reviewers. These papers represent a mix of foundational and explanatory papers that may provide some basis from which junior faculty members might build upon as they both undergo the peer-review process and act as reviewers in turn.

via Academic Primer Series: Key Papers About Peer Review. – PubMed – NCBI.

ABSTRACT: Academic Primer Series: Five Key Papers about Study Designs in Medical Education

INTRODUCTION:
A proper understanding of study design is essential to creating successful studies. This is also important when reading or peer reviewing publications. In this article, we aimed to identify and summarize key papers that would be helpful for faculty members interested in learning more about study design in medical education research.
METHODS:
The online discussions of the 2016-2017 Academic Life in Emergency Medicine Faculty Incubator program included a robust and vigorous discussion about education study design, which highlighted a number of papers on that topic. We augmented this list of papers with further suggestions by expert mentors. Via this process, we created a list of 29 papers in total on the topic of medical education study design. After gathering these papers, our authorship group engaged in a modified Delphi approach to build consensus on the papers that were most valuable for the understanding of proper study design in medical education.
RESULTS:
We selected the top five most highly rated papers on the topic domain of study design as determined by our study group. We subsequently summarized these papers with respect to their relevance to junior faculty members and to faculty developers.
CONCLUSION:
This article summarizes five key papers addressing study design in medical education with discussions and applications for junior faculty members and faculty developers. These papers provide a basis upon which junior faculty members might build for developing and analyzing studies.

via Academic Primer Series: Five Key Papers about Study Designs in Medical Education. – PubMed – NCBI.

ABSTRACT: In search of educational efficiency: 30 years of Medical Education’s top-cited articles

CONTEXT:
Academic journals represent shared spaces wherein the significance of thematic areas, methodologies and paradigms are debated and shaped through collective engagement. By studying journals in their historical and cultural contexts, the academic community can gain insight into the ways in which authors and audiences propose, develop, harness, revise and discard research subjects, methodologies and practices.
METHODS:
Thirty top-cited articles published in Medical Education between 1986 and 2014 were analysed in a two-step process. First, a descriptive classification of articles allowed us to quantify the frequency of content areas over the time span studied. Secondly, a discourse analysis was conducted to identify the continuities, disruptions and tensions within the three most prominent content areas.
RESULTS:
The top-cited articles in Medical Education focused on three major areas of interest: problem-based learning, simulation and assessment. In each of these areas of interest, we noted a tension between the desire to produce and apply standardised tools, and the recognition that the contexts of medical education are highly variable and influenced by political and financial considerations. The general preoccupation with achieving efficiency may paradoxically jeopardise the ability of medical schools to address the contextual needs of students, teachers and patients.
CONCLUSIONS:
Understanding the topics of interest for a journal’s scholarly audience and how these topics are discursively positioned, provides important information for researchers in deciding how they wish to engage with the field, as well as for educators as they assess the relevance of educational products for their local contexts.

via In search of educational efficiency: 30 years of Medical Education’s top-cited articles. – PubMed – NCBI.