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Author: Brian S McGowan, PhD

MANUSCRIPT: Continuing Professional Development via Social Media or Conference Attendance: A Cost Analysis

BACKGROUND:
Professional development is essential in the health disciplines. Knowing the cost and value of educational approaches informs decisions and choices about learning and teaching practices.
OBJECTIVE:
The primary aim of this study was to conduct a cost analysis of participation in continuing professional development via social media compared with live conference attendance.
METHODS:
Clinicians interested in musculoskeletal care were invited to participate in the study activities. Quantitative data were obtained from an anonymous electronic questionnaire.
RESULTS:
Of the 272 individuals invited to contribute data to this study, 150 clinicians predominantly from Australia, United States, United Kingdom, India, and Malaysia completed the outcome measures. Half of the respondents (78/150, 52.0%) believed that they would learn more with the live conference format. The median perceived participation costs for the live conference format was Aus $1596 (interquartile range, IQR 172.50-2852.00). The perceived cost of participation for equivalent content delivered via social media was Aus $15 (IQR 0.00-58.50). The majority of the clinicians (114/146, 78.1%, missing data n=4) indicated that they would pay for a subscription-based service, delivered by social media, to the median value of Aus $59.50.
CONCLUSIONS:
Social media platforms are evolving into an acceptable and financially sustainable medium for the continued professional development of health professionals. When factoring in the reduced costs of participation and the reduced loss of employable hours from the perspective of the health service, professional development via social media has unique strengths that challenge the traditional live conference delivery format.

via Continuing Professional Development via Social Media or Conference Attendance: A Cost Analysis. – PubMed – NCBI.

RESOURCE: No evidence to back idea of learning styles

Generally known as “learning styles”, it is the belief that individuals can benefit from receiving information in their preferred format, based on a self-report questionnaire. This belief has much intuitive appeal because individuals are better at some things than others and ultimately there may be a brain basis for these differences. Learning styles promises to optimise education by tailoring materials to match the individual’s preferred mode of sensory information processing.Teachers must ditch ‘neuromyth’ of learning styles, say scientists Read moreThere are, however, a number of problems with the learning styles approach. First, there is no coherent framework of preferred learning styles. Usually, individuals are categorised into one of three preferred styles of auditory, visual or kinesthetic learners based on self-reports. One study found that there were more than 70 different models of learning styles including among others, “left v right brain,” “holistic v serialists,” “verbalisers v visualisers” and so on. The second problem is that categorising individuals can lead to the assumption of fixed or rigid learning style, which can impair motivation to apply oneself or adapt.Finally, and most damning, is that there have been systematic studies of the effectiveness of learning styles that have consistently found either no evidence or very weak evidence to support the hypothesis

via No evidence to back idea of learning styles | Letter | Education | The Guardian.

ABSTRACT: Are Surgeons Born or Made? A Comparison of Personality Traits and Learning Styles Between Surgical Trainees and Medical Students.

OBJECTIVE:
Medical students and surgical trainees differ considerably in both their preferential learning styles and personality traits. This study compares the personality profiles and learning styles of surgical trainees with a cohort of medical students specifically intent on pursuing a surgical career.
DESIGN:
A cross-sectional study was conducted contrasting surgical trainees with medical students specifying surgical career intent. The 50-item International Personality Item Pool Big-Five Factor Marker (FFM) questionnaire was used to score 5 personality domains (extraversion, conscientiousness, agreeableness, openness to experience, and neuroticism). The 24-item Learning Style Inventory (LSI) Questionnaire was used to determine the preferential learning styles (visual, auditory, or tactile). χ(2) Analysis and independent samples t-test were used to compare LSI and FFM scores, respectively.
SETTING:
Surgical trainees from several UK surgical centers were contrasted to undergraduate medical students.
PARTICIPANTS:
A total of 53 medical students who had specifically declared desire to pursue a surgical career and were currently undertaking an undergraduate intercalated degree in surgical sciences were included and contrasted to 37 UK core surgical trainees (postgraduate years 3-4).
RESULTS:
The LSI questionnaire was completed by 53 students and 37 trainees. FFM questionnaire was completed by 29 medical students and 34 trainees. No significant difference for learning styles preference was detected between the 2 groups (p = 0.139), with the visual modality being the preferred learning style for both students and trainees (69.8% and 54.1%, respectively). Neuroticism was the only personality trait to differ significantly between the 2 groups, with medical students scoring significantly higher than trainees (2.9 vs. 2.6, p = 0.03).
CONCLUSIONS:
Medical students intent on pursuing a surgical career exhibit similar personality traits and learning styles to surgical trainees, with both groups preferring the visual learning modality. These findings facilitate future research into potential ways of improving both the training and selection of students and junior trainees onto residency programs.

via Are Surgeons Born or Made? A Comparison of Personality Traits and Learning Styles Between Surgical Trainees and Medical Students. – PubMed – NCBI.

MANUSCRIPT: Usage of 3D models of tetralogy of Fallot for medical education: impact on learning congenital heart disease

Background

Congenital heart disease (CHD) is the most common human birth defect, and clinicians need to understand the anatomy to effectively care for patients with CHD. However, standard two-dimensional (2D) display methods do not adequately carry the critical spatial information to reflect CHD anatomy. Three-dimensional (3D) models may be useful in improving the understanding of CHD, without requiring a mastery of cardiac imaging. The study aimed to evaluate the impact of 3D models on how pediatric residents understand and learn about tetralogy of Fallot following a teaching session.

Methods

Pediatric residents rotating through an inpatient Cardiology rotation were recruited. The sessions were randomized into using either conventional 2D drawings of tetralogy of Fallot or physical 3D models printed from 3D cardiac imaging data sets (cardiac MR, CT, and 3D echocardiogram). Knowledge acquisition was measured by comparing pre-session and post-session knowledge test scores. Learner satisfaction and self-efficacy ratings were measured with questionnaires filled out by the residents after the teaching sessions. Comparisons between the test scores, learner satisfaction and self-efficacy questionnaires for the two groups were assessed with paired t-test.

Results

Thirty-five pediatric residents enrolled into the study, with no significant differences in background characteristics, including previous clinical exposure to tetralogy of Fallot. The 2D image group (n = 17) and 3D model group (n = 18) demonstrated similar knowledge acquisition in post-test scores. Residents who were taught with 3D models gave a higher composite learner satisfaction scores (P = 0.03). The 3D model group also had higher self-efficacy aggregate scores, but the difference was not statistically significant (P = 0.39).

Conclusion

Physical 3D models enhance resident education around the topic of tetralogy of Fallot by improving learner satisfaction. Future studies should examine the impact of models on teaching CHD that are more complex and elaborate.

via Usage of 3D models of tetralogy of Fallot for medical education: impact on learning congenital heart disease.

ABSTRACT: Enhancing the connection between the classroom and the clinical workplace: A systematic review.

INTRODUCTION:
Although medical students are increasingly exposed to clinical experiences as part of their training, these often occur parallel with, rather than connected to, their classroom-based learning experiences. Additionally, students seem to struggle with spontaneously making the connection between these spheres of their training themselves. Therefore, this systematic review synthesized the existing evidence about educational interventions that aim to enhance the connection between learning in the classroom and its application in the workplace.
METHODS:
Electronic databases (AMED, CINAHL, EMBASE, ERIC, Medline, RDRB, PsycINFO and WoS) were screened for quantitative and qualitative studies investigating educational interventions that referenced a connection between the classroom and workplace-based experiences within undergraduate, graduate or postgraduate medical education.
RESULTS:
Three types of interventions were identified: classroom to workplace interventions, workplace to classroom interventions, and interventions involving multiple connections between the two settings. Most interventions involved a tool (e. g. video, flow chart) or a specific process (e. g. linking patient cases with classroom-based learning content, reflecting on differences between what was learned and how it works in practice) which aimed to enhance the connection between the two settings.
DISCUSSION:
Small-scale interventions can bring classroom learning and workplace practice into closer alignment. Such interventions appear to be the necessary accompaniments to curricular structures, helping bridge the gap between classroom learning and workplace experience. This paper documents examples that may serve to assist medical educators in connecting the classroom and the workplace.

via Enhancing the connection between the classroom and the clinical workplace: A systematic review. – PubMed – NCBI.

ABSTRACT: The role of morbidity and mortality rounds in medical education: a scoping review.

CONTEXT:
There is increasing focus on how health care professionals can be trained effectively in quality improvement and patient safety principles. The morbidity and mortality round (MMR) has often been used as a tool with which to examine and teach care quality, yet little is known of its implementation and educational outcomes.
OBJECTIVES:
The objectives of this scoping review are to examine and summarise the literature on how the MMR is designed and delivered, and to identify how it is evaluated for effectiveness in addressing medical education outcomes.
METHODS:
A literature search of the PubMed, MEDLINE, PsycInfo and Cochrane Library databases was conducted for articles published from 1980 to 1 June 2016. Publications in English describing the design, implementation and evaluation of MMRs were included. A total of 67 studies were identified, including eight survey-based studies, four literature reviews, one ethnographic study, three opinion papers, two qualitative observation studies and 49 case studies of education programmes with or without formal evaluation. Study outcomes were categorised using Donald Moore’s framework for the evaluation of continuing medical education (CME).
RESULTS:
There is much heterogeneity within the literature regarding the implementation, delivery and goals of the MMR. Common design components included explicit programme goals and objectives, the case selection process, case presentation models and some form of case analysis. Evaluation of CME outcomes for MMR were mainly limited to learner participation, satisfaction and self-assessed changes in knowledge.
CONCLUSIONS:
The MMR is widely utilised as an educational tool to promote medical education, patient safety and quality improvement. Although evidence to guide the design and implementation of the MMR to achieve measurable CME outcomes remains limited, there are components associated with positive improvements to learning and performance outcomes.

via The role of morbidity and mortality rounds in medical education: a scoping review. – PubMed – NCBI.

ABSTRACT: Associations between teaching effectiveness and participant self-reflection in continuing medical education.

Effective medical educators can engage learners through self-reflection. However, little is known about the relationships between teaching effectiveness and self-reflection in continuing medical education (CME). We aimed to determine associations between presenter teaching effectiveness and participant self-reflection in conference-based CME. This cross-sectional study evaluated presenters and participants at a national CME course. Participants provided CME teaching effectiveness (CMETE) ratings and self-reflection scores for each presentation. Overall CMETE and CME self-reflection scores (five-point Likert scale with one as strongly disagree and five as strongly agree) were averaged for each presentation. Correlations were measured among self-reflection, CMETE, and presentation characteristics. In total, 624 participants returned 430 evaluations (response, 68.9%) for the 38 presentations. Correlation between CMETE and self-reflection was medium (Pearson correlation, 0.3-0.5) or large (0.5-1.0) for most presentations (n = 33, 86.9%). Higher mean (SD) CME reflection scores were associated with clinical cases (3.66 [0.12] vs. 3.48 [0.14]; p = 0.003) and audience response (3.66 [0.12] vs. 3.51 [0.14]; p = 0.005). To our knowledge, this is the first study to show a relationship between teaching effectiveness and participant self-reflection in conference-based CME. Presenters should consider using clinical cases and audience response systems to increase teaching effectiveness and promote self-reflection among CME learners.

via Associations between teaching effectiveness and participant self-reflection in continuing medical education. – PubMed – NCBI.

ABSTRACT: Continuing professional development: putting the learner back at the centre.

Continuing professional development (CPD) is changing. Once seen as flexible on the basis of personal choice and mainly consisting of conferences and lecture style meetings, it is now much more likely to be specified, mandatory and linked to specific regulatory or quality improvement activities. This may not be well aligned with how adult professionals learn best and the evidence of resulting change in practice is limited. Also there is a danger of losing out on serendipity in learning by pushing experienced professionals into focusing excessively on mandatory activities that seem to be increasingly ‘ticking the box’. However, the previous impression of flexibility may have hidden poor education practice. This paper defines CPD and asks whether there are problems with CPD. It looks at how adults are thought to learn and places this in the context of current practice. It considers practical models of how to deal with a series of common challenges met by those who provide and undertake CPD.

via Continuing professional development: putting the learner back at the centre. – PubMed – NCBI.

ABSTRACT: Why assessment in medical education needs a solid foundation in modern test theory.

Despite the frequent use of state-of-the-art psychometric models in the field of medical education, there is a growing body of literature that questions their usefulness in the assessment of medical competence. Essentially, a number of authors raised doubt about the appropriateness of psychometric models as a guiding framework to secure and refine current approaches to the assessment of medical competence. In addition, an intriguing phenomenon known as case specificity is specific to the controversy on the use of psychometric models for the assessment of medical competence. Broadly speaking, case specificity is the finding of instability of performances across clinical cases, tasks, or problems. As stability of performances is, generally speaking, a central assumption in psychometric models, case specificity may limit their applicability. This has probably fueled critiques of the field of psychometrics with a substantial amount of potential empirical evidence. This article aimed to explain the fundamental ideas employed in psychometric theory, and how they might be problematic in the context of assessing medical competence. We further aimed to show why and how some critiques do not hold for the field of psychometrics as a whole, but rather only for specific psychometric approaches. Hence, we highlight approaches that, from our perspective, seem to offer promising possibilities when applied in the assessment of medical competence. In conclusion, we advocate for a more differentiated view on psychometric models and their usage.

via Why assessment in medical education needs a solid foundation in modern test theory. – PubMed – NCBI.

Irrationality – undermining learning for millennia

This past Tuesday was March 14th – or 3/14 – otherwise known as Pi Day. Here in the Northeast US, Pi Day was wretched, bringing 10-30 inches of snow, layered with three inches of sleet. As I write this there is a 3-foot tall, nearly concrete, pile of ice at the end of my driveway and a 8-foot tall mound of  brownish-gray ice at the end of my cul de sac…it has been an unexpected (and unwanted) reminder of harsh realities of winter…and humanity…and vulnerability…

As one does in such circumstances, I used this ‘down’ time to reflect on the science of learning 😉

I have written previously about ‘nudges’ here, here, and here – as well as exploring the idea of ‘learning as a behavior‘…but given the irrationality of Pi Day, I am not sure I set up the foundational reality of these ideas – so let me take a moment to do just that:

“We usually think of ourselves as sitting the driver’s seat, with ultimate control over the decisions we made and the direction our life takes; but, alas, this perception has more to do with our desires-with how we want to view ourselves-than with reality” – Dan Ariely, Predictably Irrational: The Hidden Forces That Shape Our Decisions

To ultimately understand why learning is undermined without supporting the Learning Actions Model, one needs to come to grips with the reality that learners (humans) often have a limited control over their decisions (behaviors). We are victims of a myriad of biases that mislead us and result in us being ‘predictably irrational’.

“We all want explanations for why we behave as we do and for the ways the world around us functions. Even when our feeble explanations have little to do with reality. We tell ourselves story after story until we come up with an explanation that we like and that sounds reasonable enough to believe. And when the story portrays us in a more glowing and positive light, so much the better.” ― Dan Ariely, The Honest Truth About Dishonesty: How We Lie to Everyone – Especially Ourselves

Just like we all know that exercise is a rational behavior (in our best interests), we struggle to exercise regularly. And, just like committing to a good diet is a rational behavior (in our best interests), we struggle to eat healthy. So it is true with the natural learning actions – the universal and necessary actions of learning are clearly ‘in our best interests’ and yet our research demonstrates that learners (humans) often fail to commit effectively to these behaviors. As a result, learning is undermined…over and over and over again.

Importantly, this is NOT a damning statement about failed learners – it is a simple recognition of human irrationality – and more than that, it is an eye-opening opportunity.

This is why the learning architecture that we have engineered is so critical to supporting effective educational experiences – quite simply, the irrationality of learners prevents them from effectively committing to the learning actions that are in their best interests…and understanding this empowers educators to ensure that the structure and nudges for better learning behaviors are always available.