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Author: Brian S McGowan, PhD

MANUSCRIPT: Virtual Patients in continuing medical education and residency training

AIM:
Virtual patients (VPs) are a one-of-a-kind e-learning resource, fostering clinical reasoning skills through clinical case examples. The combination with face-to-face teaching is important for their successful integration, which is referred to as “blended learning”. So far little is known about the use of VPs in the field of continuing medical education and residency training. The pilot study presented here inquired the application of VPs in the framework of a pediatric residency revision course.
METHODS:
Around 200 participants of a pediatric nephology lecture (‘nephrotic and nephritic syndrome in children’) were offered two VPs as a wrap-up session at the revision course of the German Society for Pediatrics and Adolescent Medicine (DGKJ) 2009 in Heidelberg, Germany. Using a web-based survey form, different aspects were evaluated concerning the learning experiences with VPs, the combination with the lecture, and the use of VPs for residency training in general.
RESULTS:
N=40 evaluable survey forms were returned (approximately 21%). The return rate was impaired by a technical problem with the local Wi-Fi firewall. The participants perceived the work-up of the VPs as a worthwhile learning experience, with proper preparation for diagnosing and treating real patients with similar complaints. Case presentations, interactivity, and locally and timely independent repetitive practices were, in particular, pointed out. On being asked about the use of VPs in general for residency training, there was a distinct demand for more such offers.
CONCLUSION:
VPs may reasonably complement existing learning activities in residency training.

via Virtual Patients in continuing medical education and residency training: a pilot project for acceptance analysis in the framework of a residency re… – PubMed – NCBI.

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ABSTRACT: Measuring the Impact of Longitudinal Faculty Development: A Study of Academic Achievement

PURPOSE:
Although faculty development programs in medical education have increased over the past two decades, there is a lack of rigorous program evaluation. The aim of this study was to determine quantifiable outcomes of Harvard Medical School’s (HMS’s) Fellowship in Medical Education and evaluate attainment of its goals.
METHOD:
In 2005 and 2009 the authors collected curricula vitae (CVs) and conducted within-subject analysis of 42 fellowship graduates and also conducted comparison analysis between 12 academic year 2005 fellows and 12 faculty who did not participate in the program. The authors identified 10 metrics of academic advancement. CV analysis for the 42 graduates started 2 years prior to fellowship enrollment and continued for 2-year intervals until June 2009 (10 years of data collection). CV analysis for the comparison group was from 2003 to 2009. The authors also analyzed association between gender and academic outcomes.
RESULTS:
Fellowship graduates demonstrated significant changes in 4 of 10 academic metrics by the end of the fellowship year: academic promotion, educational leadership, education committees, and education funding. Two metrics-educational leadership and committees-showed increased outcomes two years post fellowship, with a positive trend for promotions. Fellowship graduates significantly outpaced the comparison group in 6 of 10 metrics. Women did significantly more committee work, secured more education funding, and were promoted more often than men.
CONCLUSIONS:
Findings indicate that the HMS Fellowship in Medical Education meets programmatic goals and produces positive, measurable academic outcomes. Standardized evaluation metrics of longitudinal faculty development programs would aid cross-institutional comparisons.

via Measuring the Impact of Longitudinal Faculty Development: A Study of Academic Achievement. – PubMed – NCBI.

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RESOURCE: Threshold Concepts: Undergraduate Teaching, Postgraduate Training and Professional Development A short introduction and bibliography

Over the past decade this concept has been embraced by many disciplines outside economics; indeed the above quote is from Glynis Cousin’s excellent short introduction to the concept written for earth scientists. The threshold concept has been seen as a valuable tool, not only in facilitating students’ understanding of their subject, but in aiding the rational development of curricula in rapidly expanding arenas where there is a strong tendency to overload the curriculum (Cousin, [7, 9]). This web page will describe, briefly, the characteristics of a threshold concept and list selected references to the work of those examining its value in a broad range of disciplines.

via The Threshold Concept.

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ABSTRACT: Building capacity for education research among clinical educators in the health professions

BACKGROUND/PURPOSE:
There is a growing desire for health professions educators to generate high-quality education research; yet, few of them encounter the training to do so. In response, health professions faculties have increasingly been devoting resources to provide members with the skills necessary for education research. The form and impact of these efforts have not been reviewed, though such a synthesis could be useful for practice. The objectives of this systematic review were to (1) identify interventions aimed at building capacity for education research among health professions clinical educators and (2) review the outcomes of these interventions.
METHODOLOGY:
We developed a systematic review protocol based on our pilot scoping search. This protocol underwent peer review and was prospectively registered with the Best Evidence Medical Education Collaboration. Based on this protocol, we conducted a comprehensive search of health professions’ databases and related grey literature. Systematic methods were applied: two independent reviewers completed title screening and full text review for inclusion, data extraction, and methodological quality assessment. Studies were included if they reported outcomes for interventions designed to increase capacity for health professions clinical educators to conduct education research. We conducted a qualitative synthesis of the evidence which included detailed reporting of intervention characteristics and outcomes.
RESULTS:
Our search returned 14, 149 results, 241 of which were retained after title and abstract screening, and 30 of which met inclusion criteria after full text review. Seven groups of interventions were identified, the most frequent being teaching scholars programs (n = 10), health professions education fellowships (n = 3) or master’s programs (n = 4). The most commonly measured outcome was change related to enhanced scholarly outputs (grants, papers, abstracts, and presentations) post-intervention. Unfortunately, most of the included studies lacked detailed description of the intervention and were of low to moderate quality with post-test only design.
DISCUSSION/CONCLUSIONS:
This review demonstrates that various interventions can have a positive impact on the ability of health professions clinical educators to conduct education research. We note several key elements of the interventions including: (1) protected time, (2) mentorship and/or collaboration, (3) departmental and institutional commitment and leadership, and (4) financial support. Through our analysis we describe the complexities around evaluating clinical educators’ health professions research activities and the interventions used to promote education research. While improved study quality would allow more detailed understanding and evaluation of these key features, we are able to provide recommendations for potential strategies for improving participation in and quality of health professions education research based on this analysis.

via Building capacity for education research among clinical educators in the health professions: A BEME (Best Evidence Medical Education) Systematic Re… – PubMed – NCBI.

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ABSTRACT: Exploring patterns and pattern languages of medical education.

CONTEXT:
The practices and concepts of medical education are often treated as global constants even though they can take many forms depending on the contexts in which they are realised. This represents challenges in presenting and appraising medical education research, as well as in translating practices and concepts between different contexts. This paper explores the problem and seeks to respond to its challenges.
METHODS:
This paper explores the application of architectural theorist Christopher Alexander’s work on patterns and pattern languages to medical education. The authors review the underlying concepts of patterns and pattern language, they consider the development of pattern languages in medical education, they suggest possible applications of pattern languages for medical education and they discuss the implications of such use. Examples are drawn from across the field of medical education.
RESULTS:
The authors argue that the deliberate and systematic use of patterns and pattern languages in describing medical educational activities, systems and contexts can help us to make sense of the world, and the pattern languages of medical education have the potential to advance understanding and scholarship in medical education, to drive innovation and to enable critical engagement with many of the underlying issues in this field.

via Exploring patterns and pattern languages of medical education. – PubMed – NCBI.

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ABSTRACT: How does peer teaching compare to faculty teaching?

PURPOSE:
In undergraduate medical education, peer-teaching has become an established and common method to enhance student learning. Evidence suggests that peer-teaching provides learning benefits for both learners and tutors. We aimed to describe the outcomes for medical students taught by peers through systematic review and meta-analysis of existing literature.
METHODS:
Seven databases were searched through 21 terms and their Boolean combinations. Studies reporting knowledge or skills outcomes of students taught by peers compared to those taught by faculty or qualified clinicians were included. Extracted data on students’ knowledge and skills outcomes were synthesised through a random effects model meta-analysis.
RESULTS:
The search yielded 2292 studies. Five hundred and fifty-three duplicates and 1611 irrelevant articles were removed during title-screening. The abstracts of 128 papers were screened against the inclusion and exclusion criteria. Ten studies have been included in the review. Meta-analyses showed no significant difference in peer-teaching compared to faculty teaching for knowledge or skills outcomes, standardised mean differences were 0.07 (95% CI: -0.07, 0.21) and 0.11 (95% CI: -0.07, 1.29), respectively.
CONCLUSION:
Students taught by peers do not have significantly different outcomes to those taught by faculty. As the process of teaching helps to develop both tutor knowledge and teaching skills, peer-teaching should be supported.

via How does peer teaching compare to faculty teaching? A systematic review and meta-analysis. – PubMed – NCBI.

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ABSTRACT: Twitter in urology and other surgical specialties at global conferences

BACKGROUND:
Over recent years, Twitter has demonstrated an expanding role in scientific discussion, surgical news and conferences. This study evaluates the role of Twitter in urological conferences, with comparison to other surgical specialties.
METHODS:
A retrospective analysis of Twitter metrics during the two largest recent English-speaking conferences for each surgical specialty was performed. Using www.symplur.com, all ‘tweets’ under the official conference hashtag from 0000 hour the first day to 24.00 hour the final day were assessed. The number of impressions, ‘tweeters’ and rates of ‘tweeting’ were analysed.
RESULTS:
Nine of 18 conferences examined had official hashtags registered with Symplur Healthcare Hashtags. Plastic and urological surgery had both major conferences registered. Only one of two conferences for each cardiothoracic, general, orthopaedic, otolaryngology and paediatric was registered. Both major neurosurgical and vascular conferences were unregistered. Urological conferences were associated with significantly more Twitter activity than non-urological surgical conferences in all parameters, with greater than triple the number of impressions, tweets and ‘tweeters’. Urological surgical conferences were associated with 337% more tweets and 164% more impressions per conference day, than non-urological surgical conferences.
CONCLUSION:
Twitter has been used to supplement surgical conferences. In this regard, the urological community leads the way compared to the remainder of surgical specialty communities

via Twitter in urology and other surgical specialties at global conferences. – PubMed – NCBI.

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ABSTRACT: Instant Messaging in Dental Education.

Instant messaging (IM) is when users communicate instantly via their mobile devices, and it has become one of the most preferred choices of tools to communicate amongst health professions students. The aim of this study was to understand how dental students communicate via IM, faculty members’ perspectives on using IM to communicate with students, and whether such tools are useful in the learning environment. After free-associating themes on online communication, two draft topic guides for structured interviews were designed that focussed on mobile device-related communication activities. A total of 20 students and six faculty members at the University of Birmingham School of Dentistry agreed to take part in the interviews. Students were selected from years 1-5 representing each year group. The most preferred communication tools were emails, social networking, and IM. Emails were used for more formal messages, and IM and social networking sites were used for shorter messages. WhatsApp was the most used IM app because of its popular features such as being able to check if recipients have read and received messages and group work. The students reported that changes were necessary to improve their communication with faculty members. The faculty members reported having mixed feelings toward the use of IM to communicate with students. The students wished to make such tools a permanent part of their learning environment, but only with the approval of faculty members. The faculty members were willing to accept IM as a communication tool only if it is monitored and maintained by the university and has a positive effect on learning.

via Instant Messaging in Dental Education. – PubMed – NCBI.

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ABSTRACT: How can we improve teaching of ECG interpretation skills? Findings from a prospective randomised trial.

BACKGROUND:
There is an ongoing debate on how ECG interpretation should be taught during undergraduate medical training. This study addressed the impact of teaching format, examination consequences and student motivation on skills retention.
METHODS:
A total of 493 fourth-year medical students participated in a six-group, partially randomised trial. Students received three levels of teaching intensity: self-directed learning (2 groups), lectures (2 groups) or small-group peer-teaching (2 groups). On each level of teaching intensity, end-of-course written examinations (ECG exit exam) were summative in one group and formative in the other. Learning outcome was assessed in a retention test two months later.
RESULTS:
Retention test scores were predicted by summative assessments (adjusted beta 4.08; 95% CI 1.39-6.78) but not by the type of teaching. Overall performance levels and motivation did not predict performance decrease or skills retention.
CONCLUSIONS:
Summative assessments increase medium-term retention of ECG interpretation skills, irrespective of instructional format.

via How can we improve teaching of ECG interpretation skills? Findings from a prospective randomised trial. – PubMed – NCBI.

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MANUSCRIPT: Knowledge and Perceptions of College Students Regarding the Physician Assistant Profession

Purpose: Physician assistants (PAs) are nationally certified and state-licensed medical professionals who practice medicine on healthcare teams with physicians and other providers. Despite the increasing popularity and utility of the profession, knowledge of the role of PAs remains scarce among many segments of the population. The purpose of this study was to determine the knowledge and perceptions of the PA profession among undergraduate college students, as well as what factors are associated with better knowledge and perception of the profession. Methods: Using a cross-sectional survey, information was gathered regarding knowledge and perception of PAs. A total of 364 students were surveyed from randomly selected undergraduate courses at a Connecticut public university. Results: Knowledge scores were significantly higher (p<0.05) in older students, female students, those with plans to pursue a healthcare career, those majoring in health and human services, and those satisfied with care received from a PA. Significantly better perceptions (p<0.05) of PAs were found in older students, those with plans for a future career in healthcare, those majoring in health and human services, those who received prior care from a PA, and those who were satisfied with prior care from a PA. After a short educational intervention, improvements in perceptions were statistically significant (p<0.001) in the surveyed population. Conclusion: This study identifies areas of needed improvement in knowledge and perception of PAs and also provides impetus for educational and marketing-based interventions to improve knowledge and perception of the PA profession in the college student population.

via Knowledge and Perceptions of College Students Regarding the Physician Assistant Profession. – PubMed – NCBI.

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