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Author: Brian S McGowan, PhD

MANUSCRIPT: Curriculum Mapping with Academic Analytics in Medical and Healthcare Education.

BACKGROUND:
No universal solution, based on an approved pedagogical approach, exists to parametrically describe, effectively manage, and clearly visualize a higher education institution’s curriculum, including tools for unveiling relationships inside curricular datasets.
OBJECTIVE:
We aim to solve the issue of medical curriculum mapping to improve understanding of the complex structure and content of medical education programs. Our effort is based on the long-term development and implementation of an original web-based platform, which supports an outcomes-based approach to medical and healthcare education and is suitable for repeated updates and adoption to curriculum innovations.
METHODS:
We adopted data exploration and visualization approaches in the context of medical curriculum innovations in higher education institutions domain. We have developed a robust platform, covering detailed formal metadata specifications down to the level of learning units, interconnections, and learning outcomes, in accordance with Bloom’s taxonomy and direct links to a particular biomedical nomenclature. Furthermore, we used selected modeling techniques and data mining methods to generate academic analytics reports from medical curriculum mapping datasets.
RESULTS:
We present a solution that allows users to effectively optimize a curriculum structure that is described with appropriate metadata, such as course attributes, learning units and outcomes, a standardized vocabulary nomenclature, and a tree structure of essential terms. We present a case study implementation that includes effective support for curriculum reengineering efforts of academics through a comprehensive overview of the General Medicine study program. Moreover, we introduce deep content analysis of a dataset that was captured with the use of the curriculum mapping platform; this may assist in detecting any potentially problematic areas, and hence it may help to construct a comprehensive overview for the subsequent global in-depth medical curriculum inspection.
CONCLUSIONS:
We have proposed, developed, and implemented an original framework for medical and healthcare curriculum innovations and harmonization, including: planning model, mapping model, and selected academic analytics extracted with the use of data mining.

via Curriculum Mapping with Academic Analytics in Medical and Healthcare Education. – PubMed – NCBI.

ABSTRACT: Playing in the “Gutter”: Cultivating Creativity in Medical Education and Practice.

In comics, “gutters” are the empty spaces between panels that readers must navigate to weave disjointed visual sequences into coherent narratives. A gutter, however, is more than a blank space-it represents a creative zone for making connections and for constructing meaning from disparate ideas, values, and experiences.Over the course of medical training, learners encounter various “gutters” created by the disconnected subject blocks and learning experiences within the curriculum, the ambiguity and uncertainty of medical practice, and the conflicts and tensions within clinical encounters. Navigating these gutters requires not only medical knowledge and skills but also creativity, defined as the ability to make connections between disparate fragments to create meaningful, new configurations.To cultivate medical students’ creative capacity, the authors developed the Integrated Clinical Arts (ICA) program, a required component of the first-year curriculum at the Warren Alpert Medical School of Brown University. ICA workshops are designed to place students in a metaphorical gutter, wherein they can practice making connections between medicine and arts-based disciplines. By playing in the gutter, students have opportunities to broaden their perspectives, gain new insights into both medical practice and themselves, and explore different ways of making meaning. Student feedback on the ICA program highlights an important role for creativity and the arts in medicine: to transform gutters from potential learning barriers into opportunities for discovery, self-reflection, and personal growth.

via Playing in the “Gutter”: Cultivating Creativity in Medical Education and Practice. – PubMed – NCBI.

ABSTRACT: Contextual Errors in Medical Decision Making: Overlooked and Understudied

Although it is widely recognized that effective clinical practice requires attending to the circumstances and needs of individual patients-their life context-rather than just treating disease, the implications of not doing so are rarely assessed. What are, for instance, the consequences of prescribing a medication that is appropriate for treating a clinical condition but inappropriate for a particular individual either because she or he cannot afford it, lacks the skills to administer it correctly, or is unable to adhere to the regimen because of competing responsibilities such as working the night shift? Conversely, what are the gains to health and health care when such contextual factors are addressed? Finally, can performance measures be employed and developed for the clinician behaviors associated with contextualizing care to guide improvements in care? The authors have explored these questions through observational and experimental studies to define the parameters of patient context, introduce strategies for measuring clinician attention to patient context, and assess the impact of that attention on care planning, patient health care outcomes, and costs. The authors suggest that inattention to patient context is an underrecognized cause of medical error (“contextual error”), that detecting its presence usually requires listening in on the visit, and that it has significant implications for quality of care. Also described is preliminary work to reduce contextual errors. Evidence suggests that this nascent area of research has significant implications for performance assessment and medical education in addressing deficits in quality of care.

via Contextual Errors in Medical Decision Making: Overlooked and Understudied. – PubMed – NCBI.

ABSTRACT: In Pursuit of Meaningful Use of Learning Goals in Residency

PURPOSE:
Medical education aims to equip physicians for lifelong learning, an objective supported by the conceptual framework of self-regulated learning (SRL). Learning goals have been used to develop SRL skills in learners across the medical education continuum. This study’s purpose was to elicit residents’ perspectives on learning goal use and to develop explanations suggesting how aspects of the learning environment may facilitate or hinder the meaningful use of learning goals in residency.
METHOD:
Resident focus groups and program director interviews were conducted in 2012-2013, audio-recorded, and transcribed. Programs were selected to maximize diversity of size, geographic location, type of program, and current use of learning goals. Data were analyzed using the constant comparative method associated with grounded theory. Further analysis compared themes frequently occurring together to strengthen the understanding of relationships between the themes. Through iterative discussions, investigators built a grounded theory.
RESULTS:
Ninety-five third-year residents and 12 program directors at 12 pediatric residency programs participated. The analysis identified 21 subthemes grouped into 5 themes: program support, faculty roles, goal characteristics and purposes, resident attributes, and accountability and goal follow-through. Review of relationships between the themes revealed a pyramid of support with program support as the foundation that facilitates the layers above it, leading to goal follow-through.
CONCLUSIONS:
Program support facilitates each step of the SRL process that leads to meaningful use of learning goals in residency. A strong foundation of program support should include attention to aspects of the implicit curriculum as well as the explicit curriculum.

via In Pursuit of Meaningful Use of Learning Goals in Residency: A Qualitative Study of Pediatric Residents. – PubMed – NCBI.

ABSTRACT: Entrustment Decision Making in Clinical Training.

The decision to trust a medical trainee with the critical responsibility to care for a patient is fundamental to clinical training. When carefully and deliberately made, such decisions can serve as significant stimuli for learning and also shape the assessment of trainees. Holding back entrustment decisions too much may hamper the trainee’s development toward unsupervised practice. When carelessly made, however, they jeopardize patient safety. Entrustment decision-making processes, therefore, deserve careful analysis.Members (including the authors) of the International Competency-Based Medical Education Collaborative conducted a content analysis of the entrustment decision-making process in health care training during a two-day summit in September 2013 and subsequently reviewed the pertinent literature to arrive at a description of the critical features of this process, which informs this article.The authors discuss theoretical backgrounds and terminology of trust and entrustment in the clinical workplace. The competency-based movement and the introduction of entrustable professional activities force educators to rethink the grounds for assessment in the workplace. Anticipating a decision to grant autonomy at a designated level of supervision appears to align better with health care practice than do most current assessment practices. The authors distinguish different modes of trust and entrustment decisions and elaborate five categories, each with related factors, that determine when decisions to trust trainees are made: the trainee, supervisor, situation, task, and the relationship between trainee and supervisor. The authors’ aim in this article is to lay a theoretical foundation for a new approach to workplace training and assessment.

via Entrustment Decision Making in Clinical Training. – PubMed – NCBI.

ABSTRACT: Professional dermatology societies in the USA: an overview

This is a concise overview in a table format for the current membership-based dermatology societies in the USA. The primary objective of these societies is to provide continuous medical education. These societies serve all health care providers in dermatology care, including physician assistants and nurses. There is a clear need for establishing more societies which focus on different aspect of dermatology. There is always a potential for improving the educational activities of these societies.

via Professional dermatology societies in the USA: an overview. – PubMed – NCBI.

RESOURCE: 20 Popular Technology in Education Quotes

We all love reading quotes. Benefits are more than just getting that dose of inspiration and hope. Read out the list below of technology in education quotes to know it yourself.

1) “Technology is just a tool. In terms of getting the kids working together and motivating them, the teacher is most important.” – Bill Gates

2) “There can be infinite uses of the computer and of new age technology, but if teachers themselves are not able to bring it into the classroom and make it work, then it fails.” – Nancy Kassebaum

3) “Any teacher that can be replaced with a computer, deserves to be.” – David Thornburg

4) “Teachers need to integrate technology seamlessly into the curriculum instead of viewing it as an add-on, an afterthought, or an event.” – Heidi-Hayes Jacobs

… … …

via 20 Popular Technology in Education Quotes – EdTechReview™ (ETR).

RESOURCE: 5 Ways to Turn Panels from Boring To Brilliant

What Are the Worst Things About Panels?
So how do we loathe panels? It turns out there are 10 main ways, according to a recent survey.

10. Too many panelists. The optimal number, Arnold said, is three or four–four is best if you are concerned that one may drop out.
9. Poor time management
8. A panel discussion that isn’t actually a conversation. Especially painful is the hot-potato moderator who asks each panelist the same question, so by the time you get to the third or fourth, they’re straining to come up with anything remotely interesting to say that hasn’t already been said.
7. A panel that goes off-topic or has no real point
6. No audience engagement
5. Ego and self-promotion (one of my personal pet peeves)
4. Out-of-control panelists
3. Unprepared moderator and panelists
2. Dominating panelists
1. An ineffective moderator.

via Improve Panel Discussions | No More Boring Panels | face2face.

ABSTRACT: Electronic and postal reminders for improving immunisation coverage in children

INTRODUCTION:
Worldwide, suboptimal immunisation coverage causes the deaths of more than one million children under five from vaccine-preventable diseases every year. Reasons for suboptimal coverage are multifactorial, and a combination of interventions is needed to improve compliance with immunisation schedules. One intervention relies on reminders, where the health system prompts caregivers to attend immunisation appointments on time or re-engages caregivers who have defaulted on scheduled appointments. We undertake this systematic review to investigate the potential of reminders using emails, phone calls, social media, letters or postcards to improve immunisation coverage in children under five.
METHODS AND ANALYSIS:
We will search for published and unpublished randomised controlled trials and non-randomised controlled trials in PubMed, Scopus, CINAHL, CENTRAL, Science Citation Index, WHOLIS, Clinicaltrials.gov and the WHO International Clinical Trials Platform. We will conduct screening of search results, study selection, data extraction and risk-of-bias assessment in duplicate, resolving disagreements by consensus. In addition, we will pool data from clinically homogeneous studies using random-effects meta-analysis; assess heterogeneity of effects using the χ2 test of homogeneity; and quantify any observed heterogeneity using the I2 statistic.
ETHICS AND DISSEMINATION:
This protocol does not need approval by an ethics committee because we will use publicly available data, without directly involving human participants. The results will provide updated evidence on the effects of electronic and postal reminders on immunisation coverage, and we will discuss the applicability of the findings to low and middle-income countries. We plan to disseminate review findings through publication in a peer-reviewed journal and presentation at relevant conferences. In addition, we will prepare a policymaker-friendly summary using a validated format (eg, SUPPORT Summary) and disseminate this through social media and email discussion groups.

via Electronic and postal reminders for improving immunisation coverage in children: protocol for a systematic review and meta-analysis. – PubMed – NCBI.

MANUSCRIPT: The perceived effects of faculty presence vs. absence on small-group learning and group dynamics

BACKGROUND:
Medical education increasingly relies on small-group learning. Small group learning provides more active learning, better retention, higher satisfaction, and facilitates development of problem-solving and team-working abilities. However, less is known about student experience and preference for different small groups teaching models. We evaluated group educational dynamics and group learning process in medical school clerkship small group case-based settings, with a faculty member present versus absent.
METHODS:
Students completed surveys after cases when the faculty was present (“in”) or absent (“out”) for the bulk of the discussion. 228 paired surveys (114 pairs) were available for paired analysis, assessing group dynamics, group learning process, student preference, and participation through self-report and self-rating of group behaviors tied to learning and discussion quality.
RESULTS:
Ratings of group dynamics and group learning process were significantly higher with the faculty absent vs. present (p range <0.001 to 0.015). Students also reported higher levels of participation when the faculty member was absent (p = 0.03). Students were more likely to express a preference for having the faculty member present after “in” case vs. “out” case discussions. (p < 0.001). There was no difference in reported success of the case discussion after “in” vs. “out” cases (p = 0.67).
CONCLUSIONS:
Student groups without faculty present reported better group dynamics, group learning processes, and participation with faculty absent. Students reported that they feel somewhat dependent on faculty, especially when the faculty is present, though there was no significant difference in students reporting that they obtained the most they could from the discussion of the case after both “in” and “out” cases.

via The perceived effects of faculty presence vs. absence on small-group learning and group dynamics: a quasi-experimental study. – PubMed – NCBI.