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Author: Brian S McGowan, PhD

ABSTRACT: Evolution of practice gaps in gastrointestinal and endoscopic surgery: 2012 report from the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES) Continuing Education Committee.

BACKGROUND:
In an effort to fulfill its charge to develop and maintain a comprehensive educational program to serve the members of the Society of American Gastrointestinal and Endoscopic Surgeons (SAGES), the SAGES Continuing Education Committee (CEC) reports a summary of findings related to its evaluation of the 2012 SAGES annual meeting.
METHODS:
All attendees to the 2012 annual meeting had the opportunity to complete an immediate postmeeting questionnaire as part of their continuing medical education (CME) certification in which they identified up to two learning themes, answered questions related to potential practice change items that are based on those learning themes, and complete a needs assessment related to important learning topics for future meetings. In addition, participants in the postgraduate and hands-on courses were asked to complete questions about case volume and comfort levels related to procedures/topics in those courses. All respondents to this initial survey were sent a 3-month follow-up questionnaire in which they were asked how successfully they had implemented the intended practice changes and what, if any, barriers they encountered. Postgraduate and hands-on course participants completed case volume and comfort level questions. Descriptive statistical analysis of this deidentified data was undertaken.
RESULTS:
Response rates were 42 % and 56 % for CME-eligible attendees/respondents for the immediate postmeeting and 3-month follow-up questionnaires, respectively. Top learning themes for respondents were Bariatric, Hernia, Foregut, and Colorectal. Improving minimally invasive surgical (MIS) technique and managing complications related to MIS procedures were top intended practice changes. Partial implementation was common with top barriers including cost restrictions, lack of institutional support, and lack of time.
CONCLUSIONS:
The 2012 annual meeting analysis provides insight into educational needs among respondents and will help with planning content for future meetings

via Evolution of practice gaps in gastrointestinal a… [Surg Endosc. 2013] – PubMed – NCBI.

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MANUSCRIPT: Limitations of poster presentations reporting educational innovations at a major international medical education conference.

Background: In most areas of medical research, the label of ‘quality’ is associated with well-accepted standards. Whilst its interpretation in the field of medical education is contentious, there is agreement on the key elements required when reporting novel teaching strategies. We set out to assess if these features had been fulfilled by poster presentations at a major international medical education conference. Methods: Such posters were analysed in four key areas: reporting of theoretical underpinning, explanation of instructional design methods, descriptions of the resources needed for introduction, and the offering of materials to support dissemination. Results: Three hundred and twelve posters were reviewed with 170 suitable for analysis. Forty-one percent described their methods of instruction or innovation design. Thirty-three percent gave details of equipment, and 29% of studies described resources that may be required for delivering such an intervention. Further resources to support dissemination of their innovation were offered by 36%. Twenty-three percent described the theoretical underpinning or conceptual frameworks upon which their work was based. Conclusions: These findings suggest that posters presenting educational innovation are currently limited in what they offer to educators. Presenters should seek to enhance their reporting of these crucial aspects by employing existing published guidance, and organising committees may wish to consider explicitly requesting such information at the time of initial submission.

via Limitations of poster presentations reportin… [Med Educ Online. 2013] – PubMed – NCBI.

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MANUSCRIPT: An exploratory study into the effect of time-restricted internet access on face-validity, construct validity and reliability of postgraduate knowledge progress testing.

BACKGROUND:
Yearly formative knowledge testing (also known as progress testing) was shown to have a limited construct-validity and reliability in postgraduate medical education. One way to improve construct-validity and reliability is to improve the authenticity of a test. As easily accessible internet has become inseparably linked to daily clinical practice, we hypothesized that allowing internet access for a limited amount of time during the progress test would improve the perception of authenticity (face-validity) of the test, which would in turn improve the construct-validity and reliability of postgraduate progress testing.
METHODS:
Postgraduate trainees taking the yearly knowledge progress test were asked to participate in a study where they could access the internet for 30 minutes at the end of a traditional pen and paper test. Before and after the test they were asked to complete a short questionnaire regarding the face-validity of the test.
RESULTS:
Mean test scores increased significantly for all training years. Trainees indicated that the face-validity of the test improved with internet access and that they would like to continue to have internet access during future testing. Internet access did not improve the construct-validity or reliability of the test.
CONCLUSION:
Improving the face-validity of postgraduate progress testing, by adding the possibility to search the internet for a limited amount of time, positively influences test performance and face-validity. However, it did not change the reliability or the construct-validity of the test.

via An exploratory study into the effect of time-re… [BMC Med Educ. 2013] – PubMed – NCBI.

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ABSTRACT: Building learning communities: evolution of the colleges at Vanderbilt University School of Medicine

Learning communities, which are an emerging trend in medical education, create a foundation for professional and academic development through the establishment of longitudinal relationships between students and faculty. In this article, the authors describe the robust learning community system at Vanderbilt University School of Medicine, which encompasses wellness, career planning, professional development, and academics.The Vanderbilt Advisory Colleges Program introduced in 2006 initially focused on two goals: promoting wellness and providing career advising. In the 2011-2012 academic year, the focus of the colleges expanded to incorporate an enhanced level of personal career advising and an academic component. In the four-year College Colloquium course, faculty selected as college mentors teach the medical humanities and lead sessions dedicated to student professional development in the areas of leadership, research, and service-learning. This academic and professional development program builds on the existing strengths of the colleges and has transformed the colleges into learning communities.The authors reflect on lessons learned and discuss future plans. They report that internal data and data from the Association of American Medical Colleges Medical School Graduation Questionnaire support consistently high and increasing satisfaction among Vanderbilt medical students, across the metrics of personal counseling, faculty mentoring, and career planning.

via Building learning communities: evolution of the col… [Acad Med. 2013] – PubMed – NCBI.

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ABSTRACT: Reframing clinical workplace learning using the theory of distributed cognition

In medicine, knowledge is embodied and socially, temporally, spatially, and culturally distributed between actors and their environment. In addition, clinicians increasingly are using technology in their daily work to gain and share knowledge. Despite these characteristics, surprisingly few studies have incorporated the theory of distributed cognition (DCog), which emphasizes how cognition is distributed in a wider system in the form of multimodal representations (e.g., clinical images, speech, gazes, and gestures) between social actors (e.g., doctors and patients) in the physical environment (e.g., with technological instruments and computers). In this article, the authors provide an example of an interaction between medical actors. Using that example, they then introduce the important concepts of the DCog theory, identifying five characteristics of clinical representations-that they are interwoven, co-constructed, redundantly accessed, intersubjectively shared, and substantiated-and discuss their value for learning. By contrasting these DCog perspectives with studies from the field of medical education, the authors argue that researchers should focus future medical education scholarship on the ways in which medical actors use and connect speech, bodily movements (e.g., gestures), and the visual and haptic structures of their own bodies and of artifacts, such as technological instruments and computers, to construct complex, multimodal representations. They also argue that future scholarship should “zoom in” on detailed, moment-by-moment analysis and, at the same time, “zoom out” following the distribution of cognition through an overall system to develop a more integrated view of clinical workplace learning.

via Reframing clinical workplace learning using the the… [Acad Med. 2013] – PubMed – NCBI.

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ABSTRACT: Considering the clinical context of medical education.

The article by Chen and colleagues in this issue suggests that the context in which clinical medical education is executed matters, especially if we intend to meet the projected future physician workforce needs in the United States. Placing learners in the highest-performing medical settings seems intuitive, but this can be disruptive to the patient care interface, especially in high-performing health care delivery systems. Simply placing learners in a well-functioning, highly reliable health care delivery system focused on systems of care and directed at improving quality and safety is not enough for learners. Educational experiences must be planned, organized, and strategically aligned with clinical operations to ensure seamless integration with highly reliable health care delivery systems. The authors draw on their experience at Geisinger Health System to explore the challenges and advantages to integrating the education and patient care missions of academic clinical sites for learners, patients, faculty, and the future of the workforce.

via Considering the clinical context of medical education. [Acad Med. 2013] – PubMed – NCBI.

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ABSTRACT: The role of ePortfolios in supporting continuing professional development in practice

ePortfolios, based on models of reflective practice, are viewed as important tools in facilitating and supporting lifelong learning across the medical education continuum. MAINPORT, the ePortfolio designed by the Royal College of Physicians and Surgeons of Canada, supports the continuing professional development CPD and lifelong learning of specialist physicians practicing in Canada by providing tools to develop CPD plans, set and track progress of established learning goals, document and reflect on learning activities, and create the foundation for physicians to manage their learning. In this article, the authors summarize the key design principles of the Royal Colleges ePortfolio: learner-centered; interoperable; ease of access. The current core functionality as well as future planned functionality for MAINPORT are described under three domains: recording and reflecting on completed CPD activities; managing learning in practice; accessing learning resources and programs. The future MAINPORT will evolve to become a foundational tool to support the shift towards competency-based medical education across the continuum of medical education; from residency to retirement. MAINPORT will facilitate the ability of physicians to demonstrate their expertise over time and how their learning has enabled improvements to their practice in contributing to improved health outcomes for patients.

via The role of ePortfolios in supporting continuing p… [Med Teach. 2013] – PubMed – NCBI.

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RESOURCE: Comment from member of research team on USA Today flipped classroom article

The USA Today article paints an inaccurate picture of our work and I wanted to try to clarify some things and continue this conversation with you and your readers. (I am only writing on my own behalf and not for my collaborators on this study.)

My biggest regret is that the article greatly oversimplifies things by portraying our study as an attempt to answer whether flipped classrooms work or not. That kind of research question is too blunt to be useful. Our goal is to better understand the conditions under which flipped classrooms lead to better student outcomes. As Phil and others here point out, there are many different manifestations of what we mean by the term “flipped classroom” and that we should be wary about talking about it as if there is one canonical implementation. How are the benefits of flipped classrooms affected by school and student contexts, and are there other benefits that we haven’t yet characterized? We don’t have any preconceived answers to these research questions. While folks might disagree with us whether these research questions are interesting or not, they should at least know that we’re aware of the good work that others have already done and we’re trying to build on it rather than debunk it.

via Comment from member of research team on USA Today flipped classroom article |e-Literate.

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RESOURCE: ‘Flipping’ Classrooms May Not Make Much Difference

In preliminary research, professors at Harvey Mudd College haven’t found that students learn more or more easily in so-called flipped courses than in traditional classes, USA Today reports. In flipped courses, students watch professors’ lectures online before coming to class, then spend the class period in discussions or activities that reinforce and advance the lecture material.

Earlier this year, the National Science Foundation gave four professors at the college in Claremont, Calif., a three-year grant for $199,544 to study flipped classrooms. That research isn’t complete yet, but the professors already tried flipping their own classes last year and found “no statistical difference” in student outcomes.

The article notes that flipping classes requires professors both to record lectures in advance and to come up with activities that will engage students in class sessions. Nancy Lape, a professor of engineering at Harvey Mudd, said instructors’ lives “might be easier and their students might be happier if they just do a traditional class.”

via QuickWire: ‘Flipping’ Classrooms May Not Make Much Difference – Wired Campus – The Chronicle of Higher Education.

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RESOURCE: Should Teachers Share Online?

There are some who feel that teachers who share are the best teachers. In fact, Shareski more directly states that you don’t have to share to be a great teacher, but doing so does make you great. I disagree. Not sharing makes you a less-than-great teacher. In other words, it is impossible to be a great teacher without sharing and without the necessary tools to get the job done. Would you hire a plumber to fix your sink if that plumber did not have the tools necessary to do the job? Teachers rely on objects, materials, technologies, etc. to teach, just as doctors rely on objects, materials, technologies, etc. to help cure people. Would you go to a psychiatrist who hadn’t studied, or who had not kept up with the latest discourse around the most current treatments? Isn’t formal and informal study just a big sharing exercise? How many teachers would hold back or admit to holding back what they know to their students due to a fear of sharing?

via Should Teachers Share Online? – Edudemic – Edudemic.

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