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Author: Brian S McGowan, PhD

ABSTRACT: Exploring the use of a facebook page in anatomy education

Facebook is the most popular social media site visited by university students on a daily basis. Consequently, Facebook is the logical place to start with for integrating social media technologies into education. This study explores how a faculty-administered Facebook Page can be used to supplement anatomy education beyond the traditional classroom. Observations were made on students perceptions and effectiveness of using the Page, potential benefits and challenges of such use, and which Insights metrics best reflect users engagement. The Human Anatomy Education Page was launched on Facebook and incorporated into anatomy resources for 157 medical students during two academic years. Students use of Facebook and their perceptions of the Page were surveyed. Facebooks “Insights” tool was also used to evaluate Page performance during a period of 600 days. The majority of in-class students had a Facebook account which they adopted in education. Most students perceived Human Anatomy Education Page as effective in contributing to learning and favored “self-assessment” posts. The majority of students agreed that Facebook could be a suitable learning environment. The “Insights” tool revealed globally distributed fans with considerable Page interactions. The use of a faculty-administered Facebook Page provided a venue to enhance classroom teaching without intruding into students social life. A wider educational use of Facebook should be adopted not only because students are embracing its use, but for its inherent potentials in boosting learning. The “Insights” metrics analyzed in this study might be helpful when establishing and evaluating the performance of education-oriented Facebook Pages.

via Exploring the use of a facebook page in anatom… [Anat Sci Educ. 2013] – PubMed – NCBI.

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MANUSCRIPT: Teaching, Learning, Complexity and Health Professions Education

The purpose of this paper is to disturb the way we think about teaching and learning and to offer a view of health professions education from the perspective of complexity thinking. To discuss complexity and the profound shift it makes with current thinking it is helpful to recall that prior to the 16th century it was believed, in the Western world, that all things on earth and in the heavens were guided by a divine hand. Galileo, Newton, Copernicus, Descartes, and Bacon, among others, challenged and changed the status quo. Exploration and the gathering of evidence through experimentation, together with the rise individualism helped give birth to the scientific and industrial revolutions. Descartes wrote that everything should be broken down into its smallest component parts in order to understand the whole. This has had a profound and lasting effect palpable today in health professions education where mechanistic explanations still prevail and reductionist approaches to curriculum rooted in Cartesian and Newtonian linear causality are common. This is the dominant paradigm of western science and society. It is how we organize our schools. It is how we teach.

http://www.iamse.org/jiamse/volume20-2s/20-2s-162-165.pdf

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MANUSCRIPT: Team-based learning for psychiatry residents: a mixed methods study

Background
Team-based learning (TBL) is an effective teaching method for medical students. It improves knowledge acquisition and has benefits regarding learner engagement and teamwork skills. In medical education it is predominately used with undergraduates but has potential benefits for training clinicians. The aims of this study were to examine the impact of TBL in a sample of psychiatrists in terms of classroom engagement, attitudes towards teamwork, learner views and experiences of TBL.

Methods
Forty-four psychiatry residents participated in an Addictions Psychiatry TBL module. Mixed-methods were used for evaluation. Self-rated measures of classroom engagement (Classroom Engagement Survey, CES) were compared with conventional lectures, and attitudes regarding the value of teams (Value of Teams Scale, VTS) were compared before and after the module. Independent t-tests were used to compare `lecture? CES scores with TBL CES scores and pre and post scores for the VTS. Feedback questionnaires were completed. Interviews were conducted with a subset of residents and transcripts analysed using thematic analysis.

Results
Twenty-eight residents completed post-course measures (response rate 63.6%). Seven participants volunteered for qualitative interviews?one from each team. There was a significant difference in the mean CES score lectures compared to TBL (p?<?0.001) but no difference was found in mean VTS score pre and post for either subscale (p?=?0.519; p?=?0.809). All items on the feedback questionnaire were positively rated except two regarding session preparation. The qualitative analysis generated seven themes under four domains: `Learning in teams?, `Impact on the individual learner?, `Relationship with the teacher? and `Efficiency and effectiveness of the learning process?.

Conclusions
In this group of residents, TBL significantly improved learner-rated classroom engagement and seemed to promote interactivity between learners. TBL was generally well-received, although required learners to prepare for class which was difficult for some. TBL did not change these clinicians? views about teamwork.

via BMC Medical Education | Abstract | Team-based learning for psychiatry residents: a mixed methods study.

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MANUSCRIPT: Programmatic assessment of competency-based workplace learning: when theory meets practice

Background
In competency-based medical education emphasis has shifted towards outcomes, capabilities, and learner-centeredness. Together with a focus on sustained evidence of professional competence this calls for new methods of teaching and assessment. Recently, medical educators advocates the use of a holistic, programmatic approach towards assessment. Besides maximum facilitation of learning it should improve the validity and reliability of measurements and documentation of competence development. We explored how, in a competency-based curriculum, current theories on programmatic assessment interacted with educational practice.

Methods
In a development study including evaluation, we investigated the implementation of a theory-based programme of assessment. Between April 2011 and May 2012 quantitative evaluation data were collected and used to guide group interviews that explored the experiences of students and clinical supervisors with the assessment programme. We coded the transcripts and emerging topics were organised into a list of lessons learned.

Results
The programme mainly focuses on the integration of learning and assessment by motivating and supporting students to seek and accumulate feedback. The assessment instruments were aligned to cover predefined competencies to enable aggregation of information in a structured and meaningful way. Assessments that were designed as formative learning experiences were increasingly perceived as summative by students. Peer feedback was experienced as a valuable method for formative feedback. Social interaction and external guidance seemed to be of crucial importance to scaffold self-directed learning. Aggregating data from individual assessments into a holistic portfolio judgement required expertise and extensive training and supervision of judges.

Conclusions
A programme of assessment with low-stakes assessments providing simultaneously formative feedback and input for summative decisions proved not easy to implement. Careful preparation and guidance of the implementation process was crucial. Assessment for learning requires meaningful feedback with each assessment. Special attention should be paid to the quality of feedback at individual assessment moments. Comprehensive attention for faculty development and training for students is essential for the successful implementation of an assessment programme.

via BMC Medical Education | Abstract | Programmatic assessment of competency-based workplace learning: when theory meets practice.

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ABSTRACT: Simulation-based training for cardiac auscultation skills: systematic review and meta-analysis

OBJECTIVES:
The current review examines the effectiveness of simulation-based medical education (SBME) for training health professionals in cardiac physical examination and examines the relative effectiveness of key instructional design features.
METHODS:
Data sources included a comprehensive, systematic search of MEDLINE, EMBASE, CINAHL, PsychINFO, ERIC, Web of Science, and Scopus through May 2011. Included studies investigated SBME to teach health profession learners cardiac physical examination skills using outcomes of knowledge or skill. We carried out duplicate assessment of study quality and data abstraction and pooled effect sizes using random effects.
RESULTS:
We identified 18 articles for inclusion. Thirteen compared SBME to no-intervention (either single group pre-post comparisons or SBME added to other instruction common to all learners, such as traditional bedside teaching), three compared SBME to other educational interventions, and two compared two SBME interventions. Meta-analysis of the 13 no-intervention comparison studies demonstrated that simulation-based instruction in cardiac auscultation was effective, with pooled effect sizes of 1.10 (95 % CI 0.49-1.72; p < 0.001; I(2) = 92.4 %) for knowledge outcomes and 0.87 (95 % CI 0.52-1.22; p < 0.001; I(2) = 91.5 %) for skills. In sub-group analysis, hands-on practice with the simulator appeared to be an important teaching technique. Narrative review of the comparative effectiveness studies suggests that SBME may be of similar effectiveness to other active educational interventions, but more studies are required.
LIMITATIONS:
The quantity of published evidence and the relative lack of comparative effectiveness studies limit this review.
CONCLUSIONS:
SBME is an effective educational strategy for teaching cardiac auscultation. Future studies should focus on comparing key instructional design features and establishing SBME’s relative effectiveness compared to other educational interventions.

via Simulation-based training for cardiac auscu… [J Gen Intern Med. 2013] – PubMed – NCBI.

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ABSTRACT: Primary care physicians’ knowledge of the ophthalmic effects of diabetes

OBJECTIVE:Previous studies suggest that many patients with diabetes do not receive an annual dilated eye examination because of a lack of referrals from primary care physicians (PCPs). This study aims to determine the depth of knowledge of PCPs regarding diabetic eye disease.DESIGN:Cross-sectional assessment.PARTICIPANTS:Ninety-seven PCPs.METHODS:An 8-question, multiple-choice assessment was administered over a 3-month period to 208 PCPs in attendance at continuing medical education conferences.RESULTS:Ninety-seven PCPs completed the assessment. Participants had a mean total score of 5.9 of 8 possible (73.8%). Questions regarding screening, clinical findings, and prevention were answered correctly by ≥81% of the respondents. However, questions regarding risk factors and complications were answered correctly by less than 35% of the respondents. No difference in scores was found based on the type of residency training received or the number of years in practice.CONCLUSIONS:Although PCPs may require greater education in the complications and risk factors of diabetic eye disease, study participants demonstrated a good overall depth of knowledge regarding diabetic eye disease. Thus, previous reports of only 35% to 55% of patients with diabetes receiving an annual dilated fundus examination are likely not due to a lack of physician education.

via Primary care physicians’ knowledge of the o… [Can J Ophthalmol. 2013] – PubMed – NCBI.

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ABSTRACT: Making the professionalism curriculum for undergraduate medical education more relevant

Background: This study was an assessment of the professionalism curriculum at a community-based medical school from the perspective of undergraduate medical students. Aims: The goal of this study was to ascertain the perspectives of faculty and students on their interpretations of professionalism and its role in medical education to improve and expand existing professionalism curricula. Method: An online survey was created and sent to all students (n = 245) and selected faculty (n = 41). The survey utilized multiple choice and open-ended questions to allow responders to provide their insights on the definition of professionalism and detail how professionalism is taught and evaluated at their institution. A content analysis was conducted to categorize open-ended responses and the resulting themes were further examined using SPSS 20.0 for Windows (IBM Corp., Armonk, NY) frequency analyses. Results: Students and faculty respondents were similar in their definitions of medical professionalism and their perceptions of teaching methods. Role modeling was the most common and preferred method of professionalism education. Responses to whether evaluations of professional behavior were effective suggested both students and faculty are unclear about current professionalism assessments. Conclusion: This study showed that a cohesive standardized definition of professionalism is needed, as well as clearer guidelines on how professionalism is assessed.

via Making the professionalism curriculum for undergra… [Med Teach. 2013] – PubMed – NCBI.

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ABSTRACT: Lifelong Learning and Self-assessment Is Relevant to Emergency Physician

BACKGROUND:
The Lifelong Learning and Self-assessment (LLSA) component of the American Board of Emergency Medicine (ABEM) Maintenance of Certification (MOC) program is a self-assessment exercise for physicians. Beginning in 2011, an optional continuing medical education (CME) activity was added.
OBJECTIVES:
As a part of a CME activity option for the LLSA, a survey was used to determine the relevancy of the LLSA readings and the degree to which medical knowledge garnered by the LLSA activity would modify clinical care.
METHODS:
Survey results from the 2011 LLSA CME activity were reviewed. This survey was composed of seven items, including questions about the relevancy of the readings and the impact on the physician’s clinical practice. The questions used a 5-point Likert scale and data underwent descriptive analyses.
RESULTS:
There were 2841 physicians who took the LLSA test during the study period, of whom 1354 (47.7%) opted to participate in the 2011 LLSA CME activity. All participants completed surveys. The LLSA readings were reported to be relevant to the overall clinical practice of Emergency Medicine (69.6% strongly relevant, 28.1% some relevance, and 2.3% little or no relevance), and provided information that would likely help them change their clinical practices (high likelihood 38.8%, some likelihood 53.0%, little or no change 8.2%).
CONCLUSIONS:
The LLSA component of the ABEM MOC program is relevant to the clinical practice of Emergency Medicine. Through this program, physicians gain new knowledge about the practice of Emergency Medicine, some of which is reported to change physicians’ clinical practices.

via Lifelong Learning and Self-assessment Is Relevan… [J Emerg Med. 2013] – PubMed – NCBI.

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ABSTRACT: Simulation in healthcare education: A best evidence practical guide. AMEE Guide No. 82

Over the past two decades, there has been an exponential and enthusiastic adoption of simulation in healthcare education internationally. Medicine has learned much from professions that have established programs in simulation for training, such as aviation, the military and space exploration. Increased demands on training hours, limited patient encounters, and a focus on patient safety have led to a new paradigm of education in healthcare that increasingly involves technology and innovative ways to provide a standardized curriculum. A robust body of literature is growing, seeking to answer the question of how best to use simulation in healthcare education. Building on the groundwork of the Best Evidence in Medical Education (BEME) Guide on the features of simulators that lead to effective learning, this current Guide provides practical guidance to aid educators in effectively using simulation for training. It is a selective review to describe best practices and illustrative case studies. This Guide is the second part of a two-part AMEE Guide on simulation in healthcare education. The first Guide focuses on building a simulation program, and discusses more operational topics such as types of simulators, simulation center structure and set-up, fidelity management, and scenario engineering, as well as faculty preparation. This Guide will focus on the educational principles that lead to effective learning, and include topics such as feedback and debriefing, deliberate practice, and curriculum integration – all central to simulation efficacy. The important subjects of mastery learning, range of difficulty, capturing clinical variation, and individualized learning are also examined. Finally, we discuss approaches to team training and suggest future directions. Each section follows a framework of background and definition, its importance to effective use of simulation, practical points with examples, and challenges generally encountered. Simulation-based healthcare education has great potential for use throughout the healthcare education continuum, from undergraduate to continuing education. It can also be used to train a variety of healthcare providers in different disciplines from novices to experts. This Guide aims to equip healthcare educators with the tools to use this learning modality to its full capability.

via Simulation in healthcare education: A best evidenc… [Med Teach. 2013] – PubMed – NCBI.

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ABSTRACT: Sex differences among obstetrician-gynecologists: a review of survey studies.

Whether practice differences exist between the sexes is a question of clinical and educational significance. The obstetrician-gynecologist ob-gyn workforce has been shifting to majority women. An examination of sex differences in ob-gyn practice contributes to the discussion about how the changing workforce may impact womens healthcare. We sought to review survey studies to assess whether there are specific topics in which differences in attitudes, opinions, and practice patterns between male and female ob-gyns are apparent. We conducted a systematic review to identify all survey studies of ob-gyns from the years 2002-2012. A total of 93 studies were reviewed to identify statements of sex differences and categorized by conceptual theme. Sex differences were identified in a number of areas. In general, women report more supportive attitudes toward abortion. A number of differences were identified with regard to workforce issues, such as women earning 23% less than their male counterparts as reported in 1 study and working an average of 4.1 fewer hours per week than men in another study. Men typically provide higher selfratings than women in a number of areas. Other noted findings include men tending toward more pharmaceutical therapies and women making more referrals for medical conditions. Although a number of areas of difference were identified, the impact of such differences is yet to be determined. Additional research may help to clarify the reasons for such differences and their potential impact on patients. Target Audience: Obstetricians and gynecologists, family physicians Learning Objectives: After completing this CME activity, physicians should be better able to determine how the relevance of studying sex differences among physicians, specifically ob-gyns, can help improve patient care, assess whether there are topical areas in which male and female ob-gyns have reported different beliefs, practices, attitudes, and opinions, and examine how the limitations of survey studies and systematic reviews can affect the findings of these studies and reviews

via Sex differences among obstetrician-gynec… [Obstet Gynecol Surv. 2013] – PubMed – NCBI.

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