Author: Brian S McGowan, PhD

BACKGROUND:
Despite thousands of publications over the past 90 years on the assessment of teaching effectiveness, there is still confusion, misunderstanding, and hand-to-hand combat on several topics that seem to pop up over and over again on listservs, blogs, articles, books, and medical education/teaching conference programs. If you are measuring teaching performance in face-to-face, blended/hybrid, or online courses, then you are probably struggling with one or more of these topics or flashpoints.
AIM:
To decrease the popping and struggling by providing a state-of-the-art update of research and practices and a “consumer’s guide to trouble-shooting these flashpoints.”
METHODS:
Five flashpoints are defined, the salient issues and research described, and, finally, specific, concrete recommendations for moving forward are proffered. Those flashpoints are: (1) student ratings vs. multiple sources of evidence; (2) sources of evidence vs. decisions: which come first?’ (3) quality of “home-grown” rating scales vs. commercially-developed scales; (4) paper-and-pencil vs. online scale administration; and (5) standardized vs. unstandardized online scale administrations. The first three relate to the sources of evidence chosen and the last two pertain to online administration issues.
RESULTS:
Many medical schools/colleges and higher education in general fall far short of their potential and the available technology to comprehensively assess teaching effectiveness. Specific recommendations were given to improve the quality and variety of the sources of evidence used for formative and summative decisions and their administration procedures.
CONCLUSIONS:
Multiple sources of evidence collected through online administration, when possible, can furnish a solid foundation from which to infer teaching effectiveness and contribute to fair and equitable decisions about faculty contract renewal, merit pay, and promotion and tenure.

via Top five flashpoints in the assessment of teaching… [Med Teach. 2013] – PubMed – NCBI.

As medical education research continues to diversify methodologically and theoretically, medical education researchers have been increasingly willing to challenge taken-for-granted assumptions about the form, content and function of medical education. In this AMEE guide we describe historical, discourse and text analysis approaches that can help researchers and educators question the inevitability of things that are currently seen as ‘natural’. Why is such questioning important? By articulating our assumptions and interrogating the ‘naturalness’ of the status quo, one can then begin to ask why things are the way they are. Researchers can, for example, ask whether the models of medical education organization and delivery that currently seem ‘natural’ to them have been developed in order to provide the most benefit to students or patients–or whether they have, rather, been developed in ways that provide power to faculty members, medical schools or the medical profession as a whole. An understanding of the interplay of practices and power is a valuable tool for opening up the field to new possibilities for better medical education. The recognition that our current models, rather than being ‘natural’, were created in particular historical contexts for any number of contingent reasons leads inexorably to the possibility of change. For if our current ways of doing things are not, in fact, inevitable, not only can they be questioned, they can be made better; they can changed in ways that are attentive to whom they benefit, are congruent with our current beliefs about best practice and may lead to the production of better doctors.

via Looking back to move forward: using history, disco… [Med Teach. 2013] – PubMed – NCBI.

OBJECTIVES:
In their work, health care professionals have to deal daily with inconsistent health information and are confronted with differing therapeutic health concepts. Medical education should prepare students to handle these challenges adequately. The aim of this study was to contribute to a better understanding of how students deal with inconsistencies in health knowledge when they are presented with either a therapeutic concept they accept or one they reject.
METHODS:
Seventy-six students of physiotherapy participated in this 2 × 2 experiment with health information (consistent versus inconsistent information) and therapeutic concept (congruent versus contradictory therapeutic concept) as between-group factors. The participants’ task was to improve the quality of a text about the effectiveness of stretching; participants were randomly assigned to one of four texts. Knowledge acquisition and text modification were measured as dependent variables.
RESULTS:
Students acquired more knowledge when they worked with a text containing inconsistent information. Medical information that was presented in agreement with a student’s therapeutic concept was also more readily acquired than the same information presented posing a contradictory therapeutic concept. Participants modified the contradictory text in order to adapt it to their own point of view. Disagreement resulted in a disregard or devaluation of the information itself, which in turn was detrimental to learning.
CONCLUSIONS:
It is a problem when prospective health care professionals turn a blind eye to discrepancies that do not fit their view of the world. It may be useful for educational purposes to include a knowledge conflict caused by a combination of conviction and inconsistent information to facilitate learning processes.

via How students deal with inconsistencies in health kn… [Med Educ. 2013] – PubMed – NCBI.

CONTEXT:
Conventional continuing medical education (CME) has been shown to have modest effects on doctor performance. New educational approaches based on the review of routine practices have brought better results. Little is known about factors that affect the outcomes of these approaches, especially in middle-income countries. This study aimed to investigate factors that influence the learning and quality of clinical performance in CME based on reflection upon experiences.
METHODS:
A questionnaire and a clinical performance test were administered to 165 general practitioners engaged in a CME programme in Brazil. The questionnaire assessed behaviours related to four input variables (individual reflection on practices, peer review of experiences, self-regulated learning and learning skills) and two mediating variables (identification of learning needs and engagement in learning activities, the latter consisting of self-study of scientific literature, consultations about patient problems, and attendance at courses). Structural equation modelling was used to test a hypothesised model of relationships between these variables and the outcome variable of clinical performance, measured by the clinical performance test.
RESULTS:
After minor adjustments, the hypothesised model fit the empirical data well. Individual reflection fostered identification of learning needs, but also directly positively influenced the quality of clinical performance. Peer review did not affect identification of learning needs, but directly positively affected clinical performance. Learning skills and self-regulation did not help in identifying learning needs, but self-regulation enhanced study of the scientific literature, the learning activity that most positively influenced clinical performance. Consultation with colleagues, the activity most frequently triggered by the identification of learning needs, did not affect performance, and attendance of courses had only limited effect.
CONCLUSIONS:
This study shed light on the factors that influence learning and performance improvement in continuing education based on the review of routine practices in middle-income settings. The findings support the importance of reflection on practices as an instrument for enhancing clinical performance.

via Effects of reviewing routine practices on learning … [Med Educ. 2013] – PubMed – NCBI.