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Adv Health Sci Educ Theory Pract 2019 Apr 2. Epub 2019 Apr 2.

Centre for Education Development and Research in Health Professions, University Medical Center Groningen, Groningen, The Netherlands.

Feedback on clinical performance of residents is seen as a fundamental element in postgraduate medical education. Although literature on feedback in medical education is abundant, many supervisors struggle with providing this feedback and residents experience feedback as insufficiently constructive. With a detailed analysis of real-world feedback conversations, this study aims to contribute to the current literature by deepening the understanding of how feedback on residents' performance is provided, and to formulate recommendations for improvement of feedback practice. Read More

Adv Health Sci Educ Theory Pract 2019 Mar 27. Epub 2019 Mar 27.

Department of Health Management, School of Health Sciences, Ariel University, Ariel, Israel.

There is a widespread consensus about the need for accreditation systems for evaluating post-graduate medical education programs, but accreditation systems differ substantially across countries. A cross-country comparison of accreditation systems could provide valuable input into policy development processes. We reviewed the accreditation systems of five countries: The United States, Canada, The United Kingdom, Germany and Israel. Read More

Adv Health Sci Educ Theory Pract 2019 Mar 26. Epub 2019 Mar 26.

Edinburgh Medical School, Chancellor's Building, Little France Crescent, Edinburgh, EH16 4SB, UK.

Within the expansion of postgraduate educational qualifications for health professionals, graduate attributes have become important markers of outcomes and value. However, it is not clear how or when graduate attributes develop, or how they are applied in professional practice after graduation. We interviewed 17 graduates from two online Master's programmes to explore their perceptions of how postgraduate study had influenced their practice and professional identity. Read More

Adv Health Sci Educ Theory Pract 2019 Mar 26. Epub 2019 Mar 26.

McMaster Faculty of Health Sciences Education Research, Innovation and Theory Program, McMaster University, Hamilton, Canada.

Due to an unfortunate turn of events, Fig. 3 was omitted from the original publication. Read More

Adv Health Sci Educ Theory Pract 2019 Mar 23. Epub 2019 Mar 23.

Department of Medicine & Centre for Health Education Scholarship, University of British Columbia, Vancouver, Canada.

Safe and effective healthcare requires that new knowledge or skills, once learned, are incorporated into professional practice. However, this process is not always straightforward. Learning takes place in complex contexts, requiring practitioners to overcome various motivational, systemic, emotional, and social barriers to the application of knowledge. Read More

Adv Health Sci Educ Theory Pract 2019 Mar 6. Epub 2019 Mar 6.

Gender Medicine Unit, Medical University of Innsbruck, Innrain 66, 6020, Innsbruck, Austria.

Studies have continuously shown that fewer women than men achieve leadership positions in academic medicine. In the current study we explored gender differences in clinical position among academic physicians at three university hospitals, each in a different European country. These countries, Sweden, the Netherlands and Austria, differ in terms of gender equality. Read More

Adv Health Sci Educ Theory Pract 2019 Mar 4. Epub 2019 Mar 4.

Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.

Mentoring is suffering from a shortage of trained mentors which compromise the efficacy of novice mentoring or mentoring between a senior clinician and a junior clinician. E-mentoring is proposed as a means of supplementing this dominant form of mentoring in medicine by providing accessible, timely and longitudinal support for mentees. However, with little is known about e-mentoring nor its role in a blended mentoring approach, a systematic scoping review is proposed to evaluate these gaps in understanding in order to better understand e-mentoring and assess the viability of employing e-mentoring practice to support novice mentoring. Read More

Adv Health Sci Educ Theory Pract 2019 Mar 2. Epub 2019 Mar 2.

Graduate Research School, Auckland University of Technology, Auckland, New Zealand.

Interprofessional practice is commonly discussed in the literature in terms of competencies. In this study we move away from the theoretical notions of criteria, concepts and guidelines to adopt an ontological approach which seeks to stay as close to the lived experience as possible. Our research asked 12 participants from a variety of health disciplines to tell their stories of working interprofessionally. Read More

Adv Health Sci Educ Theory Pract 2019 Feb 27. Epub 2019 Feb 27.

Department of Health Sciences and Kinesiology, Georgia Southern University, P.O. Box 8076, Statesboro, GA, 30460, USA.

It is well-documented that retrieval practice enhances the recall of simple and complex information (Karpicke and Aue in Educ Psychol Rev 27(2):317-326, 2015). Evidence is also accumulating that retrieval practice can enhance other cognitive processes such as the ability to critically evaluate research articles (Dobson et al. in Med Educ 52(5):513-525, 2018) and transfer of learning (Butler in J Exp Psychol Learn Mem Cogn 36(5):1118, 2010). Read More

Adv Health Sci Educ Theory Pract 2019 Mar;24(1):3-14

Department of Health Research Methods, Evidence and Impact, McMaster University, Hamilton, ON, Canada.

Adv Health Sci Educ Theory Pract 2019 Mar;24(1)

McMaster University, Hamilton, ON, Canada.

Adv Health Sci Educ Theory Pract 2019 Feb 6. Epub 2019 Feb 6.

Erasmus University Rotterdam, Rotterdam, Netherlands.

Pre-class preparation is a crucial component of team-based learning (TBL). Lack of preparation hinders both individual learning and team performance during TBL. The purpose of the present study was to explore how the grading of the individual readiness assurance test (iRAT) can affect pre-class preparation, iRAT performance and performance in the end-of-year examination. Read More

Adv Health Sci Educ Theory Pract 2019 Feb 4. Epub 2019 Feb 4.

Centre for Medical Education, Faculty of Life Sciences and Medicine, King's College London, London, UK.

The well-structured medical communication models that are typically described in textbooks are relevant to practice, but the actual messy interactional realities of consultations are often a far cry away from them. As a result, medical trainees frequently encounter difficulties when applying communication skills acquired during training to medical practice. This paper reflects on how clinical communication research and courses can incorporate the growing need for context-bound communication skills training. Read More

Adv Health Sci Educ Theory Pract 2019 Jan 29. Epub 2019 Jan 29.

McMaster Faculty of Health Sciences Education Research, Innovation and Theory Program, McMaster University, Hamilton, Canada.

There is an ongoing debate regarding the cause of diagnostic errors. One view is that errors result from unconscious application of cognitive heuristics; the alternative is that errors are a consequence of knowledge deficits. The objective of this study was to compare the effectiveness of checklists that (a) identify and address cognitive biases or (b) promote knowledge retrieval, as a means to reduce errors in ECG interpretation. Read More

Adv Health Sci Educ Theory Pract 2019 Jan 22. Epub 2019 Jan 22.

Centre for Research and Development of Education, University Medical Centre Utrecht, PO Box # 85500, 3508 GA, Utrecht, The Netherlands.

In this paper, we will first discuss two current meta-theories dealing with different, aspects of "truth". The first metatheory conceives of truth in terms of coherence (rationality, consistency): a body of knowledge is true when it contains no inconsistencies and has at least some credibility. The second metatheory conceives of truth as correspondence, i. Read More

Adv Health Sci Educ Theory Pract 2019 Jan 18. Epub 2019 Jan 18.

School of Health Professions Education, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands.

Maximising the potential of the workplace as a learning environment entails understanding the complexity of its members' interactions. Although some articles have explored how residents engage with supervisors, nurses and pharmacists individually, there is little research on how residents enter into and engage with the broader community of clinical practice (CoCP). To this end, we designed a constructivist grounded theory study that took place at Universidad Javeriana in Bogotá, Colombia. Read More

Adv Health Sci Educ Theory Pract 2019 Jan 17. Epub 2019 Jan 17.

Department of Clinical Science and Education, Södersjukhuset, Karolinska Institutet, Forskningscentrum, Sjukhusbacken 10, 118 46, Stockholm, Sweden.

Several studies have demonstrated that medical students and doctors rank specialties differently in terms of perceived status and prestige. At the same time some of the specialties have problems with recruiting and retaining staff. This study aimed to understand what constitutes status and prestige in the medical field and how it influences medical doctors' choice of specialty. Read More

Adv Health Sci Educ Theory Pract 2019 Jan 10. Epub 2019 Jan 10.

Institute of Health Care Sciences, Sahlgrenska Academy, University of Gothenburg, POB 457, 405 30, Gothenburg, Sweden.

While person-centred care has gained increasing prominence in recent decades as a goal for healthcare systems, mainstream implementation remains tentative and there is a lack of knowledge about how to develop person-centred care in practice. This study therefore aimed to explore what may be required in order for person-centred care programmes to be successful. The study used an ethnographic method of data collection. Read More

Adv Health Sci Educ Theory Pract 2019 Jan 9. Epub 2019 Jan 9.

Department of Education, Saarland University, Saarbrücken, Germany.

The present study aims at fostering undergraduate medical students' clinical reasoning by learning from errors. By fostering the acquisition of "negative knowledge" about typical cognitive errors in the medical reasoning process, we support learners in avoiding future erroneous decisions and actions in similar situations. Since learning from errors is based on self-explanation activities, we provided additional prompting procedures to foster the effectiveness of the error-based instructional approach. Read More

Adv Health Sci Educ Theory Pract 2018 Dec 11. Epub 2018 Dec 11.

The Hospital for Sick Children, Toronto, ON, Canada.

Direct observation of clinical skills is central to assessment in a competency-based medical education model, yet little is known about how direct observation is experienced by trainees and observers. The objective of the study is to explore how direct observation was experienced by residents and faculty in the context of the I-PASS Handoff Study. In this multi-center qualitative study, we conducted focus groups and semi-structured interviews of residents and faculty members at eight tertiary pediatric centers in North America that implemented the I-PASS Handoff Bundle. Read More

Adv Health Sci Educ Theory Pract 2018 Dec 5. Epub 2018 Dec 5.

Professional Performance Research Group, Department of Medical Psychology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands.

An optimal learning climate is crucial for the quality of residency training and may also improve residents' well-being and empathy. We investigated the associations of learning climate with residents' work-related well-being. A multicenter questionnaire study was performed among 271 surgery and gynaecology residents in 21 training programs from September 2012 to February 2013. Read More

Adv Health Sci Educ Theory Pract 2018 Nov 19. Epub 2018 Nov 19.

Western University, London, Canada.

Learner engagement matters, particularly in simulation-based education. Indeed, it has been argued that instructional design only matters in the service of engaging learners in a simulation encounter. Yet despite its purported importance, our understanding of what engagement is, how to define it, how to measure it, and how to assess it is limited. Read More

Adv Health Sci Educ Theory Pract 2018 Nov 16. Epub 2018 Nov 16.

Unit of Development and Research in Medical Education (UDREM), Faculty of Medicine, University of Geneva, Centre Médical Universitaire, 1, rue Michel Servet, 1211, Geneve, Switzerland.

Previous research highlighted associations between students' motivation for medical studies and their learning approaches on the one hand and empathy on the other. Internal motivational factors for studying medicine (e.g. Read More

Adv Health Sci Educ Theory Pract 2018 Nov 15. Epub 2018 Nov 15.

Department of Clinical Sciences and Education, Södersjukhuset, Karolinska Institutet, Sjukhusbacken 10, 118 83, Stockholm, Sweden.

The aim of this study was to explore challenging encounters experienced by registered nurses (RN) during their first year in the emergency medical service by using the social learning theory of communities of practice. During the first year in a new professional practice, a new RN experiences a transition during which the new professional identity is being formed. This is a challenging and demanding period of time. Read More

Adv Health Sci Educ Theory Pract 2018 Nov 13. Epub 2018 Nov 13.

Department of Counseling and Higher Education, The University of North Texas, Denton, TX, USA.

Financial support for institutional research is relatively stagnant, and thus institutions are likely to seek tuition revenue to offset the costs of research and teaching. It is likely that this has led to increases in tuition driven activities, and thus has limited research activities of academic physical therapy (PT) programs in particular. However, the relationships between sources of program revenue, the number of graduates from PT programs, and the scholarly production of PT faculty have not been studied. Read More

Adv Health Sci Educ Theory Pract 2018 Nov 12. Epub 2018 Nov 12.

Life and Health Sciences Research Institute (ICVS), School of Medicine, University of Minho, Braga, Portugal.

Dropping out from undergraduate medical education is costly for students, medical schools, and society in general. Therefore, the early identification of potential dropout students is important. The contribution of personal features to dropout rates has merited exploration. Read More

Adv Health Sci Educ Theory Pract 2018 Dec;23(5):863-866

McMaster University, Hamilton, ON, Canada.

Adv Health Sci Educ Theory Pract 2018 Nov 2. Epub 2018 Nov 2.

Department of Surgery and Centre for Health Education Scholarship, University of British Columbia, Vancouver, BC, Canada.

Learning to take safe and effective action in complex settings rife with uncertainty is essential for patient safety and quality care. Doing so is not easy for trainees, as they often consider certainty to be a necessary precursor for action and subsequently struggle in these settings. Understanding how skillful clinicians work comfortably when uncertain, therefore, offers an important opportunity to facilitate trainees' clinical reasoning development. Read More

Adv Health Sci Educ Theory Pract 2018 Nov 1. Epub 2018 Nov 1.

Department of Research in Education, VUmc School of Medical Sciences, Amsterdam UMC, PO Box 7057, 1007 MB, Amsterdam, The Netherlands.

Standardized narratives or profiles can facilitate identification of poor professional behaviour of medical students. If unprofessional behaviour is identified, educators can help the student to improve their professional performance. In an earlier study, based on opinions of frontline teachers from one institution, the authors identified three profiles of medical students' unprofessional behaviour: (1) Poor reliability, (2) Poor reliability and poor insight, and (3) Poor reliability, poor insight and poor adaptability. Read More

Adv Health Sci Educ Theory Pract 2018 Oct 31. Epub 2018 Oct 31.

Allan Waters Family Simulation Centre, St. Michael's Hospital, Toronto, ON, Canada.

Self-regulated learning is optimized when instructional supports are provided. We evaluated three supports for self-regulated simulation-based training: practice schedules, normative comparisons, and learning goals. Participants practiced 5 endoscopy tasks on a physical simulator, then completed 4 repetitions on a virtual reality simulator. Read More

Adv Health Sci Educ Theory Pract 2019 Mar 25;24(1):141-150. Epub 2018 Oct 25.

National Board of Medical Examiners, 3750 Market Street, Philadelphia, PA, 19104, USA.

Research suggests that the three-option format is optimal for multiple choice questions (MCQs). This conclusion is supported by numerous studies showing that most distractors (i.e. Read More

Adv Health Sci Educ Theory Pract 2019 Mar 20;24(1):151-165. Epub 2018 Oct 20.

Center for Innovation in Medical Education, Leiden University Medical Center, Leiden, The Netherlands.

Comprehension of physiology is essential for development of clinical reasoning. However, medical students often struggle to understand physiological concepts. Interactive learning through Peer instruction (PI) is known to stimulate students' comprehension, but its relative efficacy and working mechanisms remain to be elucidated. Read More

Adv Health Sci Educ Theory Pract 2018 Oct 10. Epub 2018 Oct 10.

Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada.

More than 100 years ago, Osler inspired educators to consider health professions education (HPE) as intricately reliant on patients. Since that time, patient involvement in HPE has taken on many different meanings. The result is a disparate body of literature that is challenging to search, making it difficult to determine how to continue to build knowledge in the field. Read More

Adv Health Sci Educ Theory Pract 2019 Mar 9;24(1):85-102. Epub 2018 Oct 9.

Eastern Health Clinical School, Monash University and Deakin University, Box Hill, VIC, Australia.

The increasing use of direct observation tools to assess routine performance has resulted in the growing reliance on assessor-based judgements in the workplace. However, we have a limited understanding of how assessors make judgements and formulate ratings in real world contexts. The current research on assessor cognition has largely focused on the cognitive domain but the contextual factors are equally important, and both are closely interconnected. Read More

Adv Health Sci Educ Theory Pract 2019 Mar 3;24(1):125-140. Epub 2018 Oct 3.

Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Tomtebodavägen 18A, 171 77, Stockholm, Sweden.

Many medical universities offer educational development activities to support clinical teachers in their teaching role. Research has focused on the scope and effectiveness of such activities and on why individual teachers attend. However, systemic perspectives that go beyond a focus on individual participants are scarce in the existing literature. Read More

Adv Health Sci Educ Theory Pract 2018 Oct 3. Epub 2018 Oct 3.

Griffith University, Brisbane, QLD, Australia.

There has been an observed increase in literature concerning feedback within the last decade, with the importance of feedback well documented. Current discourse promotes feedback as an interactive, dialogic process between the learner and the learning partner. While much has been written about effective feedback, less is known about key elements that support dialogic feedback. Read More

Adv Health Sci Educ Theory Pract 2019 Mar 27;24(1):103-123. Epub 2018 Sep 27.

Wilson Centre for Research in Education, Toronto, ON, Canada.

Many international medical graduates (IMGs) enter North American residency programs every year. The Canadian IMG physician pool increasingly includes Canadian-born IMGs (C-IMGs) along with Immigrant-IMGs (I-IMGs). Similar trends exist in the United States. Read More

Adv Health Sci Educ Theory Pract 2019 Mar 31;24(1):45-63. Epub 2018 Aug 31.

Institute for Innovations in Medical Education, New York University School of Medicine, New York, NY, USA.

Learning curves can support a competency-based approach to assessment for learning. When interpreting repeated assessment data displayed as learning curves, a key assessment question is: "How well is each learner learning?" We outline the validity argument and investigation relevant to this question, for a computer-based repeated assessment of competence in electrocardiogram (ECG) interpretation. We developed an on-line ECG learning program based on 292 anonymized ECGs collected from an electronic patient database. Read More

Adv Health Sci Educ Theory Pract 2018 Oct;23(4):665-669

McMaster University, Hamilton, ON, Canada.

Adv Health Sci Educ Theory Pract 2019 Mar 18;24(1):65-84. Epub 2018 Aug 18.

Department of Medical Education, Faculty of Medicine, University of Botswana, Gaborone, Botswana.

The merits of integrative learning in promoting better educational outcomes are not questionable. However, there are contentious views on how to implement it. In addition, there is scanty evidence on how students experience it and how they develop the ability to integrate learning. Read More

Adv Health Sci Educ Theory Pract 2018 Aug 9. Epub 2018 Aug 9.

School of kinesiology and physical activity sciences, Université de Montréal, Montréal, QC, Canada.

The objective of scientific, or more broadly, academic knowledge is to provide an understanding of the social and natural world that lies beyond common sense and everyday thinking. Academics use an array of techniques, methods and conceptual apparatuses to achieve this goal. The question we explore in this essay is the following: Does the grounded theory approach, in the constructivist version developed by Kathy Charmaz, provide the necessary methodological tools for the creation of knowledge and theories beyond everyday thinking? To conduct our analysis, we have drawn on the rationalist epistemology originally developed by Gaston Bachelard and taken up a few decades later by Pierre Bourdieu and colleagues to look at the epistemological foundation of the CGT methods as defined by Charmaz. Read More

Adv Health Sci Educ Theory Pract 2018 Dec 7;23(5):977-993. Epub 2018 Aug 7.

Professional Performance Research Group, Department of Medical Psychology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, PO Box 22660, 1100 DD, Amsterdam, The Netherlands.

The well-being of residents, our future medical specialists, is not only beneficial to the individual physician but also conditional for delivering high-quality patient care. Therefore, the authors further explored how residents experience their own well-being in relation to their professional and personal life. The authors conducted a qualitative study based on a phenomenological approach. Read More

Adv Health Sci Educ Theory Pract 2019 Mar 2;24(1):33-43. Epub 2018 Aug 2.

Western Sydney University, Sydney, Australia.

This study compared the profile of those who, after initial failure to be selected, choose to reapply to study medicine with those who did not reapply. It also evaluates the chance of a successful outcome for re-applicants. In 2013, 4007 applicants to undergraduate medical schools in the largest state in Australia were unsuccessful. Read More

Adv Health Sci Educ Theory Pract 2019 Mar 26;24(1):15-32. Epub 2018 Jul 26.

Department of Medicine, University of Alberta, Edmonton, Canada.

The use of patient educators is one of many teaching strategies meant to foster principles of patient-centred care. We previously found that early patient educator exposure helped to shape the understanding of patient-centredness in pre-clerkship learners. We now expand on this work to evaluate whether there is persistence of initial perceptions and to explore general reflections on longer-term impacts of early patient educator exposures once learners are immersed in the clinical phase of their training. Read More

Adv Health Sci Educ Theory Pract 2018 Dec 25;23(5):921-935. Epub 2018 Jul 25.

Research in Education, VUmc School of Medical Sciences, P.O. Box 7057, 1007 MB, Amsterdam, The Netherlands.

Underperformance among ethnic minority students has been reported in several studies. Autonomous motivation (acting out of true interest or personal endorsement) is associated with better learning and academic performance. This study examined whether study strategy (surface, achieving, and deep) was a mediator between the type of motivation (autonomous and controlled motivation) and academic performance (GPA and clerkship performance), and whether these relations are different for students from different ethnic groups to gain a better understanding about the needed intervention/support in the curriculum. Read More

Adv Health Sci Educ Theory Pract 2018 Dec 24;23(5):995-1003. Epub 2018 Jul 24.

Office of Medical Education, University of Kansas Medical Center, Kansas City, KS, 66160, USA.

This study compared the effects of two types of delayed feedback (correct response or correct response + rationale) provided to students by a computer-based testing system following an exam. The preclinical medical curriculum at the University of Kansas Medical Center uses a two-exam system for summative assessments in which students test, revisit material, and then re-test (same content, different questions), with the higher score used to determine the students' grades. Using a quasi-experimental design and data collected during the normal course of instruction, test and re-test scores from midterm multiple choice examinations were compared between academic year (AY) 2015-2016, which provided delayed feedback with the correct answer only, and AY 2016-2017, where delayed feedback consisted of the correct answer plus a rationale. Read More

Adv Health Sci Educ Theory Pract 2018 Dec 18;23(5):961-976. Epub 2018 Jul 18.

Centre for Learning Sciences and Technologies, Open University of The Netherlands, Heerlen, The Netherlands.

Visual problem solving is essential to highly visual and knowledge-intensive professional domains such as clinical pathology, which trainees learn by participating in relevant tasks at the workplace (apprenticeship). Proper guidance of the visual problem solving of apprentices by the master is necessary. Interaction and adaptation to the expertise level of the learner are identified as key ingredients of this guidance. Read More

Adv Health Sci Educ Theory Pract 2018 Aug;23(3):449-453

McMaster University, Hamilton, ON, Canada.

Adv Health Sci Educ Theory Pract 2018 Dec 6;23(5):937-959. Epub 2018 Jul 6.

Keele University School of Medicine, Keele, Staffordshire, UK.

Recent literature places more emphasis on assessment comments rather than relying solely on scores. Both are variable, however, emanating from assessment judgements. One established source of variability is "contrast effects": scores are shifted away from the depicted level of competence in a preceding encounter. Read More

Adv Health Sci Educ Theory Pract 2018 Dec 2;23(5):899-920. Epub 2018 Jul 2.

The Cleveland Clinic, Cleveland, OH, USA.

The Jefferson Scale of Empathy (JSE) is a broadly used instrument developed to measure empathy in the context of health professions education and patient care. Evidence in support of psychometrics of the JSE has been reported in health professions students and practitioners with the exception of osteopathic medical students. This study was designed to examine measurement properties, underlying components, and latent variable structure of the JSE in a nationwide sample of first-year matriculants at U. Read More