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Adv Health Sci Educ Theory Pract 2021 Jun 21. Epub 2021 Jun 21.

Department of Innovation in Medical Education and Faculty of Medicine, University of Ottawa, Ottawa, ON, Canada.

In both clinical and health professions education research, rich pictures, or participant-generated drawings of complex phenomena, are gaining recognition as a useful method for exploring multifaceted and emotional topics in medicine. For instance, two recent studies used rich pictures to augment semi-structured interviews exploring trainees', health care professionals' (HCPs), and parents' experiences of difficult conversations in the Neonatal Intensive Care Unit (NICU)-an environment in which communication is often challenging, anxiety-provoking, and emotionally distressing. In both studies, participants were invited to draw a picture depicting how they experienced a difficult conversation in this setting. Read More

Adv Health Sci Educ Theory Pract 2021 Jun 17. Epub 2021 Jun 17.

Department of General Practice, Erasmus Medical Center Rotterdam, Postbus 2040, 3000, Rotterdam, CA, The Netherlands.

This paper argues that abductive reasoning has a central place in theorizing Health Professions Education. At the root of abduction lies a fundamental debate: How do we connect practice, which is always singular and unique, with theory, which describes the world in terms of rules, generalizations, and universals? While abduction was initially seen as the 'poor cousin' of deduction and induction, ultimately it has something important to tell us about the role of imagination and humility in theorizing Health Professions Education. It is that which makes theory possible, because it allows us to ask what might be the case and calls attention to the role of creative leaps in theory. Read More

Adv Health Sci Educ Theory Pract 2021 Jun 12. Epub 2021 Jun 12.

Edson College of Nursing and Health Innovation, Arizona State University, Downtown Phoenix Campus, Phoenix, AZ, USA.

Studies primarily involving single health professions programs suggest that holistic review in admissions can increase underrepresented minority (URM) representation among admitted students. However, data showing little improvement in the overall proportion of URMs in many health professions, despite widespread use of holistic review, suggest that relatively few programs using holistic review admit substantial proportions of underrepresented minorities. Therefore, more research is needed to understand factors that facilitate holistic review practices that successfully promote diverse student enrollment. Read More

Adv Health Sci Educ Theory Pract 2021 May 26. Epub 2021 May 26.

Department of Medicine & Office of Research and Development in Medical Education, University of California at San Francisco School of Medicine, San Francisco, CA, USA.

Cognitive Load Theory has emerged as an important approach to improving instruction in the health professions workplace, including patient handovers. At the same time, there is growing recognition that emotion influences learning through numerous cognitive processes including motivation, attention, working memory, and long-term memory. This study explores how emotion influences the cognitive load experienced by trainees performing patient handovers. Read More

Adv Health Sci Educ Theory Pract 2021 May 18. Epub 2021 May 18.

McNally Project for Paramedicine Research, Toronto, ON, Canada.

Competency frameworks provide a link between professional practice, education, training, and assessment. They support and inform downstream processes such as curriculum design, assessment, accreditation and professional accountability. However, existing guidelines are limited in accounting for the complexities of professional practice potentially undermining utility of such guidelines and validity of outcomes. Read More

Adv Health Sci Educ Theory Pract 2021 May 12. Epub 2021 May 12.

Department of Educational & Counselling Psychology, McGill University, Montreal, Canada.

Medical learners' achievement emotions during educational activities have remained unexamined in Asian cultural contexts. The Medical Emotion Scale (MES) was previously developed to assess achievement emotions experienced by North American medical learners during learning activities. The goal of this study was to create and validate a Japanese version of the Medical Emotion Scale (J-MES). Read More

Adv Health Sci Educ Theory Pract 2021 May 11. Epub 2021 May 11.

Department of Emergency Medicine, Inselspital University Hospital, University of Berne, 3010, Freiburgstrasse, Berne, Switzerland.

The use of response formats in assessments of medical knowledge and clinical reasoning continues to be the focus of both research and debate. In this article, we report on an experimental study in which we address the question of how much list-type selected response formats and short-essay type constructed response formats are related to differences in how test takers approach clinical reasoning tasks. The design of this study was informed by a framework developed within cognitive psychology which stresses the importance of the interplay between two components of reasoning-self-monitoring and response inhibition-while solving a task or case. Read More

Adv Health Sci Educ Theory Pract 2021 Apr 24. Epub 2021 Apr 24.

Department of Medicine, Wilson Centre for Research in Education, University of Toronto, Toronto, Canada.

The current discourse on competency-based medical education (CBME) is confounded by a lack of agreement on definitions and philosophical assumptions. This phenomenon impacts curriculum implementation, program evaluation and disrupts dialogue with the education community. The purpose of this study is to explore how Canadian key opinion leaders describe the philosophy and practice of CBME. Read More

Adv Health Sci Educ Theory Pract 2021 Apr 25. Epub 2021 Apr 25.

School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada.

Medical education literature suggests clinically-integrated teaching may be the most effective approach to teach evidence-based practice (EBP). Before implementing this educational best practice in rehabilitation curricula, it is imperative to better understand the current context, barriers and facilitators to teach EBP in rehabilitation from the academic to the clinical setting. The aim of this study was to explore faculty and preceptors' experiences and perceptions of teaching EBP in rehabilitation professions, namely occupational therapy, physical therapy and speech-language pathology. Read More

Adv Health Sci Educ Theory Pract 2021 Apr 24. Epub 2021 Apr 24.

The Wilson Centre and Post-MD Education. University Health Network and University of Toronto, Toronto, ON, Canada.

Programmatic assessment is now well entrenched in medical education, allowing us to reflect on when it first emerged and how it evolved into the form we know today. Drawing upon the intellectual tradition of historical epistemology, we provide a philosophically-oriented historiographical study of programmatic assessment. Our goal is to trace its relatively short historical trajectory by describing shifting configurations in its scene of inquiry-focusing on questions, practices, and philosophical presuppositions. Read More

Adv Health Sci Educ Theory Pract 2021 Apr 20. Epub 2021 Apr 20.

Department of Brain and Cognitive Engineering, Korea University, 145 Anam-ro, Seongbuk-gu, Seoul, 02841, South Korea.

There is growing concern about a potential decline in empathy among medical students over time. Despite the importance of empathy toward patients in medicine, it remains unclear the nature of the changes in empathy among medical students. Thus, we systematically investigated affective and cognitive empathy for patients among medical students using neuroscientific approach. Read More

Adv Health Sci Educ Theory Pract 2021 Apr 13. Epub 2021 Apr 13.

Health Professions Education Unit, Hull York Medical School, York, UK.

Transition to practice can be a turbulent time for new doctors. It has been proposed transition is experienced non-linearly in physical, psychological, cultural and social domains. What is less well known, however, is whether transition within these domains can contribute to the experience of moral injury in new doctors. Read More

Adv Health Sci Educ Theory Pract 2021 05 12;26(2):347-351. Epub 2021 Apr 12.

Department of Community Health Sciences and Office of Health and Medical Education Scholarship, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.

Adv Health Sci Educ Theory Pract 2021 Mar 29. Epub 2021 Mar 29.

III. Department of Medicine, University Hospital Hamburg-Eppendorf, Hamburg, Germany.

Assessing competence is a tremendous challenge in medical education. There are two contrasting approaches in competence assessment: an analytic approach that aims to precisely measure observable constituents and facets of competence and a holistic approach that focuses on a comprehensive assessment of competences in complex real situations reflecting actual performance. We would like to contribute to the existing discourse about medical competence and its assessment by proposing an approach that can provide orientation for the development of competence-based assessment concepts in undergraduate and postgraduate medical education. Read More

Adv Health Sci Educ Theory Pract 2021 Mar 26. Epub 2021 Mar 26.

Department of Nursing, University of South Dakota School of Health Sciences, 414 E. Clark Street, Lee Medicine and Science Hall 303, Vermillion, SD, 57069, USA.

Increased importance has been placed on noncognitive skills in professional development and by accrediting bodies of health professions programs in recent years. Therefore, the purpose of this study was to conduct a comprehensive systematic review of evidence examining effects of academic resilience, grit, perceived stress, locus of control, and Big Five Personality Traits on academic performance of health professions students. A literature search of peer-reviewed, English-language articles describing select noncognitive factors was performed using seven databases. Read More

Adv Health Sci Educ Theory Pract 2021 Mar 25. Epub 2021 Mar 25.

School of Health Professions Education, Maastricht University, Universiteitssingel 60, 6229 ER, Maastricht, The Netherlands.

Direct observation (DO) of residents by supervisors is a highly recommended educational tool in postgraduate medical education, yet its uptake is poor. Residents and supervisors report various reasons for not engaging in DO. Some of these relate to their interaction with patients during DO. Read More

Adv Health Sci Educ Theory Pract 2021 Mar 19. Epub 2021 Mar 19.

Centre for Faculty Development, Faculty of Medicine, University of Toronto At St. Michael's Hospital, 30 Bond Street, Toronto, ON, M5B 2W8, Canada.

In this article we introduce a synthesis of education "paradigms," adapted from a multi-disciplinary body of literature and tailored to health professions education (HPE). Each paradigm involves a particular perspective on the purpose of education, the nature of knowledge, what knowledge is valued and included in the curriculum, what it means to learn and how learning is assessed, and the roles of teachers and learners in the learning process. We aim to foster awareness of how these different paradigms look in practice and to illustrate the importance of alignment between teaching, learning and assessment practices with paradigmatic values and assumptions. Read More

Adv Health Sci Educ Theory Pract 2021 Mar 17. Epub 2021 Mar 17.

Faculty of Health Sciences, Centre for Health Sciences Education, University of Witwatersrand, Johannesburg, South Africa.

The development of competence among student nurses is important to nurse educators, nursing regulatory bodies, employers and patients. Several teaching and learning strategies support the development of competence among student nurses, but the level of competence at the point of graduation remains below expected standards. Therefore, more research is needed to find strategies that can enhance the development of competence among students. Read More

Adv Health Sci Educ Theory Pract 2021 Mar 9. Epub 2021 Mar 9.

Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore.

It was recently shown that novice medical students could be trained to demonstrate the speed-to-diagnosis and diagnostic accuracy typical of System-1-type reasoning. However, the effectiveness of this training can only be fully evaluated when considering the extent to which knowledge transfer and long-term retention occur as a result, the former of which is known to be notoriously difficult to achieve. This study aimed to investigate whether knowledge learned during an online training exercise for chest X-ray diagnosis promoted either knowledge transfer or retention, or both. Read More

Adv Health Sci Educ Theory Pract 2021 Mar 6. Epub 2021 Mar 6.

Department of Experimental, Diagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum - University of Bologna, Via Giuseppe Massarenti 9, 40138, Bologna, Italy.

Medical education is highly demanding and evidence shows that medical students are three times more susceptible to deteriorating physical and mental health than the average college student. While trait anxiety may further increase such risk, little is known about the role of trait mindfulness in mitigating these effects. Here we examine the protective role of specific mindfulness facets as mediators in pathways from trait anxiety to perceived stress, psychosomatic burden and sleep-wake quality in medical students, across repeated measurements throughout the first trimester of the school year. Read More

Adv Health Sci Educ Theory Pract 2021 Mar 3. Epub 2021 Mar 3.

The Petrie-Flom Center for Health Law Policy, Biotechnology, and Bioethics at Harvard Law School, Harvard University, 23 Everett Street, Cambridge, MA, 02138, USA.

Health Artificial Intelligence (AI) has the potential to improve health care, but at the same time, raises many ethical challenges. Within the field of health AI ethics, the solutions to the questions posed by ethical issues such as informed consent, bias, safety, transparency, patient privacy, and allocation are complex and difficult to navigate. The increasing amount of data, market forces, and changing landscape of health care suggest that medical students may be faced with a workplace in which understanding how to safely and effectively interact with health AIs will be essential. Read More

Adv Health Sci Educ Theory Pract 2021 Mar 2. Epub 2021 Mar 2.

School of Physical and Occupational Therapy, Faculty of Medicine and Health Sciences, McGill University, Montreal, Canada.

Evidence informed approaches to health professions education can ensure accountability to learners and society in providing meaningful and effective education and helping resource strained systems via streamlined and cost-efficient practices. Knowledge translation and implementation science are two areas of study originally developed in clinical medicine in response to concerns that health care practices were incongruent with the scientific evidence. Two decades of research have led to important advances in our understanding of the nature and magnitude of research-practice gaps, the factors that support or impede adoption of evidence in clinical decision-making, and in the design and evaluation of theory driven interventions to reduce gaps. Read More

Adv Health Sci Educ Theory Pract 2021 Mar 1. Epub 2021 Mar 1.

RCSI Health Professions' Education Centre, 123 St Stephen's Green, Dublin, Ireland.

Although the evidence base around uncertainty and education has expanded in recent years, a lack of clarity around conceptual terms and a heterogeneity of study designs means that this landscape remains indistinct. This scoping review explores how undergraduate health professions' students learn to engage with uncertainty related to their academic practice. To our knowledge, this is the first scoping review which examines teaching and learning related to uncertainty across multiple health professions. Read More

Adv Health Sci Educ Theory Pract 2021 Mar 1. Epub 2021 Mar 1.

Institute for Innovations in Medical Education, NYU Grossman School of Medicine, 550 First Avenue, MSB G109, New York, NY, 10016, USA.

Visual diagnosis of radiographs, histology and electrocardiograms lends itself to deliberate practice, facilitated by large online banks of cases. Which cases to supply to which learners in which order is still to be worked out, with there being considerable potential for adapting the learning. Advances in statistical modeling, based on an accumulating learning curve, offer methods for more effectively pairing learners with cases of known calibrations. Read More

Adv Health Sci Educ Theory Pract 2021 Mar 1. Epub 2021 Mar 1.

Center for Education Development and Research in Health Professions (CEDAR), University Medical Center Groningen, Antonius Deusinglaan 1, 9713 AV, Groningen, The Netherlands.

In the midst of continuous health professions curriculum reforms, critical questions arise about the extent to which conceptual ideas are actually put into practice. Curricula are often not implemented as intended. An under-explored aspect that might play a role is governance. Read More

Adv Health Sci Educ Theory Pract 2021 Feb 27. Epub 2021 Feb 27.

Monash Centre for Scholarship in Health Education, Monash University, Level 3, 27 Rainforest Walk, Clayton Campus Wellington Road, Clayton, VIC, 3800, Australia.

Learning through work is a common feature of preparing health professionals for practice. Current understandings of work-integrated learning or a 'work-based placement', focus on students being consumers of experiences rather than providing a reciprocal benefit to the organisation in which they are placed. More nuanced understanding of the ways that students can offer value to organisations may provide new opportunities and increased capacity for workplace learning. Read More

Adv Health Sci Educ Theory Pract 2021 03 22;26(1):1-3. Epub 2021 Feb 22.

Department of Community Health Sciences and Office of Health and Medical Education Scholarship, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.

Adv Health Sci Educ Theory Pract 2021 Feb 12. Epub 2021 Feb 12.

Medizinische Klinik und Polklinik IV, Klinikum der Universität München, LMU Munich, Munich, Germany.

When physicians are asked to determine the positive predictive value from the a priori probability of a disease and the sensitivity and false positive rate of a medical test (Bayesian reasoning), it often comes to misjudgments with serious consequences. In daily clinical practice, however, it is not only important that doctors receive a tool with which they can correctly judge-the speed of these judgments is also a crucial factor. In this study, we analyzed accuracy and efficiency in medical Bayesian inferences. Read More

Adv Health Sci Educ Theory Pract 2021 Feb 15. Epub 2021 Feb 15.

Erasmus Medical Center, Dr. Molewaterplein 40, P.O. Box 2040, 3015 GD, Rotterdam, The Netherlands.

The potential of reflection for learning and development is broadly accepted across the medical curriculum. Our understanding of how exactly reflection yields its educational promise, however, is limited to broad hints at the relation between reflection and learning. Yet, such understanding is essential to the (re)design of reflection education for learning and development. Read More

Adv Health Sci Educ Theory Pract 2021 Feb 15. Epub 2021 Feb 15.

GPEx Ltd., 132 Greenhill Road, Unley, South Australia, 5061, Australia.

A central principle of programmatic assessment is that the final decision is not a surprise to the learner. To achieve this, assessments must demonstrate predictive and consequential validity, however, to date, research has only focussed on the former. The present study attempts to address this gap by examining the predictive and consequential validity of flagging systems used by Australian General Practice regional training organisations (RTOs) in relation to Fellowship examinations. Read More