Medical education
-
Randomized Controlled Trial
Clinical supervision and learning opportunities during simulated acute care scenarios.
Closer clinical supervision has been increasingly promoted to improve patient care. However, the continuous bedside presence of supervisors may threaten the model of progressive independence traditionally associated with effective clinical training. Studies have shown favourable effects of closer supervision on trainees' learning, but have not paid specific attention to the learning processes involved. ⋯ The shift of responsibility for patient care occurred during both direct and distant supervision, and did not necessarily translate into a lack of opportunities for trainee participation and practice.
-
The author describes a career in which he combined clinical surgery with the formal study of medical education. In the 1980s, when the author embarked on this career track, it was an uncommon pathway. Over the last 30 years there has been an exponential increase in the number of individuals who have made medical education their principal academic focus. This paper provides examples from the author's personal story and lessons derived from that experience. ⋯ The author describes several of the lessons learned in the course of his career in medical education. He argues that successful enterprises in scholarship in medicine are almost invariably the product of interdisciplinarity. He describes the power of a joint venture between a university and an academic hospital. He argues that the geographical footprint of an emerging centre is critical. He discusses the importance of graduate studentship in an emerging discipline and enterprise.
-
Meta Analysis
How much evidence does it take? A cumulative meta-analysis of outcomes of simulation-based education.
Studies that investigate research questions that have already been resolved represent a waste of resources. However, the failure to collect sufficient evidence to resolve a given question results in ambiguity. ⋯ Some replication is necessary to obtain stable estimates of effect and to explore different contexts, but the number of studies of SBE often exceeds the minimum number of replications required.
-
In-training evaluation (ITE) is used to assess resident competencies in clinical settings. This assessment is documented on an evaluation report (In-Training Evaluation Report [ITER]). Unfortunately, the quality of these reports can be questionable. Therefore, training programmes to improve report quality are common. The Completed Clinical Evaluation Report Rating (CCERR) was developed to assess completed report quality and has been shown to do so in a reliable manner, thus enabling the evaluation of these programmes. The CCERR is a resource-intensive instrument, which may limit its use. The purpose of this study was to create a screening measure (Proxy-CCERR) that can predict the CCERR outcome in a less resource-intensive manner. ⋯ It is possible to model CCERR scores in a highly predictive manner. The predictive variables can be easily extracted in an automated process. Because this model is less resource-intensive than the CCERR, it makes it possible to provide feedback from ITER training programmes to large groups of supervisors and institutions, and even to create automated feedback systems using Proxy-CCERR scores.
-
Review Meta Analysis
Debriefing for technology-enhanced simulation: a systematic review and meta-analysis.
Debriefing is a common feature of technology-enhanced simulation (TES) education. However, evidence for its effectiveness remains unclear. We sought to characterise how debriefing is reported in the TES literature, identify debriefing features that are associated with improved outcomes, and evaluate the effectiveness of debriefing when combined with TES. ⋯ Limited evidence suggests that video-assisted debriefing yields outcomes similar to those of non-video-assisted debriefing. Other debriefing design features show mixed or non-significant results. As debriefing characteristics are usually incompletely reported, future debriefing research should describe all the key debriefing characteristics along with their associated descriptors.