Advances in health sciences education : theory and practice
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Adv Health Sci Educ Theory Pract · Aug 2014
Understanding trust as an essential element of trainee supervision and learning in the workplace.
Clinical supervision requires that supervisors make decisions about how much independence to allow their trainees for patient care tasks. The simultaneous goals of ensuring quality patient care and affording trainees appropriate and progressively greater responsibility require that the supervising physician trusts the trainee. Trust allows the trainee to experience increasing levels of participation and responsibility in the workplace in a way that builds competence for future practice. ⋯ This literature-based overview of these five factors informs design principles for clinical education that support the granting of entrustment. Entrustable professional activities offer promise as an example of a novel supervision and assessment strategy based on trust. Informed by the design principles offered here, entrustment can support supervisors' accountability for the outcomes of training by maintaining focus on future patient care outcomes.
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Adv Health Sci Educ Theory Pract · May 2014
Review Meta AnalysisFeedback for simulation-based procedural skills training: a meta-analysis and critical narrative synthesis.
Although feedback has been identified as a key instructional feature in simulation based medical education (SBME), we remain uncertain as to the magnitude of its effectiveness and the mechanisms by which it may be effective. We employed a meta-analysis and critical narrative synthesis to examine the effectiveness of feedback for SBME procedural skills training and to examine how it works in this context. ⋯ Multiple sources of feedback, including instructor feedback, lead to short-term performance gains although data on long-term effects is lacking. The mechanism by which feedback may be operating is consistent with the guidance hypothesis, with more research needed to examine other mechanisms such as cognitive load theory and social development theory.
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Adv Health Sci Educ Theory Pract · May 2014
ReviewWhat counts as validity evidence? Examples and prevalence in a systematic review of simulation-based assessment.
Ongoing transformations in health professions education underscore the need for valid and reliable assessment. The current standard for assessment validation requires evidence from five sources: content, response process, internal structure, relations with other variables, and consequences. However, researchers remain uncertain regarding the types of data that contribute to each evidence source. ⋯ Evidence of response process and consequences were each present in <10 % of studies. We conclude that relations with training level appear to be overrepresented in this field, while evidence of consequences and response process are infrequently reported. Validation science will be improved as educators use established frameworks to collect and interpret evidence from the full spectrum of possible sources and elements.
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Adv Health Sci Educ Theory Pract · Mar 2014
Examining changes in certification/licensure requirements and the international medical graduate examinee pool.
Changes in certification requirements and examinee characteristics are likely to influence the validity of the evidence associated with interpretations made based on test data. We examined whether changes in Educational Commission for Foreign Medical Graduates (ECFMG) certification requirements over time were associated with changes in internal medicine (IM) residency program director ratings and certification examination scores. Comparisons were made between physicians who were ECFMG-certified before and after the Clinical Skills Assessment (CSA) requirement. ⋯ The main effect of migration status was statistically significant and weak (Wilks' λ = 0.98, F 5,15391 = 45.3, P < 0.01; η = 0.02). Differences in ABIM Internal Medicine Certification Examination scores based on whether or not CSA were required was statistically significant, although the magnitude of the association between these variables was very small. The findings suggest that the implementation of an additional evaluation of skills (e.g., history-taking, physical examination) as a prerequisite to postgraduate medical education (residency) provides some additional, relevant data to those who select ECFMG-certified residents.
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Adv Health Sci Educ Theory Pract · Mar 2014
A qualitative study of work-life choices in academic internal medicine.
The high attrition rate of female physicians pursuing an academic medicine research career has not been examined in the context of career development theory. We explored how internal medicine residents and faculty experience their work within the context of their broader life domain in order to identify strategies for facilitating career advancement. ⋯ Female researchers and educators reported more strategies for multiple role planning and management than female practitioners. Interventions aimed at enhancing academic internists' planning and self-efficacy for multiple role management should be investigated as a potential means for increasing participation and facilitate advancement.