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Medical Education Online Dec 2023The goal of this systematic review was to examine self-directed learning (SDL) assessment practices in undergraduate health professions education. (Review)
Review
PURPOSE
The goal of this systematic review was to examine self-directed learning (SDL) assessment practices in undergraduate health professions education.
METHODS
Seven electronic databases were searched (PubMed, Embase, PsycINFO, ERIC, CINAHL, Scopus, and Web of Science) to retrieve English-language articles published between 2015 and July of 2022, investigating assessment of SDL learning outcomes. Extracted data included the sample size, field of study, study design, SDL activity type, SDL assessment method, number of SDL assessments used, study quality, number of SDL components present utilising the framework the authors developed, and SDL activity outcomes. We also assessed relationships between SDL assessment method and number of SDL components, study quality, field of study, and study outcomes.
RESULTS
Of the 141 studies included, the majority of study participants were medical (51.8%) or nursing (34.8%) students. The most common SDL assessment method used was internally-developed perception surveys (49.6%). When evaluating outcomes for SDL activities, most studies reported a positive or mixed/neutral outcome (58.2% and 34.8%, respectively). There was a statistically significant relationship between both number and type of assessments used, and study quality, with knowledge assessments (median-IQR 11.5) being associated with higher study quality ( < 0.001). Less than half (48.9%) of the studies used more than one assessment method to evaluate the effectiveness of SDL activities. Having more than one assessment (mean 9.49) was associated with higher quality study ( < 0.001).
CONCLUSIONS
The results of our systematic review suggest that SDL assessment practices within undergraduate health professions education vary greatly, as different aspects of SDL were leveraged and implemented by diverse groups of learners to meet different learning needs and professional accreditation requirements. Evidence-based best practices for the assessment of SDL across undergraduate healthcare professions education should include the use of multiple assessments, with direct and indirect measures, to more accurately assess student performance.
Topics: Humans; Health Occupations; Learning; Motivation; Qualitative Research; Program Evaluation; Self-Directed Learning as Topic; Students, Medical; Students, Nursing; Students, Health Occupations
PubMed: 36919556
DOI: 10.1080/10872981.2023.2189553 -
Annals of Dyslexia Oct 2023We conducted a realist review of state-authorized dyslexia pilot projects to understand how they have been implemented and evaluated, and the extent to which they adhere... (Review)
Review
We conducted a realist review of state-authorized dyslexia pilot projects to understand how they have been implemented and evaluated, and the extent to which they adhere to best practice recommendations. We found that states have piloted broadly similar policy programs minimally consisting of professional development, universal screening, and instructional intervention. However, none of the pilot report documents we reviewed included explicit logic models or theories of action, which makes it difficult to understand the pilot projects and their results. Officially, most of the pilot project evaluations sought to establish the effectiveness of their programs. However, only two states used evaluation designs that are well-suited to making causal inferences about program effects, which complicates the interpretation of pilot project results. To make future pilot projects more useful to evidence-based policymaking, we make recommendations to improve their design, implementation, and evaluation.
Topics: Humans; Dyslexia; Pilot Projects; Reading
PubMed: 37300716
DOI: 10.1007/s11881-023-00284-6 -
Journal of Pain and Symptom Management Apr 2024No prior study has assessed grief and bereavement curriculum in Hospice and Palliative Medicine (HPM) fellowship programs in the United States.
INTRODUCTION
No prior study has assessed grief and bereavement curriculum in Hospice and Palliative Medicine (HPM) fellowship programs in the United States.
METHODS
A 14-item survey was created and distributed to Accreditation Council for Graduate Medical Education (ACGME)-accredited HPM fellowship Program Directors to assess program demographics, curriculum emphasis, grief and bereavement programming, and attitudes toward grief and bereavement training for HPM fellows.
RESULTS
The overall survey response rate was 63%. Most palliative care programs were academic (74%) and had four or fewer fellows (85%). 90% devoted a minority (0%-10%) of their curriculum to grief and bereavement training. Most programs reported at least some program-led grief and bereavement programming (69%); however, 53% endorsed that fellows are not very or not at all involved in this programming. Almost half of programs only have a small amount of programming related to supporting families after loss (49%). The majority endorsed having a great deal of programming for debriefing or supporting fellows through professional grief (55%), and the most common modalities were debriefing sessions (62%) and ensuring access to mental health resources (41%). The most common ways of teaching grief and bereavement were through bedside/anecdotal teaching and lectures/case conferences. Most program directors felt that palliative care fellowships should provide grief and bereavement training (81%) and consider it important or very important for fellows to learn how to process grief and bereavement (92%).
DISCUSSION
It was widely reported by program directors that grief and bereavement training are important curricular components for HPM fellows. Acknowledging professional grief remains an underrecognized need in palliative care training and practice. Our study suggests that for grief and bereavement curricula in HPM fellowships, the time dedicated, specific types, and amount of fellow involvement was highly variable. It will be critical for programs to disseminate best practices to help move toward a more uniform approach for ensuring basic competency in grief and bereavement training in HPM fellowship programs in the United States.
Topics: Humans; United States; Palliative Care; Fellowships and Scholarships; Hospice Care; Curriculum; Education, Medical, Graduate; Surveys and Questionnaires; Grief
PubMed: 38215895
DOI: 10.1016/j.jpainsymman.2024.01.007 -
Medical Science Educator Oct 2023After a period of "emergency remote teaching" precipitated by COVID-19, academic medical centers are moving into a second, more mature phase in online education. This...
After a period of "emergency remote teaching" precipitated by COVID-19, academic medical centers are moving into a second, more mature phase in online education. This article offers guidance to institutions planning for this second phase. In it, we advocate a reorientation towards "instructional teams;" outline typical roles and skill sets on instructional teams; discuss the hardware, software, and space required to develop high-quality online courses; and describe common pitfalls experienced by instructional teams along with strategies to avoid them. Our objective is to help institutions hoping to develop high-quality, sustainable online programming to set realistic and informed expectations, allocate resources intelligently, hire appropriately, and work productively.
PubMed: 37886263
DOI: 10.1007/s40670-023-01850-8 -
Transfusion Dec 2023
Review
Topics: Humans; Transfusion Medicine; Computer-Assisted Instruction; Learning
PubMed: 37876263
DOI: 10.1111/trf.17564 -
The Surgeon : Journal of the Royal... Oct 2023This study reviews the current state of robotic surgery training for surgeons, including the various curricula, training methods, and tools available, as well as the... (Review)
Review
INTRODUCTION
This study reviews the current state of robotic surgery training for surgeons, including the various curricula, training methods, and tools available, as well as the challenges and limitations of these.
METHODS
The authors carried out a literature search across PubMed, MEDLINE, and Google Scholar using keywords related to 'robotic surgery', 'computer-assisted surgery', 'simulation', 'virtual reality', 'surgical training', and 'surgical education'. Full text analysis was performed on 112 articles.
TRAINING PROGRAMMES
The training program for robotic surgery should focus on proficiency, deliberation, and distribution principles. The curricula can be broadly split up into pre-console and console-side training. Pre-Console and Console-Side Training: Simulation training is an important aspect of robotic surgery training to improve technical skill acquisition and reduce mental workload, which helps prepare trainees for live procedures.
OPERATIVE PERFORMANCE ASSESSMENT
The study also discusses the various validated assessment tools used for operative performance assessments.
FUTURE ADVANCES
Finally, the authors propose potential future directions for robotic surgery training, including the use of emerging technologies such as AI and machine learning for real-time feedback, remote mentoring, and augmented reality platforms like Proximie to reduce costs and overcome geographic limitations.
CONCLUSION
Standardisation in trainee performance assessment is needed. Each of the robotic curricula and platforms has strengths and weaknesses. The ERUS Robotic Curriculum represents an evidence-based example of how to implement training from novice to expert. Remote mentoring and augmented reality platforms can overcome the challenges of high equipment costs and limited access to experts. Emerging technologies offer promising advancements for real-time feedback and immersive training environments, improving patient outcomes.
Topics: Humans; Robotic Surgical Procedures; Robotics; Curriculum; Computer Simulation; Workload; Simulation Training; Clinical Competence
PubMed: 36932015
DOI: 10.1016/j.surge.2023.02.006 -
American Journal of Audiology Sep 2023This study aimed to assess the level and quality of evidence supporting the use of simulation in audiology education regarding enhanced knowledge, skills,...
PURPOSE
This study aimed to assess the level and quality of evidence supporting the use of simulation in audiology education regarding enhanced knowledge, skills, self-confidence, and satisfaction.
METHOD
A systematic review of qualitative and quantitative peer-reviewed literature published between 2000 and 2023 was conducted. The PICO mnemonic (where P = population, I = intervention, C = comparison, and O = outcomes) was used to frame the clinical question and generate search terms. Search strategies were executed in seven databases. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were used to track the peer-reviewed literature identification and selection process. The Joanna Briggs Institute Critical Appraisal Checklists and Levels of Evidence were used to characterize the research studies.
RESULTS
A total of 668 records were identified. Nineteen peer-reviewed publications met the inclusion criteria. Diverse study designs, interventions, assessment techniques, and simulation types were identified. Characteristics of included studies (e.g., author, year, study purpose) were reported by evidence tables. Primary and secondary outcomes were identified and described. Results indicate statistical and/or clinically significant improvements in knowledge, skills, and/or self-confidence following simulation training. Each study was critically appraised, and the level, quality, and strength were assigned.
CONCLUSIONS
The use of simulation as an educational method among audiology students has been shown to dramatically increase knowledge, skills, and self-confidence. However, the use of simulation in audiology education is still behind compared to other health professions. As a result, there are a limited number of simulation-based studies in audiology. Most health academic institutions have well-designed simulation centers; therefore, audiology programs are urged to collaborate with colleagues in other professions and benefit from the services offered by these facilities.
Topics: Humans; Audiology; Educational Status; Schools; Students; Simulation Training
PubMed: 37595779
DOI: 10.1044/2023_AJA-23-00054 -
Advances in Physiology Education Dec 2023Application-of-knowledge skills are highly valued in clinical medicine, as indicated by recent changes to licensure and entrance exams for nursing and physician programs...
Application-of-knowledge skills are highly valued in clinical medicine, as indicated by recent changes to licensure and entrance exams for nursing and physician programs (i.e., the NCLEX and MCAT). Such emphasis should be both welcomed and supported by approaches to teaching human anatomy and physiology that emphasize critical thinking skills built upon logic, reasoning, and judgment. The argument for development of these skills is not simply philosophical. Rather, such emphasis is strongly supported by a 2016 Johns Hopkins study (Makary MA, Daniel M. 353: i2139, 2016) that estimates that medical errors are now the third leading cause of death in the United States! Active learning techniques known to require critical thinking skills are often supplemental to standard expository lecturing or other avenues of imparting content knowledge (reading, videos, etc.). We propose that all content dissemination can and should provide for the development of critical thinking skills, preparing students for active learning techniques requiring this ability. This can be accomplished by establishing an intellectual framework for understanding the adaptive benefits of anatomical or physiological traits. Additionally, explanations conveying the causality of mechanistic sequences result in learning content within intuitive functional groups rather than as isolated phenomena, the latter often accomplished mainly through memorization as opposed to real understanding. Here, we provide a template for lecture development based upon these principles as well as a specific example from human anatomy and physiology. Our hope is to provide a model for how students should think about all physiology, making comprehensive coverage of content (an impossible task!) much less important. Critical thinking skills are essential to the effective performance of many careers, particularly those involving health care. To aid the development of these skills in physiology, the formation of logical cognitive frameworks needs to be supported via instruction that emphasizes the context of physiological functions (the "why") as well as the causality of their sequential actions. Within such frameworks, students become capable of cognitive reasoning required to reach intuitive conclusions after system perturbations.
Topics: Humans; Thinking; Problem-Based Learning; Problem Solving; Judgment; Curriculum
PubMed: 37732369
DOI: 10.1152/advan.00131.2023 -
Anesthesia and Analgesia Apr 2024Airway management, a defined procedural and cognitive skillset embracing routine tracheal intubation and emergency airway rescue, is most often acquired through an... (Review)
Review
Airway management, a defined procedural and cognitive skillset embracing routine tracheal intubation and emergency airway rescue, is most often acquired through an apprenticeship model of opportunistic learning during anesthesia or acute care residency training. This training engages a host of modalities to teach and embed skill sets but is generally time- and location-constrained. Virtual reality (VR)-based simulation training offers the potential for reproducible and asynchronous skill acquisition and maintenance, an advantage that may be important with restricted trainee work hours and low frequency but high-risk events. In the absence of a formal curriculum from training bodies-or expert guidance from medical professional societies-local initiatives have filled the VR training void in an unstructured fashion. We undertook a scoping review to explore current VR-based airway management training programs to assess their approach, outcomes, and technologies to discover programming gaps. English-language publications addressing any aspect of VR simulation training for airway management were identified across PubMed, Embase, and Scopus. Relevant articles were used to craft a scoping review conforming to the Scale for quality Assessment of Narrative Review Articles (SANRA) best-practice guidance. Fifteen studies described VR simulation programs to teach airway management skills, including flexible fibreoptic bronchoscopic intubation (n = 10), direct laryngoscopy (n = 2), and emergency cricothyroidotomy (n = 1). All studies were single institution initiatives and all reported different protocols and end points using bespoke applications of commercial technology or homegrown technologic solutions. VR-based simulation for airway management currently occurs outside of a formal curriculum structure, only for specific skill sets, and without a training pathway for educators. Medical educators with simulation training and medical professional societies with content expertise have the opportunity to develop consensus guidelines that inform training curricula as well as specialty technology use.
Topics: Virtual Reality; Curriculum; Computer Simulation; Simulation Training; Airway Management; Clinical Competence
PubMed: 37467164
DOI: 10.1213/ANE.0000000000006611 -
End-of-Life Care Education as Blended Learning Approach for General Practitioners: a Scoping Review.Journal of Cancer Education : the... Oct 2023General practitioners (GPs) are critical in providing primary palliative care in the community. Apprehensions about managing a dying person at home, difficulties in... (Review)
Review
General practitioners (GPs) are critical in providing primary palliative care in the community. Apprehensions about managing a dying person at home, difficulties in goals of care discussion, limited resources and lack of palliative care education often hinder end-of-life care provision in the community. This review focused on the end-of-life care training programs accessed by GPs and sought to understand if the training programs' content and mode of delivery aligned with their preferred needs. MEDLINE, EMBASE, CINAHL, and PsycINFO were searched to identify articles published in English between 01 January 1990 and 30 September 2022. Additionally, searches were conducted using SCOPUS, the Web of Science, and the Cochrane database using free texts. The reviewers screened the titles, abstracts, and full text to identify eligible studies and extracted textual data to analyse and generate themes. Out of 5532 citations initially accessed, 17 studies were included in the review. Six themes were generated: knowledge translation, skill development, a change in attitude, self-efficacy, satisfaction, and patient outcomes. The GPs' end-of-life care knowledge, skills, attitude, self-efficacy, and patient outcomes were better when their training had a combination of small-group interactive workshops, trigger case-based reflective learning, mentor-facilitated experiential learning, web-based modules, and peer learning. The synthesis of review findings supports blended learning as a training approach for general the practitioners' end-of-life care education as it facilitates learning and patient outcomes.
Topics: Humans; General Practitioners; Learning; Problem-Based Learning; Knowledge; Terminal Care
PubMed: 37648949
DOI: 10.1007/s13187-023-02358-w