When is an EPA not an EPA?Do pre-recorded lecture vodcasts affect lecture attendance?What is the impact of sociodemographic characteristics of applicants in multiple mini-interviews?How do patient educators help students to learn?
Are all EPAs really EPAs?
Ara Tekian
Since the introduction of the Core EPAs by AAMC in 2014, there has been a lot of discussion in medical schools at the undergraduate level. All US medical schools are expected to implement these 13 Core EPAs; yet, at this very premature stage, there is a lot of confusion for what an EPA really means.
An EPA is defined as “a unit of professional practice that can be fully entrusted to a trainee, as soon as he or she has demonstrated the necessary competence to execute this activity unsupervised”. EPAs are independent, observable, and measurable units of work in both process (with a defined beginning and end) and outcome. While “competencies” are abilities of individuals that in the aggregate define a good physician, “EPAs” are units of work that represent the day-to-day work of the professional, which can lead to a recognized outcome.
Effective methods of teaching and learning in anatomy as a basic science: A BEME systematic review: BEME GUIDE No. 44
C. Dominique Losco, William D. Grant, Anthony Armson, Amanda J. Meyer and Bruce F. Walker
Anatomy is a subject essential for medical practice, yet time committed to teaching is on the decline, and resources required to teach anatomy are costly, particularly dissection. Advances in technology are a potential solution to the problem, while maintaining the quality of teaching required for eventual clinical application. This BEME review aims to identify methods used to teach anatomy, including those demonstrated to enhance knowledge acquisition and retention.
Advancing technology in medical education, along with the decline in anatomy teaching, has led to increasing research on the effectiveness of various teaching methods (interventions) in anatomy. Emphasis is also being placed on student learning and the effects of student characteristics such as personality types, along with a re-emergence of the concepts of student learning styles and learning approaches seen in much of the new literature on teaching and learning in anatomy, despite controversy over the validity of these concepts.
Twelve tips on how to establish a new undergraduate firm on a critical care unit
Nasser Khan, Keiarash Jovestani, Craig Spencer, Raymond Man, Mark Pugh and Alexander Woywodt
The Critical Care Unit (CrCU) is a unique clinical environment not only regarding the wide variety of patients, presentations, and interventions, but also in its meticulous, holistic, and investigative approach to patient management. These twelve tips build on a novel placement for Year 3 undergraduate medical students.
The Critical Care Unit (CrCU) is a unique clinical environment not only regarding the wide variety of patients, presentations, and interventions but also in its meticulous, holistic, and investigative approach to patient management. There is emphasis on physiology and pathophysiology and on multidisciplinary team work. A CrCU should thus be a rich learning environment for undergraduate medical education, and it is surprising how little attention undergraduate education on CrCU has received in the literature.
Do prerecorded lecture vodcasts affect lecture attendance of first-year pre-clinical Graduate Entry to Medicine students?
Mark G. Rae and Dervla O’Malley
The authors investigate whether or not providing pre-recorded physiology video podcasts to first year Graduate Entry to Medicine (GEM) students affects their attendance at live lectures.
Due to their popularity with students, many medical schools are now also facilitating the recording and on-line storage of “live” lectures for later review by students. This development means that, purely in terms of information retrieval, students can now miss lectures almost consequence-free as they can view the recorded lectures at their leisure at a later date. Indeed, such is the concern about the possible negative impact upon lecture attendance that the provision of recorded lectures to students online may cause, that many lecturers are actively against such a move.
Measuring professional identity formation early in medical school
Adina Kalet, Lynn Buckvar-Keltz, Victoria Harnik, Verna Monson, Steven Hubbard, Ruth Crowe, Hyuksoon S. Song and Sandra Yingling
This paper aims to assess the feasibility and utility of measuring baseline Professional Identity Formation (PIF) in a theory-based professionalism curriculum for early medical students.
Medical students are becoming physicians. The ways in which they form their professional identity along with multiple other identities matters to their present and future well-being and relationships. This is both, a dynamic personal as well as a complex interpersonal and socio-cultural, highly subjective developmental process.
Student academic performance in rural clinical schools: The impact of cohort size and competition
Brendan P. Condon, Paul S. Worley, John R. Condon and David J. Prideaux
The Deakin University School of Medicine was launched in 2008 as a rurally focused medical school in south-eastern Australia. This research was designed to examine the effectiveness of the school’s adoption of small regional clinical school settings, concluding that the smaller sites appear to have provided superior support for student learning in this new medical school, though this advantage diminishes when smaller cohorts are co-located with students from other medical schools.
Is bigger necessarily better when it comes to clinical education? Over the last decade, many developed countries have recognized that they have needed to increase the number of medical school graduates. This has prompted debate at the national level as to whether it is better to increase the numbers of students in existing schools, or to create entirely new schools.
Developing a competency framework for academic physicians
Lina Daouk-Öyry, Ghazi Zaatari, Tina Sahakian, Boushra Rahal Alameh and Nabil Mansour
A mismatch exists between the requirements of the multifaceted role of the academic physician and their education. Medical institutions use faculty development initiatives to support their junior academic physicians; however, these rarely revolve around academic physician competencies. The aim of this study was to identify these academic physician competencies and develop a competency framework customized to an organizational context.
Physicians in academic careers are faced with a challenge in fulfilling their new tripartite role (teacher, researcher, and clinician) due to a mismatch between their educational training and the requirements of their multifaceted role. This challenge might grow given the expected increase in the administrative responsibilities that they will assume during their careers. Medical curricula are typically designed to develop the clinical knowledge, skills, abilities, and other characteristics necessary for patient care and while they are witnessing a shift towards non-clinical competency development, these are limited to clinical education and training years and do not cover all the non-clinical competencies expected of academic physicians.
Causes of resident lapses in professional conduct during the training: A qualitative study on the perspectives of residents
Hyung-Joo Chang, Young-Mee Lee, Young-Hee Lee and Hyo-Jin Kwon
To enhance medical professionalism among residents, there is a need for systematic and structured training programs, adequate professionalism education with clear codes of conduct, and active monitoring and feedback systems.
Since residents play a multifaceted role in hospitals not only as trainees, but also as educators and practitioners, their behavior can have significant influence on patients and junior doctors. Medical academics have been aware of the impact of resident professionalism on the quality of patient care, and have tried to promote ethical and professional practices during residency training. However, many studies have reported a wide range of resident misconduct which concerns educators as unprofessional behavior in early educational periods can last for entire medical career.
Impact of sociodemographic characteristics of applicants in multiple mini-interviews
Jean-Michel Leduc, Richard Rioux, Robert Gagnon, Christian Bourdy and Ashley Dennis
Multiple mini-interviews (MMI) are commonly used for medical school admission. Age, gender, ethnicity, socioeconomic status and language seem to be associated with applicants’ MMI scores because of perceived differences in communications skills and life experiences. Monitoring this association may provide guidance to improve fairness of MMI stations.
As communication is a central component of MMI, it can be considered as an exchange between an applicant and an assessor taking place in a given context (i.e. MMI station). Indeed, both send (“encode”) and receive (“decode”) information and influence each other through feedback. Moreover, an array of factors may act as barriers or enablers to communication. For instance, in MMI as in any communication interaction, barriers (“noise”), either psycho logical (e.g., preconceived ideas, prejudice, etc.), semantic (e.g., language differences or jargon) or physical (e.g., hearing impairment) can lead to a poorer exchange and, possibly, poorer results.
Heutagogic approach to developing capable learners
Reem Rachel Abraham and Ramnarayan Komattil
The twenty first century higher education sector has come a long way after undergoing continuous metamorphosis from pedagogy to andragogy. This paper highlights the current educational practices based on heutagogy, in higher education, considers its application in the context of undergraduate medical education and also discusses a few challenges anticipated in incorporating this approach along with the existing undergraduate medical curriculum.
Learning is a continuous process and should happen in a changing world by the learners adapting to the changes. As educators, we are entrusted with the challenging task of equipping learners with the skills of the process of learning “how to learn” and how to reach at judicious judgments in uncertain situations, in order to prepare themselves for their future professional life. The learning experience that learners gain through their undergraduate medical training must exceed beyond the acquisition of knowledge and skills. It should prime them for the sophisticated work skills expected out of them in today’s changing work place scenario.
Should we assess clinical performance in single patient encounters or consistent behaviours of clinical performance over a series of encounters? A qualitative exploration of narrative trainee profiles
Marjolein Oerlemans, Patrick Dielissen, Angelique Timmerman, Paul Ram, Bas Maiburg, Jean Muris and Cees van der Vleuten
A variety of tools have been developed to assess performance which typically use a single clinical encounter as a source for making competency inferences. This strategy may miss consistent behaviors. According to experienced clinical supervisors, consistent behaviors do exist in GP trainees when observing clinical performance over time.
… we need holistic assessment instruments that aim to collect rich qualitative information and target the integration of competences in diverse clinical contexts, so that the progressive aspect of learning is taken into consideration. By observing performance on repeated occasions, rich qualitative feedback on consistent behaviors can be gathered over time.
How patient educators help students to learn: An exploratory study
Phoebe T. M. Cheng and Angela Towle
Benefits of the active involvement of patients in educating health professionals are well-recognized, but little is known about how patient educators facilitate student learning. This exploratory qualitative study investigated the teaching practices and experiences that prepared patient educators for their roles in a longitudinal interprofessional health mentors program.
Much has been written about student attitudes towards, and educational benefits of, patient involvement. However, little attention has been given to what patient educators do, intentionally or otherwise, to facilitate student learning. Studies of the patient experience have mostly enquired about their feelings, or perceived benefits and challenges. Benefits include empowerment, validation, increased under- standing of their illness, development of a coherent illness narrative and improved relationships with health care providers.
Students generate items for an online formative assessment: Is it motivating?
Rianne Poot, Renske A. M. de Kleijn, Harold V. M. van Rijen and Jan van Tartwijk
This study proposes a way of explaining the motivational value of an e-learning task by looking at students’ perceived competence, autonomy, value of the task and relatedness. Student-generated items are considered of high task value, and help to perceive relatedness between students. With the right instruction, students feel competent to engage in the task.
According to the self-determination theory, the degree of intrinsic motivation is determined by the fulfilment of three basic psychological needs: Autonomy, Competence, and Relatedness. Ryan and Deci argue that when students do not feel that they are in control of their own learning processes (autonomy), do not think that they can execute the task (competence) or when they do not feel respected, and cared for by others (relatedness), intrinsic motivation will decrease.
Mentors, monsters, and medical education
Daniel R. George and Michael J. Green
The authors reflect on the analysis of comics created by 4th-year medical students in a humanities elective, noting the frequency with which students invoke horror imagery and how often physician mentors are portrayed as monsters, devils, demons, land sharks, and angry old men.
Though often tongue-in-cheek, some of the depictions even showed these raving, wild-eyed mentors as perpetrators of cartoonish acts of violence—devouring or decapitating underperforming trainees, barking out death threats, or posturing in ways that were so intimidating as to cause students to lose control of their bladders.
Bedside teaching with unwell patients: Can it ever be appropriate?
Nithish Jayakuma
Bedside teaching may have been the primary mode of clinical teaching decades ago, but its relevance and importance has gradually been diminished; multiple reasons have been provided for this including the availability of accurate diagnostic tests as well as time constraints on clinicians.
It is not unreasonable, therefore, to assume that patients who are unwell are less likely to be examined by medical students. It is also not unreasonable to assume that unwell patients are more likely to have physical signs. An unfortunate irony.
AND IN THE LETTERS …
Is positive doctor role modelling a two way street?
Reporting clinical error