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Hoy — Abril 13th 2021Tus fuentes RSS

Study protocol: content and perceived educational utility of different modalities of clinical teaching visit (CTV) workplace-based assessments within Australian general practice vocational training: a cross-sectional study

Por: Fielding · A. · Mundy · B. E. · Tapley · A. · Klein · L. · Gani · S. · Bentley · M. · Boland · R. · Zbaidi · L. · van Driel · M. L. · Holliday · E. · Magin · P.
Introduction

Clinical teaching visits (CTVs) are formative workplace-based assessments that involve a senior general practitioner (GP) observing a clinical practice session of a general practice registrar (specialist vocational GP trainee). These visits constitute a key part of Australian GP training. Despite being mandatory and resource-intensive, there is a paucity of evidence regarding the content and educational utility of CTVs. This study aims to establish the content and educational utility of CTVs across varying practice settings within Australia, as perceived by registrars and their assessors (‘CT visitors’). In addition, this study aims to establish registrar, CT visitor and practice factors associated with CTV content and perceived CTV utility ratings.

Methods and analysis

This study will collect data prospectively using online questionnaires completed soon after incident CTVs. Participants will be registrars and CT visitors of CTVs conducted from March 2020 to January 2021. The setting is three Regional Training Organisations across four Australian states and territories (encompassing 37% of Australian GP registrars).

Outcome factors will be a number of specified CTV content elements occurring during the CTV as well as participants’ perceptions of CTV utility, which will be analysed using univariate and multivariable regression.

Ethics and dissemination

Ethics approval has been granted by the University of Newcastle Human Research Ethics Committee, approval number H-2020-0037. Study findings are planned to be disseminated via conference presentation, peer-reviewed journals, educational practice translational workshops and the GP Synergy research subwebsite.

Educational needs in the COVID-19 pandemic: a Delphi study among doctors and nurses in Wuhan, China

Por: Hou · X. · Hu · W. · Russell · L. · Kuang · M. · Konge · L. · Nayahangan · L. J.
Objective

To identify theoretical and technical aspects regarding treatment, prevention of spread and protection of staff to inform the development of a comprehensive training curriculum on COVID-19 management.

Design

Cross-sectional study.

Setting

Nine hospitals caring for patients with COVID-19 in Wuhan, China.

Participants

134 Chinese healthcare professionals (74 doctors and 60 nurses) who were deployed to Wuhan, China during the COVID-19 epidemic were included. A two-round Delphi process was initiated between March and May 2020. In the first round, the participants identified knowledge, technical and behavioural (ie, non-technical) skills that are needed to treat patients, prevent spread of the virus and protect healthcare workers. In round 2, the participants rated each item according to its importance to be included in a training curriculum on COVID-19. Consensus for inclusion in the final list was set at 80%.

Primary outcome measures

Knowledge, technical and behavioural (ie, non-technical) skills that could form the basis of a training curriculum for COVID-19 management.

Results

In the first round 1398 items were suggested by the doctors and reduced to 67 items after content analysis (treatment of patients: n=47; infection prevention and control: n=20). The nurses suggested 1193 items that were reduced to 70 items (treatment of patients: n=49; infection prevention and control: n=21). In round 2, the response rates were 82% in doctors and 93% in nurses. Fifty-eight items of knowledge, technical and behavioural skills were agreed on by the doctors to include in the final list. For the nurses, 58 items were agreed on.

Conclusions

This needs assessment process resulted in a comprehensive list of knowledge, technical and behavioural skills for COVID-19 management. Educators can use these to guide decisions regarding content of training curricula not only for COVID-19 management but also in preparation for future viral pandemic outbreaks.

Multimethods study comparing the experiences of medical clinical academics with nurses, midwives and allied health professionals pursuing a clinical academic career

Por: Trusson · D. · Rowley · E. · Barratt · J.
Objectives

This study aimed to compare experiences of medical clinical academics (MCAs) with those of nurses, midwives and allied health professionals (NMAHPs) pursuing a clinical academic career.

Design

A multimethods approach was used to elicit qualitative data. Both sets of participants completed similar online surveys followed by in-depth interviews to explore emerging themes.

Setting

The research was conducted in the East Midlands of England, encompassing two Higher Education Institutions and four National Health Service Trusts.

Participants

Surveys were completed by 67 NMAHPs and 73 MCA trainees. Sixteen participants from each group were interviewed following a similar interview schedule.

Results

The survey data revealed notable differences in demographics of the two study populations, reflecting their different career structures. MCAs were younger and they all combined clinical and academic training, lengthening the time before qualification. In contrast, most NMAHPs had been in their clinical post for some years before embarking on a clinical academic pathway. Both routes had financial and personal repercussions and participants faced similar obstacles. However, there was also evidence of wide-ranging benefits from combining clinical and academic roles.

Conclusions

Variations in experiences between the two study populations highlight a need for a clear academic pathway for all health professionals, as well as sufficient opportunities post-PhD to enable clinical academics to fully use their dual skills.

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Identifying the competencies of Chinas paediatric residents: a modified Delphi method study

Por: Wang · Y. · Wang · T. · Wang · A. · Chen · S. · Jiao · L. · Shi · J. · Feng · X. · Meng · K.
Purpose

Standardised Training of Paediatric Resident (STPR) plays an essential role in training qualified paediatricians. Until now, China had no paediatric resident competency index system to effectively guide and evaluate the competence of paediatric residents. This study aimed to establish a competency index system for paediatric residents in China to provide a reference for improving the training system and quality of STPR.

Study design and setting

This study conducted two rounds of Delphi expert consultation survey among paediatric medical experts (n=16), followed by screening, revising and supplementing indicators using the boundary value method. Next, the analytic hierarchy process was used to determine the weight of indicators and finally establish a competency index system for paediatric residents.

Results

The results of the statistical analysis revealed a positive coefficient of 100% for both rounds of expert consultation. The expert authority coefficient values were 0.82 and 0.83, and the expert coordination coefficient test was p

Conclusions

In this study, a competency index system for paediatric residents was constructed following the characteristics and quality requirements for paediatric residents in China and is expected to significantly improve the overall level of paediatricians’ medical service quality and supply.

Key elements of effective postgraduate GP educational environments: a mixed methods study

Por: Malau-Aduli · B. S. · Alele · F. O. · Heggarty · P. · Reeve · C. · Teague · P.-A.
Objectives

Evidence in the literature suggests that satisfaction with postgraduate general practice (GP) training is associated with the quality of the educational environment. This study aimed to examine GP registrars’ level of satisfaction with a distributed model of training in a regional educational environment and investigate the relationship between satisfaction and academic performance.

Study design

A longitudinal 3-year study was conducted among GP registrars at James Cook University using a sequential explanatory mixed methods research design. GP registrars’ satisfaction was obtained using the scan of postgraduate educational environment domains tool. A focus group discussion was conducted to explore GP registrars’ perceptions of satisfaction with the educational environment.

Setting

James Cook University General Practice Training (JCU GPT) programme.

Participants

Six hundred and fifty one (651) GP registrars enrolled between 2016 and 2018 at JCU GPT programme.

Results

651 registrars completed the satisfaction survey between 2016 and 2018. Overall, 92% of the registrars were satisfied with the educational training environment. Registrars who had become fellows reported higher satisfaction levels compared with those who were still in training (mean=4.39 vs 4.20, p=0.001). However, academic performance had no impact on level of satisfaction with the educational environment. Similarly, practice location did not influence registrars’ satisfaction rates. Four themes (rich rural/remote educational environment, supportive learning environment, readiness to continue with rural practice and practice culture) emerged from the thematic data analysis.

Conclusion

A clinical learning environment that focuses on and supports individual learning needs is vital for effective postgraduate medical training. This study suggests that JCU GPT programme’s distributed model fostered a satisfying and supportive training environment with rich educational experiences that enhance retention of GP registrars in rural/remote North Queensland, Australia. The findings of this study may be applicable to other settings with similar training models.

Formative peer assessment in higher healthcare education programmes: a scoping review

Por: Stenberg · M. · Mangrio · E. · Bengtsson · M. · Carlson · E.
Objectives

Formative peer assessment focuses on learning and development of the student learning process. This implies that students are taking responsibility for assessing the work of their peers by giving and receiving feedback to each other. The aim was to compile research about formative peer assessment presented in higher healthcare education, focusing on the rationale, the interventions, the experiences of students and teachers and the outcomes of formative assessment interventions.

Design

A scoping review.

Data sources

Searches were conducted until May 2019 in PubMed, Cumulative Index to Nursing and Allied Health Literature, Education Research Complete and Education Research Centre. Grey literature was searched in Library Search, Google Scholar and Science Direct.

Eligibility criteria

Studies addressing formative peer assessment in higher education, focusing on medicine, nursing, midwifery, dentistry, physical or occupational therapy and radiology published in peer-reviewed articles or in grey literature.

Data extractions and synthesis

Out of 1452 studies, 37 met the inclusion criteria and were critically appraised using relevant Critical Appraisal Skills Programme, Joanna Briggs Institute and Mixed Methods Appraisal Tool tools. The pertinent data were analysed using thematic analysis.

Result

The critical appraisal resulted in 18 included studies with high and moderate quality. The rationale for using formative peer assessment relates to giving and receiving constructive feedback as a means to promote learning. The experience and outcome of formative peer assessment interventions from the perspective of students and teachers are presented within three themes: (1) organisation and structure of the formative peer assessment activities, (2) personal attributes and consequences for oneself and relationships and (3) experience and outcome of feedback and learning.

Conclusion

Healthcare education must consider preparing and introducing students to collaborative learning, and thus develop well-designed learning activities aligned with the learning outcomes. Since peer collaboration seems to affect students’ and teachers’ experiences of formative peer assessment, empirical investigations exploring collaboration between students are of utmost importance.

Experiences of telehealth e-mentoring within postgraduate musculoskeletal physical therapy education in the UK and Canada: a protocol for parallel mixed-methods studies and cross-cultural comparison

Por: Heneghan · N. R. · Nazareth · M. · Johnson · W. J. · Tyros · I. · Sadi · J. · Gillis · H. · Rushton · A. B.
Introduction

Mentored clinical practice is central to demonstrating achievement of International Educational Standards in advanced musculoskeletal physical therapy. While traditionally delivered face-to-face, telehealth e-mentoring is a novel alternative to offering this unique pedagogy to facilitate mentee critical reflection, deeper learning and enhanced knowledge translation to optimise patient care. With COVID-19 resulting in widespread adoption of telehealth and access to mentors often limited by geography or cost, the potential value of telehealth e-mentoring needs investigating. To investigate the experiences and outcomes of multiple stakeholders (student mentees, mentors and patients) engaged in musculoskeletal physical therapy telehealth e-mentoring across two universities (UK and Canada).

Methods and analysis

Using case study design, we will use sequential mixed methods involving qualitative and quantitative components based on existing evidence. To examine the influence of telehealth e-mentoring on health outcomes in patients with musculoskeletal complaints, we will use patient-reported outcomes for satisfaction, patient empowerment and change in musculoskeletal health. We will conduct semistructured interviews to explore the development of critical thinking, clinical reasoning, communication skills and confidence of students engaged in telehealth e-mentoring. To explore the mentor acceptability and appropriateness of telehealth e-mentoring, we will conduct a focus group in each site. Finally, we will include a focus group of participants from each site to allow a cross-cultural comparison of findings to inform international stakeholders. Quantitative data will be analysed using descriptive statistics (median and IQR) to describe changes in outcome data and qualitative data will be analysed following the Framework Method.

Ethics and dissemination

This study has ethical approval from both institutions: the University of Birmingham (ERN_20-0695) and Western University (2020-116233-47832). Findings will be published in a peer-reviewed journal and disseminated to key stakeholders in musculoskeletal physical therapy education and practice.

Attitudes of pharmacy students towards patient safety: a cross-sectional study from six developing countries

Por: Naser · A. Y. · Alsairafi · Z. K. · Awaisu · A. · Alwafi · H. · Awwad · O. · Dahmash · E. Z. · Hussain · S. · Alyami · H. S. · Alsharif · A. · Singh · A. K. · Jeragh-Alhaddad · F. B. · Kautsar · A. P. · AbuAlhommos · A. K.
Objective

To evaluate the attitudes of undergraduate pharmacy students towards patient safety in six developing countries.

Design

A cross-sectional study.

Setting

Participants were enrolled from the participating universities in six countries.

Participants

Undergraduate pharmacy students from the participating universities in six developing countries (Jordan, Saudi Arabia, Kuwait, Qatar, India and Indonesia) were invited to participate in the study between October 2018 and September 2019.

Primary outcome

Attitudes towards patient safety was measured using 14-item questionnaire that contained five subscales: being quality-improvement focused, internalising errors regardless of harm, value of contextual learning, acceptability of questioning more senior healthcare professionals’ behaviour and attitude towards open disclosure. Multiple-linear regression analysis was used to identify predictors of positive attitudes towards patient safety.

Results

A total of 2595 students participated in this study (1044 from Jordan, 514 from Saudi Arabia, 134 from Kuwait, 61 from Qatar, 416 from India and 429 from Indonesia). Overall, the pharmacy students reported a positive attitude towards patient safety with a mean score of 37.4 (SD=7.0) out of 56 (66.8%). The ‘being quality-improvement focused’ subscale had the highest score, 75.6%. The subscale with the lowest score was ‘internalising errors regardless of harm’, 49.2%. Female students had significantly better attitudes towards patient safety scores compared with male students (p=0.001). Being at a higher level of study and involvement in or witnessing harm to patients while practising were important predictors of negative attitudes towards patient safety (p

Conclusion

Patient safety content should be covered comprehensively in pharmacy curricula and reinforced in each year of study. This should be more focused on students in their final year of study and who have started their training. This will ensure that the next generation of pharmacists are equipped with the requisite knowledge, core competencies and attitudes to ensure optimal patient safety when they practice.

How do we assess resilience and grit among internal medicine residents at the Mayo Clinic? A longitudinal validity study including correlations with medical knowledge, professionalism and clinical performance

Por: Alahdab · F. · Halvorsen · A. J. · Mandrekar · J. N. · Vaa · B. E. · Montori · V. M. · West · C. P. · Murad · M. H. · Beckman · T. J.
Background

There has been limited research on the positive aspects of physician wellness and to our knowledge there have been no validity studies on measures of resilience and grit among internal medicine (IM) residents.

Objectives

To investigate the validity of resilience (10 items Connor-Davidson Resilience Scale (CD-RISC 10)) and grit (Short Grit Scale (GRIT-S)) scores among IM residents at a large academic centre, and assess potential associations with previously validated measures of medical knowledge, clinical performance and professionalism.

Methods

We evaluated CD-RISC 10 and GRIT-S instrument scores among IM residents at the Mayo Clinic Rochester, Minnesota between July 2017 and June 2019. We analysed dimensionality, internal consistency reliability and criterion validity in terms of relationships between resilience and grit, with standardised measures of residents’ medical knowledge (in-training examination (ITE)), clinical performance (faculty and peer evaluations and Mini-Clinical Evaluation Examination (mini-CEX)) and professionalism/dutifulness (conference attendance and evaluation completion).

Results

A total of 213 out of 253 (84.2%) survey-eligible IM residents provided both CD-RISC 10 and GRIT-S survey responses. Internal consistency reliability (Cronbach alpha) was excellent for CD-RISC 10 (0.93) and GRIT-S (0.82) overall, and for the GRIT subscales of consistency of interest (0.84) and perseverance of effort (0.71). CD-RISC 10 scores were negatively associated with ITE percentile (β=–3.4, 95% CI –6.2 to –0.5, p=0.02) and mini-CEX (β=–0.2, 95% CI –0.5 to –0.02, p=0.03). GRIT-S scores were positively associated with evaluation completion percentage (β=2.51, 95% CI 0.35 to 4.67, p=0.02) and conference attendance (β=2.70, 95% CI 0.11 to 5.29, p=0.04).

Conclusions

This study revealed favourable validity evidence for CD-RISC 10 and GRIT-S among IM residents. Residents demonstrated resilience within a competitive training environment despite less favourable test performance and grittiness that was manifested by completing tasks. This initial validity study provides a foundation for further research on resilience and grit among physicians in training.

Factors associated with the mental health status of medical students during the COVID-19 pandemic: a cross-sectional study in Japan

Por: Arima · M. · Takamiya · Y. · Furuta · A. · Siriratsivawong · K. · Tsuchiya · S. · Izumi · M.
Objective

The COVID-19 pandemic had a substantial impact on university students, including those in medical schools, with disruption in routine education causing significant psychological distress. The objective of this study was to evaluate the factors associated with psychological distress among medical students during the period of enforced home quarantine from March through May 2020.

Design

A cross-sectional study.

Setting

One Japanese medical school.

Participants

571 medical students.

Primary and secondary outcome measures

Self-administered electronic questionnaires including the K-6 scale for psychological distress, the Rosenberg Self-Esteem Scale (RSES) for self-esteem and the General Self-Efficacy Scale (GSES) for self-efficacy were distributed. To assess the determinant factor for psychological distress, variables such as sex, grade in school, living conditions, and RSES and GSES scores were evaluated in regression analysis.

Results

163 respondents (28.5%) scored ≥5 on the K-6 scale, indicating a significant degree of psychological distress. Logistic regression revealed that a higher score on RSES (p

Conclusions

This study identified that self-efficacy and self-esteem were both influential factors for predicting psychological distress during the current COVID-19 pandemic. Medical schools should provide support for mental health and educational initiatives directed at enhancing self-esteem and self-efficacy, with a focus on improving personal resilience. In emergency situations, such as that faced in response to the COVID-19 pandemic, initial programmes might target students with higher levels of self-efficacy. By contrast, under routine situations, these efforts should be directed towards students with lower self-esteem as primary means to prevent depression.

Worried, weary and worn out: mixed-method study of stress and well-being in final-year medical students

Por: Lane · A. · McGrath · J. · Cleary · E. · Guerandel · A. · Malone · K. M.
Objective

Although there is much focus on burnout and psychological distress among doctors, studies about stress and well-being in medical students are limited but could inform early intervention and prevention strategies.

Design

The primary aim of this mixed-method, cross-sectional survey was to compare objective and subjective levels of stress in final-year medical students (2017) and to explore their perspectives on the factors they considered relevant to their well-being.

Setting

University College Dublin, the largest university in Ireland.

Participants

161 of 235 medical students participated in this study (response rate 69%).

Results

65.2% of students scored over accepted norms for the Perceived Stress Scale (34.8% low, 55.9% moderate and 9.3% high). 35% scored low, 28.7% moderate and 36.3% high on the Subjective Stress Scale. Thematic analysis identified worry about exams, relationships, concern about the future, work–life balance and finance; one in three students reported worry, irritability and hostility; many felt worn out. Cognitive impacts included overthinking, poor concentration, sense of failure, hopelessness and procrastination. Almost a third reported sleep and appetite disturbance, fatigue and weariness. A quarter reported a ‘positive reaction’ to stress. Positive strategies to manage stress included connection and talking, exercise, non-study activity and meditation. Unhelpful strategies included isolation and substance use. No student reported using the college support services or sought professional help.

Conclusion

Medical students experience high levels of psychological distress, similar to their more senior doctor colleagues. They are disinclined to avail of traditional college help services. Toxic effects of stress may impact their cognition, learning, engagement and empathy and may increase patient risk and adverse outcomes. The focus of well-being in doctors should be extended upstream and embedded in the curriculum where it could prevent future burnout, improve retention to the profession and deliver better outcomes for patients.

Undergraduate exposure to patient presentations on the acute medical placement: a prospective study in a London teaching hospital

Por: Fung · C. Y. · Tan · Z. M. · Savage · A. · Rahim · M. · Osman · F. · Adnan · M. · Peleva · E. · Sam · A. H.
Objectives

To identify the availability and variability of learning opportunities through patient presentations on an acute medical placement at a teaching hospital.

Design

A prospective study evaluating all acute admissions to the Acute Medical Unit over 14 days (336 hours). Clinical presentations and the day and time of admission were recorded and compared with the learning outcomes specified in the medical school curriculum.

Setting

An Acute Medical Unit at a London teaching hospital.

Outcomes

(1) Number of clinical presentations to the Acute Medical Unit over 14 days and (2) differences between the availability and variation of admissions and presentations between in-hours and out-of-hours.

Results

There were 359 admissions, representing 1318 presentations. Of those presentations, 76.6% were admitted out-of-hours and 23.4% in-hours. Gastrointestinal bleeding, tachycardia, oedema and raised inflammatory markers were over three times more common per hour out-of-hours than in-hours. Hypoxia was only seen out-of-hours. Important clinical presentations in the curriculum such as chest pain and hemiparesis were not commonly seen.

Conclusions

There is greater availability of presentations seen out-of-hours and a changing landscape of presentations seen in-hours. The out-of-hours presentation profile may be due to expanded community and specialist services. Medical schools need to carefully consider the timing and location of their clinical placements to maximise undergraduate learning opportunities.

Manuscript review continuing medical education: a retrospective investigation of the learning outcomes from this peer reviewer benefit

Por: Kawczak · S. · Mustafa · S.
Objectives

This study investigates the learning outcomes for peer reviewers participating in a manuscript review continuing medical education (CME) process. CME from serving as a peer reviewer is one of the many benefits of serving as a reviewer.

Design

This is a descriptive study retrospectively analysing learning outcomes self-reported by peer reviewers from 2013 to 2017 using a CME assessment framework.

Setting, participants and primary outcome measures

Participant data are from 1985 peer reviewers who completed 2413 manuscript reviews over 32 medical journals from 2013 to 2017 and completed the CME process after their prepublication manuscript review. 417 reviewer responses were practice behaviour change(s) that were studied in depth using an assessment framework on changes in knowledge, competence and performance.

Results

The results show positive learning outcomes reported by reviewers at the knowledge, competence and performance behaviour levels as a result of reviewing manuscripts. Higher levels of learning outcomes are more frequently achieved when reviewers consult multiple sources when conducting reviews. Reviewer demographics, such as gender or years of experience, did not have a significant association to learning outcomes.

Conclusions

Manuscript Review CME is an effective way that learning within the peer reviewer process can occur and helps reviewers gain knowledge, improve competence and make changes to their professional practice at all stages of their careers. Journal publishers should emphasise and support reviewers through offering CME to reviewers and encourage consultation of multiple sources when conducting reviews, which is an added benefit and resource to help professionals continue their development.

Role of formative assessment in predicting academic success among GP registrars: a retrospective longitudinal study

Por: Heggarty · P. · Teague · P.-A. · Alele · F. · Adu · M. · Malau-Aduli · B. S.
Objectives

The James Cook University General Practice Training (JCU GPT) programme’s internal formative exams were compared with the Royal Australian College of General Practitioners (RACGP) pre-entry exams to determine ability to predict final performance in the RACGP fellowship exams.

Design

A retrospective longitudinal study.

Setting

General Practice (GP) trainees enrolled between 2016 and 2019 at a Registered Training Organisation in regional Queensland, Australia.

Participants

376 GP trainees enrolled in the training programme.

Exposure measures

The pre-entry exams were Multiple-Mini Interviews (MMI), Situational Judgement Test (SJT) and Candidate Assessment and Applied Knowledge Test. The internal formative exams comprised multiple choice questions (MCQ1 and MCQ2), short answer questions, clinical skills and clinical reasoning.

Primary outcome measure

The college exams were Applied Knowledge Test (AKT), Key Feature Problems (KFP) and Objective Structured Clinical Examination (OSCE).

Results

Correlations (r), coefficients of determination (R2) and OR were used as parameters for estimating strength of relationship and precision of predictive accuracy. SJT and MMI were moderately (r=0.13 to 0.31) and MCQ1 and MCQ2 highly (r=0.37 to 0.53) correlated with all college exams (p2 ranging from 0.070 to 0.376. MCQ1 was predictive of failure in all college exams (AKT: OR=2.32, KFP: OR=3.99; OSCE: OR=3.46); while MCQ2 predicted failure in AKT (OR=2.83) and KFP (OR=3.15).

Conclusion

We conclude that the internal MCQ formative exams predict performance in the RACGP fellowship exams. We propose that our formative assessment tools could be used as academic markers for early identification of potentially struggling trainees.

Exploring the effectiveness of technology-based learning on the educational outcomes of undergraduate healthcare students: an overview of systematic reviews protocol

Por: Romli · M. H. · Cheema · M. S. · Mehat · M. Z. · Md Hashim · N. F. · Abdul Hamid · H.
Introduction

Rapid technology development due to the introduction of Industrial Revolution 4.0 and Internet of Things has created a demand and gradual transition from traditional teaching and learning to technology-based learning in higher education, including healthcare education. The COVID-19 pandemic has accelerated this process, with educators now required to quickly adapt to and adopt such changes. The abundance of available systematic reviews has made the effectiveness of such approaches ambiguous especially in healthcare education. Therefore, a protocol of the overview of systematic reviews (OoSR) is planned to extrapolate the effectiveness of technology-based learning in undergraduate healthcare education.

Methods and analysis

Scopus, CINAHL, Academic Search Complete, Cochrane Library, MEDLINE and Psychology and Behavioral Sciences Collection databases were selected. Screening was conducted independently by at least two authors and the decision for inclusion was done through discussion or involvement of an arbiter against a predetermined criteria. Included articles will be evaluated for quality using A MeaSurement Tool to Assess systematic Reviews and Risk of Bias in Systematic Review tools, while primary systematic review articles will be cross-checked and reported for any overlapping using the ‘corrected covered area’ method. Only narrative synthesis will be employed according to the predefined themes into two major dimensions—theory and knowledge generation (focusing on cognitive taxonomy due to its ability to be generalised across disciplines), and clinical-based competence (focusing on psychomotor and affective taxonomies due to discipline-specific influence). The type of technology used will be identified and extracted.

Ethics and dissemination

The OoSR involves analysis of secondary data from published literature, thus ethical approval is not required. The findings will provide a valuable insight for policymakers, stakeholders, and researchers in terms of technology-based learning implementation and gaps identification. The findings will be published in several reports due to the extensiveness of the topic and will be disseminated through peer-reviewed publications and conferences.

PROSPERO registration number

CRD4202017974.

Diversity in health professional education scholarship: a document analysis of international author representation in leading journals

Por: Buffone · B. · Djuana · I. · Yang · K. · Wilby · K. J. · El Hajj · M. S. · Wilbur · K.
Objectives

The global distribution of health professionals and associated training programmes is wide but prior study has demonstrated reported scholarship of teaching and learning arises from predominantly Western perspectives.

Design

We conducted a document analysis to examine authorship of recent publications to explore current international representation.

Data sources

The table of contents of seven high-impact English-language health professional education journals between 2008 and 2018 was extracted from Embase.

Eligibility criteria

The journals were selected according to highest aggregate ranking across specific scientific impact indices and stating health professional education in scope; only original research and review articles from these publications were included for analysis.

Data extraction and synthesis

The table of contents was extracted and eligible publications screened by independent reviewers who further characterised the geographic affiliations of the publishing research teams and study settings (if applicable).

Results

A total 12 018 titles were screened and 7793 (64.8%) articles included. Most were collaborations (7048, 90.4%) conducted by authors from single geographic regions (5851, 86%). Single-region teams were most often formed from countries in North America (56%), Northern Europe (14%) or Western Europe (10%). Overall lead authorship from Asian, African or South American regions was less than 15%, 5% and 1%, respectively. Geographic representation varied somewhat by journal, but not across time.

Conclusions

Diversity in health professional education scholarship, as marked by nation of authors’ professional affiliations, remains low. Under-representation of published research outside Global North regions limits dissemination of novel ideas resulting in unidirectional flow of experiences and a concentrated worldview of teaching and learning.

Examining the effect of non-specialised clinical rotations upon medical students Thanatophobia and Self-efficacy in Palliative Care: a prospective observational study in two medical schools

Por: Gryschek · G. · Cecilio-Fernandes · D. · Barros · G. A. M. d. · Mason · S. · de Carvalho-Filho · M. A.
Introduction

Including palliative care (PC) in overloaded medical curricula is a challenge, especially where there is a lack of PC specialists. We hypothesised that non-specialised rotations could provide meaningful PC learning when there are enough clinical experiences, with adequate feedback.

Objective

Observe the effects of including PC topics in non-specialised placements for undergraduate medical students in two different medical schools.

Design

Observational prospective study.

Setting

Medical schools in Brazil.

Participants

134 sixth-year medical students of two medical schools.

Methods

This was a longitudinal study that observed the development of Self-efficacy in Palliative Care (SEPC) and Thanatophobia (TS) in sixth-year medical students in different non-specialised clinical rotations in two Brazilian medical schools (MS1 and MS2). We enrolled 78 students in MS1 during the Emergency and Critical Care rotation and 56 students in MS2 during the rotation in Anaesthesiology. Both schools provide PC discussions with different learning environment and approaches.

Primary outcomes

SEPC and TS Scales were used to assess students at the beginning and the end of the rotations.

Results

In both schools’ students had an increase in SEPC and a decrease in TS scores.

Conclusion

Non-specialised rotations that consider PC competencies as core aspects of being a doctor can be effective to develop SEPC and decrease TS levels.

Psychometric properties of the Chinese version of the TeamSTEPPS teamwork perceptions questionnaire to measure teamwork perceptions of Chinese residents: a cross-sectional study

Por: Qu · J. · Zhu · Y. · Cui · L. · Yang · L. · Lai · Y. · Ye · X. · Qu · B.
Objectives

The purpose of this research was to evaluate the psychometric properties of the TeamSTEPPS Teamwork Perception Questionnaire (T-TPQ) among the Chinese residents.

Design

Cross-sectional study.

Setting

A clinical hospital of the China Medical University in Liaoning Province, China.

Participants

A total of 664 residents were enrolled in this research. The valid response rate was 83.0% (664 of 800 residents).

Main outcome measures

Internal consistency and test–retest reliability were used to assess the reliability of the questionnaire. The construct validity of the Chinese T-TPQ was evaluated by confirmatory factor analysis. Furthermore, the concurrent, convergent and discriminant validity were analysed.

Results

Cronbach’s α coefficient of the T-TPQ in Chinese language was 0.923. Except for the communication dimension (0.649), the Cronbach’s α coefficient of all dimensions were satisfactory. The T-TPQ and its five dimensions reported a good test–retest reliability (0.740–0.881, p

Conclusions

The T-TPQ in Chinese language demonstrated good psychometric characteristics and was a reliable and valid questionnaire to measure the Chinese health professionals’ perception of teamwork. Thus, the Chinese version of the T-TPQ could be applied in teamwork training programmes and medical education research.

Added value of assessing medical students reflective writings in communication skills training: a longitudinal study in four academic centres

Objectives

This study describes the development and implementation of a model to assess students’ communication skills highlighting the use of reflective writing. We aimed to evaluate the usefulness of the students’ reflections in the assessment of communication skills.

Design

Third-year and fourth-year medical students enrolled in an elective course on clinical communication skills development were assessed using different assessment methods.

Setting and participants

The communication skills course was offered at four universities (three in Brazil and one in Portugal) and included 69 students.

Outcome measures

The students were assessed by a Multiple-Choice Questionnaire (MCQ), an objective structured clinical examination (OSCE) and reflective writing narratives. The Cronbach’s alpha, dimensionality and the person’s correlation were applied to evaluate the reliability of the assessment methods and their correlations. Reflective witting was assessed by applying the Reflection Evaluation for Enhanced Competencies Tool Rubric (Reflect Score (RS)) to measure reflections’ depth, and the Thematic Score (TS) to map and grade reflections’ themes.

Results

The Cronbach alpha for the MCQ, OSCE global score, TS and RS were, respectively, 0.697, 0.633, 0.784 and 0.850. The interobserver correlation for the TS and RS were, respectively, 0.907 and 0.816. The assessment of reflection using the TS was significantly correlated with the MCQ (r=0.412; p=0.019), OSCE (0.439; p=0.012) and RS (0.410; p=0.020). The RS did not correlate with the MCQ and OSCE.

Conclusions

Assessing reflection through mapping the themes and analysing the depth of reflective writing expands the assessment of communication skills. While the assessment of reflective themes is related to the cognitive and behavioural domains of learning, the reflective depth seems to be a specific competence, not correlated with other assessment methods—possibly a metacognitive domain.

Perceptions of medical students towards online teaching during the COVID-19 pandemic: a national cross-sectional survey of 2721 UK medical students

Por: Dost · S. · Hossain · A. · Shehab · M. · Abdelwahed · A. · Al-Nusair · L.
Objectives

To investigate perceptions of medical students on the role of online teaching in facilitating medical education during the COVID-19 pandemic.

Design

Cross-sectional, online national survey.

Setting

Responses collected online from 4th May 2020 to 11th May 2020 across 40 UK medical schools.

Participants

Medical students across all years from UK-registered medical schools.

Main outcome measures

The uses, experiences, perceived benefits and barriers of online teaching during the COVID-19 pandemic.

Results

2721 medical students across 39 medical schools responded. Medical schools adapted to the pandemic in different ways. The changes included the development of new distance-learning platforms on which content was released, remote delivery of lectures using platforms and the use of question banks and other online active recall resources. A significant difference was found between time spent on online platforms before and during COVID-19, with 7.35% students before versus 23.56% students during the pandemic spending >15 hours per week (p

Conclusions

Online teaching has enabled the continuation of medical education during these unprecedented times. Moving forward from this pandemic, in order to maximise the benefits of both face-to-face and online teaching and to improve the efficacy of medical education in the future, we suggest medical schools resort to teaching formats such as team-based/problem-based learning. This uses online teaching platforms allowing students to digest information in their own time but also allows students to then constructively discuss this material with peers. It has also been shown to be effective in terms of achieving learning outcomes. Beyond COVID-19, we anticipate further incorporation of online teaching methods within traditional medical education. This may accompany the observed shift in medical practice towards virtual consultations.

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