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AbstractPurposeMethods and MaterialsResultsConclusionsPhysician educators are often expected to direct educational programs and assume roles that conform to field norms for career advancement but that may not afford meaningful work for educators. The purpose of this study was to describe and analyse the perspectives and actions taken by physician educators in response to tension between feeling compelled to direct an educational program and doing educationally meaningful work.We used data from a longitudinal study and focused on three participants who, over the course of the five-year study, offered significant insights into how physician educators act in ways that run counter to expectations for career advancement. Our narrative analysis entailed organizing data from interview transcripts into time-ordered displays, weaving data into counternarratives that were edited by participants, and using the theory of faculty agency (and its key constructs, strategic perspectives and strategic action) to thread the stories together.In each counternarrative, the participant deliberated their sense of being a physician educator (strategic perspectives) and when expectations became untenable, they did what they needed to do to engage in meaningful work (strategic action) rather than comply with expectations for career advancement in academic medicine. For one participant, faculty agency meant leaving academic medicine; for another, it meant reducing clinical time so that unpaid time could be devoted to education; and for another, it meant opting not do direct a reputable education program.Faculty agency is a useful theoretical lens for conceptualizing how physician educators navigate their careers in academic medicine. Counternarratives that illuminate faculty agency offer stories that describe alternate career paths and portend a different future for physician educators. [ABSTRACT FROM AUTHOR]

Blalock and Balmer demonstrate how using organizational theories and longitudinal qualitative research may enhance analysis of gender disparities in academic medicine and transform organizations into sites of possibilities for women. [ABSTRACT FROM AUTHOR]

Context: Longitudinal qualitative research is an approach to research that entails generating qualitative data with the same participants over extended periods of time to understand their lived experiences as those experiences unfold. Knowing about dynamic lived experiences in medical education, that is, learning journeys with stops and starts, detours, transitions and reversals, enriches understanding of events and accomplishments along the way. The purpose of this paper is to create access points to longitudinal qualitative research in support of increasing its use in medical education. Methods: The authors explore and argue for different conceptualisations of time: analysing lived experiences through time versus analysing lived experiences cross‐sectional or via 2‐point follow‐up studies and considering time as subjective and fluid as well as objective and fixed. They introduce applications of longitudinal qualitative research from several academic domains: investigating development and formal education; building longitudinal research relationship; and exploring interconnections between individual journeys and social structures. They provide an illustrative overview of longitudinal qualitative research in medical education, and end with practical advice, or pearls, for medical education investigators interested in using this research approach: collecting data recursively; analysing longitudinal data in three strands; addressing mutual reflexivity; using theory to illuminate time; and making a long‐term commitment to longitudinal qualitative research. Conclusions: Longitudinal qualitative research stretches investigators to think differently about time and undertake more complex analyses to understand dynamic lived experiences. Research in medical education will likely be impoverished if the focus remains on time as fixed. Seeing things qualitatively through time, where time is fluid and the past, present and future interpenetrate, produces a rich understanding that can move the field forward. Lived experiences in medical education, with their starts, stops, detours, transitions, and reversals, determine understanding of events. Longitudinal qualitative research offers a way to gain knowledge into these dynamic journeys. [ABSTRACT FROM AUTHOR]

Introduction: Despite its widespread application in medical education, belonging to a single community of practice does not reflect the overall experience of physician‐educators. Knowing how physician‐educators find their way among different communities of practice (ie their landscape of practice) has implications for professional development but the limited description in the literature. In this longitudinal qualitative research, we explored how physicians who pursue graduate degrees in medical education navigate their landscape of practice. Methods: 11/29 physicians in one cohort of a masters in medical education programme were interviewed annually from 2016 (programme start) to 2020 (2 years post‐graduation). We iteratively collected and analysed data, creating inductive codes and categorising coded data by mode of identification (engagement, imagination, alignment) and time. We organised narratives into time‐ordered data matrices so that final analysis wove together mode, time and participant. Results: All participants consistently spoke of navigating their landscape of practice, which included the community created in the graduate programme; but that single community 'doesn't define the journey itself'. They shifted engagement from teaching individual learners to translating what they learned in the graduate programme to develop educational projects and produce scholarship. They shifted the imagination from relying on internal and external assessments to experience‐inspired versions of their future self. And they shifted alignment from belonging to the graduate programme's community of practice, then belonging to different communities in their landscape of practice and ultimately focussing on communities that mattered most to them. Discussion: Physicians in a graduate programme in medical education navigated their dynamic landscape of practice by shifting how they engaged in medical education, as well as what they imagined and who they aligned with as physician‐educators. Our work offers novel insights into how knowledgeability emerges through time as overlapping modes of identification. In this study, the authors explore how physician‐educator identity developed in one community of practice (a graduate program in medical education) expands to interactions with other communities to form a landscape of practice. [ABSTRACT FROM AUTHOR]

Phenomenon: The number of women who enter medical school has been on par with the number of men for almost 20 years, but parity in training has not translated to equity in professional life. To capitalize on the perspective of women faculty with established careers in academic medicine and to bring theory to the largely descriptive research on gender inequity in academic medicine, the authors used the Theory of Gendered Organizations to demonstrate how academic medical centers function as inherently gendered organizations. Approach: The authors recruited women faculty with established careers at one academic medical center based on purposeful and snowball sampling and interviewed 30 participants in Summer/Fall 2018. They coded and analyzed data inductively. In later stages of analysis they used sensitizing concepts from the Theory of Gendered Organizations to guide our focus on formal expectations of, and informal interactions in, the academic medical center. Findings: The disjuncture, i.e., "lip service", between formal expectations intended to be gender-neutral and informal interactions that advantaged men demonstrated how the academic medical center functioned as a gendered organization. Participants experienced these interactions as being treated differently than men and/or being stereotyped. As their careers progressed, participants recognized gender inequity as embedded in the organization, or as they said, "the way things were stacked". Subsequent to this recognition, they navigated this gendered organization by advocating for themselves and younger women faculty. Insights: Women with established careers in academic medicine experienced gender inequity as embedded in the organization but navigate gendered interactions by advocating for themselves and for younger women. Using the Theory of Gendered Organizations as an analytic lens demonstrates how academic medical centers function as gendered organizations; these findings can inform both theory-based research and pragmatic change strategies. [ABSTRACT FROM AUTHOR]

Background. For uncommon events in medicine, such as pediatric CPR, more frequent training is associated with improved performance among healthcare providers and physicians in training. Gamified learning may facilitate motivation to practice CPR, though studies to support this are lacking. Intervention. Residents were interviewed to understand motivating factors for CPR practice outside of a traditional classroom certification setting. Methods. We used a qualitative study design within a larger multinational study. Semi-structured, one-on-one interviews were completed with pediatric residents using a constructivist approach. Transcripts were reviewed independently by two authors (IHG, JLS). Results. The inductive framework gradually moved away from gamification and towards that of self-determination. Participating residents reported several types of intrinsic and extrinsic motivational drivers towards practicing CPR, such as practicing CPR to prepare, or as a connection to clinical practice. Some themes were amotivational, such as performance anxiety, and detracted from their drive to practice. Despite a gamification design to this curriculum, these components were rarely mentioned. These themes related to achieving Maslow's three psychological needs of autonomy, relatedness and competence. Conclusion. The motivation to practice CPR among residents aligns with the self-determination theory. By stimulating intrinsic motivating factors, future curriculum design may better motivate residents to practice CPR. [ABSTRACT FROM AUTHOR]

BACKGROUND: Providing and learning from feedback are essential components of medical education, and typically described as resistant to change. But given a decade of change in the clinical context in which feedback occurs, the authors asked if, and how, perceptions of feedback and feedback behaviors might have changed in response to contextual affordances. METHODS: In 2017, the authors conducted a follow-up, ethnographic study on 2 general pediatric floors at the same children's hospital where another ethnographic study on a general pediatric floor was conducted in 2007. Data sources included (1) 21 and 34 hours of observation in 2007 and 2017, respectively, (2) 35 and 25 interviews with general pediatric attending physicians and residents in 2007 and 2017, respectively, and (3) a review of 120 program documents spanning 2007 to 2017. Data were coded and organized around 3 recommendations for feedback that were derived from 2007 data and served as standards for assessing change in 2017. RESULTS: Data revealed progress in achieving each recommendation. Compared with 2007, participants in 2017 more clearly distinguished between feedback and evaluation; residents were more aware of in-the-moment feedback, and they had shifted their orientation from evaluation and grades to feedback and learning. Explanations for progress in achieving recommendations, which were derived from the data, pointed to institutional and national influences, namely, the pediatric milestones. CONCLUSIONS: On the basis of follow-up, ethnographic data, changes in the clinical context of pediatric education may afford positive change in perceptions of feedback and feedback behavior and point to influences within and beyond the institution. [ABSTRACT FROM AUTHOR]

The article discusses the use of longitudinal qualitative research (LQR), an approach to research in which data are collected from the same participants to assess change through time, in medical education. It introduces the fundamentals of LQR, such as the why, what and how. It shares the LQR study as an example and highlight personal reflections about doing LQR.

OBJECTIVES: Pediatric residency trainees interface with electrocardiograms (EKG) as part of routine clinical care. Depending on workflow and availability of support staff, trainees may be required to obtain EKGs on patients, though training on this skill varies. Our intervention seeks to train incoming pediatric residents on obtaining EKGs from pediatric patients and identifying common problems that may result in acquisition of low-fidelity EKGs. METHODS: A team of physicians, EKG technicians, and simulation educators designed a 30-min didactic and experiential learning opportunity for incoming pediatric trainees held prior to their start of clinical responsibilities. During the session, trainees were introduced to the basics of EKG acquisition and common quality issues that arise. Afterwards, they practiced placing EKG leads on a mannequin and a live model. A pre- and post-session survey was utilized to assess the session's utility and participant's learning. RESULTS: The intervention was perceived as a valuable experience by participants over the course of 2 years. We found increased participant comfort with performing and troubleshooting EKGs (P <.001). There was a 33% improvement in quality assessment of EKG rhythm strips after the session (P <.001). CONCLUSION: Given the importance of EKGs to the care of pediatric patients, it is essential that pediatricians receive adequate training in acquiring and assessing EKG quality. This intervention was deemed to be highly useful with a demonstrated improvement in EKG troubleshooting skills among first year pediatric residents. This session improves learner comfort with essential clinical responsibilities and identification of low-quality EKGs that often warrant repeat testing. [ABSTRACT FROM AUTHOR]

BACKGROUND AND OBJECTIVE: Although nonphysician reentry transitions have been characterized in literature, little is known about the reentry physicians in general, or residents in particular. We conducted a qualitative study to explore pediatric residents' reentry, using reverse culture shock as a conceptual framework. METHODS: Eighteen pediatric residents who completed global health experiences in Africa (9 categorical residents with 1-month elective, 9 global child health residents with 12-month training) participated in interviews that included a card-sort to solicit emotional responses consistent with the conceptual framework. Data in the form of interview transcripts were coded and analyzed according to principles of grounded theory. RESULTS: All pediatric residents, despite variable time abroad, reported a range of emotional responses on reentry to residency. Global child health residents felt disconnection and frustration more intensely than categorical residents, whereas categorical residents felt invigoration more intensely than global child health residents. Although residents met with program leadership after their return, no resident described these meetings as a formal debriefing, and few described a deliberate strategy for processing emotions on reentry. CONCLUSIONS: Consistent with reverse culture shock, pediatric residents felt a range of emotions as they move toward a steady state of acculturating back into their residency program. Residency programs might consider creating safety nets to help cultivate support for residents when they reenter training. [ABSTRACT FROM AUTHOR]

Consider using your evaluation findings to populate the annual program evaluation or selfstudy, and sponsoring institution's documents. How evaluation findings are communicated directly influences how stakeholders understand and react to the data and ultimately their decisions. Janet M. Riddle, MD (@JanetRiddleDME) Dorene F. Balmer, PhD (@dorenebalmer) Deborah Simpson, PhD (@debsimpson3) The Challenge Your program evaluation team has completed its evaluation of a comprehensive diversity, equity, and inclusion (DEI) workshop series for program residents and faculty. [Extracted from the article]

Research is an important part of educational scholarship. Knowledge of research methodologies is essential for both conducting research as well as determining the soundness of the findings from published studies. Our goals for this paper therefore are to inform medical education researchers of the range and key components of educational research designs. We will discuss both qualitative and quantitative approaches to educational research. Qualitative methods will be presented according to traditions that have a distinguished history in particular disciplines. Quantitative methods will be presented according to an evidence-based hierarchy akin to that of evidence-based medicine with the stronger designs (systematic reviews and well conducted educational randomized controlled trials) at the top, and weaker designs (descriptive studies without comparison groups, or single case studies) at the bottom. It should be appreciated, however, that the research question determines the study design. Therefore, the onus is on the researcher to choose a design that is appropriate to answering the question. We conclude with an overview of how educational researchers should describe the study design and methods in order to provide transparency and clarity. [ABSTRACT FROM AUTHOR]

Background: Faculty development programs tend to be oriented around content, yet many have produced positive outcomes unrelated to the content. We describe a faculty development program that utilized the processes of shared reading and guided reflection espoused by narrative medicine. Description: To date, 25 preceptors in the Foundations of Clinical Medicine course have participated. The program consists of weekly seminars in which participants actively engage with text as a basis for conversation around content as well as teaching strategies. Evaluation: Using qualitative methods, we examined notes from seminars, in-depth interviews, and review of curricular documents; we used conceptual frameworks from education as interpretive lenses. Participants recognized both personal growth and transformation in relationships with each other, which created the opportunity, and the means, to address and reshape norms and teaching practices at the institution. Conclusions: Process-oriented faculty development programs may foster growth of individuals, contribute to transformation in relationships, and ultimately influence teaching practices. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To examine how attending physicians and senior residents negotiated shared responsibilities for teaching and supervising on clinical work rounds. METHODS: As part of a larger ethnographic field study, we observed clinical work rounds on a General Pediatrics ward over 8 months, and interviewed 14 of 18 attending physicians and 9 of 11 senior residents whom we observed. Struck by the frequency of 2 codes in that data set ("stand back" and "step up"), we used the metaphor of a dance as an analytic strategy for understanding the dynamic relationship between attending physicians and senior residents. RESULTS: Like a traditional dance with a priori choreography, and consistent with the traditional premise in graduate medical education, attending physicians frequently "stood back" and senior residents, accordingly, "stepped up" and took on teaching and supervising responsibilities. Less often, both attending physicians and senior residents assumed the lead, or attending physicians stepped up rather than entrust senior residents. The complex clinical context sometimes changed the choreography. Attending physicians and senior residents understood their mutual responsibilities but were not bound by them; they improvised to maintain high-quality patient care. CONCLUSIONS: The metaphor of a dance enabled us to better understand not only how attending physicians and senior residents negotiate shared responsibilities for teaching and supervision on clinical work rounds, but also how the clinical context impacts this negotiation. A better understanding of this negotiated relationship may help to clarify assumptions and set realistic expectations for what it might take for senior residents to assume progressive responsibility for these responsibilities in today's clinical context. [ABSTRACT FROM AUTHOR]

Medical Education 2010: 44: 1105-1116 Objectives Teaching at the bedside during attending rounds is considered to be fundamental to medical education. We conducted an ethnographic case study to investigate such teaching in general paediatrics as a social phenomenon and to explore change over time in both the meaning of rounds and the context in which rounds take place. Methods We conducted a case study from January to August 2006 on a 22-bed general paediatric unit in an urban children's hospital and focused our observation on interns, senior residents and attending physicians. We observed the medical team during its normal activities on the study unit and conducted semi-structured interviews with a sample of attendings, interns and senior residents. We compiled a list of codes that emerged from patterns in the data and constructed a rich description of rounds according to the principles of inductive analysis. Results Four themes emerged from the data: (i) attending rounds are a pervasive and routine part of clinical education; (ii) interns, senior residents and attending physicians hold assumptions about what should happen on rounds; (iii) tension exists between interns', senior residents' and attending physicians' assumptions about bedside teaching during rounds and the reality imposed by contextual factors, and (iv) bedside teaching during rounds is impacted, but not prohibited, by contextual factors. Conclusions Our case study provides evidence that bedside teaching during rounds is a pedagogical ideal entrenched in medical education. Participants readily acknowledged teaching at the bedside during rounds as something they perceived should happen, although, in actuality, it was infrequently achieved. This study revealed a telling inconsistency in language and behaviour: 'bedside rounds' was embedded in the participants' ordinary language, but the activity was not necessarily part of their ordinary behaviour. We propose that the practice of bedside teaching is best explained as a ritual. Considering bedside teaching as a ritual helps to explain why rounds are sacrosanct and helps to develop more appropriate expectations for rounds. [ABSTRACT FROM AUTHOR]

Context Apprenticeship learning is common in medical education, but is often situated in theoretical frameworks which highlight its cognitive but not its social dimension. Methods We conducted an ethnographic case study of paediatric residents’ learning relationships with their preceptors in a community-based paediatric continuity site. It included 5 months (100 hours) of direct observation, and semi-structured interviews with 10 residents (before and after observation) and 10 primary care paediatricians who served as their continuity preceptors (after observation). Interview transcripts and notes from observations were inductively coded and analysed for major themes. Results Our observations and reports of resident learning trajectories fit well with the concept of legitimate peripheral participation. Residents learned the everyday practice of primary care as they worked alongside experienced paediatricians in the continuity clinic. Although the direction of learning was towards central participation in patient care, residents learned during transient shifts to the periphery of practice. As a function of residents’ increased participation, preceptors moved into more supportive roles. Residents were not only learners; at times they were teachers who facilitated preceptors’ learning. Conclusions Legitimate peripheral participation is a concept that helps to explain apprenticeship as a dynamic social relationship which shapes, and is shaped by, learning that takes place in clinical practice. Other concepts shed light on the bidirectional nature of apprenticeship learning. [ABSTRACT FROM AUTHOR]

Background: Six general competencies form the framework for accreditation of postgraduate fellowship programs and maintenance of certification for physician specialists. Fellows' perceptions of these competencies, however, remain unexplored. Aims: To examine fellows' perceptions of the importance of the competencies to medical education and the contribution of fellowship training to mastery of the competencies, and to explore the alignment of the competencies with critical learning experiences. Methods: Semi-structured interviews were conducted with 20 pediatric fellows in five divisions at one institution. Fellows recounted critical learning experiences, rated each competency for importance and contribution of training, and explained their ratings. Interviews were analyzed using standard qualitative methods. Results: Fellows assigned high ratings to medical knowledge and patient care for importance and contribution of training to mastery, referring to these competencies as 'staples of training'. They rated interpersonal and communication skills and professionalism higher for importance than contribution of training, viewing them as inherent traits or learned before fellowship. Fellows were unfamiliar with practice-based learning and improvement and systems-based practice and typically perceived them as secondary to training. Descriptions of critical learning experiences substantiated competency ratings for medical knowledge and patient care, but not practice-based learning and improvement. Conclusions: Fellows perceive traditional knowledge and skills of medical practice as fundamental to postgraduate training, but other competencies as less central. [ABSTRACT FROM AUTHOR]

OBJECTIVES: Pediatric residency trainees interface with electrocardiograms (EKG) as part of routine clinical care. Depending on workflow and availability of support staff, trainees may be required to obtain EKGs on patients, though training on this skill varies. Our intervention seeks to train incoming pediatric residents on obtaining EKGs from pediatric patients and identifying common problems that may result in acquisition of low-fidelity EKGs. METHODS: A team of physicians, EKG technicians, and simulation educators designed a 30-min didactic and experiential learning opportunity for incoming pediatric trainees held prior to their start of clinical responsibilities. During the session, trainees were introduced to the basics of EKG acquisition and common quality issues that arise. Afterwards, they practiced placing EKG leads on a mannequin and a live model. A pre- and post-session survey was utilized to assess the session's utility and participant's learning. RESULTS: The intervention was perceived as a valuable experience by participants over the course of 2 years. We found increased participant comfort with performing and troubleshooting EKGs (P<.001). There was a 33% improvement in quality assessment of EKG rhythm strips after the session (P<.001). CONCLUSION: Given the importance of EKGs to the care of pediatric patients, it is essential that pediatricians receive adequate training in acquiring and assessing EKG quality. This intervention was deemed to be highly useful with a demonstrated improvement in EKG troubleshooting skills among first year pediatric residents. This session improves learner comfort with essential clinical responsibilities and identification of lowquality EKGs that often warrant repeat testing. [ABSTRACT FROM AUTHOR]

Context Methods Conclusions Despite increasing discussion and scholarship, equity in assessment is rarely defined and distinguished in a way that allows for shared understanding in medical education. This paper seeks to clarify and expand the conversation about equity in assessment by critically reviewing three distinct and evolving orientations toward equity in assessment. Orientations refers to the positions, attitudes, interests or priorities individuals can hold toward equity in assessment. The three orientations include fairness‐oriented assessment, assessment for inclusion and justice‐oriented assessment. While fairness‐oriented assessment is a prevailing orientation in medical education, assessment for inclusion and justice‐oriented assessment, originally developed in other fields of education, deserve careful consideration.In this paper, the authors explore unique underpinning assumptions of each orientation by critically examining the foundational literature of each orientation. They reflect on the unique perspectives each orientation provides, including the actions one might take and what advantages and disadvantages might result from looking at equity in assessment from any one orientation.Informed by this reflection, the authors propose that to more effectively advance equity in assessment in medical education, those working in the field should clearly identify their respective orientations, intentionally choose methods, tools and measures aligned with their orientations and expand their work by exploring alternative orientations. [ABSTRACT FROM AUTHOR]

AbstractPhenomenonApproachFindingsInsightsMarginalized individuals in medicine face many structural inequities which can have enduring consequences on their progress. Therefore, inequity must be addressed by dismantling underlying unjust policies, environments, and curricula. However, once these injustices have been taken apart, how do we build more just systems from the rubble? Many current strategies to address this question have foundational values of urgency, solutionism, and top-down leadership.This paper explores a counternarrative: Design Justice. As a set of guiding principles, Design Justice centers the experiences and perspectives of marginalized individuals and communities. These principles include mutual accountability and transparency, co-ownership, and community-led outcomes, and honoring local, traditional, Indigenous knowledge.Rooted in critical scholarship and critical design, Design Justice recognizes the interconnectedness of various forms of marginalization and works to critically examine power dynamics that exist in every design process. These co-created principles act as practical guardrails, directing progress toward justice.This paper begins with an overview of Design Justice’s history in critical scholarship and critical design, providing foundational background knowledge for medical educators, scholars, and leaders in key concepts of justice and design. We explore how the Design Justice principles were developed and have been applied across sectors, highlighting its applications, including education applications. Finally, we raise critical questions about medical education prompted by Design Justice. [ABSTRACT FROM AUTHOR]

Development of skills in diagnostic reasoning is paramount to the transition from novice to expert clinicians. Efforts to standardize approaches to diagnosis and treatment using clinical pathways are increasingly common. The effects of implementing pathways into systems of care during diagnostic education and practice among pediatric residents are not well described. To characterize pediatric residents' perceptions of the tradeoffs between clinical pathway use and diagnostic reasoning. We conducted a qualitative study from May to December 2019. Senior pediatric residents from a high-volume general pediatric inpatient service at an academic hospital participated in semi-structured interviews. We utilized a basic interpretive qualitative approach informed by a dual process diagnostic reasoning framework. Nine residents recruited via email were interviewed. Residents reported using pathways when admitting patients and during teaching rounds. All residents described using pathways primarily as management tools for patients with a predetermined diagnosis, rather than as aids in formulating a diagnosis. As such, pathways primed residents to circumvent crucial steps of deliberate diagnostic reasoning. However, residents relied on bedside assessment to identify when patients are "not quite fitting the mold" of the current pathway diagnosis, facilitating recalibration of the diagnostic process. This study identifies important educational implications at the intersection of residents' cognitive diagnostic processes and use of clinical pathways. We highlight potential challenges clinical pathways pose for skill development in diagnostic reasoning by pediatric residents. We suggest opportunities for educators to leverage clinical pathways as a framework for development of these skills. [ABSTRACT FROM AUTHOR]

Background: Workplace learning in critical care settings is complex and challenging. Research has explored learner‐, teacher‐, and context‐related factors that influence medical residents' engagement in critical care workplaces in Western but not in non‐Western cultures. This limits our understanding of workplace learning globally and how we can better support resident learning in diverse cultures. Objective: To explore how paediatric residents engage in workplace learning in a Thai Paediatric Intensive Care Unit (PICU) and how this culturally situated workplace shapes their learning. Methods: In this qualitative study, we recruited paediatric residents (n = 16) from a tertiary care hospital in Thailand for semi‐structured interviews. We used reflexive thematic analysis to describe, analyse and interpret residents' experiences of workplace learning, and to capitalise on our own experience as an analytic resource. Results: We constructed three themes to represent participants' narratives: PICU cases and context as dynamic affordances; impact of psychological safety; and the role of attending physicians. While Thai PICU cases and context could afford participation and thus learning, Thailand's collectivist culture, which prioritises group needs over individual needs, contributed to a sense of psychological safety within culturally‐endorsed, professional and social hierarchies, and set the stage for workplace learning. Despite their higher status in these hierarchies, attending physicians facilitated resident learning by fostering open dialogue, joint problem‐solving and a low‐stress atmosphere. Conclusions: Workplace learning in a Thai PICU while challenging, is uniquely facilitated by Thailand's collectivist culture that fosters psychological safety and attending physicians' invitation in, and learn from, the workplace optimises learning. [ABSTRACT FROM AUTHOR]

The article focuses on the evaluation relative to the prospective participants for the Innovation in Pediatric Education (IIPE) program. It mentions that evaluation is recognized as the systematic needs assessment of the worth of a particular object or activity like in the instance of IIPE. It states that IIPE intends to establish projects to promote pediatric education wherein it evaluates plans to determine the projects which could have the greatest potency for distribution to other residency programs. It discusses the theoretical approaches that could be used for evaluation. It highlights the logic models that could be utilized for evaluation wherein it is a framework of graphic depictions on the association between the activities and outcomes of the program.

The article discusses the distinction between qualitative research and program evaluation which includes they hold different guiding principles, focuses on different methods on practical concerns, and qualitative addresses theoretical issues where as program addresses pragmatic issues.

The article focuses on the Initiative for Innovation in Pediatric Education (IIPE) and its development as of 2012. It states that IIPE aims to facilitate, oversee, and initiate innovation modification in pediatric residency education. It provides a snapshot organized around the cycle called Do-Observe-Reflect.

A personal narrative is presented which explores the author's experience of meeting his mentor who helped him in his career.

Graduate medical education programs are expected to conduct an annual program evaluation. While general guidelines exist, innovative and feasible approaches to program evaluations may help efforts at program improvement. Appreciative Inquiry is an approach that focuses on successful moments, effective processes, and programs' strengths. We implemented a novel application of Appreciative Inquiry and its 4 phases (Inquire, Imagine, Innovate, and Implement) and demonstrate how it led to meaningful improvements in a pediatric pulmonology fellowship program. As part of the Inquire and Imagine phases, the authors developed an interview guide that aligned with Appreciative Inquiry concepts. Two faculty members conducted semistructured interviews with a convenience sample of 11 of 14 fellowship alumni. Interviews were audiotaped, transcribed, and reviewed. A summary of the findings was presented to the Program Evaluation Committee, which then directed the Innovate and Implement phases. Appreciative Inquiry was acceptable to the alumni and feasible with the authors' self-directed learning approach and minimal administrative and financial support. In the Inquire phase, alumni identified program strengths and successes. In the Imagine phase, alumni identified program changes that could aid transition to independent practice for future fellows (an identified program goal). Based on the results of the Appreciative Inquiry, program leadership and the Program Evaluation Committee selected improvements for implementation. For small programs, Appreciative Inquiry is an innovative and feasible approach to program evaluation that facilitates actionable program improvement recommendations. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article "Alternative perceptions of the educational value of attending rounds," by Hinchey K. and McArdle P.

Background: The experience of transitioning to an academic faculty position can be improved with standardized educational interventions. Although a number of such interventions have been described, few utilize an evaluation framework, describe a robust evaluation process, and addresswhy their interventions were successful. In this article, the authors apply a logic model to describe their efforts to develop, implement, evaluate, and revise a comprehensive academic career development curriculum among pediatric subspecialty fellows. They describe inputs, activities, outputs, and outcomes using quantitative data from fellow evaluations and qualitative data from faculty interviews. Methods: Methods are described under the input and activities sections. The curriculum started with collaboration among educational leadership and conducting a needs assessment. Using the needs assessment results and targeted learning objectives, we piloted the curriculum and then implemented the full curriculum 1 year later. Results: Results are described under the outputs and outcomes sections. We present immediate, short-term, and 6-month evaluation data. Cumulative data over 3 years reveal that fellows consistently acquired knowledge relevant to transitioning and that they applied acquired knowledge to prepare for finding jobs and career advancement. The curriculum also benefits faculty instructors who gain a sense of reward by filling a critical knowledge gap and fostering fellows' professional growth. Conclusion: The authors relate the success and effectiveness of the curriculum to principles of adult learning, and share lessons learned, including the importance of buy-in from junior and senior fellows and faculty, collaboration, and designating the time to teach and learn. [ABSTRACT FROM AUTHOR]

The article discusses the results of surveys to determine the perspectives of fellows and fellow program directors (FPD) about the delayed fellowship start date for residents pursuing subspecialty training. It reveals that delaying the start date would provide time for trainees to relocate, reduce stress, and improve wellness. The Council of Pediatric Subspecialties' recommendations to improve the residency to fellowship transition are highlighted.