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Background: Non-technical skills (NTS) are essential for healthcare professionals. Earlier the students are made aware of this, the more time they have to acquire these skills. Escape rooms have been introduced in the medical literature but a detailed published manual on setting up and running such a learning modality is lacking. The purpose of this paper is to describe the use of an escape room to create learning opportunities, including detailed instructions, as well as an evaluation from two settings. Methods: A medical escape room focusing on NTS was developed and run in two different settings: a university summer school – EMSS17, and an international healthcare congress – EMS2018. Questionnaire data investigating entertainment value, self-evaluated use of NTS and ideas for further use of the escape room concept was obtained. Further, video analyses were conducted to triangulate self-rated analyses. Results: Majority of the participants found the escape room psychologically safe and enjoyable and would recommend the concept to other students and healthcare professionals. Video analyses showed the same tendencies regarding the use of NTS as reported by participants. Conclusions: This paper presents a fully applicable escape room manual, ready to implement, adapt, and modify. Evaluation data support the proof of concept. [ABSTRACT FROM AUTHOR]

Background: Peer reviewing for medical education journals is an art, a privilege, a responsibility and a service to the profession. Writing a review report requires skills and commitment and takes time. Novice reviewers may be interested in participating in this service, but they might lack sufficient knowledge of their role as peer reviewers and the skills needed to conduct a comprehensive and fair review. Aims: The aims of this article are to help novice reviewers in their preparation of manuscript review reports and improve their confidence and skills in their role as reviewers. Methods: We reviewed the literature in this area and applied lessons learned from our experience as peer reviewers. In addition, one of the authors has presented several training workshops for faculty reviewers. Results: Incorporating all the methods described, we have developed a series of simple strategies that medical educators can utilise to perform high-quality reviews of manuscripts. Conclusions: Though the development of skills in reviewing medical education papers is the outcome of continuous practice and experience; the strategies described in this article will be of value to those starting their professional contribution as reviewers and enhance their skills in this area. [ABSTRACT FROM AUTHOR]

Background: The use of technology within education has now crossed the Rubicon; student expectations, the increasing availability of both hardware and software and the push to fully blended learning environments mean that educational institutions cannot afford to turn their backs on technology-enhanced learning (TEL). The ability to meaningfully evaluate the impact of TEL resources nevertheless remains problematic. Aims: This paper aims to establish a robust means of evaluating individual resources and meaningfully measure their impact upon learning within the context of the program in which they are used. Methods: Based upon the experience of developing and evaluating a range of mobile and desktop based TEL resources, this paper outlines a new four-stage evaluation process, taking into account learner satisfaction, learner gain, and the impact of a resource on both the individual and the institution in which it has been adapted. Results: A new multi-level model of TEL resource evaluation is proposed, which includes a preliminary evaluation of need, learner satisfaction and gain, learner impact and institutional impact. Each of these levels are discussed in detail, and in relation to existing TEL evaluation frameworks. Conclusions: This paper details a holistic, meaningful evaluation model for individual TEL resources within the specific context in which they are used. It is proposed that this model is adopted to ensure that TEL resources are evaluated in a more meaningful and robust manner than is currently undertaken. [ABSTRACT FROM AUTHOR]

Despite the numerous calls for integrating quality improvement and patient safety (QIPS) curricula into health professions education, there are limited examples of effective implementation for early learners. Typically, pre-clinical QIPS experiences involve lectures or lessons that are disconnected from the practice of medicine. Consequently, students often prioritize other content they consider more important. As a result, they may enter clinical settings without essential QIPS skills and struggle to incorporate these concepts into their early professional identity formation. In this paper, we present twelve tips aimed at assisting educators in developing QIPS education early in the curricula of health professions students. These tips address various key issues, including aligning incentives, providing longitudinal experiences, incorporating real-world care outcomes, optimizing learning environments, communicating successes, and continually enhancing education and care delivery processes. [ABSTRACT FROM AUTHOR]

Surgery is a highly competitive specialty that offers a wide range of subspecialties. The presence of surgical education and rotations in the medical school curriculum is often lacking, and for this reason many medical students have little experience of surgery during their time in medical school. This paper presents twelve tips for medical students who are interested in pursuing a career in surgery, offering different ways of exposure into activities related to surgical care. Understanding the practice of surgery and self-reflecting on one's personality and suitability for a career in surgery are key. Moreover, surgical care is not only limited to the surgeon's table–other opportunities to learn more about surgery exist outside of the operating room. Extra-curricular activities in research and leadership are also vital in developing an interest in surgery and competitive edge in medical students. [ABSTRACT FROM AUTHOR]

In response to the numerous challenges resident trainees currently face in their ability to competently acquire the requisite skills, knowledge and attitudes upon graduation, medical educators have looked to a competency-based medical education (CBME) approach as a possible solution. As CBME has already been implemented in many jurisdictions around the world, certain challenges in implementation have been experienced. One important challenge identified relates to how regulatory bodies can either assist or unintentionally hinder implementation. By examining the varied experiences from Canada, the USA and the Netherlands in implementing CBME, this paper identifies how regulatory bodies can support and advance worldwide efforts of furthering its implementation. If regulatory bodies restructure accreditation and regulatory criteria to align with CBME principles, work together in a coordinated fashion to ensure alignment of vital regulatory meaures throughout the training and practice continuum of a physician, and allow for (if not incentivize) individuals and programs to be innovative in adapting CBME to meet their local environments, it is likely that the worldwide implementation of CBME will occur successfully. [ABSTRACT FROM AUTHOR]

A number of planetary boundaries, including climate change as a result of greenhouse gas emissions, has already been exceeded. This situation has deleterious consequences for public health. Paradoxically, 4.4% of these emissions are attributable to the healthcare sector. These problems have not been sufficiently acknowledged in health professions curricula. This paper addresses two main issues, humanistic learning and the application of knowledge acquisition to clinical practice. Humanistic learning principles can be used to emphasize learner-centered approaches, including knowledge acquisition and reflection to increase self-awareness. Applying humanistic principles in everyday life and clinical practice can encourage stewardship, assisting students to become agents for change. In terms of knowledge and skills application to clinical practice, an overview of varied and novel approaches of how sustainable education can be integrated at different stages of training across several health care professions is provided. The Health and Environment Adaptive Response Taskforce (HEART) platform as an example of creating empowered learners, the NurSusTOOLKIT, a multi-disciplinary collaboration offering free adaptable educational resources for educators and the Greener Anaesthesia and Sustainability Project (GASP), an example of bridging the transition to clinical practice, are described. [ABSTRACT FROM AUTHOR]

Objective: Online videos are commonly used in medical education. The aim of this review was to investigate the role of online instructional videos in teaching procedural skills to postgraduate medical learners. Methods: This systematic narrative review was conducted according to the PRISMA guidelines. MEDLINE, Cochrane Central Register of Controlled Trials, EMBASE, ERIC and Google Scholar were searched. Full texts that applied to online videos, postgraduate medical learners and procedural skills were included without language restrictions. The methodological quality of the studies was evaluated using a validated tool. A thematic analysis of the studies was carried out using a general inductive approach. Results: A total of 785 articles were retrieved and the full text was reviewed for 66 articles that met the inclusion and exclusion criteria of the study. Twenty papers that were relevant to the role of online videos in postgraduate medical education of procedural skills were used for this review. They were heterogenous in the outcomes collected and the evidence was of variable quality. There was strong evidence for the use of online videos for procedural skill knowledge acquisition and retention. Online videos were used for various purposes, such as supervision, assessment, postoperative debriefing, providing feedback, and promoting reflection. Conclusion: Online videos are a valuable educational tool especially for procedural skill knowledge acquisition and retention. Future research needs to be carried out on the appropriate use of platforms in disseminating and using online videos, identifying the factors surrounding the learners, video characteristics, and data protection. [ABSTRACT FROM AUTHOR]

In response to growing curriculum pressures and reduced time dedicated to teaching anatomy, research has been conducted into developing innovative teaching techniques. This raises important questions for neuroanatomy education regarding which teaching techniques are most beneficial for knowledge acquisition and long-term retention, and how they are best implemented. This focused systematic review aims to provide a review of technology-enhanced teaching methods available to neuroanatomy educators, particularly in knowledge acquisition and long-term retention, compared to traditional didactic techniques, and proposes reasons for why they work in some contexts. Electronic databases were searched from January 2015 to June 2020 with keywords that included combinations of 'neuroanatomy,' 'technology,' 'teaching,' and 'effectiveness' combined with Boolean phrases 'AND' and 'OR.' The contexts and outcomes for all studies were summarised while coding, and theories for why particular interventions worked were discussed. There were 4287 articles identified for screening, with 13 studies included for final analysis. There were four technologies of interest: stereoscopic views of videos, stereoscopic views of images, augmented reality (AR), and virtual reality (VR). No recommendation for a particular teaching method was made in six studies (46%) while recommendations (from weak to moderate) were made in seven studies (54%). There was weak to moderate evidence for the efficacy of stereoscopic images and AR, and no difference in the use of stereoscopic videos or VR compared to controls. To date, technology-enhanced teaching is not inferior to teaching by conventional didactic methods. There are promising results for these methods in complex spatial anatomy and reducing cognitive load. Possible reasons for why interventions worked were described including students' engagement with the object, cognitive load theory, complex spatial relationships, and the technology learning curve. Future research may build on the theorised explanations proposed here and develop and test innovative technologies that build on prior research. [ABSTRACT FROM AUTHOR]

Small group teaching (SGT) is not just the delivery of teaching to a small number of learners – it is, instead, underpinned by learner–learner interaction, discussion, and collaboration. The advent of readily available technology, combined with the need to maintain learner and teacher safety during the COVID-19 pandemic, has led to a surge in remote learning, and significant increases in synchronous hybrid learning environments, also known as HyFlex learning, in which some learners join remotely and others do so in-person. Teaching in this manner brings new challenges and opportunities and, when compared to face-to-face SGT, requires teachers to employ a complementary repertoire of skills. Against this backdrop, and with the pressing need to up-skill teachers in this domain, we take a fresh look at previously published tips for SGT and reboot these strategies in the context of remote and HyFlex SGT. The challenges of adapting these tips in a changed environment will be considered, and refashioned strategies for their application will be offered. [ABSTRACT FROM AUTHOR]

Introduction: Intercalated BScs (iBScs) are an optional part of undergraduate (UG) medicine courses in UK, Eire, Australia, New Zealand, the West Indies, Hong Kong, South Africa and Canada, consisting of advanced study into a particular field of medicine, often combined with research. They potentially improve students' skills and allow exploration of specific areas of interest. They are, however, expensive for institutions and students and delay workforce entry. There is conflicting evidence about their impact. Methods: A mixed-method systematic review (meta-analysis and critical interpretive synthesis) of the biomedical and educational literature, focusing on the impact of iBScs on UG performance, skills, and career choice, and to explore students' and other stakeholders' opinions about iBScs. Results: In the meta-analytic part of this review, we identified five studies which met our predetermined quality criteria. For UG performance, two studies using different methodologies report an improvement in UG performance; one study reported an Odds Ratio [OR] of 3.58 [95% CI 1.47-8.83] and the second reported a significant improvement in finals scores (1.27 points advantage 95% CI 0.52-2.02). One study reported a mixed result, while two studies showed no improvement. Regarding skills and attitudes, one paper suggested iBScs lead to the development of deeper learning styles. With regard to subsequent careers, two studies suggested that for those students undertaking an iBSc there is an increased chance following an academic career [ORs of 3.6 (2.3-5.8) to 5.94 (3.6-11.5)]. Seven of eight studies (with broader selection criteria) reported that iBSc students were less likely to pursue GP careers (ORs no effect to 0.17 [0.07-0.36]). Meta-analysis of the data was not possible. In the critical interpretative synthesis analysis, we identified 46 articles, from which three themes emerged; firstly, the decision to undertake an iBSc, with students receiving conflicting advice; secondly, the educational experience, with intellectual growth balanced against financial costs; finally, the ramifications of the iBSc, including some suggestion of improved employment prospects and the potential to nurture qualities that make 'better' doctors. Conclusion: Intercalated BScs may improve UG performance and increase the likelihood of pursuing academic careers, and are associated with a reduced likelihood of following a GP career. They help students to develop reflexivity and key skills, such as a better understanding of critical appraisal and research. The decision to undertake an iBSc is contentious; students feel ill-informed about the benefits. These findings could have implications for a variety of international enrichment programmes. [ABSTRACT FROM AUTHOR]

Purpose: Interprofessional continuing education (IPCE) health care educators must plan activities as members of interprofessional teams and deliver activities to an interprofessional audience. Evidence in the literature suggests they are not well prepared to meet this challenge. This paper reviews one strategy to improve the knowledge, skills, attitudes, and practices of IPCE educators. Methods: Seven faculty development workshops were conducted within the USA, Europe, Asia, and the Middle East. Approximately 250 learners participated in the workshops in total, with 107 in an IRB-approved research study. Results: From the research cohorts demonstrated improved knowledge and skills over a 12-month period. Knowledge and skills scores increased most significantly from baseline to 3 months and remained above baseline at 6-12 months. The workshop was not an effective strategy to improve attitudes towards IPCE, though attitude scores were already high prior to participating. Conclusions: All participants actively engaged in the workshops. There were no observed differences in engagement by geographic region, gender, age, or profession. Participants stated they were better able to understand the roles of other team members; perspectives of patients, families, and caregivers; and their own roles on clinical teams. Participants described gaining a new appreciation for the complexity of designing IPCE. [ABSTRACT FROM AUTHOR]

Background: Medical education is a dynamic process that will continuously evolve to respond to changes in the foundations of medicine, the clinical practice of medicine and in health systems science. Purpose: In this paper, we review how assessing learning in such a dynamic environment requires comprehensive flexible and adaptable methodological approaches designed to assess knowledge attainment and transfer, clinical skills/competency development, and ethical/professional behavior. Adaptive assessments should measure the learner’s ability to observe where changes in health care delivery are needed and how to implement them. Balancing formative and summative assessments will promote reflective learning so that each student will reach her/his highest potential. From the programmatic perspective, measuring the design and delivery of instruction in relation to students? efforts to achieve competency will improve learning and foster continuous professional development of faculty and advance the science of learning. Approach: We describe how two medical schools are approaching adaptive assessment, including using portfolio systems that encompass teaching and learning experiences while offering real-time longitudinal tracking of digital data toward improving learning and provide curricula continuous improvement cycles. Using latest technologies, portfolios produce actionable data displays with precise guidance for learning and program development. [ABSTRACT FROM AUTHOR]

Critical appraisal is an important skill for practicing evidence-based medicine. Most assessments of critical appraisal focus either on knowledge about research design or evaluate a written critique of an article. This paper presents a Bayesian framework for assessing critical appraisal through measuring how clinical decisions and judgments change with the introduction of new research evidence. In a skilled clinician-appraiser, new evidence is predicted to cause the clinician to revise beliefs in the appropriateness of a decision, in proportion to both the strength of the findings and the methodological soundness of the research which produced the findings. The framework is illustrated by two studies using different items, respondents, and designs. [ABSTRACT FROM AUTHOR]

MCQs of the multiple true/false (MTF) variety were widely used in summative assessment 25 years ago. They could test a number of skills in addition to recall of factual knowledge, and were reliable, discriminatory, reproducible and cost-effective. However, there are now considerable doubts about their construct validity, mainly because of the varying responses of examinees to negative countermarking and the 'don't know' option, and the strategies they use when sitting examinations. Extended matching and one-from-five questions are now preferable, and negative countermarking is outmoded. MTF questions are still valuable in formative assessment and revision but are not recommended for summative examinations. [ABSTRACT FROM AUTHOR]

A diverse range of health professionals use psychomotor skills as part of their professional practice roles. Most health disciplines use large or complex psychomotor skills. These skills are first taught by the educator then acquired, performed, and lastly learned. Psychomotor skills may be taught using a variety of widely-accepted and published teaching models. The number of teaching steps used in these models varies from two to seven. However, the utility of these models to teach skill acquisition and skill retention are disputable when teaching complex skills, in contrast to simple skills. Contemporary motor learning and cognition literature frames instructional practices which may assist the teaching and learning of complex task-based skills. This paper reports 11 steps to be considered when teaching psychomotor skills. [ABSTRACT FROM AUTHOR]

To determine whether ultrasound training in which the expert's eye movements are superimposed to the underlying ultrasound video (eye movement modeling examples; EMMEs) leads to better learner outcomes than traditional eye movement-free instructions. 106 undergraduate medical students were randomized in two groups; 51 students in the EMME group watched 5-min ultrasound examination videos combined with the eye movements of an expert performing the task. The identical videos without the eye movements were shown to 55 students in the control group. Performance and behavioral parameters were compared prepost interventional using ANOVAs. Additionally, cognitive load, and prior knowledge in anatomy were surveyed. After training, the EMME group identified more sonoanatomical structures correctly, and completed the tasks faster than the control group. This effect was partly mediated by a reduction of extraneous cognitive load. Participants with greater prior anatomical knowledge benefited the most from the EMME training. Displaying experts' eye movements in medical imaging training appears to be an effective way to foster medical interpretation skills of undergraduate medical students. One underlying mechanism might be that practicing with eye movements reduces cognitive load and helps learners activate their prior knowledge. [ABSTRACT FROM AUTHOR]

Most undergraduate written examinations use multiple-choice questions, such as single best answer questions (SBAQs) to assess medical knowledge. In recent years, a strong evidence base has emerged for the use of very short answer questions (VSAQs). VSAQs have been shown to be an acceptable, reliable, discriminatory, and cost-effective assessment tool in both formative and summative undergraduate assessments. VSAQs address many of the concerns raised by educators using SBAQs including inauthentic clinical scenarios, cueing and test-taking behaviours by students, as well as the limited feedback SBAQs provide for both students and teachers. The widespread use of VSAQs in medical assessment has yet to be adopted, possibly due to lack of familiarity and experience with this assessment method. The following twelve tips have been constructed using our own practical experience of VSAQs alongside supporting evidence from the literature to help medical educators successfully plan, construct and implement VSAQs within medical curricula. [ABSTRACT FROM AUTHOR]

Tactical decision games (TDGs) have been used in healthcare and other safety-critical industries to develop non-technical skills training (NTS). TDGs have been shown to be a realistic, feasible, and useful way of teaching NTS such as decision making, task prioritisation, situational awareness, and team working. Our 12-tips for using TDG to teach NTS are based on our experience of integrating them into an undergraduate medical and nursing programme. We cover how to design successful TDGs, how to facilitate and debrief them and how to integrate TDGs into curricula. We have found TDGs to be a cost-effective, low fidelity, and useful method of delivering NTS teaching, ideally as an adjunct to immersive simulation. Learners find them a useful way to be introduced to NTS in a safe and relaxed environment, with particular emphasis on critical decision making and prioritisation. [ABSTRACT FROM AUTHOR]

To improve critical thinking skills and enhance team dynamics, a pilot study for inclusion of a murder mystery activity within the pharmacy practice skills laboratory was designed for student pharmacists. In groups, students participated in a murder mystery activity and were assessed via rubrics to critically evaluate potential reasons for a patient's death and find solutions for process improvements. Through an optional survey, students were asked about their group's ability to work as part of a healthcare team, which included identification of conflict management techniques. Faculty used an inductive coding process on student feedback to identify strengths and opportunities for growth. All groups successfully completed the patient's cause of death and root cause analysis. Overall, students agreed their teams worked well together in solving this mystery. Communication was found to be both a strength and a weakness among group members and many students were able to self-identify conflict management strategies that were utilized during the activities. Use of a murder mystery activity in a pharmacy skills laboratory is a unique approach to foster development of critical thinking skills and highlights the complexity with which a healthcare team must operate together to provide patient care. [ABSTRACT FROM AUTHOR]

Medical schools are increasingly utilising remote learning. Remote learning can take many forms such as online lectures, small group tutorials, virtual clinical skills sessions, and online case presentations. Remote learning presents both challenges and opportunities for students globally. This article shares twelve tips from senior medical students, based on the author's personal experience of remote learning and the relevant literature, to help others maximise the benefits of both synchronous and asynchronous remote learning. The authors include guidance on how to approach the remote format, embrace the use of technology, detail helpful open-access resources, and encourage students to become independent learners. [ABSTRACT FROM AUTHOR]

Disruption to healthcare settings can present a significant challenge to traditional, face-to-face models of learning in medical education. Reductions in undergraduate medical students' clinical exposure, whether due to periods of increased healthcare demand, localised service changes or infectious disease outbreaks, are likely to result in fewer opportunities to develop key clinical and practical skills. Proficiency in these skills is often essential to progression and future practice, creating a broad incentive for students to develop techniques to maintain and refine their clinical skills during disrupted placements. These tips, based on our experiences as senior medical students, are intended to help students on disrupted placements to engage in reflective practice, discover ways to facilitate further opportunities for clinical skills learning, and to make the most of clinical skills learning opportunities that they do receive. [ABSTRACT FROM AUTHOR]

Visual art has been increasingly incorporated into medical education and has been shown to enhance important competencies, such as empathy. However, limited evidence on effective visual art program design and evaluation processes remain. This systematic review examines the format, content, and espoused outcomes of visual art-based training programs in undergraduate medical education. A comprehensive literature search of MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, and ProQuestERIC on undergraduate medical education and visual arts retrieved 1703 articles published from 2014 to 2020. After reviewing inclusion and exclusion criteria, 23 articles were chosen for full review and synthesis. Program format and content varied, ranging from 1-day specific competency focused programs to well-structured comprehensive 6–12-week programs. 6 areas of program foci were identified: observation skills, empathy, tolerance to uncertainty, cultural sensitivity, team building and collaboration, and wellness and resiliency. Although several programs used validated measures to assess skills acquisition, they seldom addressed long-term outcomes. Our findings indicate that visual art-based education hold a promise to enhance important competencies in medical education, particularly empathy. Clinical observation, in particular, had the strongest evidence of its effectiveness compared to the other competencies. Future programs incorporating visual arts will benefit from a longitudinal (greater than 6 weeks) program which incorporates guided artworks, reflection exercises, and a group discussion to provide a stronger foundation for the development of core competencies. We propose using validated scales to measure outcomes in future studies and follow-up with participants to better assess Kirkpatrick Level 3 and 4 outcomes. [ABSTRACT FROM AUTHOR]

This AMEE guide provides a robust framework and practical strategies for health professions educators to enhance their writing skills and engage in successful scholarship within a collaborative writing team. Whether scholarly output involves peer-reviewed articles, book chapters, blogs and online posts, online educational resources, collaborative writing requires more than the usual core writing skills, it requires teamwork, leadership and followership, negotiation, and conflict resolution, mentoring and more. Whilst educators can attend workshops or courses to enhance their writing skills, there may be fewer opportunities to join a community of scholars and engage in successful collaborative writing. There is very little guidance on how to find, join, position oneself and contribute to a writing group. Once individuals join a group, further questions arise as to how to contribute, when and whom to ask for help, whether their contribution is significant, and how to move from the periphery to the centre of the group. The most important question of all is how to translate disparate ideas into a shared key message and articulate it clearly. In this guide, we describe the value of working within a collaborative writing group; reflect on principles that anchor the concept of writing as a team and guide team behaviours; suggest explicit strategies to overcome challenges and promote successful writing that contributes to and advances the field; and review challenges to starting, maintaining, and completing writing tasks. We approach writing through three lenses: that of the individual writer, the writing team, and the scholarly product, the ultimate goal being meaningful contributions to the field of Health Professions Education. [ABSTRACT FROM AUTHOR]

An introduction to the journal is presented that focuses on continuing professional development (CPD), including a historical overview of continuing medical education (CME), the use of learning science for the improvement of CME and CPD, and a framework to help CPD educators design educational interventions that are intended to achieve higher-level outcomes.

To improve health, physicians are increasingly called to advocate. Yet medical schools have only recently focused on health advocacy skill-building. Limited work to date addresses assessing medical student advocacy on behalf of patients. We describe how students and clinical supervisors (CS) in two urban longitudinal integrated clerkships (LIC) experience patient advocacy and how introducing a new advocacy assessment impacts them. Using a thematic approach, we analyzed transcripts of focus groups during 2018–2019. Seventeen of 24 (71%) students and 15 of 21 (71%) CS participated in the focus groups. We describe how students perceive their advocacy role as they accompany the patient, amplify their voice, and facilitate connection. The rationale for advocacy assessment includes that it (1) adds a novel dimension to the written and verbal assessment, (2) drives student learning, (3) aligns with the institutional goal to promote equity, and (4) impacts CS teaching and clinical practice. Challenges are the ambiguity of expectations, pressure to 'perform,' and a moral overlay to advocacy assessment. Findings demonstrate how educational alliances between students and CS and longitudinal relationships between LIC students and patients offer a constructive opportunity for advocacy assessment. We describe suggestions to hone and expand the reach of advocacy assessment. [ABSTRACT FROM AUTHOR]

Telemedicine is now an established mode of clinical care for most medical specialties, and clinical teachers must teach and precept learners in this modality. However, faculty need training on how best to teach students when caring for patients via telemedicine. Effectively incorporating learners into telemedicine visits to optimize their education is a critical skill for clinical teachers. In this article, we review 12 practical tips unique to telemedicine to engage and educate undergraduate medical education learners in building their clinical skills. We outline synchronous and asynchronous elements before, during, and after the patient encounter to facilitate teaching while improving patient care. These principles can also be adapted for teaching in other health professions as well as postgraduate medical education. [ABSTRACT FROM AUTHOR]

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Coaching supports academic goals, professional development and wellbeing in medical education. Scant literature exists on training and assessing coaches and evaluating coaching programs. To begin filling this gap, we created a set of coach competencies for medical education using a modified Delphi approach. An expert team assembled, comprised of seven experts in the field of coaching. A modified Delphi approach was utilized to develop competencies. Fifteen competencies in five domains resulted: coaching process and structure, relational skills, coaching skills, coaching theories and models, and coach development. These competencies delineate essential features of a coach in medical education. Next steps include creating faculty development and assessment tools for coaching. [ABSTRACT FROM AUTHOR]

Peripheral Intravenous access (PIV) is a procedure undertaken by Medical Practitioners and Non-Medical Practitioners. Traditional PIV uses a visual and tactile technique to locate blood vessels close to the surface of the skin. Chronic medical conditions, dehydration, obesity and recurrent intravenous access can make PIV challenging. Ultrasound (US) guided PIV is recommended to aid the identification of the arm arteries and veins and improve the success rate of needle placement in difficult cases. Medical and non-medical schools, and hospital organisations, are recognising the importance of US guided PIV education for undergraduate and postgraduate Medical and Non-Medical Practitioners. This to promote independence, efficiency and to improve patient safety. The aim of this 12 tips article is to highlight the considerations and practicalities of integrating and delivering, a practical based skills (PBS) session, on the use of US guided practice as an adjunct in difficult PIV, into the undergraduate medical education curricula. [ABSTRACT FROM AUTHOR]

Background: Mapping is a fundamental way of displaying spatial human cognition. It is a rapid technique of summarising and presenting large amount of information. Social map is a technique that finds use as a participatory rural appraisal tool. Aim: To evaluate the feasibility of using social mapping as a public health teaching tool. Methods: A resident doctor posted in the Urban Health Training Centre was assigned to do social mapping of an urban resettlement colony. The area was first divided into segments. The mapping was done by people residing in each segment and compiled with the assistance of the resident doctor. Results: Social mapping helped the student acquire various cognitive, affective and psychomotor skills. It also helped in understanding the geographical area, people, language, cultural practices, social networks and interactions. It trained the student in using rapid appraisal techniques, cartography, effective and succinct summarising and presentation of data of social relevance. The different language and cultural background of the community was the main challenge encountered. Conclusion: Social mapping is an excellent learning and a very practical teaching tool in public health, especially when the researcher/health care provider has little knowledge about his/her field practice area. [ABSTRACT FROM AUTHOR]

The article discusses self-regulated learning (SRL), a self-directive, proactive process of self-generated behaviors, thoughts and actions planned and enacted to attain a learning goal. Topics include a variety of methods that have been used to promote and assess SRL, implications of SRL for learners' development, and cyclical, recursive phases of the self-regulation model.

Introduction: Identifying priority research topics that meet the needs of multiple stakeholders should maximize research investment. Aim: To identify priorities for health education research. Methods: A three-stage sequential mixed methods study was conducted. Priorities for health education research were identified through a qualitative survey with 104 students, patients, academics, and clinicians across five health sciences and 12 professions (stage 1). These findings were analyzed using framework analysis and transposed into a quantitative survey whereby 780 stakeholders rated and ranked the identified priorities. Descriptive statistics identified priorities, exploratory factor analysis grouped priorities and differences between stakeholders were determined using Mann–Whitney U tests (stage 2). Six individual or group interviews with 16 participants (stage 3) further explicated the results from previous stages. Results: Of 30 priorities identified, the top were: how best to ensure students develop the required skills for work; how to promote resiliency and well-being in students; and ensuring the curriculum prepares students for work. For the majority of priorities, no significant differences were found between different stakeholder groups. Conclusions: These findings will be used to inform health educational research strategy both locally and nationally. Further research should explore if setting priorities can be translated effectively into education research policy and practice. [ABSTRACT FROM AUTHOR]

Background: Threshold skills are defined as new ways of thinking about and performing in a discipline. They represent transformed ways of thinking and doing that are pivotal to learners' progress. Our aim was to establish whether clinical reasoning exhibited features of a threshold skill. Methods: Twenty-five final-year medical students were interviewed with a five-question protocol about how they were learning clinical reasoning. Students' responses were analyzed using a deductive method to identify features of threshold skills. Results: Students' descriptions of learning clinical reasoning exhibited five features: transformation, troublesomeness, integration, association with practice, and issues with transferability. Conclusions: Viewing clinical reasoning as a threshold skill is a novel interpretation of its nature and has implications for learning, teaching, and research. Students can be reassured that, although initially troublesome, with practice, they will not only learn the skill but also how to use it more effectively. Teachers can help students to understand that clinical reasoning is difficult to learn and will require time and repeated practice under supervision to develop. [ABSTRACT FROM AUTHOR]

Medical students employ various study strategies to master large amounts of information during their medical education. Digital flashcards are an interactive, self-directed study stool that may improve knowledge retention by combining the principles of active recall and spaced-repetition. They may be studied during and beyond undergraduate medical education. However, making flashcards can be an onerous task. In this article, we describe twelve tips on how to establish and maintain a collaborative digital flashcard project based on the undergraduate medical curriculum. [ABSTRACT FROM AUTHOR]

Background: Medical students engaged in research develop general skills that are instrumental to clinical practice. The systematic review, a cornerstone of evidence-based medicine, represents an ideal starting point for student researchers. Aim and methods: To outline twelve tips on conducting a systematic review for medical students with limited research experience. Results: The tips in this article are practical, comprehensive, and informed by the authors experience as medical students. Conclusion: The twelve tips can help medical students contribute to the literature and build a valuable skillset for future research and clinical practice. [ABSTRACT FROM AUTHOR]

Background: The use of virtual patients (VPs), due to their high complexity and/or inappropriate sequencing with other instructional methods, might cause a high cognitive load, which hampers learning. Aim: To investigate the efficiency of instructional methods that involved three different applications of VPs combined with lectures. Method: From two consecutive batches, 171 out of 183 students have participated in lecture and VPs sessions. One group received a lecture session followed by a collaborative VPs learning activity (collaborative deductive). The other two groups received a lecture session and an independent VP learning activity, which either followed the lecture session (independent deductive) or preceded it (independent inductive). All groups were administrated written knowledge acquisition and retention tests as well as transfer tests using two new VPs. All participants completed a cognitive load questionnaire, which measured intrinsic, extraneous and germane load. Mixed effect analysis of cognitive load and efficiency using the R statistical program was performed. Results: The highest intrinsic and extraneous load was found in the independent inductive group, while the lowest intrinsic and extraneous load was seen in the collaborative deductive group. Furthermore, comparisons showed a significantly higher efficiency, that is, higher performance in combination with lower cognitive load, for the collaborative deductive group than for the other two groups. Conclusion: Collaborative use of VPs after a lecture is the most efficient instructional method, of those tested, as it leads to better learning and transfer combined with lower cognitive load, when compared with independent use of VPs, either before or after the lecture. [ABSTRACT FROM AUTHOR]

Background: The worlds of a physician and a jazz musician seem entirely different. Various studies, however, relating the concepts behind jazz music to medical practice and education, have been published. The aim of this essayistic review is to summarize previously described concepts behind jazz music and its required artistic skills that could be translated to medicine, encouraging doctors, medical students and medical educators to see their professional environment from a different perspective. Methods: A systematic search was conducted using PubMed, Embase, and ERIC databases, combining keywords with regard to jazz, medicine and medical education. Background information concerning jazz music and several jazz musicians was retrieved through an additional nonsystematic search using Google Scholar. Results: Lessons with regard to improvisational skills, both in communication with patients and in a technical context, communication skills, leadership, interprofessional teamwork and coping with errors are presented. Conclusions: Doctors and medical students could learn various lessons from jazz music performance and jazz musicians. The potential and the possibilities of implementing jazz into the medical curriculum, in order to contribute to the development of professional skills and attitudes of medical students, could be explored further. [ABSTRACT FROM AUTHOR]

Background: Medical students need to be trained in delivering diversity-responsive health care but unknown is what competencies teachers need. The aim of this study was to devise a framework of competencies for diversity teaching. Methods: An open-ended questionnaire about essential diversity teaching competencies was sent to a panel. This resulted in a list of 74 teaching competencies, which was sent in a second round to the panel for rating. The final framework of competencies was approved by the panel. Results: Thirty-four experts participated. The final framework consisted of 10 competencies that were seen as essential for all medical teachers: (1) ability to critically reflect on own values and beliefs; (2) ability to communicate about individuals in a nondiscriminatory, nonstereotyping way; (3) empathy for patients regardless of ethnicity, race or nationality; (4) awareness of intersectionality; (5) awareness of own ethnic and cultural background; (6) knowledge of ethnic and social determinants of physical and mental health of migrants; (7) ability to reflect with students on the social or cultural context of the patient relevant to the medical encounter; (8) awareness that teachers are role models in the way they talk about patients from different ethnic, cultural and social backgrounds; (9) empathy for students of diverse ethnic, cultural and social background; (10) ability to engage, motivate and let all students participate. Conclusions: This framework of teaching competencies can be used in faculty development programs to adequately train all medical teachers. [ABSTRACT FROM AUTHOR]

Medical school is designed to provide students with the necessary education and training needed to be effective and safe physicians. Debates about how best to instruct medical students along this trajectory are abundant. Students learn through a planned curriculum as well as a self-directed one motivated by their own level of interest and ability to access and integrate the exponential growth of medical information available through technology. The rate of change in clinical findings means that some of what is learned in today’s classroom will likely be out of date by the time of graduation. To achieve and maintain expertise, students are faced with this challenge. This article explores ways to support medical students in acquiring the skills they need to become adaptive experts. In particular, instructional strategies for supporting the acquisition of fast, accurate, and superior reproducible performance are described with an emphasis on self-regulated learning where students learn to learn flexibly, seeking out opportunities to take knowledge to new levels. [ABSTRACT FROM AUTHOR]

Purpose: Adaptive learning emerges when precise assessment informs delivery of educational materials. This study will demonstrate how data from Human Dx, a case-based e-learning platform, can characterize an individual’s diagnostic reasoning skills, and deliver tailored content to improve accuracy. Methods: Pearson Chi-square analysis was used to assess variability in accuracy across three groups of participants (attendings, residents, and medical students) and three categories of cases (core medical, surgical, and other). Logistic regression analyses were conducted to explore the relationship between solve duration and accuracy. Mean accuracy and duration were calculated for 370 individuals. Repeated measures analysis of variance (ANOVA) were used to assess variability for an individual solver across the three categories. Results: There were significant differences in accuracy across the three groups and the three categories (p < 0.001). Individual solvers have significant variance in accuracy across the three categories. Shorter solve duration predicted higher accuracy. Patterns of performance were identified; four profiles are highlighted to demonstrate potential adaptive learning interventions. Conclusions: Human Dx can assess diagnostic reasoning skills. When weaknesses are identified, adaptive learning strategies can push content to promote skill development. This has implications for customizing curricular elements to improve the diagnostic skills of healthcare professionals. [ABSTRACT FROM AUTHOR]

Background: Shifting from paternalistic to patient-centred doctor-patient relationships has seen a growing number of medical programs incorporate brief motivational interviewing training in their curriculum. Some medical educators, however, are unsure of precisely what, when, and how to incorporate such training. Aims: This article provides educators with 12 tips for teaching brief motivational interviewing to medical students, premised on evidence-based pedagogy. Methods: Tips were drawn from the literature and authors’ own experiences. Results: The 12 tips are: (1) Set clear learning objectives, (2) Select experienced educators, (3) Provide theoretical perspectives, (4) Share the evidence base, (5) Outline the “spirit”, principles, and sequence, (6) Show students what it looks like, (7) Give students a scaffold to follow, (8) Provide opportunities for skill practice, (9) Involve clinical students in teaching, (10) Use varied formative and summative assessments, (11) Integrate and maintain, and (12) Reflect and evaluate. Conclusions: We describe what to include and why, and outline when and how to teach the essential components of brief motivational interviewing knowledge and skills in a medical curriculum. [ABSTRACT FROM AUTHOR]

Background: Medical education has a longstanding tradition of using logbooks to record activities. The portfolio is an alternative tool to document competence and promote reflective practice. This study assessed the acceptance of portfolio use among Saudi undergraduate medical students. Methods: Portfolios were introduced in the 2nd through 5th years at King Abdulaziz University over a two-year period (2013-2015). At the end of each academic year, students completed a mixed questionnaire that included a self-assessment of skills learned through the use of portfolio. Results: The results showed a difference in focus between basic and clinical years: in basic years students’ focus was on acquiring practical skills, but in clinical years they focused more on acquiring complex skills, including identifying and managing problems. The questionnaire responses nonetheless revealed a positive trend in acceptance (belief in the educational value) of portfolios among students and their mentors, across the years of the program. Conclusions: Using portfolios as a developmental learning and formative assessment tool in the early undergraduate years was found to contribute to students’ ability to create their own clinical skills guidelines in later years, as well as to engage in and appreciate reflective learning. [ABSTRACT FROM AUTHOR]

Introduction: Participation in short-term educational experiences in global health (STEGHs) among medical trainees is increasingly accompanied by interest in conducting research while abroad. Because formal training in both global health and research methods is currently under-represented in most medical curricula, trainees are often unfamiliar with the knowledge, attitudes, and skills necessary to design and conduct research successfully. This narrative review identifies essential global health research competencies for medical trainees engaged in STEGHs. Methods: The authors searched the literature using the terms global health, competency, research, research methods/process/training, scholarly project, medical student, and medical education/education. Because articles directly addressing global health research competencies for medical trainees were limited, the authors additionally drew on the broader literature addressing general research competencies and global health competencies. Findings: Articles yielded by the literature search, combined with established guidelines in research ethics and global health ethics, were used to identify six core domains and twenty discrete competencies fundamental to global health research at a level appropriate for medical trainees enrolled in STEGHs. Consideration was given to diverse research modalities, varying levels of training, and the availability of mentoring and on-site support. Discussion: Research may provide important benefits to medical trainees and host partners. These competencies provide a starting point; however, circumstances at any host site may necessitate additional competencies specific to that setting. These competencies are also limited by the methodology employed in their development and the need for additional perspectives from host partners. Conclusions: The competencies identified outline basic knowledge, attitudes, and skills necessary for medical trainees to conduct limited global health research while participating in STEGHS. They may also be used as a basis for curriculum development, assessment, and research capacity development. [ABSTRACT FROM AUTHOR]

Background:In medical education, students need to acquire skills to self-direct(ed) learning (SDL), to enable their development into self-directing and reflective professionals. This study addressed the mentor perspective on how processes in the mentor–student interaction influenced development of SDL. Methods:n = 22 mentors of a graduate-entry medical school with a problem-based curriculum and longitudinal mentoring system were interviewed (n = 1 recording failed). Using activity theory (AT) as a theoretical framework, thematic analysis was applied to the interview data to identify important themes. Results:Four themes emerged: centered around the role of the portfolio, guiding of students’ SDL in the context of assessment procedures, mentor-role boundaries and longitudinal development of skills by both the mentor and mentee. Application of AT showed that in the interactions between themes tensions or supportive factors could emerge for activities in the mentoring process. Conclusion:The mentors’ perspective on coaching and development of reflection and SDL of medical students yielded important insights into factors that can hinder or support students’ SDL, during a longitudinal mentor–student interaction. Coaching skills of the mentor, the interaction with a portfolio and the context of a mentor community are important factors in a longitudinal mentor–student interaction that can translate to students’ SDL skills. [ABSTRACT FROM PUBLISHER]