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Context: Virtual reality is used in many courses and in multiple ways in medical pedagogy, but not in critical appraisal learning. Aim: To evaluate the usability and interest of virtual reality in this reflective teaching context. Methods: Sixteen third year of physiotherapy students' at the University of Limoges were taught critical appraisal of an article with virtual reality. Questionnaires asked them about their feelings, side effects (VRSQ), usability of the system (SUS) and user experience (AttrackDiff 2). A critical appraisal worksheet was completed by the students after reading a scientific article, and then completed after the virtual reality session, giving two formative scores. The students' learning path in the virtual experience was analyzed. Results: Learners scored significantly higher after viewing the virtual reality module (13.1 ± 3.0 and 14.3 ± 3.1 respectively, p < 0.05). Students described the tool as motivating, allowing them to focus and facilitating better understanding of a scientific study. Usability and attractiveness of the virtual reality module was satisfactory, despite the presence of some adverse effects. Conclusion: Virtual reality seems to be an interesting tool to use in the context of critical appraisal learning, and it can be deployed at distance in e-learning. [ABSTRACT FROM AUTHOR]

Introduction: Medical education is a recent addition in the field of scientific research. Indeed it has spread to many countries. The goal of this review was to quantify the involvement of French teams in medical education research. Method: A systematic review of two databases (Pubmed and the archives of the Pédagogie Médicale journal) over a 15-year period was carried out. Results: Research in medical education is growing in France (a 12- fold increase over 15 years) even though it remains lower than in other countries, such as Canada or neighboring Germany. Overall, the French contribution to research in medical education stands at 0.22% in Pubmed and 21% in Pédagogie Médicale. Surgical and general specialties, including obstetrics and gynecology, anesthesiology, public health, internal medicine and family and emergency medicine, were the research fields most targeted. Most of the work focused on teaching assessment. Though impact factors were often under 4, the level of publication according to the SIGAPS classification was relatively high with 50% of papers published in A, B or C-ranked journals. Discussion: The results reveal how knowledge in medical education research, researcher training with respect to methodological specificities and the French team's aims in developing quality scientific data in the research field are lacking. Conclusion: French research in medical education needs further development. Medicaleducation leaders and research centers appear crucial in this respect. [ABSTRACT FROM AUTHOR]

Context and background: In full expansion, the serious game is a video game for educational purposes, i. e. a virtual simulation device on digital equipment combining game elements and an educational objective. This pedagogical tool allows for experiential learning; therefore, it can be used to train health professionals in clinical reasoning and decision-making. Objective: Based on theoretical arguments and on a targeted narrative review of the literature, this paper takes stock of the documented impacts of the effectiveness of serious games for the training of health professionals and formulates some pedagogical perspectives. Analysis: Serious games allow for the operationalization of four conditions that promote learning: attention, active cognitive engagement, feedback and consolidation. Although heterogeneous, the evidence in the literature shows that, under certain conditions, serious games can support learning that enhances decision-making in a manner comparable to traditional devices. Some uncertainty remains as to their exact place in relation to other devices using digital resources or other pedagogical methods. Further pedagogical research is needed in areas such as motivation and pedagogical modalities. Conclusion: Serious games are one of the pedagogical tools available to teachers when they wish to offer their students active and experiential learning opportunities, for example in the context of training focused on decision-making. [ABSTRACT FROM AUTHOR]

Background: A myth is a story or tale that makes one believe to "truths" which turn out to be completely or partially untrue. Various myths in medical education have been described along the years, which are perpetuated despite evidence against them. Analysis: several myths are revisited. Some are classic, such as the belief that teaching must be adapted to the learning styles, or that there are generic skills to avoid cognitive biases; others are less diffused, such as the belief that there is a predictive selection system for professional skills, or that harassment and sexism are less prevalent in one's own institution. Beyond lists of myths, the paper discusses some of the potential mechanisms by which they arise and are perpetuated, as well as some tentative ways to deconstruct them and prevent their occurrence. [ABSTRACT FROM AUTHOR]

Background: Debriefing within the health sector is often considered as a learner-centered knowledge-building thinking process. The trainer plays a facilitating role in this process. However, various studies stress the importance of explicit debriefing. This paper looks closely at the effectiveness of different types of debriefing following simulation training for experienced learners who work in emergency teams. Aim: This study aims to ascertain whether explicit debriefing is as effective for experienced professionals as it has been shown to be for novice learners. Method: This monocentric randomized prospective study was carried out as part of a simulation program based on cardiac arrest emergency interventions. The self-reported knowledge of each participant, their self-efficacy and the team effectiveness were measured before and after the simulation training. Results: The results show a beneficial effect on knowledge and on self-efficacy for both types of debriefing. Patient care was optimized for both types of debriefing. Conclusion: Both types of post-simulation training debriefing are effective for experienced emergency teams. [ABSTRACT FROM AUTHOR]

Context: Healthcare programs innovate to improve teaching of Indigenous realities to nonindigenous undergraduates. However, there are no validated French-language scales to measure the impact of those interventions on prejudices toward Indigenous peoples. Goal: This paper aims at presenting the French translation and preliminary validation of the Old-Fashioned and Modern Prejudiced Attitudes Toward Aboriginals Scales (O-PATAS and M-PATAS). Methods: Thirty medical students completed the original version (OV) and translated (TV) and 78 additional students completed the TV. Cronbach’s alpha (α) andMcDonald’s omega(ω) were used to assess the reliability of the scales. Concurrent validity was assessed with intra-class correlations and paired t-tests comparing OV and TV scores. Construct validity was explored with a two-factor factorial analysis. Results: Fidelity of the TV scales is acceptable and comparable to the ones found in the OV (α≥0.81, ω≥0.85). The absence of difference between the OV and TV scores, and the strong intraclass correlation between the total scores in both languages (r ≥0.80, p<0.001) support concurrent validity of the TV. The factor analysis did not reproduce the 2-factors structure expected, likely due to a lack of power. Conclusion: This study reports a TV of the O-PATAS and M-PATAS with similar psychometric properties to their OV. A use of these versions at a larger scale will allow to assess their dimensionalities in French Canadian settings. [ABSTRACT FROM AUTHOR]

Context and background: The concept of social accountability in health (SAH) is emerging as a major challenge, at the moment when the health systems are more than ever in difficulty and when society as a whole encounters new events linked to a pandemic that forces our main preoccupations towards a necessary paradigm shift. Objective: This paper offers a brief retrospective of the notion of accountability, from that of social responsibility in entrepreneurship, under the light of the human sciences (philosophy, anthropology, sociology) and discuss how the concept concerns the core of the professional exercise in health. Analysis: How can the social and environmental preoccupations be integrated in the daily medical practice without overloading the already overburden of the health professionals? Several hypotheses are conditioning this process: one of which is the introduction of a systemic thought, making possible a transformative action, a commitment around the values, a co-management with all the professionals and the involved stakeholders. This hypothesis draws the contours of a broadened definition of the SAH, including all actors of health and correlated activities. [ABSTRACT FROM AUTHOR]

Background: The recent COVID pandemic put health training in front of a new situation, in which the frame of organizational and pedagogical elements changed. The ministerial directive of “educational continuity” forced health science educators to urgently rethink the teaching and learning system and put in place more or less satisfactory online assessment. How to assess in a constrained context? Objectives: Based on pedagogical tools and methods proposed to education a large French university, this paper aims to propose a set of solutions to transform knowledge and clinical skills assessment into face-to-face in a distance format, in the perspective of a potential recurrence of health crisis or in a deliberate choice to develop remote or blended learning in the future. [ABSTRACT FROM AUTHOR]

Background: Traditional approaches in health sciences education based on evaluation and measurement are ill equipped to take into account the introduction of competency-based training programs. Closer examination and testing of alternative methodologies, based on participatory and qualitative research approaches, to study how competencies are developed has become a necessity. We suggest that competency development relies heavily on the construction, the sharing and the application of experiential learning. Goal: This paper presents concepts and methodologies to support educators who chose to carry out research projects that focus on personal pathways, lived experiences and the learning that was generated to study competency development in the health professions. Results: This article reflects the work of an international group of researchers engaged in research about the development and the role of experiential learning in professional practice. Two broad approaches to reveal experiential learning are presented: one based on biography where an individual reveals the knowledge they have acquired by way of experience. The other is through structured and didactic task analysis, which can offer insights in how individuals and groups learn at work. Both approaches, coming from work psychology and educational sciences, afford a nuanced view of how professional competencies are developed. Conclusion: The overview provided in this article about experiential learning as a research subject and as a way to understand competency development should enable health professionals seeking ways to conduct innovative and participative research projects in health sciences education that meld both research and training. [ABSTRACT FROM AUTHOR]

Background: The "concours d'Internat" (internship) written exam has evolved since 2004 with changes being made to its structure, format and content. Objective : The aim of our study was to evaluate the clinical-case based questions which is part of the national ranking examination (ECN) required for admittance into post-graduate specialty medical training. Materials and methods: We used a pre-established checklist to analyze ECN paper records, between 2004 and 2011. A total of 72 papers were examined. They included 525 questions over an 8-year period. We specifically focused on aptitudes and knowledge required to answer each question, as well as the degree to which the questions themselves met the criteria set out by the Centre National des Concours de l'Internat (CNCI), in terms of subject matter, format and content. Results: The average question had 214 words (ranging from 59 to 514 words). There were generally 3 or 4 elements of data to analyze, requiring students to independently interpret each in order to be able to answer the question on the whole. Questions (20%) focused mostly on diagnoses and 26% in the paraclinical field. Some 32% of questions focused on clinical management and only 5% on physical examination. 80% of papers required students to fully explain the reasoning underlying the answers provided, and in 75% of papers overall patient care and management skills were tested. Lastly, communication skills which included giving the appropriate information to patients were evaluated in 18% of papers. Conclusion: With respect of terminal educational objectives for the second part of graduate medical training, which represents the official ECN program, records used in the tests administered from 2004 to 2008 show satisfactory content validity. Overall, they formally comply with the recommendations for authors of the CNCI records. [ABSTRACT FROM AUTHOR]

Background: Canadian medical education programs are jointly accredited by the Committee on Accreditation of Canadian Medical Schools (CACMS) and by the Liaison Committee on Medical Education (LCME). A recently signed Memorandum of Understanding now provides CACMS with autonomy in the accreditation decision-making process of Canadian medical educatin programs. Analysis: This paper presents a brief overview of the accreditation process of Canadian medical education programs and of the context in which the new Canadian accreditation standards were developed. The new Canadian standards are available through the provided electronic link. [ABSTRACT FROM AUTHOR]

Context: The paper challenges the historical novelty of the social-responsibilityof- medicine concept by reviewing the history of social medicine and its ethical novelty and highlighting that it is part of the medical identity. Analysis: The authors show that this concept involves asking ourselves how we can democratically determine health policies in general and medical education programs in particular. Lastly, they state that research and teaching in the field of human and social sciences play a valuable role in identifying changes in needs, values and health services. [ABSTRACT FROM AUTHOR]

Context and issues: Faculties of medicine within the French-speaking world are increasingly focused on the importance of defining their social accountability and aligning their mission and goals accordingly. Concurrently, the ECFMG is requiring that graduates who want to train in the US after 2023 come from accredited medical schools. However, most French-speaking schools are not accredited. Objectives and analysis: This paper describes Canada's efforts to clearly define the social-accountability mandate of medical schools and how this key concept in their mission has now been incorporated in the accreditation standards of the Committee on Accreditation of Canadian Medical Schools (CACMS). CACMs not only accredits Canadian medical schools but has received full recognition by the World Federation for Medical Education. Conclusion: Canada looks forward to continuing to partner with French-speaking schools around the world to advance social accountability and accreditation. [ABSTRACT FROM AUTHOR]

Context: Within the context of clinical supervision by direct observation of a resident in family medicine, the preceptors faced an educational deadlock. Objective: This paper describes and analyses this situation from the perspective of the educational alliance, an emerging conceptual framework. [ABSTRACT FROM AUTHOR]

Context: In France first-year medical students are required to take a course focusing on humanities. Considering the institutional context, the course's goal and philosophy are worth examining. Objectifs and method: The course content, teaching methods and evaluation procedures vary greatly from one university to another. Based on the "constructive alignment" framework, this paper proposes an outline of possible pedagogical alternatives drawing on (i) an evaluation conducted in our university (ii) and a comparison based on a sampling of French universities. Results: The practical choices are related to a more general concept of what humanities in a medical curriculum should bring to students. [ABSTRACT FROM AUTHOR]

Background: Portfolios in post-graduate healthcare education are used to support reflective practice, deliver summative assessment, aid knowledge management processes and are seen as a key connection between learning at organisational and individual levels. This systematic review draws together the evidence on the effectiveness of portfolios across postgraduate healthcare and examines the implications of portfolios migrating from paper to an electronic medium across all professional settings. Methods: A literature search was conducted for articles describing the use of a portfolio for learning in a work or professional study environment. It was designed for high sensitivity and conducted across a wide range of published and unpublished sources relevant to professional education. No limits for study design or outcomes, country of origin or language were set. Blinded, paired quality rating was carried out, and detailed appraisal of and data extraction from included articles was managed using an online tool developed specifically for the review. Findings were discussed in-depth by the team, to identify and group pertinent themes when answering the research questions. Results: Fifty six articles from 10 countries involving seven healthcare professions met our inclusion criteria and minimum quality threshold; mostly uncontrolled observational studies. Portfolios encouraged reflection in some groups, and facilitated engagement with learning. There was limited evidence of the influence of a number of factors on portfolio use, including ongoing support from mentors or peers, implementation method, user attitude and level of initial training. Confounding variables underlying these issues, however have not been fully investigated. A number of authors explored the reliability and validity of portfolios for summative assessment but reports of accuracy across the disparate evidence base varied. Links to competency and Quality Assurance frameworks have been demonstrated. There were conflicting reports about whether the different purposes of portfolios can be combined without compromising the meaningfulness of the contents. There was good evidence that the flexibility of the electronic format brought additional benefits to users, assessors and organisations, and encouraged more enthusiastic use. Security of data remained a high priority issue at all levels, and there was emerging evidence of successful transfer between electronic portfolio systems. Conclusion: The evidence base is extensive, but contains few high quality studies with generalisable messages about the effectiveness of portfolios. There is, however, good evidence that if well implemented, portfolios are effective and practical in a number of ways including increasing personal responsibility for learning and supporting professional development. Electronic versions are better at encouraging reflection and users voluntarily spend longer on them. Regular feedback from a mentor enhances this success, despite competing demands on users' time and occasional scepticism about the purpose of a portfolio. Reports of inter-rater reliability for summative assessments of portfolio data are varied and there is benefit to be gained from triangulating with other assessment methods. There was insufficient evidence to draw conclusions on how portfolios work in interdisciplinary settings. [ABSTRACT FROM AUTHOR]

Background: Academic council services are fundamental in medicine and health sciences programs where students are exposed to considerable stress, which can impact their academic performance and lead to dropping out. Objective: The paper presents a unique aid service, the student life assistant service, available at the faculty of medicine and health sciences (Faculté de médecine et des sciences de la santé - FMSS) of Université de Sherbrooke. Program description: The service consists of 22 faculty teachers who provide considerate and confidential help to all FMSS students who request it. Managed by a coordinator and an assistant dean it is designed to: 1) offer structured quality service from experienced teachers, 2) promote continuity and accessibility of service to students and 3) provide answers suited to student needs in terms of personal, academic and professional development. Discussion and conclusion: The service is increasingly popular among students. It brings together teachers from various FMSS academic programs who provide coaching, ongoing training and group progress tutoring, all of which fosters networking and experience sharing. Since the teachers are former students in the FMSS programs, they are able to share the experiences and difficulties they themselves went through. After 7 years spent on improving the service the faculty was convinced of its relevance and tangible contribution to student well-being and development. [ABSTRACT FROM AUTHOR]

Context and objective: In Belgium, master-level physiotherapy studies are both taught in higher education colleges or universities and provide equal access to the physiotherapy profession at the end of curriculums. In 2008, faced with the need to consider a reform of physiotherapy teaching, the two institutions began work on developing a common integrated competency framework. This paper reports on the process and results of the development of an integrated competency framework. Methods: Principles of both project and competency engineering were implemented to promote a participatory and representative approach of professional practice settings; several stakeholder groups were set up, including two internal and external validation groups. The process was based on the conceptual framework of professional didactics. Results: The integrated competency structure includes the following: a professional physiotherapy framework; an educational framework; the definition of competencies and abilities, with criteria and indicators (headings); a quality criteria list; the clusters of recognized situations; the final integrative goal; a summary of the process and methodology; a glossary; a list of participants involved in the development of the competency framework; a bibliography. Conclusion: The development of the integrated competency framework provided an opportunity to initiate a process that challenges numerous physiotherapy curriculum issues, including the educational, identity and institutional aspects. [ABSTRACT FROM AUTHOR]

Context and issue: Recent developments in educational programs introduced a new concept framework in education, that of the competence-based approach. The framework challenges the limits of the objective-based approach in pedagogy. This paper discusses integrating the emotional intelligence concept in the reasoning of the competence-based approach in health training curriculums. Objectives: 1) To critically assess a number of competency frameworks (CF) that claim to take into account the field of emotional intelligence and to develop a number of basic guidelines in order to more clearly and specifically reframe them in terms of emotional competence (EC) in accordance with recent developments in the psychology of emotions; 2) To verify if the analytic mapping of an emerging taxonomy of EC and a general framework of an integrated competence-based approach (ICBA) provides data that mutually consolidate the construct validity. Methods: An interpretative and comprehensive qualitative approach based on content analysis of preexisting data was used. Material was made up of four SRC stemming from a methodical and systematical planning of health professional training. The interpretative analysis and thematic categorization of the SRC content was based on an analytical grid that drew on relevant and specific scientific literature. Results: The fields and taxonomical levels of emotional competence are well documented in general, but they are sometimes over- or under-represented according to the various CF. In addition some statements are unclear. The temporary taxonomy of the EC provides an adequate categorization of EC detailed in the four CF. There is consistency between the temporary taxonomy of EC and the APCi, which mutually validate each other. Conclusion: The temporary taxonomy of the EC allows the adequate categorization of EC explicited in the four CF. There is a real concordance between the temporary taxonomy of EC and ICBA which trends to validate each other. [ABSTRACT FROM AUTHOR]

Context: Family practice is changing dramatically and especially in the educational field. The purpose of this study is to assess the evolution of practical dissertations in primary care submitted at the teaching hospital in Angers between two periods with a ten-year interval (1997-99 and 2007-09). Material and methods: In a retrospective and comparative study, information was collected on students, thesis directors and jury, dissertation form (type of study, methods for collecting data, number of pages, article form), contents (topic and thematic trends) as well as eventual publications in scientific journals. Results: A statistically significant increase was observed in the number of general practitioners acting as thesis directors between period 1 and 2: 9% to 46% (p < 0,001). Family-practice dissertations accounted for 23% in period 1 and 58% in period 2 (p < 0,001). The study also indicates a decrease in clinical case reports based on data collected from case files as opposed to best practice studies carried out through questionnaires and interviews. Dissertations were published as scientific papers in 51% of cases in period 2 and 4% in period 1 (p < 0.001). Publications listed in Medline total 6.3% in period 1 and 14% in period 2 (p = 0.04). Conclusion: The study highlights major changes in practical theses in primary care both in terms of form and subject with research reflecting the comprehensive aspect of primary care. [ABSTRACT FROM AUTHOR]

Introduction: In recent years, the use of portfolios as learning and assessment tools has become more widespread across the range of health professions. Whilst a growing body of literature has accompanied these trends, there is no clear collated of the evidence for the educational effects of the use of portfolios in undergraduate education. This systematic review is the result of our work to provide such a summary. Methods: We developed a protocol based on the recommendations of the Best Evidence Medical Education (BEME) collaboration. Citations retrieved by electronic searches of 10 databases were assessed against pre-defined inclusion/exclusion criteria by two independent reviewers and full texts of potentially relevant articles were obtained. Studies were identified for inclusion in the review by examination of full text articles by two independent reviewers. At all stages, discrepancies were resolved by consensus. Data relating to characteristics of the student population, intervention, outcome measures, study design and outcomes were collected using a piloted data extraction form. Each study was assessed against 11 quality indicators designed to provide information about how well it was designed and conducted; and against the Kirkpatrick hierarchy as modified for educational settings. Comparisons between different groups were carried out using the Kruskal--Wallis test (non-parametric ANOVA) or the Mann--Whitney U test as appropriate. Results: Electronic searches yielded 2348 citations. A further 23 citations were obtained by hand searching of reference lists. Five hundred and fifty four full articles were retrieved and assessed against our inclusion criteria. Of the 69 studies included in our review, 18 were from medicine, 32 from nursing and 19 from other allied health professions, including dentistry, physiotherapy and radiography. In all professional groups, portfolios were used mainly in the clinical setting, completion was mostly compulsory, reflection required and assessment (either formative, summative or a combination of both) the norm. Three studies used electronic portfolios. Whilst many studies used a combination of data collection methods, over half of all included studies used questionnaires, a third used focus group interviews and another third used direct assessment of portfolios. Most studies assessed student or tutor perceptions of the effect of the use of portfolios on their learning. Five studies used a comparative design, one of which was a randomized controlled trial. Studies were most likely to meet the quality indicators relating to appropriateness of study subjects, clarity of research question and completeness of data. However, in many studies, methods were not reported in sufficient detail to allow a judgement to be made. Nineteen of the 69 included studies (27%) met seven or more quality indicators. Across all professions, such "higher quality" studies were more likely to have been published recently. The median "quality score" (number of indicators met) rose from two for studies published in 2000 or earlier to seven for studies published in 2005 or later. Significant differences were observed between the quality scores for studies published in or before 2000 and those published between 2001 and 2004 (p¼0.027), those published in or before 2000 and those published in 2005 or later (p¼0.002) and between all studies (p¼0.004). Similar trends were seen in all professional groups. Fifty nine (85%) of the included studies were assessed at level 1 of the modified Kirkpatrick hierarchy (i.e. "participation" effects, including "post hoc" evaluations of student perceptions of the effects of keeping a portfolio on their learning). Nine (13%) of the studies reported direct measurement of changes in student skills or attitudes and one study reported a change in student behaviour. The main effects of portfolio use identified by the included studies were: improvement in student knowledge and understanding (28 studies, six at Kirkpatrick level 2 or above), greater self-awareness and encouragement of reflection (44 studies, seven at Kirkpatrick level 2 or above) and the ability to learn independently (10 studies, one at Kirkpatrick level 2). The findings of higher quality studies also identified benefits in these areas. They reported improved student knowledge and understanding, particularly the ability to integrate theory with practice, although a correlation with improved scores in other assessments was not always apparent. Greater self-awareness and engagement in reflection were also noted, although some studies questioned the quality of the reflection undertaken. Higher quality studies also suggest that use of portfolios improves feedback to students and gives tutors a greater awareness of students' needs, may help students to cope with uncertain or emotionally demanding situations and prepares students for postgraduate settings in which reflective practice is required. Time commitment required to collate a portfolio was the major drawback identified. In two of the studies, this was found to detract from other clinical learning. Conclusions: At present, the strength and extent of the evidence base for the educational effects of portfolios in the undergraduate setting is limited. However, there is evidence of an improving trend in the quality of reported studies. "Higher quality" papers identify improvements in knowledge and understanding, increased self-awareness and engagement in reflection and improved student--tutor relationships as the main benefits of portfolio use. However, they also suggest that whilst portfolios encourage students to engage in reflection, the quality of those reflections cannot be assumed and that the time commitment required for portfolio completion may detract from other learning or deter students from engaging with the process unless required to do so by the demands of assessment. Further work is needed to strengthen the evidence base for portfolio use, particularly comparative studies which observe changes in student knowledge and abilities directly, rather than reporting on their perceptions once a portfolio has been completed. [ABSTRACT FROM AUTHOR]

Context: In chronic disease management, the relevance of the Therapeutic Patient Education (TPE) as a complement to health care has been demonstrated. However, implementing it reveals some inconsistencies. In psychology and pedagogy, the weight of representations on professional practices is generally known. Objectives: The qualitative study is designed to understand health, education and care representations among caregivers as well as their impact on educational practices. The paper focuses on representations and their suitability to the (biomedical or biopsychosocial) model. Methods: Semi-structured interviews were conducted with 30 French-speaking caregivers-educators in Belgium. Content analysis was performed and led to a mixed categorization. Results: Several new representations appear and indicate a shift towards subjective mental-health objectives. "Shared" terms emerge but have diverse meanings. A (perfect) match between representations and a single model (biomedical or biopsychosocial) remains marginal. Conclusion: Additional research needs to be carried out to for the results to apply generally. Appropriate coaching and training must be rethought to ensure the implementation of the TPE. [ABSTRACT FROM AUTHOR]