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Introduction To date, research studying health professions education scholarship units has overlooked the perspectives of research scientists in the field, despite their important role in these units. This research explores how health professions education scientists uphold and/or upend the institutional logics of the units they work within. Methods Recruited via snowball sampling, 29 Canadian health professions education scientists participated in semi-structured interviews that lasted between 32–55 min. Data analysis was informed by the theories of organizational institutionalism—specifically, the microfoundation element of sensemaking. Results Respondents’ narrations of career success were overtly linked to their research-oriented pursuits above other expectations (i.e., teaching, service). Discussion Respondents’ narrative revealed a mismatch between the value they associated with teaching- and service-related pursuits, and the value the institution associated with those pursuits. Participants indicated a need to reconceptualize the institutional value associated with these endeavors. Electronic supplementary material The online version of this article (10.1007/s40037-020-00577-1) contains supplementary material, which is available to authorized users.

Soon after the identification of the novel coronavirus in Wuhan, the city experienced a massive outbreak of COVID-19 that severely strained the existing health system. All of the city's teaching hospitals repurposed buildings for COVID-19 patients, and recruited physicians and trainees of all backgrounds to care of these patients. The authors discuss some of the challenges faced by residency training programs during this period and how they were addressed.

Background Parents can assess residents’ non-technical skills (NTS) in pediatric emergency departments (EDs). There are no assessment tools, with validity evidence, for parental use in pediatric EDs. The purpose of this study was to develop the Parents’ Assessment of Residents Enacting Non-Technical Skills (PARENTS) educational assessment tool and collect three sources of validity evidence (i.e., content, response process, internal structure) for it. Methods We established content evidence for the PARENTS through interviews with physician-educators and residents, focus groups with parents, a literature review, and a modified nominal group technique with experts. We collected response process evidence through cognitive interviews with parents. To examine the internal structure evidence, we administered the PARENTS and performed exploratory factor analysis. Results Initially, a 20-item PARENTS was developed. Cognitive interviews led to the removal of one closed-ended item, the addition of resident photographs, and wording/formatting changes. Thirty-seven residents and 434 parents participated in the administration of the resulting 19-item PARENTS. Following factor analysis, a one-factor model prevailed. Conclusions The study presents initial validity evidence for the PARENTS. It also highlights strategies for potentially: (a) involving parents in the assessment of residents, (b) improving the assessment of NTS in pediatric EDs, and (c) capturing parents’ perspectives to improve the preparation of future physicians. Electronic supplementary material The online version of this article (10.1186/s12909-017-1042-9) contains supplementary material, which is available to authorized users.

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.

Resident and faculty views of program strengths and opportunities for improvement (OFIs) offer insight into how stakeholders assess key elements of the learning environment.Background This study sought (1) to assess the degree to which residents and faculty in 359 programs in 5 surgical specialties (obstetrics and gynecology, orthopaedic surgery, otolaryngology, plastic surgery, and surgery) were aligned or divergent in their respective views of program strengths and OFIs; and (2) to evaluate whether responses to selected questions on the Accreditation Council for Graduate Medical Education (ACGME) Resident Survey correlated with strengths or OFIs identified by the residents during the site visit.Objective Faculty and resident lists of program strengths and OFIs in site visit reports for 2012 and 2013 were aggregated, analyzed, and compared to responses on the Resident Survey.Methods While there was considerable alignment in resident and faculty perceptions of program strengths and OFIs, some attributes were more important to one or the other group. Collegiality was valued highly by both stakeholder groups. Responses to 2 questions on the ACGME Resident Survey were associated with resident-identified OFIs in site visit reports pertaining to aspects of the didactic program and responsiveness to resident suggestions for improvement.Results The findings offer program leadership additional insight into how 2 key stakeholder groups view elements of the learning environment as program strengths or OFIs and may serve as useful focal areas for ongoing improvement activities.Conclusions

Introduction Being procedurally competent to perform pediatric rapid sequence intubation (pRSI) is an ACGME requirement for emergency medicine residents. There are few assessment tools to assess this technique with adequate validity evidence. An objective structured assessment of technical skills for pRSI (OSATS-pRSI) was developed and validity evidence was obtained in four of five areas of validity: content, relation to other variables, and inter-rater reliability. Methods This assessment tool was designed to be used to evaluate learner's performance during pPRSI using a standard respiratory distress scenario and a pediatric high-fidelity simulator (Laerdal SimBaby). The scenario was a 7-month old infant who presented to the Emergency Department in respiratory distress. A framework of a previously established objective structured assessment of technical skills (OSATS) tool was modified for pRSI by a panel of pediatric and general emergency medicine physicians. Emergency medicine residents (postgraduate year 1-4) were prospectively enrolled in a pRSI simulation scenario and evaluated by two raters using the modified tool. Results Sessions were videotaped and reviewed by the same raters at least 4 months later. Raters were blinded to their initial rating. Interrater agreement was determined by using the Krippendorff generalized concordance method. Overall interrater agreement for live review was 0.75 (95% CI = 0.72 — 0.78) and for video was 0.79 (95% CI = 0.73 — 0.82). Live review was significantly superior to video review in only one of the OSATS domains (preparation) and was equivalent in the other domains. Intrarater agreement between the live and video evaluation was very good, greater than 0.75 for all raters, with a mean of 0.81 (95% CI = 0.76 — 0.85). Two domains of the modified OSATS instrument (preintubation process and intubation technique) were able to discriminate trainees by level of training and neonatal experience. Discussion The modified OSATS assessment tool demonstrates validity evidence in content, inter- and intra-rater reliability, and relation to other variables. There are limited number of assessment tools for pRSI with validity evidence. This tool has demonstrated validity evidence in content, response process, and inter- and intra-rater reliability. This tool was successfully piloted by 45 emergency medicine residents and showed increased performance in two domains with increasing PGY level.

Health sciences librarians have been involved in the education of medical residents and fellows for many years, traditionally providing orientation to library resources or refreshers on MEDLINE searching [1–4]. With the increased focus on evidence-based medicine (EBM) in residency education, health sciences librarians have found a natural partnership in teaching EBM search skills in the postgraduate curriculum [5–12]. However, even with EBM opening the door for increased librarian instruction, the level of librarian involvement in residency education varies greatly by institutional or departmental interest, institutional culture, program directors, librarian expertise, and marketing techniques. In 2002, the Accreditation Council on Graduate Medical Education (ACGME) mandated the use of outcomes assessment in ACGME-accredited programs. One area of particular interest to librarians was the practice-based learning and improvement (PBLI) competency, which included information-searching and -management skills. Specifically, PBLI competencies include “the ability to locate, appraise, and assimilate evidence from scientific studies related to their patients' health problems and to use information technology to optimize learning,” as well as other competencies related to lifelong learning [13]. Teaching and evaluating PBLI is challenging for many graduate medical education (GME) programs because it includes competencies in areas many medical school faculty do not possess expertise in and may themselves be in need of skill development [14–18]. In addition, few tools have been developed to measure resident learning in this area [17, 19, 20].

Purpose The purpose of this study was to describe the validation process for assessing an instrument to assess residents' aseptic technique skills. Methods The validation study entailed comparisons of the performance of aseptic technique procedures between postgraduate year–1 (PGY-1) surgical residents and PGY-2/3 surgical residents. We also compared the performance of PGY-1 surgical residents from 2 different academic years for the same procedures. Finally, we compared the performance of novices (medical students) and experts (operating room nurses) in an effort to determine validity. Results Our initial analysis found no significant difference between the performance of PGY-1 (mean score, 75.8) and PGY-2/3 (mean score, 75.6) surgical residents for aseptic technique (t(55) = 0.84, P = 0.404). Further investigation of validity was obtained to determine whether the no difference results reflected a lack of reliability or validity or a true equivalence between the 2 cohorts. The comparison of novices and experts produced the following findings. For reliability, the internal consistency of the checklist for each of the 2 raters was 0.87 and 0.71 (Cronbach α), interrater reliability was 0.74, with P < 0.001 (intraclass correlation coefficient) for the global scale. (Internal consistency was done within instrument, ie, between items not between raters.) For validity, operating room nurses outperformed students on the global scale (t14 = 7.47, P < 0.0001 and t(14) = 10.66, P < 0.0001 for the 2 raters, respectively) and on several checklist items. The effect size values for raters were large (Cohen d = 3.0 and 4.4), providing validity evidence for the ability of this assessment to detect difference in performance on this task. Conclusion The validation study showed that the instrument exhibited reliability and evidence for validity, making it useful for the assesment of aseptic technique skills in different specialties. Programs may want to consider using a validated instrument to check competence given that appropriate use of sterile technique frequently occurs in the context of unsupervised activities. Further work is needed to enhance resident skills in the area of aspectic technique because of limited improvement despite additional clinical experience.

Background There is significant variability in undergraduate Otolaryngology – Head and Neck Surgery (OTOHNS) curricula across Canadian medical schools. As part of an extracurricular program delivered jointly with other surgical specialties, the Surgical Exploration and Discovery (SEAD) program presents an opportunity for medical students to experience OTOHNS. The purpose of this study is to review the participation and outcome of OTOHNS in the SEAD program. Methods The SEAD program is a two-week, 80-hour, structured curriculum that exposes first-year medical students to nine surgical specialties across three domains: (1) operating room observerships, (2) career discussions with surgeons, and (3) simulation workshops. During observerships students watched or assisted in surgical cases over a 4-hour period. The one-hour career discussion provided a specialty overview and time for students’ questions. The simulation included four stations, each run by a surgeon or resident; students rotated in small groups to each station: epistaxis, peritonsillar abscess, tracheostomy, and ear examination. Participants completed questionnaires before and after the program to evaluate changes in career interests; self-assessment of knowledge and skills was also completed following each simulation. Baseline and final evaluations were compared using the Wilcoxon Signed-Rank test. Results SEAD participants showed significant improvement in knowledge and confidence in surgical skills specific to OTOHNS. The greatest knowledge gain was in ear examination, and greatest gain in confidence was in draining peritonsillar abscesses. The OTOHNS session received a mean rating of 4.8 on a 5-point scale and was the most popular surgical specialty participating in the program. Eight of the 18 participants were interested in OTOHNS as a career at baseline; over the course of the program, two students gained interest and two lost interest in OTOHNS as a potential career path, demonstrating the potential for helping students refine their career choice. Conclusions Participants were able to develop OTOHNS knowledge and surgical skills as well as refine their perspective on OTOHNS as a potential career option. These findings demonstrate the potential benefits of OTOHNS departments/divisions implementing observerships, simulations, and career information sessions in pre-clerkship medical education, either in the context of SEAD or as an independent initiative. Electronic supplementary material The online version of this article (doi:10.1186/s40463-015-0059-5) contains supplementary material, which is available to authorized users.