Search

ContextTransformative learning (TL) has been described as learning that challenges established perspectives, leading to new ways of being in the world. As a learning theory it has resonated with educators globally, including those in the health professions. Described as a complex metatheory, TL has evolved over time, eliciting divergent interpretations of the construct. This scoping review provides a comprehensive synthesis of how TL is currently represented in the health professions education literature, including how it influences curricular activities, to inform its future application in the field.MethodsArksey and O'Malley's six-step framework was adopted to review the period from 2006 to May 2018. A total of 10 bibliographic databases were searched, generating 1532 potential studies. After several rounds of review, first of abstracts and then of full texts, 99 studies were mapped by two independent reviewers onto the internally developed data extraction sheet. Descriptive information about included studies was aggregated. Discursive data were subjected to content analysis.ResultsA mix of conceptual and empirical research papers, which used a range of qualitative methodologies, were included. Studies from the USA, the UK and Australia were most prevalent. Insights relating to how opportunities for TL were created, how it manifests and influences behaviour, as well as how it is experienced, demonstrated much congruency. Conceptions of TL were seen to be clustered around the work of key theorists.ConclusionsThe training of health professionals often takes place in unfamiliar settings where students are encouraged to be active participants in providing care. This increases the opportunity for exposure to learning experiences that are potentially transformative, allowing for a pedagogy of uncertainty that acknowledges the complexity of the world we live in and questions what we believe we know about it. TL provides educators in the health professions with a theoretical lens through which they can view such student learning.

Global health education (GHE) continues to be a growing initiative in many medical schools across the world. This focus is no longer limited to participants from high-income countries and has expanded to institutions and students from low- and middle-income settings. With this shift has come a need to develop meaningful curricula through engagement between educators and learners who represent the sending institutions and the diverse settings in which GHE takes place. The Bellagio Global Health Education Initiative (BGHEI) was founded to create a space for such debate and discussion and to generate guidelines towards a universal curriculum for global health. In this article, we describe the development and process of our work and outline six overarching principles that ought to be considered when adopting an inclusive approach to GHE curriculum development.

BACKGROUND: Delivering difficult news to families is an essential but challenging skill. Pediatric trainees report limited confidence in this skill and perform poorly in simulation. We implemented the American Academy of Pediatrics (AAP) Resilience Curriculum and evaluated performance and self-efficacy in delivering difficult news. METHODS: The AAP Resilience Curriculum, using the SPIKES (Set-up, Perception, Invitation, Knowledge, Empathy, and Summary) framework, was taught to pediatric fellows. Fellows’ performance during simulations with standardized patients before and after curriculum implementation was scored with a SPIKES checklist. Preand post-test surveys assessed self-efficacy in delivering difficult news. RESULTS: Fellows (n=19) significantly improved their performance in delivering difficult news, increasing the median SPIKES checklist scores from 78% to 90% completion (P<0.001). Pediatric fellows (n=35) reported improved confidence from 3.4/5 to 3.9 (P=0.01). CONCLUSIONS: Pediatric fellows demonstrated significant improvement in their ability to deliver difficult news during a simulated patient encounter and reported increased self-efficacy in delivering difficult news. [ABSTRACT FROM AUTHOR]

Background: There exists strong evidence for the early introduction of peanut to at‐risk infants for the primary prevention of peanut allergy. There is a need for educational initiatives to assist in dissemination and implementation of updated clinical guidelines on peanut allergy prevention. Approach: The aim for this project was to create an innovative curriculum for paediatricians on peanut allergy prevention. The Intervention to Reduce Early Allergy (Peanut) in Childhood (iREACH) study was leveraged to recruit paediatricians for a needs assessment. Materials from the iREACH study, including an educational YouTube video and knowledge survey, were evaluated. Applying findings from the needs assessment, an innovative curriculum was developed, and updated knowledge survey questions were developed. Evaluation: The iREACH YouTube video had suboptimal viewing behaviours, and iREACH participants had high baseline knowledge scores that did improve after viewing the video. The majority of respondents to the needs assessment felt that all paediatricians needed access to an effective educational module on peanut allergy prevention, and they wanted a broadly accessible curriculum that incorporated quality media and content segmentation. An online, interactive curriculum was developed that includes clinical cases and games, and updated knowledge questions were created with associated internal structure and reliability evidence, as well as relation to other variables evidence. Implication: The next steps of this project will focus on curriculum implementation and evaluation through a randomised, prospective study with the aim to serve as an educational model for how to integrate specialty‐specific guidelines into broader clinical practice through education. [ABSTRACT FROM AUTHOR]

A separate program that teaches residents how to teach can be effective in developing their roles as health care leaders. Researchers outlined a pilot program designed to improve residents' teaching skills. The residents and medical educators that developed the course tailored each year of the program to match the expected responsibilities of each year of residency. The program progressed from basic teaching skills to small group skills to large group skills. The format of the course involved a series of workshops designed to involve the participants in practicing their skills. They assessed the effectiveness of the course through questionnaires and interviews. Residents reported a new appreciation and awareness of the value of teaching after completing the course. New teaching skills that the residents reported using frequently included demonstration while teaching and the use of positive feedback first when evaluating a learner., ABBREVIATIONS. CHB, Children's Hospital Boston; HMS, Harvard Medical School; PGY, postgraduate year. Programs to improve the teaching of residents seem to have received renewed interest and increased attention. Several have [...]