Benchmarking for research-related competencies – a curricular mapping approach at medical faculties in Germany

Objectives: Internationally, scientific and research-related competencies need to be sufficiently targeted as core outcomes in many undergraduate medical curricula. Since 2015, standards have been recommended for Germany in the National Competency-based Learning Objective Catalogue in Medicine (NKLM). The aim of this study is to develop a multi-center mapping approach for curricular benchmarking against national standards and against other medical faculties.

Method: A total of 277 faculty members from four German medical faculties have mapped the local curriculum against the scientific and research-related NKLM objectives, using consented procedures, metrics, and tools. The amount of mapping citations of each objective is used as indicator for its weighting in the local curriculum. Achieved competency levels after five-year education are compared.

Results: All four programs fulfill the NKLM standards, with each emphasizing different sub-competencies explicitly in writing (Scholar: 17–41% of all courses; Medical Scientific Skills: 14–37% of all courses). Faculties show major or full agreement in objective weighting: Scholar 44%, scientific skills 79%. The given NKLM competency level is met or even outperformed in 78–100% of the courses.

Conclusions: The multi-center mapping approach provides an informative dataset allowing curricular diagnosis by external benchmarking and guidance for optimization of local curricula.     

Implementing competency-based medical education: What changes in curricular structure and processes are needed?

Medical educators must prepare for a number of challenges when they decide to implement a competency-based curriculum. Many of these challenges will pertain to three key aspects of implementation: organizing the structural changes that will be necessary to deliver new curricula and methods of assessment; modifying the processes of teaching and evaluation; and helping to change the culture of education so that the CBME paradigm gains acceptance. This paper focuses on nine key considerations that will support positive change in first two of these areas. Key considerations include: ensuring that educational continuity exists amongst all levels of medical education, altering how time is used in medical education, involving CBME in human health resources planning, ensuring that competent doctors work in competent health care systems, ensuring that information technology supports CBME, ensuring that faculty development is supported, ensuring that the rights and responsibilities of the learner are appropriately balanced in the workplace, preparing for the costs of change, and having appropriate leadership in order to achieve success in implementation.     

Twelve tips for choosing and surviving a PhD in medical education – a student perspective

The decision to undertake a PhD in medical education could mark a critical point in defining your future career. Attaining the highest level of degree in such a diverse and rewarding area as medical education may not only provide you with an opportunity to undertake important new research, but could also unlock different job opportunities. As is often the case, such rewards are not gained lightly. There can be real challenges in making the decision to undertake and then to successfully navigate a PhD. The specific subject and process of each doctorate is unique, leaving many prospective and current students uncertain as to what to expect. We offer our twelve tips from the perspective of two current PhD students to help guide those who share our interest in medical education and are considering doctoral study.     

Does hearing the patient perspective improve consultation skills in examinations? An exploratory randomized controlled trial in medical undergraduate education

Purpose: Medical education increasingly includes patient perspectives, but few studies look at the impact on students’ proficiency in standard examinations. We explored students’ exam performance after viewing video of patients’ experiences.

Methods: Eighty-eight medical students were randomized to one of two e-learning modules. The experimental group saw video clips of patients describing their colposcopy, while the control group viewed a clinician describing the procedure. Students then completed a Multiple Choice Questionnaire (MCQ) and were assessed by a blinded clinical examiner in an Objective Structured Clinical Examination (OSCE) with a blinded simulated patient (SP). The SP scored students using the Doctors’ Interpersonal Skills Questionnaire (DISQ). Students rated the module’s effect on their skills and confidence. Regression analyses were used to compare the effect of the two modules on these outcomes, adjusting for gender and graduate entry.

Results: The experimental group performed better in the OSCE than the control group (odds ratio 2.7 [95%CI 1.2–6.1]; p?=?0.016). They also reported significantly more confidence in key areas, including comfort with patients’ emotions (odds ratio 6.4 [95%CI 2.7–14.9]; p?<?0.0005). There were no other significant differences.

Conclusion: Teaching that included recorded elements of real patient experience significantly improved students’ examination performance and confidence.     

Undergraduate medical students’ perspectives of skills,uses and preferences of information technology in medical education: A cross-sectional study in a Saudi Medical College

Abstract

Background: Information technology (IT) is widely used in medical education. However, there are not enough studies about IT uses and preferences among traditional and problem-based learning (PBL) medical students.

Aim: To compare IT skills, uses and preferences for education between traditional and PBL medical students’.

Method: A cross-sectional study; a modified Educause Center for Analysis and Research online survey was sent to traditional curriculum 5th and PBL 4th year medical students of King Saud University.

Results: Most of the responding 176 students prefer mobile devices and moderate amount of IT in education. Fourth and fifth year students perceived high academic value of Google (94.2 vs. 86.7%, p?=?0.34), YouTube (90.7 vs. 92.2%, p?=?0.83) and PubMed (83.7 vs. 86.7%, p?=?0.06). More 4th year than 5th year students rated themselves as skilled in learning management system (54.7 vs. 21.1%, p?=?0.0001) and Smartboard use (40.7 vs. 23.3%, p?=?0.04). Most students rated faculty IT skills as effective. Students agreed that technology helps working faster (95.5%) and make learning creative (85.9%).

Conclusions: More integration of information literacy and IT training in medical curricula is needed to enhance better utilization of full features of IT resources available for learning and problem solving. National multi-institutional studies are recommended.     

Can nurses teach tomorrow's doctors? A nursing perspective on involvement in community-based medical education

The increasing importance of primary care suggests an important role for the whole primary healthcare team in the education of 'tomorrow's doctors'. Few studies have evaluated the contribution and views of staff other than general practitioners. We used a questionnaire survey to elicit the perspective of 65 community-based nurses involved in a new undergraduate medical course. Some 67% of the cohort had already undertaken training to teach others, and were confident of their teaching skills but were overly reliant on the general practitioners for information, and on the goodwill of colleagues for time to teach. The findings suggest a need for structural changes in the process of multidisciplinary medical education, supporting the need for teaching commitments to be coordinated at practice rather than individual tutor level. The high level of professional development for teaching among community nurses suggests that there is a sound basis for encouraging such valuable professional input into medical education in the future.     

Randomized controlled trials and meta-analysis in medical education: what role do they play?

Education researchers seek to understand what works, for whom, in what circumstances. Unfortunately, educational environments are complex and research itself is highly context dependent. Faced with these challenges, some have argued that qualitative methods should supplant quantitative methods such as randomized controlled trials (RCTs) and meta-analysis. I disagree. Good qualitative and mixed-methods research are complementary to, rather than exclusive of, quantitative methods. The complexity and challenges we face should not beguile us into ignoring methods that provide strong evidence. What, then, is the proper role for RCTs and meta-analysis in medical education? First, the choice of study design depends on the research question. RCTs and meta-analysis are appropriate for many, but not all, study goals. They have compelling strengths but also numerous limitations. Second, strong methods will not compensate for a pointless question. RCTs do not advance the science when they make confounded comparisons, or make comparison with no intervention. Third, clinical medicine now faces many of the same challenges we encounter in education. We can learn much from other fields about how to handle complexity in RCTs. Finally, no single study will definitively answer any research question. We need carefully planned, theory-building, programmatic research, reflecting a variety of paradigms and approaches, as we accumulate evidence to change the art and science of education.     

Can achievement emotions be used to better understand motivation, learning, and performance in medical education?

In this article, we consider an emergent theory of human emotion. The overarching purpose of the article is to introduce medical education researchers to the notion of achievement emotions and provide a brief overview of how this work can inform the theory, research, and practice of medical education. First, we define achievement emotions and describe one of the leading contemporary theories of achievement emotions, control-value theory (Pekrun R. 2006. The control-value theory of achievement emotions: Assumptions, corollaries, and implications for educational research and practice. Educ Psychol Rev 18:315-341.). Next, we distinguish between different types of achievement emotions, their proximal causes, and their consequences for motivation, learning, and performance, and we discuss several implications for educational practice. Finally, we end with a call for more research on achievement emotions in medical education to facilitate our understanding of emotions and their impact on important educational outcomes.     

Interest and perceived barriers toward careers in academic medicine among medical students at Alfaisal University – College of Medicine: A Saudi Arabian perspective

Abstract

Aims: [1] Identify the percentage of undergraduate students who are interested in academic medicine (AM) careers, [2] Explore the relationship between students’ characteristics, previous experiences and interest in AM careers and [3] Determine students’ perceived barriers toward AM careers at Alfaisal University – College of Medicine.

Methods: An online, anonymous, random, self-rating survey was administered during spring 2013–2014 to second-year and third-year students (n?=?302). Chi-square test was used to correlate between interest in AM careers and students’ characteristics. Mann–Whitney U-test was used to compare the mean 5-point Likert scale responses between male and female students.

Results: A total of 231 students participated in the survey (response rate: 76.5%). A total of 32 students (13.9%) expressed interest in AM careers, and this percentage significantly differed by gender, academic year, interest in teaching and research and previous research experiences (p?<?0.05). The top three barriers were “lower income” (77.5%), “competing pressures to fulfill clinical-teaching-research duties” (73.6%) and “lack of career advising” (69.7%). As opposed to males, females achieved higher statistically significant differences of means regarding: “competing pressures to fulfill clinical-teaching-research duties” (p?<?0.001) and “lack of same-gender role models in AM careers” (p?<?0.000).

Conclusions: AM careers were unpopular by students. Curricular, extracurricular and institutional measures should be implemented to rectify this dilemma.     

Tensions in mentoring medical students toward self-directed and reflective learning in a longitudinal portfolio-based mentoring system – An activity theory analysis

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.     

Evaluating the quality of teaching in medical education: are we using the evidence for both formative and summative purposes?

Heightened focus on the quality of teaching in medical schools has led to increased use of student surveys as a means of evaluating teaching. In some institutions, however, the summative purpose is emphasized over the developmental or self-improvement objective. The aim of this study was to examine the utility of a student evaluation of teaching questionnaire for use in administrative decision making (summative purpose) and in identification of faculty whose instruction needs improvement (formative purpose). Results of this analysis are discussed in addition to related issues regarding faculty development and the importance of adopting multiple methods of evaluating and documenting teaching and other educational activity.