Enhancing Educational Scholarship Through Conceptual Frameworks: A Challenge and Roadmap for Medical Educators

Zackoff, Matthew; Real, Francis J.; Abramson, Erika L.; Li, Su-Ting Terry; Klein, Melissa; Gusic, Maryellen E.

doi:10.1016/j.acap.2018.08.003

Cited by 64 publications

(44 citation statements)

References 20 publications

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“…If the learner is failing to appropriately intervene during the simulation, it is preferable to pause and redirect rather than allow the mannequin to severely decompensate or expire. Keeping in line with cognitive load theory, 21 assistance should be provided to the learner to prevent excessive struggling and a negative learning experience during the simulation. We approached this simulation as a formative process.…”

Section: Discussionmentioning

confidence: 99%

“When in Doubt, Change It out”: A Case-Based Simulation for Pediatric Residents Caring for Hospitalized Tracheostomy-Dependent Children

et al. 2020

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Introduction: Caring for technology-dependent children, such as those with tracheostomy and ventilator dependence, can be new and frightening for pediatric residents. Education about emergencies in this patient population is important because these children are at risk for in-hospital complications. Safe care of the tracheostomy-dependent child requires the ability to recognize common complications, such as tracheostomy tube obstruction or decannulation, and intervene appropriately by suctioning and/or replacing the tracheostomy tube. This simulation-based curriculum teaches learners to identify and practice the management of these tracheostomy tube complications through low-fidelity simulation exercises. Methods: We created a simulation session with three cases reflecting in-hospital scenarios encountered by resident physicians caring for tracheostomy-dependent children in the inpatient setting. The simulation scenario, simulation environment preparation, materials list, and debriefing outline are provided for the instructor for each simulation case. Validity evidence for the assessment tool was obtained by calculating the interrater reliability of two different raters. Resident feedback was obtained through anonymous surveys. Results: Twelve pediatric senior residents completed the experience. It received overwhelmingly positive feedback on learner evaluation forms, with 90% finding the experience very or extremely helpful. The intraclass correlation coefficient of interrater reliability for our assessment tool was 0.93. Discussion: The simulation was well received by residents. The interrater reliability was acceptable. This low-fidelity simulation exercise can easily be executed with minimal materials or instructor training. High-yield, just-in-time training with postcase debriefing is key to the simulation's success.

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Section: Discussionmentioning

confidence: 99%

“When in Doubt, Change It out”: A Case-Based Simulation for Pediatric Residents Caring for Hospitalized Tracheostomy-Dependent Children

et al. 2020

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“…Grounding medical education in this or other learning theories, such as Kolb's experiential learning cycle or Schon's reflective practice, can produce innovative, robust interventions that are more likely to succeed. 61,62 Fourth, integrating wellness programs into the existing didactic residency curriculum made the interventions more available and accessible to residents. 51,57,58 In one case, a feasibility study showed that offering interventions during protected class time was possible with strategic planning and coordination with other clinicians to cover shifts.…”

Section: Discussionmentioning

confidence: 99%

Evaluating Wellness Interventions for Resident Physicians: A Systematic Review

Eskander

Rajaguru

Greenberg

2020

Journal of Graduate Medical Education

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Background Wellness initiatives implemented by graduate medical education programs can help mitigate burnout in resident physicians. Objective This systematic review seeks to identify factors that impact the effectiveness of resident wellness interventions and to provide a conceptual framework to guide future interventions. Methods Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, 6 electronic databases were searched in November 2019 using variations of the keywords “resident physicians,” “wellness,” and “intervention.” Peer-reviewed full-text English-language articles on controlled studies were considered for inclusion. The quality of the studies was assessed using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) guidelines. Results The initial search disclosed 1196 articles, of which 18 studies enrolling 666 resident physicians met inclusion criteria for qualitative review. Interventions using peer support and individual meditation enhanced well-being. Effective wellness interventions also used educational theory to guide program development, surveyed participants to guide intervention design, incorporated programming into existing didactic curricula, and recruited voluntary participants. The quality of most of the included studies was poor (13 of 18, 72%) and could be improved by using standardized wellness assessments supported by validity evidence. Conclusions This systematic review suggests that future resident wellness initiatives should focus on grounding interventions in educational theory, forging consensus on wellness instruments with validity evidence, and examining the impact of initiatives on patient outcomes. A logic model can provide a framework for designing and implementing effective wellness interventions.

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“…12 The conceptual framework utilized was ''situated learning-guided participation'' in which didactic and interactive activities facilitate independent learning. 13 The 90-minute educational workshop included an interactive presentation on unconscious bias. To briefly demonstrate implicit bias, participants were rapidly shown images of 5 individuals in succession and they recorded their first impressions of the persons regarding trustworthiness and presumed profession.…”

Section: Methodsmentioning

confidence: 99%

Defeating Unconscious Bias: The Role of a Structured, Reflective, and Interactive Workshop

Ogunyemi

2021

Journal of Graduate Medical Education

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Background Unconscious or implicit biases are universal and detrimental to health care and the learning environment but can be corrected. Historical interventions used the Implicit Association Test (IAT), which may have limitations. Objective We determined the efficacy of an implicit bias training without using the IAT. Methods From April 2019 to June 2020, a 90-minute educational workshop was attended by students, residents, and faculty. The curriculum included an interactive unconscious biases presentation, videoclips using vignettes to demonstrate workplace impact of unconscious biases with strategies to counter, and reflective group discussions. The evaluation included pre- and postintervention surveys. Participants were shown images of 5 individuals and recorded first impressions regarding trustworthiness and presumed profession to unmask implicit bias. Results Of approximately 273 participants, 181 were given the survey, of which 103 (57%) completed it with significant increases from pre- to postintervention assessments for perception scores (28.87 [SEM 0.585] vs 32.73 [0.576], P < .001) and knowledge scores (5.68 [0.191] vs 7.22 [0.157], P < .001). For a White male physician covered in tattoos, only 2% correctly identified him as a physician, and 60% felt he was untrustworthy. For a smiling Black female astronaut, only 13% correctly identified her as an astronaut. For a brooding White male serial killer, 50% found him trustworthy. Conclusions An interactive unconscious bias workshop, performed without the use of an IAT, was associated with increases in perceptions and knowledge regarding implicit biases. The findings also confirmed inaccurate first impression stereotypical assumptions based on ethnicity, outward appearances, couture, and media influences.

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Enhancing Educational Scholarship Through Conceptual Frameworks: A Challenge and Roadmap for Medical Educators

Cited by 64 publications

References 20 publications

“When in Doubt, Change It out”: A Case-Based Simulation for Pediatric Residents Caring for Hospitalized Tracheostomy-Dependent Children

“When in Doubt, Change It out”: A Case-Based Simulation for Pediatric Residents Caring for Hospitalized Tracheostomy-Dependent Children

Evaluating Wellness Interventions for Resident Physicians: A Systematic Review

Defeating Unconscious Bias: The Role of a Structured, Reflective, and Interactive Workshop

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