Column Editors: Craig Campbell, MD and Joseph Szot, MD
This issue, our editors have selected articles that address some of the most controversial and challenging topics of the day.
Henderson R, Sehgal A, Barnabe C, Roach P, Crowshoe LL.Acad Med. 2023 Apr 3. doi: 10.1097/ACM.0000000000005228. Online ahead of print. PMID: 37027212
In 2015, the Truth and Reconciliation Commission (TRC) of Canada outlined 94 Calls to Action, which formalized a responsibility for all people and institutions in Canada to confront and craft paths to remedy the legacy of the country’s colonial past. This article outlines efforts by stakeholders at one medical school to mobilize their institution to address the TRC’s Calls to Action via the Indigenous Health Dialogue (IHD) which uses a critical collaborative consensus-building process. Through this process, a critical reflective framework of domains, reconciliatory themes, truths, and action themes were developed, highlighting key areas to develop Indigenous health within the medical school to address health inequities faced by Indigenous peoples in Canada. Recognizing Indigenous health as a distinct discipline and promoting and supporting Indigenous inclusion, the authors provided insights related to factors that are at the heart of Indigenous health inequities and resources for overcoming inequities.
Teaching the Teachers: Development and Evaluation of a Racial Health Equity Curriculum for Faculty.
Falusi O, Chun-Seeley L, de la Torre D, Dooley DG, Baiyewu M, Gborkorquellie TT, Merrill CT, Davis E, Ward MC. MedEdPORTAL. 2023 Mar 28;19:11305. doi: 10.15766/mep_2374-8265.11305. eCollection 2023. PMID: 36999061 Free PMC article. Review.
This article describes the development of a curriculum for faculty education on racism and actions to advance racial health equity. The curriculum design was based on a literature review and needs assessments and consisted of four (4) live and virtual 1-hour sessions incorporating interactive didactics, cases, reflection, goal setting, and discussion. The curriculum was offered to 78 faculty members, who reflected a multidisciplinary group of pediatric faculty at a children’s hospital, and evaluated using pre- and post-surveys at the beginning and end of the curriculum, along with a survey after each session. Participants reported high satisfaction and increased knowledge at the end of each session. Qualitative themes included self-reflection on personal biases, application of health equity frameworks and tools, strategies for becoming disruptors of racism, and the importance of systemic change and policy. This curriculum appears to be an effective method for increasing faculty knowledge and comfort to highlight the impact of racism on health and to model the principles of health equity.
A theoretical systematic review of patient involvement in health and social care education.
Bennett-Weston A, Gay S, Anderson ES. Adv Health Sci Educ Theory Pract. 2023 Mar;28(1):279-304. doi: 10.1007/s10459-022-10137-3. Epub 2022 Jul 16. PMID: 35841446 Free PMC article. Review.
This systematic review was conducted to synthesize how theory shapes our understanding of patient involvement in health, as well as social care education of patient involvement in health and social care education. A narrative synthesis was undertaken using Activity Theory as an analytical lens to highlight the multifaceted components of patient involvement in professional education. Seven high-quality, theoretically underpinned studies were included. Four studies applied theory to pedagogy, showing how deep learning from patient involvement occurred. Three studies applied theory to illuminate the complexity of involving patients in the educational system, showing how patients can be supported and valued in teaching roles. This review highlights that more work is required to identify the mechanisms through which patient involvement enhances learning and, to explore what involvement within the education community can mean for faculty and patients. This review contributes to our understanding of patient-educator partnerships for learning and how these could be progressed by further high-quality theory driven studies designed to include the patient voice.
de Raad T, Wiersma F, Kuilman L, Ten Cate O. J Contin Educ Health Prof. 2023 Jan 1;43(1):28-33. doi: 10.1097/CEH.0000000000000467. Epub 2022 Dec 21. PMID: 36728984 Free PMC article.
This article explores how entrustable professional activities (EPAs) used during training may also have significance after graduation. The authors investigated the use of EPAs among alumni of Master Physician Assistant programs in the Netherlands, where EPAs have been used since 2010. All registered Dutch physician assistants (PAs) (n = 1441) were invited to participate in a voluntary, anonymous survey focusing on the use of EPAs after graduation. A total of 421 PAs (response rate 29%) yielded information about the significance of EPAs after training. Almost all EPA-trained PAs (96%; n = 103) considered the EPA structure suitable to maintain and renew entrustment. Furthermore, PAs reported continued use of the EPA framework to seek formal qualifications through entrustment decisions. This study demonstrates that EPAs can play an ongoing role for PAs after graduation and support the continuous use of the EPA framework for entrustment decisions from graduation until retirement.
Sidhu NS, Allen KJ, Civil N, Johnstone CSH, Wong M, Taylor JA, Gough K, Hennessy M. Med Teach. 2023 Feb;45(2):219-228. doi: 10.1080/0142159X.2022.2126758. Epub 2022 Sep 30. PMID: 36179761 Review.
The authors of this paper sought to identify an inclusive structure or framework for competency domains that can be applied to educators. Using an integrative review, 2942 initial citations published from 2000 to January 2020 were identified and 67 articles describing educator competency domains were eligible for analysis. The inductive thematic analysis identified six distinct domains of educator competence: Teaching and facilitating learning; Designing and planning learning; Assessment of learning; Educational research and scholarship; Educational leadership and management; Educational environment, quality, and safety. The distinct educator competency domains identified in this analysis were applicable across a range of healthcare disciplines and provide a guide for the development and evaluation of educator competency frameworks.
Learning needs assessments in continuing professional development: A scoping review.
Al-Ismail MS, Naseralallah LM, Hussain TA, Stewart D, Alkhiyami D, Abu Rasheed HM, Daud A, Pallivalapila A, Nazar Z. Med Teach. 2023 Feb;45(2):203-211. doi: 10.1080/0142159X.2022.2126756. Epub 2022 Sep 30. PMID: 36179760 Review.
This scoping review aimed to collate, summarize, and categorize the reported Learning Needs Analysis approaches adopted to inform healthcare professional CPD and highlight the gaps for further research. One hundred fifty-one (151) studies were included in the review; and the majority adopted quantitative methods in the form of self-assessment surveys. Mixed-methods approaches were reported in only 35 studies. Descriptions of Learning Needs Analysis development lacked detail of measures required to enhance their rigor or robustness. These findings do not reflect recommendations offered by the CPD literature. Further investigations are required to evaluate more recently advocated Learning Needs Analysis approaches and add to their limited evidence-base. Similarly, the existing support afforded to CPD developers warrants further study in order to identify the necessary resource, infrastructure and expertise essential to design and deliver effective CPD programs.
Competencies for the Use of Artificial Intelligence-Based Tools by Health Care Professionals.
Russell RG, Lovett Novak L, Patel M, Garvey KV, Craig KJT, Jackson GP, Moore D, Miller BM. Acad Med. 2023 Mar 1;98(3):348-356. doi: 10.1097/ACM.0000000000004963. Epub 2022 Sep 6. PMID: 36731054
This qualitative study defined artificial intelligence (AI)-related competencies by interviewing experts in the field. The semi-structured interviews were thematically analyzed and coded. Six competencies and 25 sub competencies were formulated from the analysis. The six (6) competencies could be used to guide future teaching and learning of AI based tools in health care.
Fostering “Reflection-On-Practice” Through a Multisource Feedback and Peer Coaching Pilot Program.
Curran V, Fleet L, Whitton C. J Contin Educ Health Prof. 2022 Dec 21. doi:10.1097/CEH.0000000000000483. Online ahead of print. PMID: 36729010
This study evaluated a pilot program of Multisource feedback (MSF) and peer coaching to evaluate their effect on fostering reflective practice. Participants completed an MSF assessment of their practice followed by peer coaching. The coaches were oriented to R2C2, an evidence-based, theory-driven feedback model. MSF and peer coaching emerged as keys to reflection on practice and facilitating conversations with peers designed to strengthen practice through self-directed professional development.
Exploring the Study of Simulation as a Continuing Professional Development Strategy for Physicians.
Tavares W, Piquette D, Luong D, Chiu M, Dyte C, Fraser K, Clark M. J Contin Educ Health Prof. 2022 Dec 21. doi: 10.1097/CEH.0000000000000470. Online ahead of print. PMID: 36728972
This scoping review of the literature on simulation based CPD examined studies involving simulation in practicing physicians’ CPD, their motivations to participate, strategies to enroll physicians, as well as simulation effectiveness. Simulation is an effective experiential educational method, however, the factors influencing uptake by physicians for CPD is unclear. It appears further exploration of physicians’ motivations to participate in simulation such as, personal, social, educational or contextual factors are warranted.
Science of Learning Strategy Series: Article 3, Interleaving.
Van Hoof TJ, Sumeracki MA, Madan CR. J Contin Educ Health Prof. 2022 Oct 1;42(4):265-268. doi: 10.1097/CEH.0000000000000418. Epub 2022 Feb 17. PMID: 35170479
This article is the third installment of a series on the science of learning. This article focuses on interleaving an evidence based, learning science strategy that is relevant to the planning and implementation of CPD. Interleaving involves mixing related, but different areas of study, forcing the brain to reconcile the relationship between the areas while understanding each area well. If utilized properly, CPD can leverage interleaving which leads to improved educational activities and more informed choices for learners.
Team Stress and Its Impact on Interprofessional Teams: A Narrative Review.
Sorensen D, Cristancho S, Soh M, Varpio L. Teach Learn Med. 2023 Jan 10:1-11. doi: 10.1080/10401334.2022.2163400. Online ahead of print. PMID: 36625564
The authors conducted a narrative review on team stress experienced by interprofessional teams. The literature reported on four stressors that impacted teams, time pressure, life threats, environmental distractors and communication issues. Teams reacted with engagement/cohesion and communication/coordination. Stressors can either hinder or improve team performance. By better understanding how team stress impacts teams, it could better prepare healthcare professionals to work on interprofessional teams.
Effect of the COVID-19 Pandemic on Accredited Continuing Medical Education in the United States.
McMahon GT. J Contin Educ Health Prof. 2022 Oct 1;42(4):e125-e127. doi: 10.1097/CEH.0000000000000443. Epub 2022 Jun 14. PMID: 36469803
This brief report analyzes the impact of the COVID-19 pandemic on CME in the United States. Organizations accredited by the ACCME are required to submit detailed data about their educational programs annually. This report compares the data sets from 2019 and 2020 for pandemic related changes. Comparing 2019 and 2020 reflected a decrease in accredited organizations, activities, hours of instruction and revenue in 2020. It was also noted that there was an increased engagement in CME by physicians, and virtual learning formats predominated
Craig Campbell, MD is Director of Curriculum, Faculty of Medicine, University of Ottawa. Joseph Szot, MD is Associate Dean for CME and Integrative Education, University of Iowa Carver College of Medicine, Iowa.
