Publications and Scholarship
By William Rayburn, MD, MBA
Each issue, this column will provide a list of insightful publications on topics of interest to teaching faculty and professionals in CME/CPD.
Little guidance exists about training providers in the core competency of compassion This study of 57 providers working in a palliative care setting involved focus groups and one-on-one interviews. The participants agreed that compassionate behaviors can be taught and form a hallmark of quality care. Guidance was provided on the core components (self-awareness, experiential learning, effective and affective communication skills) for evidence -based educational interventions. (Sinclair S, Hack T, McClement S, Raffin-Bouchal S, Chochinov H, Hagen N. BMC Med Educ. 2020; 20:249. Doi: 10.1186/s12909-020-021654-8. PMID32758216).
Cost is a barrier to new educational initiatives This just-in-time online program at the University of Toronto was developed for high-quality medical programming in procedural instruction (thoracentesis, paracentesis, lumbar puncture) to internal medicine trainees. The modules produced four principles aimed at decreasing costs while creating efficiencies. Compared with commercial vendors, the cost to produce these modules was less than 3% of the anticipated costs. The learning appeared acceptable to the residents based on 1,800 website instructional sessions at other Canadian cities. (Kaplovitch E, Otremba M, Morgan M, Devine L. J Grad Med Educ. 2019; 11: 713-716. Doi: 10.4300/JGME-D-00155.1. PMID: 31871575).
A significant proportion of teachers who instruct healthcare students are sessional (adjunct/temporary part-time) faculty. Research is lacking on teaching identity, motivations, and needs of those faculty. This online need assessment, based on informal interviews and literature reviews, involved 78 tenure-track faculty and 160 sessional faculty using validated scales. This comparison suggested that sessional faculty enjoyed being teachers but desired more expressed appreciation and connectedness to their department. They also preferred digital formats for pedagogy before and during their teaching career. Suggestions for faculty development for sessional faculty are offered. (Snook A, Schram A, Sveinsson T, Jones B. BMC Med Educ. 2019; 19: 349. Doi: 10.1186/s12909-019-1779-4. PMID: 31510995)
Prior studies have reported significant negative attitudes among both faculty and residents toward direct observation and feedback. This structured feedback program, implemented in a psychiatry continuity clinic, incorporated many of the recommended features, including protected time for direct observation and feedback within longitudinal faculty relationships. With repeated practice within a longitudinal relationship, trainees perceived the feedback as credible, described feedback as high, and valued the two-way conversation. While the program overcame many past challenges, the residents discounted disagreeable feedback, illustrating a significant limitation. (Young J, Sugarman R, Schwartz J, O’Sullivan P. Teach Learn Med. 2020; 12: 1011. Doi: 10.1080/10401334.2020.1767107. PMID: 32529844)
The MAL theoretical framework describes an integrated approach to learning that combines features of educational theory with self-regulated learning and aspects of quality improvement. This report is a culmination of discussions between medical educators participating at a national presentation discussing creating effective learning. Three themes were the adaptive educator, support for learning, and institutional commitment. Faculty must be flexible when developing MAL in the following manners: learning experiences that support active learning, focusing on groups as well as individual learners, and supporting a culture of learning with appropriate resources. (Auerbach L, Santen S, Cutrer W, Daniel M, Wilson-Delfosse A, Roberts N. Med Teach. 2020; 5: 1-5. Doi: 10.1080/0142159X.2020.1801998. PMID: 32755327)
All Dutch universities require all faculty to obtain a teaching qualification certificate. This project was conducted to better understand what is needed to enhance faculty engagement as teachers. Themes that emerged involved four challenge/solution categories – Competence, Context, Community, and Career. This requires institutional attention to not just faculty Competence needs, but also to the factors of Context, Community, and Career that comprise the culture experienced by faculty teachers. This 4 – C framework can help focus institutional attention on existing gaps in all domains and guide the development of more comprehensive solutions. (van Bruggen L, Ten Cate O, Chen HC. Teach Learn Med. 2020;Apr 6: 1-9. Doi 10.1080/10401334.2020.1742124. PMID: 32251617)
The interest for qualitative research methodology has expanded beyond theoretical academic research on medical education. It has potential in exploring the social, emotional, and psychological aspects of care and in broadening professionals’ scientific competencies. This 1-year practical training program consisted of a focused ethnography (scientific description of individual cultures) for collecting data including participant observations, field notes, semi-structured interviews, and a focus group. Broadening the perspectives of professionals in their workplace by means of learning qualitative methodology may have an evident quality improvement return. Strategies for hands-on training in continuing education are proposed. (Ghirotto L, De Panfilis L, Di Leo S. BMC Med Edu. 2020; 20: 269. Doi: 10.1186/s12909-020-02191-5).
Healthcare professionals rely on annual general meetings to obtain up-to-date information and practice guidelines. This study evaluates the quality of evidence presented during abstract sessions during a recent 5-year period at the Canadian Society of Nephrology annual meeting. The results indicate a consistent increase in quality of evidence and collaborative submissions. This assessment and analysis of meeting presentation quality can serve as a means of monitoring quality of evidence with a standardized framework for other specialty annual meetings and the research community. (Zamir N, Gholami A, Jajarmi Y, Jackson Chornenki N, Patel A, Dore K. J Contin Educ Health Prof. 2019; 39: 152-159-7. Doi: 10.1097/CEH.0000000000000244. PMID: 30908402).
William Rayburn, MD, MBA is an emeritus distinguished professor, chair of obstetrics and gynecology, and associate dean at the University of New Mexico School of Medicne, Albuquerque, NM and a clinical professor of obstetrics and gynecology and graduate studies at the Medical University of South Carolina, Charleston, SC.