Medical education
-
Many studies have examined how educational innovations in postgraduate medical education (PGME) impact on teaching and learning, but little is known about effects in the clinical workplace outside the strictly education-related domain. Insights into the full scope of effects may facilitate the implementation and acceptance of innovations because expectations can be made more realistic, and difficulties and pitfalls anticipated. Using workplace-based assessment (WBA) as a reference case, this study aimed to determine which types of effect are perceived by users of innovations in PGME. ⋯ These outcomes are in line with theoretical notions regarding innovations in general and may be helpful in the implementation of other innovations in PGME. Given the substantial effects of innovations outside the strictly education-related domain, individuals designing and implementing innovations should consider all potential effects, including those identified in this study.
-
Remediation is usually offered to medical students and doctors in training who underperform on written or clinical examinations. However, there is uncertainty and conflicting evidence about the effectiveness of remediation. The aim of this systematic review was to synthesise the available evidence to clarify how and why remediation interventions may have worked in order to progress knowledge on this topic. ⋯ Most remediation interventions in medical education focus on improving performance to pass a re-sit of an examination or assessment and provide no insight into what types of extra support work, or how much extra teaching is critical, in terms of developing learning. More recent studies are generally of better quality. Rigorous approaches to developing and evaluating remediation interventions are required.
-
Checklists are commonly proposed tools to reduce error. However, when applied by experts, checklists have the potential to increase cognitive load and result in 'expertise reversal'. One potential solution is to use checklists in the verification stage, rather than in the initial interpretation stage of diagnostic decisions. This may avoid expertise reversal by preserving the experts' initial approach. Whether checklist use during the verification stage of diagnostic decision making improves experts' diagnostic decisions is unknown. ⋯ Among ECG interpretation experts, checklist use during the verification stage of diagnostic decisions did not increase cognitive load or cause expertise reversal, but did reduce diagnostic error.
-
Given the trend among medical students away from primary care medicine and toward specialties that allow for more controllable lifestyles, the identification of factors associated with specialty choice is important. Burnout is one such factor. The purpose of this study was to examine the associations between burnout and residency specialty choice in terms of provision for a less versus more controllable lifestyle (e.g. internal medicine versus dermatology) and a lower versus higher income (e.g. paediatrics versus anaesthesiology). ⋯ Specialty choices regarding lifestyle controllability and income were associated with the amount and type of medical school burnout, as well as with lifestyle-, prestige- and patient care-related motivation. Given that burnout may influence specialty choice, particularly with regard to the primary care specialties, medical schools may consider the utility of burnout prevention strategies.