Medical teacher
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Physicians' empathy is generally regarded as important and attempts are made to foster empathy. However, research indicates that the medical students' empathy is often stunted during medical education, and our understanding of how empathy is modulated during medical education is limited. This critical review explores some relatively-neglected challenges in the literature on empathy development in medical education. ⋯ This may contribute to sustain a double-blinded, dichotomized clinical gaze--a clinical gaze that tends to separate biomedical aspects from human experience and understanding and to neglect existential aspects of both the physician and the patient. Empathy training and the humanities should not be situated outside the hard core of medicine, but rather foster critical discussions of the limits and strengths of biomedical paradigms throughout medicine. In this way, the gap between biomedicine and the humanities could be bridged, and empathy training could contribute both in developing physicians' general clinical perception and judgement and in preventing the widespread stunting of empathy.
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The UK General Medical Council (GMC) in its regulatory capacity conducts formal tests of competence (TOCs) on doctors whose performance is of concern. TOCs are individually tailored to each doctor's specialty and grade. ⋯ The blueprint described was easy to construct and is easy to use. It reflects the knowledge, skills and behaviours (learning outcomes) to be assessed. It guides commissioning of test material and enables the systematic and faithful sampling of common and important problems. The principles described have potential for wider application to blueprinting in undergraduate or clinical training programmes. Such a blueprint can provide the essential link between a curriculum and its assessment system and ensure that assessment content is stable over time.
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The portfolio assessment process is important for assessing learner achievement. ⋯ The 12 exit learning outcomes of Dundee curriculum provide an appropriate framework for the portfolio assessment process, but the content of the portfolio requires fine-tuning particularly with regard to quantity. Time allocated to examiners for the portfolio assessment process needs to be balanced against practicability. The holistic picture of the candidate provided by the process was one of its strengths.
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Usability testing is widely used in the commercial world during the process of developing new products, especially software and websites. However, it appears to be rarely used in the development of e-learning in medical education. ⋯ Testing under the conditions that the e-learning intervention will typically be used is the preferred method but more extreme situations can provide useful information. Product development should be iterative and rapid cycles of testing and refinement are essential to produce an effective e-learning intervention.
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Competency-based education in the health care professions has become a prominent approach to postgraduate training in Canada, the Netherlands, the United Kingdom, the United States, and many other countries. Competency frameworks devised at national and international levels have been well received, and in many cases mandated, by governing bodies. However, the teaching and assessment of competencies pose questions of practicality, validity, and reliability. ⋯ Competencies and "entrustable professional activities" (EPAs) relate to each other as two dimensions of a grid in which each EPA can be mapped back to a number of competencies. This backward visioning from EPAs to competencies is proposed as a guide to curriculum planning and assessment. The authors discuss experiences with this conceptual model in research, curriculum development and learner assessment.