Teaching and learning in medicine
-
Over the past 25 years, three major forces have had a significant influence on licensure and certification: the shift in focus from educational process to educational outcomes, the increasing recognition of the need for learning and assessment throughout a physician's career, and the changes in technology and psychometrics that have opened new vistas for assessment. These forces have led to significant changes in assessment for licensure and certification. To respond to these forces, licensure and certification programs have improved the ways in which their examinations are constructed, scored, and delivered. ⋯ Finally, they have invested in research intended to validate their programs in four ways: (a) the acceptability of the program to stakeholders, (b) the extent to which stakeholders are encouraged to learn and improve, (c) the extent to which there is a relationship between performance in the programs and external measures, and (d) the extent to which there is a relationship between performance as measured by the assessment and performance in practice. Over the past 25 years, changes in licensure and certification have been driven by the educational outcomes movement, the need for lifelong learning, and advances in technology and psychometrics. Over the next 25 years, we expect these forces to continue to exert pressure for change which will lead to additional improvement and expansion in examination processes, methods of assessment, and validation research.
-
Recently, clinical diagnostic reasoning has been characterized by "dual processing" models, which postulate a fast, unconscious (System 1) component and a slow, logical, analytical (System 2) component. However, there are a number of variants of this basic model, which may lead to conflicting claims. This paper critically reviews current theories and evidence about the nature of clinical diagnostic reasoning. ⋯ Consequently, from this model, the best strategy for reducing errors is to make students aware of the biases and to encourage them to rely more on System 2. However, an accumulation of evidence suggests that (a) strategies directed at increasing analytical (System 2) processing, by slowing down, reducing distractions, paying conscious attention, and (b) strategies directed at making students aware of the effect of cognitive biases, have no impact on error rates. Conversely, strategies based on increasing application of relevant knowledge appear to have some success and are consistent with basic research on concept formation.
-
This article aims to review the past practices of educational technology and envision future directions for medical education. The discussion starts with a historical review of definitions and perspectives of educational technology, in which the authors propose that educators adopt a broader process-oriented understanding of educational technology. ⋯ As new technologies continue to arise, this process-oriented understanding and outcome-based expectations of educational technology should be embraced. With this view, educational technology should be valued in terms of how well the technological process informs and facilitates learning, and the acquisition and maintenance of clinical expertise.
-
Randomized Controlled Trial
Low cost, high yield: simulation of obstetric emergencies for family medicine training.
Simulation is now the educational standard for emergency training in residency and is particularly useful on a labor and delivery unit, which is often a stressful environment for learners given the frequency of emergencies. However, simulation can be costly. ⋯ We demonstrated the feasibility and acceptability of two low-cost obstetric emergency simulations and found that they may result in persistent increases in trainee knowledge.
-
Mentorship is critical to professional development and academic success. Unfortunately, only about 40% of medical students can identify a mentor. While group mentorship has been evaluated - the concept of a specialty specific, tiered group mentorship program (TGMP) has not. In the latter, each member of the group represents a unique education or professional level. ⋯ A tiered group mentorship program improved the ability of students to identify a mentor. Students identified mentoring relationships from individuals at various professional levels.