BMC medical education
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BMC medical education · Sep 2019
Comparative StudyChanges of collective orientation through a medical student's anaesthesia simulation course - simulation-based training study with non-technical skills debriefing versus medical debriefing.
Non-technical skills (NTS) are known to have a positive impact on quality of medical care. The team performance enhancing behaviour, as an example for NTS, is termed "Collective Orientation" (CO). In this study, we investigated the effect of a simulator-based anaesthesia training upon student's CO in relation to medical and TeamGAINS (guided team self-correction, advocacy-inquiry and systemic-constructivist techniques) debriefing. We hypothesized (a) the scale collective orientation, as demonstrated in other team setting, is applicable to fourth year German medical students, (b) collective orientation increases by a four-hour anaesthesia simulation course, (c) the change in collective orientation can be influenced by type of debriefing. ⋯ The collective orientation questionnaire can be applied to fourth year medical students. Simulation courses influence the attitude towards teamwork. The influence is negatively to the subscale "affiliation" by a "medical debriefing" and independently regardless of the nature of the debriefing for the subscale "dominance". We recommend a debriefing for medical students using the TeamGAINS approach to clarify the connection between the individual performance and non-technical skills. Anaesthesia simulation courses have the potential being a part of a longitudinal education curriculum for teaching non-technical skills.
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BMC medical education · Sep 2019
Leadership aspirations among residents in obstetrics and gynecology in the United States: a cross-sectional analysis.
Most residents and faculty in obstetrics and gynecology (Ob/Gyn) are women. However, only a third of Ob/Gyn academic leadership positions are held by women in the United States. ⋯ Gender disparity in goal-setting toward leadership is identified as early as residency training in Ob/Gyn. This imbalance in leadership aspirations can be addressed with targeted mentorship.
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BMC medical education · Aug 2019
Comparative StudyRapid cycle deliberate practice vs. traditional simulation in a resource-limited setting.
We sought to develop a low-fidelity simulation-based curriculum for pediatric residents in Rwanda utilizing either rapid cycle deliberate practice (RCDP) or traditional debriefing, and to determine whether RCDP leads to greater improvement in simulation-based performance and in resident confidence compared with traditional debriefing. ⋯ Completion of a six-month low-fidelity simulation-based curriculum for pediatric residents in Rwanda led to statistically significant improvement in performance on a simulated resuscitation. RCDP and traditional low-fidelity simulation-based instruction may both be valuable tools to improve resuscitation skills in pediatric residents in resource-limited settings.
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BMC medical education · Aug 2019
Exploring the introduction of entrustment rating scales in an existing objective structured clinical examination.
The concept of EPAs is increasingly applied to assess trainees' workplace performance by means of entrustment ratings. OSCEs assess performance in a simulated setting, and it is unclear whether entrustment ratings can be integrated into these exams. This study explores the introduction of an entrustment rating scale into an existing OSCE. ⋯ The findings provide an empirical basis to broaden our understanding of the potential use of entrustment ratings in existing OSCEs. They provide directions for future, more specific studies. The ratings might be used for formative feedback on students' readiness for workplace practice.
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BMC medical education · Jul 2019
Learning to drive: resident physicians' perceptions of how attending physicians promote and undermine autonomy.
Providing appropriate levels of autonomy to resident physicians is an important facet of graduate medical education, allowing learners to progress toward the ultimate goal of independent practice. While studies have identified the importance of autonomy to the development of resident physicians, less is known about resident perspectives on their "lived experiences" with autonomy and ways in which clinical educators either promote or undermine it. The current study aims to provide an empirically based practical framework based on resident perspectives through which supervising physicians can attempt to more adequately foster resident physician autonomy. ⋯ Fostering autonomy is a critical aspect of medical education. Allowing residents to take the lead in the delivery of patient care while supporting them as important members of the health care team can help to promote resident autonomy in the clinical setting.