Advances in Health Sciences Education

Medical school admissions is a contentious and high stakes selection activity. Many assessment approaches are available to support selection; but how are decisions about building, monitoring, and adapting admissions systems made? What shapes the processes and practices that underpin selection decisions? We explore how these decisions are made across several Canadian medical schools, and how values shape the creation, monitoring, and adaptation of admissions systems. Using phenomenography (a qualitative method suited to examining variability), the authors analyzed interviews with 10 current or previous heads of admissions from 10 different undergraduate medical education programs in Canada...

Even though past research suggests that visual learning may benefit from conceptual knowledge, current interventions for medical image evaluation often focus on procedural knowledge, mainly by teaching classification algorithms. We compared the efficacy of pure procedural knowledge (three-point checklist for evaluating skin lesions) versus combined procedural plus conceptual knowledge (histological explanations for each of the three points). All students then trained their classification skills with a visual learning resource that included images of two types of pigmented skin lesions: benign nevi and malignant melanomas...

Becoming a healthcare professional is a complex process, where learning occurs in various ways. This study explores an extracurricular learning approach, called the Social Health Bridge-Building Programme, designed to address health inequities. Student volunteers accompany persons in a socially vulnerable situation to healthcare appointments. Operating outside the realms of health education, the programme intends to provide an alternative road to training healthcare students to become capable of engaging with diverse populations, and reducing barriers to healthcare access...

To explore the existing literature on the effect of Interprofessional Education (IPE) on the work environment of health professionals. The research question was systematized according to the PCC (Population, Concept, and Context) format. A scoping review was performed. A search of multiple bibliographic databases identified 407 papers, of which 21 met the inclusion criteria. The populations of the 21 studies reviewed were composed of professionals in the fields of medicine, nursing, psychology, occupational therapy, physiotherapy, and social work, among others...

This column is intended to address the kinds of knotty problems and dilemmas with which many scholars grapple in studying health professions education. In this article, the authors conclude their short series of articles on academic authorship by addressing the question of how to determine author order, including taking into account power dynamics that may be at play.

Oncology residents routinely engage in ethically complex decision-making discussions with patients, while observing and interacting with their teaching consultant. If clinical competency in oncology decision-making guidance is to be taught deliberately and effectively, it is necessary to understand resident experiences in this context to develop appropriate educational and faculty development initiatives. Four junior and two senior postgraduate oncology residents participated in semi-structured interviews during October and November 2021 which explored their experiences of real-world decision-making scenarios...

Consumer and community involvement (also referred to as patient and public involvement) in health-related curricula involves actively partnering with people with lived experience of health and social care systems. While health professions education has a long history of interaction with patients or consumers, a shift in the way consumer and community engage in health-related education has created novel opportunities for mutual relationships valuing lived experience expertise and shifting traditional education power relations...

Scholarly practice (SP) is considered a key competency of occupational therapy and physiotherapy. To date, the three sectors-education/research, practice, and policy/regulation-that support SP have been working relatively independently. The goals of this project were to (a) understand how representatives of the three sectors conceptualize SP; (b) define each sector's individual and collective roles in supporting SP; (c) identify factors influencing the enactment of SP and the specific needs of how best to support SP; and (d) co-develop goals and strategies to support SP across all sectors...

First impressions can influence rater-based judgments but their contribution to rater bias is unclear. Research suggests raters can overcome first impressions in experimental exam contexts with explicit first impressions, but these findings may not generalize to a workplace context with implicit first impressions. The study had two aims. First, to assess if first impressions affect raters' judgments when workplace performance changes. Second, whether explicitly stating these impressions affects subsequent ratings compared to implicitly-formed first impressions...

In this editorial, the editor considers issues of trust, accountability, and verification in the work of scholars, institutions, and journals, and challenges readers to examine the interdependencies of trust, accountability, and verification in shaping the field of health professions education.

Research has demonstrated erosion of empathy in students during medical education. Particularly, U.S. studies have demonstrated empathy declines during clinical training in the third and fourth year of traditional medical programs. Yet, studies conducted outside the U.S. have not confirmed this trend. Timing and extent of patient interactions have been identified as empathy-protective factors. The need to examine empathy within different learning contexts has been noted, as has the need for longitudinal and time-series research designs to analyze trajectories...

Health sciences students face many challenges in regard to clinical practical learning. A better understanding of student learning is required to address student needs in this crucial phase. The theory of self-regulated learning provides a comprehensive view of learning and could serve as a basis for further research. There are instruments to assess self-regulated learning in preclinical academic learning. However, there are no such instruments for workplace learning. The aim of the present study is to provide a comprehensive inventory from which researchers can select those scales that are relevant to their research questions in the investigation of workplace learning...

Medical improvisation (improv) applies theater principles and techniques to improve communication and teamwork with health professionals (HP). Improv curricula have increased over time, but little is known about best practices in curricula development, implementation, and assessment. We sought to complete a state-of-the-art review of medical improv curricula to teach HP learners communication skills. A literature search of MEDLINE and 8 other databases on HP medical education and medical improv communication curricula occurred...

To emphasize to learners how factors outside individual control impact health, scholars introduced the concept of structural competency. Structural competency refers to the development of analytical skills that reveal the larger societal context beyond the patient-clinician interaction that shapes health outcomes. The growing adoption of structural competency curricula, however, has revealed that prelicensure and early career health professionals can feel overwhelmed by the mismatch between the wide scale of entrenched problems and the limited scope of their therapeutic skills...

Simulation is accepted as an effective method of learning procedural skills. However, the translational outcomes of skills acquired through simulation still warrants investigation. We designed this study to assess if skills laboratory training in addition to bedside learning (intervention group [IG]) would provide better learning results than bedside learning alone (control group [CG]) in the context of venipuncture training. This prospective, cluster-randomized, single-blind study took place at the Faculty of Medicine, University of Kelaniya, Sri Lanka...

Recently, a new digital clinical reasoning test (DCRT) was developed to evaluate students' clinical-reasoning skills. Although an assessment tool may be soundly constructed, it may still prove inadequate in practice by failing to function as intended. Therefore, more insight is needed into the effects of the DCRT in practice. Individual semi-structured interviews and template analysis were used to collect and process qualitative data. The template, based on the interview guide, contained six themes: (1) DCRT itself, (2) test debriefing, (3) reflection, (4) practice/workplace, (5) DCRT versus practice and (6) 'other'...

Objective structured clinical examination (OSCE) is widely used to assess medical students' clinical skills. Virtual OSCEs were used in place of in-person OSCEs during the COVID-19 pandemic; however, their reliability is yet to be robustly analyzed. By applying generalizability (G) theory, this study aimed to evaluate the reliability of a hybrid OSCE, which admixed in-person and online methods, and gain insights into improving OSCEs' reliability. During the 2020-2021 hybrid OSCEs, one examinee, one rater, and a vinyl mannequin for physical examination participated onsite, and a standardized simulated patient (SP) for medical interviewing and another rater joined online in one virtual breakout room on an audiovisual conferencing system...

Health professions educators often use social media to share knowledge; however, it is unclear what specific dissemination and knowledge translation (KT) processes are occurring and the implications of this sharing for health professions education (HPE). This study explored how educators have used social media as a mechanism of dissemination and KT in the literature. A critical scoping review methodology, informed by Engeström's Activity Theory, was employed. Twelve databases were searched and studies that: (a) addressed health professions educators; (b) described the use of social media for dissemination or KT; (c) focused on a regulated health profession; (d) focused on undergraduate or graduate education; and (e) were published in English or French between 2011 and 2021 were included...

Quantitative measures of systematic differences in OSCE scoring across examiners (often termed examiner stringency) can threaten the validity of examination outcomes. Such effects are usually conceptualised and operationalised based solely on checklist/domain scores in a station, and global grades are not often used in this type of analysis. In this work, a large candidate-level exam dataset is analysed to develop a more sophisticated understanding of examiner stringency. Station scores are modelled based on global grades-with each candidate, station and examiner allowed to vary in their ability/stringency/difficulty in the modelling...

Perfectionism is a personality orientation associated with mental health and adjustment problems. Recent evidence demonstrates that perfectionism is widespread among students and on the rise, with recent generations of students placing increasingly more importance on perfection. Whilst the extant literature is vast, it tends to focus on psychopathology and identification of perfectionism correlates rather than the experience of student perfectionism. Furthermore, the education literature is scant and there is a need to understand the deeper processes and nuances of perfectionism, particularly within health professions education where intense study demands, competition to gain entry to educational programmes, and professional cultures may nurture the problem...