Thinking Beyond Measurement, Description and Judgement: Fourth Generation Evaluation in Family-Centered Pediatric Healthcare Organizations

Background: Although pediatric healthcare organizations have widely implemented the philosophy of family-centered care (FCC), evaluators and health professionals have not explored how to preserve the philosophy of FCC in evaluation processes. Purpose:  To illustrate how fourth generation evaluation, in theory, could facilitate collaboration between evaluators and families and uphold the philosophy of FCC in evaluation. Exploration focuses on describing the ways in which fourth generation evaluation is consistent with FCC and outlining a strategy for implementing it within pediatric healthcare organizations.  Discussion: Current evaluation practices used in healthcare organizations reflect what some describe as the first three generations of evaluation: measurement-, descriptive-, and judgment-oriented evaluation. While these generations encourage evaluators and health professionals to use systematic and rigorous approaches and techniques, they negate opportunities to explore issues that may surface in more flexible evaluation processes and do little to promote FCC in evaluation. Fourth generation evaluation is based on the constructivist paradigm, and its hermeneutic dialectic process moves beyond these generations, as well as the problems associated with them, to reflect the FCC notions of family participation, partnership, collaboration, respect, and joint decision-making. Conclusion: The collaborative and dialogue-oriented environment of pediatric healthcare organizations provides an ideal context for fourth generation evaluation. Although this evaluation approach is consistent with the philosophy of FCC, more research is required to understand the strengths and limitations of using it in these organizations.Keywords: family-centered care; pediatrics; fourth generation evaluation; constructivist paradig

Making Interdisciplinary Collaboration Work: Key Ideas, a Case Study and Lessons Learned

This article discusses the ‘lessons learned’ from an attempt to establish an interdisciplinary education research group. The growth, development and dissolution of the group are treated as an instrumental case study. Current literature on interdisciplinary collaboration is synthesized in order to provide a frame for analysis. Data was collected over several years and included three rounds of written participant reflections and documentation of group activities and meetings. Five major themes arose from the research, covering issues such as disciplinary diversity, common ground, interpersonal relationships, career pressures, and the need for concrete problems and tangible progress. Based on these themes, a number of ‘lessons learned’ are discussed which will likely be of great interest to those considering similar interdisciplinary initiatives.Cet article discute des «leçons apprises» d’une tentative visant l’établissement d’un groupe de recherche sur l’enseignement interdisciplinaire. La croissance, le développement et la dissolution du groupe sont présentés comme une étude de cas déterminante. Les ouvrages actuels portant sur la collaboration interdisciplinaire sont synthétisés de sorte à produire un cadre pour l’analyse. La collecte des données s’est étendue sur plusieurs années et a impliqué trois cycles de réflexions écrites par les participants et de documentation des activités de groupe et des réunions. Cinq grands thèmes ont découlé de la recherche, portant sur des questions comme la diversité disciplinaire, le terrain d’entente, les relations interpersonnelles, les pressions professionnelles, et le besoin de problèmes concrets et de progrès tangibles. À partir de ces thèmes, on discute de plusieurs «leçons apprises» qui intéresseront sans doute ceux qui envisagent des initiatives interdisciplinaires similaires

Thinking Beyond Measurement, Description and Judgement: Fourth Generation Evaluation in Family-Centered Pediatric Healthcare Organizations

Background: Although pediatric healthcare organizations have widely implemented the philosophy of family-centered care (FCC), evaluators and health professionals have not explored how to preserve the philosophy of FCC in evaluation processes. Purpose:  To illustrate how fourth generation evaluation, in theory, could facilitate collaboration between evaluators and families and uphold the philosophy of FCC in evaluation. Exploration focuses on describing the ways in which fourth generation evaluation is consistent with FCC and outlining a strategy for implementing it within pediatric healthcare organizations.  Discussion: Current evaluation practices used in healthcare organizations reflect what some describe as the first three generations of evaluation: measurement-, descriptive-, and judgment-oriented evaluation. While these generations encourage evaluators and health professionals to use systematic and rigorous approaches and techniques, they negate opportunities to explore issues that may surface in more flexible evaluation processes and do little to promote FCC in evaluation. Fourth generation evaluation is based on the constructivist paradigm, and its hermeneutic dialectic process moves beyond these generations, as well as the problems associated with them, to reflect the FCC notions of family participation, partnership, collaboration, respect, and joint decision-making. Conclusion: The collaborative and dialogue-oriented environment of pediatric healthcare organizations provides an ideal context for fourth generation evaluation. Although this evaluation approach is consistent with the philosophy of FCC, more research is required to understand the strengths and limitations of using it in these organizations.Keywords: family-centered care; pediatrics; fourth generation evaluation; constructivist paradig

Life imitating art: Depictions of the hidden curriculum in medical television programs

Abstract Background The hidden curriculum represents influences occurring within the culture of medicine that indirectly alter medical professionals’ interactions, beliefs and clinical practices throughout their training. One approach to increase medical student awareness of the hidden curriculum is to provide them with readily available examples of how it is enacted in medicine; as such the purpose of this study was to examine depictions of the hidden curriculum in popular medical television programs. Methods One full season of ER, Grey’s Anatomy and Scrubs were selected for review. A summative content analysis was performed to ascertain the presence of depictions of the hidden curriculum, as well as to record the type, frequency and quality of examples. A second reviewer also viewed a random selection of episodes from each series to establish coding reliability. Results The most prevalent themes across all television programs were: the hierarchical nature of medicine; challenges during transitional stages in medicine; the importance of role modeling; patient dehumanization; faking or overstating one’s capabilities; unprofessionalism; the loss of idealism; and difficulties with work-life balance. Conclusions The hidden curriculum is frequently depicted in popular medical television shows. These examples of the hidden curriculum could serve as a valuable teaching resource in undergraduate medical programs

Additional file 1: of Life imitating art: Depictions of the hidden curriculum in medical television programs

Emergent coding scheme and hidden curriculum examples by series, episode and time. (DOC 94 kb

Faculty experiences regarding a global partnership for anesthesia postgraduate training: a qualitative study

PURPOSE: Partnerships for postgraduate medical education between institutions in high-income countries and low- and middle-income countries are increasingly common models that can create capacity in human resources for health. Nevertheless, data are currently limited to guide the development of this kind of educational program. METHODS: We conducted semi-structured interviews with visiting and local faculty members in the externally supported University of Zambia Master of Medicine Anesthesia Program. Interviews were thematically analyzed with qualitative methodology. RESULTS: Respondents spoke of differences in clinical practice, including resource limitations, organizational issues, presentation and comorbidities of patients, surgical techniques, and cultural issues relating to communication and teamwork. A key theme was communication amongst distributed visiting faculty. Infrequent face-to-face meetings jeopardized programmatic learning and the consistency of teaching and assessment. Co-learning was considered central to the development of a new program, as visiting faculty had to adapt to local challenges while establishing themselves as visiting experts. An ongoing challenge for faculty was determining when to adapt to the local context to facilitate patient care and when to insist on familiar standards of practice in order to advocate for patient safety. CONCLUSIONS: As a new and evolving program, the findings from this study highlight challenges and opportunities for faculty as part of a partnership for postgraduate medical education. Since maintaining an effective faculty is essential to ensure the sustainability of any teaching program, this work may help other similar programs to anticipate and overcome potential challenge