Apprentissage par l’expérience, collaboration et réflexion : les ingrédients clés de la formation professorale longitudinale

Background: Longitudinal faculty development (LFD) may allow for increased uptake of teaching skills, especially in a forum where teachers can reflect individually and collectively on the new skills. However, the exact processes by which such interventions are effective need further exploration. Methods: This qualitative study examined an LFD initiative teaching a novel feedback approach attended by five family practice physicians. The initiative began with two 1.5-hour workshops: Goal-Oriented Feedback (as the teaching skill to be developed) and Narrative Reflection (as the tool to support personal reflection on the skill being learned). Over the subsequent six-months, the five participants iteratively applied the feedback approach in their teaching and engaged in narrative reflection at four 1-hour group sessions. Transcripts from the group discussions and exit interviews were analyzed using thematic analysis. Results: Iteratively trialing, individually reflecting on, and collectively exploring efforts to implement the new feedback approach resulted in the development of a learning community among the group. This sense of community created a safe space for reflection, while motivating ongoing efforts to learn the skill. Individual pre-reflection prepared individuals for group co-reflection; however, written narratives were not essential. Conclusion: LFD initiatives should include an emphasis on ensuring opportunities for iterative attempts of teaching skills, guided self-reflection, and collaborative group reflection and learning to ensure sustainable change to teaching practices. Contexte : La formation professorale longitudinale (FPL) peut faciliter l’acquisition d’habiletés pédagogiques, surtout dans le cadre d’un forum où les enseignants peuvent réfléchir individuellement et collectivement à ces nouvelles habiletés. Cependant, les processus exacts qui rendent ces interventions efficaces doivent être explorés davantage. Méthodes : Cette étude qualitative examine une initiative de FPL qui comprend l’enseignement d’une nouvelle approche de rétroaction à laquelle ont participé cinq médecins de famille. L’initiative a commencé avec la tenue de deux ateliers d’une heure et demie, le premier sur la rétroaction axée sur les objectifs (l’habileté d’enseignement à développer) et le deuxième sur la réflexion narrative (comme outil pour soutenir la réflexion personnelle sur cette habileté en apprentissage). Au cours des six mois suivants, les cinq participants ont appliqué de manière itérative l’approche de la rétroaction dans leur enseignement et se sont livrés à une réflexion narrative lors de quatre séances de groupe d’une heure. Des transcriptions des discussions de groupe et des entretiens de clôture ont fait l’objet d’une analyse thématique. Résultats : L’expérimentation itérative, la réflexion individuelle et l’exploration collective des efforts de mise en œuvre de la nouvelle approche de rétroaction ont permis de développer une communauté d’apprentissage au sein du groupe. Ce sentiment de communauté a créé un environnement sûr pour la réflexion, tout en motivant les efforts continus pour apprendre l’habileté. La préréflexion individuelle préparait les participants à la co-réflexion de groupe; cependant, les récits écrits n’étaient pas essentiels. Conclusion :  Les initiatives de FPL devraient mettre l’emphase sur les occasions de mise en application itérative des habiletés d’enseignement, d’autoréflexion guidée et de réflexion et d’apprentissage collaboratifs en groupe pour assurer un changement durable des pratiques d’enseignement

Preserving professional credibility: grounded theory study of medical trainees’ requests for clinical support

Objective To develop a conceptual framework of the influences on medical trainees’ decisions regarding requests for clinical support from a supervisor

Measuring Self-assessment: Current State of the Art

The competent physician pursues lifelong learning through the recognition of deficiencies and the formulation of appropriate learning goals. Despite the accepted theoretical value of self-assessment, studies have consistently shown that the accuracy of self-assessment is poor. This paper examines the methodological issues that plague the measurement of self-assessment ability and presents several strategies that address these methodological problems within the current paradigm. In addition, the article proposes an alternative conceptualization of self-assessment and describes its associated methods. The conclusions of prior research in this domain must be re-examined in light of the common pitfalls encountered in the design of the studies and the analyses of the data. Future efforts to elucidate self-assessment phenomena need to consider the implications of this review.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/41768/1/10459_2004_Article_397832.pd

Exploring the divergence between self-assessment and self-monitoring

Many models of professional self-regulation call upon individual practitioners to take responsibility both for identifying the limits of their own skills and for redressing their identified limits through continuing professional development activities. Despite these expectations, a considerable literature in the domain of self-assessment has questioned the ability of the self-regulating professional to enact this process effectively. In response, authors have recently suggested that the construction of self-assessment as represented in the self-regulation literature is, itself, problematic. In this paper we report a pair of studies that examine the relationship between self-assessment (a global judgment of one’s ability in a particular domain) and self-monitoring (a moment-by-moment awareness of the likelihood that one maintains the skill/knowledge to act in a particular situation). These studies reveal that, despite poor correlations between performance and self-assessments (consistent with what is typically seen in the self-assessment literature), participant performance was strongly related to several measures of self-monitoring including: the decision to answer or defer responding to a question, the amount of time required to make that decision to answer or defer, and the confidence expressed in an answer when provided. This apparent divergence between poor overall self-assessment and effective self-monitoring is considered in terms of how the findings might inform our understanding of the cognitive mechanisms yielding both self-monitoring judgments and self-assessments and how that understanding might be used to better direct education and learning efforts

Research in Medical Education: Balancing Service and Science*

Since the latter part of the 1990’s, the English-speaking medical education community has been engaged in a debate concerning the types of research that should have priority. To shed light on this debate and to better understand its implications for the practice of research, 23 semi-structured interviews were conducted with “influential figures” from the community. The results were analyzed using the concept of “field” developed by the sociologist Pierre Bourdieu. The results reveal that a large majority of these influential figures believe that research in medical education continues to be of insufficient quality despite the progress that has taken place over the past 2 decades. According to this group, studies tend to be both redundant and opportunistic, and researchers tend to have limited understanding of both theory and methodological practice from the social sciences. Three factors were identified by the participants to explain the current problems in research: the working conditions of researchers, budgetary restraints in financing research in medical education, and the conception of research in the medical environment. Two principal means for improving research are presented: intensifying collaboration between PhD’s and clinicians, and encouraging the diversification of perspectives brought to bear on research in medical education

The Development of an Online Practice-Based Evaluation Tool for Social Work

Objective: This paper describes the development of a practice-based evaluation (PBE) tool that allows instructors to represent their student’s clinical performance in a way that is sufficiently authentic to resonate with both instructors and students, is psychometrically sound, and is feasible in the context of real practice. Method: A new online evaluation tool was designed to address several of the problems associated with previous methods of evaluation, and was tested on 190 field instructor—student pairs. Results: Results demonstrated feasibility of the tool, high acceptability from students and faculty, high internal consistency, and clearly reduced ceiling effect, when compared with a traditional competency-based evaluation (CBE) tool. It did, however, continue to result in a strong skew toward positive evaluation and did not increase the identification of students at risk. Conclusions: The online PBE tool demonstrates promise in redressing some of the evaluation issues posed by the previous CBE model of evaluation.This research was generously supported by a grant from the Social Sciences and Humanities Research Council of Canada

Remediation in Practice:A Polarity to be Managed

ABSTRACT: Originally developed in the business literature, a polarity is a concept where 2 distinctive and opposing characteristics (poles), each presenting advantages and disadvantages or opportunities and pitfalls, must both be taken into account to ensure effective management of a challenging problem. Managing a polarity is a thorny endeavor because it entails striving to maximize the benefits of both poles while simultaneously minimizing or controlling the downsides of each. Previous investigations into stakeholder conceptualizations of remediation led us to suggest that remediation is framed in stakeholders' minds simultaneously as an educational endeavor (ie, the remediatee needs educational support to regain full competence) and a regulatory act (ie, the revocation of the individual's professional right to self-regulate their practice and learning). In this article, we argue that viewing remediation for practicing physicians as a polarity to be managed offers a framework that can further the conversation about how to address some of remediation's challenges