Humility and respect: core values in medical education

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/102253/1/medu12269.pd

Using evaluation research to improve medical education

Evaluation research is a form of applied research that scrutinises how well a particular programme, practice, procedure or policy is operating. Evaluation researchers use both quantitative and qualitative research data to construct a collective picture of the programme under evaluation.Medical educators need to provide information about a particular programme using the methods of evaluation research in order to make a decision on the potential adoption, improvements and refinements of the programme. Improving curricula and pedagogical methods using these methods may enhance health care education.We provide an overview of the methods of evaluation research in the context of medical education. We discuss the application, general methodology, methods of collecting data and analysis for each type of evaluation research.The methods of evaluation research described in this article enable medical educators to gain a comprehensive understanding of evaluation research in the context of medical education. The use of evaluation research findings helps medical educators to make informed decisions regarding a programme and any future actions related to it.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/79207/1/j.1743-498X.2010.00383.x.pd

A longitudinal study of self-assessment accuracy

Although studies have examined medical students' ability to self-assess their performance, there are few longitudinal studies that document the stability of self-assessment accuracy over time. This study compares actual and estimated examination performance for three classes during their first 3 years of medical school. Methods  Students assessed their performance on classroom examinations and objective structured clinical examination (OSCE) stations. Each self-assessment was then contrasted with their actual performance using idiographic (within-subject) methods to define three measures of self-assessment accuracy: bias (arithmetic differences of actual and estimated scores), deviation (absolute differences of actual and estimated scores), and covariation (correlation of actual and estimated scores). These measures were computed for four intervals over the course of 3 years. Multivariate analyses of variance and correlational analyses were used to evaluate the stability of these measures. Results  Self-assessment accuracy measures were relatively stable over the first 2 years of medical school with a decease occurring in the third year. However, the correlational analyses indicated that the stability of self-assessment accuracy was comparable to the stability of actual performance over this same period. Conclusion  The apparent decline in accuracy in the third year may reflect the transition from familiar classroom-based examinations to the substantially different clinical examination tasks of the third year OSCE. However, the stability of self-assessment accuracy compares favorably with the stability of actual performance over this period. These results suggest that self-assessment accuracy is a relatively stable individual characteristic that may be influenced by task familiarity.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/75505/1/j.1365-2923.2003.01567.x.pd

Relationship Between Symptoms and Health‐Related Quality of Life in Patients Treated for Hypertension

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/90331/1/phco.24.4.344.33177.pd

The promise of competency-based education in the health professions for improving global health

Abstract Competency-based education (CBE) provides a useful alternative to time-based models for preparing health professionals and constructing educational programs. We describe the concept of ‘competence’ and ‘competencies’ as well as the critical curricular implications that derive from a focus on ‘competence’ rather than ‘time’. These implications include: defining educational outcomes, developing individualized learning pathways, setting standards, and the centrality of valid assessment so as to reflect stakeholder priorities. We also highlight four challenges to implementing CBE: identifying the health needs of the community, defining competencies, developing self-regulated and flexible learning options, and assessing learners for competence. While CBE has been a prominent focus of educational reform in resource-rich countries, we believe it has even more potential to align educational programs with health system priorities in more resource-limited settings. Because CBE begins with a careful consideration of the competencies desired in the health professional workforce to address health care priorities, it provides a vehicle for integrating the health needs of the country with the values of the profession.http://deepblue.lib.umich.edu/bitstream/2027.42/112402/1/12960_2012_Article_314.pd

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

Assessing the Learning Environment at the University of Michigan Medical School Through a National Collaboration

The Learning Environment Study involves 28 medical schools belonging to the Innovative Strategies for Transforming the Education of Physicians (ISTEP): an initiative founded by the American Medical Association in 2006. ISTEP is a unique medical education research collaborative that brings together individuals and institutions across the continuum of student/physician learning with a mission to foster evidence-based changes in physician education that will improve patient care. In early 2010, ISTEP developed a protocol to examine the undergraduate medical education environment: a prospective, repeated measures, longitudinal research design, employing a diverse set of established measures. The class of 2014 became the first cohort enrolled in this study, with 11 schools participating. A second cohort from the class of 2015 became the second cohort with 25 schools participating. The results reported here summarize the University of Michigan Medical School data for student empathy, patient-provider orientation, ways of coping, tolerance for ambiguity, and their perceptions of the learning environment at UMMS.http://deepblue.lib.umich.edu/bitstream/2027.42/91290/1/poster1.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/91290/3/MEDI01poster.pd

The Willed Body Donor Interview project: Medical student and donor expectations

The Anatomical Donations Program at the University of Michigan Medical School (UMMS) has begun a multiphase project wherein interviews of donors will be recorded and later shown to medical students who participate in the anatomical dissection course. The first phase of this project included surveys of both current UMMS medical students and donors concerning their perceptions of such a program. A five‐question survey administered via Qualtrics software was electronically mailed to all current medical students at UMMS, and a survey was mailed to registered and potential donors requesting information from the UMMS on anatomical donations. A total of 224 medical student responses (response rate 33%) and 54 donor responses (response rate 27%) were received. Seventy‐four percent of students and 81% of donors reported they would participate in this program if it existed. Students and donors supported the implementation of this program for varying reasons, though many felt strongly they would not want to participate in a donor interview program. These qualitative results support those of previous studies that show a majority of students desire a closer personal relationship with the donor, and these are the first results to be reported on donor perceptions of a donor interview program. Although many students and donors are in favor of instituting this program, others feel strongly that such an experience could be traumatic. The causes of these differing reactions need to be further explored, and the opinions of those who object to this study will be respected by maintaining voluntary participation in future phases of this study. Anat Sci Educ 6: 90–100. © 2012 American Association of Anatomists.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/97164/1/1326_ftp.pd

It’s worth the wait: optimizing questioning methods for effective intraoperative teaching

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/138426/1/ans14046_am.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/138426/2/ans14046.pd

Medical Students' Problem-Solving Skills Predict How They Experience Medical School

Ob jective The learning environment impacts medical students’ motivation, attitudes, academic performance, and professionalism. Aspects of the learning environment— faculty and administrative treatment of students, student social experiences, consequences for intellectual honesty and ethical integrety—constitute a “hid- den curriculum” which every medical school must strive to improve. As part of the American Medical Association’s Innovative Strategies for Transforming the Education of Physicians (ISTEP) initiative, the Learning Environment Study (LES), we sought psychological predictors of student subjective experience of the learning environment. We predicted that a measure of students’ tendency to react to difficult situations immediately upon matriculation would predict how they rated various aspects of their medical school experience at the end of their second year. Methods 155 undergraduate medical students from the classes of 2014 and 2015 com- pleted a subset of the Ways of Coping Scale (WCS: 22 items comprising 8 validated subscores, Folkman & Lazarus, 1986) at the time of matriculation and the Medical Student Learning Environment Scale (MSLES: 17 items an- alyzed individually, Rosenbaum, et al, 2007) at the end of their second year. We performed multiple regression Ratings on each MSLES item by the 8 WCS subscores. Results Social aspects of medical school were rated more positively by students with higher Planful Problem-Solving and Positive Reappraisal scores: these students make conscious efforts to actively, productively address their difficult situations. In contrast, students with high Escape Avoidance scores gave lower ratings for “Students gather together for informal activities.” Students who were more emotionally controlled (high Self-Controlling scores) found the school administration less likely to take meaningful action to support students and that students were reluctant to share their troubles with each other. Student who tend to seek Social Support when dealing with problems had difficulties finding time for interests outside of medicine and reported intense competition for grades. Conclusions Students’ experience of medical school is to some extent a function of their general approach to problem-solving. To improve the learning environment, schools should be sensitive to students’ differences in this regard. Encouraging students to use planful problem-solving and positive reappraisal may have pos- itive benefits. This analysis represents one only school and an analysis of the larger multi-institutional ISTEP LES dataset may challenge the consistency of these results across schools.http://deepblue.lib.umich.edu/bitstream/2027.42/97017/1/Stansfield2013WaysofCoping-abstract.pdfhttp://deepblue.lib.umich.edu/bitstream/2027.42/97017/3/CGEA2013-Stansfield.pd