Developing residents’ feedback literacy in emergency medicine: Lessons from design-based research

Objectives: Residents in emergency medicine have reported dissatisfaction with feedback. One strategy to improve feedback is to enhance learners’ feedback literacy—i.e., capabilities as seekers, processors, and users of performance information. To do this, however, the context in which feedback occurs needs to be understood. We investigated how residents typically engage with feedback in an emergency department, along with the potential opportunities to improve feedback engagement in this context. We used this information to develop a program to improve learners’ feedback literacy in context and traced the reported translation to practice. Methods: We conducted a year-long design-based research study informed by agentic feedback principles. Over five cycles in 2019, we interviewed residents and iteratively developed a feedback literacy program. Sixty-six residents participated and data collected included qualitative evaluation surveys (n = 55), educator-written reflections (n = 5), and semistructured interviews with residents (n = 21). Qualitative data were analyzed using framework analysis. Results: When adopting an agentic stance, residents reported changes to the frequency and tenor of their feedback conversations, rendering the interactions more helpful. Despite reporting overall shifts in their conceptions of feedback, they needed to adjust their feedback engagement depending on changing contextual factors such as workload. These microsocial adjustments suggest their feedback literacy develops through an interdependent process of individual intention for feedback engagement—informed by an agentic stance—and dynamic adjustment in response to the environment. Conclusions: Resident feedback literacy is profoundly contextualized, so developing feedback literacy in emergency contexts is more nuanced than previously reported. While feedback literacy can be supported through targeted education, our findings raise questions for understanding how emergency medicine environments afford and constrain learner feedback engagement. Our findings also challenge the extent to which this contextual feedback know-how can be “developed” purposefully outside of the everyday work.</p

I vælten: kulturanalysens nye hverdag

In vogue: the new everyday of cultural analysis   Based on two examples from user-driven innovation projects, we discuss what it means to undertake cultural analysis when the task is to change practices of everyday life. Whether it is about new garbage bins or new bathrooms, the examples enable us to demonstrate how and why companies and public-sector institutions are increasingly inviting cultural analysts to contribute to their work. At the same time, the examples allow us to illustrate some of the difficulties that cultural analysts experience when they – in the name of change – begin to scrutinise and ‘stir up’ the practices of everyday life; for instance, by studying how citizens with disabilities handle garbage and personal hygiene. What happens, we ask, when cultural analysis is called upon to inform the ways in which such complex practices might change? Through our two examples, we show how the difficulty relates to balancing a desire for change with a respect for the durable structures and fundamental differences of everyday life. One of the main objectives of cultural analysis is to identify and describe such structures and differences, and then to bring our insights to the attention of various stakeholders. As a result, cultural analysis – often via ethnographic fieldwork – brings citizens and users into being. This cannot always be fitted into the predefined range of possibilities that many change-oriented projects – consciously or unconsciously – operate within

“Thinking on your feet”—a qualitative study of debriefing practice

Background: Debriefing is a significant component of simulation-based education (SBE). Regardless of how and where immersive simulation is used to support learning, debriefing has a critical role to optimise learning outcomes. Although the literature describes different debriefing methods and approaches that constitute effective debriefing, there are discrepancies as to what is actually practised and how experts or experienced debriefers perceive and approach debriefing. This study sought to explore the self-reported practices of expert debriefers.Methods: We used a qualitative approach to explore experts&rsquo; debriefing practices. Peer-nominated expert debriefers who use immersive manikin-based simulations were identified in the healthcare simulation community across Australia. Twenty-four expert debriefers were purposively sampled to participate in semi-structured telephone interviews lasting 45&ndash;90 min. Interviews were transcribed and independently analysed using inductive thematic analysis.Results: Codes emerging through the data analysis clustered into four major categories: (1) Values: ideas and beliefs representing the fundamental principles that underpinned interviewees&rsquo; debriefing practices. (2) Artistry: debriefing practices which are dynamic and creative. (3) Techniques: the specific methods used by interviewees to promote a productive and safe learning environment. (4) Development: changes in interviewees&rsquo; debriefing practices over time.Conclusions: The &ldquo;practice development triangle&rdquo; inspired by the work of Handal and Lauvas offers a framework for our themes. A feature of the triangle is that the values of expert debriefers provide a foundation for associated artistry and techniques. This framework may provide a different emphasis for courses and programmes designed to support debriefing practices where microskill development is often privileged, especially those microskills associated with techniques (plan of action, creating a safe environment, managing learning objectives, promoting learner reflection and co-debriefing). Across the levels in the practice development triangle, the importance of continuing professional development is acknowledged. Strengths and limitations of the study are noted

I vælten: kulturanalysens nye hverdag

In vogue: the new everyday of cultural analysis   Based on two examples from user-driven innovation projects, we discuss what it means to undertake cultural analysis when the task is to change practices of everyday life. Whether it is about new garbage bins or new bathrooms, the examples enable us to demonstrate how and why companies and public-sector institutions are increasingly inviting cultural analysts to contribute to their work. At the same time, the examples allow us to illustrate some of the difficulties that cultural analysts experience when they – in the name of change – begin to scrutinise and ‘stir up’ the practices of everyday life; for instance, by studying how citizens with disabilities handle garbage and personal hygiene. What happens, we ask, when cultural analysis is called upon to inform the ways in which such complex practices might change? Through our two examples, we show how the difficulty relates to balancing a desire for change with a respect for the durable structures and fundamental differences of everyday life. One of the main objectives of cultural analysis is to identify and describe such structures and differences, and then to bring our insights to the attention of various stakeholders. As a result, cultural analysis – often via ethnographic fieldwork – brings citizens and users into being. This cannot always be fitted into the predefined range of possibilities that many change-oriented projects – consciously or unconsciously – operate within

Analyse af elbilers forbrug

Det er et mål for EU at opnå en kraftig reduktion i udledningen af CO2 fra transportsektoren. Elbiler kan være en af måderne at opnå dele af denne reduktion fordi det er muligt at oplade elbiler med strøm fra vedvarende energikilder så som vindmøller. En væsentlig udfordring med at erstatte brændstofbiler med elbiler er, at elbilerne har en betydelig kortere rækkevidde. Denne artikel anvender GPS data fra 164 elbiler og 447 brændstofbiler til at undersøge om der er forskelle på, hvordan elbiler og brændstofbiler anvendes og hvilke hastigheder de kører med. Herudover anvendes forbrugsdata (CAN bus data) fra elbiler til at vurdere på den faktiske rækkevidde for disse biler. Hovedkonklusionerne er, at ture i elbiler generelt er lidt kortere, at elbiler kører lidt stærkere i byerne, men betydeligt langsommere på motorvejene. For rækkevidden af elbiler konkluderes det, at dette er meget afhængigt af årstiden (temperaturen) og spænder fra 77 km (vinteren) til 130 km (sommeren) for den type af elbiler undersøgt i denne artikel

Az elektronikus írásbeliség és problémái

In situ plan. (PDF 1566 kb