2018 Ottawa consensus statement : Selection and recruitment to the healthcare professions

Acknowledgments: The authors thank Tom Kinirons and Sarah Stott of Work Psychology Group for supporting the consensus group discussions and workshops, and in preparing the final manuscript. We also gratefully acknowledge Professor Lambert Schuwirth for his helpful comments on an earlier draft of this paperPeer reviewedPostprin

The Hidden Curriculum of Veterinary Education: Mediators and Moderators of Its Effects

The “hidden curriculum” has long been supposed to have an effect on students' learning during their clinical education, and in particular in shaping their ideas of what it means to be a professional. Despite this, there has been little evidence linking specific changes in professional attitudes to the individual components of the hidden curriculum. This study aimed to recognize those components that led to a change in students' professional attitudes at a UK veterinary school, as well as to identify the attitudes most affected. Observations were made of 11 student groups across five clinical rotations, followed by semi-structured interviews with 23 students at the end of their rotation experience. Data were combined and analyzed thematically, taking both an inductive and deductive approach. Views about the importance of technical competence and communication skills were promoted as a result of students' interaction with the hidden curriculum, and tensions were revealed in relation to their attitudes toward compassion and empathy, autonomy and responsibility, and lifestyle ethic. The assessment processes of rotations and the clinical service organization served to communicate the messages of the hidden curriculum, bringing about changes in student professional attitudes, while student-selected role models and the student rotation groups moderated the effects of these influences

Exploring the tensions of being and becoming a medical educator

BackgroundPrevious studies have identified tensions medical faculty encounter in their roles but not specifically those with a qualification in medical education. It is likely that those with postgraduate qualifications may face additional tensions (i.e., internal or external conflicts or concerns) from differentiation by others, greater responsibilities and translational work against the status quo. This study explores the complex and multi-faceted tensions of educators with qualifications in medical education at various stages in their career.MethodsThe data described were collected in 2013–14 as part of a larger, three-phase mixed-methods research study employing a constructivist grounded theory analytic approach to understand identity formation among medical educators. The over-arching theoretical framework for the study was Communities of Practice. Thirty-six educators who had undertaken or were undertaking a postgraduate qualification in medical education took part in semi-structured interviews.ResultsParticipants expressed multiple tensions associated with both becoming and being a healthcare educator. Educational roles had to be juggled with clinical work, challenging their work-life balance. Medical education was regarded as having lower prestige, and therefore pay, than other healthcare career tracks. Medical education is a vast speciality, making it difficult as a generalist to keep up-to-date in all its areas. Interestingly, the graduates with extensive experience in education reported no fears, rather asserting that the qualification gave them job variety.ConclusionThis is the first detailed study exploring the tensions of educators with postgraduate qualifications in medical education. It complements and extends the findings of the previous studies by identifying tensions common as well as specific to active students and graduates. These tensions may lead to detachment, cynicism and a weak sense of identity among healthcare educators. Postgraduate programmes in medical education can help their students identify these tensions in becoming and develop coping strategies. Separate career routes, specific job descriptions and academic workload models for medical educators are recommended to further the professionalisation of medical education

More mentoring needed? A cross-sectional study of mentoring programs for medical students in Germany

<p>Abstract</p> <p>Background</p> <p>Despite increasing recognition that mentoring is essential early in medical careers, little is known about the prevalence of mentoring programs for medical students. We conducted this study to survey all medical schools in Germany regarding the prevalence of mentoring programs for medical students as well as the characteristics, goals and effectiveness of these programs.</p> <p>Methods</p> <p>A definition of mentoring was established and program inclusion criteria were determined based on a review of the literature. The literature defined mentoring as a steady, long-lasting relationship designed to promote the mentee's overall development. We developed a questionnaire to assess key characteristics of mentoring programs: the advocated mentoring model, the number of participating mentees and mentors, funding and staff, and characteristics of mentees and mentors (e.g., level of training). In addition, the survey characterized the mentee-mentor relationship regarding the frequency of meetings, forms of communication, incentives for mentors, the mode of matching mentors and mentees, and results of program evaluations. Furthermore, participants were asked to characterize the aims of their programs. The questionnaire consisted of 34 questions total, in multiple-choice (17), numeric (7) and free-text (10) format. This questionnaire was sent to deans and medical education faculty in Germany between June and September 2009. For numeric answers, mean, median, and standard deviation were determined. For free-text items, responses were coded into categories using qualitative free text analysis.</p> <p>Results</p> <p>We received responses from all 36 medical schools in Germany. We found that 20 out of 36 medical schools in Germany offer 22 active mentoring programs with a median of 125 and a total of 5,843 medical students (6.9 - 7.4% of all German medical students) enrolled as mentees at the time of the survey. 14 out of 22 programs (63%) have been established within the last 2 years. Six programs (27%) offer mentoring in a one-on-one setting. 18 programs (82%) feature faculty physicians as mentors. Nine programs (41%) involve students as mentors in a peer-mentoring setting. The most commonly reported goals of the mentoring programs include: establishing the mentee's professional network (13 programs, 59%), enhancement of academic performance (11 programs, 50%) and counseling students in difficulties (10 programs, 45%).</p> <p>Conclusions</p> <p>Despite a clear upsurge of mentoring programs for German medical students over recent years, the overall availability of mentoring is still limited. The mentoring models and goals of the existing programs vary considerably. Outcome data from controlled studies are needed to compare the efficiency and effectiveness of different forms of mentoring for medical students.</p

Mentoring programs for medical students - a review of the PubMed literature 2000 - 2008

Abstract Background Although mentoring is acknowledged as a key to successful and satisfying careers in medicine, formal mentoring programs for medical students are lacking in most countries. Within the framework of planning a mentoring program for medical students at Zurich University, an investigation was carried out into what types of programs exist, what the objectives pursued by such programs are, and what effects are reported. Methods A PubMed literature search was conducted for 2000 - 2008 using the following keywords or their combinations: mentoring, mentoring program, medical student, mentor, mentee, protégé, mentorship. Although a total of 438 publications were identified, only 25 papers met the selection criteria for structured programs and student mentoring surveys. Results The mentoring programs reported in 14 papers aim to provide career counseling, develop professionalism, increase students' interest in research, and support them in their personal growth. There are both one-to-one and group mentorships, established in the first two years of medical school and continuing through graduation. The personal student-faculty relationship is important in that it helps students to feel that they are benefiting from individual advice and encourages them to give more thought to their career choices. Other benefits are an increase in research productivity and improved medical school performance in general. Mentored students also rate their overall well-being as higher. - The 11 surveys address the requirements for being an effective mentor as well as a successful mentee. A mentor should empower and encourage the mentee, be a role model, build a professional network, and assist in the mentee's personal development. A mentee should set agendas, follow through, accept criticism, and be able to assess performance and the benefits derived from the mentoring relationship. Conclusion Mentoring is obviously an important career advancement tool for medical students. In Europe, more mentoring programs should be developed, but would need to be rigorously assessed based on evidence of their value in terms of both their impact on the career paths of juniors and their benefit for the mentors. Medical schools could then be monitored with respect to the provision of mentorships as a quality characteristic.</p

A longitudinal study of the characteristics and performances of medical students and graduates from the Arab countries

BACKGROUND: While international physician migration has been studied extensively, more focused and regional explorations are not commonplace. In many Arab countries, medical education is conducted in English and students/graduates seek postgraduate opportunities in other countries such as the United States (US). Eligibility for residency training in the US requires certification by the Educational Commission for Foreign Medical Graduates (ECFMG). This study investigates ECFMG application trends, examination performance, and US physician practice data to quantify the abilities and examine the career pathways of Arab-trained physicians. METHODS: Medical students and graduates from 15 Arab countries where English is the language of medical school instruction were studied. The performances (1(st) attempt pass rates) of individuals on the United States Medical Licensing Examination Step 1, Step 2CK (clinical knowledge), and and a combination of Step 2CS (clinical skills) and ECFMG CSA (clinical skills assessment) were tallied and contrasted by country. Based on physician practice data, the contribution of Arab-trained physicians to the US healthcare workforce was explored. Descriptive statistics (means, frequencies) were used to summarize the collected data. RESULTS: Between 1998 and 2012, there has been an increase in the number of Arab trained students/graduates seeking ECFMG certification. Examination performance varied considerably across countries, suggesting differences in the quality of medical education programs in the Eastern Mediterranean Region. Based on current US practice data, physicians from some Arab countries who seek postgraduate opportunities in the US are less likely to stay in the US following specialty training. CONCLUSION: Countries, or regions, with concerns about physician migration, physican performance, or the pedagogical quality of their training programs should conduct longitudinal research studies to help inform medical education policies

Die 60% Bestehensgrenze überwinden und die Qualität der Prüfungen verbessern

It is not unusual for institutions around the world to have fixed standards (e.g., 60%) for all of their examinations. This creates problems in the creation of examinations, since all of the content has to be chosen with an eye toward this fixed standard. As a result, the validity of the decisions based on these examinations can be adversely influenced, making them less useful for their intended purposes. Over the past several decades, many institutions have addressed this problem by using standard setting methods which are defensible, acceptable, and credible , . Many methods are available and the major reasons to use them is to ensure that test content is appropriately selected and to be as fair to the students and other test users as possible , . One barrier to the wider use of these methods is that some institutions object to the fact that the fixed standard (e.g., 60%) has not been applied. However, it is possible to rescale the passing score so that it is equal to the fixed standard, and then apply that same rescaling calculation to all of the test scores. This ensures that the institutional guidelines are not violated and allows the application of accepted methods of standard-setting. In turn, the application of these methods allow the content of the test to be selected without regard to a fixed standard, increases the validity of the decisions being made, and ensures a fairer and more accurate test of students.Es ist weltweit häufig üblich, formale Bestehensgrenzen (z. B. 60%) für alle Prüfungen festzulegen. Dies führt zu Problemen bei der Entwicklung von Prüfungen, da der gesamte Inhalt der Prüfung im Hinblick auf diesen festgelegten Standard abzustimmen ist. Infolgedessen kann die Validität der Entscheidungen, die auf diesen Prüfungen fußen, nachteilig beeinflusst werden und den Nutzen für ihren beabsichtigten Verwendungszweck einschränken.Im Laufe der letzten Jahrzehnte begegneten viele Institute diesem Problem durch die Verwendung von Verfahren des "Standard-Settings", also Festlegungen der Bestehensgrenzen, die vertretbar, akzeptabel und zuverlässig sind , . Hierzu steht eine Vielzahl an Methoden zur Verfügung und die Hauptgründe, diese zu nutzen, bestehen darin, sicherzustellen, dass der Testinhalt adäquat ausgewählt und so fair wie möglich gegenüber den Studierenden und anderen Testanwendern ist , .Ein Hindernis für die breitere Anwendung dieser Verfahren ist, dass vielerorts die Tatsache beanstandet wird, dass dabei die formal festgesetzte Bestehensgrenze (z. B. 60%) nicht eingehalten wird. Es ist jedoch möglich, durch Umskalierungen die Bestehensgrenze neu zu definieren, so dass diese dem festgelegten Standard entspricht und dieselbe Skalierung auf alle Testergebnisse anwendet. Dies stellt sicher, dass die institutionellen Richtlinien nicht verletzt werden und ermöglicht die Anwendung der anerkannten Verfahren des Standard-Settings. Im Gegenzug gestattet die Anwendung dieser Verfahren die Auswahl der Prüfungsinhalte ohne Berücksichtigung des festgelegten Standards, was die Validität der getroffenen Entscheidungen erhöht und eine gerechtere und genauere Prüfung der Studierenden ermöglich