To fail is human: remediating remediation in medical education.

IntroductionRemediating failing medical learners has traditionally been a craft activity responding to individual learner and remediator circumstances. Although there have been moves towards more systematic approaches to remediation (at least at the institutional level), these changes have tended to focus on due process and defensibility rather than on educational principles. As remediation practice evolves, there is a growing need for common theoretical and systems-based perspectives to guide this work.MethodsThis paper steps back from the practicalities of remediation practice to take a critical systems perspective on remediation in contemporary medical education. In doing so, the authors acknowledge the complex interactions between institutional, professional, and societal forces that are both facilitators of and barriers to effective remediation practices.ResultsThe authors propose a model that situates remediation within the contexts of society as a whole, the medical profession, and medical education institutions. They also outline a number of recommendations to constructively align remediation principles and practices, support a continuum of remediation practices, destigmatize remediation, and develop institutional communities of practice in remediation.DiscussionMedical educators must embrace a responsible and accountable systems-level approach to remediation if they are to meet their obligations to provide a safe and effective physician workforce

The Calgary student run clinic in context: a mixed-methods case study

Background: Student Run Clinics (SRCs) provide students with clinical education while caring for underserved populations. While much of the research on SRCs comes from the USA, SRCs in other contexts need to be appraised in the context of the systems they interact with. This study explored how stakeholders in the University of Calgary’s SRC perceived its purpose and beneficiaries with respect to patients, students, undergraduate medical education, and its intersections within the healthcare system in Calgary.  Methods: Data came from the SRC’s EMR and stakeholder interviews at the Inn from the Cold (IFTC) shelter. Qualitative data were analyzed using standard grounded theory techniques. Results: There were 13 interviews - seven with student clinicians and six with preceptors and other stakeholders. Interviews highlighted the uncertainty of the SRCs role. Majority of participants saw the SRC as facilitating further access to other healthcare services, while some commented on its primarily education-focused role. Major limitations in the SRC’s scope of care and its integration with other services were identified. Conclusion: SRCs need to consider theiraccountabilities, both educational and healthcare-focused at individual and organization levels, in order to function as responsible healthcare providers in Calgary

Discourses of student orientation to medical education programs

Background: Although medical students’ initial orientation is an important point of transition in medical education, there is a paucity of literature on the subject and major variations in the ways that different institutions orient incoming medical students to their programs. Methods: We conducted a discourse analysis of medical education orientation in the literature and on data from a survey of peer institutions’ approaches to orientation. Results: These two discourses of orientation had clear similarities, in particular, the critical role of ceremony and symbols, and the focus on developing professionalism and physician identities. There were also differences between them, in particular, in the way that the discourse in the literature focused on the symbolic and professional aspects of orientation; something we have called ‘cultural orientation’. Meanwhile, those who were responsible for orientation in their own institutions tended to focus on the practical and social dimensions. Conclusion: By examining how orientation has been described and discussed, we identify three domains of orientation: cultural, social, and practical. These domains are relatively distinct in terms of the activities associated with them, and in terms of who is involved in organizing and running these activities. We also describe orientation as a liminal activity system on the threshold of medical school where incoming students initially cross into the profession. Interestingly, this state of ambiguity also extends to the scholarship of orientation with only some of its aspects attracting formal enquiry, even though there is a growing interest in transitions in medical education as a whole. We hope, therefore, that this study can help to legitimize enquiry into orientation in all its forms and that it can begin to situate the role of orientation more firmly within the firmament of medical education practice and research

METRICS: a pattern language of scholarship in medical education

Scholarly activity in health professions education has been growing steadily but despite the broad interest, quite what is considered to be scholarly activity in medical education has remained vague. Boyer’s classes of scholarly activity (Boyer 1990) and Glassick et al.’s criteria required of an artefact to render it scholarly (Glassick et al. 1997) have been widely discussed. While the Glassick model has helped to define to what scholarly activity should be, we have found the Boyer model of what kinds of activity count as scholarship is lacking. We have developed the METRICS model of scholarly activity in medical education that maps more directly to scholarly activities. Metascholarship - activities that reflect on the nature of scholarship; Evaluation - activities that measure value or axiology; Translation - activities that move findings or practices from one domain to another; Research - activities that focus on theory generation or testing (experimental, descriptive or explanatory); Innovation - activities that focus on creating new ideas, objects and practices; Conceptual - activities that explore or develop new models, concepts, and paradigms; Synthesis - activities that focus on the integration of existing knowledge and practice. Having built the METRICS model and tested it extensively in our own practice, we now seek to engage others in its use and appraisal

METRICS: a pattern language of scholarship in medical education

Scholarly activity in health professions education has been growing steadily but despite the broad interest, quite what is considered to be scholarly activity in medical education has remained vague. Boyer’s classes of scholarly activity (Boyer 1990) and Glassick et al.’s criteria required of an artefact to render it scholarly (Glassick et al. 1997) have been widely discussed. While the Glassick model has helped to define to what scholarly activity should be, we have found the Boyer model of what kinds of activity count as scholarship is lacking. We have developed the METRICS model of scholarly activity in medical education that maps more directly to scholarly activities. Metascholarship - activities that reflect on the nature of scholarship; Evaluation - activities that measure value or axiology; Translation - activities that move findings or practices from one domain to another; Research - activities that focus on theory generation or testing (experimental, descriptive or explanatory); Innovation - activities that focus on creating new ideas, objects and practices; Conceptual - activities that explore or develop new models, concepts, and paradigms; Synthesis - activities that focus on the integration of existing knowledge and practice. Having built the METRICS model and tested it extensively in our own practice, we now seek to engage others in its use and appraisal

Design for learning : deconstructing virtual patient activities

Digital technologies are used in almost every aspect of contemporary health professional education (HPE) but our understanding of their true potential as instructional tools rather than administrative tools has not significantly advanced in the last decade. One notable exception to this has been the rise of the ‘virtual patient’ as an educational intervention in HPE. This article attempts to deconstruct the virtual patient concept by developing a model of virtual patients as artifacts with intrinsic encoded properties and emergent constructed properties that build on the core concept of ‘activity’

Getting started with curriculum mapping in a veterinary degree program

Catriona Bell – ORCID: 0000-0001-8501-1697 https://orcid.org/0000-0001-8501-1697Item not available in this repository.The Royal (Dick) School of Veterinary Studies at the University of Edinburgh, UK, recently initiated a curriculum-mapping project to develop a tool that would facilitate curriculum review, improve integration and clarity across the curriculum, and provide a transparent method of demonstrating outcomes for quality-assurance purposes. The key finding from this project was that the curriculum-mapping process is a more resource-intensive undertaking than expected, and one that should not been taken lightly. At the time the project began, no commercial software was available that could be integrated with the program's other online systems or had content appropriate to an outcomes-based veterinary degree program. We recommend that future projects ensure a minimum of one dedicated full-time staff member, plus adequate educational technology support to develop a coherent and consistent format for the curriculum map that is integrated with the rest of the local online environment. Identifying the main focus of the map is also recommended at an early stage, as is the instigation of a small-scale pilot exercise to identify major local issues before starting the full mapping process. Future sustainability and development of a curriculum map also require buy-in from colleagues to ensure that relevant components of the map (e.g., learning objectives) are maintained and developed appropriately. This article is aimed at our colleagues who are considering starting a curriculum-mapping process at their institutions; we provide a brief overview of curriculum mapping, based on current literature, and then illustrate the process using our own experiences.The work described here was made possible in part through funding from the Principal's e-Learning Fund at the University of Edinburgh.https://doi.org/10.3138/jvme.36.1.10036pubpub

Evaluating technology-enhanced learning: A comprehensive framework

<div><p></p><p><b>Background</b>: The absence of a standard, comprehensive approach to evaluating technology-enhanced learning (TEL) limits the utility of individual evaluations, and impedes the integration and synthesis of results across studies.</p><p><b>Purpose</b>: To outline a comprehensive framework for approaching TEL evaluation in medical education, and to develop instruments for measuring the perceptions of TEL learners and instructors.</p><p><b>Methods and results</b>: Using both theoretical constructs of inquiry in education and a synthesis of existing models and instruments, we outlined a general model for evaluation that links utility, principles, and practices. From this we derived a framework for TEL evaluation that identifies seven data collection activities: needs analysis; documentation of processes, decisions, and final product; usability testing; observation of implementation; assessment of participant experience; assessment of learning outcomes; and evaluation of cost, reusability, and sustainability. We then used existing quality standards and approaches to develop instruments for assessing the experiences of learners and instructors using TEL.</p><p><b>Conclusions</b>: No single evaluation is likely to collect all of this information, nor would any single audience likely find all information elements equally useful. However, consistent use of a common evaluation framework across different courses and institutions would avoid duplication of effort and allow cross-course comparisons.</p></div

To fail is human: remediating remediation in medical education.

IntroductionRemediating failing medical learners has traditionally been a craft activity responding to individual learner and remediator circumstances. Although there have been moves towards more systematic approaches to remediation (at least at the institutional level), these changes have tended to focus on due process and defensibility rather than on educational principles. As remediation practice evolves, there is a growing need for common theoretical and systems-based perspectives to guide this work.MethodsThis paper steps back from the practicalities of remediation practice to take a critical systems perspective on remediation in contemporary medical education. In doing so, the authors acknowledge the complex interactions between institutional, professional, and societal forces that are both facilitators of and barriers to effective remediation practices.ResultsThe authors propose a model that situates remediation within the contexts of society as a whole, the medical profession, and medical education institutions. They also outline a number of recommendations to constructively align remediation principles and practices, support a continuum of remediation practices, destigmatize remediation, and develop institutional communities of practice in remediation.DiscussionMedical educators must embrace a responsible and accountable systems-level approach to remediation if they are to meet their obligations to provide a safe and effective physician workforce