Getting Better Together: A Website Review of Peer Coaching Initiatives for Medical Educators.

Phenomenon: Peer coaching is a form of faculty development in which medical educators collegially work together to improve their teaching. Benefits include use of evidence-based teaching practices, promotion of collegial discussions, and reflection within the workplace teaching context. Some faculty developers have expertise in designing and offering peer coaching initiatives for medical educators. However, because of a paucity of reporting on these initiatives in the literature, this specialized knowledge is not readily accessible to the health professions education community. This gap hinders practice advancement and creates barriers for new initiative implementation. Approach: The authors conducted a website review to identify, examine, and conceptually map characteristics of peer coaching initiatives at Association of American Medical Colleges-accredited medical schools. Forty-five initiatives were included that maintained publicly accessible websites, performed direct observation of teaching with feedback, and had a stated purpose of improving teaching. Data collection included details related to initiative purpose, structure, participation, observation of teaching, feedback, and support of learning. Findings: Most initiatives were voluntary and provided formative feedback with the sole purpose of improving teaching. Nearly all used a three-phase process with a preobservation meeting for goal setting, direct observation of teaching, and a postobservation meeting with feedback. Many initiatives required peer coach training and expertise. Reflection, collaboration, confidentiality, and use of an observation instrument were frequently mentioned. Insights: This website review provides faculty developers with a knowledge synthesis of how present-day peer coaching initiatives are structured and enacted-laying a foundation to collaborate, build best practices, and identify areas for future research. These findings enable faculty developers to learn from and build upon others' examples. Future research should explore whether there is an ideal coaching model and location for peer coaching within the higher level organization. In addition, researchers should seek to build consensus on initiative characteristics that enhance participation and foster teaching effectiveness.

Testing Quick Response (QR) Codes as an Innovation to Improve Feedback Among Geographically-Separated Clerkship Sites.

BACKGROUND AND OBJECTIVES: Collection of feedback regarding medical student clinical experiences for formative or summative purposes remains a challenge across clinical settings. The purpose of this study was to determine whether the use of a quick response (QR) code-linked online feedback form improves the frequency and efficiency of rater feedback. METHODS: In 2016, we compared paper-based feedback forms, an online feedback form, and a QR code-linked online feedback form at 15 family medicine clerkship sites across the United States. Outcome measures included usability, number of feedback submissions per student, number of unique raters providing feedback, and timeliness of feedback provided to the clerkship director. RESULTS: The feedback method was significantly associated with usability, with QR code scoring the highest, and paper second. Accessing feedback via QR code was associated with the shortest time to prepare feedback. Across four rotations, separate repeated measures analyses of variance showed no effect of feedback system on the number of submissions per student or the number of unique raters. CONCLUSIONS: The results of this study demonstrate that preceptors in the family medicine clerkship rate QR code-linked feedback as a high usability platform. Additionally, this platform resulted in faster form completion than paper or online forms. An overarching finding of this study is that feedback forms must be portable and easily accessible. Potential implementation barriers and the social norm for providing feedback in this manner need to be considered.

Acupuncture for the Treatment of Sports Injuries in an Austere Environment.

For sports injuries in an austere environment, narcotic pain medications are often unavailable or have limiting side effects like sedation or constipation. Meanwhile, nonsteroidal anti-inflammatory medications are frequently associated with gastrointestinal side effects and acetaminophen liver toxicity. A trained physician can rapidly use certain acupuncture techniques in an austere environment with potentially fewer side effects. Current medical literature notes low to moderate quality evidence for the use of acupuncture in lower back pain and osteoarthritis of the knee. There is emerging evidence for the use of acupuncture in traumatic brain injury. The U.S. military uses acupuncture in deployed settings to treat battlefield injuries with promising results. This article reviews the military's current use of acupuncture to treat injuries in a deployed setting and how this may translate to the care of a sports injury in an austere environment.