Blue Sky Thinking: Physician Assistant Accreditation and the Potential Impact on the Programs, Faculty, and the Profession.

ABSTRACT: Blue sky thinking references the opportunity to brainstorm about a topic without limits… to consider what things might be like if creative thoughts were unconstrained by current philosophies or other boundaries. This article is a call to our fellow educators to consider how blue sky thinking applied to physician assistant (PA) program accreditation might further advance programs, faculty, and the profession. To develop and maintain a PA program, institutions must voluntarily undergo evaluation by the Accreditation Review Commission on Education for the Physician Assistant. Compliance with accreditation encourages sound educational practices, promotes program self-study, stimulates innovation, maintains confidence with the public, and focuses on continuous quality improvement. In addition, accreditation "can hold institutions accountable for desired outcomes and professional standards." Indeed, while the PA profession has promulgated across the globe, the 50+ years of graduating PAs educated with the highest quality education assures that the United States remains a gold standard. As the 5th edition of the standards are implemented and planning for the 6th edition is underway, in the spirit of continuous quality improvement, we encourage stakeholders of the PA profession to contemplate ways in which accreditation might continue to purposefully advance a desired future state for the profession. In this article, we draw on examples from other health professions which might inform a discussion around the future of PA accreditation. Specifically, the topics of a unified profession title and degree, a specific title and position for program leadership, a modification to how PA programs receive medical direction, and efforts to advance scholarship are addressed.

Real-time text message surveys reveal student perceptions of personnel resources throughout a course-based research experience.

Course-based research experiences (CREs) are designed to engage students in authentic scientific experiences that are embedded into a standard curriculum. CREs provide valuable research experiences to large numbers of undergraduate biology students, however, CRE implementation can require many personnel. Because limited personnel may be a barrier to widespread CRE implementation, our goal was to discover which personnel students valued throughout a CRE and the ways they were valuable. We investigated students' perceptions of personnel resources throughout a semester-long CRE using two survey approaches. Using a text message survey administered multiple times per week, real-time data was collected about which personnel resource students perceived to be the most helpful. Using a web-based survey administered five times throughout the semester, retrospective data was collected about how often students used each personnel resource and how helpful students perceived each personnel resource to be. Graduate teaching assistants (TAs) were consistently selected as the most helpful personnel resource by the majority of respondents throughout the semester, with most respondents describing graduate TAs providing project-specific feedback. Although less frequently, undergraduate TAs were also consistently selected as the most helpful personnel resource. Respondents described undergraduate TAs providing project-specific feedback, general feedback, and project-specific resources. Data from the retrospective, web-based survey largely mirrored the real-time, text message survey data. Throughout the semester, most respondents reported using graduate TAs "Often" or "Always" and that graduate TAs were "Very" or "Extremely" helpful. Throughout most of the semester, most respondents also reported using undergraduate TAs "Often" or "Always" and that undergraduate TAs were "Very" or "Extremely" helpful. The results of this descriptive study underscore the importance of graduate and undergraduate TAs in the development and implementation of CREs, emphasizing the need for departments and course coordinators to be intentional in planning TA training that prepares TAs to fulfill their critical role in CRE implementation.

Factores psicosociales y desempeño docente en un instituto superior tecnológico en Quito, Ecuador / Psychosocial factors and teaching performance at a higher technological institute in Quito, Ecuador

RESUMEN Introducción: los riesgos psicosociales afectan física y mentalmente a los trabajadores. Las condiciones laborales de docentes universitarios implican responsabilidades académicas y administrativas, exponiéndolos a altos niveles de riesgo psicosocial. Objetivo: el objetivo del estudio fue determinar la relación de los factores psicosociales en el desempeño docente, en un instituto superior tecnológico en Quito, Ecuador. Materiales y métodos: se realizó un estudio cuantitativo, observacional, transversal, prospectivo y analítico en una población de 89 docentes. Se aplicó, por su alta confiabilidad, la encuesta de Factores de Riesgo Psicosociales de Silva, para evaluar los factores de riesgo en el trabajo académico. El desempeño docente se midió según la escala de calificación del Ministerio del Trabajo de Ecuador. Se calcularon inferencias y asociaciones a través de la prueba de Chi cuadrado y el odds ratio. Resultados: hubo un 47,2 % del género femenino y un 52,8 % del masculino. Predominó el grupo etario de 31 a 40 años. Entre los factores de riesgo psicosocial predominó el parámetro de exigencias laborales. El 75,3 % presentó riesgo psicosocial medio, no reflejado con el desempeño docente. Conclusiones: se constató la presencia de factores de riesgo psicosociales en los docentes, relacionados con la carga de trabajo, contenido y características de las tareas, entre otros aspectos. Se comprobó que el desempeño docente no se afectó por la presencia de factores de riesgo psicosociales (AU).

ABSTRACT Introduction: psychosocial risks physically and mentally affect workers. The working conditions of university teachers involve academic and administrative responsibilities, exposing them to high levels of psychosocial risk. Objective: the objective of the study was to determine the relationship of psychosocial factors in teaching performance at a higher technological institute in Quito, Ecuador. Materials and methods: a quantitative, observational, transversal, prospective and analytical study was conducted in a population of 89 teachers. Because of its high reliability, the Silva Psychosocial Risk Factors survey was applied to assess risk factors in academic work. The teaching performance was measured according to the rating scale of the Ministry of Labor of Ecuador. Inferences and associations were calculated through the Chi squared test and the odds ratio. Results: 47.2 % of the teachers were women and 52.8 % were men. The 31-40 years old age-group predominated. Among the psychosocial risk factors, the parameters of work requirements predominated. 75.3 % showed average psychosocial risk, not reflected with teaching performance. Conclusions: It was stated the existence of psychosocial risk factors in teachers, related to the workload, content and characteristics of the task, among other aspects. We found that teaching performance was not affected by the presence of psychosocial risk factors (AU).

Creating SPACE to evolve academic assessment.

Universities and research institutions have to assess individuals when making decisions about hiring, promotion and tenure, but there are concerns that such assessments are overly reliant on metrics and proxy measures of research quality that overlook important factors such as academic rigor, data sharing and mentoring. These concerns have led to calls for universities and institutions to reform the methods they use to assess research and researchers. Here we present a new tool called SPACE that has been designed to help universities and institutions implement such reforms. The tool focuses on five core capabilities and can be used by universities and institutions at all stages of reform process.

Metodología para la formación profesional de alumnos ayudantes, mediante tareas docentes de desempeño / Methodology for the professional training of assistant student s by means of performance educational tasks

RESUMEN Introducción: la validación sistemática de los resultados de la práctica educativa en las universidades médicas cubanas, revela la importancia y trascendencia del proceso de formación profesional de alumnos ayudantes en las diferentes disciplinas, a partir de la determinación de las necesidades formativas de carácter docente o científico-técnico. Objetivo: elaborar una metodología para la formación profesional de alumnos ayudantes, mediante el empleo de tareas docentes de desempeño. Materiales y métodos: durante la investigación se aplicaron métodos como el analítico-sintético, el histórico-lógico y la sistematización. También se empleó una encuesta de autoevaluación, la consulta a expertos y el grupo focal para la validación de la metodología. Para el procesamiento de los datos, fueron aplicados métodos estadístico-matemáticos. Resultados: la metodología fue validada teóricamente mediante la consulta a expertos y el desarrollo de un grupo focal integrado por nueve especialistas, quienes evaluaron de muy adecuado cuatro de los seis indicadores propuestos. Las sugerencias realizadas se encaminaron hacia el logro de aspectos conceptuales y metodológicos, enriqueciéndose la propuesta inicial. Conclusiones: se elaboró una metodología para la formación profesional de alumnos ayudantes, mediante el empleo de tareas docentes de desempeño. Sus contenidos estructurales quedaron definidos en cuatro etapas fundamentales: diagnóstico, planificación, ejecución y evaluación (AU).

ABSTRACT Introduction: the systematic validation of the results of the educational practice in Cuban medical universities discloses the importance and transcendence of the process of assistant students' professional training in the different academic subjects, starting from the determination of the training necessities of educational and scientific-technical character. Objective: to elaborate a methodology for the professional training of assistant students using performance educational tasks. Materials and methods: during the research the authors applied methods like the analytic-synthetic and the historical-logical ones and systematization. An auto-assessment survey, experts' consultation and the focal group for methodology validation were also used. Mathematic-statistical methods were applied for data processing. Results: the methodology was theoretically validated by means of experts' consultation and the development of a focal nine-specialist group, who evaluated as very suitable four of the six proposed indicators. The suggestions made headed toward the achievement of conceptual and methodological aspects, making the initial proposal richer. Conclusions: a methodology for the professional training of assistant students was elaborated by means of the employment of performance educational tasks. The methodology structural contents were defined in four essential stages: diagnosis, planning, implementation and evaluation (AU).

The Evolving Social Purpose of Academic Freedom.

In the face of the increasing substitution of free speech for academic freedom, I argue for the distinctiveness and irreplaceability of the latter. Academic freedom has evolved alongside universities in order to support the important social purpose universities serve. Having limned this evolution, I compare academic freedom and free speech. This comparison reveals freedom of expression to be an individual freedom, and academic freedom to be a group-differentiated freedom with a social purpose. I argue that the social purpose of academic freedom behooves an inclusive approach to group differentiation.

Environmental influences and individual characteristics that affect learner-centered teaching practices.

Research-based teaching practices can improve student learning outcomes in a variety of complex educational environments. The implementation of learner-centered teaching practices in STEM can both benefit from or be constrained by different factors related to individual instructors and the teaching environment. Additionally, we know little of how the instructional climate varies across institutions and how this climate affects teaching practices. Our study sought to examine the relative importance of environmental influences and individual characteristics on learner-centered teaching practices across institutions. We also assessed differences in our study population and departmental climate for 35 US higher education institutions across the country. We found that self-efficacy in teaching and professional development exert a strong influence on faculty teaching practices in biology. While departmental climate did not emerge as a significant predictor of teaching practices, there was consistently low support for teaching, and institution size was negatively correlated with leadership and evaluation of effective teaching. We also found that intensive professional development programs, such as the Faculty Institutes for Reforming Science Teaching IV program, may prepare instructors to teach learner-centered courses in different collegial teaching climates. Our results suggest that through cultivating self-efficacy and participating in iterative professional development, instructors can implement effective teaching practices in a variety of institutional environments.

Navigate the Challenges of Simulation for Assessment: A Faculty Development Workshop.

Introduction: Given barriers to learner assessment in the authentic clinical environment, simulated patient encounters are gaining attention as a valuable opportunity for competency assessment across the health professions. Simulation-based assessments offer advantages over traditional methods by providing realistic clinical scenarios through which a range of technical, analytical, and communication skills can be demonstrated. However, simulation for the purpose of assessment represents a paradigm shift with unique challenges, including preservation of a safe learning environment, standardization across learners, and application of valid assessment tools. Our goal was to create an interactive workshop to equip educators with the knowledge and skills needed to conduct assessments in a simulated environment. Methods: Participants engaged in a 90-minute workshop with large-group facilitated discussions and small-group activities for practical skill development. Facilitators guided attendees through a simulated grading exercise followed by in-depth analysis of three types of assessment tools. Participants designed a comprehensive simulation-based assessment encounter, including selection or creation of an assessment tool. Results: We have led two iterations of this workshop, including an in-person format at an international conference and a virtual format at our institution during the COVID-19 pandemic, with a total of 93 participants. Survey responses indicated strong overall ratings and impactfulness of the workshop. Discussion: Our workshop provides a practical, evidence-based framework to guide educators in the development of a simulation-based assessment program, including optimization of the environment, design of the simulated case, and utilization of meaningful, valid assessment tools.

Operating Principles and Competencies for Engagement in Global/Local Settings.

This article reviews operating principles to guide engagement with local and global partners aimed at improving child health status. In the realms of research, education, clinical care, and administration, these principles are part of an organizing framework to be paired with faculty competencies that address the values/ethics of engagement, specific roles/responsibilities of partners, effective communication strategies among partners, the value of teamwork, and a full understanding of special considerations. Readers are referred to examples of prior advocacy work and implementation research models.

Docentes universitarios inclusivos: qué les caracteriza y cómo conciben la discapacidad / Inclusive University Teachers: What Characterizes them and how do they Think about Disability

El incremento de estudiantes con discapacidad en las universidades españo­las conlleva la necesidad de desarrollar prácticas docentes inclusivas que garanticen la par­ticipación y el aprendizaje de todo el alumnado. Con este trabajo se pretende: (1) conocer las concepciones que el profesorado universitario que ejerce prácticas docentes inclusivas tiene sobre la discapacidad; (2) analizar las razones que les motivan para tener en cuenta las necesidades de los estudiantes con discapacidad, y (3) describir las características que les definen. En el estudio participaron 42 docentes que fueron seleccionados como inclusivos por estudiantes con discapacidad de seis universidades públicas de diferentes comunida­des autónomas de España (Andalucía, Valencia y Madrid). Estos docentes pertenecían a diferentes áreas de conocimiento y todos impartían docencia en Facultades de Ciencias de la Educación. Se siguió una metodología biográfico-narrativa, mediante el uso de entrevis­tas semiestructuradas. Los resultados indicaron que la mayoría del profesorado concebía la discapacidad desde el modelo social, abogando por una educación inclusiva. Entre las razones que les llevaban a responder a las necesidades de este alumnado estaban la expe­riencia previa con personas con discapacidad, el principio de igualdad y su responsabilidad como docente. Respecto a las características de estos docentes inclusivos, destacan la em­patía, el compromiso, la flexibilidad y la vocación docente

The increase in the number of students with disabilities in Spanish uni­versities implies the need to develop inclusive teaching practices that guarantee the par­ticipation and learning of all students. This work is intended: (1) to know the concep­tions that the university teaching staff who carry out inclusive teaching practices have about disability; (2) to analyze the reasons that motivate them to attend to the needs of students with disabilities, and (3) to describe the characteristics that define them. The study involved 42 faculty members who were selected as inclusive by students with disabilities from six public universities in different autonomous communities of Spain (Andalusia, Valencia and Madrid). These faculty members belonged to different areas of knowledge and all of them taught in Faculties of Educational Sciences. A biographi­cal-narrative methodology was used by using semi-structured interviews. Results indi­cated that the majority of the faculty conceived disability from the social, advocating for an inclusive education. Among the reasons that led them to approach to these students were previous experience with people with disabilities, the principle of equality and their responsibility as lecturers. Regarding the characteristics of these inclusive faculty members, empathy, commitment, flexibility and teaching vocation stand out

Pearls and Pitfalls of the Virtual Interview: Perspectives From Both Sides of the Camera.

As the SARS-COV-2 pandemic created the need for social distancing and the implementation of nonessential travel bans, residency and fellowship programs have moved toward a web-based virtual process for applicant interviews. As part of the Society of Asian Academic Surgeons 5th Annual Meeting, an expert panel was convened to provide guidance for prospective applicants who are new to the process. This article provides perspectives from applicants who have successfully navigated the surgical subspecialty fellowship process, as well as program leadership who have held virtual interviews.

Predicting the 2016 US News & World Report rankings using a reputation and prestige model.

INTRODUCTION: The objective was to determine institutional, faculty, and student attributes predictive of the 2016 US News & World Report (USNWR) pharmacy rankings and to explore if student attributes modify program rankings. METHODS: Institutional attributes and student and faculty resources and outcomes were obtained from various sources. Regression analyses predicted rankings. RESULTS: USNWR rankings were higher for older programs, those located at an academic health center or classified as a research-intensive institution, and members of a Power Five athletic conference. Number of fulltime equivalent faculty, Pharmacy College Admissions Test composite percentile, pharmacy practice h-index score, funding rank, and first time North American Pharmacist Licensure Examination (NAPLEX) pass rate predicted higher rankings. Nearly 45% of programs in the empiric models left or entered the top 25 rankings compared with the existing USNWR method (range 31 place increase to 22 place decrease). Among USNWR top 25 ranked programs, 16 remained in the top 25 in all four empiric models and three were not included in any of the models. Six USNWF unranked programs moved into the top 25 by one or more of the empiric models. CONCLUSIONS: Faculty and student attributes significantly impact program rankings, while impact of institutional attributes is negligible if independent of student and faculty attributes. Faculty numbers and productivity influence USNWR rankings more than student academic preparation and success on NAPLEX. These findings will inform efforts to improve the validity of the USNWR rankings and identify programs that are both prestigious and of high quality.

A randomised trial of the effectiveness of instructor versus automated manikin feedback for training junior doctors in life support skills.

INTRODUCTION: Australian Standards require that clinicians undergo regular training in skills required to respond to the acute deterioration of a patient. Training focuses on the ability to appropriately respond to cardiac arrest, including delivering cardiac compressions, ventilation and appropriate defibrillation. Providing such training comes at a significant cost to the organisation and impacts on clinician time in direct patient care. If effective, the use of an automated manikin could significantly reduce costs and provide consistent training experiences. METHODS: Fifty-six resident medical officers were randomised to two groups to test two skills components of hospital life support training under two feedback conditions. The skills components were cardiac compressions and bag-valve-mask ventilation. The feedback conditions were automated feedback delivered by a simulation manikin and traditional feedback delivered by an instructor. All participants were exposed to both skills components and both feedback conditions in a counterbalanced block design. Participants completed surveys before and after training. RESULTS: The results demonstrated significantly better performance in cardiac compressions under the automated manikin feedback condition compared with the instructor feedback condition. This difference was not observed in bag-valve-mask ventilation. The majority of participants found the automated manikin feedback more useful than the instructor feedback. DISCUSSION: Automated manikin feedback was not inferior to instructor feedback for skill acquisition in cardiac compressions training. The automated feedback condition did not achieve the same level of significance in bag-valve-mask ventilation training. Results suggest training with automated feedback presents a cost-effective opportunity to lessen the training burden, whilst improving skill acquisition.

Cross-cultural adaptation of the EFFECT questionnaire into Brazilian Portuguese / Adaptação transcultural do questionário EFFECT para português brasileiro

Abstract: Introduction: Clinical teaching is based on a real work environment, in professional practice settings, such as health services and units, under the supervision of the preceptor. Providing medical teachers with an assessment of their teaching skills is a powerful tool for improving clinical learning for students in training. In this context, the EFFECT (Evaluation and Feedback for Effective Clinical Teaching) questionnaire was developed by Dutch researchers in 2012 for teacher evaluation, being validated based on the literature about medical teaching in the workplace and incorporates the skills of the Canadian competency-based medical curriculum. Objective: To translate and cross-culturally adapt into Brazilian Portuguese and to validate the EFFECT questionnaire for teacher evaluation by Medical students. Method: Cross-cultural adaptation with the following steps: initial translation of the English version, synthesis of translated versions, back-translation, creation of a consensual version in Brazilian Portuguese, with adaptation, review, and analysis of content validity by an expert committee, pre-test with retrospective clarification interview, and reliability analysis by factorial analysis and internal consistency test (Cronbach's alpha coefficient). Result: In the translation and back-translation stages, the disagreements were related to the use of synonyms and none of the items were modified in terms of their understanding, but in terms of adaptation into the Brazilian context. The evaluation of the expert committee showed the versions maintained the semantic and idiomatic equivalences of the content. Eighty-nine students participated in the pre-test. The internal consistency of the EFFECT questionnaire in Brazilian Portuguese was excellent for all domains, with Cronbach's alpha coefficient ranging from 0.82 to 0.94. Conclusion: The translated and adapted version of the EFFECT questionnaire into Brazilian Portuguese is equivalent to the original instrument and has evidence of high validity and reliability, being able to constitute a national tool to evaluate the efficiency of clinical medicine teaching.

Resumo: Introdução: O ensino clínico é baseado em ambiente de trabalho real, em cenários de prática profissional, como serviços e unidades de saúde, sob a supervisão do preceptor. Proporcionar aos docentes de graduação médica uma avaliação sobre suas habilidades de ensino é uma ferramenta poderosa para melhorar a aprendizagem clínica dos estudantes em formação. Nesse contexto, o questionário Evaluation and Feedback for Effective Clinical Teaching (EFFECT) foi desenvolvido por pesquisadores holandeses em 2012 para avaliação docente, sendo validado com base na literatura sobre o ensino médico em local de trabalho. Esse instrumento incorpora as competências do currículo baseado em competências canadense. Objetivo: Este estudo teve como objetivos traduzir, adaptar transculturalmente para português do Brasil e validar o questionário EFFECT para avaliação docente por estudantes de Medicina. Método: A adaptação transcultural empregou as seguintes fases: tradução inicial da versão em inglês; síntese de versões traduzidas; tradução reversa; criação de versão consensual em português do Brasil, com adaptação, revisão e análise de validade de conteúdo por comitê de especialistas; pré-teste com entrevista retrospectiva de esclarecimento e análise de confiabilidade por análise fatorial e teste de consistência interna (coeficiente alfa de Cronbach). Resultado: Nas etapas de tradução e tradução reversa, as discordâncias relacionaram-se ao uso de sinônimos, e nenhum dos itens foi modificado em relação ao seu entendimento, e sim na adequação para a realidade brasileira. A avaliação do comitê de especialistas demonstrou que as versões mantinham a equivalência semântica e idiomática do conteúdo. Participaram do pré-teste 89 alunos. A consistência interna do EFFECT em português do Brasil mostrou-se excelente para todos os domínios, com coeficiente alfa de Cronbach variando de 0,82 a 0,94. Conclusão: A versão traduzida e adaptada do questionário EFFECT em português do Brasil possui equivalência cultural com o instrumento original e evidência de alta validade e confiabilidade, podendo constituir-se em instrumento nacional de avaliação da eficiência do ensino clínico de docente de Medicina.

A novel faculty development tool for writing a letter of recommendation.

OBJECTIVE: Based on a national survey of program directors we developed a letter of recommendation (LOR) scoring rubric (SR) to assess LORs submitted to a pediatric residency program. The objective was to use the SR to analyze: the consistency of LOR ratings across raters and LOR components that contributed to impression of the LOR and candidate. METHODS: We graded 30 LORs submitted to a pediatric residency program that were evenly distributed based on final rank by our program. The SR contained 3 sections (letter features, phrases, and applicant abilities) and 2 questions about the quality of the LOR (LORQ) and impression of the candidate (IC) after reading the LOR on a 5-point Likert scale. Inter-rater reliability was calculated with intraclass correlation coefficients (ICC(2,1)). Pearson (r) correlations and stepwise multivariate linear regression modeling predicted LORQ and IC. Mean scores of phrases, features, and applicant abilities were analyzed with ANOVA and Bonferroni correction. RESULTS: Phrases (ICC(2,1) = 0.82, p<0.001)) and features (ICC(2,1) = 0.60, p<0.001)) were rated consistently, while applicant abilities were not (ICC(2,1) = 0.28, p<0.001)). For features, LORQ (R2 = 0.75, p<0.001) and IC (R2 = 0.58, p<0.001) were best predicated by: writing about candidates' abilities, strength of recommendation, and depth of interaction with the applicant. For abilities, LORQ (R2 = 0.47, p<0.001) and IC (R2 = 0.51, p<0.001) were best predicted by: clinical reasoning, leadership, and communication skills (0.2). There were significant differences for phrases and features (p<0.05). CONCLUSIONS: The SR was consistent across raters and correlates with impression of LORQ and IC. This rubric has potential as a faculty development tool for writing LORS.