A Comparison of 2 Debriefing Rubrics to Assess Facilitator Adherence to the PEARLS Debriefing Framework.

INTRODUCTION: Many educators have adopted the Promoting Excellence and Reflective Learning in Simulation (PEARLS) model to guide debriefing sessions in simulation-based learning. The PEARLS Debriefing Checklist (PDC), a 28-item instrument, and the PEARLS Debriefing Adherence Rubric (PDAR), a 13-item instrument, assess facilitator adherence to the model. The aims of this study were to collect evidence of concurrent validity and to evaluate their unique strengths. METHODS: A review of 130 video recorded debriefings from a synchronous high-fidelity mannequin simulation event involving third-year medical students was undertaken. Each debriefing was scored utilizing both instruments. Internal consistency was determined by calculating a Cronbach's α. A Pearson correlation was used to evaluate concurrent validity. Discrimination indices were also calculated. RESULTS: Cronbach's α values were 0.515 and 0.714 for the PDAR and PDC, respectively, with ≥0.70 to ≤0.90 considered to be an acceptable range. The Pearson correlation coefficient for the total sum of the scores of both instruments was 0.648, with a values between ±0.60 and ±0.80 considered strong correlations. All items on the PDAR had positive discrimination indices; 3 items on the PDC had indices ≤0, with values between -0.2 and 0.2 considered unsatisfactory. Four items on both instruments had indices >0.4, indicating only fair discrimination between high and low performers. CONCLUSIONS: Both instruments exhibit unique strengths and limitations. The PDC demonstrated greater internal consistency, likely secondary to having more items, with the tradeoff of redundant items and laborious implementation. Both had concurrent validity in nearly all subdomains. The PDAR had proportionally more items with high discrimination and no items with indices ≤0. A revised instrument incorporating PDC items with high reliability and validity and removing those identified as redundant or poor discriminators, the PDAR 2, is proposed.

The Power of One Word to Paint a Halo or a Horn: Demonstrating the Halo Effect in Learner Handover and Subsequent Evaluation.

PURPOSE: Learner evaluation based upon direct observation is a cornerstone of modern competency-based medical education. Learner handover has become a widely accepted practice. Cognitive attribution bias is a potential threat to the validity of learner evaluation following learner handover. METHOD: In this 2 x 2 (learner handover: halos/horns x learner gender: man/woman) factorial, nonequivalent comparison group experimental design, registered attendees at a national medical education conference watched 1 of 2 videos (depicting a woman learner or man learner) of simulated learner-patient encounters. Data were collected on April 30 and May 1, 2022. Participants received learner handover conditioning before watching the video. The conditioning was randomized to suggest the learner they were about to watch was either "above-average" (halos) or "below-average" (horns). Following the video, participants completed an evaluation form. RESULTS: Participants rated the learner in a video encounter preceded by a horns statement significantly lower than the learner in a video encounter preceded by a halo statement, F (1,65) = 10.15, P < .01, η 2 = .14, horns mean adj = 12.49 (CI 11.34, 13.63), halo mean adj = 15.10 (CI 13.93, 16.28). This represented a scoring difference of 2.61 points on a 30-point scale. More years of teaching experience was negatively associated with the score, F (1,65) = 13.44, P < .001, η 2 = .17. CONCLUSIONS: Learner conditioning differing by a single word, labeling a learner as either "above-average" or "below-average" resulted in a large difference in scoring by medical educators.

Leveraging Medical Simulation for Faculty Development in Interprofessional Education: A Pilot Study.

This mixed-methods pilot study aimed to determine the faculty perceptions and knowledge of interprofessional education (IPE) before and after a faculty development program at a health sciences campus that used medical simulation as the pedagogy. Thirty health professions faculty completed a pre- and post-survey instrument to evaluate their understanding and perceptions of IPE. The survey data were analyzed using paired t-tests. Participants contributed post-training to a semi-structured focus group that used thematic analysis. The pilot study findings included a statistically significant increase in IPE knowledge and perceptions by the participating faculty, corroborated by the focus group responses. The focus group responses emphasized the use of IPE: to teach soft skills in communication to students, to create a new culture of healthcare professionals, to discuss role biases and assumptions, and to create of a new healthcare team which included non-caregivers.

Student Performance During a Simulated Patient Encounter Has No Impact on Debriefer Adherence to PEARLS Debriefing Model.

PURPOSE: Debriefing is necessary for effective simulation education. The PEARLS (Promoting Excellence and Reflective Learning in Simulations) is a scripted debriefing model that incorporates debriefing best practices. It was hypothesized that student simulation performance might impact facilitator adherence to the PEARLS debriefing model. There are no published findings on the effect of student performance on debriefer behavior. METHODS: Third-year medical students participated in a video-recorded, formative simulation to treat a high-fidelity mannequin for an asthma exacerbation. A faculty debriefer trained in the PEARLS model evaluated student performance with a standardized rubric and conducted a recorded debriefing. Debriefing recordings were analyzed for debriefer adherence to the PEARLS model. Debriefers were assigned a debriefing score (DS) from 0 to 13; 13 was perfect adherence to the model. Definitive intervention (DI) for asthma exacerbation was defined as bronchodilator therapy. Critical actions were as follows: a focused history, heart/lung exam, giving oxygen, and giving a bronchodilator. RESULTS: Mean DS for the debriefers of students who provided DI was 8.57; 9.14 for those students who did not (P = 0.25). Mean DS for debriefers of students who completed all critical actions was 8.68; 8.52 for those students who did not (P = 0.62). Analysis of elapsed time to DI showed no relationship between the time DI was provided and DS. CONCLUSIONS: Student performance had no impact on debriefer performance, suggesting the PEARLS model is an effective aid for debriefers, regardless of learner performance. These findings suggest student performance may not bias facilitators' ability to conduct quality debriefings.

Six ways to get a grip on leveraging the expertise of Instructional Design and Technology professionals.

We underutilize the knowledge and skills of Instructional Design and Technology (IDT) professionals, despite the frequent challenges in implementing learning technologies in medical education. This is largely due to a lack of understanding among stakeholders regarding the expertise of IDT professionals and their role in technology implementation processes. We seek to improve technology implementation outcomes by explaining the IDT field's foundational tenets of a systems perspective and disciplined approach, clarifying the role that IDT professionals can play in educational technology initiatives, and providing guidance on how to foster productive collaborations in pursuit of effective technology-enhanced learning.

Bien que souvent confrontés aux défis de la mise en oeuvre des technologies éducatives en éducation médicale, nous sous-utilisons les connaissances et les compétences technopédagogues. Cela est largement dû à un manque de compréhension, chez les parties prenantes, de l'expertise de ces professionnels et de leur rôle dans les processus de mise en œuvre des technologies. Dans le but d'améliorer les impacts de la mise en œuvre des technologies, nous expliquons les principes fondamentaux de la technopédagogie, à savoir une perspective systémique et une approche rigoureuse, tout en clarifiant le rôle que les technopédagogues peuvent jouer dans les initiatives technologiques éducatives. Nous proposons également des conseils sur la manière de favoriser des collaborations productives en vue d'un apprentissage efficace optimisé par les technologies.

Linking Patient Care Ownership and Professional Identity Formation through Simulation.

THEORY: The link between ownership of patient care and professional identity formation (PIF) has not been formally established, yet PIF researchers frequently cite clinical experiences as powerful contributions to PIF. Hypothesis: Using clinical simulation, this study aimed to explore the relationship between patient care ownership and the cognitive processes involved in the creation of a professional identity. Methods: In 2018-2019, 189 third-year students participated in a simulation in which they were placed in the role of a physician treating a patient in respiratory distress. Data were collected from 12 focus groups (n = 84; 44% of the third-year class), each lasting 15-25 minute. Students were asked four questions designed to identify moments when they felt like a physician and experienced feelings of ownership. Each focus group was transcribed and analyzed for the presence of known elements that contribute to feelings of psychological ownership, and then inductively for how students related their feelings of ownership to their professional identity. Results: When students were asked to take ownership of their patient's care, they underwent a three-step process: (1) experiencing disorientation, (2) reconceptualizing roles and responsibilities, and (3) reorientation to professional goals. Patient care ownership was disorienting because it marked a departure from the clinical roles the students had previously experienced. While disoriented, students engaged in a process of reflection during which they asked themselves who they were, who they were becoming, and who they needed to become to effectively serve in the role of a physician. This process prompted students to realize the limitations of their clinical reasoning abilities and that the role of a physician requires new ways of thinking. Conclusions: This study advances a conceptual model of PIF that identifies patient care ownership as a catalyst in developing a professional identity. Assuming responsibility for patients places students into an unfamiliar role, which opens a channel for students to access new perspectives in their development as physicians.

Demystifying Content Analysis.

Objective. In the course of daily teaching responsibilities, pharmacy educators collect rich data that can provide valuable insight into student learning. This article describes the qualitative data analysis method of content analysis, which can be useful to pharmacy educators because of its application in the investigation of a wide variety of data sources, including textual, visual, and audio files. Findings. Both manifest and latent content analysis approaches are described, with several examples used to illustrate the processes. This article also offers insights into the variety of relevant terms and visualizations found in the content analysis literature. Finally, common threats to the reliability and validity of content analysis are discussed, along with suitable strategies to mitigate these risks during analysis. Summary. This review of content analysis as a qualitative data analysis method will provide clarity and actionable instruction for both novice and experienced pharmacy education researchers.

Gender differences in the expression and cognition of empathy among nursing students: An educational assessment study.

BACKGROUND: In the medical context, previous studies found that female care providers present more empathy with patients than their male counterparts. Yet, the explanatory mechanisms for such a difference are not fully explored. PURPOSE: Guided by the message design logics, this study looked to assess the differences in the expression of empathy by male and female nursing students. METHODS: The data included transcripts of conversations between 343 undergraduate nursing students and a virtual patient. RESULTS: Study hypothesis, which was supported, predicted that when presented with opportunities to express empathy female students will use such opportunities more frequently than male students. RQ1 assessed the level of empathic responses and showed no differences between male and female students. RQ2 focused on the cognitive models of empathy and showed that female students had more complex maps that included a larger number and levels of empathy-related concepts. CLINICAL RELEVANCE: While both male and female students could benefit from education and support in effective expression of empathy, tailored education could promote the recognition of opportunities to be empathic among male students. Clinical communication skill training programs should consider gender-sensitive interventions to support and promote male nurse empathy skills.

Demographic and spatial trends in diabetes-related virtual nursing examinations.

Diabetes currently affects nearly 30 million Americans, but the distribution of cases is not uniform across all demographics or every state. In the course of their education, nurses learn how to become important conduits for information on diabetes management during their eventual interactions with patients. Exploring the status and trends of diabetes-related knowledge in nursing students is one method to explore the idea that one's community affects how one sees disease. However, they are not yet experts, which places them in a period of transition. This study used data mined from the Shadow Health Digital Clinical Experience™ virtual patient exams conducted by nursing students between the years of 2012 and 2015 to find any potential demographic or spatial trends within simulation performance results from nursing students who examined a virtual patient with self-managed diabetes. Findings of the analysis indicated that age and experience affected the way in which an examination was conducted, where older and more experienced nursing students asked 8% fewer examination questions, yet showed 32% more empathy and offered 76% more educational statements than their younger counterparts. Spatial trends were less pronounced, although deeper analysis revealed that students in states closer to the national mean for population rate with diabetes perform better, show more empathy, and offer more educational statements during examinations compared to states well above or well below the national mean. This suggests that targeted information may be preferable to "one-size-fits-all" public health awareness and education programs for diabetes programs used uniformly across the country.

Empathic Communication in Virtual Education for Nursing Students: I'm Sorry to Hear That.

The current study examined the communication strategies used by undergraduate nursing students (N = 343) to express empathy during simulated health history interviews. Interacting with a virtual patient, students encountered up to 9 information disclosures that warranted the expression of empathy but recognized few (33.54%). Sophistication of language to express empathy varied depending on the disclosure topic. These findings suggest that empathy as a learned skill can be incorporated into a variety of nursing contexts.

Virtually Nursing: Emerging Technologies in Nursing Education.

Augmented reality and virtual simulation technologies in nursing education are burgeoning. Preliminary evidence suggests that these innovative pedagogical approaches are effective. The aim of this article is to present 6 newly emerged products and systems that may improve nursing education. Technologies may present opportunities to improve teaching efforts, better engage students, and transform nursing education.