One Room Schoolhouse: A Novel Intervention for Inspired Academic Half-Day Learning in Distributed Campus Settings.

INTRODUCTION: Some studies on academic half days (AHDs) suggest that learning in this context is associated with a lack of educational engagement. This challenge may be amplified in distributed campus settings, where geographical disadvantages demand reliance on videoconferencing or considerable time spent travelling to in-person learning events. Concerns about the educational effectiveness of AHDs by learners within our distributed campus setting led to the development and evaluation of the One Room Schoolhouse (ORS), a unique, evidence-informed, community-based curriculum that partially replaced the AHD sessions delivered at the main campus. It was hypothesized that creating an AHD experience that was clinically reflective of the community in which residents practiced and where residents were given the autonomy to implement novel pedagogical elements would result in better test scores and improved learner satisfaction among ORS learners. METHODS: The ORS was implemented at McMaster University's Waterloo Regional Campus in 2017. Residents across training cohorts (N = 9) engaged in co-learning based on scenarios co-developed from clinical experiences within the region. The learning approach relied on multiple, evidence-informed pedagogical strategies. A multi-method approach was used to evaluate the ORS curriculum. Between-subject analyses of variance were used to compare scores on practice exams (COPE and PRITE), in-training assessment reports (ITARs), and objective structured clinical exams (OSCEs) between learners who took part in the ORS and learners at the main campus. A semi-structured focus group probing residents' experiences with the ORS was analyzed using interpretive description. RESULTS: ORS learners significantly outperformed learners at the main campus on the November OSCE (p = .02), but not on the COPE, PRITE, ITARs, or September OSCE (p's < .05). Qualitative themes suggested advantages of the ORS in inspiring learning, engaging learners, and improving self-confidence in knowledge acquisition. These findings are aligned with the broader literature on learner agency, social development, and communities of practice. CONCLUSION: While the quantitative data only showed a significant difference between the 2 curricula on 1 measure (ie, the November OSCE), the qualitative findings offered an opportunity for educators to reimagine what medical education might consist of beyond the confines of a "traditional" AHD. Creating opportunities to enhance personal agency when acquiring knowledge, inspiring engagement about patient-related problems, and incorporating interdisciplinary learning through community engagement were critical pedagogical elements that were attributed to the success of the ORS.

Expanding the role of PAs in the treatment of severe and persistent mental illness.

Patients with severe and persistent mental illness often face limited access to psychiatric and primary care. This exploratory qualitative analysis studied the effect of introducing a PA into a comprehensive outpatient psychiatric team. Early results suggest this model improves the quality and access to primary and psychiatric care.

Implementation research evidence uptake and use for policy-making.

A major obstacle to the progress of the Millennium Development Goals has been the inability of health systems in many low- and middle-income countries to effectively implement evidence-informed interventions. This article discusses the relationships between implementation research and knowledge translation and identifies the role of implementation research in the design and execution of evidence-informed policy. After a discussion of the benefits and synergies needed to translate implementation research into action, the article discusses how implementation research can be used along the entire continuum of the use of evidence to inform policy. It provides specific examples of the use of implementation research in national level programmes by looking at the scale up of zinc for the treatment of childhood diarrhoea in Bangladesh and the scaling up of malaria treatment in Burkina Faso. A number of tested strategies to support the transfer of implementation research results into policy-making are provided to help meet the standards that are increasingly expected from evidence-informed policy-making practices.

Issue brief: Engaging Civil Society in Supporting Research Use in Health Systems

While the term "civil society" is in widespread use in many countries, particularly in low- and middle-income countries, in some countries (such as Canada) the terms "voluntary organization," "non-governmental organization," and "advocacy group" are much more commonly used.(1) The term "stakeholder" typically means something broader than civil society, whereas the term "interest group" tends to be associated with private, not public, interests, and more accurately can be considered to include both civil society and organizations under the direct control of for-profit firms. Similarly, quasi non-governmental organizations (QUANGOs), which are financed by government yet operate independently of them, can be considered a hybrid.