The development of a reporting form for peer observation of online learning courses: An e-Delphi consensus study of educators working in health professions education.

INTRODUCTION: Peer observation of online teaching has been suggested to maintain and monitor online learning standards. However, this practice and the designed peer observation forms have been almost exclusively restricted to face-to-face or stand-alone synchronous/asynchronous sessions. This study, therefore, aimed to identify criteria for the successful design and delivery of online courses and develop a rigorous form specifically designed for peer observation of teaching in online learning environments applicable to the Health Professions Education context. MATERIALS AND METHODS: A three-round e-Delphi technique was used to gather consensus on categories/items and process/structure of the peer observation form. A total of 21 international, experienced online educators working in Health Professions Education were recruited. A 75% consensus was considered as the minimum agreement level. RESULTS: Response rates were 100% (n = 21), 81% (n = 17) and 90% (n = 19) respectively. The intensity of consensus was 38%-93%, while the agreement/disagreement consensus was 57%-100%. In Round 1, the 13 topics proposed as major categories for design and delivery reached agreement consensus. One option reached agreement on how to approach and structure the peer-observation process. All items within major categories reached agreement in Rounds 2 and 3. The resulting form presents 13 major categories with 81 items. CONCLUSION: The identified criteria and developed form address relevant educational principles such as constructive alignment, online instructional design, retrieval practice and spaced learning, cognitive load, and constructive feedback and authentic assessment, all of which have been suggested as critical aspects to ensure a high-quality learning experience. This adds to the literature and to educational practice as clear, evidence-based guidance for the design and delivery of online courses, which differ distinctly from traditional face-to-face teaching. The developed form expands the options for peer observation, from face-to-face and stand-alone synchronous/asynchronous sessions to fully online courses.

Common models and approaches for the clinical educator to plan effective feedback encounters.

Giving constructive feedback is crucial for learners to bridge the gap between their current performance and the desired standards of competence. Giving effective feedback is a skill that can be learned, practiced, and improved. Therefore, our aim was to explore models in clinical settings and assess their transferability to different clinical feedback encounters. We identified the 6 most common and accepted feedback models, including the Feedback Sandwich, the Pendleton Rules, the One-Minute Preceptor, the SET-GO model, the R2C2 (Rapport/Reaction/Content/Coach), and the ALOBA (Agenda Led Outcome-based Analysis) model. We present a handy resource describing their structure, strengths and weaknesses, requirements for educators and learners, and suitable feedback encounters for use for each model. These feedback models represent practical frameworks for educators to adopt but also to adapt to their preferred style, combining and modifying them if necessary to suit their needs and context.

Implementation and lessons learned from 2 online interprofessional faculty development programs for improving educational practice in the health professions in Chile and the United Kingdom from 2018 to 2021.

This study presents the design, implementation, and lessons learned from 2 fit-for-purpose online interprofessional faculty development programs for educational practice improvement in the health professions in Chile and the United Kingdom from 2018 to 2021. Both programs were designed to enhance teaching and learning practices in an interprofessional environment based on 4 pillars: professional diversity, egalitarianism, blended/online learning, and active learning strategies. A multidisciplinary mix of educators participated, showing similar results. The 3 main lessons learned were that the following factors facilitated an interprofessional environment: a professions-inclusive teaching style, a flexible learning climate, and interprofessional peer work. These lessons may be transferable to other programs seeking to enhance and support interprofessionality. Faculty development initiatives preparing educators for interprofessional practice should be an integral component of health professions education, as delivering these courses within professional silos is no longer justifiable. As the relevance of interprofessional education grows, an effective way of promoting interprofessonal education is to train the trainers in formal interprofessional settings.

Online patient simulation training to improve clinical reasoning: a feasibility randomised controlled trial.

BACKGROUND: Online patient simulations (OPS) are a novel method for teaching clinical reasoning skills to students and could contribute to reducing diagnostic errors. However, little is known about how best to implement and evaluate OPS in medical curricula. The aim of this study was to assess the feasibility, acceptability and potential effects of eCREST - the electronic Clinical Reasoning Educational Simulation Tool. METHODS: A feasibility randomised controlled trial was conducted with final year undergraduate students from three UK medical schools in academic year 2016/2017 (cohort one) and 2017/2018 (cohort two). Student volunteers were recruited in cohort one via email and on teaching days, and in cohort two eCREST was also integrated into a relevant module in the curriculum. The intervention group received three patient cases and the control group received teaching as usual; allocation ratio was 1:1. Researchers were blind to allocation. Clinical reasoning skills were measured using a survey after 1 week and a patient case after 1 month. RESULTS: Across schools, 264 students participated (18.2% of all eligible). Cohort two had greater uptake (183/833, 22%) than cohort one (81/621, 13%). After 1 week, 99/137 (72%) of the intervention and 86/127 (68%) of the control group remained in the study. eCREST improved students' ability to gather essential information from patients over controls (OR = 1.4; 95% CI 1.1-1.7, n = 148). Of the intervention group, most (80/98, 82%) agreed eCREST helped them to learn clinical reasoning skills. CONCLUSIONS: eCREST was highly acceptable and improved data gathering skills that could reduce diagnostic errors. Uptake was low but improved when integrated into course delivery. A summative trial is needed to estimate effectiveness.

Supporting motivation in teams working remotely: The role of basic psychological needs.

The current disruptive and abrupt transition to remote activities that educational institutions are facing represents a major challenge for the entire academic community. While most concerns have centred on how learning activities may successfully transit from face-to-face to remote delivery, little attention has been given to how educators can be supported in this new unchartered territory. In this article, we discuss the crucial role of team leaders and how their management and leadership style may have great potential to support educators' motivation. Based on Self-determination Theory, we offer a framework through which team leaders may contribute to create optimal remote working environments for educators. We argue that educators' autonomous motivation depends on how they perceive their remote work environment as supportive of their basic psychological needs of autonomy, competence and relatedness. Then, we highlight a series of practical recommendations by which team leaders may be more needs-supportive. Working from home requires space, trust, open communication and flexibility, especially considering that team members may have different clinical or personal circumstances. We therefore hope these suggestions are helpful to cultivate educators' autonomous motivation, which is beneficial not only for themselves but also for others in their institution, including their co-workers and students.

Exploring threshold concepts in population health.

BACKGROUND: Doctors are increasingly expected to improve the health and well-being of populations, as well as to care for individuals. However, despite extensive efforts to integrate population health into undergraduate programmes, engaging students in such learning is notoriously challenging. Threshold concepts are transformative, integrative, irreversible and fundamental to understanding a discipline. Grasping such concepts requires learners to cross a liminal space, which often involves struggle. METHODS: We employed a form of transactional curriculum enquiry, involving qualitative and quantitative methods, with experienced population health medical educators to identify and explore threshold and troublesome concepts in population health. RESULTS: Attributing causality, inequalities in health and doctors' responsibility for populations not just individuals were the concepts most participants thought were threshold. The value of qualitative research, health as politically and socially determined and not taking evidence at face value were the concepts ranked as most troublesome for learners. Participants found the notions of threshold and troublesome concepts helpful and empowering. They described ways these new ideas would influence how they taught population health. DISCUSSION: Transactional curriculum enquiry can offer insights into which population health concepts may be threshold and troublesome. The number of such concepts identified in this study may help explain why students often struggle to engage in population health learning. Understanding which concepts are threshold and particularly which are troublesome can help teachers to better support learners and can also inform curriculum design. If our students are to … take responsibility for populations as well as individuals … it is vital that they cross these fundamental thresholds in learning.

Humanising medicine: teaching on tri-morbidity using expert patient narratives in medical education.

Expert patients have recognised benefits for both students and patients in medical education. However, marginalised patients such as homeless patients are less likely to participate. Learning from such individuals is crucial for future doctors, who can, in turn, aid their inclusion in society and improve access to health care. A 'humanising medicine' lecture was delivered to Year Four medical students at Norwich Medical School. The lecture utilised narratives from patients with experience of homelessness and tri-morbidity (physical and mental health problems and substance abuse). We used a qualitative approach to evaluate this teaching and understand the experience of both students and patients. Students were asked to complete questionnaires, whereas expert patients were interviewed. We thematically analysed data using an inductive approach. Students reported an increased understanding, empathy and preparedness to consult with marginalised patients. Expert patients described positive feelings about their involvement, giving something back, and the therapeutic benefits of telling their story. We found that including marginalised patients in medical education had positive benefits for both students and patients. Our findings suggest that expert patient narratives are valuable in medical education particularly in teaching and learning about medical complexity and tri-morbidity.

A Longitudinal Pathway for Clinical Educators: a Case Study.

This article was migrated. The article was marked as recommended. It is increasingly being recognised that medical education research and scholarship are essential if we are to provide innovative, research-informed teaching to medical students. Developing a discrete pathway for the professional development of clinical educators side by side with clinical training would enable such training to be offered to high caliber candidates. However, the challenges faced by clinical educators trying to deliver both the clinical and educational components of their training to a high standard must not be underestimated. In addition, employing institutions need to consider and agree criteria for career progression of these clinical academics. Identifying a mentor who can guide professional development is crucial, particularly in the early stages.