Faculty retention at a young medical school in crisis times and beyond: prospects, challenges and propositions from a mixed-methods study.

BACKGROUND: Retention of faculty constitutes a significant challenge for higher education institutions, especially in times of crisis. Lebanon has been experiencing economic recession since the end of its civil war in 1990 until its complete collapse in 2019. This resulted in a massive faculty exodus, escaping the daily struggle with the sinking economy. PURPOSE: The purpose of this study was to empirically investigate the factors that precipitate faculty attrition and the measures that foster long-term commitment to the institution in a time of unprecedented crisis. METHODS: An online anonymous survey, using a Likert scale, gathered responses from 92 faculty members. Quantitative findings were complemented by a qualitative exploration of emergent themes in comments. A team of three certified researchers conducted the analysis. Inductive analysis identified recurring themes, with steps like intercoder reliability checks and member-checking enhancing data validity. The researchers ensured methodological rigour, subject expertise, and overall reliability and validity of the thematic analysis. RESULTS: A total of 78 faculty participated in the survey (84.8%), with 79.5% reporting overall satisfaction, but a varying degree of satisfaction was noted across items. Faculty satisfaction was highest in areas such as respectful interactions (91.0%), belonging to the workplace (85.9%), communication from the Dean's office (85.9%), supportive environment and medical school leadership's commitment to retaining faculty (82.1%). Financial assistance, support for research and professional assistance were identified as important retention measures. Effective, transparent communication from leadership was highlighted as a critical factor during times of crisis. CONCLUSION: This study provides strategies for faculty retention in times of crisis that include ensuring timely salary payments, supporting research and professional development, fostering a positive work environment and implementing bonding programmes. Transparent communication from leadership is vital for faculty satisfaction and retention. These findings can aid medical schools and other institutions facing faculty attrition during crises.

Evaluating the validity evidence of an OSCE: results from a new medical school.

BACKGROUND: To prevent the problems of traditional clinical evaluation, the "Objective Structured Clinical Examination (OSCE)" was presented by Harden as a more valid and reliable assessment instrument. However, an essential condition to guarantee a high-quality and effective OSCE is the assurance of evidence to support the validity of its scores. This study examines the psychometric properties of OSCE scores, with an emphasis on consequential and internal structure validity evidence. METHODS: Fifty-three first year medical students took part in a summative OSCE at the Lebanese American University-School of Medicine. Evidence to support consequential validity was gathered by using criterion-based standard setting methods. Internal structure validity evidence was gathered by examining various psychometric measures both at the station level and across the complete OSCE. RESULTS: Compared to our actual method of computing results, the introduction of standard setting resulted in lower students' average grades and a higher cut score. Across stations, Cronbach's alpha was moderately low. CONCLUSION: Gathering consequential and internal structure validity evidence by multiple metrics provides support for or against the quality of an OSCE. It is critical that this analysis be performed routinely on local iterations of given tests, and the results used to enhance the quality of assessment.

Exploring the thesis experience of Master of Health professions education graduates: a qualitative study.

OBJECTIVES: To explore the thesis experience of recent Master of Health Professions Education (MHPE) graduates in the University of Illinois at Chicago (UIC) program. METHODS: This is a qualitative case study exploring the experience of MHPE graduates between 2014 and 2016 (n=31). Using convenience sampling, all graduates with an email address (n=30) were invited to participate in an online survey and semi-structured interviews. Interviews were completed in-person or via telephone or video conference; interviewers collected detailed notes and audio recordings.  Two authors independently analyzed the data iteratively using thematic analysis and discrepancies were discussed and resolved. RESULTS: Survey results (n=20, 67%) revealed an average graduation of 5.1 years; 10 graduates (33%) were interviewed. Three themes related to the thesis experience were identified: success factors, challenges, and outcomes. Success factors, when present, promoted completion of a thesis; these included: a supportive program environment, time management, available resources, MHPE foundational coursework, aligning theses with career goals, and identifying a project with limited scope. Challenges made thesis completion more difficult for graduates; these included: institutional factors, personal or professional responsibilities, burnout, externally-imposed deadlines, and barriers in the research process. Despite these challenges, completing the thesis resulted in many professional or personal benefits (outcomes). CONCLUSIONS: Multiple success factors and challenges were identified in the master's thesis process among MHPE graduates at UIC. These findings can help students conducting education-based scholarship through the master's thesis process. This study also informs program evaluation and improvements and outlines personal and professional outcomes of completing a master's thesis.

Effect of a simulation-based workshop on breaking bad news for anesthesiology residents: an intervention study.

BACKGROUND: Breaking bad news (BBN) to patients and their relatives is a complex and stressful task. The ideal structure, training methods and assessment instruments best used to teach and assess BBN for anesthesiology residents remain unclear. The purpose of this study is to evaluate the effectiveness of an education intervention for BBN based on immersive experiences with a high fidelity simulator and role-play with standardized patients (SPs). A secondary purpose is to gather validity evidence to support the use of a GRIEV_ING instrument to assess BBN skills. METHODS: The communication skills for BBN of 16 residents were assessed via videotaped SP encounters at baseline and immediately post-intervention. Residents' perceptions about their ability and comfort for BBN were collected using pre and post workshop surveys. RESULTS: Posttest scores were significantly higher than the pretest scores for the GRIEV_ING checklist, as well as on the communication global rating. The GRIEV_ING checklist had acceptable inter-rater and internal-consistency reliabilities. Performance was not related to years of training, or previous BBN experience. CONCLUSION: Anesthesiology residents' communication skills when BBN in relation to a critical incident may be improved with educational interventions based on immersive experiences with a high fidelity simulator and role-play with SPs.

Entrustable Professional Activities: A Faculty Development Workshop for Adding EPAs Into Your Medical Trainee's Assessment Portfolio.

INTRODUCTION: The last 3 decades have seen significant changes in medical education and corresponding assessment of medical trainees. Competency-based medical education provided a more comprehensive model than the previous time-based process but remained insufficient. Introduced in 2005, entrustable professional activities (EPAs) offer a more robust curriculum development and assessment process, especially in regard to clinician-oriented workplace-based assessments. Despite their intuitive match with decisions made in the clinical environment daily by clinicians, the development of specialty-specific EPAs and corresponding culturally situated assessment tools has lagged. METHODS: To address this gap, a 90-minute faculty development workshop was created to introduce faculty to EPAs and their assessment and to provide hands-on practice developing and using EPAs. RESULTS: Previous facilitations of this workshop received favorable responses from participants regarding level of detail, understanding of the content, and intent to employ EPAs at their own institutions. DISCUSSION: Implementation of EPAs into the assessment portfolio of medical trainees following this workshop will maximize confidence in determining when a trainee is ready for independent practice.