Journal of Graduate Medical Education 

About: Journal of Graduate Medical Education is an academic journal published by Accreditation Council for Graduate Medical Education. The journal publishes majorly in the area(s): Graduate medical education & Medicine. It has an ISSN identifier of 1949-8357. Over the lifetime, 2261 publications have been published receiving 34734 citations.

Using Effect Size-or Why the P Value Is Not Enough.

Abstract: Effect size helps readers understand the magnitude of differences found, whereas statistical significance examines whether the findings are likely to be due to chance. Both are essential for readers to understand the full impact of your work. Report both in the Abstract and Results sections.

Analyzing and Interpreting Data From Likert-Type Scales

Abstract: Likert-type scales are frequently used in medical education and medical education research. Common uses include end-of-rotation trainee feedback, faculty evaluations of trainees, and assessment of performance after an educational intervention. A sizable percentage of the educational research manuscripts submitted to the Journal of Graduate Medical Education employ a Likert scale for part or all of the outcome assessments. Thus, understanding the interpretation and analysis of data derived from Likert scales is imperative for those working in medical education and education research. The goal of this article is to provide readers who do not have extensive statistics background with the basics needed to understand these concepts. Developed in 1932 by Rensis Likert1 to measure attitudes, the typical Likert scale is a 5- or 7-point ordinal scale used by respondents to rate the degree to which they agree or disagree with a statement (table). In an ordinal scale, responses can be rated or ranked, but the distance between responses is not measurable. Thus, the differences between “always,” “often,” and “sometimes” on a frequency response Likert scale are not necessarily equal. In other words, one cannot assume that the difference between responses is equidistant even though the numbers assigned to those responses are. This is in contrast to interval data, in which the difference between responses can be calculated and the numbers do refer to a measureable “something.” An example of interval data would be numbers of procedures done per resident: a score of 3 means the resident has conducted 3 procedures. Interestingly, with computer technology, survey designers can create continuous measure scales that do provide interval responses as an alternative to a Likert scale. The various continuous measures for pain are well-known examples of this (figure 1). FIGURE 1 Continuous Measure Example TABLE Typical Likert Scales

Nuts and Bolts of Entrustable Professional Activities

Abstract: The entrustable professional activity (EPA) concept allows faculty to make competency-based decisions on the level of supervision required by trainees. Competency-based education targets standardized levels of proficiency to guarantee that all learners have a sufficient level of proficiency at the completion of training. Collectively, the competencies (ACGME or CanMEDS) constitute a framework that describes the qualities of professionals. Such a framework provides generalized descriptions to guide learners, their supervisors, and institutions in teaching and assessment. However, these frameworks must translate to the world of medical practice. EPAs were conceived to facilitate this translation, addressing the concern that competency frameworks would otherwise be too theoretical to be useful for training and assessment in daily practice.

Burnout During Residency Training: A Literature Review

Abstract: Objective Burnout is a state of mental and physical exhaustion related to work or care giving activities. Burnout during residency training has gained significant attention secondary to concerns regarding job performance and patient care. This article reviews the relevant literature on burnout in order to provide information to educators about its prevalence, features, impact, and potential interventions. Methods Studies were identified through a Medline and PsychInfo search from 1974 to 2009. Fifty-one studies were identified. Definition and description of burnout and measurement methods are presented followed by a thorough review of the studies. Results An examination of the burnout literature reveals that it is prevalent in medical students (28%–45%), residents (27%–75%, depending on specialty), as well as practicing physicians. Psychological distress and physical symptoms can impact work performance and patient safety. Distress during medical school can lead to burnout, which in turn can resu...

Qualitative Research Part II: Participants, Analysis, and Quality Assurance

Abstract: This is the second of a two-part series on qualitative research. Part 1 in the December 2011 issue of Journal of Graduate Medical Education provided an introduction to the topic and compared characteristics of quantitative and qualitative research, identified common data collection approaches, and briefly described data analysis and quality assessment techniques. Part II describes in more detail specific techniques and methods used to select participants, analyze data, and ensure research quality and rigor. If you are relatively new to qualitative research, some references you may find especially helpful are provided below. The two texts by Creswell 2008 and 2009 are clear and practical.1,2 In 2008, the British Medical Journal offered a series of short essays on qualitative research; the references provided are easily read and digested.3–,8 For those wishing to pursue qualitative research in more detail, a suggestion is to start with the appropriate chapters in Creswell 2008,1 and then move to the other texts suggested.9–,11 To summarize the previous editorial, while quantitative research focuses predominantly on the impact of an intervention and generally answers questions like “did it work?” and “what was the outcome?”, qualitative research focuses on understanding the intervention or phenomenon and exploring questions like “why was this effective or not?” and “how is this helpful for learning?” The intent of qualitative research is to contribute to understanding. Hence, the research procedures for selecting participants, analyzing data, and ensuring research rigor differ from those for quantitative research. The following sections address these approaches. table 1 provides a comparative summary of methodological approaches for quantitative and qualitative research. TABLE 1 A Comparison of Qualitative and Quantitative Methodological Approaches Data collection methods most commonly used in qualitative research are individual or group interviews (including focus groups), observation, and document review. They can be used alone or in combination. While the following sections are written in the context of using interviews or focus groups to collect data, the principles described for sample selection, data analysis, and quality assurance are applicable across qualitative approaches.