How to measure success: the impact of scholarly concentrations on students--a literature review.
TL;DR: Scholarly concentrations (SCs) are elective or required curricular experiences that give students opportunities to study subjects in-depth beyond the conventional medical curriculum and require them to complete an independent scholarly project.
Abstract: PurposeScholarly concentrations (SCs) are elective or required curricular experiences that give students opportunities to study subjects in-depth beyond the conventional medical curriculum and require them to complete an independent scholarly project. This literature review explores the ques
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TL;DR: Arguments in favor of the use of EPAs in UME are discussed, and it is suggested that EPAs could be operationalized for UME if UME-specific EPAs were developed and the entrustment scale were expanded.
Abstract: Many graduate medical education (GME) programs have started to consider and adopt entrustable professional activities (EPAs) in their competency frameworks. Do EPAs also have a place in undergraduate medical education (UME)? In this Perspective article, the authors discuss arguments in favor of the use of EPAs in UME. A competency framework that aligns UME and GME outcome expectations would allow for better integration across the educational continuum. The EPA approach would be consistent with what is known about progressive skill development. The key principles underlying EPAs, workplace learning and trust, are generalizable and would also be applicable to UME learners. Lastly, EPAs could increase transparency in the workplace regarding student abilities and help ensure safe and quality patient care. The authors also outline what UME EPAs might look like, suggesting core, specialty-specific, and elective EPAs related to core clinical residency entry expectations and learner interest. UME EPAs would be defined as essential health care activities with which one would expect to entrust a resident at the beginning of residency to perform without direct supervision. Finally, the authors recommend a refinement and expansion of the entrustment and supervision scale previously developed for GME to better incorporate the supervision expectations for UME learners. They suggest that EPAs could be operationalized for UME if UME-specific EPAs were developed and the entrustment scale were expanded.
297 citations
TL;DR: An explanation for why research competence does not align more closely with research motivation is derived from students’ lack of understanding of the concept of translational research, as well as a lack of awareness of the research activity being undertaken by their teachers and mentors.
Abstract: Background: Research training is essential in a modern undergraduate medical curriculum. Our evaluation aimed to (a) gauge students’ awareness of research activities, (b) compare students’ perceptions of their transferable and research-specific skills competencies, (c) determine students’ motivation for research and (d) obtain students’ personal views on doing research. Methods: Undergraduate medical students (N=317) completed a research skills questionnaire developed by the Centre for Excellence in Teaching and Learning in Applied Undergraduate Research Skills (CETLAURS) at Reading University. The questionnaire assessed students’ transferable skills, research-specific skills (e.g., study design, data collection and data analysis), research experience and attitude and motivation towards doing research. Results: The majority of students are motivated to pursue research. Graduate entrants and male students appear to be the most confident regarding their research skills competencies. Although all students recognise the role of research in medical practice, many are unaware of the medical research activities or successes within their university. Of those who report no interest in a career incorporating research, a common perception was that researchers are isolated from patients and clinical practice. Discussion: Students have a narrow definition of research and what it entails. An explanation for why research competence does not align more closely with research motivation is derived from students’ lack of understanding of the concept of translational research, as well as a lack of awareness of the research activity being undertaken by their teachers and mentors. We plan to address this with specific research awareness initiatives. Keywords: undergraduate; research skills; translational research; training; scholarly activity programmes (Published: 10 September 2010) Citation: Medical Education Online 2010, 15: 5212 - DOI: 10.3402/meo.v15i0.5212
211 citations
TL;DR: Encouraging research culture and fostering the development of inquiry and research-based learning among medical students is now a high priority in order to develop more and better clinician-researchers.
Abstract: The rapid development of new drugs, therapies, and devices has created a dramatic increase in the number of clinical research studies that highlights the need for greater participation in research by physicians as well as patients. Furthermore, the potential of clinical research is unlikely to be reached without greater participation of physicians in research. Physicians face a variety of barriers with regard to participation in clinical research. These barriers are system-or organization-related as well as research-and physician-related. To encourage physician participation, appropriate organizational and operational infrastructures are needed in health care institutes to support research planning and management. All physicians should receive education and training in the fundamentals of research design and methodology, which need to be incorporated into undergraduate medical education and postgraduate training curricula and then reinforced through continuing medical education. Medical schools need to analyze current practices of teaching-learning and research, and reflect upon possible changes needed to develop a 'student-focused teaching-learning and research culture'. This article examines the barriers to and benefits of physician participation in clinical research as well as interventions needed to increase their participation, including the specific role of undergraduate medical education. The main challenge is the unwillingness of many physicians and patients to participate in clinical trials. Barriers to participation include lack of time, lack of resources, trial-specific issues, communication difficulties, conflicts between the role of clinician and scientist, inadequate research experience and training for physicians, lack of rewards and recognition for physicians, and sometimes a scientifically uninteresting research question, among others. Strategies to encourage physician participation in clinical research include financial and nonfinancial incentives, adequate training, research questions that are in line with physician interests and have clear potential to improve patient care, and regular feedback. Finally, encouraging research culture and fostering the development of inquiry and research-based learning among medical students is now a high priority in order to develop more and better clinician-researchers.
108 citations
TL;DR: The authors believe that this type of program has the potential to significantly impact the education of medical students through scholarly, in-depth inquiry and longitudinal faculty mentorship.
Abstract: Many medical curricula now include programs that provide students with opportunities for scholarship beyond that provided by their traditional, core curricula. These scholarly concentration (SC) programs vary greatly in focus and structure, but they share the goal of producing physicians with improved analytic, creative, and critical-thinking skills. In this article, the authors explore models of both required and elective SC programs. They gathered information through a review of medical school Web sites and direct contact with representatives of individual programs. Additionally, they discuss in-depth the SC programs of the Warren Alpert Medical School of Brown University; the University of South Florida College of Medicine; the University of California, San Francisco; and Stanford University School of Medicine. The authors describe each program's focus, participation, duration, centralization, capstone requirement, faculty involvement, and areas of concentration. Established to address a variety of challenges in the U.S. medical education system, these four programs provide an array of possible models for schools that are considering the establishment of an SC program. Although data on the impact of SC programs are lacking, the authors believe that this type of program has the potential to significantly impact the education of medical students through scholarly, in-depth inquiry and longitudinal faculty mentorship.
99 citations
TL;DR: The scholarly work that has addressed the fifth recommendation of the 1988 World Conference on Medical Education: ‘Train teachers as educators, not content experts alone, and reward excellence in this field as fully as excellence in biomedical research or clinical practice’ is described.
Abstract: Context
This article describes the scholarly work that has addressed the fifth recommendation of the 1988 World Conference on Medical Education: ‘Train teachers as educators, not content experts alone, and reward excellence in this field as fully as excellence in biomedical research or clinical practice’.
Progress
Over the past 30 years, scholars have defined the preparation needed for teaching and other educator roles, and created faculty development delivery systems to train teachers as educators. To reward the excellence of educators, scholars have expanded definitions of scholarship, defined educator roles and criteria for judging excellence, and developed educator portfolios to make achievements visible for peer review. Despite these efforts, the scholarship of discovery continues to be more highly prized and rewarded than the scholarship of teaching. These values are deeply embedded in university culture and policies.
Challenges
To remedy the structural inequalities between researchers and educators, a holistic approach to rewarding the broad range of educational roles and educational scholarship is needed. This requires strong advocacy to create changes in academic rewards and support policies, provide a clear career trajectory for educators using learning analytics, expand programmes for faculty development, support health professions education scholarship units and academies of medical educators, and create mechanisms to ensure high standards for all educators.
76 citations
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01 Apr 2009
TL;DR: The "Kirkpatrick Model" for evaluating training programs is the most widely used approach in the corporate, government, and academic worlds as discussed by the authors, focusing on four key areas: reaction, learning, behavior, and results.
Abstract: The "Kirkpatrick Model" for Evaluating Training Programs is the most widely used approach in the corporate, government, and academic worlds. First developed in 1959, it focuses on four key areas: reaction, learning, behavior, and results. Evaluating Training Programs provides a comprehensive guide to Kirkpatrick's four-level model, along with detailed case studies that show how the approach is used successfully in a wide range of programs and institutions. The third edition revises and updates existing material and includes new strategies for managing change effectively.
3,758 citations
TL;DR: A conceptual framework for and a brief update on commonly used and emerging methods of assessment is provided, discusses the strengths and limitations of each method, and identifies several major challenges in assessing professional competence and performance.
Abstract: This article in the Medical Education series provides a conceptual framework for and a brief update on commonly used and emerging methods of assessment, discusses the strengths and limitations of each method, and identifies several major challenges in assessing professional competence and performance.
1,288 citations
TL;DR: The authors found that in the 1970s and 1980s much attention was given to the need for and the development of professional competencies for many medical disciplines, little attention was devoted to defining the benchmarks of specific competencies, how to attain them, or the evaluation of competence.
Abstract: Realizing medical education is on the brink of a major paradigm shift from structure- and process-based to competency-based education and measurement of outcomes, the authors reviewed the existing medical literature to provide practical insight into how to accomplish full implementation and evaluation of this new paradigm. They searched Medline and the Educational Resource Information Clearinghouse from the 1960s until the present, reviewed the titles and abstracts of the 469 articles the search produced, and chose 68 relevant articles for full review. The authors found that in the 1970s and 1980s much attention was given to the need for and the development of professional competencies for many medical disciplines. Little attention, however, was devoted to defining the benchmarks of specific competencies, how to attain them, or the evaluation of competence. Lack of evaluation strategies was likely one of the forces responsible for the threedecade lag between initiation of the movement and widespread adoption. Lessons learned from past experiences include the importance of strategic planning and faculty and learner buy-in for defining competencies. In addition, the benchmarks for defining competency and the thresholds for attaining competence must be clearly delineated. The development of appropriate assessment tools to measure competence remains the challenge of this decade, and educators must be responsible for studying the impact of this paradigm shift to determine whether its ultimate effect is the production of more competent physicians. Acad. Med. 2002;77:361‐367.
866 citations
TL;DR: This review concludes that the quality of medical education research in the United States is under threat due to a combination of factors, including the high level of uncertainty about the sources of abuse, and the low level of awareness of abuse in the medical profession.
Abstract: CONTEXT Authors have questioned the degree to which medical education research informs practice and advances the science of medical education. OBJECTIVE This study aims to propose a framework for classifying the purposes of education research and to quantify the frequencies of purposes among medical education experiments. METHODS We looked at articles published in 2003 and 2004 in Academic Medicine, Advances in Health Sciences Education, American Journal of Surgery, Journal of General Internal Medicine, Medical Education and Teaching and Learning in Medicine (1459 articles). From the 185 articles describing education experiments, a random sample of 110 was selected. The purpose of each study was classified as description ('What was done?'), justification ('Did it work?') or clarification ('Why or how did it work?'). Educational topics were identified inductively and each study was classified accordingly. RESULTS Of the 105 articles suitable for review, 75 (72%) were justification studies, 17 (16%) were description studies, and 13 (12%) were clarification studies. Experimental studies of assessment methods (5/6, 83%) and interventions aimed at knowledge and attitudes (5/28, 18%) were more likely to be clarification studies than were studies addressing other educational topics (< 8%). CONCLUSIONS Clarification studies are uncommon in experimental studies in medical education. Studies with this purpose (i.e. studies asking: 'How and why does it work?') are needed to deepen our understanding and advance the art and science of medical education. We hope that this framework stimulates education scholars to reflect on the purpose of their inquiry and the research questions they ask, and to strive to ask more clarification questions.
383 citations
TL;DR: Over two decades of experience with NIH-sponsored medical student research programs at two medical schools strongly support the ability of these programs to interest medical students in research and academic careers.
Abstract: Context A decline in the number of physician-scientists has been identified in the United States for at least two decades. Although many mechanisms have been proposed to reverse this trend, most of these have concentrated on MD/PhD programs, research in subspecialty fellowships, and other approaches later in physician training. Few have emphasized early medical student research experiences as a contributing solution. Objective To determine the effect of a medical student research experience on career choices and attitudes about biomedical research. Design, Setting, and Participants We jointly report 25 years of experience with National Institutes of Health (NIH)-sponsored Medical Student Research Fellowship programs (MSRFs) at two colleges of medicine, the University of Tennessee Health Science Center and Vanderbilt University. In both programs, students work during the summer of their first or second year of medical school on a research project that is mentored by an established scientist and participate in a structured program (lectures, visiting professor). Main Outcome Measures We gathered data using pre- and postresearch fellowship questionnaires to assess (a) quality of research experiences; (b) tabulation of productivity, that is, pre-sentations, abstracts, publications, and awards; (c) long-term tracking of former program participants; (d) comparison of residency placements by medical student researchers; and (e) comments from former program participants on the effects of their students9 research experiences on career choices. Results During this time, approximately 1,000 medical students participated in the two programs. Follow-up data (for short-term evaluations, 96-132 respondents with a response rate > 82%; for long-term evaluations, 88-118 respondents with a response rate > 29-33%) strongly suggest (a) interest in an academic career increased, (b) one-third to half of former student respondents considered themselves to be in academic medicine, (c) the vast majority of students conducted additional research after their medical student research experience, and (d) a large number of students were currently doing research or had published or presented their work at scientific meetings. Conclusions Over two decades of experience with NIH-sponsored medical student research programs at two medical schools strongly support the ability of these programs to interest medical students in research and academic careers. MSRFs should be included in strategies to reverse the decline in the number of physician-scientists.
261 citations