Margaret Bearman

Random comparison of ‘virtual patient’ models in the context of teaching clinical communication skills

Two types of virtual patient designs can be distinguished: a ‘narrative’ structure and a ‘problem‐solving’ structure. This study compares the same virtual patient with two different structures within the domain of communication skills.

Qualitative synthesis and systematic review in health professions education

Context  Formal qualitative synthesis is the process of pooling qualitative and mixed‐method research data, and then drawing conclusions regarding the collective meaning of the research. Qualitative synthesis is regularly used within systematic reviews in the health professions literature, although such use has been heavily debated in the general literature. This controversy arises in part from the inherent tensions found when generalisations are derived from in‐depth studies that are heavily context‐dependent.

Learning surgical communication, leadership and teamwork through simulation.

BACKGROUND In Australia and New Zealand, surgical trainees are expected to develop competencies across 9 domains. Although structured training is provided in several domains, there is little or no formal program for professionalism, communication, collaboration, and management and leadership. The Australian federal Department of Health and Aging funded a pilot course in simulation-based education to address these competencies for surgical trainees. This article describes the course and evaluation. METHODS Course development: Content and methods drew on best-evidence for teaching and learning these competencies from other disciplines. Course evaluation: Participants completed surveys using rating scales and free text comments to identify aspects of the course that worked well and those that needed improvement. RESULTS Eleven of 12 participants completed evaluation forms immediately after the course. Participants reported largely meeting learning objectives and valuing the educational methods. High levels of realism in simulations contributed to the ease with which participants immersed themselves in scenarios. CONCLUSIONS This study demonstrates that a course designed to teach competencies in communication, teamwork, leadership, and the encompassing professionalism to surgical trainees is feasible. Although participants valued the content and methods, they identified areas for development. Limitations of the evaluation are highlighted, and further areas for research are identified.

Systematic review methodology in higher education

Systematic review methodology can be distinguished from narrative reviews of the literature through its emphasis on transparent, structured and comprehensive approaches to searching the literature and its requirement for formal synthesis of research findings. There appears to be relatively little use of the systematic review methodology within the higher education sector. This paper outlines the systematic review methodology, including variations, explores debates regarding systematic reviews from the educational literature and describes particular issues for its application within higher education. We conclude that thoughtful use of the systematic review methodology may be of benefit to the sector.

‘Is there a Plan B?’: clinical educators supporting underperforming students in practice settings

The relationship between supervisors and students in work-based clinical settings is complex, but critical to the appropriate development of the learner. This study investigated the experiences of physiotherapy clinical educators of working with underperforming students, and specifically explored educational strategies used with this subgroup of learners. Findings indicated the cyclical relationship between clinical educators stressful experiences of working in multifaceted roles within a clinical environment and their tendencies to provide ‘more more more’ – more of the same strategies, more feedback and supervision, and more of themselves – as their primary approach to supporting underperforming students. The data suggest that clinical educators did not have an alternative (‘Plan B’) if the ‘more more more’ approach did not produce results. We argue that the problem of managing underperforming students is a complex one without easy solutions but a focus on systems changes rather than upon individual students or clinical educators should be considered.

Sociomateriality matters to family practitioners as supervisors

A useful perspective from which to frame this work is Rogoff’s three planes of analysis for understanding learning, which comprise those of the individual, the interpersonal and the community. These three planes are inseparable – learning is always mutually constituted across these three analytical planes – so that when one plane is foregrounded, the others remain in the background, but still inform understanding. The article by Wearne et al. foregrounds the individual primarily and places some focus on the interpersonal to better elucidate the supervisory relationship. What remains primarily in the background are the communities within which the supervision occurs and their interconnections with the supervisor and trainee, and the supervisory relationship. We argue here, as Rogoff does, that it is incomplete to focus only on the relationship between individual development and social interaction without concern for the cultural activity in which personal and interpersonal actions take place. Even when the environmental milieu is briefly discussed, it is presented as something that is under the control of the FP-supervisors who ‘are responsible for constructing positive learning environments’.

Learning Empathy Through Simulation: A Systematic Literature Review

Summary Statement Simulation is increasingly used as an educational methodology for teaching empathy to preservice health professional students. This systematic review aimed to determine if and how simulation, including games, simulated patients, and role-play, might develop empathy and empathetic behaviors in learners. Eleven databases or clearing houses including MEDLINE, EMBASE, CINAHL, PsychInfo, and ERIC were searched for all articles published from any date until May 2014, using terms relating to (i) preservice health professional students, (ii) simulation, and (iii) empathy. Twenty-seven studies met the inclusion criteria, including 9 randomized controlled trials. A narrative synthesis suggests that simulation may be an appropriate method to teach empathy to preservice health professional students and identifies the value of the learner taking the role of the patient.

Avoiding tokenism in health professional education

Perhaps one way to think about the scientist-doctor is as a ‘go-between’ who works at the interface between the patient and the technium To return to the two papers published in this issue of the journal, as both imply, thinking about thinking is clearly important, but the kind of thinking in which students and trainees need to engage concerns their roles as applied scientists and how one co-produces knowledge with others. Perhaps the issue to be resolved does not really concern a ‘yes ⁄ no’ decision on the impact of philosophy, but refers to where philosophy is to be found. Rather than problematising the predominance of science in the curriculum, it may be that medical education should become even more scientific but that we need to adopt a broader definition of what that means.

How Technology Shapes Assessment Design: Findings from a Study of University Teachers.

A wide range of technologies has been developed to enhance assessment, but adoption has been inconsistent. This is despite assessment being critical to student learning and certification. To understand why this is the case and how it can be addressed, we need to explore the perspectives of academics responsible for designing and implementing technology-supported assessment strategies. This paper reports on the experience of designing technology-supported assessment based on interviews with 33 Australian university teachers. The findings reveal the desire to achieve greater efficiencies and to be contemporary and innovative as key drivers of technology adoption for assessment. Participants sought to shape student behaviors through their designs and made adaptations in response to positive feedback and undesirable outcomes. Many designs required modification because of a lack of appropriate support, leading to compromise and, in some cases, abandonment. These findings highlight the challenges to effective technology-supported assessment design and demonstrate the difficulties university teachers face when attempting to negotiate mixed messages within institutions and the demands of design work. We use these findings to suggest opportunities to improve support by offering pedagogical guidance and technical help at critical stages of the design process and encouraging an iterative approach to design.

Strategic approaches to simulation-based education: A case study from Australia

This paper addresses some of the challenges met when developing widely distributed, broad spectrum, simulation-based education (SBE) for health professionals, such as resource duplication, inconsistent facilities utilization, discipline-specific silos, and the intersection of academic institutions and health services sectors. We examine three primary contributors to successful simulation-based practices - strategic planning, program development, and professional networks. Further, we provide examples of how each of these contributors function at different levels to assure comprehensive, yet sustainable approaches to implementing SBE for greatest impact at national, state, regional, and institutional levels. We draw on the example of Australia and its state and regional government structures, including the challenges in providing health services across a widely variable geography and population distribution. The types of health services and issues relating to health provision and management reflect those found in many western countries. Our hope is that the experiences gained at each level of governance within Australia may inform similar, successful development in other countries. We emphasize the importance of leadership and investment at the national level that serves to inform state, regional, and institutional efforts through a trickle down effect. Although evaluation of the strategic planning, program development, and professional networks described in this case study is still ongoing, their preliminary coordination has resulted in significant investment and support at all levels.