Maureen Topps

Exploring digital professionalism

Abstract The widespread use of digital media (both computing devices and the services they access) has blurred the boundaries between our personal and professional lives. Contemporary students are the last to remember a time before the widespread use of the Internet and they will be the first to practice in a largely e-health environment. This article explores concepts of digital professionalism and their place in contemporary medical education, and proposes a series of principles of digital professionalism to guide teaching, learning and practice in the healthcare professions. Despite the many risks and fears surrounding their use, digital media are not an intrinsic threat to medical professionalism. Professionals should maintain the capacity for deliberate, ethical, and accountable practice when using digital media. The authors describe a digital professionalism framework structured around concepts of proficiency, reputation, and responsibility. Digital professionalism can be integrated into medical education using strategies based on awareness, alignment, assessment, and accountability. These principles of digital professionalism provide a way for medical students and medical practitioners to embrace the positive aspects of digital media use while being mindful and deliberate in its use to avoid or minimize any negative consequences.

Evolving concepts of assessment in a competency-based world

Abstract Competency-based medical education (CBME) is an approach to the design of educational systems or curricula that focuses on graduate abilities or competencies. It has been adopted in many jurisdictions, and in recent years an explosion of publications has examined its implementation and provided a critique of the approach. Assessment in a CBME context is often based on observations or judgments about an individual’s level of expertise; it emphasizes frequent, direct observation of performance along with constructive and timely feedback to ensure that learners, including clinicians, have the expertise they need to perform entrusted tasks. This paper explores recent developments since the publication in 2010 of Holmboe and colleagues’ description of CBME assessment. Seven themes regarding assessment that arose at the second invitational summit on CBME, held in 2013, are described: competency frameworks, the reconceptualization of validity, qualitative methods, milestones, feedback, assessment processes, and assessment across the medical education continuum. Medical educators interested in CBME, or assessment more generally, should consider the implications for their practice of the review of these emerging concepts.

Using Activity Data and Analytics to Address Medical Education’s Social Contract

Abstract Contemporary medical education is increasingly dependent on the assessment judgments and in-training evaluations of preceptors, especially in competency-based programs. However, preceptors are subject to biases and inconsistencies in undertaking these assessment tasks, and they are often reluctant to provide a negative judgment on their learners. The sustainability and reliability of these models of assessment are therefore questionable and more reliable alternatives are needed. We now find ourselves in a digital world, immersed in ambient surveillance on a large portion of our lives. If the commercial world is tracking our activities to a fine degree, why are we not embracing these same techniques in tracking the activities of our learners? Some would cite the right to privacy, but others have noted that we have effectively suborned that right some time ago. Either way, parsing these data (much of which we already collect) using activity-driven metrics and big data analytic approaches can provide a much broader-based assessment of the competencies of our learners, based on what they do rather than what their teachers say they do. Based on our work with virtual scenarios and virtual learners, and on our work with the Medbiquitous Learning Experience Working Group, we present some suggested approaches to how medical education programs can embrace activity metrics.

Where do physicians start and end

Medical education is primarily about training physicians and maintaining their capabilities over time. Given that physicians are the primary focus of the field, there is a need for a clear idea of what physicians are or could be. This paper seeks to explore this issue by posing the simple question: ?Where do physicians start and end?’ In doing so, the authors explore a series of different conceptual frames, including those of a physician’s physical dimensions, their cellular boundaries, personal intentions and beliefs, professional identity, regulation, entrustability, professional performance, extended cognition, and disability. This existential look at the concept of a physician demonstrates the plurality of medical education scholarship and the implications of the many intersecting points of view in the field.