Setting up and operationalizing a health professions education research (HPER) unit: AMEE Guide No.170.

In the same way as clinical medicine, health professions education should be evidence-based rather than based on tradition and convenience. Health professions education research (HPER), an academic area that first emerged in the 1950s, is essential for identifying new and better ways to educate health professionals. Again, just as with clinical research, setting up sustainable HPER units is critical to coordinate research efforts and facilitate the production of clear and strategic HPER. In this AMEE guide we draw upon the scholarly and grey literature and our own experiences as HPER unit leaders in several different global contexts to provide practical guidance on establishing and sustaining a HPER unit. We outline the multiple elements and considerations required to set up and operationalize a successful HPER unit, from engagement of key stakeholders and documentation of milestones to the production of programmatic research and its implementation. These are considered under the areas of  â€¢ Who do you need to partner with?  â€¢ Setting the agenda - or What will your unit be known for?  â€¢ Your most valuable resource - people!  â€¢ Operationalizing your HPER agenda  â€¢ Leading the way  We provide concrete tips on each of the above and illustrate these key steps with examples from our own experiences or the wider literature. Whether the reader is beginning, maintaining, or seeking to renew their HPER unit, we hope that the guidance we provide is as useful as it has been to us during our own research program building endeavours.

A Scoping Review of the Literature on Entrustable Professional Activities in Surgery Residency Programs.

OBJECTIVE: Entrustable professional activities (EPAs) are a crucial component of contemporary postgraduate medical education with many surgery residency programs having implemented EPAs as a competency assessment framework to assess and provide feedback on the performance of their residents. Despite broad implementation of EPAs, there is a paucity of evidence regarding the impact of EPAs on the learners and learning environments. A first step in improving understanding of the use and impact of EPAs is by mapping the rising number of EPA-related publications from the field of surgery. The primary objective of this scoping review is to examine the nature, extent, and range of articles on the development, implementation, and assessment of EPAs. The second objective is to identify the experiences and factors that influence EPA implementation and use in practice in surgical specialties. DESIGN: Scoping review. Four electronic databases (Medline, Embase, Education Source, and ERIC) were searched on January 20, 2022, and then again on July 19, 2023. A quasi-statistical content analysis was employed to quantify and draw meaning from the information related to the development, implementation, assessment, validity, reliability, and experiences with EPAs in the workplace. PARTICIPANTS: A total of 42 empirical and nonempirical articles were included. RESULTS: Four thematic categories describe the topic areas in included articles related to: 1) the development and refinement of EPAs, including the multiple steps taken to develop and refine unique EPAs for surgery residency programs; 2) the methods for implementing EPAs; 3) outcomes of EPA use in practice; 4) barriers, facilitators, and areas for improvement for the implementation and use of EPAs in surgical education. CONCLUSIONS: This scoping review highlights the key trends and gaps from the rapidly increasing number of publications on EPAs in surgery residency, from development to their use in the workplace. Existing EPA studies lack a theoretical and/or conceptual basis; future development and implementation studies should adopt implementation science frameworks to better structure and operationalize EPAs within surgery residency programs.

How Surgeons Think to Avoid Error: A Case Study of the Neurovascular Bundle Sparing During a Robotic Prostatectomy.

OBJECTIVE: To illustrate how experts efficiently navigate a "slowing down moment" to obtain optimal surgical outcomes using the neurovascular bundle sparing during a robotic prostatectomy as a case study. DESIGN: A series of semistructured interviews with four expert uro-oncologists were completed using a cognitive task analysis methodology. Cognitive task analysis, CTA, refers to the interview and extraction of a general body of knowledge. Each interview participant completed four 1 to 2-hour semistructured CTA interviews. The interview data were then deconstructed, coded, and analyzed using a grounded theory analysis to produce a CTA-grid for a robotic prostatectomy for each surgeon, with headings of: surgical steps, simplification maneuvers, visual cues, error/complication recognition, and error/complication management and avoidance. SETTING: The study took place at an academic teaching hospital located in an urban center in Canada. PARTICIPANTS: Four expert uro-oncologists participated in the study. RESULTS: Visual cues, landmarks, common pitfalls, and technique were identified as the 4 key components of the decision-making happening during a slowing down moment in the neurovascular bundle sparing during a robotic prostatectomy. CONCLUSION: The data obtained from the CTA is novel information identifying patterns and cues that expert surgeons use to inform their surgical decision-making and avoid errors. This decision-making knowledge of visual cues, landmarks, common pitfalls and techniques is also generalizable for other surgical subspecialties. Surgeon educators, surgical teaching programs and trainees looking to improve their decision-making skills could use these components to guide their educational strategies.

Family Member Experiences in Intensive Care Units Care: Insights From a Family Involvement Tool Implementation Trial.

Family involvement is widely considered an important part of patient care in the intensive care unit. From professional health care organizations, government, and hospital associations, there has been a cultural shift toward family presence as part of a wider commitment to patient-centered care. At the same time, the meaning and impact of family involvement in the intensive care unit setting remain opaque and under-studied. This study employed an ethnographic approach to better understand family involvement in practice and from the perspective of health care professionals and family members by studying an implementation trial of a family involvement tool in two intensive care units over 2 years. The findings revealed that an expanded and self-defined role for family members as carers in the intensive care unit challenged the current configuration of the nurse patient/family relationship and that family members were aware of these dynamics. While the intensive care unit implementation teams were both motivated to implement a novel way of facilitating family involvement, the processual, organizational, and contextual factors in the intensive care units largely determined the possibilities of its application. This suggests that interventions should address the specific context in which they are employed.

Twelve tips for bringing competencies into continuing professional development: Curriculum mapping.

This article was migrated. The article was marked as recommended. There is a growing worldwide awareness in the field of health professions education and research that a successful implementation of competency-based medical education (CBME) requires embracing all stages of professional development (from undergraduate, through residency to continuing education). However, despite increased levels of cognizance and even enthusiasm about the importance of the entire continuum for the ultimate goal of improved healthcare, much work still remains as CBME principles are not widely adopted in continuing professional development (CPD). Much has been written about the process of competency-based curriculum development (e.g., the formation and development of meaningful and measurable outcomes) in undergraduate studies and postgraduate training, but not in CPD. If we expect a CPD curriculum to integrate CBME, competencies must be developed and clearly specified how they will fit into a coherent and implementable curriculum structure. In this article, we describe existing practices some educational institutions have, including our experiences in the Office of CPD at the University of Ottawa, Canada, in designing a competency-based curriculum and provide 12 tips for those who begin their journey of organizing, developing, and implementing such curricula. We conclude that in order to translate a competency-based approach into CPD, educational programs will have to refine curricula across health professionals' education using curriculum mapping as an important tool of curriculum development and evaluation.