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BACKGROUND: As endoscopy does not lend itself well to assisting or exposure by the teacher, most of the teaching is, by necessity, done verbally. METHODS: The verbal teaching occurring during 19 colonoscopies and 14 gastroscopies was recorded by dictaphone and later transcribed. The resultant 53-page transcript was then analyzed using the Grounded Theory method. Teaching was compared between learners with less than one month versus more than one month of training and between teaching of colonoscopy versus gastroscopy. RESULTS: The process of iterative review and repeated testing yielded 6 types of verbal teaching: demonstration by the teacher, motor instructions, broad tips/tricks/pointers, verbal feedback, questioning, and non-procedural information. Inter-rater agreement was excellent (Fleiss's kappa = 0.76) between resident (DM), the non-medical educator (MP), and the medical teacher (MM). Overall, there was less non-procedural teaching (6.7% vs 23.7%, p = 0.01) and a trend towards more teaching moments per case (13.2 vs 7.9, p = 0.07) in the first month of the rotation compared to the later months. A greater proportion of the teaching for colonoscopy involved demonstration (13.7% vs. 2.7%, p = 0.040) and tips/tricks/pointers (26.6% vs. 12.4%, p = 0.012) compared to gastroscopy. CONCLUSIONS: We describe a means of categorizing verbal teaching in endoscopy that is simple and shows strong inter-rater agreement that will serve as a starting point for further studies aiming to improve how endoscopy is taught.
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Endoscopía/educación , Enseñanza/clasificación , Competencia Clínica , Colonoscopía/educación , Docentes Médicos , Gastroscopía/educación , Humanos , Enseñanza/métodos , Conducta Verbal/clasificaciónRESUMEN
BACKGROUND: Arts-based approaches to knowledge translation are emerging as powerful interprofessional strategies with potential to facilitate evidence uptake, communication, knowledge, attitude, and behavior change across healthcare provider and consumer groups. These strategies are in the early stages of development. To date, no classification system for arts-based knowledge translation exists, which limits development and understandings of effectiveness in evidence syntheses. PURPOSE: We developed a classification schema of arts-based knowledge translation strategies based on two mechanisms by which these approaches function: (a) the degree of precision in key message delivery, and (b) the degree of end-user participation. We demonstrate how this classification is necessary to explore how context, time, and location shape arts-based knowledge translation strategies. DISCUSSION: Classifying arts-based knowledge translation strategies according to their core attributes extends understandings of the appropriateness of these approaches for various healthcare settings and provider groups. The classification schema developed may enhance understanding of how, where, and for whom arts-based knowledge translation approaches are effective, and enable theorizing of essential knowledge translation constructs, such as the influence of context, time, and location on utilization strategies. LINKING EVIDENCE TO ACTION: The classification schema developed may encourage systematic inquiry into the effectiveness of these approaches in diverse interprofessional contexts.
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Arte , Comunicación , Medicina Basada en la Evidencia/métodos , Conocimientos, Actitudes y Práctica en Salud , Personal de Salud/educación , Enseñanza/clasificación , Investigación Biomédica Traslacional/clasificación , Medicina Basada en la Evidencia/organización & administración , Humanos , Enseñanza/métodos , Investigación Biomédica Traslacional/educaciónRESUMEN
Childhood experiences with nature are decisive for children's wellbeing. The need for outdoor activities has been duly recognized in the preschool curriculum in Slovenia. However, there are some obstacles to this approach-specifically, tick-borne diseases. This study examines the views and experiences of Slovenian preschool teachers (n = 158) with ticks and tick-borne diseases in order to create a safer environment for the further development of outdoor education. The majority of the respondents engage in outdoor teaching once or several times a week. They have very frequent contact with ticks and tick-borne diseases in their professional lives. More than four-fifths of the respondents carry out some tick-prevention measures in preschools, but room for improvement remains. The respondents report rare cases in which parents or guardians have tried to prohibit them from visiting outdoor areas because of tick-borne diseases, and they explain how they dealt with the situation. The attitude of preschool teachers toward ticks and tick-borne diseases did not correlate significantly with the frequency with which they went outdoors in preschools. This study therefore concludes that, despite the objective risks associated with tick-borne diseases, there is still broad consensus among educators and parents on the importance of outdoor education in the early years.
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Conocimientos, Actitudes y Práctica en Salud , Acontecimientos que Cambian la Vida , Maestros/psicología , Enseñanza/estadística & datos numéricos , Enfermedades por Picaduras de Garrapatas/psicología , Garrapatas , Animales , Actividades Humanas , Recreación , Maestros/estadística & datos numéricos , Eslovenia , Enseñanza/clasificaciónRESUMEN
BACKGROUND: Teachers can be at risk of exposure to psychosocial hazards. Improving workplace safety for teachers, within a 'systems thinking' context, should begin with understanding the work. OBJECTIVE: While much is known about what teachers do, little is known about how teachers conceptualize 'work'. Knowing how teachers conceptualize 'work' provides a reference point for exploring attitudes towards work health and safety. METHODS: The paper presents a review of the literature, an overview of heuristic methodology describing and interpreting the lived experience of teachers as workers, and analysis of teachers' accounts of work. The heuristic approach allowed the author to compare their lived experiences and perceptions as a teacher with the lived experience of teachers in the NSW school system. RESULTS: Teaching is work that is both rewarding and hazardous. It is argued that teachers draw on battle motifs, perceive a need for safety within a workplace context, and have an ability to conduct personal risk assessments. CONCLUSIONS: Findings from the study provided direction for the second phase of the project that is aimed at exploring the ways in which teachers conceptualize psychosocial work- related hazards and the extent to which they are visible in teaching practice and policy.
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Empleo , Maestros/psicología , Enseñanza/clasificación , Actitud , Femenino , Heurística , Humanos , Masculino , Nueva Gales del Sur , Factores Socioeconómicos , Encuestas y Cuestionarios , Enseñanza/psicologíaRESUMEN
OBJECTIVE: This study compared live instructor-led training with video-based instruction in personal protective equipment (PPE) donning and doffing. It assessed the difference in performance between (1) attending 1 instructor-led training session in donning and doffing PPE at 1 month prior to assessment, and (2) watching training videos for 1 month. METHODS: This randomized controlled trial pilot study divided 21 medical students and junior doctors into 2 groups. Control group participants attended 1 instructor-led training session. Video group participants watched training videos demonstrating the same procedures, which they could freely watch again at home. After 1 month, a doctor performed a blind evaluation of performance using checklists. RESULTS: Nineteen participants were assessed after 1 month. The mean donning score was 84.8/100 for the instructor-led group and 88/100 for the video group; mean effect size was 3.2 (95% CI: -7.5 to 9.5). The mean doffing score was 79.1/100 for the instructor-led group and 73.9/100 for the video group; mean effect size was 5.2 (95% CI: -7.6 to 18). CONCLUSION: Our study found no significant difference in donning and doffing scores between instructor-led and video lessons. Video training could be a fast and resource-efficient method of training in PPE donning and doffing in responding to the COVID-19 pandemic.
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Personal de Salud/educación , Personal de Salud/psicología , Equipo de Protección Personal , Enseñanza/normas , Personal de Salud/estadística & datos numéricos , Humanos , Pandemias/prevención & control , Pandemias/estadística & datos numéricos , Proyectos Piloto , Enseñanza/clasificación , Enseñanza/estadística & datos numéricosRESUMEN
BACKGROUND: Limited information on the covariates of burnout syndrome in French teachers is available. The aim of this study was to evaluate the relative contributions of individual and contextual factors on the three burnout dimensions: emotional exhaustion, depersonalization, and reduced personal accomplishment. METHODS: The source data come from an epidemiological postal survey on physical and mental health conducted in 2005 among 20,099 education workers (in activity or retired) selected at random from the health plan records of the national education system. The response rate was 52.4%. Teachers in activity currently giving classes to students who participated in the survey (n = 3,940) were invited to complete a self-administered questionnaire including the Maslach Burnout Inventory. 2,558 teachers provided complete data (64.9%). Variables associated with high emotional exhaustion (highest quartile of score), high depersonalization (highest quartile), and reduced personal accomplishment (lowest quartile) were evaluated using multivariate logistic regression. Studied variables referred to demographic characteristics, socio-professional environment, job dissatisfaction, experienced difficulties at work, and teaching motivations. RESULTS: Different variables were associated with each burnout dimension. Female teachers were more susceptible to high emotional exhaustion and reduced personal accomplishment, whereas male teachers were more susceptible to high depersonalization. Elementary school teachers were more susceptible to high emotional exhaustion, but less susceptible to high depersonalization and reduced personal accomplishment than their higher school level counterparts. Experienced difficulties with pupils were associated with all three dimensions. A socio-economically underprivileged school neighbourhood was also related to high emotional exhaustion and high depersonalization. CONCLUSION: Programs to enhance teaching environment might be an interesting approach to try to prevent burnout. It would be useful to take the different dimensions into account in planning the intervention.
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Agotamiento Profesional/psicología , Docentes/estadística & datos numéricos , Adulto , Agotamiento Profesional/clasificación , Estudios Transversales , Recolección de Datos , Interpretación Estadística de Datos , Femenino , Francia , Humanos , Italia , Masculino , Estado Civil , Persona de Mediana Edad , Encuestas y Cuestionarios , Enseñanza/clasificaciónRESUMEN
The purpose of this article is to examine the current health promotion orientation of youth sports clubs in Finland in view of the standards created previously for the health promoting sports club (HPSC). Ninety-seven youth sports clubs participated, and 273 sports club officials and 240 coaches answered the questionnaires. To describe clubs health promotion orientations, an HPSC index was created. The HPSC index was formulated on sub-indices by factor analysis. The sub-indices were: policy, ideology, practice and environment indexes. The results indicate that youth sports clubs are fairly health promoting in general. On average, the clubs fulfilled 12 standards for HPSC out of 22. Every fourth club was categorized as higher health promoting (> or = 15 fulfilled standards), and every third as lower health promoting (<11 fulfilled standards). The variation between clubs was wide. The clubs that had been recognized as exemplary and hence certified by the Young Finland Association were more likely to recognize health promotion than non-certified clubs (OR = 2.36, p = 0.016). The sports club officials were twice as likely to evaluate their clubs as higher health promoting than the coaches (OR = 2.04, p = 0.041). Under the sub-indices, ideologies were recognized best, others less. These findings indicate that minority of the youth sports clubs have realized health promotion comprehensively as a part of their activities. There is a lot of need for development, especially in the area of health promotion policies and practices. The instruments used proved valid and reliable and can therefore be recommended for international use.
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Actitud , Centros de Acondicionamiento/normas , Promoción de la Salud/estadística & datos numéricos , Educación y Entrenamiento Físico/normas , Deportes/normas , Enseñanza/normas , Adolescente , Adulto , Certificación , Niño , Preescolar , Análisis por Conglomerados , Cultura , Escolaridad , Femenino , Finlandia , Centros de Acondicionamiento/organización & administración , Humanos , Masculino , Persona de Mediana Edad , Educación y Entrenamiento Físico/organización & administración , Evaluación de Programas y Proyectos de Salud , Medio Social , Deportes/clasificación , Encuestas y Cuestionarios , Enseñanza/clasificación , Voluntarios , Adulto JovenRESUMEN
AIM: To compare dyad (training in pairs without an instructor) with resource-intensive instructor-led training for laypersons' paediatric resuscitation skills in a non-inferiority trial and examine cost-effectiveness of the training methods. METHODS: In this randomised parallel group non-inferiority trial, 155 dyad and 175 instructor-led laypersons were trained in Basic Life Support and Foreign Body Airway Obstruction Management. Dyads were given instructional videos, hands-on exercises and provided feedback to their partner for 50 min. Instructor-led laypersons trained in groups of six for two hours. Learning were assessed in scenarios immediately after training and, subsequently, at 14 days, 1, and 3 months. Pass rates, cost-effectiveness of producing a competent layperson (passing both tests), and non-inferiority were analysed. RESULTS: Sixty-eight (45.6%) dyad and 130 (74.3%) instructor-led laypersons passed the basic life support test (p < 0.001). For Foreign Body Airway Obstruction Management 77 (54.2%) dyad and 130 (79.3%) for instructor-led laypersons passed (p < 0.001). Skills decreased over three months for both groups. Forty-two (30.4%) dyad and ninety-eight (59.8%) for instructor-led laypersons were competent after training (p < 0.001). The lower effectiveness of dyad training had reduced costs (p < 0.001). For each 10,000 USD allocated to training, dyad training would result in 71 vs. 65 competent laypersons for instructor-led training. Non-inferiority of dyad training could not be established. CONCLUSION: Instructor-led training was the most effective but also the most expensive training method, making it less cost-effective than dyad training. When the aim is to train for quantity rather than quality, dyad training would be the preferred choice of training method.
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Obstrucción de las Vías Aéreas/terapia , Educación no Profesional , Cuerpos Extraños/complicaciones , Paro Cardíaco Extrahospitalario/terapia , Resucitación , Enseñanza , Obstrucción de las Vías Aéreas/etiología , Niño , Análisis Costo-Beneficio , Educación no Profesional/economía , Educación no Profesional/métodos , Evaluación Educacional , Femenino , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Pediatría/métodos , Resucitación/educación , Resucitación/métodos , Enseñanza/clasificación , Enseñanza/normasRESUMEN
OBJECTIVE: A five-level training program was first proposed 10 years ago for surgeons learning endoscopic endonasal surgery (EES) of the skull base. Levels were based on the complexity of anatomy, risk of neurovascular injury, intradural dissection, technical difficulty and vascularity of tumors. METHOD: A three-phase validation concept is proposed: 1) face validity (the classification is related to clinically significant elements), 2) construct validity (the classification predicts the outcome), and 3) inter-team validation (the classification applies to other surgical teams). Consecutive cases over a 1-year time span were retrospectively classified. Primary outcome measures included: complication rates (cranial nerve injury, stroke and vascular injury, cerebrospinal fluid [CSF] leak and infection), estimated blood loss and duration of surgery. RESULTS: Two hundred and nine consecutive cases were analyzed. The distribution of cases for each category was: 63 cases in level II, 70 cases in level III, 66 cases in level IV, and 10 cases in level V. Construct validity demonstrated statistical difference with increasing rate of complications from level II to level III and from level III to level IV; also, specific rates of cranial nerve injury and CSF leak increased between levels III and IV. Face validity identified 162 citations since publication of the original article. Inter-team validation demonstrated no difference between two teams of surgeons. CONCLUSION: This study provides a three-phase validation of training levels for endoscopic skull base surgery. Adoption of a progressive systematic approach to learning EES from least complex to advanced procedures is expected to minimize the risks while surgical teams gain experience. LEVEL OF EVIDENCE: 3 Laryngoscope, 129:2253-2257, 2019.
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Cirugía Endoscópica por Orificios Naturales/educación , Procedimientos Neuroquirúrgicos/educación , Base del Cráneo/cirugía , Cirujanos/educación , Enseñanza/clasificación , Adulto , Pérdida de Sangre Quirúrgica/estadística & datos numéricos , Competencia Clínica/estadística & datos numéricos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Cirugía Endoscópica por Orificios Naturales/efectos adversos , Procedimientos Neuroquirúrgicos/efectos adversos , Nariz/cirugía , Tempo Operativo , Complicaciones Posoperatorias/epidemiología , Complicaciones Posoperatorias/etiología , Estudios RetrospectivosRESUMEN
INTRODUCTION: The Special Forces Assessment and Selection (SFAS) is an extremely physically and mentally demanding 19- to 20-day course designed to determine whether Soldiers are qualified to enter the Special Forces Qualification Course. As a first step to understand medical problems during SFAS, this study examined injuries, illnesses, and activities associated with injuries during the course. MATERIALS AND METHODS: Medical events during the SFAS course were compiled from Sick Call Trackers (a log of medical encounters maintained by medical personnel in the field) and Chronology of Medical Care (Standard Form 600). Descriptive statistics were calculated for each injury and illness and injuries were compiled by the activities performed when the injuries occurred. RESULTS: Of the 800 Soldiers who volunteered for the study, 38% (n = 307/800) and 12% (n = 97/800) experienced one or more injuries and/or illnesses, respectively. The most common injuries were blisters and abrasions/lacerations with incidences of 20% (n = 158/800) and 13% (104/800), respectively. The most common illnesses were respiratory infections, other infections, contact dermatitis, and allergies with incidences of 7% (n = 57/800), 2% (n = 14/800), 2% (n = 14/800), and 2% (n = 13/800), respectively. Among all injuries recorded (n = 573), the most common were blisters (46%), abrasions/lacerations (24%), pain (not otherwise specified) (19%), tendonitis (3%), and sprains (3%). Among all illnesses recorded (n = 133), the most common were respiratory infections (56%), allergies (11%), contact dermatitis (11%), and other infections (11%). Most injuries were experienced during land navigation (44%), team events (20%), and foot marching (11%), running (6%), and the obstacle course (5%), but when the estimated time involved for each event was considered, activities with the highest injury rates were the obstacle course (65 injuries/hr), running (27 injuries/hr), the Combat Readiness Assessment (activity involving combat-related tasks) (20 injuries/hr), and foot marching (16 injuries/hr). CONCLUSION: The major limitations of this investigation were: 1) the low specificity with regard to many of the diagnoses/complaints; and 2) the fact that the medical problems reported here are only those seen by medical care providers and are likely an underestimate of the total morbidity in the SFAS course. Soldiers often self-treat and some may be reluctant to see medical personnel because of how it might affect their rating in the course. Nonetheless, this investigation alerts medical personnel to the injuries and illnesses to expect, and public health workers and leadership with activities to target for injury prevention measures during SFAS.
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Personal Militar/estadística & datos numéricos , Acondicionamiento Físico Humano/normas , Enseñanza/clasificación , Heridas y Lesiones/epidemiología , Adulto , Índice de Masa Corporal , Femenino , Humanos , Incidencia , Masculino , Personal Militar/clasificación , Acondicionamiento Físico Humano/psicología , Acondicionamiento Físico Humano/estadística & datos numéricos , Factores de Riesgo , Enseñanza/estadística & datos numéricos , Estados Unidos/epidemiologíaRESUMEN
Development of a higher-order instruction taxonomy, informed by best practice in driver education (Goals for Driver Education) and self-determination theory (guiding teaching strategies), was tested. Inter-coder reliability was assessed by coding 93 data elements from 5-min clips from three driving instructors. Seventy-three instruction and 32 teaching approach codes were selected. Reliability between two independent coders was high (IOCâ¯=â¯94.6%). Application to data from 17 randomly-selected, 1-h lessons (nâ¯=â¯3 driving instructors) in a pilot study of professional learner driver lessons assessed taxonomy validity. Missed, taken, and untaken opportunities for higher-order instruction via 9 instruction and 19 teaching-approach categories were identified. Reliability assessment and taxonomy application demonstrates evidence to facilitate a comprehensive understanding of driving instruction content and quality, with implications for assessing and evaluating the impact of higher-order instruction in relation to driving and other safety-critical sectors requiring higher-order skills.
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Conducción de Automóvil/educación , Educación Profesional/clasificación , Educación Profesional/métodos , Seguridad , Enseñanza/clasificación , Femenino , Objetivos , Humanos , Masculino , Motivación , Vehículos a Motor , Observación , Variaciones Dependientes del Observador , Proyectos Piloto , Reproducibilidad de los ResultadosRESUMEN
Introducción: Las nuevas generaciones de alumnos (generación Z o nativa digital) en la actualidad han provocado la necesidad de implantar nuevas metodologías docentes en las que el alumnado sea un sujeto activo y participativo en su propio proceso de aprendizaje. Entre estas metodologías, el uso del aprendizaje basado en juegos puede considerarse una alternativa que refuerce a la clásica clase magistral y las clases prácticas en la docencia universitaria. Sujetos y métodos: Utilización del aprendizaje basado en juegos (juegos serios) en los alumnos matriculados de la asignatura de Anatomía Humana I (Aparato Locomotor), de primer curso del grado de Medicina en la Universidad de Zaragoza. Resultados: El uso de esta metodología ha sido valorado, mediante encuesta de evaluación de respuesta voluntaria, de manera muy positiva, haciendo hincapié en el efecto que tiene sobre la motivación, la participación y la integración de contenidos teóricos y prácticos. Conclusión: El aprendizaje basado en juegos debe considerarse como una potente alternativa que mejora la motivación, la participación y la integración de contenido en el aula de educación superior.(AU)
Introduction: The new generations of students, such as the current generation Z or digital natives, have provoked the need to implement new teaching methodologies where students are active and participative subjects in their own learning process. Among these methodologies, the use of game-based learning can be considered an alternative to reinforce the classic master class in university teaching. Subjects and methods: Use of game-based learning (serious games), in students enrolled in the subject of Human Anatomy I (Locomotor System), first year of the Degree of Medicine at the Universidad de Zaragoza. Results: The use of this methodology has been evaluated, by means of a voluntary evaluation survey, in a very positive way, emphasizing the effect on motivation, participation and integration of theoretical and practical contents. Conclusion: Game-based learning should be considered as a powerful alternative that improves motivation, participation and content integration in the higher education classroom.(AU)
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Humanos , Masculino , Femenino , Anatomía/educación , Educación Médica , Motivación , Aprendizaje/clasificación , Enseñanza/clasificación , MedicinaRESUMEN
Unlike in other countries, postgraduate training in Germany is not attached to academic centres. Content and duration of postgraduate training are stipulated by the federal medical boards, with the process being unstructured and solely at the responsibility of the trainee. As a model for a structured postgraduate training programme, the Dutch training system for general practitioners is described in detail. The most important difference is the funding of trainees and training facilities within the frame of structured training programmes by the Dutch Ministry of Health. Acquisition of qualifications thus becomes more important than the work performance of the trainee. After reforming graduate medical training, it is now time to rethink postgraduate training in Germany.
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Curriculum , Educación de Postgrado en Medicina/clasificación , Evaluación Educacional , Medicina Familiar y Comunitaria/educación , Enseñanza/clasificación , Alemania , Países BajosRESUMEN
OBJECTIVES: Endotracheal intubation (ETI) is an important skill for all emergency providers; our ability to train and assess our learners is integral to providing optimal patient care. The primary aim of this study was to assess the inter-rater reliability (IRR) and discriminant validity of a novel field ETI assessment tool using a checklist-derived performance score (PS) and critical failure (CF) rate. METHODS: Forty-three participants (18 paramedic students, 11 paramedics, and 14 emergency physicians [EPs]) performed ETI during a simulated trauma scenario on a pseudo-ventilated cadaver. Each participant was assessed by two experienced raters. IRR was calculated using the intraclass correlation coefficient. Regarding discriminant validity, a Kruskal-Wallis test was used to analyze PSs and a χ2 test was used for CFs. Mean global rating scale (GRS) scores were compared using an analysis of variance. RESULTS: The ETI assessment tool had excellent IRR, with an intraclass correlation coefficient of 0.94. There was a significant difference in PSs, CFs, and GRSs (p < 0.05) between cohorts. CONCLUSION: The novel field ETI assessment tool has excellent reliability among trained raters and discriminates between experienced ETI providers (EPs) and less experienced ETI performers using PSs, CFs, and GRSs on a fresh cadaveric model.
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Lista de Verificación/normas , Evaluación Educacional/normas , Intubación Intratraqueal/normas , Adulto , Manejo de la Vía Aérea/métodos , Manejo de la Vía Aérea/normas , Lista de Verificación/métodos , Competencia Clínica/normas , Competencia Clínica/estadística & datos numéricos , Estudios de Cohortes , Evaluación Educacional/métodos , Femenino , Personal de Salud/normas , Personal de Salud/estadística & datos numéricos , Humanos , Intubación Intratraqueal/métodos , Intubación Intratraqueal/estadística & datos numéricos , Masculino , Estudios Prospectivos , Reproducibilidad de los Resultados , Enseñanza/clasificación , Enseñanza/estadística & datos numéricos , Estudios de Validación como AsuntoRESUMEN
BACKGROUND: The German ophthalmological training is still a very individually organized system with only one final oral examination at the end of the 5-year residency. At the beginning of 2013 a new residency program was introduced at the department of ophthalmology of the Heinrich-Heine University Duesseldorf. This study evaluated the resident satisfaction with the new concept. MATERIAL AND METHODS: The new residency program consists of three main changes: firstly a structured training with fixed rotation in the various subdisciplines of ophthalmology, secondly a list of practical skills examinations that has to be completed during the 5-year program and thirdly annual intermediate oral examinations. The satisfaction of the residents with the new program was anonymously evaluated with a Likert scale-based questionnaire with 15 items and additional free text comments. RESULTS: (1) The structured training was mostly rated positively and 9 out of 12 of residents favored a continuation of the training concept in this form. (2) Only 7 out of 11 residents (64 %) wanted to continue the practical skills examinations in this form and only approximately half of the residents saw a positive effect of these examinations. (3) Regarding the annual examinations 8 out of 11 residents (73 %) reported that the examinations helped them to assess their skills better, 91 % (10 out of 11) reported a learning motivation, 90 % (9 out of 10) an improvement in learning due to the examinations and 73 % (8 out of 11) were of the opinion that the examinations should take place regularly. DISCUSSION: The structured training and the annual examinations were positively evaluated. These changes could be effectively implemented even with a relatively small personnel structure. In comparison the practical skill examinations were rated relatively negatively, probably because of the further increase of daily work. The number of skills to be demonstrated is currently reduced and the integration of testing into the clinical routine of examiners and examinees is under revision.
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Centros Médicos Académicos/estadística & datos numéricos , Internado y Residencia/clasificación , Oftalmología/clasificación , Oftalmología/educación , Evaluación de Programas y Proyectos de Salud , Enseñanza/clasificación , Curriculum/estadística & datos numéricos , Alemania , Internado y Residencia/estadística & datos numéricos , Encuestas y CuestionariosRESUMEN
OBJECTIVES: To study surgical teaching captured on film and analyze it at a fine level of detail to categorize physical teaching behaviors. DESIGN: We describe live, filmed, intraoperative nonverbal exchanges between surgical attending physicians and their trainees (residents and fellows). From the films, we chose key teaching moments and transcribed participants' utterances, actions, and gestures. In follow-up interviews, attending physicians and trainees watched videos of their teaching case and answered open-ended questions about their teaching methods. Using a grounded theory approach, we examined the videos and interviews for what might be construed as a teaching behavior and refined the physical teaching categories through constant comparison. SETTING: We filmed 5 cases in the operating suite of a university teaching hospital that provides gynecologic surgical care. PARTICIPANTS: We included 5 attending gynecologic surgeons, 3 fellows, and 5 residents for this study. RESULTS: More than 6 hours of film and 3 hours of interviews were transcribed, and more than 250 physical teaching motions were captured. Attending surgeons relied on actions and gestures, sometimes wordlessly, to achieve pedagogical and surgical goals simultaneously. Physical teaching included attending physician-initiated actions that required immediate corollary actions from the trainee, gestures to illustrate a step or indicate which instrument to be used next, supporting or retracting tissues, repositioning the trainee's instruments, and placement of the attending physicians' hands on the trainees' hands to guide them. Attending physicians often voiced surprise at the range of their own teaching behaviors captured on film. Interrater reliability was high using the Cohen κ, which was 0.76 for the physical categories. CONCLUSIONS: Physical guidance is essential in educating a surgical trainee, may be tacit, and is not always accompanied by speech. Awareness of teaching behaviors may encourage deliberate teaching and reflection on how to innovate pedagogy for the teaching operating room.
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Competencia Clínica , Relaciones Interpersonales , Mentores/psicología , Cirujanos/psicología , Enseñanza/clasificación , Adulto , Comunicación , Educación de Postgrado en Medicina/métodos , Femenino , Humanos , Internado y Residencia , Masculino , Cuerpo Médico de Hospitales , Quirófanos , Muestreo , Cirujanos/educación , Estados Unidos , Grabación en VideoRESUMEN
BACKGROUND: Germany, like many other countries, will soon have a shortage of qualified doctors. One reason for the dissatisfaction amongst medical residents are the relatively unstructured residency training programs despite increasing importance of outcome-based education. The aim of our study was to identify characteristics and requirements for good teaching during anesthesiology residency training from the resident's point of view. METHODS: A consensus workshop with residents from all medical universities in Germany was held. Participants were allocated to one of the three topics, chosen based on a 2009 nationwide evaluation of residency. The three topics were (A) characteristics of helpful/good teachers, (B) characteristics of helpful/good conditions and (C) characteristics of helpful/good curricular structure. Each group followed a nominal group technique consensus process to define and rank characteristics for a good residency. RESULTS: 31 (79.5%) resident representatives were present. The consented results put emphasis on the importance of structured curricula including transparent goals and objectives, in training formative assessments and quality assurance measures for the program. Residents further long for trained trainers with formal teaching qualifications and protected teaching time. CONCLUSIONS: Good residency training requires careful consideration of all stakeholders' needs. Results reflect and extend previous findings and are at least to some degree easily implemented. These findings are an important step to establish a broader consensus within the discipline.
Asunto(s)
Anestesiología/educación , Actitud del Personal de Salud , Evaluación Educacional/estadística & datos numéricos , Docentes , Internado y Residencia/estadística & datos numéricos , Enseñanza/clasificación , Enseñanza/estadística & datos numéricos , Adulto , Curriculum , Evaluación Educacional/métodos , Femenino , Alemania , Humanos , Masculino , Competencia Profesional/estadística & datos numéricos , Garantía de la Calidad de Atención de Salud/métodos , Adulto JovenRESUMEN
INTRODUCCIÓN: La interacción de los profesores con los estudiantes, la supervisión de las prácticas clínicas y el profesionalismo son temas que explora el instrumento de evaluación del desempeño docente que recoge la opinión de los residentes sobre las competencias educativas de profesores titulares y adjuntos. OBJETIVO: 1)Recuperar los testimonios de los residentes sobre el modelo de rol y el compromiso de sus profesores con su aprendizaje; 2)reconocer las estrategias educativas empleadas por los docentes en contextos clínicos; 3)visibilizar las dificultades de contratación en la planta académica actual del PUEM que afectan el proceso educativo, y 4)reportar las menciones de maltrato y percepción de injusticia de los residentes por sus profesores. MATERIAL Y MÉTODO: Estudio cualitativo que consideró los comentarios a pregunta abierta de 1.628 residentes sobre el desempeño docente en las residencias médicas. Se clasificaron en 10 categorías con subcategorías y se cuantificaron las tendencias positiva y negativa. Posteriormente se analizaron los testimonios de acuerdo a los 3 temas del cuestionario. RESULTADOS: Para los residentes, las categorías del profesor como modelo a seguir y el compromiso académico del docente obtuvieron el mayor número de opiniones positivas, mientras que la contratación del profesor y las estrategias educativas empleadas por este último reportaron el mayor número de comentarios negativos. DISCUSIÓN: Los comentarios libres que plasmaron los residentes sobre el desempeño docente reflejan las fortalezas y debilidades del proceso educativo en contextos hospitalarios, lo que permite un acercamiento cualitativo a la relación con sus profesores
INTRODUCTION: Teacher and student interaction, the monitoring of clinical practices, and professionalism are the issues that the teaching performance assessment tool examines by gathering the opinions of the residents on the educational skills of teaching staff and lecturers. OBJECTIVE: The aim of this study was to: (I)gathering the comments of the residents about the role model and commitment of tutors to their training; (II)to determine the educational strategies used by teachers in clinical settings; (III)to show the current recruitment difficulties of the Medical Specialisations Plan (PUEM) affect the educational process, and (IV)to report the residents mentions of abuse and perceived unfairness by their teachers. MATERIAL AND METHOD: Qualitative study that considered the written comments by 1,628 residents in an open question regarding teaching performance in medical residencies. They were classified into 10 categories with sub-categories and the positive and negative trends were quantified. The comments were analysed according to the 3 topics of the questionnaire. RESULTS: For residents, the categories of the educator as role model and academic commitment of the teacher obtained the largest number of positive reviews, while hiring of teachers and educational strategies employed by the latter reported the highest number of negative comments. DISCUSSION: The free comments expressed by the residents on the teaching performance reflect the strengths and weaknesses of the teaching process in hospital contexts, which provides a qualitative approach to the relationship with their teachers
Asunto(s)
Humanos , Docentes/clasificación , Evaluación Educacional/estadística & datos numéricos , Educación de Postgrado en Medicina/clasificación , Aprendizaje Basado en Problemas/tendencias , Enseñanza/clasificación , Internado y Residencia/clasificación , Relaciones Interpersonales , Investigación Cualitativa , Satisfacción Personal , Competencia Profesional/estadística & datos numéricos , MéxicoRESUMEN
BACKGROUND: Many university departments use students' evaluations of teaching (SET) to compare and rank courses. However, absenteeism from class is often nonrandom and, therefore, SET for different courses might not be comparable. OBJECTIVE: The present study aims to answer two questions. Are SET positively biased due to absenteeism? Do procedures, which adjust for absenteeism, change course rankings? RESEARCH DESIGN: The author discusses the problem from a missing data perspective and present empirical results from regression models to determine which factors are simultaneously associated with students' class attendance and course ratings. In order to determine the extent of these biases, the author then corrects average ratings for students' absenteeism and inspect changes in course rankings resulting from this adjustment. SUBJECTS: The author analyzes SET data on the individual level. One or more course ratings are available for each student. MEASURES: Individual course ratings and absenteeism served as the key outcomes. RESULTS: Absenteeism decreases with rising teaching quality. Furthermore, both factors are systematically related to student and course attributes. Weighting students' ratings by actual absenteeism leads to mostly small changes in ranks, which follow a power law. Only a few, average courses are disproportionally influenced by the adjustment. Weighting by predicted absenteeism leads to very small changes in ranks. Again, average courses are more strongly affected than courses of very high or low in quality. CONCLUSIONS: No-shows bias course ratings and rankings. SET are more appropriate to identify high- and low-quality courses than to determine the exact ranks of average courses.