The impact of human cadaveric dissection on professional identity formation in medical students.

BACKGROUND: As technology advances, some schools are moving away from human cadaveric dissection to teach anatomy, leading to concern regarding the possible loss of a professional identity building experience. This study explored the role of dissection in students' professional identity formation. METHODS: A mixed-methods study was conducted using survey methodology and semi-structured interviews of medical students at an American-style graduate-entry medical school in Singapore. The questionnaire adopted the conceptual framework of the Ring Theory of Personhood and the MacLeod-Clark Professional Identity Scale was used to measure professional identity, followed by semi-structured interviews of students using Braun and Clarke's six-phase reflexive thematic analysis. RESULTS: Respondents did not differ substantively from non-respondents by age, nationality, or ethnicity, and year of entering medical school, however, they were slightly more female dominant. The number of hours of hands-on participation in dissection showed no significant relationship (r2 = 0.010; p = 0.424) with professional identity formation measured by the MacLeod-Clark Professional Identity Scale. Despite the survey results, semi-structured interviews revealed rich and nuanced findings suggesting the influence of dissection in participants' professional identity formation through deepening students' appreciation of humanistic values and enhancing their notions of patients' personhood. Notably, students without dissection experience did not express these sentiments and were orientated towards knowledge acquisition. CONCLUSION: While our findings do not suggest that dissection strongly impacts students' professional identity formation, students shared thought-provoking experiences which suggest some level of its contribution. Careful consideration of this phenomenon should be exercised prior to removing dissection in favour of technological alternatives.

Strategic Paragraphing 2.0: Techniques for Enhancing Inter-Paragraph Coherence.

Most of us pay attention to intra-paragraph coherence: the idea that the sentences within a paragraph should logically develop a single idea. But we forget, or we struggle to master inter-paragraph coherence: the idea that paragraphs should be arranged so that our argument develops logically. Proximity isn't always enough to signal to readers how paragraphs are building on one another to create a compelling argument. Readers may still end up having to infer how one paragraph is linked to the next, and when they can't make those inferences (or they make them incorrectly) coherence suffers. This Writer's Craft offers techniques to enhance inter-paragraph coherence more consciously so that readers don't fall through the cracks between our paragraphs.

Measuring Interprofessional Collaboration's Impact on Healthcare Services Using the Quadruple Aim Framework: A Protocol Paper.

Despite decades of research on the impact of interprofessional collaboration (IPC), we still lack definitive proof that team-based care can lead to a tangible effect on healthcare outcomes. Without return on investment (ROI) evidence, healthcare leaders cannot justifiably throw their weight behind IPC, and the institutional push for healthcare manpower reforms crucial for facilitating IPC will remain variable and fragmentary. The lack of proof for the ROI of IPC is likely due to a lack of a unifying conceptual framework and the over-reliance on the single-method study design. To address the gaps, this paper describes a protocol which uses as a framework the Quadruple Aim which examines the ROI of IPC using four dimensions: patient outcomes, patient experience, provider well-being, and cost of care. A multimethod approach is proposed whereby patient outcomes are measured using quantitative methods, and patient experience and provider well-being are assessed using qualitative methods. Healthcare costs will be calculated using the time-driven activity-based costing methodology. The study is set in a Singapore-based national and regional center that takes care of patients with neurological issues.

'It's going to change the way we train': Qualitative evaluation of a transformative faculty development workshop.

INTRODUCTION: Relatively little is known about faculty development (FD) activities that help participants achieve sustainable behavioral change. This qualitative study evaluated the medium- to long-term impact of a FD workshop informed by transformative learning (TL) theory. It aimed to discover which aspects of FD prompted healthcare professionals (HPs) to adopt effective teaching and learning practices. METHODS: Seventeen participants were interviewed between January and July 2020, 7 to 30 months after the workshop. Purposeful sampling strategies were used to collect data and analysis was performed using reflexive thematic analysis. RESULTS: Four themes were identified: perspectival shift in educational practice, re-affirmation of current practices, becoming an educator, and valuing FD that accommodates HPs' multiple communities of practice (CoPs). Workshop activities foregrounding critical discourse and reflection helped participants gain new knowledge and deeper understanding of education. TL was likely when participants already identified as an educator in addition to their HP identity. Additionally, a workplace CoP determined the type and level of support affecting HPs' development as educators. DISCUSSION: Aspects of FD that prompted HPs to adopt effective teaching and learning practices included initiatives that catalyzed critical discourse and reflection. Readiness for TL is promoted when HPs have a strong educator identity because of workplace educator CoPs. Future research could explore effecting sustainable post-workshop behavioral change in HPs through the strengthening of workplace educator CoPs. To do this, institutions could send co-located HPs from different disciplines to the same FD program.

Institutional ethnography - a primer.

This review introduces a qualitative methodology called institutional ethnography (IE) to healthcare professionals interested in studying complex social healthcare systems. We provide the historical context in which IE was developed, and explain the principles and terminology in IE for the novice researcher. Through the use of worked examples, the reader will be able to appreciate how IE can be used to approach research questions in the healthcare system that other methods would be unable to answer. We show how IE and qualitative research methods maintain quality and rigour in research findings. We hope to demonstrate to healthcare professionals and researchers that healthcare systems can be analysed as social organisations, and IE may be used to identify and understand how higher-level processes and policies affect day-to-day clinical work. This understanding may allow the formulation and implementation of actionable improvements to solve problems on the ground.

Visualizing faculty development impact: A social network analysis.

Faculty development programs have tended to focus on low levels of evaluation such as participant satisfaction rather than assess the actual changes that training has brought about in the workplace. This has prompted scholars to suggest using social network analysis as a means to provide a more rigorous method of evaluating the impact of faculty development. To test the feasibility of such a suggestion, we used the social network analysis concepts of social cohesion to assess the impact of a year-long fellowship program conducted by Duke-NUS Medical School's Academic Medicine Education Institute (AM·EI). Specifically, we used the key metrics of connectedness and betweenness centrality to assess the changes in the AM·EI fellows' information and collaboration networks post-fellowship. We invited three cohorts of AM·EI fellows (2013-2016; n = 74) to participate in a branched survey. The response rate was 64%; n = 47. Results showed that in terms of connectedness, the largest connected set more than doubled in size, and pair level reachability grew threefold. Betweenness centrality among the AM·EI fellows also increased, with more individuals reporting that they sought advice from the fellows as well as trusted the advice the fellows provided. In sum, this study suggests that it is indeed viable to use social network analysis to identify changes in social cohesion. As such, social network analysis serves as another tool for scholars to use to assess the impact of their faculty development efforts.