Philosophical Reflections on Music Therapy Musicianship.

This philosophical inquiry critically examines music therapy musicianship in order to reconceptualize the ways in which musicianship is conceived of and taught in education and training programs in the United States. Through a constructive and critical interaction with historical and extant literature, we seek to create space for the uniqueness of musicianship in our field. We challenge the relevance of the conservatory model, the primacy of the work concept, and the focus on fine art often found in educational settings. In doing so, we align music therapy musicianship with relevant musics, instrumentation, and the unique contextual and relational components of music experiences in our work. We construct multidirectional connections between musicality, musical identity, musicianship, music therapy context, musicking, and the clients'/participants' lifeworld, introducing subconcepts within and between each concept. This co-construction with the literature asserts our identity in education, training, practice, and research. We conclude by offering preliminary guidance that may further develop music therapy musicianship in education and clinical training programs, in alignment with current reports on education.

Andragogy in Practice: Applying a Theoretical Framework to Team Science Training in Biomedical Research.

This study is the first to apply the theoretical principles of Malcolm Knowles' theory of andragogy to evaluate data collected from learners who participated in team science training workshops in a biomedical research setting. Briefly, andragogy includes six principles: the learner's self-concept, the role of experience, readiness to learn, orientation to learning, the learner's need to know, and intrinsic motivation. Using an embedded study design, the primary focus was on qualitative data, with quantitative data complementing the qualitative findings. The deductive analysis demonstrated that approximately 85% of the qualitative data could be connected to at least one andragogical principle. Participant responses to positive evaluation questions were largely related to two principles: readiness to learn and problem-based learning orientation. Participant responses to negative questions were largely connected to two different principles: the role of experience and self-direction. Inductive analysis found an additional theme: meeting biological needs. Quantitative survey results supported the qualitative findings. The study findings demonstrate that andragogy can serve as a valuable construct to integrate into the development of effective team science training for biomedical researchers.

The impact of three learning methods on dental students' satisfaction and knowledge acquisition.

OBJECTIVES: Health professionals' education presents unique challenges including clinical application of knowledge and interprofessional collaboration. Additionally, institutions suffer from faculty shortages while class sizes increase. Therefore, educators seek innovative andragogical techniques utilizing minimal resources. Several active learning methods have been introduced as a solution. The aim of this study is to assess the impact of lecture (LBL), case (CBL), and team (TBL) based learning on the students' satisfaction and knowledge attainment. METHODS: A total of 134 sophomore dental students are taught pediatric dentistry course using LBL, CBL, and TBL techniques. At the end of the course, students are invited to participate in a satisfaction survey. Statistical analysis is conducted using a two-sided chi-square goodness of fit test. Students' comments are used for qualitative analysis. Final exam analysis is administered via Examsoft software. RESULTS: A total of 98% of the students participated in the survey out of which 83% met the inclusion criteria (N = 110). Students chose LBL as the method that helped them learn in a comprehensive way, provided the most comfortable environment, and presented the overall highest satisfaction with statistically significant difference (p value = 0.001). LBL questions scored the highest point biserial and discrimination index. The percentage of correct answers and difficulty level was highest for TBL. CONCLUSION: Students preferred LBL over the other learning methods. Final exam psychometrics showed favorable results for LBL and TBL. Students could potentially benefit from combining both techniques. However, more research is needed to assess the effectiveness of various teaching methods on the short- and long-term learning outcomes.

Using Concurrent Complication Reporting to Evaluate Resident Critical Thinking and Enhance Adult Learning.

OBJECTIVE: Critical thinking and accurate case analysis is difficult to quantify even within the context of routine morbidity and mortality reporting. We designed and implemented a HIPAA-compliant adverse outcome reporting system that collects weekly resident assessments of clinical care across multiple domains (case summary, complications, error analysis, Clavien-Dindo Harm, cognitive bias, standard of care, and ACGME core competencies). We hypothesized that incorporation of this system into the residency program's core curriculum would allow for identification of areas of cognitive weakness or strength and provide a longitudinal evaluation of critical thinking development. DESIGN: A validated, password-protected electronic platform linked to our electronic medical record was used to collect cases weekly in which surgical adverse events occurred. General surgery residents critiqued 1932 cases over a 4-year period from 3 major medical centers within our system. These data were reviewed by teaching faculty, corrected for accuracy and graded utilizing the software's critique algorithm. Grades were emailed to the residents at the time of the review, collected prospectively, stratified, and analyzed by post-graduate year (PGY). Evaluation of the resident scores for each domain and the resultant composite scores allowed for comparison of critical thinking skills across post-graduate year (PGY) over time. SETTING: Data was collected from 3 independently ACGME-accredited surgery residency programs over 3 tertiary hospitals within our health system. PARTICIPANTS: General surgery residents in clinical PGY 1-5. RESULTS: Residents scored highest in properly identifying ACGME core competencies and determining Clavien-Dindo scores (p < 0.006) with no improvement in providing accurate and concise clinical summaries. However, residents improved in recording data sufficient to identify error (p < 0.00001). A positive linear trend in median scores for all remaining domains except for cognitive bias was demonstrated (p < 0.001). Senior residents scored significantly higher than junior residents in all domains. Scores > 90% were never achieved. CONCLUSIONS: The use of an electronic standardized critique algorithm in the evaluation and assessment of adverse surgical case outcomes enabled the measure of residents' critical thinking skills. Feedback in the form of teaching faculty-facilitated discussion and emailed grades enhanced adult learning with a steady improvement in performance over PGY. Although residents improved with PGY, the data suggest that further improvement in all categories is possible. Implementing this standardized critique algorithm across PGY allows for evaluation of areas of individual resident weakness vs. strength, progression over time, and comparisons to peers. These data suggest that routine complication reporting may be enhanced as a critical thinking assessment tool and that improvement in critical thinking can be quantified. Incorporation of this platform into M&M conference has the potential to augment executive function and professional identity development.

A pilot resiliency course for Doctor of Nursing Practice (DNP) students: Lessons learned.

Graduate nursing students can face varied and significant stressors during their programs of study. The need for interventions to promote nursing student resiliency has been reported in the literature, by accrediting bodies, and in previous research conducted with students at the same university. Thus, the purpose of this project was to pilot a resilience course for Doctor of Nursing Practice (DNP) students. The theoretical frameworks guiding the design and implementation of the resiliency pilot program were andragogy (the science of adult learning) and rapid cycle quality improvement. The course included eleven monthly modules addressing resiliency content with written material, original videos, and online discussions and meetings. The first module overviewed the resiliency skills (Belief, Persistence, Trust, Strength, and Adaptability), five modules were dedicated to a specific resiliency skill, two modules addressed recent and anticipated challenges, two modules concentrated on the application (clinical and academic) of the resiliency skills, and the last module focused on reflection. Results of this pilot program indicate that DNP students can benefit from receiving resiliency content during their studies, especially from faculty involvement and increased peer support; however, future resiliency content may be more accepted and effective if embedded into nursing program curriculum and activities.

Applying andragogy for integrating a MOOC into a formal online learning experience in computer engineering.

In this paper, we present the results of a research experience of implementing andragogy in a learning environment designed to better meet the needs of adult learners studying part-time at a distance university. The learning environment was composed of a learning experience on a formal distance university online course that has been enriched with a non-formal component based on students' participation in a Massive Online Open Course (MOOC) related to the same topic. The non-formal experience was designed to consolidate the learning of specific content that involved difficult concepts and foster collaborative skills. The university online course is in the field of computer science and human-computer interaction. The instructional design, including the course assignments, has been guided by Knowles' principles of andragogy. Results from the data analysis of five years of academic results and student satisfaction has helped to understand the learning experience from including a MOOC in adult distance formal learning.

Doing the hard work of learning: oncologists' enduring impressions of a year-long communication skills training program.

PURPOSE: Few studies have examined the long-term impact of communication skills training for oncologists. We developed a year-long communication skills curriculum for medical oncology fellows with the primary goals of fostering life-long learning of patient-centered communication skills and internalization of associated attitudes and beliefs. We engaged learners through reflection, narrative methods, and action methods, thereby creating a non-threatening, team-based environment. The purpose of the current study was to determine whether learners perceived that they had acquired enduring skills, attitudes, and knowledge years after they participated. METHODS: Former fellows completed an online cross-sectional survey from June to July 2019 that included demographic information, 21 items on a numerical scale, and 3 narrative prompts. Survey items pertained to 4 domains, including skills, attitudes, confidence with specific scenarios, and overall impressions. The numerical scale ranged from "strongly agree" = 1 to "strongly disagree" = 5. RESULTS: A total of 114 fellows, including 27 teaching assistants, participated in the communication skills training over 8 years. The average time between the end of the training program and completion of the survey was 5.2 years. The response rate was 68/114 (64%). Forty-one (60%, 95% CI: 49.3-73.8) fellows agreed or strongly agreed that the curriculum profoundly impacted their practice of medicine. Forty-three (64%, 95% CI: 51.5-75.5) fellows strongly agreed or agreed that they often found themselves informally sharing lessons they learned during the series. Overall average domain scores were 1.89 (SD = 0.84) for skills, 2.16 (0.79) for attitudes, 2.05 (0.81) for confidence with specific challenges, and 2.38 (0.94) for lasting impressions. Results were significantly more favorable for teaching assistants than for others. CONCLUSION: Engaging, interactive, safe, and learner-centered communication skills training has an enduring and favorable impact on oncologists' self-perceived skills, confidence with specific challenges, and attitudes.

A preceptoria médica em medicina de família e comunidade: uma proposta dialógica com a andragogia / Medical preceptorship in family and community medicine: a proposal for dialogue with andragogy

Resumo: Introdução: O Brasil está em um amplo processo de fortalecimento das residências médicas nas áreas básicas, porém existe a necessidade de um currículo estruturado para qualificar a formação do preceptor. Objetivo: Este estudo teve como objetivo construir uma matriz dialógica para orientar a formação educacional da preceptoria em medicina de família e comunidade (MFC). Método: Por meio de um estudo qualitativo-analítico, analisaram-se três programas de preceptoria médica no Brasil: Associação Brasileira de Educação Médica, Hospital Sírio-Libanês e Hospital Alemão Oswaldo Cruz. Em seguida, uma proposta formativa foi apresentada contendo macrodiretrizes que possibilitem mudanças nos processos de ensino e aprendizagem para qualificação da prática preceptora em diálogo com a andragogia. Resultado: A matriz construída norteia-se pela aprendizagem do adulto, enfatizando a autonomia do aprendiz, em detrimento do controle da aprendizagem pelo educador. Envolve cinco dimensões: direcionalidade da formação; conteúdo; estratégias pedagógicas; concepções e estrutura formativa; e relação entre saúde, educação e pesquisa. Cada uma delas agrega um conjunto de diretrizes que valorizam o contexto e os princípios da formação em serviço no SUS; o desenvolvimento de competências acerca de conteúdos da atenção, gestão e educação em saúde; concepções e estruturas pautadas pela construção de vínculos significativos entre os sujeitos envolvidos no ato educativo, respeitando seus saberes prévios e experiências; estratégias pedagógicas colaborativas, trabalho com grupos operativos e o uso de tecnologias da informação e comunicação; e o estímulo à pesquisa como princípio educativo. Conclusão: A matriz considerou as necessidades da formação em MFC, baseando-se em aspectos-chave da andragogia. Acredita-se que ela possa promover mudanças nos processos de ensino-aprendizagem dos preceptores, com o objetivo de qualificar sua prática.

Abstract: Introduction: Brazil is in a broad process of strengthening medical residencies in basic areas, but there is a need for a structured curriculum to qualify the training of preceptors. Objective: To build a dialogic matrix to guide the educational training of preceptorship in Family and Community Medicine (FFM). Methodology: Through a qualitative-analytical study, three medical preceptorship programs in Brazil were analyzed, namely: Associação Brasileira de Educação Médica, Hospital Sírio-Libanês and Hospital Alemão Oswaldo Cruz. A training proposal was subsequently presented containing macro-guidelines that allow changes in the teaching and learning processes to qualify preceptor practice in dialogue with andragogy. Results: Based on andragogy, the resulting matrix emphasized the learner's autonomy, to the detriment of the educator's control of learning. It involves five dimensions: directionality of training; contents; pedagogical strategies; training concepts and structure; and the relationship between health, education and research. Each dimension included guidelines that value: the context and principles of in-service training in the SUS; the development of competences about the contents of health care, management and education; conceptions and structures guided by the construction of significant bonds between the subjects involved in the educational act, respecting their previous knowledge and experiences; collaborative pedagogical strategies, work with operative groups and the use of information and communication technologies; and encouraging research as an educational principle. Conclusion: The matrix considered the needs of FCM training, based on key aspects of andragogy. It can promote changes in the teaching-learning processes of preceptors, with the aim of qualifying their practice.

Andragogic principles in case-based discussion among medical interns in a tertiary hospital

Background@#Andragogy, the theory of adult learning is relevant to medical education especially in the clinical internship learning context. It focuses on the students, faculty, and patients interacting together while developing competencies as future practitioners. Medical interns are active adult learners, enhancing their development of knowledge, skills, and positive attitudes, and pursuing professionalism as they participate in case-based discussions (CBD).@*Objectives@#The study sought to identify the basic principles of andragogy while medical interns participate in case-based discussions including the end-of-course satisfaction. It also determined the selected demographic factors associated with the andragogic principles. @*Methodology@#Respondents included 80 interns by convenience sampling who rotated at the Department of Ophthalmology and Visual Sciences in a tertiary referral hospital. The study used a combination of descriptive quantitative and qualitative research design. A valid instrument using the Adult Learning Principles Design Elements Questionnaire (ALPDEQ) was used to measure the medical intern's andragogic orientation as well as end-of-course satisfaction. A direct, non-participant observation of case-based discussions conducted at the department was done by the researcher and research associate. @*Results and Conclusion@#The occurrence of andragogic principles specifically motivation, experience, need to know, readiness, and self-directedness was observed during the conduct of case-based discussion. There was no association between principles of andragogy and demographic factors such as age, gender, civil status, medical school, preparatory medical course, and place of origin. CBD is an effective learning strategy, which provides medical interns adequate venues to be self-directed and apply the principles of andragogy in a workplace-based setting.

Terapia ocupacional y andragogía: un llamando a la inclusión desde el fin del mundo / Occupational therapy and andragogy: an invitation to the inclusion from the end of the world

Se presenta un estudio cuantitativo destinado a determinar el interés por estudiar de adultos mayores institucionalizados de la ciudad de Punta Arenas, junto con la identificación de factores favorecedores y obstaculizadores. Se incluyó a 18 adultos mayores institucionalizados residentes del Establecimiento de Larga Estadía del Adulto Mayor de Punta Arenas. Se obtiene que el 80 por ciento de los adultos mayores encuestados reportan un alto interés por estudiar, con particular énfasis en las mujeres. Se encontró una correlación positiva: a mejor constitución de red social de apoyo (familia e institución de residencia), mayor interés por estudiar. La mayor parte quisiera terminar sus estudios inconclusos, y manifiestan interés en estudiar historia, idiomas e incluso, estudios universitarios. Los resultados de esta investigación invitan a reflexionar sobre la imagen negativa que tiene la sociedad acerca de esta etapa de la vida, sobre la necesidad de cambio para poder ofrecer los espacios necesarios para seguir desarrollándose, especialmente en el ámbito educativo, donde la andragogía es esencial para garantizar la participación, inclusión y contribución de los adultos mayores en la sociedad. Aquí la Terapia Ocupacional tiene una responsabilidad social trascendental.

Quantitative study designed to determine the interest in studying the institutionalized older people in Punta Arenas city, along with the identification of factors favoring and hindering. The sample included 18 institutionalized elders residents of long-stay Facility for the Elderly of Punta Arenas. The 80 precent of older people report a high interest in the study, with particular emphasis on women. It founds a positive correlation: a better incorporation of social support network (family and institution of residence), greater interest in studying. Most want to finish their studies unfinished, and expressed interest in studying history, languages and even higher education. The results of this research invite to reflection on the negative image that society has about this stage of life, about the need for change in order to provide the necessary space for further development, especially in education, which is essential andragogy to ensure participation, inclusion and contribution of older people in society. Here the Occupational Therapy has a crucial social responsibility.

Senior Resident Training on Educational Principles (STEP): A Proposed Innovative Step from a Developing Nation / 보건의료교육평가

Resident-as-teacher courses are pretty common in Western medical schools however they are a rarity in Asian and developing countries. The current report is a scholarly analysis of a three day orientation program for senior residents in order to improve their functioning by providing new template either for supplementing basic workshops for faculty or to advocate a change in system. The experience gained by Medical Education Unit of University College of Medical Sciences can be used to conduct training breeding grounds at national or regional levels. Resident as teachers educational interventions need to be designed taking into account their impact on education system.

The Fundamental Principles of Adult Education and their Suggestions / 医学教育

1) In the field of adult education, there is a lateral relationship of “learning/teaching” between learners and teachers. And the both collaborate for the purpose of “the attainment of the most desirable learning activity” as the subject of learning and the subject responsible for the facilitation of learning.<BR>2) Adult learners have peculiar features in each of the following aspects;‘self-concept’, ‘learning experience’‘the readiness for learning’‘the orientation for learning’‘the motivation for learning’.<BR>3) Self-directed learning is based on the idea of andragogy (the art and science of helping adults learn), and the learners actively and mutually make up their learning plans and put them into practice themselves.<BR>4) Most of the lifelong learning activities in present Japan can be divided into three types (or stages):‘Teacher (and others)-directed learning’, ‘Self-directed learning’ and ‘Self-directed and Mutual transforming leaning’. And in each, the different roles of educators are reguired.<BR>5) The values of adult education such as ‘equality’‘sympathy’‘cooperation’‘mutuality’ and ‘educativeness’ should be consciously shared between learners and teachers in the professional field and in the process of professional training.