Preparing leaders in health professions education.

In the past 15 years, the number of Master's degree programs in Health Professions Education (MHPE) has grown from 7 to 121 programs worldwide. New MHPE programs continue to be developed each year, due to increased demand for individuals with specialized knowledge concerning how to best educate future health professionals. During the 2012 Association of Medical Education in Europe (AMEE) meeting in Lyon, France, a symposium was organized to explore the reasons for the proliferation of MHPE programs worldwide. In particular, the issues explored included the need for such programs, their outcomes in developing education leaders and scholars in HPE, and facilitators, barriers and models for initiating such programs. This paper synthesizes the discussion during this symposium. Some of the reasons for enrolling in a Master's degree program in HPE include the formal credential, knowledge of a number of theories and frameworks, new approaches to problems and ways of thinking, the mentored project, and networking and working with faculty and students. The uniqueness of being a trainee in an MHPE program is the immersion in the medical education environment and the assimilation of a new approach to scholarship and a new approach to leadership.

Targeting educational interventions to clinician's stage of change.

This before-after mixed-method study assessed the effect of a diabetes education and self-efficacy training workshop on clinician knowledge, intention and self-efficacy. This workshop demonstrated and narrowed a knowledge gap but did not change intention or self-efficacy. Neither the intervention nor the measured outcomes were targeted to clinicians' stage of change.

Integrating teaching into the busy resident schedule: a learner-centered approach to raise efficiency (L-CARE) in clinical teaching.

BACKGROUND: Clinical teachers are sometimes challenged by residents who seem too busy to concentrate on their learning. In such situations, teachers must be aware to diagnose underlying problems in learners and to effectively help them maximize learning while minimizing time and energy requirements. OBJECTIVE: To develop a learner-centered model to improve efficiency of clinical teaching. METHODS: We reviewed the literature on educational diagnosis, self-directed learning, and effective/efficient teaching to put together a new model. RESULTS: The Learner-Centered Approach to Raise Efficiency (L-CARE) in Clinical Teaching is inspired from the well-known patient-centered clinical method. Using the L-CARE in clinical teaching involves: (1) addressing the learners' feelings regarding their environment as well as patient care and study issues, which provides a good learning climate facilitating educational diagnosis and management of issues that could impair learning; (2) establishing a learning contract (expectations); (3) sharing resources and strategies (ideas) that should be effective without wasting time or energy; (4) self-assessment and constructive feedback (impact). These steps are grounded in self-directed learning theory to improve motivation and ensure that learners concentrate on their own needs to promote learning efficiency. CONCLUSION: The L-CARE model integrates educational diagnosis principles, self-directed learning theory, and efficient teaching strategies to improve efficiency of clinical teaching.

The feasibility of an electronic reflective practice exercise among physiotherapy students.

BACKGROUND: Reflective practice is a skill that serves as a model for continuous learning. Like any skill, reflective practice can be improved and health professional curricula should include opportunities to develop these skills. The clinical component of health professional curriculum is a natural component where reflective practice skills can be developed. Electronic means will help students and faculty stay in contact during clinical internships. AIMS: The purpose of this study was to evaluate the feasibility of an electronic reflective practice exercise during a clinical internship and explore the potential trends on students' reflective practice skills and self-directed learning readiness. METHODS: We used a prospective pre-post intervention design in a cohort of physiotherapy students to examine feasibility and explore trends. Faculty also rated the depth of reflection papers. In addition, students completed a reflective practice exercise questionnaire and the self-directed learning readiness scale (SDLRS) was completed pre- and post-internship. RESULTS: All 84 students completed the reflective practice questionnaire. Sixty-six students consented to complete the questionnaire and 17 consented to complete the SDLRS pre- and post-internship. It took an average of 7 min for faculty to review each student's reflection and there were no significant electronic difficulties encountered. Initial reflection papers were rated at a descriptive (23%), descriptive-analytical (28%) or analytical level (33%). Eighty-six percent of students rated faculty feedback as helpful and 92% rated peer feedback as helpful. Almost all students (97%) students reported that they followed through on some or all of the items on their reflective practice learning plans. The SDLRS significantly improved with the exercise (mean difference 6.8 +/- 9.9; p < 0.05). CONCLUSIONS: This electronic reflective practice exercise during the physiotherapy students' clinical internship was feasible and demonstrated trends to positively impact the learners' skills and self-directed learning readiness.

Adapting an Effective Counseling Model from Patient-centered Care to Improve Motivation in Clinical Training Programs.

The value of establishing a patient-centered relationship within the context of the clinical encounter is well documented. The learner-centered method of medical education parallels the patient-centered clinical method; therefore, it should be explored as a method for teaching in the context of the learning encounter. In Japan and other Asian countries, rotations through services not related to the learner's chosen medical specialty are mandatory parts of the medical internship. Participation and effort in these rotations are often met with resistance from learners and are a common problem for medical educators. We adapted the counseling method for patients based on patient-centered methods such as motivational interviewing and solution-focused therapy to address this common problem. We show one case of a medical resident who lost his motivation to learn during his training. A resident has many kinds of mental and physical stress. One such problem arises from the gap between what they want to do and what they have to do. Strategies from motivational interviewing and solution-focused therapy were adapted to successfully resolve a common teaching problem in Japan. A physician teacher (preceptor) helped this resident solve the issue for himself instead of arguing in favor of change. The positive aspects of the counseling method were based on patient-centered medicine and proved useful and effective in counseling for medical residents. We may take the lessons learned from using patient-centered counseling methods to further develop a clear and systematic process of counseling methods for residents to conduct learner-centered medical education.

An evidence-based model of effective self-assessment for directing professional learning.

An innovative model for conducting meaningful self-assessments is presented to help oral health care professionals efficiently determine what to learn with the goal of remaining competent. A review and analysis of the literature drawing from several databases was conducted to develop the model. Through this process, we identified four key categories: prerequisite competencies, process, applications, and tools that are suggested to occur within a supportive environment to carry out valid self-assessments and to positively influence learning choices and practice improvements.