Self-directed learning assessment practices in undergraduate health professions education: a systematic review.

PURPOSE: The goal of this systematic review was to examine self-directed learning (SDL) assessment practices in undergraduate health professions education. METHODS: Seven electronic databases were searched (PubMed, Embase, PsycINFO, ERIC, CINAHL, Scopus, and Web of Science) to retrieve English-language articles published between 2015 and July of 2022, investigating assessment of SDL learning outcomes. Extracted data included the sample size, field of study, study design, SDL activity type, SDL assessment method, number of SDL assessments used, study quality, number of SDL components present utilising the framework the authors developed, and SDL activity outcomes. We also assessed relationships between SDL assessment method and number of SDL components, study quality, field of study, and study outcomes. RESULTS: Of the 141 studies included, the majority of study participants were medical (51.8%) or nursing (34.8%) students. The most common SDL assessment method used was internally-developed perception surveys (49.6%). When evaluating outcomes for SDL activities, most studies reported a positive or mixed/neutral outcome (58.2% and 34.8%, respectively). There was a statistically significant relationship between both number and type of assessments used, and study quality, with knowledge assessments (median-IQR 11.5) being associated with higher study quality (p < 0.001). Less than half (48.9%) of the studies used more than one assessment method to evaluate the effectiveness of SDL activities. Having more than one assessment (mean 9.49) was associated with higher quality study (p < 0.001). CONCLUSIONS: The results of our systematic review suggest that SDL assessment practices within undergraduate health professions education vary greatly, as different aspects of SDL were leveraged and implemented by diverse groups of learners to meet different learning needs and professional accreditation requirements. Evidence-based best practices for the assessment of SDL across undergraduate healthcare professions education should include the use of multiple assessments, with direct and indirect measures, to more accurately assess student performance.

Value of robotic surgery simulation for training surgical residents and attendings: a systematic review protocol.

INTRODUCTION: Robotic surgery is a method of minimally invasive surgery performed through small incisions using a remote robotic console. Surgical residents and attendings participate in simulation training to be able to effectively perform robotic surgery using wet labs, dry labs and virtual reality platforms. Our objective is to identify the effectiveness of robotic simulation on novice robotic surgeons. This review will answer our review question: To what extent are robotic simulations for training novice robotic general surgery residents and attendings associated with improved outcomes in comparison with no simulation training? METHODS AND ANALYSIS: A comprehensive search of PubMed, Embase, the Cochrane Library and Web of Science was performed. The studies were then determined to meet initial screening criteria by one individual for abstract and title with full text screening performed by two authors independently and in duplicate. Narrative themes will be collected, analysed and summarised where possible. ETHICS AND DISSEMINATION: There is no Institutional Review Board approval required given that the work is carried out on previously published papers. The final manuscript and results will be presented and published at an academic conference and peer -reviewed journal. PROSPERO REGISTRATION NUMBER: CRD42021274090.

How does telementoring impact medical education within the surgical field? A scoping review.

BACKGROUND: Surgical education strongly involves the use of mentorship to improve the confidence and efficiency of trainees. Social distancing due to the COVID-19 pandemic may serve as a catalyst to promote the use of telementoring and other remote learning opportunities in medical education. METHODS: A comprehensive literature review was performed using the electronic databases PubMed, Embase, Web of Science, Scopus, and the Cochrane Library with respect to telementoring in the surgical field. RESULTS: The overall consensus of telementoring experience among all 25 studies was generally positive, citing "positive experience," "increased confidence," and "increased surgical skill." Using over 15 different technologies, a total of 12 simulations, 149 tasks, and 491 surgeries were conducted via telementoring. Eight mentor-mentee relationships were identified, with the most common relationship being surgeon-to-surgeon in 12 studies. CONCLUSIONS: The implementation of telementoring has been shown to be effective in improving surgical skills and learner experiences while overcoming financial and geographical barriers.

Integration of arts and humanities in medicine to develop well-rounded physicians: the roles of health sciences librarians.

Over the past ten years, there has been a growing interest in integrating arts and humanities in medicine to increase learners' empathy and resilience; improve personal well-being, communication, and observational skills; enhance self-reflection; and promote professionalism. These desired skills and qualities are becoming increasingly important for the physicians of tomorrow. Parallel to curricular interventions of integrating arts and humanities to medical education, there has been an increasing research interest in investigating the impact of such interventions on medical students with respect to improving and sustaining students' empathy as they progress in their medical education and develop their professional identity. Research has yielded interesting findings on the types and effect of the interventions in the medical curriculum. The Association of the American Medical Colleges (AAMC), recognizing the unique and unrealized role of arts and humanities in preparing and equipping physicians for twenty-first-century challenges, proposed seven recommendations for advancing arts and humanities integration into medical education to improve the education, practice, and well-being of physicians and physician learners across the spectrum of medical education. Institutional initiatives of arts and humanities integration in the medical curriculum in response to the AAMC's recommendations afford health sciences librarians expansive opportunities and a new landscape of playing an important role in these initiatives. With their diverse educational background in arts, humanities, social sciences, and many other disciplines and fields, health sciences librarians are poised for meaningful contributions to their institutional goals in developing a humanistic, compassionate workforce of future physicians.

Integration of Arts and Humanities in Medical Education: a Narrative Review.

This narrative review aims to identify and review the extant literature describing methods and outcomes of embedding the arts and humanities (AH) into medical school curricula. The Association of American Medical Colleges changed the Medical College Admission Test (MCAT) in 2015 to place new emphasis on the role of liberal arts in the process of developing well-rounded physicians. Consequently, medical schools have been implementing more connections to creative writing, literature, theater, movies, music, and the visual arts into their curricula. To review the current literature, we focused on methods medical educators used to embed content related to AH into their curricula to shape and drive associated learning outcomes. We conducted searches in PubMed, CINAHL, PsycINFO, and ERIC for peer-reviewed articles from 2011 to 2020. The authors selected three dyads in medical humanities and reviewed articles independently followed by discussion to identify thematic links to major findings. Out of 261 articles, a total of 177 full-text articles were reviewed with 34 selected for final inclusion. Our review included articles describing curriculum development and delivery in publications from Australia, Canada, India, New Zealand, and the USA. This review showed medical educators are implementing didactic and experiential instructional approaches to embedding the arts, humanities, and social sciences into the medical school classroom. Medical educators' attempts to embed AH into medical school curricula show promising results. Unfortunately, small sample sizes, short-term interventions, and an over-reliance of subjective assessment measures limit our knowledge of the true impact of these interventions. More rigorous assessments of required and longitudinal coursework are necessary to know the true impact of participation in AH coursework for medical students.

Correction to: Leadership Training and Undergraduate Medical Education: a Scoping Review.

[This corrects the article DOI: 10.1007/s40670-021-01308-9.].

Leadership Training and Undergraduate Medical Education: a Scoping Review.

The purpose of this scoping review is to fill the gap in understanding the current status of intervention-based studies regarding leadership training in undergraduate medical education. As of late, there is an increased focus on the role of physicians as leaders in their fields, and communities. In order to evaluate these studies, both the PubMed and ERIC databases were searched, and an ultimate total of 35 articles methodologies were evaluated for their general methodology, curricular content, specific teaching methods, and evaluation methodologies. There were a number of trends identified, as well as remaining gaps. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s40670-021-01308-9.

Correlating Spatial Ability With Anatomy Assessment Performance: A Meta-Analysis.

Interest in spatial ability has grown over the past few decades following the emergence of correlational evidence associating spatial aptitude with educational performance in the fields of science, technology, engineering, and mathematics. The research field at large and the anatomy education literature on this topic are mixed. In an attempt to generate consensus, a meta-analysis was performed to objectively summarize the effects of spatial ability on anatomy assessment performance across multiple studies and populations. Relevant studies published within the past 50 years (1969-2019) were retrieved from eight databases. Study eligibility screening was followed by a full-text review and data extraction. Use of the Mental Rotations Test (MRT) was required for study inclusion. Out of 2,450 screened records, 15 studies were meta-analyzed. Seventy-three percent of studies (11 of 15) were from the United States and Canada, and the majority (9 of 15) studied professional students. Across 15 studies and 1,245 participants, spatial ability was weakly associated with anatomy performance (rpooled  = 0.240; CI at 95% = 0.09, 0.38; P = 0.002). Performance on spatial and relationship-based assessments (i.e., practical assessments and drawing tasks) was correlated with spatial ability, while performance on assessments utilizing non-spatial multiple-choice items was not correlated with spatial ability. A significant sex difference was also observed, wherein males outperformed females on spatial ability tasks. Given the role of spatial reasoning in learning anatomy, educators are encouraged to consider curriculum delivery modifications and a comprehensive assessment strategy so as not to disadvantage individuals with low spatial ability.

The utilization of peer feedback during collaborative learning in undergraduate medical education: a systematic review.

BACKGROUND: Peer evaluation can provide valuable feedback to medical students, and increase student confidence and quality of work. The objective of this systematic review was to examine the utilization, effectiveness, and quality of peer feedback during collaborative learning in medical education. METHODS: The PRISMA statement for reporting in systematic reviews and meta-analysis was used to guide the process of conducting the systematic review. Evaluation of level of evidence (Colthart) and types of outcomes (Kirkpatrick) were used. Two main authors reviewed articles with a third deciding on conflicting results. RESULTS: The final review included 31 studies. Problem-based learning and team-based learning were the most common collaborative learning settings. Eleven studies reported that students received instruction on how to provide appropriate peer feedback. No studies provided descriptions on whether or not the quality of feedback was evaluated by faculty. Seventeen studies evaluated the effect of peer feedback on professionalism; 12 of those studies evaluated its effectiveness for assessing professionalism and eight evaluated the use of peer feedback for professional behavior development. Ten studies examined the effect of peer feedback on student learning. Six studies examined the role of peer feedback on team dynamics. CONCLUSIONS: This systematic review indicates that peer feedback in a collaborative learning environment may be a reliable assessment for professionalism and may aid in the development of professional behavior. The review suggests implications for further research on the impact of peer feedback, including the effectiveness of providing instruction on how to provide appropriate peer feedback.

Examining an Evidence-Based Medicine Culture in Residency Education.

BACKGROUND AND OBJECTIVES: Reports of innovations in evidence-based medicine (EBM) training have focused on curriculum design and knowledge gained. Little is known about the educational culture and environment for EBM training and the extent to which those environments exist in family medicine residencies in the United States. METHODS: A literature review on this topic identified a validated EBM environment scale intended for learner use. This scale was adapted for completion by family medicine residency program directors (PDs) and administered through an omnibus survey. Responses to this scale were analyzed descriptively with program and PD demographics. An EBM culture score was calculated for each program and the results were regressed with the correlated demographics. RESULTS: In our adapted survey, family medicine PDs generally rated their residencies high on the EBM culture scale, but admitted to challenges with faculty feedback to residents about EBM skills, ability to protect time for EBM instruction, and clinician skepticism about EBM. In linear regression analysis, the mean summary score on the EBM scale was lower for female PDs and in programs with a higher proportion of international medical school graduates. CONCLUSIONS: To improve the culture for EBM teaching, family medicine residency programs should focus on faculty engagement and support and the allocation of sufficient time for EBM education.

Community Engagement at an Emerging Academic Medical Library: A Three-Pronged Outreach Model.

The Oakland University William Beaumont School of Medicine's (OUWB) service-oriented mission and vision is reflected in all aspects of the school including its culture, curriculum, research, community engagement, and the OUWB Medical Library. Though starting informally, the OUWB Medical Library's outreach program has matured and now sustains a wide array of activities each year. This outreach program has blossomed into a three-pronged model that is inclusive of activities and endeavors engaging the institution and local community: integrate, partner, and create. Among its successes and challenges, the library's ongoing outreach efforts have showcased the value of libraries in promoting community health and meaningfully contributing to the institutional mission.

Culturally competent library services and related factors among health sciences librarians: an exploratory study.

OBJECTIVE: This study investigated the current state of health sciences libraries' provision of culturally competent services to support health professions education and patient care and examined factors associated with cultural competency in relation to library services and professional development. METHODS: This was a cross-sectional study. Data were collected with a survey questionnaire that was distributed via SurveyMonkey to several health sciences librarian email discussion lists. RESULTS: Out of 176 respondents, 163 reported serving clients from diverse cultural backgrounds. Various services were provided to develop or support initiatives in cultural competency in health professions education and patient care. A considerable number of respondents were unsure or reported no library services to support initiatives in cultural competency, although a majority of respondents perceived the importance of providing culturally competent library services (156, 89.1%) and cultural competency for health sciences librarians (162, 93.1%). Those who self-identified as nonwhites perceived culturally competent services to be more important than whites (p=0.04). Those who spoke another language in addition to English had higher self-rated cultural competency (p=0.01) than those who only spoke English. CONCLUSIONS: These findings contribute to our knowledge of the types of library services provided to support cultural competency initiatives and of health sciences librarians' perceived importance in providing culturally competent library services and cultural competency for health sciences librarians. The results suggest implications for health sciences libraries in fostering professional development in cultural competency and in providing culturally competent services to increase library use by people from a wide range of cultures and backgrounds.

Epistemic cognition in medical education: a literature review.

OBJECTIVE: To review the research literature on epistemic cognition in medical education. METHODS: We conducted database searches using keywords related to epistemic cognition and medical education or practice. In duplicate, authors selected and reviewed empirical studies with a central focus on epistemic cognition and participant samples including medical students or physicians. Independent thematic analysis and consensus procedures were used to identify major findings about epistemic cognition and implications for research and medical education. RESULTS: Twenty-seven articles were selected. Themes from the findings of selected studies included developmental frameworks of epistemic cognition revealing simple epistemological positions of medical learners, increasing epistemological sophistication with experience, relationships between epistemic cognition and context, patterns in epistemic orientations to clinical practice, and reactions to ambiguity and uncertainty. Many studies identified the need for new instruments and methodologies to study epistemic cognition in medical education settings and its relationship to clinical outcomes. Relationships between epistemological beliefs and humanistic patient care and influences of medical education practices were commonly cited implications for medical education. CONCLUSIONS: Epistemic cognition is conceptualized and operationalized in a variety of ways in the medical research literature. Advancing theoretical frameworks and developing new methodological approaches to examine epistemic cognition are important areas for future research. Also, examination of the relationship between the contexts of medical learning and practice and epistemic cognition has potential for improving medical education. This work also establishes a need for further investigation into the implications of epistemic cognition for humanistic orientations and ultimately for patient care.

An Integrated, Case-Based Approach to Teaching Medical Students How to Locate the Best Available Evidence for Clinical Care.

INTRODUCTION: A major step of the evidence-based medicine (EBM) process is to locate the most current evidence in support of clinical care. This requires identifying and searching appropriate evidence-based resources. Medical library faculty at the Oakland University William Beaumont School of Medicine teach these skills as part of a dedicated EBM course at the end of the second year of the medical school curriculum. METHODS: A 3-hour "Locating the Best Available Evidence" session is divided into two major components: an optional 50-minute didactic lecture followed by a mandatory 2-hour interactive lab. Students formulate a PICO (patient, intervention, comparison, outcome) question from a case, develop search strategies, and gather evidence. Formative feedback is provided to the students to help them prepare for a final case presentation. RESULTS: Session effectiveness is assessed using course evaluations and the case presentation grade. Course evaluations indicate that students find this session structure to be especially helpful in learning the breadth of available EBM resources, preparing for their course case presentations, and acquiring skills for clinical clerkships. Quality of the case presentations also indicates students have acquired the necessary skills to be successful in practicing EBM skills in clerkship rotations and residency. DISCUSSION: Whether institutions have a dedicated EBM course or integrate EBM skills into the medical school curriculum, this session could easily be adapted and implemented. It could also be tailored for graduate or continuing medical education environments in any specialty.

A pilot study exploring the relationship between lifelong learning and factors associated with evidence-based medicine.

OBJECTIVES: To explore possible relationships between residents' lifelong learning orientation, skills in practicing evidence-based medicine (EBM), and perceptions of the environment for learning and practicing EBM. METHODS: This was a pilot study with a cross-sectional survey design. Out of 60 residents in a medical residency program, 29 participated in the study. Data were collected using a survey that comprised three sections: the JeffSPLL Scale, EBM Environment Scale, and an EBM skill questionnaire. Data were analyzed using SPSS and were reported with descriptive and inferential statistics (mean, standard deviation, Pearson's correlation, and a two-sample t-test). RESULTS: Mean scores on the JeffSPLL Scale were significantly correlated with perceptions of the EBM Scale and use of EBM resources to keep up to date or solve a specific patient care problem. There was a significant correlation between mean scores on the EBM Scale and hours per week spent in reading medical literature to solve a patient care problem. Two-sample t-tests show that residents with previous training in research methods had significantly higher scores on the JeffSPLL Scale (p=0.04), EBM Scale (p=0.006), and self-efficacy scale (p =0.024). CONCLUSIONS: Given the fact that physicians are expected to be lifelong learners over the course of their professional career, developing residents' EBM skills and creating interventions to improve specific areas in the EBM environment would likely foster residents' lifelong learning orientation.

Use of Mobile Devices to Access Resources Among Health Professions Students: A Systematic Review.

This systematic review examines types of mobile devices used by health professions students, kinds of resources and tools accessed via mobile devices, and reasons for using the devices to access the resources and tools. The review included 20 studies selected from articles published in English between January 2010 and April 2015, retrieved from PubMed and other sources. Data extracted included participants, study designs, mobile devices used, mobile resources/apps accessed, outcome measures, and advantages of and barriers to using mobile devices. The review indicates significant variability across the studies in terms of research methods, types of mobile programs implemented, resources accessed, and outcomes. There were beneficial effects of using mobile devices to access resources as well as conspicuous challenges or barriers in using mobile devices.

Application of Instructional Design Principles in Developing an Online Information Literacy Curriculum.

An online information literacy curriculum was developed as an intervention to engage students in independent study and self-assessment of their learning needs and learning outcomes, develop proficiency in information skills, and foster lifelong learning. This column demonstrates how instructional design principles were applied to create the learning experiences integrated into various courses of the medical curriculum to promote active learning of information skills and maximize self-directed learning outcomes for lifelong learning.

Continuing education for medical students: a library model.

PURPOSE: The research assessed a three-year continuing medical education-style program for medical students in a Midwestern academic medical library. METHODS: A mixed methods approach of a survey and two focus groups comparing attendees versus non-attendees assessed the program. RESULTS: Eleven students participated in the focus groups. Attendance was driven by topic interest and lunch. Barriers included lack of interest, scheduling, location, and convenience. CONCLUSIONS: Although attendance was a challenge, students valued opportunities to learn new skills. This study show cases a reproducible method to engage students outside the curriculum.

Community needs assessment to reach out to an underserved population.

A community-based participatory research project was conducted to identify health information needs of clients (an underserved population) at a homeless shelter. Staff at the shelter, medical students, and public librarians were sought as outreach partners; their needs and challenges in accessing health information resources to serve underserved populations were also assessed. The community needs assessment yielded results that helped shape a medical library's efforts in supporting medical students' service-learning activities related to humanistic education. The resulting data also informed library decisions on health information education outreach programs tailored to vulnerable, underserved populations and community partners serving the specific populations in the communities.