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1.
BMC Med Educ ; 19(1): 462, 2019 Dec 12.
Artículo en Inglés | MEDLINE | ID: mdl-31830965

RESUMEN

BACKGROUND: Educational leaders have been pointed out as being important for quality of medical education. However, their actual influence on the education can be limited. At the postgraduate level, educational leadership and its connection with quality is underexplored and knowledge about how to increase its impact is lacking. An increased understanding could be used in order to prioritize actions for strengthening the role. The aim of this study was to investigate factors related to the role of programme director associated with quality in postgraduate medical education. METHODS: A cross-sectional study was carried out. A questionnaire was sent to programme directors in Sweden (n = 519) comprising questions about background factors, work characteristics, work tasks, hindering and enabling factors, and the Utrecht Work Engagement Scale. A logistic regression and classification tree were used to identify factors associated with high qualitative education, defined as compliance with national regulations. RESULTS: The response rate was 54% (n = 279). In total, 62% of the programme directors reported high quality and factors associated with high quality included experiences of communication with residents, superiors and supervisors, and support from the supervisors. Other factors were consensus regarding postgraduate medical education at the workplace, adequate financial resources, the programme directors' competence, and their perceived impact on education. Factors of particular importance seemed to differ depending on whether the programme directors were responsible for one or for multiple units. Most high-quality education was found in cases where programme directors were responsible for a single unit and perceived sufficient impact on education. CONCLUSIONS: These results indicated that there was an association between factors related to programme director and quality in postgraduate medical education. The findings pointed out the importance of combining activities at both individual, group and organizational levels. Relational aspects should not be underestimated; faculty development and involvement are crucial.

2.
Med Teach ; 41(4): 366-372, 2019 04.
Artículo en Inglés | MEDLINE | ID: mdl-30880530

RESUMEN

Learning in a clinical context is foundational in the training of health professionals; there is simply no alternative. The subject of the clinical learning environment (CLE) is at the forefront of discussions. In this introduction to a themed issue on the CLE, we present an expanded conceptual model that approaches the CLE through six different lenses, termed "avenues:" architectural, digital, diversity and inclusion, education, psychological, and sociocultural, with each avenue represented by a paper. The aim is to facilitate dialog around the contributions of different academic disciplines to research on the CLE. Collectively the papers highlight the overlap between the various "avenues" in how they influence each other, and how they collectively have shaped the work to understand and improve the CLE. The expectation is that the various avenues can add to existing knowledge and create new ideas for interventions to improve the clinical learning environment across nations for learners and teachers with the ultimate aim of improving patient care. Research and efforts to improve the CLE are critical to learning, professional socialization and well-being for trainees as they learn and participate in patient care, and to the quality of care they will deliver over decades of practice after graduation.

3.
J Interprof Care ; 33(6): 628-635, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-30871380

RESUMEN

This paper reports a qualitative study that explored the meanings of interprofessional education (IPE) by comparing and contrasting educational leaders' perceptions with educational policy documents at an academic health professions education institution in Scandinavia. The study used Goffman's frame analysis to identify two frames of IPE by illuminating issues related to the definition, rationale, and presentation of IPE. A directed content analysis to identify these three aspects of IPE was conducted on semi-structured interviews with nine educational leaders who were overseeing the development of IPE, as well as on the institution's regulatory IPE documentation. Differences regarding definition, rationale, and presentation of IPE between the institutional regulatory IPE frame and the IPE frame of the educational leaders were found which implied difficulties for the educational leaders regarding the implementation of IPE. Based on the study's findings, the paper argues that creating awareness of the differences in meanings of IPE between different perspectives within an academic education institution is an important factor to consider when creating future organisational structures and faculty development programmes in connection to IPE.

4.
Med Teach ; 41(4): 403-407, 2019 04.
Artículo en Inglés | MEDLINE | ID: mdl-30761930

RESUMEN

Medical education has traditionally focused on the learners, the educators, and the curriculum, while tending to overlook the role of the designed environment. Experience indicates, however, that processes and outcomes of medical education are sensitive to the qualities and disposition of the spaces in which it occurs. This includes the clinical education within the patient care environment, termed the clinical learning environment (CLE). Recognition of this has informed the design of some new clinical learning spaces for the past decade. Competency-based clinical education can drive design requirements that differ materially from those associated with general purpose educational or clinical spaces. In this article, we outline two conceptual frameworks: (i) materialist spatiality and (ii) actor-network theory and consider how they can guide the design of spaces to support competency-based medical education and to guide the evaluation and discussion of the educational impacts of the spaces once built. We illustrate the use of these frameworks through discussion of the educational ambitions that underpinned the design of some recent clinical educational spaces. We close with practical points for consideration by educators and designers.

5.
BMC Med Educ ; 19(1): 3, 2019 Jan 03.
Artículo en Inglés | MEDLINE | ID: mdl-30606174

RESUMEN

BACKGROUND: Medical education leaders are important for educational quality in postgraduate medical education. Their work tasks are complex and contain different components. However, factors that are influencing leaders´ effectiveness in completing these tasks are unexplored. Understanding and developing these factors is most likely essential to strengthen postgraduate medical education and to consequently improve the quality in health care delivery. This study explores the experiences of factors that influence effectiveness of clinical consultants responsible for postgraduate medical education at clinical departments. Effectiveness was defined as fulfillment of work tasks. METHODS: A qualitative study was performed with data gathered through semi-structured face-to-face interviews with 17 consultants responsible for postgraduate medical education. Data was analyzed by qualitative content analysis. RESULTS: Findings clustered into four themes of factors influencing effectiveness: individual (being an expert, social competence), relational (support and cooperation, communication), attitudinal (shared vision, organizational values, colleagues' attitudes) and structural (organizational characteristics, regulations and guidelines, conditions for the role). The factors were experienced to influence effectiveness in a positive or a negative direction. CONCLUSIONS: This study shed light on the complex and interrelated factors experienced to have impact on the role of consultant responsible for postgraduate medical education. Viewing the result through the concept of power, the role mainly relies on personal power sources like expert and referent power whereas power connected to the position often are lacking. To increase effectiveness of the role, a differentiated strategy which involves activities at both individual, group and organizational levels is needed.


Asunto(s)
Consultores/psicología , Educación Médica Continua/organización & administración , Relaciones Interprofesionales , Liderazgo , Mentores/psicología , Educación Médica/organización & administración , Docentes Médicos , Femenino , Humanos , Masculino
6.
BMC Med Educ ; 17(1): 29, 2017 Feb 01.
Artículo en Inglés | MEDLINE | ID: mdl-28143476

RESUMEN

BACKGROUND: The mission of undergraduate medical education leaders is to strive towards the enhancement of quality of medical education and health care. The aim of this qualitative study is, with the help of critical perspectives, to contribute to the research area of undergraduate medical education leaders and their identity formation; how can the identity of undergraduate medical education leaders be defined and further explored from a power perspective? METHODS: In this explorative study, 14 educational leaders at a medical programme in Scandinavia were interviewed through semi-structured interviews. The data was analysed through Moustakas' structured, phenomenological analysis approach and then pattern matched with Gee's power-based identity model. RESULTS: Educational leaders identify themselves more as mediators than leaders and do not feel to any larger extent that their professional identity is authorised by the university. These factors potentially create difficulties when trying to communicate with medical teachers, often also with a weaker sense of professional identity, about medical education. CONCLUSIONS: The perceptions of the professional identity of undergraduate medical education leaders provide us with important notions on the complexities on executing their important mission to develop medical education: their perceptions of ambiguity towards the process of trying to lead teachers toward educational development and a perceived lack of authorisation of their work from the university level. These are important flaws to observe and correct when improving the context in which undergraduate medical education leaders are trying to develop and improve undergraduate medical programmes. A practical outcome of the results of this study is the facilitation of design of faculty development programmes for educational leaders in undergraduate medial education.


Asunto(s)
Competencia Clínica/normas , Educación de Pregrado en Medicina/métodos , Docentes Médicos/normas , Liderazgo , Educación de Pregrado en Medicina/normas , Humanos , Investigación Cualitativa , Identificación Social
7.
Med Teach ; 38(8): 755-68, 2016 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-27008030

RESUMEN

This Guide explores emerging issues on the alignment of learning spaces with the changing curriculum in medical education. As technology and new teaching methods have altered the nature of learning in medical education, it is necessary to re-think how physical learning spaces are aligned with the curriculum. The better alignment of learning spaces with the curriculum depends on more directly engaged leadership from faculty and the community of medical education for briefing the requirements for the design of all kinds of learning spaces. However, there is a lack of precedent and well-established processes as to how new kinds of learning spaces should be programmed. Such programmes are essential aspects of optimizing the intended experience of the curriculum. Faculty and the learning community need better tools and instruments to support their leadership role in briefing and programming. A Guide to critical concepts for exploring the alignment of curriculum and learning spaces is provided. The idea of a networked learning landscape is introduced as a way of assessing and evaluating the alignment of physical spaces to the emerging curriculum. The concept is used to explore how technology has widened the range of spaces and places in which learning happens as well as enabling new styles of learning. The networked learning landscaped is explored through four different scales within which learning is accommodated: the classroom, the building, the campus, and the city. High-level guidance on the process of briefing for the networked learning landscape is provided, to take into account the wider scale of learning spaces and the impact of technology. Key to a successful measurement process is argued to be the involvement of relevant academic stakeholders who can identify the strategic direction and purpose for the design of the learning environments in relation to the emerging demands of the curriculum.


Asunto(s)
Curriculum , Educación Médica , Diseño Interior y Mobiliario , Aprendizaje , Educación Médica/métodos , Guías como Asunto , Tecnología
8.
Med Educ ; 50(1): 61-8, 2016 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-26695466

RESUMEN

OBJECTIVE: The overall aim of this review is to map the area around the topic of the relationship between physical space and learning and to then draw further potential implications from this for the specific area of health profession education. METHODS: The nature of the review is a scoping review following a 5-step-model by Arksey & O'Malley. The charting of the data has been conducted with the help of the networked learning landscape framework from Nordquist and Laing. RESULTS: The majority of the research studies on classroom-scale level have focused on how technology may enable active learning. There are no identified research studies on the building-scale level. Hence, the alignment of curricula and physical learning spaces has scarcely been addressed in research from other sectors. In order to 'create a field', conclusions from both case studies and research in related areas must be identified and taken into account to provide insights into health profession education. Four areas have been identified as having potential for future development in health profession education: (i) active involvement of faculty members in the early stages of physical space development; (ii) further development of the assessment strategies for evaluating how physical space impacts learning; (iii) exploration of how informal spaces are being developed in other sectors; and (iv) initiating research projects in HPE to study how informal spaces impact on students' learning. CONCLUSION: Potentially, the results of this scoping review will result in better future research questions and better-designed studies in this new and upcoming academic field of aligning physical learning spaces and curricula in health profession education.


Asunto(s)
Curriculum , Educación Médica/métodos , Planificación Ambiental/tendencias , Empleos en Salud/educación , Aprendizaje Basado en Problemas , Docentes , Humanos , Modelos Educacionales , Proyectos de Investigación
9.
Postgrad Med J ; 91(1080): 588-93, 2015 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-26318376

RESUMEN

BACKGROUND: A programme director is often required to organise postgraduate medical education. This leadership role can include educational as well as managerial duties. Only a few published studies have explored programme directors' own perceptions of their role. There is a need to explore the use of theoretical frameworks to improve the understanding of educational roles. OBJECTIVE: To explore programme directors' own perceptions of their role in terms of tasks and functions, and to relate these roles to the theoretical framework developed by Bolman and Deal. METHODS: Semi-structured interviews were conducted with 17 programme directors between February and August 2013. The data were subjected to content analysis using a deductive approach. RESULTS: The various roles and tasks included by participants in their perceptions of their work could be categorised within the framework of functions described by Bolman and Deal. These included: structuring the education (structural function); supporting individuals and handling relations (human resource function); negotiating between different interests (political function); and influencing the culture at the departmental level (symbolic function). The functions most often emphasised by participants were the structural and human resource functions. Some tasks involved several functions which varied over time. CONCLUSIONS: Programme directors' own perceptions of their roles, tasks and functions varied widely. The theoretical framework of Bolman and Deal might be helpful when explaining and developing these roles.


Asunto(s)
Educación de Postgrado en Medicina , Capacitación en Servicio/organización & administración , Competencia Profesional/normas , Adulto , Actitud del Personal de Salud , Educación de Postgrado en Medicina/normas , Evaluación Educacional , Docentes Médicos , Femenino , Humanos , Liderazgo , Masculino , Satisfacción Personal , Rol Profesional , Evaluación de Programas y Proyectos de Salud , Investigación Cualitativa
10.
Best Pract Res Clin Anaesthesiol ; 29(1): 13-20, 2015 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-25902462

RESUMEN

This review focuses on simulation in anaesthesiology as an educational intervention from a learning perspective. Simulation-based education in anaesthesiology has implications for both faculty development and institutional needs. However, in order to find evidence for the implications of these areas, it is necessary to turn to the literature on anaesthesiology simulations, health-care simulations and also the medical education and pedagogical literature. The most important factor for successful simulation-based education on an institutional level is curriculum integration of simulation, closely connected with defined learning outcomes. The corresponding factor concerning faculty development in simulation-based education is feedback. These three factors are closely interrelated, and to understand them and how to design high-quality simulation interventions from a learning perspective, it is important to look not only to the simulation literature but also to the pedagogical literature.


Asunto(s)
Anestesiología , Educación Médica , Entrenamiento Simulado , Docentes Médicos , Humanos
13.
Med Teach ; 37(4): 337-43, 2015 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-25655659

RESUMEN

The concept of the learning landscape is used to explore the range of learning environments needed at multiple scales to better align with changes in the medical education curriculum. Four key scales that correspond to important types of learning spaces are identified: the classroom, the building, the campus and the city. "In-between" spaces are identified as growing in importance given changing patterns of learning and the use of information technology. Technology is altering how learning takes place in a wider variety of types of spaces as it is interwoven into every aspect of learning. An approach to planning learning environments which recognizes the need to think of networks of learning spaces connected across multiple scales is proposed. The focus is shifted from singular spaces to networks of inter-connected virtual and digital environments. A schematic model comprising the networked learning landscape, intended as a guide to planning that emphasizes relationships between the changing curriculum and its alignment with learning environments at multiple scales is proposed in this work. The need for higher levels of engagement of faculty, administrators and students in defining the briefs for the design of new kinds of medical education environments is highlighted.


Asunto(s)
Curriculum , Educación Médica/organización & administración , Ambiente , Internet , Aprendizaje , Educación Médica/métodos , Humanos , Modelos Educacionales , Solución de Problemas
16.
BMC Med Educ ; 14 Suppl 1: S6, 2014.
Artículo en Inglés | MEDLINE | ID: mdl-25559074

RESUMEN

BACKGROUND: The Swedish resident duty hour limit is regulated by Swedish and European legal frameworks. With a maximum average of 40 working hours per week, the Swedish duty hour regulation is one of the most restrictive in the world. At the same time, the effects of resident duty hour limits have been neither debated nor researched in the Swedish context. As a result, little is known about the Swedish conceptual framework for resident duty hours, their restriction, or their outcomes: we call this "the Swedish duty hour enigma." This situation poses a further question: How do Swedish residents themselves construct a conceptual framework for duty hour restrictions? METHODS: A case study was conducted at Karolinska University Hospital, Stockholm--an urban, research-intensive hospital setting. Semi-structured interviews were carried out with 34 residents currently in training in 6 specialties. The empirical data analysis relied on theoretical propositions and was conducted thematically using a pattern-matching technique. The interview guide was based on four main topics: the perceived effect of duty hour restrictions on (1) patient care, (2) resident education, (3) resident well-being, and (4) research. RESULTS: The residents did not perceive the volume of duty hours to be the main determinant of success or failure in the four contextual domains of patient care, resident education, resident well-being, and research. Instead, they emphasized resident well-being and a desire for flexibility. CONCLUSIONS: According to Swedish residents' conceptual framework on duty hours, the amount of time spent on duty is not a proxy for the quality of resident training. Instead, flexibility, organization, and scheduling of duty hours are considered to be the factors that have the greatest influence on resident well-being, quality of learning, and opportunities to attain the competence needed for independent practice.


Asunto(s)
Competencia Clínica/normas , Hospitales Universitarios/organización & administración , Internado y Residencia/organización & administración , Satisfacción en el Trabajo , Seguridad del Paciente , Admisión y Programación de Personal/organización & administración , Actitud del Personal de Salud , Educación de Postgrado en Medicina/organización & administración , Educación de Postgrado en Medicina/normas , Hospitales Universitarios/legislación & jurisprudencia , Humanos , Internado y Residencia/legislación & jurisprudencia , Entrevistas como Asunto , Estudios de Casos Organizacionales , Admisión y Programación de Personal/legislación & jurisprudencia , Investigación Cualitativa , Calidad de Vida , Suecia , Factores de Tiempo , Recursos Humanos
19.
J Interprof Care ; 27 Suppl 2: 5-8, 2013 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-23930685

RESUMEN

This article explores and discusses current conceptual and empirical dimensions of the study of space, place, education and interprofessional education (IPE) within a health professions context. This article addresses defining elements of the concepts, their use in nursing and medical literature and their positioning within educational theories. It outlines a series of ideas and approaches for future research aimed at investigating the intersections and relationships amongst these concepts. Importantly, this article argues that the conceptualization of space and place in IPE can potentially impact how educational space, places and curricular are (re)conducted and utilized.


Asunto(s)
Empleos en Salud/educación , Comunicación Interdisciplinaria , Diseño Interior y Mobiliario , Humanos , Aprendizaje , Investigación
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