Designing feedback processes in the workplace-based learning of undergraduate health professions education: a scoping review.

BACKGROUND: Feedback processes are crucial for learning, guiding improvement, and enhancing performance. In workplace-based learning settings, diverse teaching and assessment activities are advocated to be designed and implemented, generating feedback that students use, with proper guidance, to close the gap between current and desired performance levels. Since productive feedback processes rely on observed information regarding a student's performance, it is imperative to establish structured feedback activities within undergraduate workplace-based learning settings. However, these settings are characterized by their unpredictable nature, which can either promote learning or present challenges in offering structured learning opportunities for students. This scoping review maps literature on how feedback processes are organised in undergraduate clinical workplace-based learning settings, providing insight into the design and use of feedback. METHODS: A scoping review was conducted. Studies were identified from seven databases and ten relevant journals in medical education. The screening process was performed independently in duplicate with the support of the StArt program. Data were organized in a data chart and analyzed using thematic analysis. The feedback loop with a sociocultural perspective was used as a theoretical framework. RESULTS: The search yielded 4,877 papers, and 61 were included in the review. Two themes were identified in the qualitative analysis: (1) The organization of the feedback processes in workplace-based learning settings, and (2) Sociocultural factors influencing the organization of feedback processes. The literature describes multiple teaching and assessment activities that generate feedback information. Most papers described experiences and perceptions of diverse teaching and assessment feedback activities. Few studies described how feedback processes improve performance. Sociocultural factors such as establishing a feedback culture, enabling stable and trustworthy relationships, and enhancing student feedback agency are crucial for productive feedback processes. CONCLUSIONS: This review identified concrete ideas regarding how feedback could be organized within the clinical workplace to promote feedback processes. The feedback encounter should be organized to allow follow-up of the feedback, i.e., working on required learning and performance goals at the next occasion. The educational programs should design feedback processes by appropriately planning subsequent tasks and activities. More insight is needed in designing a full-loop feedback process, in which specific attention is needed in effective feedforward practices.

Una revisión sistemática del uso de la inteligencia artificial en la educación / A systematic review of the use of artificial intelligence in education

Introducción. El uso de la inteligencia artificial (IA) en la educación ha sido objeto de una creciente atención en los últimos años. La IA se ha utilizado para mejorar la personalización del aprendizaje, la retroalimentación y la evaluación de los estudiantes. Sin embargo, también hay desafíos y limitaciones asociados. El objetivo de este trabajo fue identificar las principales tendencias y áreas de aplicación de la inteligencia artificial en la educación, así como analizar los beneficios y limitaciones de su uso en este ámbito. Métodos. Se llevó a cabo una revisión sistemática que exploró el empleo de la inteligencia artificial en el ámbito educativo. Esta revisión siguió una metodología de investigación basada en la búsqueda de literatura, compuesta por cinco etapas. La investigación se realizó utilizando Scopus como fuente de consulta primaria y se empleó la herramienta VOSviewer para analizar los resultados obtenidos. Resultados. Se encontraron numerosos estudios que investigan el uso de la IA en la educación. Los resultados sugieren que la IA puede mejorar significativamente la personalización del aprendizaje, proporcionando recomendaciones de actividades y retroalimentación adaptadas a las necesidades individuales de cada estudiante. Conclusiones. A pesar de las ventajas del uso de la IA en la educación, también hay desafíos y limitaciones que deben abordarse, como la calidad de los datos utilizados por la IA, la necesidad de capacitación para educadores y estudiantes, y las preocupaciones sobre la privacidad y la seguridad de los datos de los estudiantes. Es importante seguir evaluando los efectos del uso de la IA en la educación para garantizar su uso efectivo y responsable.

Introduction. The use of artificial intelligence (AI) in education has been the subject of increasing attention in recent years. AI has been used to improve personalized learning, feedback, and student assessment. However, there are also challenges and limitations. The aim of this study was to identify the main trends and areas of application of artificial intelligence in education, as well as to analyze the benefits and limitations of its use in this field. Methods. A systematic review was carried out on the use of artificial intelligence in education, using a literature search research methodology with five stages, based on the Scopus query and the tool for analyzing results with VOSviewer. Results. Numerous studies investigating the use of AI in education were found. The results suggest that AI can significantly improve personalized learning by providing activity recommendations and feedback tailored to the individual needs of each student. Conclusions. Despite the advantages of using AI in education, there are also challenges and limitations that need to be addressed, such as the quality of data used by AI, the need for training for educators and students, and concerns about the privacy and security of student data. It is important to continue evaluating the effects of AI use in education to ensure its effective and responsible use.

Debriefing, a dialogical space for the development of reflective thinking in nursing / Debriefing, un espacio dialogico para el desarrollo del pensamiento reflexivo en enfermería / Debriefing, espaço dialógico para o desenvolvimento do pensamento reflexivo na enfermagem

ABSTRACT Objective: To understand the pedagogical elements necessary for the debriefing to favor the development of reflective thinking. Method: A single case study developed at the Centro de Simulación en Salud of the Escuela de Enfermería of the Universidad de Costa Rica in October 2018. Data were collected through interviews, observation and document analysis. For data analysis, the strategy of theoretical propositions and the construction of explanation technique were used. Results: The data originated two categories: 1) pedagogy of the organization, addressed elements thought by the professor to facilitate the dialogue; 2) facilitation pedagogy, brought elements from the dialogue itself that enrich the discussion, mobilize the group, provoke reflection and engagement. Final considerations: It is essential to include the following as pedagogical elements in order to favor the development of reflective thinking: prior planning, adequate environment, systematization, pedagogical training in facilitating debriefing, openness to dialogue, pedagogical respect, valorization of positive aspects, patience, and motivation.

RESUMEN Objetivo: Comprender los elementos pedagógicos necesarios para que el debriefing favorezca el desarrollo del pensamiento reflexivo. Método: La información sobre el tipo de estudio, muestra, período, lugar de la investigación, recolección y análisis de datos debe presentarse de manera clara y objetiva, sin excesivos detalles. El método debe alinearse con la sección de métodos del artículo completo, brindando información más detallada sobre el diseño del estudio y los procedimientos utilizados. Resultados: Los datos originaron dos categorías: 1) pedagogía de la organización, en que los elementos abordados pensados por el profesor para facilitar el diálogo; 2) pedagogía de la facilitación, en que el trajo elementos del propio diálogo que enriquecen la discusión, movilizan al grupo, provocan la reflexión y el compromiso. Consideraciones finales: Es imprescindible incluir como elementos pedagógicos que favorezcan el desarrollo del pensamiento reflexivo los siguientes: planeamiento previo, ambiente adecuado, sistematización, formación pedagógica en la facilitación del debriefing, apertura al diálogo, respeto pedagógico, valorización de los aspectos positivos, paciencia y motivación.

RESUMO Objetivo: Compreender os elementos pedagógicos necessários para que o debriefing favoreça o desenvolvimento do pensamento reflexivo. Método: Estudo de caso único desenvolvido no Centro de Simulaciónen Salud da Escuela de Enfermería da Universidad de Costa Rica em outubro de 2018. Os dados foram coletados por meio de entrevistas, observação e análise documental. Utilizaram-se a estratégia de proposições teóricas e a técnica de construção de explanação para a análise dos dados. Resultados: Os dados originaram duas categorias: 1) pedagogia da organização, a qual abordou elementos pensados pelo docente para facilitar o diálogo; 2) pedagogia da facilitação, a qual trouxe elementos do próprio diálogo que enriquecem a discussão, mobilizam o grupo, provocam a reflexão e o engajamento. Considerações finais: Torna-se imprescindível incluir como elementos pedagógicos que favoreçam o desenvolvimento do pensamento reflexivo os seguintes: planejamento prévio, ambiente adequado, sistematização, formação pedagógica em facilitação de debriefing, abertura ao diálogo, respeito pedagógico, valorização do positivo, paciência e motivação.

Deliberate practice of diagnostic clinical reasoning reveals low performance and improvement of diagnostic justification in pre-clerkship students.

PURPOSE: Diagnostic errors are a large burden on patient safety and improving clinical reasoning (CR) education could contribute to reducing these errors. To this end, calls have been made to implement CR training as early as the first year of medical school. However, much is still unknown about pre-clerkship students' reasoning processes. The current study aimed to observe how pre-clerkship students use clinical information during the diagnostic process. METHODS: In a prospective observational study, pre-clerkship medical students completed 10-11 self-directed online simulated CR diagnostic cases. CR skills assessed included: creation of the differential diagnosis (Ddx), diagnostic justification (DxJ), ordering investigations, and identifying the most probable diagnosis. Student performances were compared to expert-created scorecards and students received detailed individualized formative feedback for every case. RESULTS: 121 of 133 (91%) first- and second-year medical students consented to the research project. Students scored much lower for DxJ compared to scores obtained for creation of the Ddx, ordering tests, and identifying the correct diagnosis, (30-48% lower, p < 0.001). Specifically, students underutilized physical exam data (p < 0.001) and underutilized data that decreased the probability of incorrect diagnoses (p < 0.001). We observed that DxJ scores increased 40% after 10-11 practice cases (p < 0.001). CONCLUSIONS: We implemented deliberate practice with formative feedback for CR starting in the first year of medical school. Students underperformed in DxJ, particularly with analyzing the physical exam data and pertinent negative data. We observed significant improvement in DxJ performance with increased practice.

Teaching Independent Decision-Making Through a Computer-Based Drug Utilization Review Simulation.

Background: Drug utilization review (DUR) skills are important for pharmacists across all settings. Computer-based DUR simulations to teach student pharmacists are currently scarce. This article describes a computer-based DUR simulation that required limited faculty and financial resources and was implemented in collaboration among 3 institutions. Objective: To describe the innovation of a computer-based DUR simulation and its impact on pharmacy students' knowledge and confidence of DUR skills. Methods: This pre-post educational study assessed a computer-based DUR simulation that replicated the DUR process in dispensing systems. First- and third-year pharmacy students at 3 institutions were guided through simulated patient cases with various medication-related problems. The self-paced activity provided students with immediate, formative feedback and rationale for each option after an attempt was made in lieu of faculty intervention. Students completed pre-and post-assessments to evaluate changes in knowledge and confidence. Knowledge was assessed by comparing results of multiple choice and matching questions on the pre- and post-assessments. Confidence was assessed by the change in self-reported confidence scale measurements. Results: Students at all institutions (N = 405) had nonsignificant changes in knowledge scores from the pre-assessment to the post-assessment, with the exception of 1 question. All confidence survey questions significantly improved from pre- to post-assessment. Conclusion: The DUR educational innovation had a nonsignificant overall impact on students' knowledge but significantly improved confidence in their abilities. Skills-based instruction provides additional practice to increase student confidence.

Enhancement of the technical and non-technical skills of nurse anesthesia students using the Anesthetic List Management Assessment Tool in Iran: a quasi-experimental study.

PURPOSE: This study investigated the effect of evaluations based on the Anesthetic List Management Assessment Tool (ALMAT) form on improving the technical and non-technical skills of final-year nurse anesthesia students at Ahvaz Jundishapur University of Medical Sciences (AJUMS). METHODS: This was a semi-experimental study with a pre-test and post-test design. It included 45 final-year nurse anesthesia students of AJUMS and lasted for 3 months. The technical and non-technical skills of the intervention group were assessed at 4 university hospitals using formative-feedback evaluation based on the ALMAT form, from induction of anesthesia until reaching mastery and independence. Finally, the students' degree of improvement in technical and non-technical skills was compared between the intervention and control groups. Statistical tests (the independent t-test, paired t-test, and Mann-Whitney test) were used to analyze the data. RESULTS: The rate of improvement in post-test scores of technical skills was significantly higher in the intervention group than in the control group (P<0.0001). Similarly, the students in the intervention group received significantly higher post-test scores for non-technical skills than the students in the control group (P<0.0001). CONCLUSION: The findings of this study showed that the use of ALMAT as a formative-feedback evaluation method to evaluate technical and non-technical skills had a significant effect on improving these skills and was effective in helping students learn and reach mastery and independence.

Sounds good to me: A qualitative study to explore the use of audio to potentiate the student feedback experience.

BACKGROUND: The provision and uptake of feedback on academic performance is widely debated throughout higher education. Whilst many educators strive to provide students with suitable feedback on their academic work, it is often reported that the feedback is frequently not delivered in a prompt or detailed manner or is not acted upon by students. Traditionally feedback has been delivered in writing, and this study investigates the potential value of an alternative method by providing formative feedback using short audio clips. AIM: The aim of the study was to determine baccalaureate student nurses' perceptions of the influence of audio feedback on the quality of their academic work. METHOD: This is a qualitative descriptive study conducted online to determine the perceived usefulness of formative feedback. A cohort of baccalaureate nursing students (n = 199) in one Higher Education Institution in the Republic of Ireland were offered audio and written feedback on an academic assignment. Following receipt of the feedback participants completed an anonymous online questionnaire exploring their perceptions of the usefulness of audio and written feedback. The questionnaire was analysed using a thematic analysis framework. RESULTS: Thematic data analysis identified four themes: connectivity, engagement, enhanced understanding, and validation. Findings indicate that both audio and written feedback on academic work were perceived to be beneficial, however almost all of the students indicated an overwhelming preference for audio feedback. A sense of connectivity between the lecturer and the student, created through the provision of audio feedback, was the prevailing theme throughout the data. Written feedback conveyed the relevant information, but the audio feedback was more holistic and multi-dimensional and included an emotional and personal quality to which the students responded positively. CONCLUSIONS: What has not been explicitly highlighted in earlier studies but is apparent in this study, is the centrality of this sense of connectivity as a motivator to student engagement with the feedback received. Students perceive that the engagement with the feedback enhances their understanding of how they might improve their academic writing. An enhanced link between the student and the academic institution during clinical placements, achieved by the audio feedback, was a welcome and unexpected finding beyond the aim of this study.

Remote, asynchronous training and feedback enables development of neurodynamic skills in physiotherapy students.

BACKGROUND: During the COVID-19 pandemic, face-to-face teaching and learning of physiotherapy practical skills was limited. Asynchronous, remote training has been effective in development of clinical skills in some health professions. This study aimed to determine the effect of remote, asynchronous training and feedback on development of neurodynamic skills in physiotherapy students. METHODS: Longitudinal repeated measurements study, across four training sessions. Participants engaged in a remote training program for development of upper limb neurodynamic techniques. In this sequential training, participants viewed the online tutorial, practiced independently, and uploaded a video of their performance for formative assessment and feedback from a trained instructor via a checklist and rubric. RESULTS: Intra-subject analyses of 60 third-year physiotherapy students showed that the target standard of performance, with no further significant change in scores, was attained following session 2 for the checklist and session 3 for the rubric. This shows that two sessions are required to learn the procedures, and three sessions yield further improvements in performance quality. CONCLUSION: The remote, asynchronous training and feedback model proved to be an effective strategy for students' development of neurodynamic testing skills and forms a viable alternative to in-person training. This study contributes to the future of acquiring physiotherapy clinical competencies when distance or hybrid practice is required.

Debriefing or Feedback: Exploring the Impact of Two Post-Scenario Discussion Methods in the Acquisition and Retention of Non-Technical Skills.

INTRODUCTION: There is a paucity of quantitative studies objectively comparing debriefing and feedback as methods for post-scenario discussion and its impact on healthcare teams' acquisition and retention of non-technical skills. The main purpose of this study is to provide some insight on this research question, using a sample of medical students. A secondary objective explores students' opinion and preference on the post-scenario discussion. MATERIAL AND METHODS: Forty-five medical students were distributed among 15 teams, and randomly allocated to two groups. Each team participated in three different simulated scenarios, with similar levels of difficulty and opportunities to apply specific non-technical skills: leadership, communication, and task management. To assess the acquisition and retention of skills, scenarios occurred on days one (baseline), two (acquisition) and 20 (retention). Team performance was objectively evaluated by an observer, using scenario recordings. Students individually assessed different aspects of debriefing and feedback. RESULTS: Both debriefing and feedback groups showed similar overall increase in objective scores, with significant increase between days one and two (acquisition), and a smaller increase between days two and 20 (retention). Students indicated debriefing as the preferred discussion method. CONCLUSION: Debriefing and feedback are effective post-scenario discussion methods, promoting acquisition and retention of non-technical skills, by undergraduate students. Allying debriefing reflexive practice with feedback directive style, and shifting appropriately between facilitation and instruction, can be a good compromise to achieve a timely and educationally meaningful discussion.

Introdução: Há uma escassez de estudos quantitativos comparando objetivamente o debriefing e o feedback como métodos de discussão pós-cenário e o seu impacto na aquisição e retenção de competências não-técnicas pelas equipas de saúde. O objetivo principal deste estudo é explorar esta questão de investigação, usando uma amostra de estudantes de medicina. Adicionalmente, foi analisada a opinião e preferência dos estudantes sobre o método de discussão pós-cenário. Material e Métodos: Quarenta e cinco estudantes de medicina foram distribuídos em 15 equipas e alocados aleatoriamente a dois grupos. Cada equipa participou em três cenários de simulação diferentes, com níveis de dificuldade semelhantes e as mesmas oportunidades para aplicar as seguintes competências não-técnicas específicas: liderança, comunicação e gestão de tarefas. Para avaliar a aquisição e retenção de competências, os cenários decorreram nos dias um (linha de base), dois (aquisição) e 20 (retenção). O desempenho de cada equipa foi avaliado objetivamente por um observador, através da análise das gravações dos cenários e de uma checklist. Os estudantes foram ainda convidados a avaliar individualmente a condução do debriefing e do feedback. Resultados: Ambos os grupos (debriefing e feedback) demonstraram um incremento semelhante nas pontuações objetivas, com um aumento acentuado entre os dias um e dois (aquisição) e um aumento ligeiro entre os dias dois e 20 (retenção). Os estudantes indicaram o debriefing como método de discussão preferencial. Conclusão: O debriefing e o feedback são métodos eficazes de discussão pós-cenário, promovendo a aquisição e retenção de competências não-técnicas por estudantes pré-graduados. A aliança da prática reflexiva do debriefing com o estilo diretivo de feedback, alternando apropriadamente entre facilitação e instrução, é um compromisso aceitável para alcançar uma discussão educacionalmente significativa num tempo limitado.

High-touch surfaces disinfection compliance in a COVID-19 intensive care unit.

Environmental cleaning and disinfection are fundamental health care-associated infection prevention measures. This study aimed to evaluate the disinfection compliance of high-touch surfaces in a COVID-19-only intensive care unit, using a fluorescent marker. It was divided into 3 phases, baseline assessment, educational feedback, and post feedback. Disinfection compliance improved significantly from the first to the third phase, 14.3% to 51.4% (P < .001), respectively.

Reflective Teaching Journals as an Effective Embedded Formative Assessment Process of Teaching Skill Development Confidence in a Longitudinal Medical Student-as-Teacher Elective.

Background: This study focuses on the use of reflective teaching journals by fourth year US allopathic medical school students (MS4) during a longitudinal medical student-as-teacher (SaT) elective, and how MS4s self-assess their perceptions around teacher skill development and individual transitions into resident educators who teach junior learners. Method: Between September 2020 and December 2020, twelve MS4s in a longitudinal SaT elective completed 21 hours in a clinical bedside student teaching placement with embedded structured reflective teaching journals. Sixty-nine individual reflective teaching journal entries were collected in two distinct stages and analyzed using a phenomenographical lens. Conclusion: From these data, the author established three thematic categories where reflective teaching journals reveal (a) a framework for pedagogical skill building, (b) provided a sense-making tool to navigate the psychosocial environment, and (c) a framework for educator identity formation. Structured reflective teaching journals with educator feedback support self-reflection and awareness of growth through the SaT elective. Health professions educators can leverage the reflective teaching journal as a formative assessment process to help learners identify transitions and grapple with educator identity confidence and the formation of new teacher skill development to further advance the field of future health professions education.

Teleintervenção guiada por videofeedback à família de uma criança usuária de implante coclear: estudo de caso / Videofeedback-guided teleintervention for the family of a child with a cochlear implant: a case study

RESUMO Intervenções para a capacitação parental de famílias de crianças com deficiência auditiva, incluindo as usuárias de implante coclear, são apontadas como otimizadoras em seus resultados de desenvolvimento. Neste estudo de intervenção de caso único, temos por objetivos descrever o uso do videofeedback em ambiente remoto, bem como identificar a sua efetividade, a partir da análise da interação da mãe e criança, tanto para os comportamentos comunicativos da mãe como para os comportamentos da linguagem receptiva e expressiva da criança. Medidas pré e pós-intervenção foram realizadas, a partir da análise de vídeos de interação da mãe com a criança, por juízes cegos, bem como pela aplicação de instrumentos de avaliação da criança e da mãe. Foram realizadas 13 sessões, sendo 3 de avaliação nos momentos pré e pós-intervenção e 10 sessões de teleconsulta em que se empregou a ferramenta de videofeedback com a mãe. Os dados foram analisados de forma descritiva e inferencial, por meio do método JT, que determinou o Índice de Mudança Confiável (IMC) e a Significância Clínica. Houve mudança positiva confiável na linguagem receptiva e expressiva da criança, bem como mudança positiva confiável e mudança clínica significativa na interação da mãe com a criança após as 10 sessões de intervenção remota com videofeedback. A partir das mudanças confiáveis observadas neste estudo, apresentamos este modelo (Televideofeedback), como potencial para otimizar os recursos e esforços para o sucesso terapêutico na reabilitação auditiva infantil, o qual deve ser estudado em pesquisas com método rigoroso, para a ampla recomendação de seu uso.

ABSTRACT Interventions for parental training for families of hard of hearing children, including cochlear implant users, are identified as optimizing their developmental outcomes. In this single-case intervention study, we aim to describe the use of videofeedback in a remote environment, as well as to identify its effectiveness, based on the analysis of mother-child interaction, both for the mother's communicative behaviors and for the behaviors of the mother, receptive and expressive language of the child. Pre- and post-intervention measurements were performed, based on video analysis of the mother's interaction with the child, by blind judges, as well as through the application of assessment instruments for the child and the mother. There were 13 sessions, 3 of which were for evaluation before and after the intervention and 10 of teleconsultation sessions in which the videofeedback tool was used with the mother. Data were analyzed descriptively and inferentially, using the JT method, which determined the Reliable Change Index (BMI) and Clinical Significance. There was reliable positive change in the child's receptive and expressive language, as well as reliable positive change and clinically significant change in mother-child interaction after the 10 sessions of remote videofeedback intervention. Based on the reliable changes observed in this study, we present this model (televideofeedback) as a potential to optimize resources and efforts for therapeutic success in children's auditory rehabilitation, which should be studied in research with a rigorous method, for the broad recommendation of its use.

Construção de curso sobre Mini-CEX na modalidade de ensino a distância para preceptores de residência médica / Construction of a course on Mini-CEX in the distance learning modality for medical residence preceptors

Resumo Introdução: A avaliação é primordial no processo de ensino-aprendizagem do médico residente. O Mini-CEX é considerado um instrumento apropriado para realizar uma avaliação formativa, permitindo um feedback educacional estruturado. Nesse contexto, os preceptores de residência precisam estar em contínuo processo de capacitação para melhor direcionar os seus residentes, e uma forma viável de capacitação é por meio do ensino a distância (EaD). Objetivo: Este estudo teve como objetivos desenvolver e validar um curso na modalidade de EaD sobre Mini-CEX para preceptores da residência em mastologia. Método: Trata-se de desenvolvimento e validação de um produto técnico-educacional no formato de curso de capacitação e na modalidade de EaD. No processo de validação de conteúdo do produto, utilizou-se a técnica de grupo de consenso. A validação semântica foi realizada através de questionário de validação aplicado aos preceptores envolvidos na residência em mastologia. Resultado: Foi elaborado e validado um curso autoinstrucional e sem mediação, com carga horária total de duas horas. O curso teve aprovação do público-alvo por apresentar um escore médio global de 98% de satisfação e um alfa de Cronbach igual a 0,8. Conclusão: O curso desenvolvido e validado sobre Mini-CEX apresenta-se como opção relevante para a formação de preceptores de residência médica em mastologia, podendo se estender para qualquer serviço de residência médica. Ressalta-se que o curso na modalidade de EaD favorece a adesão do público-alvo apresentando um formato acessível para fortalecer o conhecimento sobre o tema, além de incentivar os preceptores a utilizar a ferramenta de avaliação educacional.

Abstract Introduction: Assessment is paramount in the resident physician's teaching-learning process. The Mini-CEX is considered an appropriate instrument to carry out formative assessment, allowing structured educational feedback. In this context, residency preceptors need to undergo a continuous training process to better prepare their residents, and a viable form of training is using Distance Education (EaD). Objective: To develop and validate a Distance Education (EaD) course on Mini-CEX for residency preceptors in Mastology. Method: Development and validation of a technical-educational product, in the format of a training course and in the Distance Education modality (EaD). The consensus group technique was used in the product content validation process. Semantic validation was carried out through a validation questionnaire applied to the preceptors involved in the residency program in Mastology. Results: A self-instructional and unmediated course was designed and validated, with a total workload of 02 (two) hours. The course was approved by the target audience, as it had an overall average score of 98% satisfaction and a Cronbach's alpha equal to 0.8. Conclusions: The course developed and validated on Mini-CEX presents itself as a relevant option for the training of medical residency preceptors in Mastology and can be extended to any medical residency service. It should be noted that the Distance Education (EaD) course favors the adherence of the target audience, with an accessible format to strengthen knowledge on the subject, in addition to encouraging preceptors to also use the educational evaluation.

Common models and approaches for the clinical educator to plan effective feedback encounters.

Giving constructive feedback is crucial for learners to bridge the gap between their current performance and the desired standards of competence. Giving effective feedback is a skill that can be learned, practiced, and improved. Therefore, our aim was to explore models in clinical settings and assess their transferability to different clinical feedback encounters. We identified the 6 most common and accepted feedback models, including the Feedback Sandwich, the Pendleton Rules, the One-Minute Preceptor, the SET-GO model, the R2C2 (Rapport/Reaction/Content/Coach), and the ALOBA (Agenda Led Outcome-based Analysis) model. We present a handy resource describing their structure, strengths and weaknesses, requirements for educators and learners, and suitable feedback encounters for use for each model. These feedback models represent practical frameworks for educators to adopt but also to adapt to their preferred style, combining and modifying them if necessary to suit their needs and context.

Opportunities to Increase Workplace Feedback: A Multi-institutional Examination.

OBJECTIVE: While feedback is an essential component of resident education, there are few large-scale studies examining when and under what conditions formative feedback is provided. Workplace-based assessment systems offer an opportunity to identify factors influencing when faculty provides feedback to trainees. Influential factors affecting feedback may provide targets for increasing and improving feedback in resident education. DESIGN: Data on whether dictated feedback was provided were obtained from the Society for Improving Medical Professional Learning (SIMPL) mobile application. We used generalized linear mixed effects models to identify the degree to which faculty members, procedures, surgical case characteristics, and trainee performance were associated with whether narrative feedback was provided using SIMPL. SETTING: This study was conducted using data from members of the SIMPL collaborative. PARTICIPANTS: 67,434 evaluations from 70 general surgery programs were included from 2015 to 2021. Of these, 25,355 evaluations included dictated feedback. RESULTS: Approximately 61% of the variation in whether dictated feedback was provided was attributable to the individual faculty member. Compared to residents who achieved autonomy ratings of "Active Help," residents who achieved ratings of "Supervision Only" (odds ratio (OR) = 0.80, 95% confidence interval (CI) = 0.72, 0.88) had a lower likelihood of receiving dictated feedback. Residents who achieved ratings of "Intermediate" (OR = 0.81, CI = 0.74, 0.89), "Practice-Ready" (OR = 0.50, CI = 0.45, 0.57), or "Exceptional (OR = 0.64, CI = 0.54, 0.76) showed a lower likelihood of receiving dictated feedback compared to those rated as "Inexperienced." Cases rated as "High" in terms of complexity were associated with an increased likelihood of having dictation (OR = 1.35, CI = 1.26, 1.44). CONCLUSIONS: The largest contributing factor for whether dictated feedback is included in a SIMPL evaluation are factors specific to the attending surgeon. Resident performance, resident autonomy, and case complexity had only modest associations with feedback decisions. Efforts to improve the amount of formative feedback for trainees should be directed towards reducing the variation in which attending surgeons elect to provide feedback.

Utilizing gamification effect through Kahoot in remote teaching of immunology: Medical students' perceptions.

Introduction: Gamification of learning is a novel pedagogical approach in education, and Kahoot is one of the game-based learning platforms widely used for formative assessments in real-time. This study aimed to explore the medical students' perception of using Kahoot in remote learning. Methods: The mixed-method study was carried out among 72 medical students (in third-year) at Eastern University, Sri Lanka, following a formative assessment on immunology conducted via zoom video conferencing and Kahoot. The students' perception was collected through a google form, which consisted of 13 statements with a 5-point Likert scale and an open-ended question. Descriptive statistics and Mann-Whitney test were computed using SPSS ver. 25. A content analysis was employed to interpret the qualitative statements. Results: The participants' age ranges from 23-28 years with male-female ratio of 1:1.57. The majority of the students felt happy (73.6%) while playing Kahoot remotely and recommended it (84.7%) for formative assessment in future. The participants agreed that Kahoot increased the focus, understanding of the subject, helped retain knowledge, motivated them to learn, provided fun during learning, and kept them active throughout. The majority of the participants agreed that Kahoot was an effective tool for distance learning. Internet connectivity and switching between two applications were identified as difficulties while playing remote mode Kahoot quizzes. Conclusion: The online gaming platform Kahoot has a positive impact on learning immunology. Kahoot maintains its fun and enjoyable nature and motivates students to learn during remote teaching of immunology.

The Use of Formative Assessment in Postgraduate Urology Training: A Systematic Review.

Formative assessment is an essential component of surgical training. However, it is not usually a mandatory component in postgraduate curricula. The purpose of this study is to identify and evaluate how formative assessments are integrated into postgraduate urology training in programs across the globe. This study consisted of a systemic review to see how formative assessments are being implemented in various urology programs globally. A total of 427 articles were identified for the literature review. Of these, only 10 were included and critically appraised. These studies explored various techniques for exploration of formative assessments in urology training programs, which included established tools, such as portfolio reviews, and direct observations of procedure skills (DOPS); novel tools, including the Dutch urology practical skills (D-UPS) program and Ottawa surgical competency operating room evaluation (O-SCORE); and curricular models. Nine of the 10 articles favored their potential utility in formative assessments. Current literature involving formative assessments in postgraduate urology programs is scarce, and available resources have a high heterogeneity between them. More structured formative assessments need to be incorporated into surgical training programs, and affiliated training institutions should be encouraged to integrate them into their curricula.

Piloting a constructive feedback model for problem-based learning in medical education.

PURPOSE: Constructive feedback is key to successful teaching and learning. The unique characteristics of problem-based learning (PBL) tutorials require a unique feedback intervention. Based on the review of existing literature, we developed a feedback model for PBL tutorials, as an extension of the feedback facilitator guide of Mubuuke and his colleagues. This study was aimed to examine the perceptions of students and tutors on the feedback model that was piloted in PBL tutorials. METHODS: This study employed a qualitative research design. The model was tested in nine online PBL sessions, selected using the maximum variation sampling strategy based on tutors' characteristics. All sessions were observed by the researcher. Afterwards, tutors and students in the PBL sessions were interviewed to explore their perceptions of the model. RESULTS: Three themes were identified based on the perceptions of the tutors and students: cognitive changes, behavioral changes, and challenges of the use of the feedback model. Both tutors and students benefited from improved cognition and behavior. However, the use of the feedback model still encountered some challenges, such as limited sources of feedback data, flexibility and adaptability of the model, content of feedback delivered, students' characteristics and performance, tutors' characteristics and self-perceptions, and supportive infrastructure. CONCLUSION: The model can be used as a reference for tutors to deliver constructive feedback during PBL tutorials. The challenges identified in using the constructive feedback model include the need for synchronized guidelines, ample time to adapt to the model, and skills training for tutors.

Intraoperative Assessment of Non-Technical Skills for Surgeons (NOTSS) and Qualitative Description of their Effects on Intraoperative Performance.

OBJECTIVE: The aims of this study were (1) to evaluate the feasibility of using the Non-Technical Skills for Surgeons (NOTSS) rating tool in assessing surgeons' non-technical skills behaviors in live operations, and (2) to describe the effect of NOTSS on intraoperative performance. SETTING DESIGN: This study was conducted in an academic hospital in North America. Two observers independently conducted direct non-participant observations using the NOTSS rating tool to assess non-technical skills, and to document examples of effective or ineffective non-technical skills behaviors. Observers took field notes to document non-technical skill gaps that were not captured by the NOTSS rating tool, and situations or scenarios that presented challenges for accurate assessment. Interclass correlation estimates and 95% confidence intervals were calculated to assess the validity of the NOTSS rating tool. Deductive thematic qualitative data analysis was used for field notes and NOTSS behavior descriptions. PARTICIPANTS: Participants were general surgeons performing either minimally invasive (robotic assisted or laparoscopic surgery), or open procedures. RESULTS: We observed 18 surgeries, involving 6 surgeons, 11 residents and one fellow resulting in 37 hours of direct observations. The mean NOTSS score was 3.8 (SD 0.41) for situation awareness, 3.75 (SD 0.47) for decision-making, 3.71 (SD 0.39) for communication and teamwork, and 3.76 (SD 0.38) for leadership. The inter-rater reliability ranged between 0.65 and 0.80 for each NOTSS categories. The observers documented examples of effective non-technical skills behaviors and examples of behaviors that need improvement. Furthermore, we described the effect of each observed behavior on intraoperative performance. One challenge to NOTSS use in live surgery was that observers had to infer situation awareness, decision-making, and coping with pressure as these were not easily observed without attending surgeons articulating their underlying thought process. CONCLUSION: The use of the NOTSS tool in live surgery is a valid and practical tool to document observed behaviors and their effect on intraoperative performance in order to provide constructive feedback to surgeons. One notable limitation is that without specific articulation by the surgeon of their underlying thought process the observer must infer specific elements. By documenting specific real-world events with high inter-rater reliability and adequate surgeon score variation the process can be used to provide useful feedback for improvement.