Journal of Educational Evaluation for Health Professions

From articles published in Journal of Educational Evaluation for Health Professions during the past two years (2022 ~ ).

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Brief report

Training and implementation of handheld ultrasound technology at Georgetown Public Hospital Corporation in Guyana: a virtual learning cohort study: Michelle Bui, Adrian Fernandez, Budheshwar Ramsukh, Onika Noel, Chris Prashad, David Bayne; J Educ Eval Health Prof. 2023;20:11. Published online April 4, 2023; DOI: https://doi.org/10.3352/jeehp.2023.20.11

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A virtual point-of-care ultrasound (POCUS) education program was initiated to introduce handheld ultrasound technology to Georgetown Public Hospital Corporation in Guyana, a low-resource setting. We studied ultrasound competency and participant satisfaction in a cohort of 20 physicians-in-training through the urology clinic. The program consisted of a training phase, where they learned how to use the Butterfly iQ ultrasound, and a mentored implementation phase, where they applied their skills in the clinic. The assessment was through written exams and an objective structured clinical exam (OSCE). Fourteen students completed the program. The written exam scores were 3.36/5 in the training phase and 3.57/5 in the mentored implementation phase, and all students earned 100% on the OSCE. Students expressed satisfaction with the program. Our POCUS education program demonstrates the potential to teach clinical skills in low-resource settings and the value of virtual global health partnerships in advancing POCUS and minimally invasive diagnostics.

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Efficacy of Handheld Ultrasound in Medical Education: A Comprehensive Systematic Review and Narrative Analysis
Mariam Haji-Hassan, Roxana-Denisa Capraș, Sorana D. Bolboacă
Diagnostics.2023; 13(24): 3665. CrossRef

Editorial

Presidential address: improving item validity and adopting computer-based testing, clinical skills assessments, artificial intelligence, and virtual reality in health professions licensing examinations in Korea: Hyunjoo Pai; J Educ Eval Health Prof. 2023;20:8. Published online March 27, 2023; DOI: https://doi.org/10.3352/jeehp.2023.20.8

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Presidential address 2024: the expansion of computer-based testing to numerous health professions licensing examinations in Korea, preparation of computer-based practical tests, and adoption of the medical metaverse
Hyunjoo Pai
Journal of Educational Evaluation for Health Professions.2024; 21: 2. CrossRef

Research article

What impacts students’ satisfaction the most from Medicine Student Experience Questionnaire in Australia: a validity study: Pin-Hsiang Huang, Gary Velan, Greg Smith, Melanie Fentoullis, Sean Edward Kennedy, Karen Jane Gibson, Kerry Uebel, Boaz Shulruf; J Educ Eval Health Prof. 2023;20:2. Published online January 18, 2023; DOI: https://doi.org/10.3352/jeehp.2023.20.2

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Purpose
This study evaluated the validity of student feedback derived from Medicine Student Experience Questionnaire (MedSEQ), as well as the predictors of students’ satisfaction in the Medicine program.
Methods
Data from MedSEQ applying to the University of New South Wales Medicine program in 2017, 2019, and 2021 were analyzed. Confirmatory factor analysis (CFA) and Cronbach’s α were used to assess the construct validity and reliability of MedSEQ respectively. Hierarchical multiple linear regressions were used to identify the factors that most impact students’ overall satisfaction with the program.
Results
A total of 1,719 students (34.50%) responded to MedSEQ. CFA showed good fit indices (root mean square error of approximation=0.051; comparative fit index=0.939; chi-square/degrees of freedom=6.429). All factors yielded good (α>0.7) or very good (α>0.8) levels of reliability, except the “online resources” factor, which had acceptable reliability (α=0.687). A multiple linear regression model with only demographic characteristics explained 3.8% of the variance in students’ overall satisfaction, whereas the model adding 8 domains from MedSEQ explained 40%, indicating that 36.2% of the variance was attributable to students’ experience across the 8 domains. Three domains had the strongest impact on overall satisfaction: “being cared for,” “satisfaction with teaching,” and “satisfaction with assessment” (β=0.327, 0.148, 0.148, respectively; all with P<0.001).
Conclusion
MedSEQ has good construct validity and high reliability, reflecting students’ satisfaction with the Medicine program. Key factors impacting students’ satisfaction are the perception of being cared for, quality teaching irrespective of the mode of delivery and fair assessment tasks which enhance learning.

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Mental health and quality of life across 6 years of medical training: A year-by-year analysis
Natalia de Castro Pecci Maddalena, Alessandra Lamas Granero Lucchetti, Ivana Lucia Damasio Moutinho, Oscarina da Silva Ezequiel, Giancarlo Lucchetti
International Journal of Social Psychiatry.2024; 70(2): 298. CrossRef

Editorial

Presidential address: reflection on work from April 2019 to 2022 and appreciation to the staff and volunteers: Yoon-Seong Lee; J Educ Eval Health Prof. 2022;19:39. Published online December 30, 2022; DOI: https://doi.org/10.3352/jeehp.2022.19.39

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Issues in the 3rd year of the COVID-19 pandemic, including computer-based testing, study design, ChatGPT, journal metrics, and appreciation to reviewers
Sun Huh
Journal of Educational Evaluation for Health Professions.2023; 20: 5. CrossRef

Review

Factors associated with medical students’ scores on the National Licensing Exam in Peru: a systematic review: Javier Alejandro Flores-Cohaila; J Educ Eval Health Prof. 2022;19:38. Published online December 29, 2022; DOI: https://doi.org/10.3352/jeehp.2022.19.38

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Purpose
This study aimed to identify factors that have been studied for their associations with National Licensing Examination (ENAM) scores in Peru.
Methods
A search was conducted of literature databases and registers, including EMBASE, SciELO, Web of Science, MEDLINE, Peru’s National Register of Research Work, and Google Scholar. The following key terms were used: “ENAM” and “associated factors.” Studies in English and Spanish were included. The quality of the included studies was evaluated using the Medical Education Research Study Quality Instrument (MERSQI).
Results
In total, 38,500 participants were enrolled in 12 studies. Most (11/12) studies were cross-sectional, except for one case-control study. Three studies were published in peer-reviewed journals. The mean MERSQI was 10.33. A better performance on the ENAM was associated with a higher-grade point average (GPA) (n=8), internship setting in EsSalud (n=4), and regular academic status (n=3). Other factors showed associations in various studies, such as medical school, internship setting, age, gender, socioeconomic status, simulations test, study resources, preparation time, learning styles, study techniques, test-anxiety, and self-regulated learning strategies.
Conclusion
The ENAM is a multifactorial phenomenon; our model gives students a locus of control on what they can do to improve their score (i.e., implement self-regulated learning strategies) and faculty, health policymakers, and managers a framework to improve the ENAM score (i.e., design remediation programs to improve GPA and integrate anxiety-management courses into the curriculum).

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Performance of ChatGPT on the Peruvian National Licensing Medical Examination: Cross-Sectional Study
Javier A Flores-Cohaila, Abigaíl García-Vicente, Sonia F Vizcarra-Jiménez, Janith P De la Cruz-Galán, Jesús D Gutiérrez-Arratia, Blanca Geraldine Quiroga Torres, Alvaro Taype-Rondan
JMIR Medical Education.2023; 9: e48039. CrossRef

Research articles

Factors affecting nursing and health technician students' satisfaction with distance learning during the COVID-19 pandemic in Morocco: a descriptive study: Aziz Naciri, Mohamed Radid, Abderrahmane Achbani, Mohamed Amine Baba, Ahmed Kharbach, Ghizlane Chemsi; J Educ Eval Health Prof. 2022;19:28. Published online October 17, 2022; DOI: https://doi.org/10.3352/jeehp.2022.19.28

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Purpose
Distance learning describes any learning based on the use of new multimedia technologies and the internet to allow students to acquire new knowledge and skills at a distance. This study aimed to determine satisfaction levels with distance learning and associated factors among nursing and health technician students during the coronavirus disease 2019 pandemic in Morocco.
Methods
An descriptive study was conducted between April and June 2022 among nursing and health technician students using a self-administered instrument. The student satisfaction questionnaire consists of 24 questions categorized into 6 subscales: instructor, technology, course setup, interaction, outcomes, and overall satisfaction. It was based on a 5-point Likert scale, ranging from 1 (strongly disagree) to 5 (strongly agree). Univariate and multivariate logistic regression analyses were conducted to identify factors associated with student satisfaction during distance learning.
Results
A total of 330 students participated in this study, and 176 students (53.3%) were satisfied with the distance learning activities. A mean score higher than 2.8 out of 5 was obtained for all subscales. Multiple regression analysis showed that students’ year of study (adjusted odds ratio [aOR], 2.34; 95% confidence interval [CI], 1.28–4.27) and internet quality (aOR, 0.47; 95% CI, 0.29–0.77) were the significant factors associated with students’ satisfaction during distance learning.
Conclusion
This study highlights the satisfaction level of students and factors that influenced it during distance learning. A thorough understanding of student satisfaction with digital environments will contribute to the successful implementation of distance learning devices in nursing.

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Satisfaction with online education among students, faculty, and parents before and after the COVID-19 outbreak: Evidence from a meta-analysis
Tianyuan Xu, Ling Xue
Frontiers in Psychology.2023;[Epub] CrossRef

Acceptability of the 8-case objective structured clinical examination of medical students in Korea using generalizability theory: a reliability study: Song Yi Park, Sang-Hwa Lee, Min-Jeong Kim, Ki-Hwan Ji, Ji Ho Ryu; J Educ Eval Health Prof. 2022;19:26. Published online September 8, 2022; DOI: https://doi.org/10.3352/jeehp.2022.19.26

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Purpose
This study investigated whether the reliability was acceptable when the number of cases in the objective structured clinical examination (OSCE) decreased from 12 to 8 using generalizability theory (GT).
Methods
This psychometric study analyzed the OSCE data of 439 fourth-year medical students conducted in the Busan and Gyeongnam areas of South Korea from July 12 to 15, 2021. The generalizability study (G-study) considered 3 facets—students (p), cases (c), and items (i)—and designed the analysis as p×(i:c) due to items being nested in a case. The acceptable generalizability (G) coefficient was set to 0.70. The G-study and decision study (D-study) were performed using G String IV ver. 6.3.8 (Papawork, Hamilton, ON, Canada).
Results
All G coefficients except for July 14 (0.69) were above 0.70. The major sources of variance components (VCs) were items nested in cases (i:c), from 51.34% to 57.70%, and residual error (pi:c), from 39.55% to 43.26%. The proportion of VCs in cases was negligible, ranging from 0% to 2.03%.
Conclusion
The case numbers decreased in the 2021 Busan and Gyeongnam OSCE. However, the reliability was acceptable. In the D-study, reliability was maintained at 0.70 or higher if there were more than 21 items/case in 8 cases and more than 18 items/case in 9 cases. However, according to the G-study, increasing the number of items nested in cases rather than the number of cases could further improve reliability. The consortium needs to maintain a case bank with various items to implement a reliable blueprinting combination for the OSCE.

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Applying the Generalizability Theory to Identify the Sources of Validity Evidence for the Quality of Communication Questionnaire
Flávia Del Castanhel, Fernanda R. Fonseca, Luciana Bonnassis Burg, Leonardo Maia Nogueira, Getúlio Rodrigues de Oliveira Filho, Suely Grosseman
American Journal of Hospice and Palliative Medicine®.2023;[Epub] CrossRef

Medical students’ self-assessed efficacy and satisfaction with training on endotracheal intubation and central venous catheterization with smart glasses in Taiwan: a non-equivalent control-group pre- and post-test study: Yu-Fan Lin, Chien-Ying Wang, Yen-Hsun Huang, Sheng-Min Lin, Ying-Ying Yang; J Educ Eval Health Prof. 2022;19:25. Published online September 2, 2022; DOI: https://doi.org/10.3352/jeehp.2022.19.25

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Purpose
Endotracheal intubation and central venous catheterization are essential procedures in clinical practice. Simulation-based technology such as smart glasses has been used to facilitate medical students’ training on these procedures. We investigated medical students’ self-assessed efficacy and satisfaction regarding the practice and training of these procedures with smart glasses in Taiwan.
Methods
This observational study enrolled 145 medical students in the 5th and 6th years participating in clerkships at Taipei Veterans General Hospital between October 2020 and December 2021. Students were divided into the smart glasses or the control group and received training at a workshop. The primary outcomes included students’ pre- and post-intervention scores for self-assessed efficacy and satisfaction with the training tool, instructor’s teaching, and the workshop.
Results
The pre-intervention scores for self-assessed efficacy of 5th- and 6th-year medical students in endotracheal intubation and central venous catheterization procedures showed no significant difference. The post-intervention score of self-assessed efficacy in the smart glasses group was better than that of the control group. Moreover, 6th-year medical students in the smart glasses group showed higher satisfaction with the training tool, instructor’s teaching, and workshop than those in the control group.
Conclusion
Smart glasses served as a suitable simulation tool for endotracheal intubation and central venous catheterization procedures training in medical students. Medical students practicing with smart glasses showed improved self-assessed efficacy and higher satisfaction with training, especially for procedural steps in a space-limited field. Simulation training on procedural skills with smart glasses in 5th-year medical students may be adjusted to improve their satisfaction.

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The use of smart glasses in nursing education: A scoping review
Charlotte Romare, Lisa Skär
Nurse Education in Practice.2023; 73: 103824. CrossRef

Case report

Successful pilot application of multi-attribute utility analysis concepts in evaluating academic-clinical partnerships in the United States: a case report: Sara Elizabeth North, Amanda Nicole Sharp; J Educ Eval Health Prof. 2022;19:18. Published online August 19, 2022; DOI: https://doi.org/10.3352/jeehp.2022.19.18

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Strong partnerships between academic health professions programs and clinical practice settings, termed academic-clinical partnerships, are essential in providing quality clinical training experiences. However, the literature does not operationalize a model by which an academic program may identify priority attributes and evaluate its partnerships. This study aimed to develop a values-based academic-clinical partnership evaluation approach, rooted in methodologies from the field of evaluation and implemented in the context of an academic Doctor of Physical Therapy clinical education program. The authors developed a semi-quantitative evaluation approach incorporating concepts from multi-attribute utility analysis (MAUA) that enabled consistent, values-based partnership evaluation. Data-informed actions led to improved overall partnership effectiveness. Pilot outcomes support the feasibility and desirability of moving toward MAUA as a potential methodological framework. Further research may lead to the development of a standardized process for any academic health profession program to perform a values-based evaluation of their academic-clinical partnerships to guide decision-making.

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Application of Multi-Attribute Utility Analysis as a Methodological Framework in Academic–Clinical Partnership Evaluation
Sara E. North
American Journal of Evaluation.2024;[Epub] CrossRef

Review

Characteristics and 10 key components of interpersonal caring: a narrative review: Susie Kim; J Educ Eval Health Prof. 2022;19:17. Published online July 25, 2022; DOI: https://doi.org/10.3352/jeehp.2022.19.17

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This paper aims to help people understand better the lives of people who are mentally ill by describing the general concept of the Interpersonal Caring Theory (ICT) and deducing 10 key components of interpersonal caring. The literature review described the definition of interpersonal caring, and its assumptions and characteristics. Furthermore, the authors’ experience with patient care suggested the critical components of interpersonal caring, which is the compassion-based therapeutic actions/behaviors through the collaborative partnership developed between nurse and client. Essential characteristics of interpersonal caring include the following: person-to-person interaction between nurse and patient, genuine love and concern toward the person, conveying trust and hope, transcending space, time, and culture, holistic approach expressed through a comprehensive and dynamic mode of communication, helping the patient focus on their self-worth, and providing culturally relevant and sensitive nursing. Ten key components of interpersonal caring in ICT include noticing, participating, sharing, active listening, companioning, complimenting, comforting, hoping, forgiving, and accepting. Interpersonal caring results from the blended understanding of the empirical, aesthetic, ethical, and intuitive aspects of a given clinical situation, and a nexus of pre-conditions, content, feelings, and sense of self-worth/self-esteem.

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Disparidades de salud en el mundo real de los pacientes con esclerosis múltiple
Roberto Rotta Escalante, Osvaldo Fustinoni, María Elisa Barone, José R. Elli, María del Carmen Martínez Perea
Neurología Argentina.2023; 15(1): 37. CrossRef

Research article

Effect of online education on the knowledge on, attitudes towards, and skills in patient safety for nursing students in Korea: a mixed-methods study: Dan Bi Cho, Won Lee, So Yoon Kim, Sungkyoung Choi; J Educ Eval Health Prof. 2022;19:14. Published online June 30, 2022; DOI: https://doi.org/10.3352/jeehp.2022.19.14

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Purpose
The purpose of this study was to evaluate the impact of synchronous online education on the patient safety competency (knowledge, attitudes, and skills) of nursing students in Korea and to explore what they thought about this educational method.
Methods
A single-group pre-and post-test design and summative content analysis were implemented. On November 14th, 2020, 110 nursing students completed synchronous online patient safety education. Patient safety competency was measured before and after the intervention using the revised Patient Safety Competency Self-Evaluation tool. The descriptive statistics, paired t-test, and Wilcoxon signed-rank test were used to analyze the data. Students also expressed their opinions about this education based on open-ended questions.
Results
All the patient safety competency scores significantly increased after intervention. A summative content analysis of the open-ended questions yielded 5 categories: educational materials, education level, education time, interaction, and educational media.
Conclusion
This study found that synchronous online patient safety education improves nursing students’ knowledge on, attitudes towards, and skills in patient safety. Nursing students also expressed a variety of positive aspects of the online education method. To improve the efficacy of synchronous online patient safety education, there is a need for further empirical studies on the appropriate class duration and difficulty of the content. It is essential to find a way to combine online education with various learning activities.

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Effects of the small private online course combined with simulation-based training in a patient safety education program among nursing students: A quasi-experimental study
Hui Li, Wenzhong Zhao, Bo Li, Yanhong Li
International Journal of Nursing Sciences.2023; 10(4): 555. CrossRef

Brief report

Educational impact of an active learning session with 6-lead mobile electrocardiography on medical students’ knowledge of cardiovascular physiology during the COVID-19 pandemic in the United States: a survey-based observational study: Alexandra Camille Greb, Emma Altieri, Irene Masini, Emily Helena Frisch, Milton Leon Greenberg; J Educ Eval Health Prof. 2022;19:12. Published online June 20, 2022; DOI: https://doi.org/10.3352/jeehp.2022.19.12

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Mobile electrocardiogram (ECG) devices are valuable tools for teaching ECG interpretation. The primary purpose of this follow-up study was to determine if an ECG active learning session could be safely and effectively performed during the coronavirus disease 2019 (COVID-19) pandemic using a newly developed mobile 6-lead ECG device. Additionally, we examined the educational impact of these active learning sessions on student knowledge of cardiovascular physiology and the utility of the mobile 6-lead ECG device in a classroom setting. In this study, first-year medical students (MS1) performed four active learning activities using the new mobile 6-lead ECG device. Data were collected from 42 MS1s through a quantitative survey administered in September 2020. Overall, students felt the activity enhanced their understanding of the course material and that the activity was performed safely and in compliance with local COVID-19 guidelines. These results emphasize student preference for hands-on, small group learning activities in spite of the pandemic.

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Medical student exam performance and perceptions of a COVID-19 pandemic-appropriate pre-clerkship medical physiology and pathophysiology curriculum
Melissa Chang, Andrew Cuyegkeng, Joseph A. Breuer, Arina Alexeeva, Abigail R. Archibald, Javier J. Lepe, Milton L. Greenberg
BMC Medical Education.2022;[Epub] CrossRef

Research article

Medical residents and attending physicians’ perceptions of feedback and teaching in the United States: a qualitative study: Madeleine Matthiesen, Michael S. Kelly, Kristina Dzara, Arabella Simpkin Begin; J Educ Eval Health Prof. 2022;19:9. Published online April 26, 2022; DOI: https://doi.org/10.3352/jeehp.2022.19.9

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Purpose
Residents and attendings agree on the importance of feedback to resident education. However, while faculty report providing frequent feedback, residents often do not perceive receiving it, particularly in the context of teaching. Given the nuanced differences between feedback and teaching, we aimed to explore resident and attending perceptions of feedback and teaching in the clinical setting.
Methods
We conducted a qualitative study of internal medicine residents and attendings from December 2018 through March 2019 at the Massachusetts General Hospital to investigate perceptions of feedback in the inpatient clinical setting. Residents and faculty were recruited to participate in focus groups. Data were analyzed using thematic analysis to explore perspectives and barriers to feedback provision and identification.
Results
Five focus groups included 33 total participants in 3 attending (n=20) and 2 resident (n=13) groups. Thematic analysis of focus group transcripts identified 7 themes which organized into 3 thematic categories: (1) disentangling feedback and teaching, (2) delivering high-quality feedback, and (3) experiencing feedback in the group setting. Residents and attendings highlighted important themes in discriminating feedback from teaching. They indicated that while feedback is reactive in response to an action or behavior, teaching is proactive and oriented toward future endeavors.
Conclusion
Confusion between the critical concepts of teaching and feedback may be minimized by allowing them to each have their intended impact, either in response to prior events or aimed toward those yet to take place.

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Resident Assessment of Clinician Educators According to Core ACGME Competencies
Bailey A. Pope, Patricia A. Carney, Mary C. Brooks, Doug R. Rice, Ashly A. Albright, Stephanie A. C. Halvorson
Journal of General Internal Medicine.2024; 39(3): 377. CrossRef

Educational/Faculty training material

Online interprofessional education materials through a community learning program during the COVID 19 pandemic in Chile: Sandra Oyarzo Torres, Mónica Espinoza Barrios; J Educ Eval Health Prof. 2022;19:6. Published online March 24, 2022; DOI: https://doi.org/10.3352/jeehp.2022.19.6

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This article aims to share the online collaborative experience of interprofessional teamwork among healthcare undergraduate students based on community learning during the coronavirus disease 2019 (COVID-19) pandemic in Chile. This experience took place in 48 different communities in Chile from November 10, 2020 to January 12, 2021. It was a way of responding to the health education needs of the community when the entire Chilean population was in confinement. Students managed to adapt to the COVID-19 pandemic despite the challenges, including internet connectivity problems and the limited time available to do the work. The educational programs and videos shared in this article will be helpful for other interprofessional health educators to implement the same kind of program.

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Successful Development and Implementation of a Large Virtual Interprofessional Education Activity Applying the Social Determinants of Health
Karl R. Kodweis, Elizabeth A. Hall, Chelsea P. Renfro, Neena Thomas-Gosain, Robin Lennon-Dearing, Jonathon K. Walker, Tyler M. Kiles
Pharmacy.2022; 10(6): 157. CrossRef

Research article

Obstetrics and gynecology residents’ satisfaction and self-confidence after an anal sphincter injury simulation-based workshop in Indonesia: a pre- and post-intervention comparison study: Riska Wahyuningtyas, Eighty Mardiyan Kurniawati, Budi Utomo, Gatut Hardianto, Hari Paraton, Tri Hastono, Djoko Kuswanto; J Educ Eval Health Prof. 2022;19:4. Published online February 14, 2022; DOI: https://doi.org/10.3352/jeehp.2022.19.4

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Purpose
Obstetric anal sphincter injury is one of the most common complications during delivery. Simulation models with manikins can be used as an effective medical learning method to improve students’ abilities before encountering patients. The present study aimed to describe the development of an anal sphincter injury model and to assess residents’ satisfaction and self-confidence after a perineal repair workshop with an anal sphincter injury simulator in Indonesia.
Methods
This was a cross-sectional study with evaluation of outcomes before and after the workshop. We created a silicone-latex simulation anal sphincter injury model. Then, we validated this simulation and used it as a simulation model for the workshop. We asked residents about their satisfaction with repairing anal sphincter injuries using a simulation model and residents’ self-confidence when practicing anal sphincter injury repair.
Results
All residents felt the simulation-based workshop was valuable (100%). Most of the scores for the similarity of the simulation model were good (about 8 out of maximum 10). The self-assessment of confidence was measured before and after the workshop. Overall self-confidence increased significantly after the workshop in identifying the external sphincter ani (EAS) (P=0.031), suturing the anal mucosa (P=0.001), suturing the internal sphincter ani (P=0.001), suturing the EAS (P<0.001), and evaluating the sphincter ani tone (P=0.016).
Conclusion
The anal sphincter injury simulator improved residents’ self-confidence in identifying the EAS, suturing the anal mucosa, suturing the internal sphincter ani, suturing the EAS, and evaluating sphincter ani tone.

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Objective structured assessment of medical students’ technical skills in second-degree perineal laceration repair with sponge model-based training
Gregor Leonhard Olmes, Merle Doerk, Erich-Franz Solomayer, Meletios P. Nigdelis, Romina-Marina Sima, Bashar Haj Hamoud
Archives of Gynecology and Obstetrics.2023;[Epub] CrossRef

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