Journal of Educational Evaluation for Health Professions

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
Radiologist preferences for faculty development initiatives to improve resident feedback in the era of competency-based medical education
Laura Wong, Ethan Sacoransky, Wilma Hopman, Omar Islam, Andrew D. Chung, Benjamin Y. M. Kwan
Medical Education Online.2024;[Epub] CrossRef
Through the Looking Glass: Comparing Hospitalists' and Internal Medicine Residents' Perceptions of Feedback
Andrew V Raikhel, Helene Starks, Gabrielle Berger, Jeffrey Redinger
Cureus.2024;[Epub] CrossRef

Brief report

Effects of a simulation-based blended training model on nurses’ treatment decision-related knowledge about oral cancer in Taiwan: a pilot survey: Chia-Chang Huang, Shiau-Shian Huang, Ying-Ying Yang, Shou-Yen Kao; J Educ Eval Health Prof. 2021;18:10. Published online May 25, 2021; DOI: https://doi.org/10.3352/jeehp.2021.18.10

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The present study aimed to evaluate the effects of virtual reality (VR) simulations combined with bedside assignments on nurses’ self-efficacy in providing pre-treatment educational services. Between March 2019 and November 2020, we conducted a study of VR educational materials that were developed to cover information about the treatment of oral cancers. The effects of the VR simulation, the thinking-path tracking map method, and bedside assignments on the nurses’ treatment decision-related knowledge were evaluated in a ward for oral cancer patients at Taipei Veterans General Hospital, Taipei, Taiwan. The blended training model significantly increased nurses’ familiarity (P<0.01) and confidence (P<0.03) regarding their knowledge of treatments and treatment decision-related knowledge. This model also significantly increased their confidence in their skills in bedside pre-treatment education for admitted oral cancer patients (P<0.002). Oral cancer-specific VR materials enhanced the effectiveness of skills training among nurses in the oral cancer ward.

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The use of simulation-based education in cancer care: a scoping review
Amina Silva, Kylie Teggart, Corey Heerschap, Jacqueline Galica, Kevin Woo, Marian Luctkar-Flude
International Journal of Healthcare Simulation.2023;[Epub] CrossRef
Application of computer-based testing in the Korean Medical Licensing Examination, the emergence of the metaverse in medical education, journal metrics and statistics, and appreciation to reviewers and volunteers
Sun Huh
Journal of Educational Evaluation for Health Professions.2022; 19: 2. CrossRef
Assessing the Financial Sustainability of High-Fidelity and Virtual Reality Simulation for Nursing Education
Michael D. Bumbach, Beth A. Culross, Santanu K. Datta
CIN: Computers, Informatics, Nursing.2022; 40(9): 615. CrossRef

Research articles

Development of a checklist to validate the framework of a narrative medicine program based on Gagne’s instructional design model in Iran through consensus of a multidisciplinary expert panel: Saeideh Daryazadeh, Nikoo Yamani, Payman Adibi; J Educ Eval Health Prof. 2019;16:34. Published online October 31, 2019; DOI: https://doi.org/10.3352/jeehp.2019.16.34

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Purpose
Narrative medicine is a patient-centered approach focusing on the development of narrative skills and self-awareness that incorporates “attending, representing, and affiliating” in clinical encounters. Acquiring narrative competency promotes clinical performance, and narratives can be used for teaching professionalism, empathy, multicultural education, and professional development. This study was conducted to develop a checklist to validate the framework of a narrative medicine program through consensus of a panel.
Methods
This expert panel study was conducted from 2018 to 2019 at Isfahan University of Medical Sciences, Iran. It included 2 phases: developing a framework in 2 steps and forming an expert panel to validate the framework in 3 rounds. We adapted a 3-stage narrative medicine model with 9 training activities from Gagne’s theory, developed a framework, and then produced a checklist to validate the framework in a multidisciplinary expert panel that consisted of 7 experts. The RAND/UCLA appropriateness method was used to assess the experts’ agreement. The first-round opinions were received by email. Consensus was achieved in the second and third rounds through face-to-face meetings to facilitate interactions and discussion among the experts.
Results
Sixteen valid indicators were approved and 100% agreement was obtained among experts (with median values in the range of 7–9 out of a maximum of 9, with no disagreement), and the framework was validated by the expert panel.
Conclusion
The 16 checklist indicators can be used to evaluate narrative medicine programs as a simple and practical guide to improve teaching effectiveness and promote life-long learning.

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Challenges of Implementing the First Narrative Medicine Course for Teaching Professionalism in Iran: A Qualitative Content Analysis
Saeideh Daryazadeh, Payman Adibi, Nikoo Yamani
Educational Research in Medical Sciences.2022;[Epub] CrossRef
Impact of a narrative medicine program on reflective capacity and empathy of medical students in Iran
Saeideh Daryazadeh, Payman Adibi, Nikoo Yamani, Roya Mollabashi
Journal of Educational Evaluation for Health Professions.2020; 17: 3. CrossRef

Satisfaction with and suitability of the problem-based learning program at the Catholic University of Korea College of Medicine: Dong Mi Yoo, A Ra Cho, Sun Kim; J Educ Eval Health Prof. 2019;16:20. Published online July 19, 2019; DOI: https://doi.org/10.3352/jeehp.2019.16.20

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Purpose
This study was conducted to identify suggestions for improving the effectiveness and promoting the success of the current problem-based learning (PBL) program at the Catholic University of Korea College of Medicine through a professor and student awareness survey.
Methods
A survey was carried out by sending out mobile Naver Form survey pages via text messages 3 times in December 2018, to 44 medical students and 74 professors. In addition, relevant official documents from the school administration were reviewed. The collected data were analyzed to identify the achievement of educational goals, overall satisfaction with, and operational suitability of the PBL program.
Results
The overall satisfaction scores for the PBL program were neutral (students, 3.27±0.95 vs. professors, 3.58±1.07; P=0.118). Regarding the achievement of educational goals, the integration of basic and clinical medicine and encouragement of learning motivation were ranked lowest. Many respondents expressed negative opinions about the modules (students, 25.0%; professors, 39.2%) and tutors (students, 54.5%; professors, 24.3%). The students and professors agreed that the offering timing of the program in medical school and the length of each phase were suitable, while opinions expressed in greater detail pointed to issues such as the classes being held too close to exams and their alignment with regular course units.
Conclusion
Issues with modules and tutors were the most pressing. Detailed and appropriate modules should be developed on the basis of advice from professors with experience in PBL tutoring. Inconsistencies in tutoring should be reduced by standardization and retraining.

Citations

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Effectiveness of problem-based learning methodology in undergraduate medical education: a scoping review
Joan Carles Trullàs, Carles Blay, Elisabet Sarri, Ramon Pujol
BMC Medical Education.2022;[Epub] CrossRef
Student and Tutor Satisfaction with Problem-Based Learning in Azerbaijan
Ulkar Sattarova, Wim Groot, Jelena Arsenijevic
Education Sciences.2021; 11(6): 288. CrossRef
A scoping review of clinical reasoning research with Asian healthcare professionals
Ching-Yi Lee, Chang-Chyi Jenq, Madawa Chandratilake, Julie Chen, Mi-Mi Chen, Hiroshi Nishigori, Gohar Wajid, Pai-Hsuang Yang, Muhamad Saiful Bahri Yusoff, Lynn Monrouxe
Advances in Health Sciences Education.2021; 26(5): 1555. CrossRef
Newly appointed medical faculty members’ self-evaluation of their educational roles at the Catholic University of Korea College of Medicine in 2020 and 2021: a cross-sectional survey-based study
Sun Kim, A Ra Cho, Chul Woon Chung
Journal of Educational Evaluation for Health Professions.2021; 18: 28. CrossRef

Does the acceptance of hybrid learning affect learning approaches in France?: Lionel Di Marco, Alain Venot, Pierre Gillois; J Educ Eval Health Prof. 2017;14:24. Published online October 20, 2017; DOI: https://doi.org/10.3352/jeehp.2017.14.24

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Abstract PDF

Purpose
Acceptance of a learning technology affects students’ intention to use that technology, but the influence of the acceptance of a learning technology on learning approaches has not been investigated in the literature. A deep learning approach is important in the field of health, where links must be created between skills, knowledge, and habits. Our hypothesis was that acceptance of a hybrid learning model would affect students’ way of learning.
Methods
We analysed these concepts, and their correlations, in the context of a flipped classroom method using a local learning management system. In a sample of all students within a single year of study in the midwifery program (n= 38), we used 3 validated scales to evaluate these concepts (the Study Process Questionnaire, My Intellectual Work Tools, and the Hybrid E-Learning Acceptance Model: Learner Perceptions).
Results
Our sample had a positive acceptance of the learning model, but a neutral intention to use it. Students reported that they were distractible during distance learning. They presented a better mean score for the deep approach than for the superficial approach (P< 0.001), which is consistent with their declared learning strategies (personal reorganization of information; search and use of examples). There was no correlation between poor acceptance of the learning model and inadequate learning approaches. The strategy of using deep learning techniques was moderately correlated with acceptance of the learning model (r_s= 0.42, P= 0.03).
Conclusion
Learning approaches were not affected by acceptance of a hybrid learning model, due to the flexibility of the tool. However, we identified problems in the students’ time utilization, which explains their neutral intention to use the system.

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Lei Zhu, Hui Xiong, Yan Ning, Miaomiao Lv
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Online learning and teaching approaches used in midwifery programs: A scoping review
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User-centered evaluation of Discord in midwifery education during the COVID-19 pandemic: Analysis of the adaptation of the tool to student needs
Lionel Di Marco
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Fares Gouzi, François Bughin, Lucie Barateau, Agathe Hubert, Savine Volland, Dalila Laoudj-Chenivesse, Emilie Passerieux, Régis Lopez, Antonia Perez-Martin, Iris Schuster-Beck, Stephan Matecki, Michel Dauzat, Yves Dauvilliers, Maurice Hayot, Jacques Merci
Pédagogie Médicale.2018; 19(2): 77. CrossRef

Development of the Clinical Teaching Effectiveness Questionnaire in the United States: Michelle E. Wormley, Wendy Romney, Anna E. Greer; J Educ Eval Health Prof. 2017;14:14. Published online June 29, 2017; DOI: https://doi.org/10.3352/jeehp.2017.14.14

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Abstract PDF

Purpose
The purpose of this study was to develop a valid measure for assessing clinical teaching effectiveness within the field of physical therapy.
Methods
The Clinical Teaching Effectiveness Questionnaire (CTEQ) was developed via a 4-stage process, including (1) initial content development, (2) content analysis with 8 clinical instructors with over 5 years of clinical teaching experience, (3) pilot testing with 205 clinical instructors from 2 universities in the Northeast of the United States, and (4) psychometric evaluation, including principal component analysis.
Results
The scale development process resulted in a 30-item questionnaire with 4 sections that relate to clinical teaching: learning experiences, learning environment, communication, and evaluation.
Conclusion
The CTEQ provides a preliminary valid measure for assessing clinical teaching effectiveness in physical therapy practice.

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Stacy Carmel, Lori Kupczynski, Shannon Groff, William Bannon
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The Medical Training Evaluation Questionnaire (MeTrE-Q): a multidimensional self-report instrument for assessing the quality of midwifery students' education
Valentina Lucia La Rosa, Michał Ciebiera, Kornelia Zaręba, Enrique Reyes-Muñoz, Tais Marques Cerentini, Fabio Barra, Simone Garzon, Gaetano Riemma, Pasquale De Franciscis, Antonio Simone Laganà, Salvatore Giovanni Vitale
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Clinical Teaching Competencies in Physical Therapist Education: A Modified Delphi Study
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Physical Therapy.2022;[Epub] CrossRef
Construct Validity and Internal Consistency of the Physical Therapist Student Evaluation of Clinical Experience and Clinical Instruction
Sean Gallivan
Journal of Physical Therapy Education.2022; 36(4): 283. CrossRef
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Nada Al-Yousuf, Salah Eldin Kassab, Hasan Alsetri, Hossam Hamdy
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Masae Shinozaki, Takashi Fukaya, Yasutsugu Asakawa, Yukari Ohashi
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Michelle E. Wormley, Wendy Romney, Kristin Schweizer, Beverly Fein, Vicki LaFay, Rebecca Martin, Anna E. Greer
Journal of Physical Therapy Education.2018; 32(4): 344. CrossRef

Brief Report

Perceptions of nursing students trained in a new model teaching ward in Malawi: Thokozani Bvumbwe; J Educ Eval Health Prof. 2015;12:53. Published online November 23, 2015; DOI: https://doi.org/10.3352/jeehp.2015.12.53

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This study aimed to investigate the perceptions of nursing students trained in a new model teaching ward in Malawi. A total of 90students from five nursing colleges were randomly assigned to one model ward and two ordinary wards in a single teaching hospital. The students were administered a revised version of the Student Evaluation of Clinical Education Environment questionnaire. Significant differences among the three wards were found in all items in the communication/feedback subscale, with the exception of the item “nursing staff provided constructive feedback” (P=0.162). Within the learning opportunities subscale all items showed significant differences among the three wards, whereas 50% of the items in the learning support/assistance subscale had significantly different responses among the three wards. Within the department atmosphere subscale, no significant differences were found in the items assessing whether an adequate number and variety of patients were present in the ward (P=0.978). The strategies that are being implemented to improve the educational environment showed positive results. Students scored the model teaching ward highly. Students who underwent precepting in the model teaching wards reported having more learning opportunities and a positive learning environment.

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STUDENT EVALUATION OF THE CLINICAL EDUCATION: ENVIRONMENT: DEVELOPMENT AND TESTING OF THE SECEE VERSION 4
Kari Sand-Jecklin, Tanya Rogers, Kesheng Wang
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Levels, antecedents, and consequences of critical thinking among clinical nurses: a quantitative literature review
Yongmi Lee, Younjae Oh
Journal of Educational Evaluation for Health Professions.2020; 17: 26. CrossRef

Research Articles

Learning styles and academic achievement among undergraduate medical students in Thailand: Wichuda Jiraporncharoen, Chaisiri Angkurawaranon, Manoch Chockjamsai, Athavudh Deesomchok, Juntima Euathrongchit; J Educ Eval Health Prof. 2015;12:38. Published online July 8, 2015; DOI: https://doi.org/10.3352/jeehp.2015.12.38

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Purpose
This study aimed to explore the associations between learning styles and high academic achievement and to ascertain whether the factors associated with high academic achievement differed between preclinical and clinical students. Methods: A survey was conducted among undergraduate medical students in Chiang Mai University, Thailand. The Index of Learning Styles questionnaire was used to assess each student’s learning style across four domains. High academic achievement was defined as a grade point average of at least 3.0. Results: Of the 1,248 eligible medical students, 1,014 (81.3%) participated. Learning styles differed between the preclinical and clinical students in the active/reflective domain. A sequential learning style was associated with high academic achievement in both preclinical and clinical students. A reflective learning style was only associated with high academic achievement among preclinical students. Conclusion: The association between learning styles and academic achievement may have differed between preclinical and clinical students due to different learning content and teaching methods. Students should be encouraged to be flexible in their own learning styles in order to engage successfully with various and changing teaching methods across the curriculum. Instructors should be also encouraged to provide a variety of teaching materials and resources to suit different learning styles.

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Rilva Lopes de Sousa Muñoz, Ligiane Medeiros Diógenes
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Evaluation of hospital-learning environment for pediatric residency in eastern region of Saudi Arabia: Waleed H. BuAli, Abdul Sattar Khan, Mohammad Hussain Al-Qahtani, Shaikha aldossary; J Educ Eval Health Prof. 2015;12:14. Published online April 18, 2015; DOI: https://doi.org/10.3352/jeehp.2015.12.14

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Abstract PDF

Purpose
No study had been conducted to assess the hospitals’ environment for learning purposes in multicenter sites in Saudi Arabia. It aims to evaluate the environment of hospitals for learning purposes of pediatric residents. Methods: We applied Postgraduate Hospital Educational Environment Measure (PHEEM) to measure the learning environment at six teaching hospitals in the Eastern Region of Saudi Arabia from September to December 2013. Results: The number of respondents was 104 (86.7%) out of 120 residents and 37 females and 67 male residents have responded. The residents’ response scored 100 out of 160 maximum score in rating of PHEEM that showed overall learning environment is favorable for training. There were some items in the social support domain suggesting improvements. There was no significant difference between male and female residents. There was a difference among the participant teaching hospitals (p<0.05). Conclusion: The result pointed an overall positive rating. Individual item scores suggested that their social life during residency could be uninspiring. They have the low satisfactory level and they feel racism, and sexual discrimination. Therefore, there is still a room for improvement.

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Teaching methods in community health nursing clerkships: experiences of healthcare staff in Iran: Eshagh Ildarabadi, Hossein Karimi-Moonaghi, Abbas Heydari, Ali Taghipour, Abdolghani Abdollahimohammad, Azizollah Arbabisarjou; J Educ Eval Health Prof. 2014;11:25. Published online September 30, 2014; DOI: https://doi.org/10.3352/jeehp.2014.11.25

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Purpose
Healthcare staff educate nursing students during their clerkships at community health nursing programs. Their teaching methods play an important role in nursing students’ acquisition of competencies; however, these methods have not been studied thoroughly. Thus, this study aims to describe, interpret, and understand the experiences of healthcare staff’s teaching methods in clerkships at a community health nursing program. Methods: This study was conducted using purposeful sampling and semi-structured interviews with 13 members of the staff of three urban healthcare centers in Iran. The data were analyzed through qualitative content analysis and thematic analysis. Results: Multiplicity of teaching was identified as the main category of teaching method, and the five subcategories were teaching through lecture, demonstration, doing, visits and field trips, and readiness. The most common method used by the healthcare staff was lecturing. Conclusion: The healthcare staff used multiple methods to teach students in the nursing clerkship of the community health program, which was the strength of the course. However, they should be familiar with, and utilize additional methods, such as discussion rather than lecture.

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Student feedback about the integrated curriculum in a Caribbean medical school: P. Ravi Shankar, Ramanan Balasubramanium, Neelam R. Dwivedi, Vivek Nuguri; J Educ Eval Health Prof. 2014;11:23. Published online September 30, 2014; DOI: https://doi.org/10.3352/jeehp.2014.11.23

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Purpose
Xavier University School of Medicine adopted an integrated, organ system-based curriculum in January 2013. The present study was aimed at determining students’ perceptions of the integrated curriculum and related assessment methods. Methods: The study was conducted on first- to fourth-semester undergraduate medical students during March 2014. The students were informed of the study and subsequently invited to participate. Focus group discussions were conducted. The curriculum’s level of integration, different courses offered, teaching-learning methods employed, and the advantages and concerns relating to the curriculum were noted. The respondents also provided feedback about the assessment methods used. Deductive content analysis was used to analyze the data. Results: Twenty-two of the 68 students (32.2%) participated in the study. The respondents expressed generally positive opinions. They felt that the curriculum prepared them well for licensing examinations and future practice. Problem-based learning sessions encouraged active learning and group work among students, thus, improving their understanding of the course material. The respondents felt that certain subjects were allocated a larger proportion of time during the sessions, as well as more questions during the integrated assessment. They also expressed an appreciation for medical humanities, and felt that sessions on the appraisal of literature needed modification. Their opinions about assessment of behavior, attitudes, and professionalism varied. Conclusion: Student opinion was positive, overall. Our findings would be of interest to other medical schools that have recently adopted an integrated curriculum or are in the process of doing so.

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