Journal of Educational Evaluation for Health Professions

Review

How to review and assess a systematic review and meta-analysis article: a methodological study (secondary publication): Seung-Kwon Myung; J Educ Eval Health Prof. 2023;20:24. Published online August 27, 2023; DOI: https://doi.org/10.3352/jeehp.2023.20.24

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Systematic reviews and meta-analyses have become central in many research fields, particularly medicine. They offer the highest level of evidence in evidence-based medicine and support the development and revision of clinical practice guidelines, which offer recommendations for clinicians caring for patients with specific diseases and conditions. This review summarizes the concepts of systematic reviews and meta-analyses and provides guidance on reviewing and assessing such papers. A systematic review refers to a review of a research question that uses explicit and systematic methods to identify, select, and critically appraise relevant research. In contrast, a meta-analysis is a quantitative statistical analysis that combines individual results on the same research question to estimate the common or mean effect. Conducting a meta-analysis involves defining a research topic, selecting a study design, searching literature in electronic databases, selecting relevant studies, and conducting the analysis. One can assess the findings of a meta-analysis by interpreting a forest plot and a funnel plot and by examining heterogeneity. When reviewing systematic reviews and meta-analyses, several essential points must be considered, including the originality and significance of the work, the comprehensiveness of the database search, the selection of studies based on inclusion and exclusion criteria, subgroup analyses by various factors, and the interpretation of the results based on the levels of evidence. This review will provide readers with helpful guidance to help them read, understand, and evaluate these articles.

Citations

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The Role of BIM in Managing Risks in Sustainability of Bridge Projects: A Systematic Review with Meta-Analysis
Dema Munef Ahmad, László Gáspár, Zsolt Bencze, Rana Ahmad Maya
Sustainability.2024; 16(3): 1242. CrossRef

Research articles

Implementation strategy for introducing a clinical skills examination to the Korean Oriental Medicine Licensing Examination: a mixed-method modified Delphi study: Chan-Young Kwon, Sanghoon Lee, Min Hwangbo, Chungsik Cho, Sangwoo Shin, Dong-Hyeon Kim, Aram Jeong, Hye-Yoon Lee; J Educ Eval Health Prof. 2023;20:23. Published online July 17, 2023; DOI: https://doi.org/10.3352/jeehp.2023.20.23

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Abstract PDF Supplementary Material: Purpose
This study investigated the validity of introducing a clinical skills examination (CSE) to the Korean Oriental Medicine Licensing Examination through a mixed-method modified Delphi study.
Methods
A 3-round Delphi study was conducted between September and November 2022. The expert panel comprised 21 oriental medicine education experts who were officially recommended by relevant institutions and organizations. The questionnaires included potential content for the CSE and a detailed implementation strategy. Subcommittees were formed to discuss concerns around the introduction of the CSE, which were collected as open-ended questions. In this study, a 66.7% or greater agreement rate was defined as achieving a consensus.
Results
The expert panel’s evaluation of the proposed clinical presentations and basic clinical skills suggested their priorities. Of the 10 items investigated for building a detailed implementation strategy for the introduction of the CSE to the Korean Oriental Medicine Licensing Examination, a consensus was achieved on 9. However, the agreement rate on the timing of the introduction of the CSE was low. Concerns around 4 clinical topics were discussed in the subcommittees, and potential solutions were proposed.
Conclusion
This study offers preliminary data and raises some concerns that can be used as a reference while discussing the introduction of the CSE to the Korean Oriental Medicine Licensing Examination.

Empirical analysis comparing the tele-objective structured clinical examination and the in-person assessment in Australia: Jonathan Zachary Felthun, Silas Taylor, Boaz Shulruf, Digby Wigram Allen; J Educ Eval Health Prof. 2021;18:23. Published online September 23, 2021; DOI: https://doi.org/10.3352/jeehp.2021.18.23

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Abstract PDF Supplementary Material

Purpose
It aimed to compare the use of the tele-objective structured clinical examination (teleOSCE) with in-person assessment in high-stakes clinical examination so as to determine the impact of the teleOSCE on the assessment undertaken. Discussion follows regarding what skills and domains can effectively be assessed in a teleOSCE.
Methods
This study is a retrospective observational analysis. It compares the results achieved by final year medical students in their clinical examination, assessed using the teleOSCE in 2020 (n=285), with those who were examined using the traditional in-person format in 2019 (n=280). The study was undertaken at the University of New South Wales, Australia.
Results
In the domain of physical examination, students in 2020 scored 0.277 points higher than those in 2019 (mean difference=–0.277, P<0.001, effect size=0.332). Across all other domains, there was no significant difference in mean scores between 2019 and 2020.
Conclusion
The teleOSCE does not negatively impact assessment in clinical examination in all domains except physical examination. If the teleOSCE is the future of clinical skills examination, assessment of physical examination will require concomitant workplace-based assessment.

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Feasibility of an online clinical assessment of competence in physiotherapy students
Brooke Flew, Lucy Chipchase, Darren Lee, Jodie A. McClelland
Physiotherapy Theory and Practice.2024; : 1. CrossRef
Radiography education in 2022 and beyond - Writing the history of the present: A narrative review
Y.X. Tay, J.P. McNulty
Radiography.2023; 29(2): 391. CrossRef
Feasibility and reliability of the pandemic-adapted online-onsite hybrid graduation OSCE in Japan
Satoshi Hara, Kunio Ohta, Daisuke Aono, Toshikatsu Tamai, Makoto Kurachi, Kimikazu Sugimori, Hiroshi Mihara, Hiroshi Ichimura, Yasuhiko Yamamoto, Hideki Nomura
Advances in Health Sciences Education.2023;[Epub] 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

Agreement between medical students’ peer assessments and faculty assessments in advanced resuscitation skills examinations in South Korea: Jinwoo Jeong, Song Yi Park, Kyung Hoon Sun; J Educ Eval Health Prof. 2021;18:4. Published online March 25, 2021; DOI: https://doi.org/10.3352/jeehp.2021.18.4

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Abstract PDF Supplementary Material: Purpose
In medical education, peer assessment is considered to be an effective learning strategy. Although several studies have examined agreement between peer and faculty assessments regarding basic life support (BLS), few studies have done so for advanced resuscitation skills (ARS) such as intubation and defibrillation. Therefore, this study aimed to determine the degree of agreement between medical students’ and faculty assessments of ARS examinations.
Methods
This retrospective explorative study was conducted during the emergency medicine (EM) clinical clerkship of fourth-year medical students from April to July 2020. A faculty assessor (FA) and a peer assessor (PA) assessed each examinee’s resuscitation skills (including BLS, intubation, and defibrillation) using a checklist that consisted of 20 binary items (performed or not performed) and 1 global proficiency rating using a 5-point Likert scale. The prior examinee assessed the next examinee after feedback and training as a PA. All 54 students participated in peer assessment. The assessments of 44 FA/PA pairs were analyzed using the intraclass correlation coefficient (ICC) and Gwet’s first-order agreement coefficient.
Results
The PA scores were higher than the FA scores (mean±standard deviation, 20.2±2.5 [FA] vs. 22.3±2.4 [PA]; P<0.001). The agreement was poor to moderate for the overall checklist (ICC, 0.55; 95% confidence interval [CI], 0.31 to 0.73; P<0.01), BLS (ICC, 0.19; 95% CI, -0.11 to 0.46; P<0.10), intubation (ICC, 0.51; 95% CI, 0.26 to 0.70; P<0.01), and defibrillation (ICC, 0.49; 95% CI, 0.23 to 0.68; P<0.01).
Conclusion
Senior medical students showed unreliable agreement in ARS assessments compared to faculty assessments. If a peer assessment is planned in skills education, comprehensive preparation and sufficient assessor training should be provided in advance.

Brief Report

Clinical performance of medical students in Korea in a whole-task emergency station in the objective structured clinical examination with a standardized patient complaining of palpitations: Song Yi Park, Hyun-Hee Kong, Min-Jeong Kim, Yoo Sang Yoon, Sang-Hwa Lee, Sunju Im, Ji-Hyun Seo; J Educ Eval Health Prof. 2020;17:42. Published online December 16, 2020; DOI: https://doi.org/10.3352/jeehp.2020.17.42

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This study assessed the clinical performance of 150 third-year medicalstudents in Busan, Korea in a whole-task emergency objective structured clinical examination station that simulated a patient with palpitations visiting the emergency department. The examination was conducted from November 25 to 27, 2019. Clinical performance was assessed as the number and percentage of students who performed history-taking (HT), a physical examination (PE), an electrocardiography (ECG) study, patient education (Ed), and clinical reasoning (CR), which were items on the checklist. It was found that 18.0% of students checked the patient’s pulse, 51.3% completed an ECG study, and 57.9% explained the results to the patient. A sizable proportion (38.0%) of students did not even attempt an ECG study. In a whole-task emergency station, students showed good performance on HT and CR, but unsatisfactory results for PE, ECG study, and Ed. Clinical skills educational programs for subjected student should focus more on PE, timely diagnostic tests, and sufficient Ed.

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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
Comparing the cut score for the borderline group method and borderline regression method with norm-referenced standard setting in an objective structured clinical examination in medical school in Korea
Song Yi Park, Sang-Hwa Lee, Min-Jeong Kim, Ki-Hwan Ji, Ji Ho Ryu
Journal of Educational Evaluation for Health Professions.2021; 18: 25. CrossRef

Research articles

Performance of the Ebel standard-setting method for the spring 2019 Royal College of Physicians and Surgeons of Canada internal medicine certification examination consisting of multiple-choice questions: Jimmy Bourque, Haley Skinner, Jonathan Dupré, Maria Bacchus, Martha Ainslie, Irene W. Y. Ma, Gary Cole; J Educ Eval Health Prof. 2020;17:12. Published online April 20, 2020; DOI: https://doi.org/10.3352/jeehp.2020.17.12

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Abstract PDF Supplementary Material

Purpose
This study aimed to assess the performance of the Ebel standard-setting method for the spring 2019 Royal College of Physicians and Surgeons of Canada internal medicine certification examination consisting of multiple-choice questions. Specifically, the following parameters were evaluated: inter-rater agreement, the correlations between Ebel scores and item facility indices, the impact of raters’ knowledge of correct answers on the Ebel score, and the effects of raters’ specialty on inter-rater agreement and Ebel scores.
Methods
Data were drawn from a Royal College of Physicians and Surgeons of Canada certification exam. The Ebel method was applied to 203 multiple-choice questions by 49 raters. Facility indices came from 194 candidates. We computed the Fleiss kappa and the Pearson correlations between Ebel scores and item facility indices. We investigated differences in the Ebel score according to whether correct answers were provided or not and differences between internists and other specialists using the t-test.
Results
The Fleiss kappa was below 0.15 for both facility and relevance. The correlation between Ebel scores and facility indices was low when correct answers were provided and negligible when they were not. The Ebel score was the same whether the correct answers were provided or not. Inter-rater agreement and Ebel scores were not significantly different between internists and other specialists.
Conclusion
Inter-rater agreement and correlations between item Ebel scores and facility indices were consistently low; furthermore, raters’ knowledge of the correct answers and raters’ specialty had no effect on Ebel scores in the present setting.

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Competency Standard Derivation for Point-of-Care Ultrasound Image Interpretation for Emergency Physicians
Maya Harel-Sterling, Charisse Kwan, Jonathan Pirie, Mark Tessaro, Dennis D. Cho, Ailish Coblentz, Mohamad Halabi, Eyal Cohen, Lynne E. Nield, Martin Pusic, Kathy Boutis
Annals of Emergency Medicine.2023; 81(4): 413. CrossRef
The effects of a land-based home exercise program on surfing performance in recreational surfers
Jerry-Thomas Monaco, Richard Boergers, Thomas Cappaert, Michael Miller, Jennifer Nelson, Meghan Schoenberger
Journal of Sports Sciences.2023; 41(4): 358. CrossRef
Medical specialty certification exams studied according to the Ottawa Quality Criteria: a systematic review
Daniel Staudenmann, Noemi Waldner, Andrea Lörwald, Sören Huwendiek
BMC Medical Education.2023;[Epub] CrossRef
A Target Population Derived Method for Developing a Competency Standard in Radiograph Interpretation
Michelle S. Lee, Martin V. Pusic, Mark Camp, Jennifer Stimec, Andrew Dixon, Benoit Carrière, Joshua E. Herman, Kathy Boutis
Teaching and Learning in Medicine.2022; 34(2): 167. CrossRef
Pediatric Musculoskeletal Radiographs: Anatomy and Fractures Prone to Diagnostic Error Among Emergency Physicians
Winny Li, Jennifer Stimec, Mark Camp, Martin Pusic, Joshua Herman, Kathy Boutis
The Journal of Emergency Medicine.2022; 62(4): 524. CrossRef
Possibility of independent use of the yes/no Angoff and Hofstee methods for the standard setting of the Korean Medical Licensing Examination written test: a descriptive study
Do-Hwan Kim, Ye Ji Kang, Hoon-Ki Park
Journal of Educational Evaluation for Health Professions.2022; 19: 33. CrossRef
Image interpretation: Learning analytics–informed education opportunities
Elana Thau, Manuela Perez, Martin V. Pusic, Martin Pecaric, David Rizzuti, Kathy Boutis
AEM Education and Training.2021;[Epub] CrossRef

Use of graded responsibility and common entrustment considerations among United States emergency medicine residency programs: Jason Lai, Benjamin Holden Schnapp, David Simon Tillman, Mary Westergaard, Jamie Hess, Aaron Kraut; J Educ Eval Health Prof. 2020;17:11. Published online April 20, 2020; DOI: https://doi.org/10.3352/jeehp.2020.17.11

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Abstract PDF Supplementary Material

Purpose
The Accreditation Council for Graduate Medical Education (ACGME) requires all residency programs to provide increasing autonomy as residents progress through training, known as graded responsibility. However, there is little guidance on how to implement graded responsibility in practice and a paucity of literature on how it is currently implemented in emergency medicine (EM). We sought to determine how EM residency programs apply graded responsibility across a variety of activities and to identify which considerations are important in affording additional responsibilities to trainees.
Methods
We conducted a cross-sectional study of EM residency programs using a 23-question survey that was distributed by email to 162 ACGME-accredited EM program directors. Seven different domains of practice were queried.
Results
We received 91 responses (56.2% response rate) to the survey. Among all domains of practice except for managing critically ill medical patients, the use of graded responsibility exceeded 50% of surveyed programs. When graded responsibility was applied, post-graduate year (PGY) level was ranked an “extremely important” or “very important” consideration between 80.9% and 100.0% of the time.
Conclusion
The majority of EM residency programs are implementing graded responsibility within most domains of practice. When decisions are made surrounding graded responsibility, programs still rely heavily on the time-based model of PGY level to determine advancement.

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Do you see what I see?: exploring trends in organizational culture perceptions across residency programs
Jennifer H. Chen, Paula Costa, Aimee Gardner
Global Surgical Education - Journal of the Association for Surgical Education.2024;[Epub] CrossRef
Guiding Fellows to Independent Practice
Maybelle Kou, Aline Baghdassarian, Kajal Khanna, Nazreen Jamal, Michele Carney, Daniel M. Fein, In Kim, Melissa L. Langhan, Jerri A. Rose, Noel S. Zuckerbraun, Cindy G. Roskind
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Journal clubs in Australian medical schools: prevalence, application, and educators’ opinions: Damian James Ianno, Kelly Mirowska-Allen, Stephen Anthony Kunz, Richard O’Brien; J Educ Eval Health Prof. 2020;17:9. Published online February 26, 2020; DOI: https://doi.org/10.3352/jeehp.2020.17.9

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Abstract PDF Supplementary Material

Purpose
Medically-focused journal clubs have been used as an educational tool for over 100 years, with research indicating that they improve knowledge, reading behaviour, and critical appraisal skills. However, it is unknown how widespread they are in Australian medical schools, nor the opinions of medical education leaders as to their value.
Methods
A nationwide cross-sectional study was performed among academic leaders from every Australian medical school. Individuals were asked to complete a survey detailing their attitudes towards journal clubs using single- or multiple-answer questions, Likert scales, and ranked data. They were asked whether students at their institutions were able to partake in journal clubs, and if so, provided details on their implementation.
Results
At least 1 response was collected from 18 of 19 Australian medical schools. The response rate was 40.8% (60 of 147), and 36 responses (60.0%) were from heads of clinical schools. Respondents from 15 of 18 institutions (83.3%) stated that their institution had a journal club. Of these, 23 (65.7%) were metropolitan institutions and 12 (34.3%) were rural institutions. Eighteen (51.4%) journal clubs were clinician-led, 13 (37.1%) were run through specific hospital departments, and 23 (65.7%) occurred during clinical years. Most respondents (20 [57.1%]) stated that the primary aim of the journal club was to develop critical appraisal skills.
Conclusion
Journal clubs are a highly regarded educational tool in the armoury of medical school educators, with significant heterogeneity in their structure, geographic prevalence, and intended purpose. Further studies of their efficacy in teaching evidence-based medicine is warranted.

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Using a journal club to navigate a maze of COVID-19 papers in a front-line hospital service
Rachel Wenke, Paulina Stehlik, John Gerrard, Sharon Mickan, David Henry
BMJ Evidence-Based Medicine.2023; 28(3): 210. CrossRef
Club bibliográfico de la Sociedad Española de Radiología Médica: Historia, análisis y perspectivas tras 10 años de trayectoria
D. Herrán de la Gala, C. Biosca Calabuig, J. Miranda Bautista
Radiología.2023; 65(4): 376. CrossRef
Spanish Society of Medical Radiology Journal Club: History, analysis and perspectives after ten years of experience
D. Herrán de la Gala, C. Biosca Calabuig, J. Miranda Bautista
Radiología (English Edition).2023; 65(4): 376. CrossRef
Assessing Medical Students’ Perception of Implementing Journal Club Activities: A Qualitative Study
Roaa Aljumaa, Reem Elmokattaf, Mohammad Aljumaa, Haifa Almuhanna , Marukh Rashid , Ismail A Abdullah, Abdul Rahman Sukar
Cureus.2023;[Epub] CrossRef
Medical students’ attitudes towards the teaching of cervical and ovarian cancer screening protocols in Ireland: a qualitative study
Paul McHugh, Donal Brennan, Mary F. Higgins
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Impact of a narrative medicine program on reflective capacity and empathy of medical students in Iran: Saeideh Daryazadeh, Payman Adibi, Nikoo Yamani, Roya Mollabashi; J Educ Eval Health Prof. 2020;17:3. Published online January 27, 2020; DOI: https://doi.org/10.3352/jeehp.2020.17.3

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Abstract PDF Supplementary Material

Purpose
Narrative medicine consists of the expression of medical experiences and the reflection on narratives to foster empathic communication with patients. Reflecting on narratives increases self-awareness and recognition of the feelings of the narrator or the story’s main character, which in turn affects the audience. This study was conducted to examine the impact of a narrative medicine program on the reflective capacity and empathy of medical students.
Methods
A quasi-experimental study was performed during the 2018–2019 academic year at Isfahan University of Medical Sciences in Iran involving 135 medical interns in 2 groups (control [n=66] and experimental [n=69]). Interns in the experimental group took part in seven 2-hour reflective practice sessions, while those in the control group underwent no educational intervention. Pre-test and post-test assessments were conducted for both groups using 2 valid and reliable tools for the assessment of reflective capacity and empathy. Mean reflection and empathy scores were compared within groups (between pre- and post-test values) and between groups (using the paired-t test and the t-test; P≤0.05).
Results
The mean reflection and empathy scores of the experimental group significantly increased from pre-test to post-test, but those of the control group did not. Moreover, the mean post-test scores were significantly different between the 2 groups (P<0.001).
Conclusion
Narrative medicine is an effective teaching method that can improve reflective capacity and empathy, thereby ultimately promoting professionalism as a core competency in medicine. Consideration of learning conditions and interdisciplinary teaching are necessary for implementing a narrative medicine program.

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Harnessing the Humanities to Foster Staff Resilience: An Annual Arts and Humanities Rounds at a Children’s Hospital
Wynne Morrison, Elizabeth Steinmiller, Sofia Lizza, Todd Dillard, Patrick Lipawen, Stephen Ludwig
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Development and psychometric testing of the narrative nursing teaching effectiveness scale: A methodological study
Yonglin Li, Meilian Lin, Xiujing Lin, Qiuhong Chen, Fangfang Wang, Weiti Chen, Feifei Huang
Nurse Education Today.2024; 133: 106060. CrossRef
Narrative medicine as a teaching strategy for nursing students to developing professionalism, empathy and humanistic caring ability: a randomized controlled trial
Mengxin Xue, Huiping Sun, Jin Xue, Jingxin Zhou, Junchao Qu, Siqi Ji, Yuan Bu, Yongbing Liu
BMC Medical Education.2023;[Epub] CrossRef
Effectiveness of narrative pedagogy in developing nursing undergraduates’ humanistic care ability for hospitalized children: A mixed-method study
Fang Liu, Yanbin Yang, Hengyu Zhou, Lin Mo, Hongyao Leng, Cui Cui
Heliyon.2023; 9(4): e15499. CrossRef
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Georgios Karnesis, Rama Sai P, Cyrus Parsa, Chaya Prasad
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Narrative Education Combined With Experiential Teaching in the Development of Empathic Competence of Undergraduate Nursing Students: Pre-Test Post-Test Design
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Arvind Rajagopalan, Qian Hui Chew, Kang Sim
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Experiential methods in ethical education of nursing and midwifery students
Bogumiła Kosicka, Patrycja Ozdoba, Magdalena Dziurka, Sylwia Boczkowska, Michał Machul, Agnieszka Chrzan-Rodak, Beata Dobrowolska
Pielegniarstwo XXI wieku / Nursing in the 21st Century.2023; 22(3): 195. CrossRef
Educational efficacy of medical humanities in empathy of medical students and healthcare professionals: a systematic review and meta-analysis
Xin Zhang, Hui-fang Pang, Zhiguang Duan
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Empathy, personality traits, and emotional management in 2nd and 4th-year dentistry students: a single-center study
Christian Lermen, Willi Wetzel, Vanessa Britz, Jasmina Sterz, Wolf O Bechstein, Teresa Schreckenbach
BMC Medical Education.2022;[Epub] CrossRef
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
Historical empathy and medicine: Pathography and empathy in Sophocles’ Philoctetes
Vassiliki Kampourelli
Medicine, Health Care and Philosophy.2022; 25(3): 561. CrossRef
The effects of narrative pedagogy on increasing nursing students' willingness to practice older people care: A mixed-methods research
Pei-Ti Hsu, Jeu-Jung Chen, Ya-Fang Ho
Nurse Education in Practice.2022; 62: 103356. CrossRef
Finding the Story in Medicine
Elizabeth Fenstermacher, Regina M. Longley, Hermioni L. Amonoo
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How does narrative medicine impact medical trainees’ learning of professionalism? A qualitative study
Chien-Da Huang, Chang-Chyi Jenq, Kuo-Chen Liao, Shu-Chung Lii, Chi-Hsien Huang, Tsai-Yu Wang
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A Systematic Review of Educational Interventions and Their Impact on Empathy and Compassion of Undergraduate Medical Students
Prianna Menezes, Salman Y. Guraya, Shaista Salman Guraya
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An introduction to narrative medicine
Matthew Krinock, Nicole Defenbaugh, Stephen DeTurk, AnnaNg Pellegrino
International Journal of Academic Medicine.2020; 6(2): 121. CrossRef

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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Abstract PDF Supplementary Material

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

An innovative resident-driven mortality case review curriculum to teach and drive system-based practice improvements in the United States: Nila S. Radhakrishnan, Margaret C. Lo, Rohit Bishnoi, Subhankar Samal, Robert Leverence, Eric Rosenberg, Zareen Zaidi; J Educ Eval Health Prof. 2018;15:31. Published online December 26, 2018; DOI: https://doi.org/10.3352/jeehp.2018.15.31

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Purpose
Traditionally, the morbidity and mortality conference (M&MC) is a forum where possible medical errors are discussed. Although M&MCs can facilitate identification of opportunities for systemwide improvements, few studies have described their use for this purpose, particularly in residency training programs. This paper describes the use of M&MC case review as a quality improvement activity that teaches system-based practice and can engage residents in improving systems of care.
Methods
Internal medicine residents at a tertiary care academic medical center reviewed 347 consecutive mortalities from March 2014 to September 2017. The residents used case review worksheets to categorize and track causes of mortality, and then debriefed with a faculty member. Selected cases were then presented at a larger interdepartmental meeting and action items were implemented. Descriptive statistics and thematic analysis were used to analyze the results.
Results
The residents identified a possible diagnostic mismatch at some point from admission to death in 54.5% of cases (n= 189) and a possible need for improved management in 48.0% of cases. Three possible management failure themes were identified, including failure to plan, failure to communicate, and failure to rescue, which accounted for 21.9%, 10.7 %, and 10.1% of cases, respectively. Following these reviews, quality improvement initiatives proposed by residents led to system-based changes.
Conclusion
A resident-driven mortality review curriculum can lead to improvements in systems of care. This novel type of curriculum can be used to teach system-based practice. The recruitment of teaching faculty with expertise in quality improvement and mortality case analyses is essential for such a project.

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Implementation of Hospital Mortality Reviews: A Systematic Review
Moritz Sebastian Schönfeld, Martin Härter, Ann Sophie Schröder, Katrin Kokartis, Hans-Jürgen Bartz, Levente Kriston
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Steven E. Raper, Patricia G. Sullivan, Lawrence S. Levin
International Journal of Surgery: Global Health.2023;[Epub] CrossRef
Defining a High-Quality and Effective Morbidity and Mortality Conference
Brendin R. Beaulieu-Jones, Spencer Wilson, Daniel S. Howard, Gordana Rasic, Ben Rembetski, Erica A. Brotschi, Luise I. Pernar
JAMA Surgery.2023; 158(12): 1336. CrossRef
Implementation of morbidity and mortality conference in a community hospital NICU and narrative review
Christina Chan, Christine Pazandak, Dimitrios Angelis
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Learning through multiple lenses: analysis of self, peer, nearpeer, and faculty assessments of a clinical history-taking task in Australia: Kylie Fitzgerald, Brett Vaughan; J Educ Eval Health Prof. 2018;15:22. Published online September 18, 2018; DOI: https://doi.org/10.3352/jeehp.2018.15.22

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Abstract PDF Supplementary Material

Purpose
Peer assessment provides a framework for developing expected skills and receiving feedback appropriate to the learner’s level. Near-peer (NP) assessment may elevate expectations and motivate learning. Feedback from peers and NPs may be a sustainable way to enhance student assessment feedback. This study analysed relationships among self, peer, NP, and faculty marking of an assessment and students’ attitudes towards marking by those various groups.
Methods
A cross-sectional study design was used. Year 2 osteopathy students (n= 86) were invited to perform self and peer assessments of a clinical history-taking and communication skills assessment. NPs and faculty also marked the assessment. Year 2 students also completed a questionnaire on their attitudes to peer/NP marking. Descriptive statistics and the Spearman rho coefficient were used to evaluate relationships across marker groups.
Results
Year 2 students (n= 9), NPs (n= 3), and faculty (n= 5) were recruited. Correlations between self and peer (r= 0.38) and self and faculty (r= 0.43) marks were moderate. A weak correlation was observed between self and NP marks (r= 0.25). Perceptions of peer and NP marking varied, with over half of the cohort suggesting that peer or NP assessments should not contribute to their grade.
Conclusion
Framing peer and NP assessment as another feedback source may offer a sustainable method for enhancing feedback without overloading faculty resources. Multiple sources of feedback may assist in developing assessment literacy and calibrating students’ self-assessment capability. The small number of students recruited suggests some acceptability of peer and NP assessment; however, further work is required to increase its acceptability.

Citations

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The extent and quality of evidence for osteopathic education: A scoping review
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History and physical exam: a retrospective analysis of a clinical opportunity
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BMC Medical Education.2023;[Epub] CrossRef
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Samuel P. León, Ernesto Panadero, Inmaculada García-Martínez
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Evaluating the Academic Performance of Mustansiriyah Medical College Teaching Staff vs. Final-Year Students Failure Rates
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Al-Rafidain Journal of Medical Sciences ( ISSN 2789-3219 ).2023; 5(1S): S151. CrossRef
History-taking level and its influencing factors among nursing undergraduates based on the virtual standardized patient testing results: Cross sectional study
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Efficacy of an asynchronous electronic curriculum in emergency medicine education in the United States: Alisa Wray, Kathryn Bennett, Megan Boysen-Osborn, Warren Wiechmann, Shannon Toohey; J Educ Eval Health Prof. 2017;14:29. Published online December 11, 2017; DOI: https://doi.org/10.3352/jeehp.2017.14.29

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241 Download
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Abstract PDF Supplementary Material

Purpose
The aim of this study was to measure the effect of an iPad-based asynchronous curriculum on emergency medicine resident performance on the in-training exam (ITE). We hypothesized that the implementation of an asynchronous curriculum (replacing 1 hour of weekly didactic time) would result in non-inferior ITE scores compared to the historical scores of residents who had participated in the traditional 5-hour weekly didactic curriculum.
Methods
The study was a retrospective, non-inferiority study. conducted at the University of California, Irvine Emergency Medicine Residency Program. We compared ITE scores from 2012 and 2013, when there were 5 weekly hours of didactic content, with scores from 2014 and 2015, when 1 hour of conference was replaced with asynchro-nous content. Examination results were compared using a non-inferiority data analysis with a 10% margin of difference.
Results
Using a non-inferiority test with a 95% confidence interval, there was no difference between the 2 groups (before and after implementation of asynchronous learning), as the confidence interval for the change of the ITE was −3.5 to 2.3 points, whereas the 10% non-inferiority margin was 7.8 points.
Conclusion
Replacing 1 hour of didactic conference with asynchronous learning showed no negative impact on resident ITE scores.

Citations

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An Asynchronous Curriculum: Learner Perspectives on Incorporating Asynchronous Learning Into In-Person and Virtual Emergency Residency Didactics
Emily L Jameyfield, Semhar Tesfai, Alejandro A Palma, Adriana S Olson
Cureus.2023;[Epub] CrossRef
A randomized controlled trial to examine the effect of the Pediatric Opioid Analgesia Self‐Instruction System (PedOASIS) tool on pediatric hematology/oncology trainee education
Rebecca E. MacDonell‐Yilmaz, Anarina Murillo, Jennifer G. Welch
Pediatric Blood & Cancer.2023;[Epub] CrossRef
Development and Validation of Pediatric Opioid Analgesia Self-Instruction System (PedOASIS): An Opioid Knowledge Tool for Pediatric Clinicians
Rebecca E. MacDonell-Yilmaz, Angela Anderson, Priya Hirway, Jennifer G. Welch
Journal of Pediatric Hematology/Oncology.2022; 44(1): e204. CrossRef
Utilizing social media for cardiovascular education
Christina Mansour, Nooshin Beygui, Mamas A Mamas, Purvi J Parwani
Heart.2022; 108(15): 1240. CrossRef
Nephrology Trainee Education Needs Assessment: Five Years and a Pandemic Later
Benjamin S. Ko, Kurtis A. Pivert, Rob Rope, Anna M. Burgner, Joshua S. Waitzman, Susan M. Halbach, Suzanne M. Boyle, Lili Chan, Stephen M. Sozio
Kidney Medicine.2022; 4(11): 100548. CrossRef
Planning Engaging, Remote, Synchronous Didactics in the COVID-19 Pandemic Era
Ronald Rivera, Jonathan Smart, Sangeeta Sakaria, Alisa Wray, Warren Wiechmann, Megan Boysen-Osborn, Shannon Toohey
JMIR Medical Education.2021; 7(2): e25213. CrossRef
Pediatric Resident Engagement With an Online Critical Care Curriculum During the Intensive Care Rotation*
Dennis A. Daniel, Sue E. Poynter, Christopher P. Landrigan, Charles A. Czeisler, Jeffrey P. Burns, Traci A. Wolbrink
Pediatric Critical Care Medicine.2020; 21(11): 986. CrossRef
Asynchronous Curriculum “Socially Synchronized”: Learning Via Competition
Jon Smart, Adriana Segura Olson, Andrew Muck
Western Journal of Emergency Medicine.2018; 20(1): 6. CrossRef

Research Articles

Impact of a novel, resource appropriate resuscitation curriculum on Nicaraguan resident physician’s management of cardiac arrest: Breena R. Taira, Aristides Orue, Edward Stapleton, Luis Lovato, Sitaram Vangala, Lucia Solorzano Tinoco, Orlando Morales; J Educ Eval Health Prof. 2016;13:25. Published online June 9, 2016; DOI: https://doi.org/10.3352/jeehp.2016.13.25

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206 Download
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Abstract PDF

Purpose
Project Strengthening Emergency Medicine, Investing in Learners in Latin America (SEMILLA) created a novel, language and resource appropriate course for the resuscitation of cardiac arrest for Nicaraguan resident physicians. We hypothesized that participation in the Project SEMILLA resuscitation program would significantly improve the physician’s management of simulated code scenarios. Methods: Thirteen Nicaraguan resident physicians were evaluated while managing simulated cardiac arrest scenarios before, immediately, and at 6 months after participating in the Project SEMILLA resuscitation program. This project was completed in 2014 in Leon, Nicaragua. The Cardiac Arrest Simulation Test (CASTest), a validated scoring system, was used to evaluate performance on a standardized simulated cardiac arrest scenario. Mixed effect logistic regression models were constructed to assess outcomes. Results: On the pre-course simulation exam, only 7.7% of subjects passed the test. Immediately post-course, the subjects achieved a 30.8% pass rate and at 6 months after the course, the pass rate was 46.2%. Compared with pre-test scores, the odds of passing the CASTest at 6 months after the course were 21.7 times higher (95% CI 4.2 to 112.8, P<0.001). Statistically significant improvement was also seen on the number of critical items completed (OR=3.75, 95% CI 2.71-5.19), total items completed (OR=4.55, 95% CI 3.4-6.11), and number of “excellent” scores on a Likert scale (OR=2.66, 95% CI 1.85-3.81). Conclusions: Nicaraguan resident physicians demonstrate improved ability to manage simulated cardiac arrest scenarios after participation in the Project SEMILLA resuscitation course and retain these skills.

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Симуляційні технології у навчанні інтернів та безперервній професійній освіті дипломованих лікарів-анестезіологів
Kateryna Bielka, Мariya Smirnova, Hanna Fomina
The Ukrainian Scientific Medical Youth Journal.2023; 139(2): 64. CrossRef
Analysis of Unstructured Text-Based Data Using Machine Learning Techniques: The Case of Pediatric Emergency Department Records in Nicaragua
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Medical Care Research and Review.2021; 78(2): 138. CrossRef
Assessing the impact of resuscitation residents on the treatment of cardiopulmonary resuscitation patients
David M. Lee, David A. Berger, Patrick A. Wloszczynski, Patrick Karabon, Lihua Qu, Michael J. Burla
The American Journal of Emergency Medicine.2021; 41: 46. CrossRef
Resuscitation Resident Impact in the Treatment of Sepsis
Michael J Burla, Nashid Shinthia, Judith A Boura, Lihua QU, David A Berger
Cureus.2020;[Epub] CrossRef
A Review of Anesthesia Simulation in Low-Income Countries
Oleg Turkot, Michael C. Banks, Seung Woo Lee, Adam Dodson, Shirley Duarte, Mwemezi Kaino, Howard Nelson-Williams, Serkan Toy, John Sampson
Current Anesthesiology Reports.2019; 9(1): 1. CrossRef
Community-based in situ simulation: bringing simulation to the masses
Barbara M. Walsh, Marc A. Auerbach, Marcie N. Gawel, Linda L. Brown, Bobbi J. Byrne, Aaron Calhoun
Advances in Simulation.2019;[Epub] CrossRef

Randomized study of effectiveness of computerized ultrasound simulators for an introductory course for residents in Brazil: Jack Philip Silva, Trevor Plescia, Nathan Molina, Ana Claudia de Oliveira Tonelli, Mark Langdorf, John Christian Fox; J Educ Eval Health Prof. 2016;13:16. Published online April 4, 2016; DOI: https://doi.org/10.3352/jeehp.2016.13.16

42,896 View
193 Download
10 Web of Science
14 Crossref

Abstract PDF

Purpose
This study aimed to assess the impact of ultrasound simulation (SonoSim) on educational outcomes of an introductory point-of-care ultrasound course compared to hands-on training with live models alone. Methods: Fifty-three internal medicine residents without ultrasound experience were randomly assigned to control or experimental groups. They participated in an introductory point-of-care ultrasound course covering eight topics in eight sessions from June 23, 2014 until July 18, 2014. Both participated in lecture and hands-on training, but experimental group received an hour of computerized simulator training instead of a second hour of hands-on training. We assessed clinical knowledge and image acquisition with written multiple-choice and practical exams, respectively. Of the 53 enrolled, 40 participants (75.5%) completed the course and all testing. Results: For the 30-item written exam, mean score of the experimental group was 23.1±3.4 (n=21) vs. 21.8±4.8 (n=19), (P>0 .05). For the practical exam, mean score for both groups was 8.7 out of 16 (P>0 .05). Conclusion: The substitution of eight hours of ultrasound simulation training for live model scanning in a 24 hour training course did not enhance performance on written and image acquisition tests in an introductory ultrasound course for residents. This result suggests that ultrasound simulation technology used as a substitute for live model training on an hour-for-hour basis, did not improve learning outcomes. Further investigation into simulation as a total replacement for live model training will provide a clearer picture of the efficacy of ultrasound simulators in medical education.

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