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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
  • 443 View
  • 95 Download
AbstractAbstract PDF
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).
Educational/faculty development materials
Common models and approaches for the clinical educator to plan effective feedback encounters  
Cesar Orsini, Veena Rodrigues, Jorge Tricio, Margarita Rosel
J Educ Eval Health Prof. 2022;19:35.   Published online December 19, 2022
DOI: https://doi.org/10.3352/jeehp.2022.19.35
  • 189 View
  • 92 Download
AbstractAbstract PDFSupplementary Material
Giving constructive feedback is crucial for learners to bridge the gap between their current performance and the desired standards of competence. Giving effective feedback is a skill that can be learned, practiced, and improved. Therefore, our aim was to explore models in clinical settings and assess their transferability to different clinical feedback encounters. We identified the 6 most common and accepted feedback models, including the Feedback Sandwich, the Pendleton Rules, the One-Minute Preceptor, the SET-GO model, the R2C2 (Rapport/Reaction/Content/Coach), and the ALOBA (Agenda Led Outcome-based Analysis) model. We present a handy resource describing their structure, strengths and weaknesses, requirements for educators and learners, and suitable feedback encounters for use for each model. These feedback models represent practical frameworks for educators to adopt but also to adapt to their preferred style, combining and modifying them if necessary to suit their needs and context.
Research articles
Physical therapy students’ perception of their ability of clinical and clinical decision-making skills enhanced after simulation-based learning courses in the United States: a repeated measures design  
Fabian Bizama, Mansoor Alameri, Kristy Jean Demers, Derrick Ferguson Campbell
J Educ Eval Health Prof. 2022;19:34.   Published online December 19, 2022
DOI: https://doi.org/10.3352/jeehp.2022.19.34
  • 201 View
  • 65 Download
AbstractAbstract PDFSupplementary Material
Purpose
It aimed to investigate physical therapy students’ perception of their ability of clinical and clinical decision-making skills after a simulation-based learning course in the United States.
Methods
Survey questionnaires were administered to voluntary participants, including 44 second and third-year physical therapy students of the University of St. Augustine for Health Sciences during 2021–2022. Thirty-six questionnaire items consisted of 4 demographic items, 1 general evaluation, 21 test items for clinical decision-making skills, and 4 clinical skill items. Descriptive and inferential statistics evaluated differences in students’ perception of their ability in clinical decision-making and clinical skills, pre- and post-simulation, and post-first clinical experience during 2021–2022.
Results
Friedman test revealed a significant increase from pre- to post-simulation in perception of the ability of clinical and clinical decision-making skills total tool score (P<0.001), clinical decision-making 21-item score (P<0.001), and clinical skills score (P<0.001). No significant differences were found between post-simulation and post-first clinical experience. Post-hoc tests indicated a significant difference between pre-simulation and post-simulation (P<0.001) and between pre-simulation and post-first clinical experience (P<0.001). Forty-three students (97.6%) either strongly agreed (59.1%) or agreed (38.5%) that simulation was a valuable learning experience.
Conclusion
The above findings suggest that simulation-based learning helped students begin their first clinical experience with enhanced clinical and clinical decision-making skills.
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
J Educ Eval Health Prof. 2022;19:33.   Published online December 12, 2022
DOI: https://doi.org/10.3352/jeehp.2022.19.33
  • 146 View
  • 54 Download
AbstractAbstract PDFSupplementary Material
Purpose
This study aims to apply the yes/no Angoff and Hofstee methods to actual Korean Medical Licensing Examination (KMLE) 2022 written examination data to estimate cut scores for the written KMLE.
Methods
Fourteen panelists gathered to derive the cut score of the 86th KMLE written examination data using the yes/no Angoff method. The panel reviewed the items individually before the meeting and shared their respective understanding of the minimum-competency physician. The standard setting process was conducted in 5 rounds over a total of 800 minutes. In addition, 2 rounds of the Hofstee method were conducted before starting the standard setting process and after the second round of yes/no Angoff.
Results
For yes/no Angoff, as each round progressed, the panel’s opinion gradually converged to a cut score of 198 points, and the final passing rate was 95.1%. The Hofstee cut score was 208 points out of a maximum 320 with a passing rate of 92.1% at the first round. It scored 204 points with a passing rate of 93.3% in the second round.
Conclusion
The difference between the cut scores obtained through yes/no Angoff and Hofstee methods did not exceed 2% points, and they were within the range of cut scores from previous studies. In both methods, the difference between the panelists decreased as rounds were repeated. Overall, our findings suggest the acceptability of cut scores and the possibility of independent use of both methods.
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
  • 668 View
  • 168 Download
AbstractAbstract PDFSupplementary Material
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.
Equal Z standard-setting method to estimate the minimum number of panelists for a medical school’s objective structured clinical examination in Taiwan: a simulation study  
Ying-Ying Yang, Pin-Hsiang Huang, Ling-Yu Yang, Chia-Chang Huang, Chih-Wei Liu, Shiau-Shian Huang, Chen-Huan Chen, Fa-Yauh Lee, Shou-Yen Kao, Boaz Shulruf
J Educ Eval Health Prof. 2022;19:27.   Published online October 17, 2022
DOI: https://doi.org/10.3352/jeehp.2022.19.27
  • 716 View
  • 74 Download
AbstractAbstract PDFSupplementary Material
Purpose
Undertaking a standard-setting exercise is a common method for setting pass/fail cut scores for high-stakes examinations. The recently introduced equal Z standard-setting method (EZ method) has been found to be a valid and effective alternative for the commonly used Angoff and Hofstee methods and their variants. The current study aims to estimate the minimum number of panelists required for obtaining acceptable and reliable cut scores using the EZ method.
Methods
The primary data were extracted from 31 panelists who used the EZ method for setting cut scores for a 12-station of medical school’s final objective structured clinical examination (OSCE) in Taiwan. For this study, a new data set composed of 1,000 random samples of different panel sizes, ranging from 5 to 25 panelists, was established and analyzed. Analysis of variance was performed to measure the differences in the cut scores set by the sampled groups, across all sizes within each station.
Results
On average, a panel of 10 experts or more yielded cut scores with confidence more than or equal to 90% and 15 experts yielded cut scores with confidence more than or equal to 95%. No significant differences in cut scores associated with panel size were identified for panels of 5 or more experts.
Conclusion
The EZ method was found to be valid and feasible. Less than an hour was required for 12 panelists to assess 12 OSCE stations. Calculating the cut scores required only basic statistical skills.
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
  • 897 View
  • 172 Download
AbstractAbstract PDFSupplementary Material
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.
Brief report
Initial steps for integrating academic electronic health records into clinical curricula of physical and occupational therapy in the United States: a survey-based observational study  
Stephen Burrows, Lola Halperin, Eric Nemec, Wendy Romney
J Educ Eval Health Prof. 2022;19:24.   Published online September 2, 2022
DOI: https://doi.org/10.3352/jeehp.2022.19.24
  • 1,045 View
  • 156 Download
AbstractAbstract PDFSupplementary Material
Training programs must be designed to prepare physical and occupational therapy students to use electronic health records (EHR) and interprofessional collaboration. This report aims to describe physical and occupational therapy students’ perceptions of integrating an academic EHR (AEHR) in their problem-based learning (PBL) curricula in the College of Health Professions, Sacred Heart University, Fairfield, Connecticut, the United States. A paper-based case approach to PBL was adapted by creating patient cases in an AEHR. Students were asked to complete chart reviews and review provider notes to enhance their learning. An online survey was conducted to determine their perceptions of using AEHR from May 2014 to August 2015. Eighty-five students completed the survey, and 88.1% felt that using an AEHR was needed, and 82.4% felt that the additional notes enhanced their understanding of the interdisciplinary team. However, 83.5% reported the AEHR system increased the time needed to extract meaningful information. Incorporating an AEHR into curricula is essential to ensure students are adequately prepared for future patient interactions.
Research articles
Possibility of using the yes/no Angoff method as a substitute for the percent Angoff method for estimating the cutoff score of the Korean Medical Licensing Examination: a simulation study
Janghee Park
J Educ Eval Health Prof. 2022;19:23.   Published online August 31, 2022
DOI: https://doi.org/10.3352/jeehp.2022.19.23
  • 933 View
  • 126 Download
  • 1 Citations
AbstractAbstract PDFSupplementary Material
Purpose
The percent Angoff (PA) method has been recommended as a reliable method to set the cutoff score instead of a fixed cut point of 60% in the Korean Medical Licensing Examination (KMLE). The yes/no Angoff (YNA) method, which is easy for panelists to judge, can be considered as an alternative because the KMLE has many items to evaluate. This study aimed to compare the cutoff score and the reliability depending on whether the PA or the YNA standard-setting method was used in the KMLE.
Methods
The materials were the open-access PA data of the KMLE. The PA data were converted to YNA data in 5 categories, in which the probabilities for a “yes” decision by panelists were 50%, 60%, 70%, 80%, and 90%. SPSS for descriptive analysis and G-string for generalizability theory were used to present the results.
Results
The PA method and the YNA method counting 60% as “yes,” estimated similar cutoff scores. Those cutoff scores were deemed acceptable based on the results of the Hofstee method. The highest reliability coefficients estimated by the generalizability test were from the PA method and the YNA method, with probabilities of 70%, 80%, 60%, and 50% for deciding “yes,” in descending order. The panelist’s specialty was the main cause of the error variance. The error size was similar regardless of the standard-setting method.
Conclusion
The above results showed that the PA method was more reliable than the YNA method in estimating the cutoff score of the KMLE. However, the YNA method with a 60% probability for deciding “yes” also can be used as a substitute for the PA method in estimating the cutoff score of the KMLE.

Citations

Citations to this article as recorded by  
  • 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
Self-control as an important factor affecting the online learning readiness of Vietnamese medical and health students during the COVID-19 pandemic: a network analysis  
Minh Tu Nguyen, Binh Thang Tran, Thanh Gia Nguyen, Minh Tri Phan, Thi Thu Tham Luong, Dinh Duong Le
J Educ Eval Health Prof. 2022;19:22.   Published online August 25, 2022
DOI: https://doi.org/10.3352/jeehp.2022.19.22
  • 1,492 View
  • 160 Download
AbstractAbstract PDFSupplementary Material
Purpose
The current study aimed to use network analysis to investigate medical and health students’ readiness for online learning during the coronavirus disease 2019 (COVID-19) pandemic at the University of Medicine and Pharmacy, Hue University.
Methods
A questionnaire survey on the students’ readiness for online learning was performed using a Google Form from May 13 to June 22, 2021. In total, 1,377 completed responses were eligible for analysis out of 1,411 participants. The network structure was estimated for readiness scales with 6 factors: computer skills, internet skills, online communication, motivation, self-control, and self-learning. Data were fitted using a Gaussian graphical model with the extended Bayesian information criterion.
Results
In 1,377 students, a network structure was identified with 6 nodes and no isolated nodes. The top 3 partial correlations were similar in networks for the overall sample and subgroups of gender and grade levels. The self-control node was the strongest for the connection to others, with the highest nodal strength. The change of nodal strength was greatest in online communication for both gender and grade levels. The correlation stability coefficient for nodal strength was achieved for all networks.
Conclusion
These findings indicated that self-control was the most important factor in students’ readiness network structures for online learning. Therefore, self-control needs to be encouraged during online learning to improve the effectiveness of achieving online learning outcomes for students.
Content validity test of a safety checklist for simulated participants in simulation-based education in the United Kingdom: a methodological study
Matthew Bradley
J Educ Eval Health Prof. 2022;19:21.   Published online August 25, 2022
DOI: https://doi.org/10.3352/jeehp.2022.19.21
  • 727 View
  • 123 Download
AbstractAbstract PDFSupplementary Material
Purpose
Simulation training is an ever-growing means of healthcare education and often involves simulated participants (SPs), commonly known as actors. Simulation-based education (SBE) can sometimes endanger SPs, and as such we have created a safety checklist for them to follow. This study describes how we developed the checklist through a quality improvement project, and then evaluated feedback responses to assess whether SPs felt our checklist was safe.
Methods
The checklist was provided to SPs working in an acute trust simulation service when delivering multidisciplinary SBE over 4 months. Using multiple plan–do–study–act cycles, the checklist was refined by reflecting on SP feedback to ensure that the standards of the safe simulation were met. We collected 21 responses from September to December 2021 after SPs completed an SBE event.
Results
The responses showed that 100% of SPs felt safe during SBE when using our checklist. The average “confidence in safety” rating before using the checklist was 6.8/10, which increased significantly to 9.2/10 after using the checklist (P<0.0005). The checklist was refined throughout the 4 months and implemented in adult and pediatric SBE as a standard operating procedure.
Conclusion
We recommend using our safety checklist as a standard operating procedure to improve the confidence and safety of SPs during safe and effective simulations.
Effect of a forensic nursing virtual education course on knowledge and clinical decision-making of master’s nursing students in Iran: a non-equivalent control group pre- and post-test study
Zeynab Firuzi, Mitra Sedghi Sabet, Fateme Jafaraghaee, Hedayat Jafari, Ehsan Kazemnezhad Leyli, Samad Karkhah, Mohammad Javad Ghazanfari
J Educ Eval Health Prof. 2022;19:20.   Published online August 25, 2022
DOI: https://doi.org/10.3352/jeehp.2022.19.20
  • 920 View
  • 165 Download
AbstractAbstract PDFSupplementary Material
Purpose
Forensic nursing is a specialty in the nursing profession based on legal procedures. This study aimed to assess the effect of a forensic nursing virtual education course on knowledge and clinical decision-making among master’s nursing students.
Methods
In a quasi-experimental study with a pre- and post-test, 106 master’s nursing students at Guilan (n=65) and Mazandaran (n=41) Universities of Medical Sciences, Iran were enrolled. Data were collected using census sampling from March to April 2021. Participants in the intervention group received a forensic nursing virtual education course in three 90-minute sessions for 2 days.
Results
A total of 88 out of 106 master’s nursing students were enrolled in this study. The mean post-education score for knowledge in the intervention group was significantly higher than in the control group (12.52 vs. 7.67, P<0.001). The mean post-education score for clinical decision-making in the intervention group was significantly higher than in the control group (16.96 vs. 13.64, P<0.001).
Conclusion
The level of knowledge and clinical decision-making of master’s nursing students regarding forensic evidence improved after the forensic nursing virtual education course in the intervention group compared to the control group. Nursing managers and policymakers can develop appropriate strategies to improve the knowledge and clinical decision-making of nursing students by using forensic nursing education courses in the curricula of nursing programs, especially in postgraduate education as an elective or mandatory course.
Technical report
Development of examination objectives based on nursing competency for the Korean Nursing Licensing Examination: a validity study  
Sujin Shin, Gwang Suk Kim, Jun-Ah Song, Inyoung Lee
J Educ Eval Health Prof. 2022;19:19.   Published online August 22, 2022
DOI: https://doi.org/10.3352/jeehp.2022.19.19
  • 823 View
  • 157 Download
AbstractAbstract PDFSupplementary Material
Purpose
This study aimed to develop the examination objectives based on nursing competency of the Korean Nursing Licensing Examination.
Methods
This is a validity study to develop the examination objectives based on nursing competency. Data were collected in December 2021. We reviewed the literature related to changing nurse roles and on the learning objectives for the Korea Medical Licensing Examination and other health personnel licensing examinations. Thereafter, we created a draft of the nursing problems list for examination objectives based on the literature review, and the content validity was evaluated by experts. A final draft of the examination objectives is presented and discussed.
Results
A total of 4 domains, 12 classes, and 85 nursing problems for the Korean Nursing Liscensing Examination were developed. They included the essentials of objectives, related factors, evaluation goals, related activity statements, related clients, related settings, and specific outcomes.
Conclusion
This study developed a draft of the examination objectives based on clinical competency that were related to the clinical situations of nurses and comprised appropriate test items for the licensing examination. Above results may be able to provide fundamental data for item development that reflects future nursing practices.
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
  • 814 View
  • 112 Download
AbstractAbstract PDFSupplementary Material
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.
Review
Prevalence of burnout and related factors in nursing faculty members: a systematic review  
Marziyeh Hosseini, Mitra Soltanian, Camellia Torabizadeh, Zahra Hadian Shirazi
J Educ Eval Health Prof. 2022;19:16.   Published online July 14, 2022
DOI: https://doi.org/10.3352/jeehp.2022.19.16
  • 1,556 View
  • 249 Download
  • 1 Citations
AbstractAbstract PDFSupplementary Material
Purpose
The current study aimed to identify the prevalence of burnout and related factors in nursing faculty members through a systematic review of the literature.
Methods
A comprehensive search of electronic databases, including Scopus, PubMed, Web of Science, Iranmedex, and Scientific Information Database was conducted via keywords extracted from Medical Subject Headings, including burnout and nursing faculty, for studies published from database inception to April 1, 2022. The quality of the included studies in this review was assessed using the appraisal tool for cross-sectional studies.
Results
A total of 2,551 nursing faculty members were enrolled in 11 studies. The mean score of burnout in nursing faculty members based on the Maslach Burnout Inventory (MBI) was 59.28 out of 132. The burnout score in this study was presented in 3 MBI subscales: emotional exhaustion, 21.24 (standard deviation [SD]=9.70) out of 54; depersonalization, 5.88 (SD=4.20) out of 30; and personal accomplishment, 32.16 (SD=6.45) out of 48. Several factors had significant relationships with burnout in nursing faculty members, including gender, level of education, hours of work, number of classroom, students taught, full-time work, job pressure, perceived stress, subjective well-being, marital status, job satisfaction, work setting satisfaction, workplace empowerment, collegial support, management style, fulfillment of self-expectation, communication style, humor, and academic position.
Conclusion
Overall, the mean burnout scores in nursing faculty members were moderate. Therefore, health policymakers and managers can reduce the likelihood of burnout in nursing faculty members by using psychosocial interventions and support.

Citations

Citations to this article as recorded by  
  • A mixed-methods study of the effectiveness and perceptions of a course design institute for health science educators
    Julie Speer, Quincy Conley, Derek Thurber, Brittany Williams, Mitzi Wasden, Brenda Jackson
    BMC Medical Education.2022;[Epub]     CrossRef

JEEHP : Journal of Educational Evaluation for Health Professions