Journal of Educational Evaluation for Health Professions

Correspondence

Item difficulty index, discrimination index, and reliability of the 26 health professions licensing examinations in 2023, Korea: a psychometric study: Yoon Hee Kim, Bo Hyun Kim, Joonki Kim, Bokyoung Jung, Sangyoung Bae; J Educ Eval Health Prof. 2024;21:40. Published online December 11, 2024; DOI: https://doi.org/10.3352/jeehp.2024.21.40

265 View
59 Download

PDF Supplementary Material

Research article

Inter-rater reliability and content validity of the measurement tool for portfolio assessments used in the Introduction to Clinical Medicine course at Ewha Womans University College of Medicine: a methodological study: Dong-Mi Yoo, Jae Jin Han; J Educ Eval Health Prof. 2024;21:39. Published online December 10, 2024; DOI: https://doi.org/10.3352/jeehp.2024.21.39

254 View
107 Download

Abstract PDF Supplementary Material: Purpose
This study aimed to examine the reliability and validity of a measurement tool for portfolio assessments in medical education. Specifically, it investigated scoring consistency among raters and assessment criteria appropriateness according to an expert panel.
Methods
A cross-sectional observational study was conducted from September to December 2018 for the Introduction to Clinical Medicine course at the Ewha Womans University College of Medicine. Data were collected for 5 randomly selected portfolios scored by a gold-standard rater and 6 trained raters. An expert panel assessed the validity of 12 assessment items using the content validity index (CVI). Statistical analysis included Pearson correlation coefficients for rater alignment, the intraclass correlation coefficient (ICC) for inter-rater reliability, and the CVI for item-level validity.
Results
Rater 1 had the highest Pearson correlation (0.8916) with the gold-standard rater, while Rater 5 had the lowest (0.4203). The ICC for all raters was 0.3821, improving to 0.4415 after excluding Raters 1 and 5, indicating a 15.6% reliability increase. All assessment items met the CVI threshold of ≥0.75, with some achieving a perfect score (CVI=1.0). However, items like “sources” and “level and degree of performance” showed lower validity (CVI=0.72).
Conclusion
The present measurement tool for portfolio assessments demonstrated moderate reliability and strong validity, supporting its use as a credible tool. For a more reliable portfolio assessment, more faculty training is needed.

Case Study

Feasibility of utilizing functional near-infrared spectroscopy to measure the cognitive load of paramedicine students undertaking high-acuity clinical simulations in Australia: a case study: Jason Betson, Erich Christian Fein, David Long, Peter Horrocks; J Educ Eval Health Prof. 2024;21:38. Published online December 10, 2024; DOI: https://doi.org/10.3352/jeehp.2024.21.38

353 View
95 Download

Abstract PDF Supplementary Material: Purpose
Paramedicine education often uses high-fidelity simulations that mimic real-life emergencies. These experiences can trigger stress responses characterized by physiological changes, including alterations in cerebral blood flow and oxygenation. Functional near-infrared spectroscopy (fNIRS) is emerging as a promising tool for assessing cognitive stress in educational settings.
Methods
Eight final-year undergraduate paramedicine students completed 2 high-acuity scenarios 7 days apart. Real-time continuous recording of cerebral blood flow and oxygenation levels in the prefrontal cortex was undertaken via fNIRS as a means of assessing neural activity during stressful scenarios.
Results
fNIRS accurately determined periods of increased cerebral oxygenation when participants were undertaking highly technical skills or making significant clinical decisions.
Conclusion
fNIRS holds potential for objectively measuring the cognitive load in undergraduate paramedicine students. By providing real-time insights into neurophysiological responses, fNIRS may enhance training outcomes in paramedicine programs and improve student well-being (Australian New Zealand Clinical Trials Registry: ACTRN12623001214628).

Research article

Validation of the 21st Century Skills Assessment Scale for public health students in Thailand: a methodological study: Suphawadee Panthumas, Kaung Zaw, Wirin Kittipichai; J Educ Eval Health Prof. 2024;21:37. Published online December 10, 2024; DOI: https://doi.org/10.3352/jeehp.2024.21.37

269 View
113 Download

Abstract PDF Supplementary Material: Purpose
This study aimed to develop and validate the 21st Century Skills Assessment Scale (21CSAS) for Thai public health (PH) undergraduate students using the Partnership for 21st Century Skills framework.
Methods
A cross-sectional survey was conducted among 727 first- to fourth-year PH undergraduate students from 4 autonomous universities in Thailand. Data were collected using self-administered questionnaires between January and March 2023. Exploratory factor analysis (EFA) was used to explore the underlying dimensions of 21CSAS, while confirmatory factor analysis (CFA) was conducted to test the hypothesized factor structure using Mplus software (Muthén & Muthén). Reliability and item discrimination were assessed using Cronbach’s α and the corrected item-total correlation, respectively.
Results
EFA performed on a dataset of 300 students revealed a 20-item scale with a 6-factor structure: (1) creativity and innovation; (2) critical thinking and problem-solving; (3) information, media, and technology; (4) communication and collaboration; (5) initiative and self-direction; and (6) social and cross-cultural skills. The rotated eigenvalues ranged from 2.12 to 1.73. CFA performed on another dataset of 427 students confirmed a good model fit (χ2/degrees of freedom=2.67, comparative fit index=0.93, Tucker-Lewis index=0.91, root mean square error of approximation=0.06, standardized root mean square residual=0.06), explaining 34%–71% of variance in the items. Item loadings ranged from 0.58 to 0.84. The 21CSAS had a Cronbach’s α of 0.92.
Conclusion
The 21CSAS proved be a valid and reliable tool for assessing 21st century skills among Thai PH undergraduate students. These findings provide insights for educational system to inform policy, practice, and research regarding 21st-century skills among undergraduate students.

History article

History of the medical licensure system in Korea from the late 1800s to 1992: Sang-Ik Hwang; J Educ Eval Health Prof. 2024;21:36. Published online December 9, 2024; DOI: https://doi.org/10.3352/jeehp.2024.21.36

161 View
62 Download

Abstract PDF Supplementary Material: The introduction of modern Western medicine in the late 19th century, notably through vaccination initiatives, marked the beginning of governmental involvement in medical licensure, with the licensing of doctors who performed vaccinations. The establishment of the national medical school “Euihakkyo” in 1899 further formalized medical education and licensure, granting graduates the privilege to practice medicine without additional examinations. The enactment of the Regulations on Doctors in 1900 by the Joseon government aimed to define doctor qualifications, including modern and traditional practitioners, comprehensively. However, resistance from the traditional medical community hindered its full implementation. During the Japanese colonial occupation of the Korean Peninsula from 1910 to 1945, the medical licensure system was controlled by colonial authorities, leading to the marginalization of traditional Korean medicine and the imposition of imperial hierarchical structures. Following liberation in 1945 from Japanese colonial rule, the Korean government undertook significant reforms, culminating in the National Medical Law, which was enacted in 1951. This law redefined doctor qualifications and reinstated the status of traditional Korean medicine. The introduction of national examinations for physicians increased state involvement in ensuring medical competence. The privatization of the Korean Medical Licensing Examination led to the establishment of the Korea Health Personnel Licensing Examination Institute in 1992, which assumed responsibility for administering licensing examinations for all healthcare workers. This shift reflected a move towards specialized management of professional standards. The evolution of the medical licensure system in Korea illustrates a dynamic process shaped by the historical context, balancing the protection of public health with the rights of medical practitioners.

Research articles

Effectiveness of ChatGPT-4o in developing continuing professional development plans for graduate radiographers: a descriptive study: Minh Chau, Elio Stefan Arruzza, Kelly Spuur; J Educ Eval Health Prof. 2024;21:34. Published online November 18, 2024; DOI: https://doi.org/10.3352/jeehp.2024.21.34

618 View
137 Download

Abstract PDF Supplementary Material: Purpose
This study evaluates the use of ChatGPT-4o in creating tailored continuing professional development (CPD) plans for radiography students, addressing the challenge of aligning CPD with Medical Radiation Practice Board of Australia (MRPBA) requirements. We hypothesized that ChatGPT-4o could support students in CPD planning while meeting regulatory standards.
Methods
A descriptive, experimental design was used to generate 3 unique CPD plans using ChatGPT-4o, each tailored to hypothetical graduate radiographers in varied clinical settings. Each plan followed MRPBA guidelines, focusing on computed tomography specialization by the second year. Three MRPBA-registered academics assessed the plans using criteria of appropriateness, timeliness, relevance, reflection, and completeness from October 2024 to November 2024. Ratings underwent analysis using the Friedman test and intraclass correlation coefficient (ICC) to measure consistency among evaluators.
Results
ChatGPT-4o generated CPD plans generally adhered to regulatory standards across scenarios. The Friedman test indicated no significant differences among raters (P=0.420, 0.761, and 0.807 for each scenario), suggesting consistent scores within scenarios. However, ICC values were low (–0.96, 0.41, and 0.058 for scenarios 1, 2, and 3), revealing variability among raters, particularly in timeliness and completeness criteria, suggesting limitations in the ChatGPT-4o’s ability to address individualized and context-specific needs.
Conclusion
ChatGPT-4o demonstrates the potential to ease the cognitive demands of CPD planning, offering structured support in CPD development. However, human oversight remains essential to ensure plans are contextually relevant and deeply reflective. Future research should focus on enhancing artificial intelligence’s personalization for CPD evaluation, highlighting ChatGPT-4o’s potential and limitations as a tool in professional education.

Comparison of virtual and in-person simulations for sepsis and trauma resuscitation training in Singapore: a randomized controlled trial: Matthew Jian Wen Low, Gene Wai Han Chan, Zisheng Li, Yiwen Koh, Chi Loong Jen, Zi Yao Lee, Lenard Tai Win Cheng; J Educ Eval Health Prof. 2024;21:33. Published online November 18, 2024; DOI: https://doi.org/10.3352/jeehp.2024.21.33

531 View
123 Download

Abstract PDF Supplementary Material: Purpose
This study aimed to compare cognitive, non-cognitive, and overall learning outcomes for sepsis and trauma resuscitation skills in novices with virtual patient simulation (VPS) versus in-person simulation (IPS).
Methods
A randomized controlled trial was conducted on junior doctors in 1 emergency department from January to December 2022, comparing 70 minutes of VPS (n=19) versus IPS (n=21) in sepsis and trauma resuscitation. Using the nominal group technique, we created skills assessment checklists and determined Bloom’s taxonomy domains for each checklist item. Two blinded raters observed participants leading 1 sepsis and 1 trauma resuscitation simulation. Satisfaction was measured using the Student Satisfaction with Learning Scale (SSLS). The SSLS and checklist scores were analyzed using the Wilcoxon rank sum test and 2-tailed t-test respectively.
Results
For sepsis, there was no significant difference between VPS and IPS in overall scores (2.0; 95% confidence interval [CI], -1.4 to 5.4; Cohen’s d=0.38), as well as in items that were cognitive (1.1; 95% CI, -1.5 to 3.7) and not only cognitive (0.9; 95% CI, -0.4 to 2.2). Likewise, for trauma, there was no significant difference in overall scores (-0.9; 95% CI, -4.1 to 2.3; Cohen’s d=0.19), as well as in items that were cognitive (-0.3; 95% CI, -2.8 to 2.1) and not only cognitive (-0.6; 95% CI, -2.4 to 1.3). The median SSLS scores were lower with VPS than with IPS (-3.0; 95% CI, -1.0 to -5.0).
Conclusion
For novices, there were no major differences in overall and non-cognitive learning outcomes for sepsis and trauma resuscitation between VPS and IPS. Learners were more satisfied with IPS than with VPS (clinicaltrials.gov identifier: NCT05201950).

Technical report

Increased accessibility of computer-based testing for residency application to a hospital in Brazil with item characteristics comparable to paper-based testing: a psychometric study: Marcos Carvalho Borges, Luciane Loures Santos, Paulo Henrique Manso, Elaine Christine Dantas Moisés, Pedro Soler Coltro, Priscilla Costa Fonseca, Paulo Roberto Alves Gentil, Rodrigo de Carvalho Santana, Lucas Faria Rodrigues, Benedito Carlos Maciel, Hilton Marcos Alves Ricz; J Educ Eval Health Prof. 2024;21:32. Published online November 11, 2024; DOI: https://doi.org/10.3352/jeehp.2024.21.32

433 View
122 Download

Abstract PDF Supplementary Material: Purpose
With the coronavirus disease 2019 pandemic, online high-stakes exams have become a viable alternative. This study evaluated the feasibility of computer-based testing (CBT) for medical residency applications in Brazil and its impacts on item quality and applicants’ access compared to paper-based testing.
Methods
In 2020, an online CBT was conducted in a Ribeirao Preto Clinical Hospital in Brazil. In total, 120 multiple-choice question items were constructed. Two years later, the exam was performed as paper-based testing. Item construction processes were similar for both exams. Difficulty and discrimination indexes, point-biserial coefficient, difficulty, discrimination, guessing parameters, and Cronbach’s α coefficient were measured based on the item response and classical test theories. Internet stability for applicants was monitored.
Results
In 2020, 4,846 individuals (57.1% female, mean age of 26.64±3.37 years) applied to the residency program, versus 2,196 individuals (55.2% female, mean age of 26.47±3.20 years) in 2022. For CBT, there was an increase of 2,650 applicants (120.7%), albeit with significant differences in demographic characteristics. There was a significant increase in applicants from more distant and lower-income Brazilian regions, such as the North (5.6% vs. 2.7%) and Northeast (16.9% vs. 9.0%). No significant differences were found in difficulty and discrimination indexes, point-biserial coefficients, and Cronbach’s α coefficients between the 2 exams.
Conclusion
Online CBT with multiple-choice questions was a viable format for a residency application exam, improving accessibility without compromising exam integrity and quality.

Research articles

Validation of the Blended Learning Usability Evaluation–Questionnaire (BLUE-Q) through an innovative Bayesian questionnaire validation approach: Anish Kumar Arora, Charo Rodriguez, Tamara Carver, Hao Zhang, Tibor Schuster; J Educ Eval Health Prof. 2024;21:31. Published online November 7, 2024; DOI: https://doi.org/10.3352/jeehp.2024.21.31

462 View
157 Download

Abstract PDF Supplementary Material: Purpose
The primary aim of this study is to validate the Blended Learning Usability Evaluation–Questionnaire (BLUE-Q) for use in the field of health professions education through a Bayesian approach. As Bayesian questionnaire validation remains elusive, a secondary aim of this article is to serve as a simplified tutorial for engaging in such validation practices in health professions education.
Methods
A total of 10 health education-based experts in blended learning were recruited to participate in a 30-minute interviewer-administered survey. On a 5-point Likert scale, experts rated how well they perceived each item of the BLUE-Q to reflect its underlying usability domain (i.e., effectiveness, efficiency, satisfaction, accessibility, organization, and learner experience). Ratings were descriptively analyzed and converted into beta prior distributions. Participants were also given the option to provide qualitative comments for each item.
Results
After reviewing the computed expert prior distributions, 31 quantitative items were identified as having a probability of “low endorsement” and were thus removed from the questionnaire. Additionally, qualitative comments were used to revise the phrasing and order of items to ensure clarity and logical flow. The BLUE-Q’s final version comprises 23 Likert-scale items and 6 open-ended items.
Conclusion
Questionnaire validation can generally be a complex, time-consuming, and costly process, inhibiting many from engaging in proper validation practices. In this study, we demonstrate that a Bayesian questionnaire validation approach can be a simple, resource-efficient, yet rigorous solution to validating a tool for content and item-domain correlation through the elicitation of domain expert endorsement ratings.

Development and validation of a measurement tool to assess student perceptions of using real patients in physical therapy education at the Rocky Mountain University, the United States: a methodological study: Stacia Hall Thompson, Hina Garg, Mary Shotwell, Michelle Webb; J Educ Eval Health Prof. 2024;21:30. Published online November 7, 2024; DOI: https://doi.org/10.3352/jeehp.2024.21.30

318 View
136 Download

Abstract PDF Supplementary Material: Purpose
This study aimed to develop and validate the Student Perceptions of Real Patient Use in Physical Therapy Education (SPRP-PTE) survey to assess physical therapy student (SPT) perceptions regarding real patient use in didactic education.
Methods
This cross-sectional observational study developed a 48-item survey and tested the survey on 130 SPTs. Face and content validity were determined by an expert review and content validity index (CVI). Construct validity and internal consistency reliability were determined via exploratory factor analysis (EFA) and Cronbach’s α.
Results
Three main constructs were identified (value, satisfaction, and confidence), each having 4 subconstruct components (overall, cognitive, psychomotor, and affective learning). Expert review demonstrated adequate face and content validity (CVI=96%). The initial EFA of the 48-item survey revealed items with inconsistent loadings and low correlations, leading to the removal of 18 items. An EFA of the 30-item survey demonstrated 1-factor loadings of all survey constructs except satisfaction and the entire survey. All constructs had adequate internal consistency (Cronbach’s α >0.85).
Conclusion
The SPRP-PTE survey provides a reliable and valid way to assess student perceptions of real patient use. Future studies are encouraged to validate the SPRP-PTE survey further.

Educational/Faculty development material

The performance of ChatGPT-4.0o in medical imaging evaluation: a cross-sectional study: Elio Stefan Arruzza, Carla Marie Evangelista, Minh Chau; J Educ Eval Health Prof. 2024;21:29. Published online October 31, 2024; DOI: https://doi.org/10.3352/jeehp.2024.21.29

927 View
229 Download
2 Web of Science
2 Crossref

Abstract PDF Supplementary Material

This study investigated the performance of ChatGPT-4.0o in evaluating the quality of positioning in radiographic images. Thirty radiographs depicting a variety of knee, elbow, ankle, hand, pelvis, and shoulder projections were produced using anthropomorphic phantoms and uploaded to ChatGPT-4.0o. The model was prompted to provide a solution to identify any positioning errors with justification and offer improvements. A panel of radiographers assessed the solutions for radiographic quality based on established positioning criteria, with a grading scale of 1–5. In only 20% of projections, ChatGPT-4.0o correctly recognized all errors with justifications and offered correct suggestions for improvement. The most commonly occurring score was 3 (9 cases, 30%), wherein the model recognized at least 1 specific error and provided a correct improvement. The mean score was 2.9. Overall, low accuracy was demonstrated, with most projections receiving only partially correct solutions. The findings reinforce the importance of robust radiography education and clinical experience.

Citations

Citations to this article as recorded by

Conversational LLM Chatbot ChatGPT-4 for Colonoscopy Boston Bowel Preparation Scoring: An Artificial Intelligence-to-Head Concordance Analysis
Raffaele Pellegrino, Alessandro Federico, Antonietta Gerarda Gravina
Diagnostics.2024; 14(22): 2537. CrossRef
Effectiveness of ChatGPT-4o in developing continuing professional development plans for graduate radiographers: a descriptive study
Minh Chau, Elio Stefan Arruzza, Kelly Spuur
Journal of Educational Evaluation for Health Professions.2024; 21: 34. CrossRef

Review

The legality and appropriateness of keeping Korean Medical Licensing Examination items confidential: a comparative analysis and review of court rulings: Jae Sun Kim, Dae Un Hong, Ju Yoen Lee; J Educ Eval Health Prof. 2024;21:28. Published online October 15, 2024; DOI: https://doi.org/10.3352/jeehp.2024.21.28

483 View
184 Download

Abstract PDF Supplementary Material: This study examines the legality and appropriateness of keeping the multiple-choice question items of the Korean Medical Licensing Examination (KMLE) confidential. Through an analysis of cases from the United States, Canada, and Australia, where medical licensing exams are conducted using item banks and computer-based testing, we found that exam items are kept confidential to ensure fairness and prevent cheating. In Korea, the Korea Health Personnel Licensing Examination Institute (KHPLEI) has been disclosing KMLE questions despite concerns over exam integrity. Korean courts have consistently ruled that multiple-choice question items prepared by public institutions are non-public information under Article 9(1)(v) of the Korea Official Information Disclosure Act (KOIDA), which exempts disclosure if it significantly hinders the fairness of exams or research and development. The Constitutional Court of Korea has upheld this provision. Given the time and cost involved in developing high-quality items and the need to accurately assess examinees’ abilities, there are compelling reasons to keep KMLE items confidential. As a public institution responsible for selecting qualified medical practitioners, KHPLEI should establish its disclosure policy based on a balanced assessment of public interest, without influence from specific groups. We conclude that KMLE questions qualify as non-public information under KOIDA, and KHPLEI may choose to maintain their confidentiality to ensure exam fairness and efficiency.

Research articles

A new performance evaluation indicator for the LEE Jong-wook Fellowship Program of Korea Foundation for International Healthcare to better assess its long-term educational impacts: a Delphi study: Minkyung Oh, Bo Young Yoon; J Educ Eval Health Prof. 2024;21:27. Published online October 2, 2024; DOI: https://doi.org/10.3352/jeehp.2024.21.27

517 View
227 Download

Abstract PDF Supplementary Material: Purpose
The Dr. LEE Jong-wook Fellowship Program, established by the Korea Foundation for International Healthcare (KOFIH), aims to strengthen healthcare capacity in partner countries. The aim of the study was to develop new performance evaluation indicators for the program to better assess long-term educational impact across various courses and professional roles.
Methods
A 3-stage process was employed. First, a literature review of established evaluation models (Kirkpatrick’s 4 levels, context/input/process/product evaluation model, Organization for Economic Cooperation and Development Assistance Committee criteria) was conducted to devise evaluation criteria. Second, these criteria were validated via a 2-round Delphi survey with 18 experts in training projects from May 2021 to June 2021. Third, the relative importance of the evaluation criteria was determined using the analytic hierarchy process (AHP), calculating weights and ensuring consistency through the consistency index and consistency ratio (CR), with CR values below 0.1 indicating acceptable consistency.
Results
The literature review led to a combined evaluation model, resulting in 4 evaluation areas, 20 items, and 92 indicators. The Delphi surveys confirmed the validity of these indicators, with content validity ratio values exceeding 0.444. The AHP analysis assigned weights to each indicator, and CR values below 0.1 indicated consistency. The final set of evaluation indicators was confirmed through a workshop with KOFIH and adopted as the new evaluation tool.
Conclusion
The developed evaluation framework provides a comprehensive tool for assessing the long-term outcomes of the Dr. LEE Jong-wook Fellowship Program. It enhances evaluation capabilities and supports improvements in the training program’s effectiveness and international healthcare collaboration.

Reliability of a workplace-based assessment for the United States general surgical trainees’ intraoperative performance using multivariate generalizability theory: a psychometric study: Ting Sun, Stella Yun Kim, Brigitte Kristin Smith, Yoon Soo Park; J Educ Eval Health Prof. 2024;21:26. Published online September 24, 2024; DOI: https://doi.org/10.3352/jeehp.2024.21.26

773 View
187 Download

Abstract PDF Supplementary Material: Purpose
The System for Improving and Measuring Procedure Learning (SIMPL), a smartphone-based operative assessment application, was developed to assess the intraoperative performance of surgical residents. This study aims to examine the reliability of the SIMPL assessment and determine the optimal number of procedures for a reliable assessment.
Methods
In this retrospective observational study, we analyzed data collected between 2015 and 2023 from 4,616 residents across 94 General Surgery Residency programs in the United States that utilized the SIMPL smartphone application. We employed multivariate generalizability theory and initially conducted generalizability studies to estimate the variance components associated with procedures. We then performed decision studies to estimate the reliability coefficient and the minimum number of procedures required for a reproducible assessment.
Results
We estimated that the reliability of the assessment of surgical trainees’ intraoperative autonomy and performance using SIMPL exceeded 0.70. Additionally, the optimal number of procedures required for a reproducible assessment was 10, 17, 15, and 17 for postgraduate year (PGY) 2, PGY 3, PGY 4, and PGY 5, respectively. Notably, the study highlighted that the assessment of residents in their senior years necessitated a larger number of procedures compared to those in their junior years.
Conclusion
The study demonstrated that the SIMPL assessment is reliably effective for evaluating the intraoperative performance of surgical trainees. Adjusting the number of procedures based on the trainees’ training stage enhances the assessment process’s accuracy and effectiveness.

Training satisfaction and future employment consideration among physician and nursing trainees at rural Veterans Affairs facilities in the United States during COVID-19: a time-series before and after study: Heather Northcraft, Tiffany Radcliff, Anne Reid Griffin, Jia Bai, Aram Dobalian; J Educ Eval Health Prof. 2024;21:25. Published online September 24, 2024; DOI: https://doi.org/10.3352/jeehp.2024.21.25

641 View
135 Download

Abstract PDF Supplementary Material: Purpose
The coronavirus disease 2019 (COVID-19) pandemic limited healthcare professional education and training opportunities in rural communities. Because the US Department of Veterans Affairs (VA) has robust programs to train clinicians in the United States, this study examined VA trainee perspectives regarding pandemic-related training in rural and urban areas and interest in future employment with the VA.
Methods
Survey responses were collected nationally from VA physicians and nursing trainees before and after COVID-19 (2018 to 2021). Logistic regression models were used to test the association between pandemic timing (pre-pandemic or pandemic), trainee program (physician or nurse), and the interaction of trainee pandemic timing and program on VA trainee satisfaction and trainee likelihood to consider future VA employment in rural and urban areas.
Results
While physician trainees at urban facilities reported decreases in overall training satisfaction and corresponding decreases in the likelihood of considering future VA employment from pre-pandemic to pandemic, rural physician trainees showed no changes in either outcome. In contrast, while nursing trainees at both urban and rural sites had decreases in training satisfaction associated with the pandemic, there was no corresponding effect on the likelihood of future employment by nurses at either urban or rural VA sites.
Conclusion
The study’s findings suggest differences in the training experiences of physicians and nurses at rural sites, as well as between physician trainees at urban and rural sites. Understanding these nuances can inform the development of targeted approaches to address the ongoing provider shortages that rural communities in the United States are facing.

First
Prev
Page of 6
Next
Last

Video clip