68 research outputs found
Video-based benchmarking: exploring an intervention that aims to increase examiner alignment in objective structured clinical exams (OSCEs)
No full textIntroduction Examiner variability poses a challenge to OSCE fairness, with existing training methods shown as largely ineffective. Assessors, however, are influenced by recent experiences. Thus, I hypothesised that a targeted, near-in-time intervention could improve examiner alignment. Video-Based Benchmarking (VBB) is a novel approach aimed at reducing examiner variability in OSCEs. It involves examiners evaluating a station-specific OSCE performance and receiving feedback shortly before scoring the target station, enabling mental calibration and adjustment to expectations. Methods Study 1 (S1): Using realist evaluation, I explored how, why, and under what conditions VBB influences scoring and its potential development. An initial program theory was formulated via literature review and tested through 16 interviews with OSCE examiners. Interviews were analysed using Context-Mechanism-Outcome configurations (CMOc’s) to test and modify this theory and develop the intervention. Study 2 (S2): This internet-based experiment tested whether VBB reduced score variability among OSCE examiners. The intervention group underwent VBB before assessing two target performances. The control group assessed the same performances without VBB and later watched the same benchmark video without feedback. Group assignment and video order were randomized. Data were analysed using a Generalized Linear Model (GLiM). FindingsS1 indicated that viewing a station-specific OSCE performance close to scoring could reduce variability by refining examiners’ internal marking framework, minimizing the need to “get their eye in,” and providing a direct performance comparator. In contrast, S2’s primary analysis found no significant impact of VBB on examiner variability. Exploratory findings suggested that VBB may benefit examiners with greater initial variance from the group mean. ConclusionsThese results imply that additional refinements to VBB might better resolve discrepancies, or that VBB may improve perceived confidence without actual alignment. While VBB shows promise in influencing examiner judgments, its effect on score variability requires further research and procedural refinement to establish its efficacy
Guidelines: the do’s, don’ts and don’t knows of feedback for clinical education
No full textIntroductionThe guidelines offered in this paper aim to amalgamate the literature on formative feedback into practical Do’s, Don’ts and Don’t Knows for individual clinical supervisors and for the institutions that support clinical learning.MethodsThe authors built consensus by an iterative process. Do’s and Don’ts were proposed based on authors’ individual teaching experience and awareness of the literature, and the amalgamated set of guidelines were then refined by all authors and the evidence was summarized for each guideline. Don’t Knows were identified as being important questions to this international group of educators which if answered would change practice. The criteria for inclusion of evidence for these guidelines were not those of a systematic review, so indicators of strength of these recommendations were developed which combine the evidence with the authors’ consensus.ResultsA set of 32 Do and Don’t guidelines with the important Don’t Knows was compiled along with a summary of the evidence for each. These are divided into guidelines for the individual clinical supervisor giving feedback to their trainee (recommendations about both the process and the content of feedback) and guidelines for the learning culture (what elements of learning culture support the exchange of meaningful feedback, and what elements constrain it?)ConclusionFeedback is not easy to get right, but it is essential to learning in medicine, and there is a wealth of evidence supporting the Do’s and warning against the Don’ts. Further research into the critical Don’t Knows of feedback is required. A new definition is offered: Helpful feedback is a supportive conversation that clarifies the trainee’s awareness of their developing competencies, enhances their self-efficacy for making progress, challenges them to set objectives for improvement, and facilitates their development of strategies to enable that improvement to occur
Action research: towards excellence in teaching, assessment and feedback for clinical consultation skills
No full textBackground Consultation skills are the core competencies required at graduation of the doctor as a practitioner. Every medical school has its own system of teaching and assessing consultation skills. These are generally amalgams of previous curricula and not rigorously developed. We took the opportunity presented by a new undergraduate medical curriculum to systematically develop the consultation skills curriculum from classroom teaching to OSCE assessment and formative workplace-based assessment and feedback.Methods The consultation skills curriculum and assessment system were developed by action research. Data were collected using mixed methods involving questionnaires, focus groups, participant interviews, student reflective summaries and routine monitoring of usage of an app which we developed for generating feedback summaries in the clinical workplace. Participants were teachers and students at Keele University school of medicine. In addition, clinical tutors from seven other UK medical schools participated in a Delphi study of undergraduate medical consultation skills competencies.Results A case study of curriculum development by action research is presented in nine published papers.Conclusion This work has contributed to medical education knowledge as follows: an instrument for assessment of consultation skills has been developed and validated; and a set of strategies for improvement of these consultation skills have been developed and validated. It has added to understanding about transfer of learning from the classroom to the workplace; the impact of assessment grades on medical students’ learning and self-perception; and the value of a system of formal workplace-based assessment.Additionally this work was one of the first applications of realist methods in medical education research, and it has developed guidance on feedback in the workplace for individual tutors and educational institutions
How do medical students’ experiences inform their opinions of general practice and its potential as a future career choice?
No full textMiss Lefroy collection
No full textA letter from Major William Howe Greene, author of 'Wooden Walls among the Ice Floes', defending his writing and the sealers against world-wide anti-sealing criticism. Also a typewritten carbon copy, with manuscript notes of 'Jowler Zeb: an epic poem of the ice floe and a sealer's yarn'
Can learning from workplace feedback be enhanced by reflective writing? A realist evaluation in UK undergraduate medical education
No full textIntroduction Doctors and medical students in the UK are currently required to provide evidence of learning by reflective writing on (among other things) feedback from colleagues. Although the theoretical value of reflecting-on-action is clear, research is still needed to know how to realise the potential of written reflection in medical education. This study arose out of efforts to improve medical student engagement with a reflective writing exercise. We used realist methodology to explain the disinclination of the majority to do written reflection on workplace feedback, and the benefits to the minority. Method Realist evaluation is a suitable approach to researching complex interventions which have worked for some and not for others. Focus groups were held over a three-year period with year 3 and 4 students. Focus group transcripts were coded for context-mechanism-outcome configurations (the realist approach to analysing data) explaining students’ choice not to write a reflection, to write a ‘tick-box’ reflection or to write for learning. A sub-set of eight students’ reflections were also analysed to ascertain evidence of learning through reflection. Results and Discussion 27 students participated in 4 focus groups. Three summary theories emerged showing the importance of context. Firstly, written reflection is effortful and benefits those who invest in it for intrinsic reasons in situations when they need to think more deeply about a learning event. Secondly, following a reflective feedback discussion writing a reflection may add little because the learning has already taken place. Thirdly, external motivation tends to result in writing a ‘tick-box’ reflection
Some like it hot: medical student views on choosing the emotional level of a simulation
No full textThis study aimed to determine the impact of giving junior medical students control over the level of emotion expressed by a simulated patient (SP) in a teaching session designed to prepare students to handle emotions when interviewing real patients on placements
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