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Medical Science Educator November Article Review from Dr. Louis Justement

It is common for undergraduate students to engage in undergraduate research experiences as part of their preparation for applying to medical and other professional schools. It is widely assumed that performing undergraduate research provides students with knowledge and skills, as well as attitudes that will prepare them for the demands of medical school, and in so doing, that this will make them more competitive for acceptance into such programs. Clearly, there is the potential for students to learn transferrable skills such as oral and written communication, problem solving, critical thinking, analytical skills, professionalism, leadership and teamwork. At the same time undergraduate research can provide students with the opportunity to learn research-specific skills and knowledge that is discipline-specific, as well as general in nature. Finally, students can be exposed to a range of attitudes in the research arena that will be of potential use going forward in their career. However, even though there is the potential for students to gain a wide range of knowledge, skills and attitudes by performing undergraduate research, this does not always happen in practice. One study to better understand the association between student and faculty perceptions about the undergraduate research experience and how differences in perceptions may negatively impact the achievement of learning objectives associated with undergraduate research is discussed in a recent paper entitled Exploring Medical Student’s and Faculty’s Perspectives on Benefits of Undergraduate Research Experience, published in the Medical Science Educator, Volume 28, (pages 553-560), 2018, by authors R Imafuku, S Yasuda, K Hashimoto, D Matsunaga, Y Ohashi, K Yamamoto, K Tsunekawa and T Saiki from Gifu University, Japan.

In this study, the authors utilize an interview-based, qualitative assessment of students and faculty who were engaged in undergraduate research to determine if their perceptions of the benefits and outcomes of the experience were aligned, and if not, where differences in perceptions were focused. The authors categorized outcomes of the undergraduate research experience into four main areas, including transferable skills, research-specific skills, knowledge and finally attitudes towards research. Interestingly, the authors found that students and faculty both perceived the undergraduate research experience as being equally valuable for imparting transferrable skills to students. However, this was the only category in which there was concurrence. Students placed more emphasis on the acquisition of research-specific skills and knowledge than did faculty. Whereas, faculty focused more on how the undergraduate experience impacted attitudes towards research. Thus, the authors found a discordance of expectations and outcomes for three out of the four main learning objective categories. In particular, the lack of agreement with respect to attitudes towards research was of significant interest as it suggests that faculty believed that the undergraduate experience should provide students with a clear appreciation of the research endeavor and how it is potentially important for their future as clinicians, whereas students had a more difficult time understanding, or appreciating, how research would be relevant to their future career. The take home message from this study is that it is critical to provide opportunities for alignment of student and faculty perceptions and expectations in order to insure that the undergraduate research experience fully achieves the intended goals.

Louis B. Justement, PhD
Director, GBS Immunology Graduate Theme
Director Undergraduate Immunology Program
Associate Director, Medical Scientist Training Program
Professor, Department of Microbiology University of Alabama at Birmingham
Member, Publications Committee



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Last Chance to Submit #IAMSE19 Oral and Poster Presentations Abstracts

The deadline for poster abstract submission is quickly drawing near! As a reminder, IAMSE is currently accepting Oral and Poster abstract presentations to be presented at the 23rd Annual IAMSE Conference. The deadline for submission is December 1, 2018 at 5 PM ET!

Please click here to submit your abstract
Please note: The first time you enter the site, if you have not already done so previously, you will be required to create a user profile.

The 2019 IAMSE Meeting will be held in Roanoke, Virginia, USA from June 8-11, 2019. All abstracts for Oral and Poster presentations must be submitted in the format requested through the online abstract submission site. Authors will be notified with a decision regarding their abstract submission by February 15. There is no limit to the number of abstracts you can submit but it is unlikely that more than two presentations per presenter can be accepted due to scheduling complexities.

IAMSE Student Grant Applications Now Being Accepted!

The International Association of Medical Science Educators (IAMSE) is pleased to announce the ScholarRx-IAMSE Student Educational Research Grants Program.

All IAMSE student members are eligible to submit a grant proposal. All students will need to have a faculty mentor sign off on the proposal confirming that all policies will be met. Proposals must be accompanied by a letter from an appropriate institutional official confirming that the institution will pay to send the student to the IAMSE meeting the year following project completion to present the results of the proposed work; timing of the presentation is flexible as to be appropriate for the completion of the project.

Applications are to be submitted on the submission page found here by 11:59 PM Eastern Time on January 15, 2019.

All information regarding the IAMSE Educational Research Grant Program for Students, including the application process, eligibility, proposal format, and evaluation criteria, can be found on the IAMSE website here.

Hurry! #IAMSE19 Call for Oral and Poster Presentations Closing Soon!

IAMSE is pleased to announce the call for abstracts for Oral and Poster presentations for the 23rd Annual IAMSE Conference to be held at the Hotel Roanoke in Roanoke, VA, USA from June 8-11, 2019. The IAMSE meeting offers opportunities for faculty development and networking, bringing together medical sciences and medical education across the continuum of healthcare education.

 

Please click here to submit your abstract today.

Please note: The first time you enter the site, you will be required to create a user profile. Even if you did submit in previous years, you need to create a new account. All abstracts for Oral and Poster presentations must be submitted in the format requested through the online abstract submission site.

 

Submission deadline is December 1, 2018. There is no limit on the number of abstracts you may submit, but it is unlikely that more than two presentations per presenter can be accepted due to scheduling complexities. Abstract acceptance notifications will be returned by February 15, 2019.

IAMSE Administrative Offices will be closed on November 22 & 23

As you may know, IAMSE maintains a listing of Medical Education Conferences on our website. We’d like to expand our listing of conferences, but to do this, we need your help!

Will you be attending any Medical Education Conferences this year or next year? If you are, please let us know! You can send this information to us via email at support@iamse.org.

Currently, the listing of conferences is located on the IAMSE website under the Events heading as Events of Interest. Here, you will be able to find information on other conferences that may be of interest to you.

What Conferences Are You Attending? Let Us Know!

As you may know, IAMSE maintains a listing of Medical Education Conferences on our website. We’d like to expand our listing of conferences, but to do this, we need your help!

Will you be attending any Medical Education Conferences this year or next year? If you are, please let us know! You can send this information to us via email at support@iamse.org.

Currently, the listing of conferences is located on the IAMSE website under the Events heading as Events of Interest. Here, you will be able to find information on other conferences that may be of interest to you.

IAMSE Featured Member: Rob Carroll

Our association is a robust and diverse set of educators, researchers, medical professionals, volunteers and academics that come from all walks of life and from around the globe. Each month we choose a member to highlight their academic and professional career, and see how they are making the best of their membership in IAMSE. This month’s Featured Member is Rob Carroll, PhD.

Robert CarrollRobert G. Carroll earned his Ph.D. in 1981 under the direction of Dr. David F. Opdyke at the Department of Physiology of the Graduate School of Biomedical Sciences of the University of Medicine and Dentistry of New Jersey-Newark. Following a 3 year post-doc at University of Mississippi Medical Center in Jackson, MS under the sponsorship of Drs. Thomas E. Lohmeier and Arthur C. Guyton, he moved to East Carolina University in 1984 as an Assistant Professor of Physiology. He is currently Professor of Physiology at the Brody School of Medicine at East Carolina University, and holds an administrative appointment as Associate Dean for Medical Student Education.

For the first 20 years of his career, Rob balanced an active research lab with his teaching and administrative duties. About 10 years ago, the research balance shifted to research in teaching and learning, and now administrative duties have limited the time available for research. Apart from his bench research publications, Rob has published 21 peer reviewed education manuscripts, edited one book, is a section editor for a Medical-Surgical Nursing textbook, and published “Elsevier’s Integrated Physiology” in 2007 and “Problem-Based Physiology” in 2010.

IAMSE was a critical part of Rob’s professional development. Rob was on the founding Board of Directors for IAMSE, served as the first secretary and as a member chair of the IAMSE membership committee. Prior to IAMSE founding, each professional society had groups interested in education, but IAMSE provided a valuable forum for interdisciplinary education conversations.

Rob was selected for the 2018 AAMC Robert Glaser Award for his contributions to medical education. He has also received the Arthur C. Guyton Physiology Educator of the Year from the American Physiological Society in 2004 and the Outstanding Alumni Award from the University of Medicine and Dentistry of New Jersey in 2005.

#IAMSE19 Call for Travel Award Applications

The IAMSE Conference Travel Awards support students or junior faculty to attend the IAMSE Annual Meeting. The amount of the 2019 Travel Awards will be $1,500, and are meant to cover expenses related to attendance at the IAMSE annual meeting in Roanoke, such as conference registration, lodging, and airfare. Any IAMSE member who will attend the 2019 Annual Meeting is eligible to apply, though preference will be given to those submitting conference proposals for a poster abstract.

To be considered for the award, an applicant must submit the following items:

1. A current CV
2. A 300 word Personal Statement
3. An abstract or description of the work, if applicable

Applications are to be submitted via the online submission form found here by December 15, 2018. If you are also submitting a poster abstract for the 2019 meeting the deadline is December 1, 2018.

IAMSE on the Road at The Generalists and AAMC

The Generalists in Medical Education will be holding their 2018 conference on November 1-2 in Austin, Texas, USA. Information on this conference can be found here.

The 2018 Association of American Medical Colleges (AAMC) Medical Education Meeting will be taking place in Austin, Texas, USA from November 2-6.  Click here for more information on the AAMC meeting.

The IAMSE booth will be present at both of these conferences to exhibit, so if you plan on attending these meetings, do not forget to swing by the IAMSE booth and say hello!

We look forward to seeing you there!

Save the Date for the Winter 2019 WAS Series!

Winter 2019 – Series Theme: Learning Environment in Health Sciences Education

January 10 – Overview & introduction of the Learning Environment – Larry Gruppen
January 17 – The Learning Environment: An International Perspective – Sean Tackett
January 24 – The Learning Environment During Residency – John Co
January 31 – Learning Environment Panel featuring discussions from Osteopathic, Nursing and PA perspectives – Luke Mortensen, Cindy Anderson and Karen Hills
February 7 – System and Case Studies – Dan Harrington

The 2019 winter series of the IAMSE webinar program will focus on the role of the learning environment in health science education. The significance and importance of the learning environment is based on the assumption that a poor environment is associated with poor student performance, burn-out and stress. Numerous reports of students experiencing increased levels of unprofessional behavior and mistreatment on the part of faculty, residents, staff and other students have raised concerns about student well being, professional development, and accreditation requirements. As a result, a major emphasis on the part of health science educators today is to evaluate the learning environment, identify areas of concern, and take measures to address these issues.

The goal of this series is to raise awareness of the importance of ensuring a positive learning environment across health sciences education and to provide examples of systems and programs that have addressed this issue in an impactful manner. The introductory session will discuss the challenges in developing a conceptual framework for the learning environment, current limitations in measuring the learning environment, and initiatives designed to improve the learning environment. The remainder of the sessions will examine the current state of affairs in a variety of different health science settings. A panel will discuss these issues from the perspective of osteopathic, nursing and physician assistant educational programs.

We will gain insight into the issues and research being conducted on the global learning environment from some selected schools outside of the United States. We will explore the learning environment in graduate medical education (ACGME) and will conclude with an in-depth practical approach of how one medical school created a robust system to monitor the learning environment which will include case studies. It is anticipated that at the end of the series the audience will be more in-tuned with the importance of maintaining a healthy learning environment and be better equipped with practical applications for their educational programs.


Registration for the Winter Webcast Audio Seminar Series is opening soon! 

IAMSE – Medical Science Educator Call for Manuscripts

Medical Science Educator, the peer-reviewed journal of the International Association of Medical Science Educators (IAMSE), publishes scholarly work in the field of health sciences education. The journal publishes four issues per year through Springer Publishing. We welcome contributions in the format of Short Communication, Original Research, Monograph, Commentary, and Innovation. Please visit our website www.medicalscienceeducator.org for a more detailed description of these types of articles.

We look forward to receiving your submissions!

IAMSE Fall 2018 WAS Session 5 Highlights

[The following notes were generated by Mark Slivkoff.]

 IAMSE Webinar Series, Fall 2018

Speaker: Stanley J. Hamstra, PhD
VP, Milestones Research and Evaluation
Accreditation Council for Graduate Medical Education (ACGME)
Title: Realizing the Promise of Big Data: Learning Analytics in Competency-Based Medical Education
Series: Evolution and Revolution in Medical Education: Technology in the 21st Century

    • Hamstra outlined the following for his webinar:
      • A Review of Milestones
      • Learning Analytics
      • Future Directions
    • Overall, the use of milestones is important because their use helps health professionals remain accountable for the education of our students

     

    A Review of Milestones

    • A special report on milestones was published by Nasca et al. in The New England Journal of Medicine (366:1051-6; 2012).
      • A main point expressed by its authors was that there had been a significant amount of variability in the quality of resident education (graduate medical education, GME)
      • The ACGME, founded in 1981, responded appropriately and the quality of GME has increased over the past 30 years
    • A competency-based approach was necessary to combat the variability characteristic of the traditional model (curriculum with educational objectives and assessments).
    • In a competency-based education model, the health needs and systems are analyzed, then the competencies are built.
    • Competence is multi-dimensional and allows faculty to ask residents:
      • What do they know? (Medical Knowledge)
      • What can they do? (PatientCare)
      • How do they conduct themselves? (Interpersonal and Communication Skills, Professionalism)
      • Are they critical and reflective? (Practice-based Learning and Improvement, Systems-based Practice)
    • Milestones were modeled on the five stages outlined in the Dreyfus Developmental Model of Learning (Novice, Advanced beginner, Competent, Proficient, and Expert).
    • Some of the key points regarding milestones:
      • Articulate shared understanding of expectations
      • Describe trajectory from a beginner in the specialty to an exceptional resident or practitioner
      • Set aspirational goals of excellence
      • Organized under six domains of clinical competency
      • Used as one indicator of a resident’s educational progress
    • Various studies have been done on the effectiveness of milestones. One article considered in the webinar was Conforti et al. (J Surg Educ. 2018;75(1):147-55), who focused on the benefits to the residency Program Director:
      • Changes in the remediation process can be implemented
        • Catching struggling residents earlier
        • Targeted improvements for individual learners
        • Identifying gaps in otherwise high performers
      • Structuring of learning goals
      • Making defensible decisions
        • Milestones provide “built-in”documentation which potential helps mitigate resident’s fighting their evaluation
      • There are numerous sub-competencies (~22) spread across over 130,000 residents, thus crunching the data is a significant task since the number of data points approaches about 3.2 million!

     

    Learning Analytics

    • Learning analytics was broken down into three pieces:
      • Concepts
      • Examples
      • Implementation
    • The purpose of the introduction of milestones revolves around entrustability: can we develop a system to ensure residents and fellows are ready for unsupervised practice by graduation?
    • S. Department of Education describes learning analytics as such: the interpretation of a wide range of data produced by and gathered on behalf of students in order to assess academic progress, predict future performance, and spot potential issues”
    • Hamstra described a Generic Milestones Template
      • Five levels
      • Emphasis placed on Level 4, What does a graduating resident look like? This level serves as the main target for graduation for most specialties, however, is NOT a requirement for graduation
    • The Data: Cross-sectional analysis at the specialty level…
      • Hamstra noted that his favorite data set, his favorite graph, is the “Proportion of Residents Attaining Level 4 or Higher: PC Sub-Competencies (June 2015) – Neurological Surgery”
        • Data makes sense, according the feedback from residency directors
        • In order of attainment, with PC08 at about 95% and PC03 at about 72%:
          • PC08: Traumatic Brain Injury
          • PC02: Critical Care
          • PC01: Brain Tumor
          • PC06: Spinal Neurosurgery
          • PC05: Pediatric Neurological Surgery
          • PC07: Vascular Neurosurgery
          • PC04: Pain and Peripheral Nerves
          • PC03: Surgical Treatment of Epilepsy and Movement Disorders
        • Conclusion: Pain and Peripheral Nerves, Epilepsy and Movement Disorders are not getting covered at specific sites
        • Change in curriculum design and assessment can be addressed
      • The Data: Longitudinal analysis at the individual level…
        • Various graphs were presented which showed milestone “trajectories” (entrance to graduation) within various specialties including:
          • Surgery, pathology (MK01 competency)
          • Wound management
        • Hamstra discussed the Odds Ratio (OR) for residents not attaining Level 4 under threshold. Students at level 1.5 or above during their first assessment (year 1) have a much greater chance at attaining Level 4 than those who score lower.
      • QUALITATIVE RESEARCH: How do Raters Make Decisions?
        • The phenomenon of “straight-lining” has been extensively looked at as well. Straight-lining is when an evaluator, such as a busy physician, gives the same score for each milestone. This, of course, is not good to do.
        • Hamstra’s group is working on how best to mitigate this phenomenon by combing through lots of specialty and sub-specialty data

    Future Directions

    • Version 2.0 of milestones are currently underway.
    • Overall, the new version (new tables) contain milestones which are more refined

    Questions asked after seminar:

    (Note that some questions and/or answers have been reworded for clarity.)

    How do these measures play in to the overall evaluation process? Some teachers do not want to personally evaluate or judge residents, and residents may take their evaluations personally.
    A couple ways to mitigate the personal nature of evaluations. First, evaluations can be done by groups rather than by individual faculty. Second, as evaluator you can have a conversation with the resident in the beginning, letting them know that they will start at level 1.

    What about the variability between residencies?
    We’re looking at the data to help us address a few questions. Do milestone ratings as a whole differ between large and small residencies? Does the size of the program matter? What is the low hanging fruit, that is, what explains the differences?

    What is a good way to ask for feedback on milestones?
    The “O” score assessment which can be applied to other specialties and skills. We’ve created a form called the OCAT (Ottawa Clinical Assessment Tool). Overall, when building forms for evaluation, you need to keep them simple.

    Do you think that the milestones should reflect the Dreyfus model?
    Dreyfus models seems to be the best fit for designing and building milestones.

    If a student finishes the milestones early, do they finish the program early?
    This is a good question and is a key debate right now. Again, milestones are used to supplement evaluations of program directors. But the gist of competency education is that if you are comfortable in graduating someone early, then go for it. Jury is still out, but in theory we’d strive for this.

    Do you have qualitative data on which students make it to Level 4 earlier?
    We do not, but we also want to ask why didn’t those residents make it to Level 4.

    How can a student reach a level of 2.5 when 2.5 is not defined?
    Half-levels are defined. I didn’t talk about this but there are specific instructions on giving a 2.5. The scale is actually a 9-point scale (1 to 5, in 0.5 increments).

    What software do you use to analyze your data?
    We use SAS, but programmers use other programs as well.


    Dr. Hamstra can be reached at shamstra@acgme.org