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A retrospective observational study - exploring food pantry referral as a clinical proxy for residents' ability to address unmet health-related social needs. 一项回顾性观察研究--探索食品储藏室转介作为居民解决未满足的健康相关社会需求能力的临床替代方案。
IF 3.1 2区 医学 Q1 EDUCATION & EDUCATIONAL RESEARCH Pub Date : 2024-12-31 Epub Date: 2024-09-20 DOI: 10.1080/10872981.2024.2404295
Michelle March, Daniel Schumacher, Andrew F Beck, Mary Carol Burkhardt, Allison Reyner, Melissa Klein

Background: Assessment of residents' ability to address unmet health-related social needs to promote social accountability remains subjective and difficult. Existing approaches rely on self-assessment surveys of residents' knowledge, skills, and attitudes following social determinants of health training, with few studies explicitly measuring clinical practice. We aimed to characterize social accountability using resident referrals to a food pantry embedded in a pediatric primary care center as an objective measure of resident ability to address unmet health-related social needs in clinical practice.

Methods: This retrospective observational study occurred from 1 January 2019, to 30 June 2020, at an urban, pediatric primary care center with an embedded food pantry. All pediatric residents received social accountability education during a 2-week Advocacy rotation intern year. During clinic visits, pediatric residents were expected to act on results of a standardized social screen that included two food insecurity questions. Food pantry referral was the primary outcome. Food pantry referral data were extracted from food pantry logs.

Results: During the 18-month study period, the pediatric primary care center food pantry was accessed at 1,031 visits. Of the 860 physician-based visits that resulted in pantry referral, 63% (n = 545) were initiated by residents. Eighty-six percent of residents (134/156) made ≥ 1 referral. Across all years, residents placed a mean of 3 (range 1-16) food pantry referrals.

Conclusions: During our study, most residents placed at least one pantry referral in response to identifying food insecurity either via the screen or during conversation with the family. Referral to a primary care embedded food pantry, one way to address acute food insecurity may serve as a measurable proxy to assess residents' ability to address unmet health-related social needs and promote social accountability in healthcare delivery.

背景:评估住院医师解决未满足的健康相关社会需求以促进社会责任的能力仍然是主观和困难的。现有的方法依赖于对住院医师接受健康社会决定因素培训后的知识、技能和态度进行自我评估调查,很少有明确衡量临床实践的研究。我们旨在利用住院医师向儿科初级保健中心内设的食品储藏室转诊的情况来描述社会责任感,以此作为住院医师在临床实践中解决未满足的健康相关社会需求的能力的客观衡量标准:这项回顾性观察研究于 2019 年 1 月 1 日至 2020 年 6 月 30 日在一个内设食品储藏室的城市儿科初级保健中心进行。所有儿科住院医师都在为期两周的倡导轮转实习年中接受了社会责任教育。在出诊期间,儿科住院医师应根据标准化社会筛查的结果采取行动,其中包括两个食物不安全问题。食物储藏室转诊是主要结果。食物储藏室转诊数据来自食物储藏室日志:在为期 18 个月的研究期间,共有 1,031 人次使用了儿科初级保健中心的食品储藏室。在导致食物储藏室转诊的 860 次医生出诊中,63%(n = 545)是由住院医师发起的。86%的住院医师(134/156)进行了 ≥ 1 次转诊。在所有年份中,居民平均转介了 3 次(1-16 次不等)食品储藏室:在我们的研究中,大多数居民在通过屏幕或与家庭交谈中发现食物不安全时,至少转介了一次食品储藏室。转介到初级保健嵌入式食品储藏室是解决严重食物不安全问题的一种方法,可作为一种可衡量的替代方法,用于评估居民解决未满足的健康相关社会需求的能力,并促进医疗保健服务中的社会责任。
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引用次数: 0
How do medical schools influence their students' career choices? A realist evaluation. 医学院如何影响学生的职业选择?现实主义评估。
IF 4.6 2区 医学 Q1 EDUCATION & EDUCATIONAL RESEARCH Pub Date : 2024-12-31 Epub Date: 2024-02-25 DOI: 10.1080/10872981.2024.2320459
Adam Thomas, Ruth Kinston, Sarah Yardley, R K McKinley, Janet Lefroy

Introduction: The career choices of medical graduates vary widely between medical schools in the UK and elsewhere and are generally not well matched with societal needs. Research has found that experiences in medical school including formal, informal and hidden curricula are important influences. We conducted a realist evaluation of how and why these various social conditions in medical school influence career thinking.

Methods: We interviewed junior doctors at the point of applying for speciality training. We selected purposively for a range of career choices. Participants were asked to describe points during their medical training when they had considered career options and how their thinking had been influenced by their context. Interview transcripts were coded for context-mechanism-outcome (CMO) configurations to test initial theories of how career decisions are made.

Results: A total of 26 junior doctors from 12 UK medical schools participated. We found 14 recurring CMO configurations in the data which explained influences on career choice occurring during medical school.

Discussion: Our initial theories about career decision-making were refined as follows: It involves a process of testing for fit of potential careers. This process is asymmetric with multiple experiences needed before deciding a career fits ('easing in') but sometimes only a single negative experience needed for a choice to be ruled out. Developing a preference for a speciality aligns with Person-Environment-Fit decision theories. Ruling out a potential career can however be a less thought-through process than rationality-based decision theories would suggest. Testing for fit is facilitated by longer and more authentic undergraduate placements, allocation of and successful completion of tasks, being treated as part of the team and enthusiastic role models. Informal career guidance is more influential than formal. We suggest some implications for medical school programmes.

导言:在英国和其他国家,不同医学院的医科毕业生的职业选择差异很大,而且一般都与社会需求不相适应。研究发现,医学院的经历(包括正式、非正式和隐性课程)是重要的影响因素。我们对医学院的各种社会条件如何以及为何影响职业思维进行了现实主义评估:我们在初级医生申请专科培训时对其进行了访谈。我们有目的地选择了一系列职业选择。我们要求受访者描述他们在医学培训期间考虑职业选择的时间点,以及他们的想法是如何受到环境影响的。我们对访谈记录进行了背景-机制-结果(CMO)配置编码,以检验关于职业决策如何做出的初步理论:共有来自英国 12 所医学院的 26 名初级医生参加了访谈。我们在数据中发现了 14 个重复出现的 CMO 配置,这些配置解释了医学院期间发生的对职业选择的影响:我们对职业决策的初步理论进行了如下改进:这涉及一个测试潜在职业是否适合的过程。这一过程是不对称的,在确定职业适合之前需要多次经历("缓入"),但有时只需要一次负面经历就可以排除选择。对专业的偏好符合 "人-环境-适合 "决策理论。然而,与基于理性的决策理论相比,排除潜在职业可能是一个不那么深思熟虑的过程。更长、更真实的大学本科实习、任务分配和任务的顺利完成、被视为团队的一部分以及热情的榜样,都有助于检验是否适合。非正式的职业指导比正式的职业指导更有影响力。我们对医学院的课程提出了一些建议。
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引用次数: 0
Ontological coaching among nursing undergraduates: a pilot randomized controlled (OCEAN) trial. 护理本科生的本体论辅导:随机对照(OCEAN)试验。
IF 3.1 2区 医学 Q1 EDUCATION & EDUCATIONAL RESEARCH Pub Date : 2024-12-31 Epub Date: 2024-07-21 DOI: 10.1080/10872981.2024.2379109
Travis Lanz-Brian Pereira, Emily Ang, Aayisha, Kuhanesan N C Naidu, Yiong Huak Chan, Shefaly Shorey

To develop and assess the preliminary effectiveness of Ontological Coaching Intervention for nursing undergraduates. Design: A pilot randomized controlled trial with a two-group pre-test and post-test followed by process-evaluation qualitative interviews. An Ontological Coaching Intervention was developed through an integration of prior literature and the collective the research team's experience, consisting of 4-6 sessions over 6-months, each lasting 30-60 minutes. Sessions encompassed exploring ontological coaching concepts, empowering nursing undergraduates to choose topics, and tailoring sessions to individual needs. Sixty undergraduates were recruited; ten were excluded for not completing the baseline questionnaires. Twenty-one nursing undergraduates were randomly assigned to the intervention group and twenty-nine undergraduates to the control group (standard academic support only). Primary (psychological well-being) and secondary (social support quantity and satisfaction, goal-setting, resilience) outcomes were measured at baseline, 3-months, and 6-months. Semi-structured interviews captured post-intervention experiences. Between-group analyses revealed a significant difference in goal-setting scores at 3-months (U = 325.5, p = 0.013), favoring the intervention group (median = 70.50, IQR = 64.25, 76.75). At 6-months, a significant difference in social support satisfaction scores (U = 114.5, p = 0.028) was found between the intervention (median = 33.00, IQR = 29.50, 35.25) and control (median = 30.00, IQR = 30.00, 35.00) groups. However, no significant between-group differences were noted in other outcome measures. Significant within-group differences were found in goal-setting scores at 3- and 6-months in the intervention group and social support quantity scores at 3- and 6-months in the control group. However, no significant within-group differences were noted in other outcome measures. Three themes were identified: Enhanced Holistic Development, Keys to Successful Coaching, and Future Directions for Successful Coaching. There is urgent need to advance research on Ontological Coaching Intervention, particularly, enhancing study rigor, broadening examinations to diverse healthcare student populations and cultural contexts, and addressing identified limitations.

针对护理专业本科生开展本体论辅导干预,并评估其初步效果。设计:随机对照试验,分两组进行前测和后测,然后进行过程评估定性访谈。本体论辅导干预是通过整合先前的文献和研究团队的集体经验而开发的,包括为期 6 个月的 4-6 次课程,每次课程持续 30-60 分钟。课程包括探索本体论辅导概念、授权护理专业本科生选择主题以及根据个人需求量身定制课程。共招募了 60 名本科生,其中 10 人因未完成基线问卷而被排除在外。21 名护理专业本科生被随机分配到干预组,29 名本科生被随机分配到对照组(仅提供标准学术支持)。分别在基线、3 个月和 6 个月时对主要结果(心理健康)和次要结果(社会支持数量和满意度、目标设定、复原力)进行测量。半结构式访谈记录了干预后的体验。组间分析显示,干预组在 3 个月时的目标设定得分有显著差异(U = 325.5,P = 0.013),干预组更有利(中位数 = 70.50,IQR = 64.25,76.75)。在 6 个月时,干预组(中位数 = 33.00,IQR = 29.50,35.25)和对照组(中位数 = 30.00,IQR = 30.00,35.00)的社会支持满意度得分存在显著差异(U = 114.5,p = 0.028)。然而,在其他结果指标方面,组间差异并不明显。干预组在 3 个月和 6 个月时的目标设定得分以及对照组在 3 个月和 6 个月时的社会支持数量得分存在显著的组内差异。然而,在其他结果测量方面,组内差异并不明显。确定了三个主题:增强整体发展、成功教练的关键和成功教练的未来方向。目前急需推进本体论教练干预的研究,特别是提高研究的严谨性,将考试范围扩大到不同的医疗保健学生群体和文化背景,并解决已发现的局限性。
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引用次数: 0
Prevent and report: a qualitative inquiry of student and faculty recommendations for preventing and reporting learner mistreatment. 预防和报告:对师生关于预防和报告虐待学生行为的建议进行定性调查。
IF 3.1 2区 医学 Q1 EDUCATION & EDUCATIONAL RESEARCH Pub Date : 2024-12-31 Epub Date: 2024-11-17 DOI: 10.1080/10872981.2024.2428170
Alejandra Colón-López, Ashley Parish, Anne Zinski

Many medical schools in the United States (US) have employed policies and programming to prevent mistreatment and encourage students to report mistreatment events. Yet, there is little evidence showing a large-scale decrease in mistreatment behaviors overall, and, in many cases, mistreatment events go unreported. This study examines views from medical students and faculty for preventing mistreatment during medical training, as well as strategies for encouraging learners to report mistreatment events when they occur. We conducted in-depth interviews and focus groups with students and faculty (n = 25) and compared and contrasted perspectives. To prevent mistreatment, both students and faculty recommended institutional-level guidance and behavioral expectations during training, while faculty suggested educational programming focused on clarifying mistreatment definitions and cultivating awareness. To encourage reporting of mistreatment events, students and faculty emphasized: access to an array of reporting mechanisms, institutional processes for maintaining anonymity or confidentiality, and follow-up procedures to address reported mistreatment. Our results suggest that students' and faculty's role in medical education may shape their perceptions of strategies to prevent mistreatment. These results can inform the development and customization of interventions for preventing mistreatment and encouraging mistreatment reporting.

美国的许多医学院都制定了相关政策和计划,以防止虐待行为并鼓励学生报告虐待事件。然而,几乎没有证据显示虐待行为总体上有大规模减少,而且在许多情况下,虐待事件并没有被报告。本研究探讨了医科学生和教师对在医学培训期间预防虐待行为的看法,以及在虐待事件发生时鼓励学员报告虐待事件的策略。我们对学生和教师(25 人)进行了深入访谈和焦点小组讨论,并对各种观点进行了比较和对比。为了防止虐待事件的发生,学生和教职员工都建议在培训期间提供机构层面的指导和行为期望,而教职员工则建议开展以澄清虐待定义和培养意识为重点的教育计划。为鼓励报告虐待事件,学生和教职员工都强调了以下几点:利用一系列报告机制、保持匿名或保密的机构流程,以及处理虐待报告的后续程序。我们的研究结果表明,学生和教师在医学教育中的角色可能会影响他们对预防虐待策略的看法。这些结果可以为制定和定制预防虐待和鼓励报告虐待的干预措施提供参考。
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引用次数: 0
Radiologist preferences for faculty development initiatives to improve resident feedback in the era of competency-based medical education. 在以能力为基础的医学教育时代,放射科医生对教师发展计划的偏好,以改善住院医生的反馈。
IF 4.6 2区 医学 Q1 EDUCATION & EDUCATIONAL RESEARCH Pub Date : 2024-12-31 Epub Date: 2024-05-29 DOI: 10.1080/10872981.2024.2357412
Laura Wong, Ethan Sacoransky, Wilma Hopman, Omar Islam, Andrew D Chung, Benjamin Y M Kwan

Introduction: Since 2022, all Canadian post-graduate medical programs have transitioned to a Competence by Design (CBD) model within a Competency-Based Medical Education (CBME) framework. The CBME model emphasized more frequent, formative assessment of residents to evaluate their progress towards predefined competencies in comparison to traditional medical education models. Faculty members therefore have increased responsibility for providing assessments to residents on a more regular basis, which has associated challenges. Our study explores faculty assessment behaviours within the CBD framework and assesses their openness to opportunities aimed at improving the quality of written feedback. Specifically, we explore faculty's receptiveness to routine metric performance reports that offer comprehensive feedback on their assessment patterns.

Methods: Online surveys were distributed to all 28 radiology faculty at Queen's University. Data were collected on demographics, feedback practices, motivations for improving the teacher-learner feedback exchange, and openness to metric performance reports and quality improvement measures. Following descriptive statistics, unpaired t-tests and one-way analysis of variance were conducted to compare groups based on experience and subspecialty.

Results: The response rate was 89% (25/28 faculty). 56% of faculty were likely to complete evaluations after working with a resident. Regarding the degree to which faculty felt written feedback is important, 62% found it at least moderately important. A majority (67%) believed that performance reports could influence their evaluation approach, with volume of written feedback being the most likely to change. Faculty expressed interest in feedback-focused development opportunities (67%), favouring Grand Rounds and workshops.

Conclusion: Assessment of preceptor perceptions reveals that faculty recognize the importance of offering high-quality written feedback to learners. Faculty openness to quality improvement interventions for curricular reform relies on having sufficient time, knowledge, and skills for effective assessments. This suggests that integrating routine performance metrics into faculty assessments could serve as a catalyst for enhancing future feedback quality.

导言:自 2022 年起,加拿大所有的医学研究生项目都在能力为本医学教育(CBME)框架内过渡到了能力设计(CBD)模式。与传统的医学教育模式相比,CBME 模式强调对住院医师进行更频繁的形成性评估,以评价他们在实现预定能力方面的进展。因此,教职员工有更大的责任为住院医师提供更多定期评估,这也带来了相关的挑战。我们的研究探讨了 CBD 框架下的教师评估行为,并评估了他们对旨在提高书面反馈质量的机会的开放程度。具体来说,我们探讨了教员对常规指标绩效报告的接受程度,这些报告提供了对其评估模式的全面反馈:方法:我们向皇后大学所有 28 名放射学教师发放了在线调查问卷。收集的数据涉及人口统计学、反馈实践、改善师生反馈交流的动机,以及对指标绩效报告和质量改进措施的开放程度。在描述性统计之后,进行了非配对 t 检验和单因子方差分析,以比较基于经验和亚专业的组别:回复率为 89%(25/28 名教员)。56%的教员有可能在与住院医师合作后完成评估。关于教员认为书面反馈的重要程度,62%的教员认为至少中等重要。大多数(67%)的教员认为,绩效报告会影响他们的评估方法,而书面反馈的数量是最有可能改变的。教员们对以反馈为重点的发展机会表示出兴趣(67%),最喜欢大查房和研讨会:结论:对戒酒师看法的评估显示,教师们认识到向学员提供高质量书面反馈的重要性。教员对课程改革质量改进措施的开放程度取决于是否有足够的时间、知识和技能进行有效评估。这表明,将常规绩效指标纳入教师评估可成为提高未来反馈质量的催化剂。
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引用次数: 0
Clues for improvement of research in objective structured clinical examination. 改进客观结构化临床检查研究的线索。
IF 3.1 2区 医学 Q1 EDUCATION & EDUCATIONAL RESEARCH Pub Date : 2024-12-31 Epub Date: 2024-06-27 DOI: 10.1080/10872981.2024.2370617
Jean Philippe Foy, Laure Serresse, Maxens Decavèle, Manon Allaire, Nadia Nathan, Marie Christine Renaud, Nada Sabourdin, Yasmine Souala-Chalet, Yanis Tamzali, Jessica Taytard, Mélanie Tran, Fleur Cohen, Hugo Bottemanne, Antoine Monsel

While objective clinical structured examination (OSCE) is a worldwide recognized and effective method to assess clinical skills of undergraduate medical students, the latest Ottawa conference on the assessment of competences raised vigorous debates regarding the future and innovations of OSCE. This study aimed to provide a comprehensive view of the global research activity on OSCE over the past decades and to identify clues for its improvement. We performed a bibliometric and scientometric analysis of OSCE papers published until March 2024. We included a description of the overall scientific productivity, as well as an unsupervised analysis of the main topics and the international scientific collaborations. A total of 3,224 items were identified from the Scopus database. There was a sudden spike in publications, especially related to virtual/remote OSCE, from 2020 to 2024. We identified leading journals and countries in terms of number of publications and citations. A co-occurrence term network identified three main clusters corresponding to different topics of research in OSCE. Two connected clusters related to OSCE performance and reliability, and a third cluster on student's experience, mental health (anxiety), and perception with few connections to the two previous clusters. Finally, the United States, the United Kingdom, and Canada were identified as leading countries in terms of scientific publications and collaborations in an international scientific network involving other European countries (the Netherlands, Belgium, Italy) as well as Saudi Arabia and Australia, and revealed the lack of important collaboration with Asian countries. Various avenues for improving OSCE research have been identified: i) developing remote OSCE with comparative studies between live and remote OSCE and issuing international recommendations for sharing remote OSCE between universities and countries; ii) fostering international collaborative studies with the support of key collaborating countries; iii) investigating the relationships between student performance and anxiety.

尽管客观临床结构化考试(OSCE)是世界公认的评估本科医学生临床技能的有效方法,但最近召开的渥太华能力评估会议就 OSCE 的未来和创新展开了激烈的讨论。本研究旨在全面了解过去几十年全球有关 OSCE 的研究活动,并找出改进 OSCE 的线索。我们对截至 2024 年 3 月发表的欧安组织论文进行了文献计量和科学计量分析。其中包括对整体科学生产力的描述,以及对主要课题和国际科学合作的无监督分析。我们从 Scopus 数据库中找到了 3,224 篇论文。从 2020 年到 2024 年,出版物数量突然激增,尤其是与虚拟/远程开放式安全与合作教育有关的出版物。我们确定了在出版物数量和引用次数方面领先的期刊和国家。通过共现词网络,我们发现了三个主要群组,分别与 OSCE 的不同研究课题相对应。两个相互关联的聚类与 OSCE 的成绩和可靠性有关,第三个聚类涉及学生的体验、心理健康(焦虑)和感知,与前两个聚类的关联很少。最后,美国、英国和加拿大被确定为在科学出版物和国际科学网络合作方面处于领先地位的国家,该网络涉及其他欧洲国家(荷兰、比利时、意大利)以及沙特阿拉伯和澳大利亚,并显示与亚洲国家缺乏重要合作。已确定了改进开放式有机考试研究的各种途径:i) 发展远程开放式有机考试,对现场和远程开放式有机考试进行比较研究,并就大学和国家之间共享远程开放式有机考试提出国际建议;ii) 在主要合作国家的支持下促进国际合作研究;iii) 调查学生成绩与焦虑之间的关系。
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引用次数: 0
Voices of the accelerated: key themes when considering implementation of an accelerated medical school program. 速成者的声音:考虑实施医学院速成计划时的关键主题。
IF 3.1 2区 医学 Q1 EDUCATION & EDUCATIONAL RESEARCH Pub Date : 2024-12-31 Epub Date: 2024-08-04 DOI: 10.1080/10872981.2024.2385666
Francesco Satriale, Arianna Winchester, Michael Partin

In this rapid communication, accelerated undergraduate medical education is examined using prior literature as well as experiences of those who have completed or are in the process of completing accelerated medical curricula. The Consortium of Accelerated Medical Pathway Programs (CAMPP) hosts an annual multi-institutional conference for all its members. During the meeting in July 2023, a virtual panel was convened from multiple constituent programs (N = 4) including medical students (N = 2), resident physicians (N = 4), and faculty (N = 2). Panel participants represented current learners or graduates from accelerated pathways of varying specialties (N = 5) to share firsthand experiences about acceleration to an audience representing over 25 medical schools. Five key themes were identified for accelerated students and trainees: Reduced debt as motivating factor to accelerate, Feeling prepared for residency, Ideal accelerated students are driven, Ability to form early professional relationships, and Less time for additional clinical experiences. Discourse from the CAMPP panel can inform current and developing accelerated programs at institutions looking to create or improve accelerated learning.

在这篇快速交流文章中,我们利用先前的文献以及那些已经完成或正在完成速成医学课程者的经验,对本科速成医学教育进行了研究。加速医学路径项目联盟(CAMPP)每年为其所有成员举办一次多机构会议。在 2023 年 7 月的会议期间,召集了来自多个成员项目(N = 4)的虚拟小组,包括医学生(N = 2)、住院医生(N = 4)和教师(N = 2)。小组成员代表了不同专业的速成路径在校生或毕业生(5 人),向代表超过 25 所医学院校的观众分享速成路径的第一手经验。针对速成学生和受训人员确定了五个关键主题:减少债务是加速学习的动力因素、感觉为住院实习做好了准备、理想的加速学习学生是有动力的、有能力形成早期的专业关系,以及更少的时间获得额外的临床经验。来自 CAMPP 小组的讨论可为希望创建或改进加速学习的机构当前和发展中的加速项目提供参考。
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引用次数: 0
Medical education research study quality instrument: an objective instrument susceptible to subjectivity. 医学教育研究质量工具:容易受主观因素影响的客观工具。
IF 3.1 2区 医学 Q1 EDUCATION & EDUCATIONAL RESEARCH Pub Date : 2024-12-31 Epub Date: 2024-01-24 DOI: 10.1080/10872981.2024.2308359
Scott Jaros, Gary Beck Dallaghan

Background: The medical education research study quality instrument (MERSQI) was designed to appraise medical education research quality based on study design criteria. As with many such tools, application of the results may have unintended consequences. This study applied the MERSQI to published medical education research identified in a bibliometric analysis.

Methods: A bibliometric analysis identified highly cited articles in medical education that two authors independently evaluated using the MERSQI. After screening duplicate or non-research articles, the authors reviewed 21 articles with the quality instrument. Initially, five articles were reviewed independently and results were compared to ensure agreed upon understanding of the instrument items. The remainder of the articles were independently reviewed. Overall scores for the articles were analyzed with a paired samples t-test and individual item ratings were analyzed for inter-rater reliability.

Results: There was a significant difference in mean MERSQI score between reviewers. Inter-rater reliability for MERSQI items labeled response rate, validity and outcomes were considered unacceptable.

Conclusions: Based on these results there is evidence that MERSQI items can be significantly influenced by interpretation, which lead to a difference in scoring. The MERSQI is a useful guide for identifying research methodologies. However, it should not be used to make judgments on the overall quality of medical education research methodology in its current format. The authors make specific recommendations for how the instrument could be revised for greater clarity and accuracy.

背景:医学教育研究质量工具(MERSQI医学教育研究质量工具(MERSQI)旨在根据研究设计标准评估医学教育研究质量。与许多此类工具一样,结果的应用可能会产生意想不到的后果。本研究将 MERSQI 应用于文献计量分析中发现的已发表的医学教育研究:方法:通过文献计量学分析,确定了两位作者使用 MERSQI 独立评估的医学教育方面的高引用率文章。在筛选出重复或非研究性文章后,作者使用质量工具对 21 篇文章进行了审查。最初,有五篇文章进行了独立评审,并对评审结果进行了比较,以确保对工具项目的理解达成一致。其余文章均为独立审核。通过配对样本 t 检验分析了文章的总体得分,并分析了单个项目评分的评分者间可靠性:结果:不同审稿人的 MERSQI 平均得分存在明显差异。MERSQI项目中标注的回应率、有效性和结果的评阅者间可靠性被认为是不可接受的:根据这些结果,有证据表明 MERSQI 项目会受到解释的显著影响,从而导致评分差异。MERSQI 是确定研究方法的有用指南。然而,在目前的形式下,它不应被用来对医学教育研究方法的整体质量做出判断。作者就如何修订该工具以提高其清晰度和准确性提出了具体建议。
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引用次数: 0
Is medical training solely to blame? Generational influences on the mental health of our medical trainees. 医学培训是唯一的罪魁祸首吗?一代人对我们医学学员心理健康的影响。
IF 3.1 2区 医学 Q1 EDUCATION & EDUCATIONAL RESEARCH Pub Date : 2024-12-31 Epub Date: 2024-03-15 DOI: 10.1080/10872981.2024.2329404
Shireen Suliman, Margaret Allen, Tawanda Chivese, Angelique E de Rijk, Richard Koopmans, Karen D Könings

Introduction: The negative impact of medical training on trainee mental health continues to be a concern. Situated within a sociocultural milieu, Generation Z and Generation Y, defined by their highly involved parents and the widespread use of technology, currently dominate undergraduate and graduate medical education respectively. It is necessary to explore medical trainees' generational characteristics and job-related factors related to stress, burnout, depression, and resilience. This might provide different perspectives and potential solutions to medical trainees' mental health.

Methods: A cross-sectional study was conducted among medical trainees (students and residents) from two institutions in Qatar. A self-administered online survey included measures for trainees' social media overuse, their parent's parenting style, the educational support by the clinical teacher, job (demands, control, and support), and work-life balance and their relation with their stress, burnout, depression, and resilience. Relationships were tested with multiple linear regression analyses.

Results: Of the 326 medical trainees who responded, 142 (44%) trainees - 93 students and 49 residents - completed all items and were included in the analysis. Social media overuse and inability to maintain a work-life balance were associated with higher levels of stress, depression, and student burnout. Higher levels of job support were associated with lower levels of stress, depression, and resident burnout, and a higher level of resilience. Job control was associated with lower burnout levels. Parenting style was unrelated to trainees' mental health.

Discussion: The two generations 'Y' and 'Z' dominating current medical training showed more stress-related complaints when there is evidence of social media overuse and failure to maintain a work-life balance, while job support counterbalances this, whereas parenting style showed no effect. Measures to enhance medical trainees' mental health may include education about the wise use of social media, encouraging spending more quality social time, and enhancing job support and job control.

简介医学培训对受训者心理健康的负面影响仍然是一个令人担忧的问题。在社会文化环境中,以父母的高度参与和技术的广泛应用为特征的 Z 世代和 Y 世代目前分别主导着本科和研究生医学教育。有必要探讨医学学员的代际特征以及与压力、职业倦怠、抑郁和抗压能力相关的工作因素。这可能会为医学学员的心理健康提供不同的视角和潜在的解决方案:对卡塔尔两所院校的医学见习生(学生和住院医师)进行了一项横断面研究。自我管理的在线调查包括受训者过度使用社交媒体、父母的养育方式、临床教师的教育支持、工作(需求、控制和支持)、工作与生活的平衡以及它们与受训者的压力、倦怠、抑郁和复原力之间的关系。这些关系通过多元线性回归分析进行了检验:在回复的 326 名医学受训者中,有 142 名(44%)受训者(93 名学生和 49 名住院医师)完成了所有项目并被纳入分析。过度使用社交媒体和无法保持工作与生活的平衡与压力、抑郁和学生倦怠程度较高有关。较高水平的工作支持与较低水平的压力、抑郁和住院医师倦怠感以及较高水平的复原力相关。工作控制与较低的职业倦怠水平相关。教养方式与学员的心理健康无关:讨论:当前医学培训中占主导地位的 "Y "和 "Z "两代人在有证据表明过度使用社交媒体和未能保持工作与生活平衡时,会表现出更多与压力相关的抱怨,而工作支持可以抵消这种抱怨,而养育方式则没有影响。提高医学学员心理健康水平的措施可包括开展明智使用社交媒体的教育、鼓励花费更多高质量的社交时间以及加强工作支持和工作控制。
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引用次数: 0
Correction. 更正。
IF 4.6 2区 医学 Q1 EDUCATION & EDUCATIONAL RESEARCH Pub Date : 2024-12-31 Epub Date: 2024-03-29 DOI: 10.1080/10872981.2024.2334472
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引用次数: 0
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Medical Education Online
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