Best evidence medical education

最佳证据医学教育
  • 文章类型: Journal Article
    可以从不同的角度观察医学教育课程的认证。监管/认证机构认为确保一定水平的质量至关重要。其他利益相关者可能会将认证过程视为负面体验,耗尽资源,和努力。虽然认证可以改善该计划的治理和管理,它对学生的直接或间接影响必须进一步调查。本研究探讨了阿瓦隆大学医学院认证现场访问的发生与学生满意度之间的关系。
    使用来自AUSOM两个认证周期的回顾性满意度数据进行了比较研究。我们使用加勒比医学和其他卫生专业教育认证局(CAAM-HP)学生调查进行数据收集,并使用了2017年、2019年和2022年的数据。有效率为70%(n=71),72%(n=47),基础科学学生占60%(n=56),80%(n=111),82%(n=115),2017年、2019年和2022年临床学生分别为70%(n=76)。针对基础科学学生的调查包括37个问题/项目,临床学生的调查包括39个问题/项目。问卷的答复采用李克特五点量表。使用非配对Wilcoxon-秩和检验评估回顾性数据。
    基础科学专业学生调查的评分从2017年到2019年(第一个认证周期)仅增加了11个项目/问题,从2019年增加到2022年所有项目/问题。从2017年到2019年(第一个认证周期),所有项目/问题的临床科学学生调查的评分均具有统计学意义的p值。从2019年到2022年,他们增加了28个问题/项目,两个项目(职业咨询的可用性和充分性)显示出统计学上显著的p值。
    认证前准备和自我评估过程,同时纠正程序的缺陷,是与认证相关的质量改进过程的重要触发因素。
    UNASSIGNED: Accreditation of medical education programs can be observed from different perspectives. Regulatory/accreditation agencies consider it vital to assure a certain level of quality. Other stakeholders may perceive the accreditation process as a negative experience, draining resources, and efforts. Although accreditation may improve the program\'s governance and administration, its direct or indirect impact on students must be further investigated. This study explores the relationship between the occurrence of accreditation site visits and student satisfaction rates at Avalon University School of Medicine.
    UNASSIGNED: A comparison study was conducted with retrospective satisfaction data from two accreditation cycles at AUSOM. We used the Caribbean Accreditation Authority for Education in Medicine and Other Health Professions (CAAM-HP) student surveys for data collection, and data from 2017, 2019, and 2022 were used. The response rate was 70% (n = 71), 72% (n = 47), and 60% (n = 56) for basic science students and 80% (n = 111), 82% (n = 115), and 70% (n = 76) for clinical students in 2017, 2019, and 2022, respectively. The survey for basic sciences students included 37 questions/items, and the survey for clinical students included 39 questions/items. The responses for the questionnaire were on the five-point Likert scale. The retrospective data were evaluated using the unpaired Wilcoxon-rank sum test.
    UNASSIGNED: The ratings for the basic science students\' survey increased from 2017 to 2019 (first accreditation cycle) only for 11 items/questions and they were increased from 2019 to 2022 for all items/questions. The ratings for clinical science students\' surveys increased from 2017 to 2019 (the first accreditation cycle) for all items/questions with a statistically significant p-value. They increased for 28 questions/items from 2019 to 2022, and two items (availability and adequacy of career counseling) showed statistically significant p-values.
    UNASSIGNED: The pre-accreditation preparation and the self-evaluation process while correcting the program\'s deficiencies are essential triggers for the quality improvement process associated with accreditation.
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  • 文章类型: Journal Article
    强制性培训被认为是建立和保持高标准专业实践的基础。然而,几乎没有证据,培训要么实现所需的学习成果,或改善患者的预后。Whist组织可能会达到强制性培训的合规目标,目的是遗漏要点吗?本系统综述旨在综合和评估法定和强制性培训的效力。
    PubMed,EMBASE,CNAHL,于2023年5月23日搜索了ERIC和CochraneCentral登记册。所有研究设计都包括在内,报告的培训必须在医疗保健环境中指定组织任务。使用改进的Kirkpatrick(KP)评级系统对数据进行编码。使用改良的医学教育研究质量工具进行批判性评估,关键评估技能计划定性研究清单和混合方法评估工具。
    纳入了25项研究,对9132名参与者和1348例患者进行了审计。研究描述了根据柯克帕特里克的结果1-4b级对强制性训练的评估,大多数(68%)在英国和急性环境中进行。训练时间从5分钟到3天不等。关于强制性培训的理由缺乏共识,核心议题,持续时间,和最佳的进修训练期。目前,强制性培训并不能始终如一地转化为安全实践的广泛改进或患者预后的改善.
    由于国际上对强制培训的必要性缺乏共识,大多数论文来自拥有中央管理的国家医疗保健系统的国家。强制实施培训方案的理由仍不明确。本综述中包含的研究不支持强制性培训提供安全实践结果的假设。这项审查的结果为进一步的研究提供了基础,以协助设计,促进,以及强制性培训的影响。
    UNASSIGNED: Mandatory training is considered fundamental to establishing and maintaining high standards of professional practice. There is little evidence however, of the training either achieving its required learning outcomes, or delivering improvement in outcomes for patients. Whist organisations may be hitting their compliance target for mandatory training, is the purpose missing the point? This systematic review aims to synthesize and evaluate the efficacy of statutory and mandatory training.
    UNASSIGNED: PubMed, EMBASE, CNAHL, ERIC and Cochrane Central registers were searched on 23rd May 2023. All research designs were included and reported training had to specify an organisational mandate within a healthcare setting. Data was coded using a modified Kirkpatrick (KP) rating system. Critical appraisal was undertaken using the Modified Medical Education Research Study Quality Instrument, Critical Appraisal Skills Programme Qualitative Studies checklist and Mixed Methods Assessment Tool.
    UNASSIGNED: Twenty-five studies were included, featuring 9132 participants and 1348 patient cases audited. Studies described evaluation of mandatory training according to Kirkpatrick\'s outcomes levels 1-4b, with the majority (68%) undertaken in the UK and within acute settings. Training duration varied from 5 min to 3 days. There is a lack of consensus regarding mandatory training rationale, core topics, duration, and optimum refresher training period. Currently, mandatory training does not consistently translate to widescale improvements in safe practice or improved patient outcomes.
    UNASSIGNED: Due to the lack of international consensus regarding the need for mandated training, most papers originated from countries with centrally administered national health care systems. The rationale for mandating training programmes remains undefined. The assumption that mandatory training is delivering safe practice outcomes is not supported by studies included in this review. The findings of this review offer a basis for further research to be undertaken to assist with the design, facilitation, and impact of mandatory training.
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  • 文章类型: Journal Article
    背景:基于案例的临床推理(CBCR)是提出的改善临床推理的方法。这份简短的报告旨在通过在线课程评估CBCR的有效性,以改善临床推理。
    方法:本研究是对ShahidBeheshti医科大学医学生进行CBCR评估的一项前后准实验研究的简要报告。
    方法:指导医学生每周进行10次2小时CBCR演示。每次会议都以疾病脚本开始,然后,根据CBCR方法,教师分五个步骤向学生提出了五个临床问题。使用四种标准临床问题在在线课程之前和之后2周评估学生的临床推理能力。
    方法:使用Wilcoxon符号秩检验来评估测试前和测试后考试成绩之间的差异。
    结果:这份简短报告显示,有21名医学生参加了CBCR在线课程的所有十个课程,并在测试前和测试后的考试中进行了评估。与测试前检查相比,测试后检查的临床推理总分显着提高(P=0.001)。就特定类型的临床问题而言,临床推理问题(CRP)和关键特征(KF)检查的平均测前评分高于测前评分(分别为P=0.001和P=0.005).
    结论:应用CBCR方法提高了医学生在课程中的临床推理总分。需要进一步的研究来评估这种改善是否会在工作场所环境中持续存在。
    BACKGROUND: Case-based clinical reasoning (CBCR) is the proposed method to improve clinical reasoning. This brief report aimed to evaluate CBCR effectiveness to improve clinical reasoning via an online course.
    METHODS: This study is a brief report of a before-after quasi-experimental study to evaluate CBCR in medical students of Shahid Beheshti University of Medical Sciences.
    METHODS: Ten online weekly 2-hour sessions of CBCR presentations were instructed to medical students. Each session started with an illness script, and then, the instructor posed the students\' five clinical questions in five steps according to the CBCR approach. The clinical reasoning ability of students was evaluated before and 2 weeks after the online courses using four types of standard clinical questions.
    METHODS: A Wilcoxon signed-rank test was used to assess the difference between pretest and posttest examination scores.
    RESULTS: This brief report revealed that twenty-one medical students participated in all ten sessions of the CBCR online course and were evaluated in pretest and posttest examinations. A significant improvement in the clinical reasoning total scores in the posttest examination compared with the pretest examination was observed (P = 0.001). In terms of specific types of clinical questions, the mean posttest scores for clinical reasoning problem (CRP) and key feature (KF) examinations were higher than the pretest scores (P = 0.001 and P = 0.005, respectively).
    CONCLUSIONS: Applying the CBCR approach improved the total clinical reasoning score of medical students during the course. Further studies are needed to evaluate whether this improvement would persist in workplace settings or not.
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  • 文章类型: Journal Article
    数字技术的变化,不断增加的数据量,方法的进步有可能释放通过卫生专业人员教育产生的大数据的价值。再加上这种潜力是合理的担忧,即如何以限制自治的方式使用或滥用数据。股本,或伤害利益相关者。这一共识声明旨在通过预测参与大数据的道德要求以及潜在的风险和挑战来解决这些问题。认识到大数据奖学金的广泛和不断发展的范围,我们专注于框架和从事研究的基础问题。我们将我们的建议放在大数据的背景下,这些大数据是通过在卫生专业人员的教育和培训的连续过程中以及在这些阶段中共享数据而创建的。最终,该声明的目标是支持大数据研究的信任和质量文化,以实现其对卫生专业教育(HPE)和社会健康的承诺。基于专家共识和文献综述,我们在(1)通过研究构建奖学金和研究中报告了19项建议,(2)考虑到独特的道德规范,(3)参与利益相关者的数据共享协作治理,(4)数据共享流程最佳实践,(5)知识翻译的重要性,(6)通过多学科合作提高奖学金的质量。根据2022年渥太华会议与会者的反馈和随后的公众参与,对建议进行了修改和完善。采纳这些建议可以帮助HPE学者在道德上分享数据,并参与高影响力的大数据奖学金。这反过来可以帮助该领域实现最终目标:高质量的教育,导致高质量的医疗保健。
    Changes in digital technology, increasing volume of data collection, and advances in methods have the potential to unleash the value of big data generated through the education of health professionals. Coupled with this potential are legitimate concerns about how data can be used or misused in ways that limit autonomy, equity, or harm stakeholders. This consensus statement is intended to address these issues by foregrounding the ethical imperatives for engaging with big data as well as the potential risks and challenges. Recognizing the wide and ever evolving scope of big data scholarship, we focus on foundational issues for framing and engaging in research. We ground our recommendations in the context of big data created through data sharing across and within the stages of the continuum of the education and training of health professionals. Ultimately, the goal of this statement is to support a culture of trust and quality for big data research to deliver on its promises for health professions education (HPE) and the health of society. Based on expert consensus and review of the literature, we report 19 recommendations in (1) framing scholarship and research through research, (2) considering unique ethical practices, (3) governance of data sharing collaborations that engage stakeholders, (4) data sharing processes best practices, (5) the importance of knowledge translation, and (6) advancing the quality of scholarship through multidisciplinary collaboration. The recommendations were modified and refined based on feedback from the 2022 Ottawa Conference attendees and subsequent public engagement. Adoption of these recommendations can help HPE scholars share data ethically and engage in high impact big data scholarship, which in turn can help the field meet the ultimate goal: high-quality education that leads to high-quality healthcare.
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  • 文章类型: Systematic Review
    本文已迁移。这篇文章被标记为推荐。半个多世纪前,麦克马斯特大学在医学教育中引入了基于问题的学习(PBL)。从那以后,数百篇评论和研究报告确定了许多影响PBL部门成功的关键问题。尽管如此,我们仍在争论PBL计划的有效性和成功。全球超过一半的医学院在其医学教育计划中引入了各种版本的PBL教学法,实现了对结果的各种修改。在本文中,我已经从许多学者和通过他们的出版物进行了审查;我已经确定了成功的PBL计划的八个重要的基本根源。任何PBL计划的成功都必须从标准化的角度进行整体评估,可靠性和有效性在这些基本根之间同步工作,而不是单个PBL单元。标准化的重要性必须考虑许多审查和研究报告中确定的所有关键问题。这些问题是许多因素之一,当纳入PBL计划的基本框架时,将以统一的结果规范所有PBL单位。教育目标原则将通过满足机构使命和学生的职业成功目标来指导PBL计划的可靠性。“作为学习的评估”应包含“整体和不同的方法”和纵向“进度测试”。这些是在成功的PBL计划中实现可靠和有效的结果评估的主要评估方法。
    This article was migrated. The article was marked as recommended. McMaster University has introduced the Problem-Based Learning (PBL) in medical education over half a century ago. Since then, hundreds of reviews and study reports have identified many critical issues affecting the success of the PBL unit. Nonetheless, we are still debating the efficacy and success of the PBL program. Over half of all medical schools globally have introduced various versions of PBL pedagogy in their medical education program achieving assorted modifications of outcomes. In this paper, I have reviewed from many scholars and through their publications; I have identified eight important Fundamental Roots for a successful PBL program. The success of any PBL program must be evaluated as a whole from the perspective of Standardization, Reliability and Validity working synchronously between these fundamental roots and not the individual PBL unit. The importance of Standardization must consider all the critical issues identified in many reviews and study reports. These issues are one of many factors when incorporated into the fundamental framework of a PBL program will regulate all PBL units in a unified outcome. The educational objective principles will guide the reliability of a PBL program by meeting the institutional mission and students\' career success goals. The \"Assessment as Learning\" should incorporate the \"Holistic and Divergent Approach\" and the longitudinal \"Progress Testing\". These are the principle methods of evaluation to achieve a reliable and valid outcome assessment in a successful PBL program.
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  • 文章类型: Journal Article
    背景:对于有兴趣从事医学职业的年轻学生来说,指导是重要的组成部分。在医疗服务不足的地区,比如农村地区,由于缺乏医疗保健专业人员的机会,导师可能很少。该项目的目的是了解执业医学生的指导。方法:作者进行了结构化,对10名当前医学生进行一对一的访谈,了解他们对导师的看法和经验。采访被转录,编码,并分析了主题和次主题。结果:我们的发现围绕三个时期的指导:1)获得导师之前;2)在指导期间;和3)在指导之后。在我们的发现中,我们描述了关键特征,如专业发展,导师的个人素质,专业和个人指导是指导学员从本科阶段开始并持续到目前教育水平的重要组成部分。结论:受访者对他们所接受的指导的经验和观点通常是积极的,虽然很明显,导师与导师的关系有一些方面可以改善。在获得的结果的基础上,设定期望,提供导师培训,和配对导师/受训者来自相似的背景是什么,我们建议创建一个受训者和导师之间的充实和有意义的关系。
    Background: Mentorship is an important component for young students interested in pursuing a career in medicine. In medically underserved areas, such as rural areas, mentorship can be sparse due to the lack of access to healthcare professionals. The purpose of this project was to gain an understanding of the mentorship received by practicing medical students. Methods: The authors conducted structured, one-on-one interviews with 10 current medical students about their perceptions and experiences with mentorship. Interviews were transcribed, coded, and analyzed for themes and subthemes. Results: Our findings revolve around three time periods of mentorship: 1) Before Obtaining a Mentor; 2) During the Mentorship; and 3) After the Mentorship.  In our findings we describe key characteristics such as professional development, personal qualities of the mentor, and professional and personal guidance as important components in guiding the mentee starting from the undergraduate level and continuing to their current level of education.  Conclusion: Interviewees\' experiences with and perspectives on the mentorship they received were generally positive, though it was evident there are some aspects of the mentee-mentor relationship that can be improved. Building on the results obtained, setting expectations, providing mentor training, and pairing mentors/mentees from similar backgrounds are what we propose to create fulfilling and meaningful relationships between a mentee and mentor.
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  • 文章类型: Journal Article
    选择是医学教育和培训的首要评估。医学院必须从学术上成功的申请者中进行选择,并确保他们选择未来临床医生的方式是稳健的,防御,对所有申请和成本效益的人都公平。然而,没有全面和有证据的指南来帮助那些负责建立或振兴当地选拔程序的人。为了解决这个差距,我们的指南借鉴了最新的研究,国际案例研究和对常见困境的考虑,为设计提供实践指导,实施和评估有效的医学院选择系统。我们从教学设计领域中借鉴了一个模型,以构建这样做所涉及的许多不同活动:ADDIE模型。ADDIE提供了一个系统的分析框架(关于选择过程要实现的结果,以及实现这些目标的障碍和促进者),设计(需要哪些工具和内容来实现选择的目标),发展(需要和可用的材料和资源),实施(计划[包括试点],做研究和调整)和评估(质量保证贯穿始终,但最后一步涉及对整个过程及其结果的广泛评估)。突出显示,合理和公平的选择进入医学院是必不可少的。本指南系统地涵盖了实现这一目标所需的过程,从需求分析到设计,开发和实施,评估选择过程的成功。
    Selection is the first assessment of medical education and training. Medical schools must select from a pool of academically successful applicants and ensure that the way in which they choose future clinicians is robust, defensible, fair to all who apply and cost-effective. However, there is no comprehensive and evidence-informed guide to help those tasked with setting up or rejuvenating their local selection process. To address this gap, our guide draws on the latest research, international case studies and consideration of common dilemmas to provide practical guidance for designing, implementing and evaluating an effective medical school selection system. We draw on a model from the field of instructional design to frame the many different activities involved in doing so: the ADDIE model. ADDIE provides a systematic framework of Analysis (of the outcomes to be achieved by the selection process, and the barriers and facilitators to achieving these), Design (what tools and content are needed so the goals of selection are achieved), Development (what materials and resources are needed and available), Implementation (plan [including piloting], do study and adjust) and Evaluation (quality assurance is embedded throughout but the last step involves extensive evaluation of the entire process and its outcomes).HIGHLIGHTSRobust, defensible and fair selection into medical school is essential. This guide systematically covers the processes required to achieve this, from needs analysis through design, development and implementation, to evaluation of the success of a selection process.
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  • 文章类型: Systematic Review
    The COVID-19 pandemic caused graduate medical education (GME) programs to pivot to virtual interviews (VIs) for recruitment and selection. This systematic review synthesizes the rapidly expanding evidence base on VIs, providing insights into preferred formats, strengths, and weaknesses.
    PubMed/MEDLINE, Scopus, ERIC, PsycINFO, MedEdPublish, and Google Scholar were searched from 1 January 2012 to 21 February 2022. Two authors independently screened titles, abstracts, full texts, performed data extraction, and assessed risk of bias using the Medical Education Research Quality Instrument. Findings were reported according to Best Evidence in Medical Education guidance.
    One hundred ten studies were included. The majority (97%) were from North America. Fourteen were conducted before COVID-19 and 96 during the pandemic. Studies involved both medical students applying to residencies (61%) and residents applying to fellowships (39%). Surgical specialties were more represented than other specialties. Applicants preferred VI days that lasted 4-6 h, with three to five individual interviews (15-20 min each), with virtual tours and opportunities to connect with current faculty and trainees. Satisfaction with VIs was high, though both applicants and programs found VIs inferior to in-person interviews for assessing \'fit.\' Confidence in ranking applicants and programs was decreased. Stakeholders universally noted significant cost and time savings with VIs, as well as equity gains and reduced carbon footprint due to eliminating travel.
    The use of VIs for GME recruitment and selection has accelerated rapidly. The findings of this review offer early insights that can guide future practice, policy, and research.
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  • 文章类型: Systematic Review
    UNASSIGNED:尽管气候危机,卫生专业教育仍未能使学生做好实践可持续医疗保健的准备,但迫切需要提供教育机会。本系统综述旨在综合适用于卫生专业课程中可持续医疗保健教育的教育方法,并批判性地评估其影响。
    UNASSIGNED:搜索的数据库:APAPsycInfo,BEI,CINAHL,Embase,ERIC,Medline,Scopus,科克伦图书馆,WebofScience,BASE,DART-Europe,ETHOS和ProQuest还利用了二次搜索技术,与2021年10月进行的搜索。符合条件的研究包括医疗保健专业学生/学员,接触到可持续的医疗保健教育,并通过对知识的影响进行评估,态度或技能。包括任何出版状态的实证研究。非英语语言学习被排除在外。合格的研究使用JBI(2022)关键评估清单进行质量评估,并以叙述方式进行综合。
    未经评估:纳入了23项研究,由3343名参与者和7名卫生专业人员组成。研究主要采用准实验设计,并证明了可变质量。最常见的教育方法是研讨会和临床技能课程,尽管观察到了八种不同的方法。对知识产生了积极影响,态度和技能。
    未经评估:多种方法已被应用于可持续医疗教育,尽管没有明显的优势。相反,概述了许多有效的方法,根据学习成果予以采纳。
    Health professions education is failing to prepare students to practice sustainable healthcare despite the climate crisis an urgent provision of educational opportunities is required. This systematic review aimed to synthesise educational approaches applied to sustainable healthcare education within health professions curricula and critically evaluate their impact.
    Databases searched: APA PsycInfo, BEI, CINAHL, Embase, ERIC, Medline, Scopus, Cochrane Library, Web of Science, BASE, DART-Europe, EThOS and ProQuest. Secondary searching techniques were also utilised, with searching conducted October 2021. Eligible studies included healthcare professional students/trainees, exposed to sustainable healthcare education, and evaluated through impact on knowledge, attitudes or skills. Empirical studies of any publication status were included. Non-English language studies were excluded. Eligible studies were quality assessed using JBI (2022) critical appraisal checklists and synthesised narratively.
    Twenty-three studies were included, comprising 3343 participants and seven health professions. Studies primarily adopted a quasi-experimental design and demonstrated variable quality. Most common educational approaches were workshops and clinical skills sessions, though eight different approaches were observed. Positive impacts were achieved for knowledge, attitudes and skills.
    Diverse approaches have been applied to sustainable healthcare education, though no superior approach is evident. Instead, many effective approaches are outlined, to be adopted in alignment with the learning outcomes.
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  • 文章类型: Journal Article
    先前的评论调查了应对COVID-19的医学教育发展,确定了远程学习的重点是未来调查的关键领域。这篇评论综合了在线学习的发展,旨在取代以前面向研究生的“课堂”活动。
    四个在线数据库(CINAHL,Embase,心理信息,和PubMed)和MedEdPublish在2020年12月21日之前进行了搜索。两位作者独立筛选了标题,摘要和全文,执行数据提取,并评估偏见的风险。PICRAT技术集成框架用于检查教师如何集成和学习者如何参与技术。报告了描述性综合和结果。专题分析探讨了局限性和经验教训。
    包括51种出版物。有15个合作,包括国际合作伙伴关系和国家项目主管网络。39项发展描述了在线现有教育产品的枢纽,12项发展描述了新的发展。大多数干预措施包括同步活动(nFif5)。虚拟参与是通过聊天促进的,虚拟白板,轮询,和突围。教师对技术的运用在很大程度上取代了传统的实践。学生参与很大程度上是互动的。基础理论并不常见。质量评估显示在研究报告和方法中存在中度到高度的偏倚风险。45个事态发展评估了反应;25个态度,知识或技能;和两种行为。结果明显呈阳性。18种出版物报道了社交媒体或其他结果,包括触角,订婚,和参与。限制包括失去社交互动,缺乏实践经验,技术挑战和研究设计问题。经验教训突出了在线学习的灵活性,以及优化在线环境的实用建议。
    这篇综述为试图在大流行后的世界中优化学习的教育工作者提供了指导。未来的发展将受益于利用合作,考虑到技术集成框架,用理论支撑发展,探索额外的结果,并以支持复制的方式设计和报告开发。
    Prior reviews investigated medical education developments in response to COVID-19, identifying the pivot to remote learning as a key area for future investigation. This review synthesized online learning developments aimed at replacing previously face-to-face \'classroom\' activities for postgraduate learners.
    Four online databases (CINAHL, Embase, PsychINFO, and PubMed) and MedEdPublish were searched through 21 December 2020. Two authors independently screened titles, abstracts and full texts, performed data extraction, and assessed risk of bias. The PICRAT technology integration framework was applied to examine how teachers integrated and learners engaged with technology. A descriptive synthesis and outcomes were reported. A thematic analysis explored limitations and lessons learned.
    Fifty-one publications were included. Fifteen collaborations were featured, including international partnerships and national networks of program directors. Thirty-nine developments described pivots of existing educational offerings online and twelve described new developments. Most interventions included synchronous activities (n Fif5). Virtual engagement was promoted through chat, virtual whiteboards, polling, and breakouts. Teacher\'s use of technology largely replaced traditional practice. Student engagement was largely interactive. Underpinning theories were uncommon. Quality assessments revealed moderate to high risk of bias in study reporting and methodology. Forty-five developments assessed reaction; twenty-five attitudes, knowledge or skills; and two behavior. Outcomes were markedly positive. Eighteen publications reported social media or other outcomes, including reach, engagement, and participation. Limitations included loss of social interactions, lack of hands-on experiences, challenges with technology and issues with study design. Lessons learned highlighted the flexibility of online learning, as well as practical advice to optimize the online environment.
    This review offers guidance to educators attempting to optimize learning in a post-pandemic world. Future developments would benefit from leveraging collaborations, considering technology integration frameworks, underpinning developments with theory, exploring additional outcomes, and designing and reporting developments in a manner that supports replication.
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