Health professions education research

卫生专业教育研究
  • 文章类型: Journal Article
    社交媒体可能会促进知识共享,但用户如何使用新知识以及它如何影响实践仍有待了解。这项探索性研究使用社会建构主义的视角来了解健康专业教育者和研究人员如何将社交媒体的知识整合到各自的实践中。我们使用#MedEd标签对健康专业教育者和研究人员进行了有目的地抽样,#HPE,和#HealthProfessionsEducation在Twitter/X.我们获得了知情同意书,通过视频会议进行采访,并从事多个周期的演绎和归纳编码和分析。参与者被确定为教育工作者和研究人员(n=12),作为研究人员(n=1),或作为加拿大的教育工作者(n=1)(n=8),美国(n=3)瑞士,爱尔兰,和中国(分别为n=1)。八名参与者积极使用社交媒体(即,创建/发布原创内容);六名参与者表示被动使用(即阅读/转发内容)。他们讨论了制作可消费消息和社交媒体身份以简化共享内容的重要性。社交媒体可访问,非等级性质可以促进知识共享,而错误信息和技术要求的潜在传播(例如,互联网接入,特定国家对平台的限制)构成了吸收的障碍。参与者描述了使用从社交媒体获得的知识作为教学工具,新的研究方法,新的理论框架,和低风险的临床干预措施。以前的研究已经证明了社交媒体是如何在经验上被用于传播或传播的,而不是作为一个积极的证据吸收过程。使用知识翻译框架,像知识到行动或理论领域框架,建议在卫生专业教育中进行基于社交媒体的知识共享活动。
    Social media may promote knowledge sharing but what users do with the new knowledge and how it may influence practice remains to be known. This exploratory study used a social constructivist lens to understand how health professions educators and researchers integrate knowledge from social media into their respective practices. We purposively sampled health professions educators and researchers using the hashtags #MedEd, #HPE, and #HealthProfessionsEducation on Twitter/X. We obtained informed consent, conducted interviews via videoconference, and engaged in multiple cycles of deductive and inductive coding and analysis. Participants identified as educators and researchers (n = 12), as researchers (n = 1), or as educators (n = 1) from Canada (n = 8), the United States (n = 3), and Switzerland, Ireland, and China (n = 1, respectively). Eight participants actively used social media (i.e., creating/posting original content); six participants indicated passive use (i.e., reading/retweeting content). They discussed the importance of crafting a consumable message and social media identity to streamline the content shared. Social media\'s accessible, non-hierarchical nature may facilitate knowledge-sharing, whereas the potential spread of misinformation and technological requirements (e.g., internet access, country-specific restrictions on platforms) present barriers to uptake. Participants described using knowledge gained from social media as teaching tools, new research methodologies, new theoretical frameworks, and low-risk clinical interventions. Previous research has demonstrated how social media has empirically been used for diffusion or dissemination rather than as an active process of evidence uptake. Using knowledge translation frameworks, like the Knowledge to Action or Theoretical Domains frameworks, to inform social media-based knowledge sharing activities in health professions education is recommended.
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  • 文章类型: Journal Article
    有意义的服务用户参与卫生专业教育需要将受健康挑战影响的“非专业”人员持有的知识整合到专业理论和实践中。涉及服务用户重新定义了谁的知识“计数”,并意味着权力的转移。这种转变在精神卫生领域尤其重要,卫生专业人员和服务用户之间的权力不平衡被放大。然而,关于服务用户参与心理健康专业教育的文献综述很少探讨权力如何体现在这项工作中。与此同时,批判和疯狂的研究学者们强调,如果没有权力的真正转移,包容性做法可能导致有害后果。我们进行了严格的审查,以探讨如何在描述服务用户参与心理健康专业教育的文献中解决权力问题。我们的团队使用共同制作的方法和批判性理论来确定权力在这项工作中如何隐式和显式地运作,以揭示服务用户参与可能无意中长期存在的不平等和权力结构。我们证明,权力渗透到服务用户参与心理健康专业教育中,但很少可见。我们还认为,通过错过定位权力的机会,这些文献促成了一系列认识上的不公正现象,揭示了心理健康专业教育中合法知识的轮廓及其新自由主义基础。最终,我们呼吁一个关键的转变,以预见权力关系,以释放服务用户更广泛地参与精神卫生专业教育和卫生专业教育的社会正义导向的变革潜力。
    Meaningful service user involvement in health professions education requires integrating knowledge held by \"lay\" people affected by health challenges into professional theories and practices. Involving service users redefines whose knowledge \"counts\" and implies a shift in power. Such a shift is especially significant in the mental health field, where power imbalances between health professionals and service users are magnified. However, reviews of the literature on service user involvement in mental health professional education do little to explore how power manifests in this work. Meanwhile critical and Mad studies scholars have highlighted that without real shifts in power, inclusion practices can lead to harmful consequences. We conducted a critical review to explore how power is addressed in the literature that describes service user involvement in mental health professions education. Our team used a co-produced approach and critical theories to identify how power implicitly and explicitly operates in this work to unearth the inequities and power structures that service user involvement may inadvertently perpetuate. We demonstrate that power permeates service user involvement in mental health professional education but is rarely made visible. We also argue that by missing the opportunity to locate power, the literature contributes to a series of epistemic injustices that reveal the contours of legitimate knowledge in mental health professions education and its neoliberal underpinnings. Ultimately, we call for a critical turn that foregrounds power relations to unlock the social justice-oriented transformative potential of service user involvement in mental health professions education and health professions education more broadly.
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  • 文章类型: Journal Article
    越来越多的人对使用人种学作为一种定性研究方法进行探索,在深度,卫生专业教育(HPE)中的文化问题。本文的重点是将数字纳入人种学。数字技术无处不在,越来越多地塑造我们的互动方式,行为,思考,并作为卫生专业教育者和学习者进行交流。因此,理解HPE的当代文化意味着关注数字空间中发生的事情。在本文中,当人种学领域存在于时空连续体之外时,我们批判性地考虑了一些潜在的问题,包括需要参与有关HPE技术和数字空间的理论研究。在对少数使用数字人种学的HPE研究进行了非常简短的回顾之后,我们仔细研究当民族志涵盖数字世界时可以获得什么,特别是在理清HPE的社会材料方面。我们绘制了在数字景观中进行人种学研究所固有的变化,特别是那些与研究领域相关的,研究者的角色和伦理问题。然后,我们使用两个示例来说明可能的HPE研究问题以及使用数字人种学来回答这些问题的潜在策略:在进行人种学研究时使用数字工具以及如何进行数字空间的人种学。我们得出的结论是,承认技术在设计中的普遍性,HPE的交付和经验开辟了新的研究问题,可以通过在人种学中拥抱数字来解决。
    There is increasing interest in the use of ethnography as a qualitative research approach to explore, in depth, issues of culture in health professions education (HPE). Our specific focus in this article is incorporating the digital into ethnography. Digital technologies are pervasively and increasingly shaping the way we interact, behave, think, and communicate as health professions educators and learners. Understanding the contemporary culture(s) of HPE thus means paying attention to what goes on in digital spaces. In this paper, we critically consider some of the potential issues when the field of ethnography exists outside the space time continuum, including the need to engage with theory in research about technology and digital spaces in HPE. After a very brief review of the few HPE studies that have used digital ethnography, we scrutinize what can be gained when ethnography encompasses the digital world, particularly in relation to untangling sociomaterial aspects of HPE. We chart the shifts inherent in conducting ethnographic research within the digital landscape, specifically those related to research field, the role of the researcher and ethical issues. We then use two examples to illustrate possible HPE research questions and potential strategies for using digital ethnography to answer those questions: using digital tools in the conduct of an ethnographic study and how to conduct an ethnography of a digital space. We conclude that acknowledging the pervasiveness of technologies in the design, delivery and experiences of HPE opens up new research questions which can be addressed by embracing the digital in ethnography.
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  • 文章类型: Journal Article
    最近,卫生专业教育研究伦理审查的价值和必要性之间的平衡一直存在争议。目前,卫生专业教育研究建议的伦理审查组织方式存在很大差异。我们提出了一个框架,描述了卫生专业教育研究中伦理审查的组织,基于人际循环模式,也被称为Leary\'sRose。该框架基于卫生专业教育研究伦理审查中的两个主要平衡,作为对主题的保护,以及如何组织道德审查和分担责任。保护性的轴/平衡范围在极端的“家长式保护性”到“自由主义的宽容”之间。组织和责任的轴/平衡范围在“集中式”到“本地/分散”的极端之间。该模型提供了对道德审查委员会立场的见解,并显示了道德批准决策的动态以及组织卫生专业教育研究道德审查的不同方法的后果。
    Recently, the balance between value and necessity of ethical review of health professions education research has been debated. At present, there are large differences in how ethical review of research proposals for health professions education is organized. We present a framework that describes the organization of ethical review in health professions education research, based on the interpersonal circumplex model, also known as Leary\'s Rose. The framework is based on the two main balances in ethical review of health professions education research, being the protectiveness for the subjects and how ethical review is organized and responsibilities are shared. The axis/balance of protectiveness ranges between the extremes \"paternalistic protective\" to \"liberal permissive\". The axis/balance of organization and responsibility ranges between the extremes of \"centralized\" to \"local/decentralized\". This model offers insight in the position of an ethical review board and shows the dynamics of the decisions for ethical approval and the consequences of the different approaches to the organization of ethical review of health professions education research.
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  • 文章类型: Journal Article
    最近,由于资源稀缺,需要为医疗保健专业教育(HPE)提供证据基础,国际上的HPE研究中心已转向确定其研究工作的优先事项。让一系列利益相关者参与研究优先级设定工作已被认为是解决减少研究人员偏见和增加社会责任感等问题的一种方法。然而,将个人分配给单一的先验利益相关者群体是复杂的,先前的研究忽视了跨类别成员资格和跨群体个人之间的协议。Further,分析使利益相关者团体相互竞争,试图了解谁优先考虑什么,并且经常无法掌握优先事项的基本原理。更深入地了解谁优先考虑哪些研究领域以及为什么需要考虑结果在上下文中的适用性,并加深社会问责制和可转移性。采用了基于网络的Q方法论方法,其中n=91名参与者(谁)来自十个预先分类的利益相关者团体,并进行了排序后访谈(为什么)。从先前的研究(什么)开发了67个Q集项目(中文/英文)。参加者主要来自台湾,尽管包括国际研究人员。Q排序是分组或单独进行的,其次是排序后的采访。最终分析包括86名参与者的Q-sorts。对Q类之间的相互关系进行因子分析(质心法)和旋转分析(Varimax法)。对访谈进行了主题分析。确定了特征值超过1的六个观点(范围=3.55-10.34;总方差为42%;35/67主题),绘制研究重点的高/低优先级:工作场所教学和学习;患者尊严和医疗保健安全;专业和医疗保健专业人员的发展;医学伦理和道德发展;医疗保健专业人员的保留和成功;为临床实践做准备。确定了18种优先次序的理由:影响,组织文化和教育者/实践者的赤字被引用得最多。每个观点,由多个利益相关者持有,包括一组独特的主题分组,目标研究参与者,受益人和理由。这两个最多产的观点代表了不同的利益相关者群体如何突出医疗保健专业在工作场所的教育的关键互补观点(教学/学习实践的功效,知识/价值观的应用)。通过照亮每个视点周围的细节,并全面描述了研究优先级设置中的“何人为什么”,其他希望进行这样的练习的人可以更容易地确定利益相关者的观点和他们的认知信念如何可以帮助塑造医疗保健专业的研究议程更普遍。
    Recently, due to scarce resources and the need to provide an evidence-base for healthcare professions\' education (HPE), HPE research centres internationally have turned to identifying priorities for their research efforts. Engaging a range of stakeholders in research priority setting exercises has been posited as one way to address the issues around reducing researcher bias and increasing social accountability. However, assigning individuals to single a priori stakeholder groups is complex, with previous research overlooking cross-category membership and agreement between individuals across groups. Further, analyses have pitched stakeholder groups against one another in an attempt to understand who prioritises what, and often fails to grasp rationales underlying priorities. A deeper understanding of who prioritises what research areas and why is required to consider applicability of results across contexts and deepen social accountability and transferability. A web-based Q-methodological approach with n=91 participants (who) from ten pre-classified stakeholder groups was employed with post-sort interviews (why). Sixty-seven Q-set items (Chinese/English languages) were developed from previous research (what). Participants were mainly from Taiwan, although international researchers were included. Q-sorting was undertaken in groups or individually, followed by post-sort interviews. Eighty-six participants\' Q-sorts were included in the final analysis. Intercorrelations among Q-sorts were factor-analysed (Centroid method) and rotated analytically (Varimax method). Interviews were thematically analysed. Six Viewpoints with eigenvalues exceeding 1 were identified (range = 3.55-10.34; 42% total variance; 35/67 topics), mapping high/low priorities for research foci: Workplace teaching and learning; Patient dignity and healthcare safety; Professionalism and healthcare professionals\' development; Medical ethics and moral development; Healthcare professionals\' retention and success; Preparing for clinical practice. Eighteen rationales for prioritisation were identified: impact, organisational culture and deficit of educators/practitioners were most highly cited. Each Viewpoint, held by multiple stakeholders, comprised a unique set of topic-groupings, target study participants, beneficiaries and rationales. The two most prolific Viewpoints represent how different stakeholder groups highlight key complementary perspectives of healthcare professions\' education in the workplace (efficacy of teaching/learning practices, application of knowledge/values). By illuminating the detail around each Viewpoint, and presenting an holistic description of the who-what-why in research priority setting, others wishing to undertake such an exercise can more easily identify how stakeholder Viewpoints and their epistemic beliefs can help shape healthcare professions\' research agendas more generally.
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  • 文章类型: Journal Article
    The field of health professions education research draws inspiration from many disciplines, creating a dynamic socio-cultural context that is replete with contests over research rigour and quality. These knowledge politics are never definitively resolved. Thus, an important question that any graduate program established within the field has to contend with is what should constitute expertise in HPER. In this paper we explore interrelated contextual, conceptual and procedural dimensions of expertise to substantiate our suggestions for a core curriculum for graduate students in health professions education. We argue that an expert in health professions education research should have both an appreciation of when knowledge politics are relevant to their research process as part of their procedural knowledge and also an awareness of why these politics can affect their work as part of their conceptual knowledge.
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  • 文章类型: Journal Article
    卫生专业教育领域的许多过程和实践更多地基于传统和假设,而不是证据和理论。随着领域的成熟,研究人员越来越多地寻求证据来支持各种教学和评估方法。然而,有一种倾向是专注于有限的一组主题,让其他领域受到忽视,限制了我们对该领域的理解。通过明确检查未描述的区域,即文献中的缺席,研究人员和学者有可能丰富我们的实践和我们领域对什么是合法研究的理解。运用布迪厄场概念的理论框架,我们对三个已发表的研究项目进行了工具性案例研究,每个项目都有缺勤的发现。我们单独检查了每个案例,然后跨案例进行分析。我们的数据集包括发表的论文,同行评审反馈,和反思笔记。每个案件都询问了不同形式的缺席:内容缺失,缺乏研究,缺乏证据。虽然类型学表明每次缺席都不同,在“证明”缺席的现实方面的挑战以及对接受严格和/或合法的发现的怀疑或不适方面,不同案例之间存在相似之处。缺勤研究有可能增加我们对该领域的理论和方法论方法。这种类型的研究对于学者来说可能是一种令人兴奋和富有成效的新方式,可以揭示迄今为止受到有限关注的卫生专业教育方面。
    Many processes and practices in the field of health professions education have been based more on tradition and assumption than on evidence and theory. As the field matures, researchers are increasingly seeking evidence to support various teaching and assessment methods. However, there is a tendency to focus on a limited set of topics, leaving other areas under-examined and limiting our understanding of the field. By explicitly examining areas that are undescribed, i.e. absences in the literature, researchers and scholars have the potential to enrich our practice and our field\'s understanding of what counts as legitimate research. Using the theoretical framework of Bourdieu\'s concept of field, we conducted an instrumental case study of three published research projects that each had a finding of absence. We examined each case individually, and then analyzed across cases. Our dataset included published papers, peer-review feedback, and reflective notes. Each of the cases interrogated a different form of absence: absence of content, absence of research, and absence of evidence. While the typology suggests that each absence was different, there were similarities across cases in terms of challenges in \'proving\' the reality of the absence and some disbelief or discomfort with accepting the findings as rigorous and/or legitimate. Absence research has potential to add to our theoretical and methodological approaches to the field. This type of research is potentially an exciting and productive new way for scholars to shed light on aspects of health professions education that have received limited attention to date.
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  • 文章类型: Journal Article
    本文批判性地研究了三个假设,这些假设是最近为推进跨学科研究而做出的努力-本文将其定义为跨学科研究人员之间的交流和合作(例如社会学,心理学,生物学)-并检查这些假设对卫生专业教育研究(HPER)的影响。这些假设是:(1)学科是孤岛,阻碍了知识在各个领域的自由流动并扼杀了创新思维;(2)跨学科研究将能够解决复杂问题的各个专业领域的研究人员聚集在一起,从而对世界有了更好的了解;(3)跨学科研究通过消除边界来减少跨研究人员群体的分裂。这些假设是塑造当代学术舞台的新信念之一;他们将学术和大学管理者的决策导向为扩大跨学科研究和培训,但没有确凿的经验证据。本文认为,HPER领域在很大程度上采用了跨学科研究的前提,但尚未就围绕这些前提进行组织的潜在影响进行辩论。作者希望激发HPER社区的成员批判性地研究促进跨学科性的无处不在的话语,并通过证据而不是未经证实的假设来反思该领域的未来。例如:HPER的研究中心和研究生课程应该鼓励跨学科或学科培训的研究人员的发展吗?培训应该主要集中在方法和方法上,还是更多地利用基于学科的知识?在学术界增加该领域的知名度并吸引最优秀的学生和研究人员参与HPER的最佳途径是什么?这些问题在当前时刻值得关注,因为HPER领域的未来取决于当前的决策。
    This article critically examines three assumptions underlying recent efforts to advance interdisciplinary research-defined in this article as communication and collaboration between researchers across academic disciplines (e.g. Sociology, Psychology, Biology)-and examines these assumptions\' implications for health professions education research (HPER). These assumptions are: (1) disciplines are silos that inhibit the free flowing of knowledge across fields and stifle innovative thinking; (2) interdisciplinary research generates a better understanding of the world as it brings together researchers from various fields of expertise capable of tackling complex problems; and (3) interdisciplinary research reduces fragmentation across groups of researchers by eliminating boundaries. These assumptions are among the new beliefs shaping the contemporary academic arena; they orient academics\' and university administrators\' decisions toward expanding interdisciplinary research and training, but without solid empirical evidence. This article argues that the field of HPER has largely adopted the premises of interdisciplinary research but has not yet debated the potential effects of organizing around these premises. The authors hope to inspire members of the HPER community to critically examine the ubiquitous discourse promoting interdisciplinarity, and engage in reflection about the future of the field informed by evidence rather than by unsubstantiated assumptions. For example: Should research centres and graduate programs in HPER encourage the development of interdisciplinary or disciplinary-trained researchers? Should training predominantly focus on methods and methodologies or draw more on disciplinary-based knowledge? What is the best route toward increasing the field\'s profile within academia and attracting the best students and researchers to engage in HPER? These are questions that merit attention at the current juncture as the future of the HPER field relies on decisions made in the present time.
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  • 文章类型: Journal Article
    Preparing health professionals in health promotion (HP) and disease prevention is essential for improvement of population health, community HP, and better health care for individuals. The aim of this article is to describe an HP project in the form of a major self-directed project-based learning task integrated within the curriculum in the second year of the medical degree program at United Arab Emirates University. The project introduces students to public health and HP practice and develops students\' literature searching, writing, presentation skills, and team work. Students learn the principles underlying behavioral change, and the design of HP programs and materials, through a lecture format. Small groups of students each choose a specific health topic for their project. Over 11 weeks, students obtain information about their topic from appropriate sources (library, PubMed, Google Scholar, credible health sources such as World Health Organization). Using the principles learned in the lectures, they develop appropriate materials for their target audience: for example, posters, a pamphlet, social media content, or a video or radio message. Students seek advice from specialist faculty as needed. In week 12, each team presents their project background, rationale, and materials to their colleagues in a seminar format open to all faculty. They then submit the materials they developed for assessment. Group marks are assigned for presentations and materials. Key concepts are assessed by multiple choice questions in comprehensive course examinations. By participation in the HP project, many students develop a solid background in prevention. The information retrieval, writing, and presentation skills, as well as experience of team work, are valuable both for the remaining years of their training and their future careers.
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  • 文章类型: Journal Article
    BACKGROUND: Graduate medical education faculty bear the responsibility of demonstrating active research and scholarship; however, faculty who choose education-focused careers may face unique obstacles related to the lack of promotion tracks, funding, career options, and research opportunities. Our objective was to address education research and scholarship barriers by providing a collaborative peer-mentoring environment and improve the production of research and scholarly outputs.
    METHODS: We describe a Medical Education Scholarship Support (MESS) group created in 2013. MESS is an interprofessional, multidisciplinary peer-mentoring education research community that now spans multiple institutions. This group meets monthly to address education research and scholarship challenges. Through this process, we develop new knowledge, research, and scholarly products, in addition to meaningful collaborations.
    RESULTS: MESS originated with eight founding members, all of whom still actively participate. MESS has proven to be a sustainable unfunded local community of practice, encouraging faculty to pursue health professions education (HPE) careers and fostering scholarship. We have met our original objectives that involved maintaining 100% participant retention; developing increased knowledge in at least seven content areas; and contributing to the development of 13 peer-reviewed publications, eight professional presentations, one Masters of Education project, and one educational curriculum.
    CONCLUSIONS: The number of individuals engaged in HPE research continues to rise. The MESS model could be adapted for use at other institutions, thereby reducing barriers HPE researchers face, providing an effective framework for trainees interested in education-focused careers, and having a broader impact on the education research landscape.
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