Improving medical education research.

Department of Medical Education, University of Michigan Medical School, Ann Arbor, Michigan 48109-0201, USA.
Teaching and Learning in Medicine (Impact Factor: 1.12). 02/2007; 19(4):331-5. DOI: 10.1080/10401330701542370
Source: PubMed


Available from: Larry D Gruppen, Apr 16, 2014
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    ABSTRACT: ContextStudies that investigate research questions that have already been resolved represent a waste of resources. However, the failure to collect sufficient evidence to resolve a given question results in ambiguity.Objectives The present study was conducted to reanalyse the results of a meta-analysis of simulation-based education (SBE) to determine: (i) whether researchers continue to replicate research studies after the answer to a research question has become known, and (ii) whether researchers perform enough replications to definitively answer important questions.MethodsA systematic search of multiple databases to May 2011 was conducted to identify original research evaluating SBE for health professionals in comparison with no intervention or any active intervention, using skill outcomes. Data were extracted by reviewers working in duplicate. Data synthesis involved a cumulative meta-analysis to illuminate patterns of evidence by sequentially adding studies according to a variable of interest (e.g. publication year) and re-calculating the pooled effect size with each addition. Cumulative meta-analysis by publication year was applied to 592 comparative studies using several thresholds of ‘sufficiency’, including: statistical significance; stable effect size classification and magnitude (Hedges’ g ± 0.1), and precise estimates (confidence intervals of less than ± 0.2).ResultsAmong studies that compared the outcomes of SBE with those of no intervention, evidence supporting a favourable effect of SBE on skills existed as early as 1973 (one publication) and further evidence confirmed a quantitatively large effect of SBE by 1997 (28 studies). Since then, a further 404 studies were published. Among studies comparing SBE with non-simulation instruction, the effect initially favoured non-simulation training, but the addition of a third study in 1997 brought the pooled effect to slightly favour simulation, and by 2004 (14 studies) this effect was statistically significant (p < 0.05) and the magnitude had stabilised (small effect). A further 37 studies were published after 2004. By contrast, evidence from studies evaluating repetition continued to show borderline statistical significance and wide confidence intervals in 2011.Conclusions Some replication is necessary to obtain stable estimates of effect and to explore different contexts, but the number of studies of SBE often exceeds the minimum number of replications required.
    Medical Education 08/2014; 48(8). DOI:10.1111/medu.12473 · 3.62 Impact Factor
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    ABSTRACT: Despite persistent calls to measure the effectiveness of educational interventions on patient outcomes, few studies have been conducted. Within musculoskeletal physiotherapy, the effects of postgraduate clinical mentoring on physiotherapist performance have been assessed, but the impact of this mentoring on patient outcomes remains unknown. The objective of this trial is to assess the effectiveness of a work-based mentoring programme to facilitate physiotherapist clinical reasoning on patient outcomes in musculoskeletal physiotherapy.
    Trials 10/2014; 15(1):409. DOI:10.1186/1745-6215-15-409 · 2.12 Impact Factor
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    ABSTRACT: Emergency medicine (EM) is defined, in part, by clinical excellence across an immense breadth of content and the provision of exemplary bedside teaching to a wide variety of learners. The specialty is also well-suited to a number of emerging areas of education scholarship, particularly in relation to team-based learning, clinical reasoning, acute care response, and simulation-based teaching. The success of EM education scholarship will be predicated on system-atic, collective attention to providing the infrastructure for this to occur. Specifically, as a new generation of emergency physicians prepares for education careers, academic organi-zations need to develop means not only to identify potential scholars but also to mentor, support, and encourage their careers. This paper summarizes the supporting literature and presents related recommendations from a 2013 consensus conference on EM education scholarship led by the Academic Section of the Canadian Association of Emer-gency Physicians. RÉ SUMÉ