The complex nature of health care and medical educational organizations, their different primary goals (clinical service versus education), different organizational structures and the necessity for ensuring efficient and harmonious relationships between these two types of organizations create a challenging environment in which to provide effective medical education leadership. The calls for reform in both medical education and health care have added to these challenges.<p> The purpose of the study was to develop a framework of leadership for medical education and contribute to the literature on leadership in medical education, based on an analysis of the perceptions of key health education leaders in Saskatchewan medical education organizations at the national level in Canada.<p> The main objectives were the identification of core competencies, challenges and strategies for effectiveness in medical education with a focus on unique aspects of about leadership in the medical education setting. Multiple methods of data collection (individual interviews and an event study with components of focus groups interviews and short surveys) with subjects of varied backgrounds and at different levels of leadership in medical education were entailed in this study.<p> The data were collected over a period of 13 months (January, 2009 - February, 2010). The perceptions of 32 medical education leaders, stratified into first- (11), middle- (6) and senior-level (15) leadership positions, based upon the hierarchical position and the scope of the job, were obtained and analyzed. Quantitative data were analyzed through descriptive statistics. Qualitative data were analyzed for themes through content analysis.<p> The findings provide useful information on leadership competencies, challenges and effectiveness strategies in medical education. Leadership competencies included five domains including personal and interpersonal characteristics, skills for effective leadership, skills as an efficient manager, skills in medical education delivery, skills as a teacher and skills as a researcher. All leaders considered personal and interpersonal characteristics to be at the core of leadership; while skills in medical education delivery, and skills as a medical education teacher and researcher were considered least important. The senior-level leaders spent most of their time in activities requiring leadership functions (e.g., strategic planning and creating alignment) followed by activities requiring managerial skills (e.g., operational management). This distinction in the rank ordering of leadership and managerial skills was not obvious for the first- and middle-level leaders; however, most did indicate that they spent more of their time in roles requiring more managerial skills than leadership skills. Among the key competencies, essential at all levels, were effective communication and building and managing relationships. For the most part, the leadership skills were acquired informally with only a few leaders having undergone formal leadership training.<p> The leaders faced three types of challenges: personal and interpersonal challenges including effective time management and personal limitations; organizational challenges including those around structures and processes, organizational communication, personal and organizational relationships, creating engagement and alignment, managing culture and resistance and limited resources; and inter-organizational challenges including competing agendas and interests of stakeholders.<p> The context (societal needs, multiple stakeholders and health care reform), content (medical education delivery and calls for reform) and culture (e.g. professionalism, apprenticeship model of medical education, and the hidden curriculum) of medical education and inherent dualities and conflict require situated leadership skills and strategies. The main leadership theories and approaches helpful in practicing contextual leadership included transactional, transformational, and servant leadership. However, other theoretical approaches, such as moral leadership and learner-centered leadership were also useful. Effective leadership was considered to include personal and interpersonal strategies, strategies for becoming an efficient manager and strategies for practicing inspiring and effective leadership. Personal and interpersonal strategies included looking after self, seeking advice, consciously developing fortitude, allotting time for priorities and thinking and personal development. Becoming an efficient manager involved diligent delegation, appropriate organizational communication and managing priorities. Practicing inspiring leadership involved developing the structure and processes to achieve vision, providing hope, developing mutually valued relationships which were considered key to engagement, alignment, leading change and managing resistance, moving from power to process, using appropriate leadership styles, developing the art of leading change and managing resistance, proactively influencing culture and accomplishing the vision.<p> In conclusion, medical education leadership was perceived as requiring both effective leadership and efficient management. The practice of inspiring and effective leadership, however, appeared to be more an art requiring an alchemy of strategies than a simple matter of application.

Background. Access to health care in northern and rural communities has been an ongoing challenge. Training undergraduate medical students in regional sites is one strategy to enhance physician recruitment and retention in rural regions. With this goal in mind, in 2004, the Northern Medical Program was created to bring undergraduate medical education to Prince George. The NMP is also hypothesized to have wider impacts on the community. This study aimed to describe perceptions of the broader impacts of the NMP. Methods. In this qualitative study, semi-structured interviews were conducted with community leaders in various sectors of Prince George. The interviewer probed about perceived current and anticipated future impacts of the program, both positive and negative. A descriptive content analysis was performed. A conceptual framework of hypothesized impacts was created based on the literature and a model of neighbourhood social capital by Carpiano (2006). Findings. Comments were overwhelmingly positive. Impacts were described on education, health services, economy, politics, and media. Some reported negative impacts included tension between the NMP and other departments at UNBC, and a strain on health system resource capacity. Participants also reported that the NMP has impacted social capital in the region. Social capital, defined as the resources belonging to a network of individuals, was a pervasive theme. Impacts on social cohesion, various forms of social capital, access to social capital and outcomes of social capital are described. Conclusions. The full impact of the NMP will likely not be felt for at least a decade, as the program is still relatively new to Prince George. Findings suggest that an undergraduate medical education program can have pervasive impacts in an underserved community. Evaluation of the impact of such programs should be broad in scope. Findings also suggest that impacts of the program on other community sectors and on social capital may in fact lead to greater human capital gains than originally anticipated. A comprehensive communication strategy should be developed and maintained to ensure continued stakeholder support for the program. Next steps include identifying key quantifiable indicators of community impact to track changes in the community over time.

Video-conferencing (VC) is a well established educational tool. Using a grounded theory approach, this study explored the experience of medical students studying remotely by VC. A convenience sample of 11 students participated in semi-structured interviews. Constant comparative analysis identified three emerging themes which were refined and verified by a focus group. The key themes were: the effect of VC on the students’ classroom experience, the development of a strong social cohesion between the students, and the impact on student learning. The participants adapted well to VC lectures but expressed reluctance to ask or answer questions in class. Participants felt they became more self-directed and better collaborative learners. Moore’s theory of transactional distance provides a possible explanation for these observations. High transactional distance was evident with less instructor-student interaction, more student-student interaction, and greater student autonomy. Understanding the transactional dynamics in the VC classroom will inform future research and faculty development. / 2011 May

No description available.

Medical education has been the subject of ongoing reform since the second part of the 18th century (Papa & Harasym, 1999). Most recently, medical education has been redefined to include a broad set of competencies over and above traditional expertise. In an attempt to facilitate this approach, different instructional models have been proposed. Most of these seek to foster learner engagement and active participation and promote life-long learning. Nevertheless, there is no consensus amongst medical educators about the optimal way to teach future physicians. Despite the efforts of both researchers and local champions, instructional innovations frequently fail. Fullan (2001) ascribes this to faulty assumptions on the part of planners as well as to the inherent complexity of the organizations involved, further stating that effective change requires some degree of reculturing. This study examines the process of educational change in an undergraduate medical course over a three-year period. Formerly taught exclusively by large class lectures, the course was redesigned to include a blend of e-learning and Team-Based Learning (TBL). The process of change is described and viewed in parallel from the perspectives of both student and teacher while uncovering contextual and process elements that contributed to the outcome. Shifting student attitudes to teaching and learning were identified over time, suggesting that these evolve in parallel to faculty experience implementing a new teaching strategy. Van Melle (2005) has suggested that acceptance of educational innovation is dependent on the environment and organizational context. The results of this study highlight the importance of these factors in the successful introduction of a new instructional paradigm as well as the value of longitudinal evaluation of instructional changes in order to better understand their transformational potential. / Thesis (Master, Education) -- Queen's University, 2009-01-24 10:02:24.877

No description available.

The study focuses on the cognitive assessment of certification examination in medicine. The purpose was to investigate the relationship between the structure of the examination questions and the examinees' written responses. The responses from three groups of residents with undergraduate degrees from McGill (3), Toronto (2) and Manitoba (2) medical schools were used. A sample of one basic science and two clinical question in Endocrinology were selected. The responses were analyzed using cognitive methods which provided a qualitative assessment of subjects' knowledge structures relative to task. / The results showed that the responses did not always correspond to task requirements. There was a general tendency to focus on specific details that the subjects understood at the expense of the global aspect of the question. There was a greater variation in performance within groups than between groups. The results also suggest that undergraduate education may have less influence on the performance in certification examination than residency training. The importance of developing examination questions with high construct and criterion validity is discussed.

Globally there is a shortage in supply of rural health professionals. Tele-health was developed to help reduce distance barriers for health professionals in geographically isolated locations seeking continued medical education (CME). E-health includes all health information and health care delivered electronically. Further, telehealth defines all telecommunication technology used to transfer health information and health care. Tele-health comes in a variety of forms including videoconferencing. The use of videoconferencing to deliver medical education for rural health professionals is expanding area for health education. Videoconferencing provides a flexible method for rural GP registrars to access CME without travel. However, there is limited knowledge surrounding the use and success of telehealth for medical education. Each new telehealth project requires evaluation in order to ensure effectiveness of future programs. This study was based on one General Practice Education Year One (GPEP-1) registrar training program trialling videoconferencing as a method of teaching rurally distant registrars. A qualitative health research thematic analysis was undertaken. All individuals involved in the study were included in this research including; three offsite registrars (who teleconferenced as they lived remotely from the seminars), three onsite registrars (who attended the face to face seminars), and three facilitators. Three focus group interviews were conducted to collect data, one for each respective group. The focus groups accounted for the participant’s individual and collective experience of teleconferencing. Seven main themes emerged from the focus groups including; group culture, facilitation, teleconferenced education, technology, personal priorities, travel, and rural/remote. These themes were further sorted into two groups; reasons for switching to teleconferencing and factors that determine the success or failure of a telehealth CME. The factors that influenced the offsite registrars reasons to switch to teleconferencing included; personal priorities, travel, and rural/ remote. Further, the other four themes determined the success or failure of the teleconferenced training including; group culture, facilitation, teleconferenced education, and technology. All seven themes were relevant for the offsite registrars and onsite registrars, however, for the facilitators only the factors that determined the success of teleconferencing were applicable. Overall, the pilot study there was no difference in the educational experience provided. This study outlined the key factors that are required for effective teleconferenced training including; face to face bonding prior to teleconferencing, a skilled facilitator that provides active facilitation, a well organised structure, good quality technology, and regular checkups with the learners teleconferencing to ensure satisfaction. Additional research is required to replicate this study to compare this teleconferenced training with further teleconferenced training.

Self-regulated learning (SRL) is associated with academic and clinical achievement. Using Zimmerman’s (2002) framework, SRL includes a cycle of forethought, performance, and reflection. To support SRL, a web-based portfolio (e-Portfolio), in the context of the intrinsic CanMEDS Roles, was introduced for undergraduate medical students at a Canadian Medical School. This exploratory, qualitative study was designed to capture students’ descriptions of their behaviours using the e-Portfolio, to examine the extent to which these were consistent with SRL processes, and to analyze the gaps between intended and actual use. Data were collected using both semi-structured interviews and a 20-item, 5-point Likert-type instrument to prompt discussion. Second-year medical student volunteers were recruited for data collection until saturation of information was reached (n=14). Thematic and content analysis were used; data were interpreted using constructivist grounded theory (Creswell, 2007). Use of one interviewer, a standardized protocol, and member checking assured consistency and trustworthiness of the data. Students explicitly described the value of the e-Portfolio as an organizational tool, and as a form of assessment. Participants identified some elements of forethought and reflection but seldom described plans to achieve and measure outcomes. During the process of uploading materials to their e-Portfolio many of the students were able to make connections between the intrinsic CanMEDS Roles they are to assume as practicing physicians and the behaviours that operationalize these roles. Students viewed the e-Portfolio as a working folder compared to the faculty goal of a cumulative portfolio. Students endorsed self-selection of artifacts and faculty mentorship to improve relevance and future motivation for learning. Limitations included privacy concerns. Participants described a goal-oriented, in contrast to a process- or learning-oriented, approach to keeping their portfolios. The gap between students’ descriptions of portfolio use and SRL were most significant for the performance phase. The dual use of a portfolio for learning and assessment resulted in some compromises to the students’ use of the portfolio for learning. Strategies to improve SRL could include specific instruction on the nature and value of SRL, faculty mentorship during the learning process, and assessment of students’ learning processes. / Thesis (Master, Education) -- Queen's University, 2014-04-29 12:53:15.642

Despite large investment by higher education institutions in technology for faculty and student use, instructional technology is not being integrated into instructions in the higher education institutions including medical education institutions. While diffusion of instructional technologies has been reached a saturation pint with early adopters of technology, it has remained limited among mainstream faculty. This investigation explored instructional technology patterns and characteristics of medical school faculty as well as contributing factors to IT adoption. The primary focus was to explore differences between early adopting faculty and mainstream faculty based on Rogers&amp / #8217 / diffusion of innovations and adopter categories theories. A mix-method research design, a quantitative methodology(survey) in conjunction with qualitative methodology(in-dept interviews) was employed for the purpose of gathering data about characteristics and adoption patterns of medical school faculty who are early adopting and mainstream. A hundred and fifty-five teaching faculty from basic science and clinical science disciplines at a Faculty of Medicine in a state university completed the survey. In-dept interviews were conducted with faculty who are early adopting and mainstream. The findings provided an evidence for similarities between adoption patterns of medical school faculty and other higher education faculty / relatively new tools associated with instruction were not adopted by majority of the faculty. As expected, some differences were found between early adopters and mainstream faculty in terms of individual characteristics, adoption patterns, perceived barriers and incentives to adoption and preferred methods of learning about technology and support. Implications of the findings for instructional technology policy and plans were reported.