A research paradigm, or set of common beliefs about research, should be a key facet of any research project. However, despite its importance, there is a paucity of general understanding in the medical sciences education community regarding what a research paradigm consists of and how to best construct one. With the move within medical sciences education towards greater methodological rigor, it is now more important than ever for all educators to understand simply how to better approach their research via paradigms. In this monograph, a simplified approach to selecting an appropriate research paradigm is outlined. Suggestions are based on broad literature, medical education sources, and the author's own experiences in solidifying and communicating their research paradigms. By assisting in detailing the philosophical underpinnings of individuals research approaches, this guide aims to help all researchers improve the rigor of their projects and improve upon overall understanding in research communication.
Introduction Medical education is committed to promoting empathic communication. Despite this, much research indicates that empathy actually decreases as students progress through medical school. In qualitative terms, relatively little is known about this changing student relationship with the concept of empathy for patients and how teaching affects it. This study explores that knowledge gap. Methods Adopting a constructivist paradigm, we utilised a research approach new to medical education: Love and Breakup Letter Methodology. A purposive sample of 20 medical students were asked to write love and break up letters to ‘empathy for patients’. The letters were prompts for the focus group discussions that followed. Forty letters and three focus group discussions were thematically analysed. Results The three major themes were: art and artifice; empathic burden; and empathy as a virtue. Students were uncomfortable with the common practice of faking empathic statements, a problem exacerbated by the need to ‘tick the empathy box’ during examinations. Students evolved their own empathic style, progressing from rote empathic statements towards phrases which suited their individual communication practice. They also learned non‐verbal empathy from positive clinician role‐modelling. Students reported considerable empathic burden. Significant barriers to empathy were reported within the hidden curriculum, including negative role‐modelling that socialises students into having less compassion for difficult patients. Students strongly associated empathy with virtue. Conclusions Medical education should address the problem of inauthentic empathy, including faking empathic s in assessments. Educators should remember the value of non‐verbal compassionate communication. The problems of empathic burden, negative role modelling and of finding empathy difficult for challenging patients may account for some of the empathy decline reported in quantitative research. Framing empathy as a virtue may help students utilise empathy more readily when faced with patients they perceive as challenging and may promote a more authentic empathic practice.
MEDICAL EDUCATION ADAPTATIONS new challenges, such as teaching virtually and attending to student well-being. In future, planning additional evaluation that includes measuring social network structural and qualitative changes, although not feasible at the onset of the COVID-19 pandemic, would be helpful to further assess impact and align with current evaluation trends.
Palliative care is central to the role of all clinical doctors. There is variability in the amount and type of teaching about palliative care at undergraduate level. Time allocated for such teaching within the undergraduate medical curricula remains scarce. Given this, the effectiveness of palliative care teaching needs to be known.ObjectivesTo evaluate the effectiveness of palliative care teaching for undergraduate medical students.DesignA systematic review was prepared according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidance. Screening, data extraction and quality assessment (mixed methods and Cochrane risk of bias tool) were performed in duplicate.Data sourcesEmbase, MEDLINE, PsycINFO, Web of Science, ClinicalTrials.gov, Cochrane and grey literature in August 2019. Studies evaluating palliative care teaching interventions with medical students were included.Results1446 titles/abstracts and 122 full-text articles were screened. 19 studies were included with 3253 participants. 17 of the varied methods palliative care teaching interventions improved knowledge outcomes. The effect of teaching on clinical practice and patient outcomes was not evaluated in any study.ConclusionsThe majority of palliative care teaching interventions reviewed improved knowledge of medical students. The studies did not show one type of teaching method to be better than others, and thus no ‘best way’ to provide teaching about palliative care was identified. High quality, comparative research is needed to further understand effectiveness of palliative care teaching on patient care/clinical practice/outcomes in the short-term and longer-term.PROSPERO registration numberCRD42018115257.
Qualitative research has long been considered the poor cousin to quantitative research. However, recently it has gained more prominence and respect, particularly within health professions education. This article aims to introduce the novice researcher to the fundamental principles of qualitative research. We introduce the basic features of qualitative research, and describe the rationale for conducting such research. We guide the researcher as to how to differentiate between the most common forms of qualitative research. We guide researchers to take the time to acquaint themselves with research paradigms, the philosophical positions that guide how research is conducted and interpreted, before selecting one's methodology and methods. Qualitative research is rigorous, and offers deeper understanding of human experiences, context, and social phenomena. We demonstrate the key considerations when selecting an appropriate methodology, ensuring that the research aim aligns with the purpose of any given methodology. The power of qualitative research should not be underestimate, but power only comes from well conducted, rigorous research. Qualitative research is not quick or easy but it has much to offer. Learning objective:To (1) understand the features of, and rationale for conducting, qualitative research and (2) differentiate between the most common forms of qualitative research.
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