Overwhelmingly, students enjoy CBL and think that it enhances their learning. The empirical data taken as a whole are inconclusive as to the effects on learning compared with other types of activity. Teachers enjoy CBL, partly because it engages, and is perceived to motivate, students. CBL seems to foster learning in small groups though whether this is the case delivery or the group learning effect is unclear.
We propose future directions for research and development, including a taxonomy to facilitate dialogue, an outline of a research strategy and reference to a comprehensive bibliography covering all health and human services.
Interprofessional education draws from a number of education, sociology and psychology theories, and these are briefly discussed. The most pressing research questions for the IPE community are defined and the challenges for IPE explored.
As part of a World Health Organization (WHO) initiative we searched the literature to explore defined learning outcomes for interprofessional education between 1988, when the last WHO technical report on interprofessional education was published, and 2009. We describe and synthesize findings from 88 citations over this 21 year period. There is a variety in the way learning outcomes are presented but there are many similarities between specific outcomes and/or objectives. Papers describing educational interventions do not always include specific outcomes or objectives. Our findings have been integrated into a list of learning outcomes with six categories for further debate and discussion. This project is part of a wider initiative initiated by the WHO in 2007 to review the current position of interprofessional education worldwide. It is also a sub-project of a learning and teaching grant funded by the Carrick Institute for Learning and Teaching within Australia. In this paper we use the CAIPE definition of interprofessional education: "Occasions when two or more professions learn with, from and about each other to improve collaboration and the quality of care" (Barr, 2002 ).
Background: Traditionally, clinical learning for medical students consists of short-term and opportunistic encounters with primarily acute-care patients, supervised by an array of clinician preceptors. In response to educational concerns, some medical schools have developed longitudinal placements rather than short-term rotations. Many of these longitudinal placements are also integrated across the core clinical disciplines, are commonly termed longitudinal integrated clerkships (LICs) and often situated in rural locations. This review aimed to explore, analyse and synthesise evidence relating to the effectiveness of longitudinal placements, for medical students in particular to determine which aspects are most critical to successful outcomes. Method: Extensive search of the literature resulted in 1679 papers and abstracts being considered, with 53 papers ultimately being included for review. The review group coded these 53 papers according to standard BEME review guidelines. Specific information extracted included: data relating to effectiveness, the location of the study, number of students involved, format, length and description of placement, the learning outcomes, research design, the impact level for evaluation and the main evaluation methods and findings. We applied a realist approach to consider what works well for whom and under what circumstances. Findings: The early LICs were all community-based immersion programs, situated in general practice and predominantly in rural settings. More recent LIC innovations were situated in tertiary-level specialist ambulatory care in urban settings. Not all placements were integrated across medical disciplines but were longitudinal in relation to location, patient base and/or supervision. Twentyfour papers focussed on one of four programs from different viewpoints. Most evaluations were student opinion (survey, interview, focus group) and/or student assessment results. Placements varied from one half day per week for six months through to full time immersion for more than 12 months. The predominant mechanism relating to factors influencing effectiveness was continuity of one or more of: patient care, supervision and mentorship, peer group and location. The success of LICs and participation satisfaction depended on the preparation of both students and clinical supervisors, and the level of support each received from their academic institutions. Conclusion: Longitudinal placements, including longitudinal integrated placements, are gaining in popularity as an alternative to traditional block rotations. Although relatively few established LICs currently exist, medical schools may look for ways to incorporate some of the principles of LICs more generally in their clinical education programmes. Further research is required to ascertain the optimum length of time for placements depending on the defined learning outcomes and timing within the programme, which students are most likely to benefit and the effects of context such as location and type of integration.
Health professionals need preparation and support to work in collaborative practice teams, a requirement brought about by an aging population and increases in chronic and complex diseases. Therefore, health professions education has seen the introduction of interprofessional education (IPE) competency frameworks to provide a common lens through which disciplines can understand, describe, and implement team-based practices. Whilst an admirable aim, often this has resulted in more confusion with the introduction of varying definitions about similar constructs, particularly in relation to what IPE actually means.The authors explore the nature of the terms competency and framework, while critically appraising the concept of competency frameworks and competency-based education. They distinguish between competencies for health professions that are profession specific, those that are generic, and those that may be achieved only through IPE. Four IPE frameworks are compared to consider their similarities and differences, which ultimately influence how IPE is implemented. They are the Interprofessional Capability Framework (United Kingdom), the National Interprofessional Competency Framework (Canada), the Core Competencies for Interprofessional Collaborative Practice (United States), and the Curtin University Interprofessional Capability Framework (Australia).The authors highlight the need for further discussion about establishing a common language, strengthening ways in which academic environments work with practice environments, and improving the assessment of interprofessional competencies and teamwork, including the development of assessment tools for collaborative practice. They also argue that for IPE frameworks to be genuinely useful, they need to augment existing curricula by emphasizing outcomes that might be attained only through interprofessional activity.
Objectives: There are currently no guidelines on the most effective ways of supporting medical students to develop high standards of medical professionalism. The aim of this review is to summarise the evidence currently available on methods used by medical schools to promote medical professionalism.Methods: We performed a systematic search of electronic databases (Medline, PsychInfo, British Education Index, Educational Resources Information Centre, Sociological Abstracts and Topics in Medical Education) from January 1998 to October 2008. Outcomes studied were methods used to support and promote the development of professionalism in medical students.Results: We identified 134 papers and five main themes for supporting the development of professionalism in medical students: curriculum design, student selection, teaching and learning methods, role modelling and assessment methods. However, the level of empirical evidence supporting each of these methods is limited.Conclusions: Identification of these five areas helps medical schools to focus the emphasis of their approaches to developing professionalism and identifies future research areas. This review offers a preliminary guide to future discovery and progress in the area of medical professionalism.
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