Introduction: Evaluators use assessment data to make judgments on resident performance within the Accreditation Council for Graduate Medical Education (ACGME) milestones framework. While workplace-based narrative assessments (WBNA) offer advantages to rating scales, validity evidence for their use in assessing the milestone sub-competencies is lacking. This study aimed to determine the frequency of sub-competencies assessed through WBNAs in an emergency medicine (EM) residency program. Methods: We performed a retrospective analysis of WBNAs of postgraduate year (PGY) 2-4 residents. A shared mental model was established by reading and discussing the milestones framework, and we created a guide for coding WBNAs to the milestone sub-competencies in an iterative process. Once inter-rater reliability was satisfactory, raters coded each WBNA to the 23 EM milestone sub-competencies. Results: We analyzed 2517 WBNAs. An average of 2.04 sub-competencies were assessed per WBNA. The sub-competencies most frequently identified were multitasking, medical knowledge, practice-based performance improvement, patient-centered communication, and team management. The sub-competencies least frequently identified were pharmacotherapy, airway management, anesthesia and acute pain management, goal-directed focused ultrasound, wound management, and vascular access. Overall, the frequency with which WBNAs assessed individual sub-competencies was low, with 14 of the 23 sub-competencies being assessed in less than 5% of WBNAs. Conclusion: WBNAs identify few milestone sub-competencies. Faculty assessed similar sub-competencies related to interpersonal and communication skills, practice-based learning and improvement, and medical knowledge, while neglecting sub-competencies related to patient care and procedural skills. These findings can help shape faculty development programs designed to improve assessments of specific workplace behaviors and provide more robust data for the summative assessment of residents.
For many instructional designers (ID), subject matter experts (SMEs) are viewed as a necessary evil. Depending upon their day job, SMEs can be challenging to work with due to their schedules and responsibilities outside the ID’s project. They can be unaware of the eLearning process, learning models and theories, and expensive—a SME can easily add thousands of dollars to an already stretched budget. However, if the ID does not have the “expert” knowledge of the content for students to achieve the learning outcomes successfully, it is improbable that the learning event will be meaningful. This paper explores students’ learning outcomes in a case-based simulated learning event before and after the inclusion of a SME on an instructional design team.
EASEL (education through application-supported experiential learning) is a platform designed to provide just-in-time content and reflection opportunities to students during field experiences, such as interviews or field labs, conducted as part of the workload in a course. This study was conducted in area of family medicine education at Indiana University-Purdue University Indianapolis. EASEL allows instructors and students flexibility to engage with course content based on the time of day and the location of each student conducting field work by providing access to questions and content before, during, and after a targeted field experience. In this study, three cohorts of family medicine students (N=20) interviewed either a health care professional or a patient and used EASEL to facilitate and support their experience in the field. This study examined the student perceptions of EASEL. The data indicated instructive information on the usability of the EASEL platform and aided developers in considering future technologies to use as a part of the platform.
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