A Systematic Scoping Review on Portfolios of Medical Educators

Hong, Daniel Zhihao; Lim, Abner Herbert; Tan, Rei; Ong, Yun Ting; Pisupati, Anushka; Chong, Eleanor Jia Xin; Quek, Chrystie Wan Ning; Lim, Jia Yin; Ting, Jacquelin Jia Qi; Chiam, Min; Chin, Annelissa; Lee, Alexia Sze Inn; Wijaya, Limin; Cook, Sandy; Krishna, Lalit Kumar Radha

doi:10.1177/23821205211000356

Cited by 25 publications

(14 citation statements)

References 103 publications

(567 reference statements)

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“…To provide a balanced review, this SSR in SEBA is overseen by an expert team comprised of medical librarians from the Yong Loo Lin School of Medicine (YLLSoM) and the National Cancer Centre Singapore (NCCS), and local education experts and clinicians at NCCS, the Palliative Care Institute Liverpool, YLLSoM and Duke-NUS Medical School. The expert team guide, oversee and support the 6 stages of SEBA to enhance the reproducibility and accountability of the process 3 38 48–51 56–62…”

Section: Methodsmentioning

confidence: 99%

Systematic scoping review on moral distress among physicians

et al. 2022

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BackgroundConcepts of moral distress (MD) among physicians have evolved and extend beyond the notion of psychological distress caused by being in a situation in which one is constrained from acting on what one knows to be right. With many accounts involving complex personal, professional, legal, ethical and moral issues, we propose a review of current understanding of MD among physicians.MethodsA systematic evidence-based approach guided systematic scoping review is proposed to map the current concepts of MD among physicians published in PubMed, Embase, PsycINFO, Web of Science, SCOPUS, ERIC and Google Scholar databases. Concurrent and independent thematic and direct content analysis (split approach) was conducted on included articles to enhance the reliability and transparency of the process. The themes and categories identified were combined using the jigsaw perspective to create domains that form the framework of the discussion that follows.ResultsA total of 30 156 abstracts were identified, 2473 full-text articles were reviewed and 128 articles were included. The five domains identified were as follows: (1) current concepts, (2) risk factors, (3) impact, (4) tools and (5) interventions.ConclusionsInitial reviews suggest that MD involves conflicts within a physician’s personal beliefs, values and principles (personal constructs) caused by personal, ethical, moral, contextual, professional and sociocultural factors. How these experiences are processed and reflected on and then integrated into the physician’s personal constructs impacts their self-concepts of personhood and identity and can result in MD. The ring theory of personhood facilitates an appreciation of how new experiences create dissonance and resonance within personal constructs. These insights allow the forwarding of a new broader concept of MD and a personalised approach to assessing and treating MD. While further studies are required to test these findings, they offer a personalised means of supporting a physician’s MD and preventing burn-out.

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Section: Methodsmentioning

confidence: 99%

Systematic scoping review on moral distress among physicians

et al. 2022

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“…Consequently, it also underlines the potential for a RToP-based tool, designed to evaluate the physician’s needs, coping and progress. Both considerations coalesce to highlight the need for a portfolio-based program as an additional source of reflection and to guide support and oversight of physicians [ 40 – 46 ].…”

Section: Resultsmentioning

confidence: 99%

Physician-patient boundaries in palliative care

Lim

Rahman

et al. 2023

BMC Palliat Care

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Background Nurturing effective physician-patient relationships is essential to the provision of patient-centred care. Palliative care physicians may apply boundary-crossings or breaches in professional standards to nurture effective physician-patient relationships. Being highly individualized and shaped by the physician’s narratives, clinical experience, and contextual considerations, boundary-crossings are susceptible to ethical and professional violations. To better appreciate this concept, we employ the Ring Theory of Personhood (RToP) to map the effects of boundary-crossings on the physician’s belief systems. Methods As part of the Tool Design SEBA methodology, a Systematic Evidence-Based Approach (SEBA) guided systematic scoping review was employed to guide the design of a semi-structured interview questionnaire with palliative care physicians. The transcripts were simultaneously content and thematically analysed. The themes and categories identified were combined using the Jigsaw Perspective and the resulting domains formed the basis for the discussion. Results The domains identified from the 12 semi-structured interviews were catalysts and boundary-crossings. Boundary-crossings attempt to address threats to a physician’s belief systems (catalysts) and are highly individualized. Employ of boundary-crossings depend on the physician’s sensitivity to these ‘catalysts’, their judgement and willingness to act, and their ability to balance various considerations and reflect on their actions and their ramifications. These experiences reshape belief systems, understandings of boundary-crossings and may influence decision-making and practice, underscoring the potential for greater professional breaches when unchecked. Conclusion Underlining its longitudinal effects, the Krishna Model underscores the importance of longitudinal support, assessment and oversight of palliative care physicians, and lays the foundation for a RToP-based tool to be employed within portfolios.

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“…Hong et al’s (2021) and Zhou et al’s (2021) adaptations 98,99 of Norcini’s (2020) concept of micro-credentialling and micro-certification in medical education 100 which forward the concepts of generalised and personalised micro-competencies provide a viable bridge between prevailing MSP content without compromising the rich mix of structure and customisation within MSPs. Based on the certification of micro-competencies within an EPA, Zhou et al (2021) suggest that generalised micro-competencies are the standards and expectations applicable to all medical students.…”

Section: Discussionmentioning

confidence: 99%

Medical Student Portfolios: A Systematic Scoping Review

Tan

Ting

Hong

et al. 2022

Journal of Medical Education and Curricular Development

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Phenomenon Medical Student Portfolios (MSP)s allow medical students to reflect and better appreciate their clinical, research and academic experiences which promotes their individual personal and professional development. However, differences in adoption rate, content design and practice setting create significant variability in their employ. With MSPs increasingly used to evaluate professional competencies and the student's professional identity formation (PIF), this has become an area of concern. Approach We adopt Krishna’s Systematic Evidence-Based Approach to carry out a Systematic Scoping Review (SSR in SEBA) on MSPs. The structured search process of six databases, concurrent use of thematic and content analysis in the Split Approach and comparisons of the themes and categories with the tabulated summaries of included articles in the Jigsaw Perspective and Funnelling Process offers enhanced transparency and reproducibility to this review. Findings The research team retrieved 14501 abstracts, reviewed 779 full-text articles and included 96 articles. Similarities between the themes, categories and tabulated summaries allowed the identification of the following funnelled domains: Purpose of MSPs, Content and structure of MSPs, Strengths and limitations of MSPs, Methods to improve MSPs, and Use of E-portfolios. Insights Variability in the employ of MSPs arise as a result of a failure to recognise its different roles and uses. Here we propose additional roles of MSPs, in particular, building on a consistent set of content materials and assessments of milestones called micro-competencies. Whislt generalised micro-competencies assess achievement of general milestones expected of all medical students, personalised micro-competencies record attainment of particular skills, knowledge and attitudes balanced against the medical student’s abilities, context and needs. This combination of micro-competencies in a consistent framework promises a holistic, authentic and longitudinal perspective of the medical student’s development and maturing PIF.

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A Systematic Scoping Review on Portfolios of Medical Educators

Cited by 25 publications

References 103 publications

Systematic scoping review on moral distress among physicians

Systematic scoping review on moral distress among physicians

Physician-patient boundaries in palliative care

Medical Student Portfolios: A Systematic Scoping Review

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