Bronchoscopy Teaching Without a Gold Standard

A Cognitive Load Theory Approach to Understanding Expert Scaffolding of Visual Problem-Solving Tasks: A Scoping Review

“…In Tambaum (2017), this was found to be the second most frequently used scaffolding behaviour, making up 42 of the 208 observed scaffolding behaviours in this study. Examples of this behaviour can also be found in Brady et al, (2021Brady et al, ( , p. 1804, where the attending physician (labelled as A-) echoes the fellow's (labelled as F-) words to provide reassurance; "F6: 'So now I come out?' A6: 'You come out.'…”

“…Passive scaffolding behaviours are instances of experts taking a step back and providing space to novices to take on responsibility, present in 13 excerpts (7.93%). The phrases 'stand back' or 'step back' are present in excerpts from Brady et al (2021) and McSharry & Lathlean (2017). In Brady et al, an attending physician describes when they determine it is appropriate to step back: You can sense it when you're there with them .…”

“…I just have a feel for it now. (Brady et al, 2021(Brady et al, , p. 1802 Knowing when to step back can be difficult in scenarios where expert-novice interactions occur over a shorter time span, or when multiple interactions are necessary, as in some nursing education programmes: You'd work with [a preceptor] a lot and they'd have trust in you then … They wouldn't be standing over you the whole time but they would always be showing you new things … When you've so many different ones [preceptors] you don't build that relationship… (McSharry & Lathlean, 2017, p. 76) Time is a vital ingredient to the passive approach, as allowing novices to see how mistakes play out can help them to build schemas about what to do and what to avoid, as demonstrated in this bakery apprentice's experience: Interviewer: Which is the best way? Apprentice: The bakery's, I believe.…”

“…For example, when contrasting Clement & Steinberg (2002) and other articles describing surgery (Brady et al, 2021;Sutkin et al, 2015aSutkin et al, , 2015b, reassurance through cueing occurs in shorter phrases in the time-intensive setting of surgery. This is shown using "yeah" and "now" in Brady andcolleagues (2021, p. 1804), and in Sutkin and colleagues (2015a, p. 248), "A: 'Cut. Go.…”

Seven Practical Recommendations for Designing and Conducting Qualitative Research in Medical Education

“…For instance, Herzog and coworkers used thematic analysis and focus groups to understand residents’ development and progression with entrustable professional activities within the medical ICU learning environment, identifying themes that might inform strategies for improved interprofessional collaboration, graded autonomy, and informal “learner as teacher” opportunities ( 11 ). Brady and coworkers performed focused ethnography and constant comparative analysis to characterize attending pulmonologist supervisory and didactic skills and behaviors during fellow-performed bronchoscopies ( 12 ). These examples, though by no means comprehensive, may help illustrate the broad value of qualitative approaches to health professions education in pulmonary and critical care medicine.…”