Integrating threshold concepts with reflective practice: Discussing a theory‐based approach for curriculum refinement in dental education

Hyde, Sarah; Wilson, David

doi:10.1111/eje.12380

Cited by 12 publications

(9 citation statements)

References 32 publications

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“…Others focused on how the introduction of TCs could reform curricula and proposed it as a novel perspective of learning in HPE. The fields in which TCs are suggested to influence curricula include midwifery students’ learning about infant feeding (Angell & Taylor, 2013 ), learning to become a physiotherapist (Barradell, 2017 ), dental education (Hyde et al, 2018 ; Kinchin et al, 2011 ), and public health for interprofessional health students (Senior & Telford, 2015 ).…”

Section: Resultsmentioning

confidence: 99%

“…As in the theme TCs influencing curriculum design there were articles mainly focusing on identifying TCs that also discussed their nature and how one should go about investigating them (Fortune & Kennedy-Jones, 2014 ; Hyde et al, 2018 ; Moeller & Fawns, 2018 ; Neve et al, 2017 , 2020 ; Nicola-Richmond et al, 2016 ). Many found the task of identifying TCs to be challenging, which was related to Meyer and Land’s notion that a TC does not necessarily need to fulfil all predefined criteria (Meyer & Land, 2003 ).…”

Section: Resultsmentioning

confidence: 99%

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Threshold concepts in health professions education research: a scoping review

Liljedahl

Palmgren

McGrath

2022

Adv in Health Sci Educ

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Threshold concepts (TCs) are increasingly used in health professions education (HPE) research. TCs are claimed to be conceptual gateways which are often traversed with substantial difficulty. In this paper, we report on a scoping review investigating the following research question: What is the scope and nature of the currently available research on threshold concepts in health professions education literature? We employed Arksey and O’Malley’s model for scoping reviews. A search for literature on TCs in HPE research between 2003 and 2020 yielded 999 records of which 59 were included in the review. The data set was subject to quantitative descriptive analysis of article characteristics as well as qualitative thematic analysis of the scope of research on TCs. Among the 59 articles selected for review, there were 30 empirical, 26 conceptual and three reviews. A majority were published in 2015 or later. Almost half of the included articles attempted to identify possible TCs within HPE. Others investigated how TCs can be traversed or suggested how TCs could influence curriculum design. Some critically appraised the framework of TC. Although TCs are increasingly utilised in HPE, the present review identified how researchers came across methodological challenges related to identifying possible TCs and definitional challenges around identifying the essential characteristics of TCs. Before embracing TCs as the next go-to theory for learning in HPE, we acknowledge the need for methodological stringeny and rigour as well as more data to support TCs. Until then, any implementation of TCs in HPE curricula should be done cautiously.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Threshold concepts in health professions education research: a scoping review

Liljedahl

Palmgren

McGrath

2022

Adv in Health Sci Educ

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“…Moreover, 153 of these participants completed all five interactive online clinical cases, with approximately half scoring over 90% in the first attempt [36]. Therefore, the transfer of theoretical knowledge through virtual tools is more effective than its integration, which represents an important challenge for the development of these types of environments and encourages the exploration of alternative technologies such as virtual reality [37,38].…”

Section: Plos Onementioning

confidence: 99%

Impact of a virtual learning environment on the conscious prescription of antibiotics among Colombian dentists

et al. 2022

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Appropriate antibiotic prescription contributes to reducing bacterial resistance; therefore, it is critical to provide training regarding this challenge. The objective of this study was to develop a virtual learning environment for antibiotic prescription and to determine its impact on dentists’ awareness, attitudes, and intention to practice. First, the learning content on multimedia resources was developed and distributed into three challenges that participants had to overcome. Then, a quasi-experimental study was performed in which the virtual learning environment was implemented on dentists from seven Colombian cities. The median of correct answers and the levels of awareness, attitudes, and intention to practice were compared before, immediately after, and 6-months post-intervention. Wilcoxon signed-rank and McNemar’s tests were used to determine the differences. A total of 206 participants who finished the virtual learning environment activities exhibited a favorable and statistically significant impact on the median of correct answers of awareness (p < 0.001), attitudes (p < 0.001), and intention to practice (p = 0.042). A significant increase occurred in the number of participants with a high level of awareness (p < 0.001) and a non-significant increase in participants with high levels of attitudes (p = 0.230) and intention to practice (p = 0.286). At 6 months, the positive effect on the median of correct answers on awareness and intention to practice persisted (p < 0.001); however, this was not evident for attitudes (p = 0.105). Moreover, there was a significant decrease in the number of participants who showed low levels of awareness (p = 0.019) and a slight increase in those with high levels of the same component (p = 0.161). The use of a virtual learning environment designed for dentists contributed to a rapid improvement in awareness and intention to practice antibiotic prescription; however, their attitudes and information retention need reinforcement.

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“…TCs have been identified in various disciplines such as nursing,4–7 dentistry,8 9 occupational therapy,10–13 pharmacy14 and physiotherapy 15. Some TCs are shared by multiple healthcare professions; ‘caring’,16 ‘role of touch’,17 ‘intraprofessionality and interprofessionality’,18 19 ‘holistic approach’, ‘uncertainty’, ‘complexity of care’, ‘consider the whole person’, ‘collective competence’ and ‘patient-centredness’ 20.…”

Section: Introductionmentioning

confidence: 99%

Identifying threshold concepts in postgraduate general practice training: a focus group, qualitative study

Hall

Chae

2022

BMJ Open

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ObjectiveTo identify threshold concepts (TCs) for physicians undergoing postgraduate medical education (PGME) in general practice.DesignAn explorative, qualitative study with 65 min focus group interviews and thematic analysis was used. Participants were asked to describe their most transformative learning experiences. Heuristical TCs were identified from the thematic analysis.SettingAotearoa/New Zealand (A/NZ).ParticipantsFifty participants, mostly comprising current trainees and educators from urban centres, and of NZ/European ethnicity.ResultsTwenty TCs covering many aspects of postgraduate general practice experience were derived from themes identified in the data. Presented in medical proverbial form for ease of recollection, these included: Money makes the practice go round; Be a legal eagle; Manage time or it will manage you; Guidelines, GPs’ little helpers; Right tool, right word, right place; The whole of the practice is greater than the sum of the parts; The personal enhances the professional; Beat biases by reflection; Chew the Complexity, Unpredictability, Diversity; Embrace the uncertainty; Not knowing is knowing; Seek and you shall find; Waiting and seeing, waiting and being; Look, listen, think between the lines; Treat the patient beyond the disease; No patient is an island; Words work wonders; Hearing is healing; Being you and being there; and; The relationship is worth a thousand consults. These TCs mapped onto core competencies in A/NZ’s PGME in general practice curriculum.ConclusionsParticipants readily identified transformative and troublesome moments in their PGME in general practice. These findings confirmed evidence for a wide range of TCs with many newly identified in this study. All TCs were fundamentally based on the doctor–patient relationship, although often involving the context and culture of general practice. Actively incorporating and teaching these identified TCs in PGME in general practice may enable trainees to grasp these important learning thresholds earlier and more easily and aid in identity and role formation.

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Integrating threshold concepts with reflective practice: Discussing a theory‐based approach for curriculum refinement in dental education

Cited by 12 publications

References 32 publications

Threshold concepts in health professions education research: a scoping review

Threshold concepts in health professions education research: a scoping review

Impact of a virtual learning environment on the conscious prescription of antibiotics among Colombian dentists

Identifying threshold concepts in postgraduate general practice training: a focus group, qualitative study

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