Latest Research in Medical Education - Newsletter #13 🧙‍♀️

411 abstracts reviewed, here are the greatest haunts, I mean hits!

🐈‍⬛ Welcome to our lucky 13th newsletter 🎃 just in time for Halloween! 🐈‍⬛

Here are our highlights…and I’ve added another special collection down below, check it out!

Learning Science:

1. Trainee growth vs. fixed mindset in clinical learning environments: enhancing, hindering and goldilocks factors
   An important psychological tool to combat this crisis is promotion of a growth mindset, which increases resilience and improves mental health outcomes. How growth mindset might be promoted within the clinical learning environment is underexplored. This study aimed to explore the factors promoting a growth mindset versus fixed mindset in trainees from the perspective of the trainees. actors promoting growth mindset adoption included passion, collaboration, diverse career and role modelling. Factors promoting fixed mindset adoption included burnout and competition. Some factors, such as grit, previous success experience and singular training location promoted a fixed mindset when too much or too little were present, and promoted a growth mindset when they were in balance (the Goldilocks principle).

2. Physician preferences for Online and In-person continuing medical education: a cross-sectional study
   A cross-sectional study was performed of attendees of two large internal medicine CME courses held in 2021. Both CME courses were offered via in-person and livestream options, and were taught by Mayo Clinic content experts. Participants, who consisted of practicing physicians seeking CME, completed a 41-question survey after CME course completion. A total of 146 participants completed the survey (response rate, 30.2%). Among the 77 respondents who attended in-person courses, the most frequent reasons indicated were the opportunity to travel (66%) and collaboration/networking with others (25%). Among the 68 respondents who attended the livestream courses, the most frequent reasons indicated included convenience (46%), and travel costs (34%). (🚨 Notice that ‘learning’ isn’t a consideration 🚨)

3. Enablers of and Barriers to Self-Regulated and Self-Directed Aptitudes of Learning (SELF-ReDiAL) in Health Professional Education: A Systematic Review and Meta-analysis

   Recently, accrediting organizations have focused on developing lifelong learners who possess self-regulated and self-directed aptitudes of learning (hereinafter SELF-ReDiAL or in short, SR). This meta-analysis aimed to identify factors which promote or deter SR in health professionals. The strongest effect was generated by wellbeing (d = 0.806; 95% confidence of interval. In respect of teaching method, problem-based learning, team-based learning, and flipped classroom showed positive effects on SR, whereas lectures were negatively associated with SR.

4. Prevalence of Dunning-Kruger effect in first semester medical students: a correlational study of self-assessment and actual academic performance
   The ability to self-assess is a crucial skill in identifying one's own strengths and weaknesses and in coordinating self-directed learning. The Dunning-Kruger effect occurs when limited knowledge causes individuals to overestimate their competence and underestimate others', leading to poor self-assessment and unrecognized incompetence. To serve as a foundation for developing strategies to improve self-assessment, the self-assessment abilities of first-semester students were assessed. 🚨The data indicate that females tend to overestimate their performance while males underestimate theirs 🚨. A pronounced Dunning-Kruger effect is evident in both genders, with significant negative correlations between self-assessment and actual performance.

genAI/LLMs:

1. Decoding medical educators' perceptions on generative artificial intelligence in medical education - Nova Southeastern University, USA.
   Positive attitude toward GenAI and disagreed on GenAI having a very negative effect on either the students' or faculty's educational experience. Eighty-five percent of our medical schools' faculty responded to had heard about GenAI, while 42% had not used it at all. Generating text (33%), automating repetitive tasks (19%), and creating multimedia content (17%) were some of the common utilizations of GenAI by school faculty. The faculty's major concerns were cheating in home assignments in assessment (97%), tendency for blunder and false information (95%), lack of context (86%), and removal of human interaction in important feedback processes (83%).

2. Comparing Scoring Consistency of Large Language Models with Faculty for Formative Assessments in Medical Education
   The Liaison Committee on Medical Education requires that medical students receive individualized feedback on their self-directed learning skills. Pre-clinical students are asked to complete multiple spaced critical appraisal assignments. However, the individual feedback requires significant faculty time. Faculty graded assignments were compared with that of ChatGPT and the scoring of individual items was comparable. ChatGPT use resulted in a fivefold reduction in faculty time and potential savings of 150 faculty hours.

3. A systematic review of large language models and their implications in medical education

   The emergence of LLMs presents a promising solution to challenges like information overload, time constraints and pressure on clinical educators. This systematic review aims to explore LLM applications in medical education, specifically their impact on medical students' learning experiences. The systematic review identified 166 studies, of which 40 were found by review to be relevant to the study. Among the 40 relevant studies, key themes included LLM capabilities, benefits such as personalised learning and challenges regarding content accuracy.

4. Shaping the future: perspectives on the Integration of Artificial Intelligence in health profession education: a multi-country survey - Middle East/Africa
   Data were collected between February and October 2023 via an online survey that covered five main domains: benefits of AI in healthcare, negative impact on patient trust, negative impact on the future of healthcare professionals, inclusion of AI in HPE curricula, and challenges hindering integration of AI in HPE.

5. Enhancing self-directed learning with custom GPT AI facilitation among medical students: A randomized controlled trial

   At 6 weeks, the intervention group showed a marginally higher median Self-Directed Learning Scale score, which further improved by 12 weeks and was sustained at the 14-week follow-up. Additionally, this group demonstrated notable improvements in the Cornell Critical Thinking Test Score at 12 weeks, which persisted into the 14-week follow-up. The group also experienced enhancements in the Global Flow Score from 6 weeks, maintaining superiority over the control group through 12 weeks.

General Themes:

1. Enhancing exam question quality in medical education through bootstrapping
   Achieving a large enough sample to reliably and validly evaluate courses, assessments, and exam questions would require extensive data collection over many years, which is inefficient, especially in the fast-changing educational environment of medical schools. This article demonstrates how advanced quantitative methods, such as bootstrapping, can provide reliable data by resampling a single dataset to create many simulated samples.

2. Vignettes: an innovative qualitative data collection tool in Medical Education research
   This article describes how to make use of exemplar vignettes in qualitative medial education research. Vignettes are particularly useful in prompting discussion with participants, when using real-life case examples may breach confidentiality. As such, using vignettes allows researchers to gain insight into participants' thinking in an ethically sensitive way.

Trainee Well-Being: A L-RiME Special Collection 📖

One is an anecdote, two is a coincidence, three is a trend…SEVEN is a special collection!

1. Promoting motivation and reducing stress in medical students by utilizing self-determination theory - a randomized controlled trial in practical psychiatry courses
   This study demonstrated that enhancing intrinsic motivation through SDT-based teaching can effectively reduce stress in medical students. Exclusively strengths-based positive feedback may have hindered exam performance, but optimizing educational concepts to promote motivation and reduce stress will be a valuable step toward improving medical students' mental well-being.

2. Making space for stories: promoting physician and medical student well-being through successful medical education storytelling events
   Storytelling events in medical education settings are a powerful way to share stories, build community, promote resilience, and foster well-being, but many educators are unsure how to go about creating an event. This paper outlines practical tips to empower readers to plan and carry out a successful, impactful storytelling event.

3. The directors of resident support program: a program evaluation of a resident well-being and support innovation
   Postgraduate Medical Education offices seeking to create resident support programs may anticipate that about 3% of residents may use a similar program per year and that the typical interaction would last 2 h, with a wide range. Feedback suggested that similar programs should have a formal process for follow-up with residents to ensure their concern was addressed and that resident supporters should have diverse lived experiences.

4. Medical Students' Views of the Future in a Rapidly Changing World
   Physicians have long been considered valued members of a solid US health care system. Significant changes in medical education, health care, and society at-large suggest that current medical students may face a different future. To help guide educators and policy makers, we set out to understand medical students' perceptions of the future of health care and their place in it.

5. Formal Parental Leave Policies and Trainee Well-Being in US Graduate Medical Education: A Systematic Review
   Extended parental leave, notably beyond 6 weeks, improved trainee well-being and professional satisfaction. Based on trainees' perspectives, ideal parental leave policies offer a minimum of 6 to 8 weeks of leave, with a formal and clearly written policy available.

6. Meet and Greet Sessions: A Unique Virtual Opt-Out Approach to Support Trainee Well-Being

   During orientation, one-half of invited GME trainees participated in a virtual, individual, brief, nonevaluative meet and greet session with a counselor using an opt-out approach, and one-third subsequently requested counseling. Survey feedback was encouraging, and this approach can serve to help normalize culture surrounding accessing mental health services.

7. Unionization of Graduate Medical Education Trainees: Perspectives from Designated Institutional Officials
   Most GME and other leaders at academic medical centers lack familiarity with resident/fellow unions, including what to expect, what decisions need to be made, and the processes involved in a unionization effort. It is important for designated institutional officials (DIOs), GME program directors, teaching faculty, and other institutional leaders to understand the drivers of resident/fellow unionization, the union organizing campaign and election process, and what follows a vote to unionize, including collective bargaining.

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