Episode length 24:50

This updated Time-and-Motion study chosen by Jason Frank is a secondary analysis of the iCOMPARE cluster RCT of 2 duty hours approaches back in episode 165. 

The authors selected 6 US university affiliated and community-based hospitals that had interns working on general medicine wards in 2016. They hired 23 observers and trained them who over 3 months, conducted 1:1 observations of 194 workdays.

Jon believes the observers deserve a medal of honour for spending nearly 200 days hospitals watching interns walk around!

Voting for Methods and Impact - at 20 minutes in.

 Authors:  Chaiyachati et al.,

Publication details:  Assessment of Inpatient Time Allocation Among First-Year Internal Medicine Residents Using Time-Motion Observations JAMA Intern Med. 2019 Apr 15. 

Episode length - 25:45

 The purpose of this study is

(1) to discuss the terms used in reference to clinical reasoning;

(2) describe how the research team categorized those terms in relation to the meanings inferred by each term and

(3) to report where there are disagreements in those interpretations 

Voting on Methods and Educational Impact start at 19:30

Authors:  Young et al.,

Publication details: The terminology of clinical reasoning in health professions education: Implications and considerations. Med Teach. 2019 Jul 17:1-8 

Jason selects an important paper on Physician burnout and how concerns have reached a strident pitch

Authors:  Panagioti, et al,.

Publication details: Association Between Physician Burnout and Patient Safety, Professionalism, and Patient Satisfaction A Systematic Review and Meta-analysis JAMA Intern Med. 2018;178(10):1317-1330.

Tell me something, dear clinician-educator: In your institution, who is more likely to be recognized, your colleague the hard-core science researcher, or your most outstanding teacher? Who will make full professor sooner? 

Authors:  Shinkai et al. 

Publication details:  Rethinking the Educator Portfolio: An Innovative Criteria-Based Model Acad Med. 2018 Jul;93(7) 

This paper, Smirnova et al, is a team of heavy hitting meded authors. The group set out to describe how CPIs, as measures of the activities, behaviours, and abilities of clinicians, can inform medical education and health care quality improvement.   

Authors conclusions: 19:55

Jason's Spare Keys: 20:37

Voting for Methods = 2, N/A, N/A, 2.

Voting for Impact = 5, 4, 5, 4.

Authors: Smirnova A et. al.,

Publication details: Defining and Adopting Clinical Performance Measures in Graduate Medical Education: Where Are We Now and Where Are We Going? Acad Med. 2019 May;94(5):671-677 

Jon's chosen article explores the information-gathering techniques of residents by analyzing their initial visual fixation patterns in a simulated resuscitation environment.

Authors:  Szulewski et al.,

Publication details:  A new way to look at simulation-based assessment: the relationship between gaze-tracking and exam performance CJEM. 2019 Jan;21(1):129-137. Epub 2018 Jun 21. 

This is Lara Varpio's 6th 'Methods Consult' for KeyLIME. 

As a PHD trained scientist working in the field, it is of Lara's opinion that her job is to help others gain the skills and expertise needed to engage in Health Professions Education scholarship and research.

Additional material about Thomas Kuhn, ontologies and epistemologies:

1. Stanford Encyclopedia of Philosophy [Internet]. Stanford University: Center for the Study of Language and Information; 2019. Available from: https://plato.stanford.edu
2. Kuhn, TS. The Structure of Scientific Revolutions. 50th ed. Chicago IL: University of Chicago Press; 2012 (Original work published in 1962).
3. Okasha, S. Philosophy of Science: A Very Short Introduction. 2nd ed. Oxford UK: Oxford University Press; 2016.

Episode length 25:55

This paper was selected by Lara Varpio it focuses on two important qualities for all clinicians to embrace and embody in their clinical work: empathy and compassion.

Voting on Methods at 22:30, and Educational Impact 23:27

Authors:  Krishnasamy et. al.,

Publication details: How does medical education affect empathy and compassion in medical students? A meta-ethnography: BEME Guide No. 57. 2019 Med Teach. 2019 Aug 7:1-12. 

Total length of episode 38:17

This episode was recorded live at ICRE 2019 in Ottawa, Ontario.

Jon presents paper first paper at 7:30

Purpose:  “…we sought to determine which interventions aimed at increasing under-represented populations are associated with meeting the desired outcomes of increasing the representation of these populations within the health professions student body.” 

Audience participation

1) 24:42 Stan Hamstra - @StanHamstra

2) 28:04 Paula Craigo  -

3) 29:05 Saleem Razack @SaleemRazack 

Methodology vote starts at: 32:04

Educational Impact vote: 34:26

Authors:   Simone et al.,

Publication details: What are the features of targeted or systemwide initiatives that affect diversity in health professions trainees? A BEME systematic review: BEME Guide No. 50 2018 Medical Teacher, 40:8, 762-780, 

Why a robust body of theory-driven research is needed for education in the clinical setting.

Authors: Cleland J, Durning S.

Publication details: Education and service: how theories can help in understanding tensions. Medical Education 2019 53: 42–55

Length: 22:52