The limited use of instructional design guidelines in healthcare simulation scenarios: an expert appraisal.

Background: Systematic reviews on simulation training effectiveness have pointed to the need to adhere to evidence-based instructional design (ID) guidelines. ID guidelines derive from sound cognitive theories and aim to optimize complex learning (integration of knowledge, skills, and attitudes) and learning transfer (application of acquired knowledge and skills in the workplace). The purpose of this study was to explore adherence to ID guidelines in simulation training programs for dealing with postpartum hemorrhage (PPH), a high-risk situation and the leading cause of maternal mortality worldwide.

High enthusiasm about long lasting mentoring relationships and older mentors.

Background: Mentoring plays a pivotal role in workplace-based learning, especially in the medical realm. Organising a formal mentoring programme can be labor and time intensive and generally impractical in resource constrained medical schools with limited numbers of mentors. Hence, informal mentoring offers a valuable alternative, but will be more likely to be effective when mentors and protégés share similar views.

Effects of an instructional design based postpartum hemorrhage simulation training on patient outcomes: an uncontrolled before-and-after study.

To compare postpartum hemorrhage (PPH) patient outcomes before and after an instructional design based PPH simulation attended by obstetrics and gynecology (OBGYN) residents. This uncontrolled before-and-after study was conducted in Recife, Brazil including all 1388 women delivering from June to August 2012 and all 1357 delivering from June to August 2013. The 36 OBGYN residents were divided into13 teams of two or three participants and were trained through ID based PPH simulation training with the following eight steps: (1) prior knowledge activation, (2) video demonstration, (3) dual-coding PPH protocol discussion-an image association during the training, (4) training scenario # 1, (5) debriefing, (6) training scenario # 2 with immediate feedback, (7) training scenario # 3, and (8) debriefing with self-assessment.

Exploring medical residents' perceived need for negotiation skills training.

Objectives: This study explores the optimal focus for negotiation skills development training by investigating how often medical residents negotiate in practice, and how they perceive the effectiveness of their negotiation capabilities.

Methods: An exploratory study was performed using a questionnaire regarding the medical residents' working environment, negotiation frequency, knowledge and skills using a 5-point Likert scale, multiple choice questions and open questions. Exploratory factor analysis with principal component analysis, varimax rotation, reliability analysis, and content analysis were used to reduce the number of variables.

Does selection pay off? A cost-benefit comparison of medical school selection and lottery systems.

Context: Resources for medical education are becoming more constrained, whereas accountability in medical education is increasing. In this constrictive environment, medical schools need to consider and justify their selection procedures in terms of costs and benefits. To date, there have been no studies focusing on this aspect of selection.

Selection into medicine: the predictive validity of an outcome-based procedure.

Background: Medical schools must select students from a large pool of well-qualified applicants. A challenging issue set forward in the broader literature is that of which cognitive and (inter)personal qualities should be measured to predict diverse later performance. To address this gap, we designed a 'backward chaining' approach to selection, based on the competences of a 'good doctor'.

Development and validation of the TOCO-TURBT tool: a summative assessment tool that measures surgical competency in transurethral resection of bladder tumour.

Background: The current shift towards competency-based residency training has increased the need for objective assessment of skills. In this study, we developed and validated an assessment tool that measures technical and non-technical competency in transurethral resection of bladder tumour (TURBT).

Methods: The 'Test Objective Competency' (TOCO)-TURBT tool was designed by means of cognitive task analysis (CTA), which included expert consensus.

Connected, attracted, and concerned: A Q study on medical crossborder curriculum partnerships.

Introduction: A new form of internationalization has been trending upward in the medical education realm: crossborder medical curriculum partnerships established to deliver the same, or adapted, curriculum to groups of geographically separated students. This study aims to investigate crossborder medical curriculum partnerships by exploring the experiences of teachers at the recipient institution who have a key role in delivering the program.

Methods: From four pioneering recipient medical schools, 24 teachers participated in a Q-sort study.

Cross-validation of a learning climate instrument in a non-western postgraduate clinical environment.

Background: In postgraduate training, there is a need to continuously assess the learning and working conditions to optimize learning. Students or trainees respond to the learning climate as they perceive it. The Dutch Residency Educational Climate Test (D-RECT) is a learning climate measurement tool with well-substantiated validity.

Selection and ranking of patient video cases in paediatric neurology in relation to learner levels.

Background: Teaching and learning with patient video cases may add authenticity, enhance diagnostic accuracy and improve chances of early diagnosis. The aim of this study is firstly to identify selection criteria for key Patient video cases (PVCs), secondly to identify trends in relevance of PVCs for learner levels and thirdly, to rank PVCs for learner levels.

Methods: Based on a literature review, we identified criteria for key PVCs for use in paediatric neurology.

Stakeholders' perceptions on competency and assessment program of entry-level pharmacists in developing countries.

Objectives: To assess the stakeholders' perceptions on the competency of entry-level pharmacists and the use of written licensure examination as the primary assessment for licensure decisions on entry-level pharmacists who have completed the Pharmacy Internship Program (PIP) in developing countries.

Method: A cross-sectional survey was conducted among stakeholders in which they completed a web-based 21-item pre-tested questionnaire to determine their views regarding the competency outcomes and assessment program for entry-level pharmacist.

Results: The stakeholders rated the entry-level pharmacists to possess all competencies except research skills.

Toward a better judgment of item relevance in progress testing.

Background: Items must be relevant to ensure item quality and test validity. Since "item relevance" has not been operationalized yet, we developed a rubric to define it. This study explores the influence of this rubric on the assessment of item relevance and on inter-rater agreement.

Electronic assessment of clinical reasoning in clerkships: A mixed-methods comparison of long-menu key-feature problems with context-rich single best answer questions.

Background: It remains unclear which item format would best suit the assessment of clinical reasoning: context-rich single best answer questions (crSBAs) or key-feature problems (KFPs). This study compared KFPs and crSBAs with respect to students' acceptance, their educational impact, and psychometric characteristics when used in a summative end-of-clinical-clerkship pediatric exam.

Methods: Fifth-year medical students (n = 377) took a computer-based exam that included 6-9 KFPs and 9-20 crSBAs which assessed their clinical reasoning skills, in addition to an objective structured clinical exam (OSCE) that assessed their clinical skills.

Stakeholder perspectives on workplace-based performance assessment: towards a better understanding of assessor behaviour.

Workplace-Based Assessment (WBA) plays a pivotal role in present-day competency-based medical curricula. Validity in WBA mainly depends on how stakeholders (e.g.

The use of instructional design guidelines to increase effectiveness of postpartum hemorrhage simulation training.

Objective: To compare learning outcomes of postpartum hemorrhage simulation training based on either instructional design guidelines or best practice.

Methods: A pretest-post-test non-equivalent groups study was conducted among obstetrics and gynecology residents in Recife, Brazil, from June 8 to August 30, 2013. The instructional design group included 13 teams, whereas the best practice group included seven teams.

A first report of East Asian students' perception of progress testing: a focus group study.

Background: Progress testing (PT) is used in Western countries to evaluate students' level of functional knowledge, and to enhance meaning-oriented and self-directed learning. However, the use of PT has not been investigated in East Asia, where reproduction-oriented and teacher-centered learning styles prevail. Here, we explored the applicability of PT by focusing on student perceptions.

Embedding of the progress test in an assessment program designed according to the principles of programmatic assessment.

Background: Progress tests (PT) are used to assess students on topics from all medical disciplines. Progress testing is usually one of the assessment methods of the cognitive domain. There is limited knowledge on how positioning of the PT in a program of assessment (PoA) influences students' PT scores, use of PT feedback and perceived learning value.

High educational impact of a national simulation-based urological curriculum including technical and non-technical skills.

Background: Although simulation training is increasingly used to meet modern technology and patient safety demands, its successful integration within surgical curricula is still rare. The Dutch Urological Practical Skills (D-UPS) curriculum provides modular simulation-based training of technical and non-technical basic urological skills in the local hospital setting. This study aims to assess the educational impact of implementing the D-UPS curriculum in the Netherlands and to provide focus points for improvement of the D-UPS curriculum according to the participants.

Content validity of workplace-based portfolios: A multi-centre study.

Background: Portfolios are used as tools to coach and assess students in the workplace. This study sought to evaluate the content validity of portfolios as reflected in their capacity to adequately assess achieved competences of medical students during clerkships.

Methods: We reviewed 120 workplace portfolios at three medical universities (Belgium and the Netherlands).

The Simbla TURBT Simulator in Urological Residency Training: From Needs Analysis to Validation.

Objective: To investigate the value of the physical Simbla Transurethral Resection of a Bladder Tumor (TURBT) simulator as an educational tool within urological residency training, by means of a training needs analysis (TNA) and assessment of its feasibility, acceptability, and face, content, and construct validity.

Methods: To analyze the training needs for TURBT, procedural steps and pitfalls were identified and the TNA was completed during an expert consensus meeting. Participants (n = 76) were divided into three groups based on their experience in TURBT: novices, intermediates, and experts.

Effect of comprehensive oncogenetics training interventions for general practitioners, evaluated at multiple performance levels.

General practitioners (GPs) are increasingly called upon to identify patients at risk for hereditary cancers, and their genetic competencies need to be enhanced. This article gives an overview of a research project on how to build effective educational modules on genetics, assessed by randomized controlled trials (RCTs), reflecting the prioritized educational needs of primary care physicians. It also reports on an ongoing study to investigate long-term increase in genetic consultation skills (1-year follow-up) and interest in and satisfaction with a supportive website on genetics among GPs.

Validity and reliability of bilingual English-Arabic version of Schutte self report emotional intelligence scale in an undergraduate Arab medical student sample.

Background: The psychological construct of emotional intelligence (EI), its theoretical models, measurement instruments and applications have been the subject of several research studies in health professions education.

Aim: The objective of the current study was to investigate the factorial validity and reliability of a bilingual version of the Schutte Self Report Emotional Intelligence Scale (SSREIS) in an undergraduate Arab medical student population.

Methods: The study was conducted during April-May 2012.

Can less be more? Comparison of an 8-item placement quality measure with the 50-item Dundee Ready Educational Environment Measure (DREEM).

Clinical clerks learn more than they are taught and not all they learn can be measured. As a result, curriculum leaders evaluate clinical educational environments. The quantitative Dundee Ready Environment Measure (DREEM) is a de facto standard for that purpose.

Combining bimodal presentation schemes and buzz groups improves clinical reasoning and learning at morning report.

Morning reports offer opportunities for intensive work-based learning. In this controlled study, we measured learning processes and outcomes with the report of paediatric emergency room patients. Twelve specialists and 12 residents were randomised into four groups and discussed the same two paediatric cases.

Impact of institute and person variables on teachers' conceptions of learning and teaching.

Background: Teachers' conceptions of learning and teaching are important for faculty development to result in enduring changes in teaching practices. Until now, studies on these conceptions have mostly focused on traditional, lecture-based curricula rather than on small-group student-centred educational formats, which are gaining ground worldwide.

Aim: To explore which factors predict teachers' conceptions in student-centred curricula.