Publications by authors named "Dorene Balmer"

Purpose: Competency-based time-variable (CBTV) graduate medical education (GME) has been implemented in Canada, Europe, and the United States, yet its perceived value has not been explored. Promotion in Place (PIP) is a CBTV GME program in which residents graduating early advance to attending status with "sheltered independence" until the standard graduation date. This study describes perceived value of CBTV GME and PIP at Mass General Brigham by capturing diverse stakeholder perspectives.

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Developing and maintaining connections with others, or what we refer to as the formation of social ties, may strengthen medical students' sense of belonging in medical school. Social ties play a particularly important role for women medical students as the medical field remains largely dominated by masculine norms. However, forming social ties remains challenging for women in medicine.

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Background: Workplace learning in critical care settings is complex and challenging. Research has explored learner-, teacher-, and context-related factors that influence medical residents' engagement in critical care workplaces in Western but not in non-Western cultures. This limits our understanding of workplace learning globally and how we can better support resident learning in diverse cultures.

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Phenomenon: Marginalized individuals in medicine face many structural inequities which can have enduring consequences on their progress. Therefore, inequity must be addressed by dismantling underlying unjust policies, environments, and curricula. However, once these injustices have been taken apart, how do we build more just systems from the rubble? Many current strategies to address this question have foundational values of urgency, solutionism, and top-down leadership.

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Context: Despite increasing discussion and scholarship, equity in assessment is rarely defined and distinguished in a way that allows for shared understanding in medical education. This paper seeks to clarify and expand the conversation about equity in assessment by critically reviewing three distinct and evolving orientations toward equity in assessment. Orientations refers to the positions, attitudes, interests or priorities individuals can hold toward equity in assessment.

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Article Synopsis
  • Medical education is incorporating arts and humanities (AHs) to enhance physician competence and professionalism, but there's a need to understand its impact specifically in graduate medical education.
  • A qualitative study with 14 internal medicine interns explored the effects of a longitudinal AHs curriculum, revealing three key themes: reclaiming personal identity, fostering a sense of community, and enhancing empathy.
  • Interns generally valued the abstract benefits of AHs, noting a fluctuating appreciation throughout their intern year, which ultimately highlighted the long-term value of AHs in their personal and professional development.
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Objective: Promoting autonomy is at the core of fellowship education. Pediatric hospital medicine (PHM) fellowship programs are relatively new, and many supervising physicians are not trained on how to promote fellow autonomy. Moreover, no studies have explored fellows' perception of autonomy throughout training.

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Purpose: Medical education journal editors work to improve scholarly rigor and expand access to scholarship. How editors conceptualize these dual roles is unknown and holds implications for the kinds of scholarship that are valued and made visible through publication. The authors applied the concept of capacity building to examine how medical education journal editors conceptualize and operationalize capacity building and to identify the contextual factors that support or constrain these efforts.

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Objective: Although positive airway pressure (PAP) is effective for treating obstructive sleep apnea (OSA) in infants, there is a lack of data on caregivers' experiences administering PAP at home. Understanding caregivers' perspectives may change health care professionals approach to PAP initiation. Our study aimed to gain comprehensive insight into caregivers' beliefs, perceptions, and challenges associated with implementing PAP for infants with OSA, considering the transition from inpatient hospitalization to home.

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Introduction: Despite tenacious efforts of continuing professional development (CPD) developers and educators, physician engagement in CPD is fraught with challenges. Research suggests that these educational interventions and the maintenance of professional competence systems that mandate them are often seen as impractical, decontextualized and check-box activities by participants. This study explores physicians' learning post graduate medical education (GME) training across their CPD journey to understand how they (a) conceive of themselves as learners and (b) engage in lifelong learning across the course of their professional careers.

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Purpose: Physician educators are often expected to direct educational programs and assume roles that conform to field norms for career advancement but that may not afford meaningful work for educators. The purpose of this study was to describe and analyse the perspectives and actions taken by physician educators in response to tension between feeling compelled to direct an educational program and doing educationally meaningful work.

Methods And Materials: We used data from a longitudinal study and focused on three participants who, over the course of the five-year study, offered significant insights into how physician educators act in ways that run counter to expectations for career advancement.

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Purpose: Electroencephalography (EEG) is commonly used in neurology, but there is variability in how neurologists interpret EEGs, potentially from variability in EEG teaching. Little is known about how EEG teaching is done to prepare neurologists for professional practice.

Methods: We interviewed a group of EEG experts to characterize their teaching practices around continuous EEG (cEEG).

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Context: A growth mindset and mastery approach have gained attention as useful learning orientations in medical education, however few studies of interventions to foster these orientations exist.

Objectives: We sought to discover whether a communication skills session on delivering serious news could foster a communication growth mindset and/or a mastery approach in medical students.

Methods: This was an interventional survey study of third-year medical students before and after a session on delivering serious news.

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Objectives: Pediatric residency trainees interface with electrocardiograms (EKG) as part of routine clinical care. Depending on workflow and availability of support staff, trainees may be required to obtain EKGs on patients, though training on this skill varies. Our intervention seeks to train incoming pediatric residents on obtaining EKGs from pediatric patients and identifying common problems that may result in acquisition of low-fidelity EKGs.

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Objective: Some pediatric residents report experiencing less autonomy when working clinically with pediatric hospital medicine (PHM) fellows than with attendings alone. We sought to explore pediatric senior resident (SR) experiences working clinically with PHM fellows, with a focus on characterizing fellow behaviors that could impact perceived resident autonomy.

Methods: In this qualitative study, we conducted virtual semistructured interviews with pediatric SRs.

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Background: Arts-and-humanities-based interventions are commonly implemented in medical education to promote well-being and mitigate the risk of burnout. However, mechanisms for achieving these effects remain uncertain within graduate medical education. The emerging field of the positive humanities offers a lens to examine whether and how arts-based interventions support well-being in internal medicine interns.

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Intrinsic inequity in assessment refers to sources of harmful discrimination inherent in the design of assessment tools and systems. This study seeks to understand intrinsic inequity in assessment systems by studying assessment policies and associated procedures in residency training, using general pediatrics as a discourse case study. Foucauldian discourse analysis (FDA) was conducted on assessment policy and procedure documents.

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Introduction: Mastery learning orientation, conceptualized as a growth mindset, can be beneficial to learners in medical education and is supported by a program...

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