Investigating the Roles and Impact of Clinical Competency Committees in Graduate Medical Education: A Narrative Review.

Although Clinical Competency Committees (CCCs) were implemented to facilitate the goals of competency-based medical education, implementation has been variable, and we do not know if and how these committees affected programs and assessment in graduate medical education (GME). To explore the roles CCCs fulfill in GME and their effect on trainees, faculty, and programs. We conducted a narrative review of CCC primary research with the following inclusion criteria: all articles must be research in nature, focused on GME and specifically studying CCCs, and published in English language journals from January 2013 to November 2022.

Clarifying and expanding equity in assessment by considering three orientations: Fairness, inclusion and justice.

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.

Leveraging Narrative Feedback in Programmatic Assessment: The Potential of Automated Text Analysis to Support Coaching and Decision-Making in Programmatic Assessment.

Introduction: Current assessment approaches increasingly use narratives to support learning, coaching and high-stakes decision-making. Interpretation of narratives, however, can be challenging and time-consuming, potentially resulting in suboptimal or inadequate use of assessment data. Support for learners, coaches as well as decision-makers in the use and interpretation of these narratives therefore seems essential.

Challenges in engaging patients in feedback conversations for health care professionals' workplace learning.

Introduction: Patient feedback is relevant information for improvement of health care professionals' performance. Engaging patients in feedback conversations can help to harness patient feedback as a powerful tool for learning. However, health care settings may prevent patients and health care professionals to effectively engage in a feedback dialogue.

Inequity is woven into the fabric: a discourse analysis of assessment in pediatric residency training.

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.

Persistence Level Reflects Antibiotic Survival of Natural Pseudomonas aeruginosa Isolates in a Murine Lung Infection Model.

Clinicians are increasingly confronted with the limitations of antibiotics to clear bacterial infections in patients. It has long been assumed that only antibiotic resistance plays a pivotal role in this phenomenon. Indeed, the worldwide emergence of antibiotic resistance is considered one of the major health threats of the 21st century.

Impact of pulmonary African trypanosomes on the immunology and function of the lung.

Approximately 20% of sleeping sickness patients exhibit respiratory complications, however, with a largely unknown role of the parasite. Here we show that tsetse fly-transmitted Trypanosoma brucei parasites rapidly and permanently colonize the lungs and occupy the extravascular spaces surrounding the blood vessels of the alveoli and bronchi. They are present as nests of multiplying parasites exhibiting close interactions with collagen and active secretion of extracellular vesicles.

Supervisory dyads' communication and alignment regarding the use of workplace-based observations: a qualitative study in general practice residency.

Background: In medical residency, performance observations are considered an important strategy to monitor competence development, provide feedback and warrant patient safety. The aim of this study was to gain insight into whether and how supervisor-resident dyads build a working repertoire regarding the use of observations, and how they discuss and align goals and approaches to observation in particular.

Methods: We used a qualitative, social constructivist approach to explore if and how supervisory dyads work towards alignment of goals and preferred approaches to performance observations.

How medical students co-regulate their learning in clinical clerkships: a social network study.

Background: Self-regulated learning is a key competence to engage in lifelong learning. Research increasingly acknowledges that medical students in clerkships need others to regulate their learning. The concept of "co-regulated learning" captures this act of regulating one's learning by interacting with others.

is an anti-inflammatory bacterium in the respiratory tract of patients with chronic lung disease.

Background: Chronic airway inflammation is the main driver of pathogenesis in respiratory diseases such as severe asthma, chronic obstructive pulmonary disease, cystic fibrosis (CF) and bronchiectasis. While the role of common pathogens in airway inflammation is widely recognised, the influence of other microbiota members is still poorly understood.

Methods: We hypothesised that the lung microbiota contains bacteria with immunomodulatory activity which modulate net levels of immune activation by key respiratory pathogens.

Putting self-regulated learning in context: Integrating self-, co-, and socially shared regulation of learning.

Processes involved in the regulation of learning have been researched for decades, because of its impact on academic and workplace performance. In fact, self-regulated learning is the focus of countless studies in health professions education and higher education in general. While we will always need competent individuals who are able to regulate their own learning, developments in healthcare require a shift from a focus on the individual to the collective: collaboration within and between healthcare teams is at the heart of high-quality patient care.

Relationships between medical students' co-regulatory network characteristics and self-regulated learning: a social network study.

Introduction: Recent conceptualizations of self-regulated learning acknowledge the importance of co-regulation, i.e., students' interactions with others in their networks to support self-regulation.

Exploring residents' perceptions of PA and NP roles and barriers to collaboration.

Objective: Developing competencies for interprofessional collaboration, including understanding other professionals' roles on interprofessional teams, is an essential component of medical education. This study explored resident physicians' perceptions of the clinical roles and responsibilities of physician assistants (PAs) and NPs in the clinical learning environment.

Methods: Using a constructivist grounded theory approach, semistructured interviews were conducted with 15 residents in one academic setting.

Ratings of performance in multisource feedback: comparing performance theories of residents and nurses.

Background: Multisource feedback (MSF) is increasingly being used to assess trainee performance, with different assessor groups fulfilling a crucial role in utility of assessment data. However, in health professions education, research on assessor behaviors in MSF is limited. When assessing trainee performance in work settings, assessors use multidimensional conceptualizations of what constitutes effective performance, also called personal performance theories, to distinguish between various behaviors and sub competencies.

How to conceptualise self-regulated learning: Implications for measurement.

When is self‐regulated learning not entirely self‐regulated? The authors argue SRL is socially embedded and we need better measurement of its reciprocal relationship with co‐regulated learning.

Student perspectives on competency-based portfolios: Does a portfolio reflect their competence development?

Introduction: Portfolio-based assessments require that learners' competence development is adequately reflected in portfolio documentation. This study explored how students select and document performance data in their portfolios and how they perceive these data to be representative for their competence development.

Methods: Students uploaded performance data in a competency-based portfolio.

Learning in the workplace: Use of informal feedback cues in doctor-patient communication.

Objectives: We expect physicians to be lifelong learners. Participation in clinical practice is an important potential source of that learning. To support physicians in this process, a better understanding of how they learn in clinical practice is necessary.

ADEA-ADEE Shaping the Future of Dental Education III: Assessment in competency-based dental education: Ways forward.

Assessment in competency-based dental education continues to be a recognized area for growth and development within dental programs around the world. At the joint American Dental Education Association (ADEA) and the Association for Dental Education in Europe (ADEE) 2019 conference, Shaping the Future of Dental Education III, the workshop on assessment was designed to continue the discussion started in 2017 at the ADEA-ADEE Shaping the Future of Dental Education II. The focus of the 2019 conference involved examining the potential of entrustable professional activities (EPAs) and current thinking about workplace-based assessment (WBA) within competency-based education in the 21st century.

The impact of entrustment assessments on feedback and learning: Trainee perspectives.

Context: Assessment for and of learning in workplace settings is at the heart of competency-based medical education. In postgraduate medical education (PGME), entrustable professional activities (EPAs) and entrustment scales are increasingly used to assess competence. However, the educational impacts of these assessment approaches remain unknown.

Beyond the self: The role of co-regulation in medical students' self-regulated learning.

Context: Medical students are expected to self-regulate their learning within complex and unpredictable clinical learning environments. Research increasingly focuses on the effects of social interactions on the development of self-regulation in workplace settings, a notion embodied within the concept of co-regulated learning (CRL). Creating workplace learning environments that effectively foster lifelong self-regulated learning (SRL) requires a deeper understanding of the relationship between CRL and SRL.

Perceptions of people with respiratory problems on physician performance evaluation-A qualitative study.

Background: Despite increasing calls for patient and public involvement in health-care quality improvement, the question of how patient evaluations can contribute to physician learning and performance assessment has received scant attention.

Objective: The objective of this study was to explore, amid calls for patient involvement in quality assurance, patients' perspectives on their role in the evaluation of physician performance and to support physicians' learning and decision making on professional competence.

Design: A qualitative study based on semi-structured interviews.

Isolation and Characterization of Clinical RSV Isolates in Belgium during the Winters of 2016-2018.

Respiratory Syncytial Virus (RSV) is a very important viral pathogen in children, immunocompromised and cardiopulmonary diseased patients and the elderly. Most of the published research with RSV was performed on RSV Long and RSV A2, isolated in 1956 and 1961, yet recent RSV isolates differ from these prototype strains. Additionally, these viruses have been serially passaged in cell culture, which may result in adaptations that affect virus-host interactions.