Educational Resources Information Center Database Research Articles

Humanitarian health education and training state-of-the-art: a scoping review.

In the past decade, humanitarian emergencies have been increasing, leading to an higher demand for humanitarian health professionalization. Education and training are critical for preparing these workers to provide effective care during crises. Understanding the current state-of-the-art in humanitarian health education is essential to inform research and development of future educational programs. This review surveys the peer-reviewed literature to provide insights into the current thinking in the field. A review was conducted in March 2023 and updated in May 2024 using PubMed, Web of Science, Scopus, and Education Resources Information Center databases for English-language peer-reviewed articles published since January 2013. The review followed the Joanna Briggs Institute methodology for scoping reviews and adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Data were analyzed using qualitative content analysis and presented as a narrative descriptive summary. After screening, 32 articles met the inclusion criteria. The themes of the selected articles focus on education and training frameworks, mapping, and programs. Despite the growing opportunities, most education and training programs are based in the Global North. The gaps identified include a lack of standardized curriculum or competency frameworks and evaluation frameworks to guide the development and evaluation of further standardized training programs. Interdisciplinary and collaborative partnerships, iterative design, and mixed teaching methods and modalities, including e-learning, facilitated successful training. However, logistical and technical constraints and the lack of standardized training frameworks were barriers to developing, implementing, and evaluating such training programs. This review provides an overview of the humanitarian health education trends over the last decade and identifies key areas for future educational development and research. The findings emphasize the importance of adapting interdisciplinary and collaborative partnerships and prioritizing the training of local staff through regional centers, local leadership, and accessible e-learning, including e-simulation. The review also highlights the need for continued research and evaluation of humanitarian health education and training programs with standardized metrics to evaluate training programs and identify areas for improvement. These steps will help ensure that humanitarian health professionals receive adequate training to provide effective healthcare in crisis situations.

Exploring the dynamics of design thinking in management education and training: a critical review, taxonomic analysis and practical implications

PurposeApplying critical analysis as the methodological framework for assessing the literature, the review seeks to present a summary and evaluation of the existing body of knowledge. This approach helps to establish the basis for developing forthcoming recommendations.Design/methodology/approachThe articles were selected through a Systematic Literature Review following the PRISMA guidelines, and utilising Scopus, Web of Science, Science Direct, and the Education Resources Information Center database. Field taxonomy is presented based on the outcomes.FindingsThrough a critical review, we offer narrative arguments that document the shortcomings in the existing literature by scrutinising study designs and highlighting suboptimal approaches. Finally, we issue a call to action for future research, envisioning its potential to reorient and reconstruct the field while enhancing the quality of future studies. This proactive stance aims to foster the development of more competent and insightful perspectives, theories, and policy recommendations within design thinking in management education and training.Practical implicationsThe research in this field holds significant potential for providing valuable practical and policy insights, contingent upon the rigorous and thorough execution of studies.Originality/valueThis article presents a robust critical review of 57 state-of-the-art articles investigating design thinking in the context of management education and training.

Art therapy for children and adolescents with autism: a systematic review

ABSTRACT Background Children and adolescents with autism spectrum disorder (ASD) experience a variety of social, behavioural and motor symptoms that impact their daily life. The benefits of art therapy (AT) have been demonstrated with other populations. Aims: This review aimed to investigate the effectiveness of AT for children and adolescents with ASD. Methods Following best practice standards in the conduct of systematic reviews, a comprehensive search of MEDLINE, Emcare, Embase, Cochrane Library, PsycINFO, OTseeker and Education Resources Information Center databases and grey literature was conducted in February 2023. Two reviewers independently undertook a two-stage literature screening process. The McMaster critical appraisal tool was utilised to determine the methodological quality of the included studies. A narrative synthesis was used to synthesise the results. Results Seven studies of varying methodological quality were included in this review. The modality and parameters of AT varied between studies, as did measures of outcomes. However, improvements in social skills (communication, interpersonal relationships and social behaviour), behavioural skills (hyperactivity/inattention and assertion) and motor skills (fine motor skills, balance and flexibility) were reported in the literature. Conclusions While AT may offer positive improvements of ASD symptoms for children and adolescents, further methodologically rigorous research is required to substantiate these findings. Implications The use of AT in clinical practice should be underpinned by sound clinical reasoning and use of robust outcome measures to evaluate the impact of such interventions.

Effectiveness of Literature Circles in Developing English Language Reading Ability: A Systematic Review

English reading ability is essential to overall language proficiency because our learning depends heavily on written materials. As a highly evolved form of collaborative learning originating in the L1 context, literature circles can provide a perfect scaffolding for reading, discussion and sharing. Thus, this reading strategy has also been widely used in L2 learning. This systematic review examines the effectiveness of literature circles in improving English language reading ability. An analysis is conducted in reference to the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) methodology. Based on the search keywords, a total of 19 articles related to the benefits of literature circles for English reading comprehension ability are identified from Scopus, Google Scholar, Dimensions and Education Resources Information Center databases. The findings from the synthesis show a trend among literature circles to integrate more modern technology and to adopt more diversified reading materials. The identified themes related to reading ability consist of six areas: self-regulation, reading skills, positive attitude, cultural awareness, critical-thinking skills and reading engagement. It is hoped this systematic review will inspire language instructors to implement literature circles to improve training students’ English reading ability.

Environmental Problems and Education in Last Five Years

Environmental education continues to be popular all the time. Researchers have been trying to raise awareness of people by doing valuable studies on this issue. However, it is very difficult to follow all of these studies. That is why this mini-review aims to present a bunch of studies on environmental pollution in the last 5 years for researchers. In order to achieve this aim, the ERIC (Education Resources Information Center) database was searched using the “Environmental” and “Pollution” keywords. Then the full-text articles directly related to environmental education since 2018 were summarized in a table in which countries they were made and which data collection tools were used. These studies were read independently by the researchers and qualitative data analysis was carried out. According to the results of the data analysis, four themes were created: i) Research on environmental education; ii) Teaching-learning method and activities about environmental education; iii) Literacy, knowledge, attitude, behavior and, awareness about environmental education; iv) COVID-19 and challenge. The relevant texts of the selected studies were placed into the appropriate theme. In the last part of the study, some suggestions were presented for future studies.

A systematic review to compare open and closed book examinations in medicine and dentistry

INTRODUCTION The COVID-19 pandemic resulted in a global lockdown of many countries, causing disruption in medicine and dentistry educational programmes. Examination formats were adapted to open book assessments to allow student progression. The aim of this review was to determine whether open book examinations (OBEs) have suitable evidence to support their inclusion alongside (or as a substitute for) closed book examinations (CBEs). METHODS In this systematic review, searches were conducted using the ERIC (Education Resources Information Center), MEDLINE® and Embase™ databases as well as the grey literature to identify articles that provided primary data on OBEs in medicine and dentistry programmes globally. In addition, reference lists of key papers were searched. Quality assessment was undertaken through an adapted appraisal tool. RESULTS Seven studies were included in the review. These comprised three randomised controlled trials, three non-randomised trials and one retrospective cohort study. All investigated OBEs in medicine. No studies were identified in dentistry. Learners reported a preference for OBEs. The use of resources was variable. However, this examination format resulted in higher mean scores than for CBEs. Clinicians reported using the same resources in OBEs as they do in their clinical practice, meaning the exam format may accurately represent the working environment. CONCLUSIONS OBEs can improve learner satisfaction, test higher order thinking skills and be a more accurate reflection of challenges encountered in clinical practice. They can help educators design assessments to fulfil regulatory requirements of students demonstrating independent clinical practice and their value should not be underestimated.

Career Development of Academic Staff in Faculties of Dentistry by Means of Mentorship Programs: Protocol for a Scoping Review.

BackgroundGlobally, the demands on dental educators continue to diversify and expand. Due to their importance and value, mentoring programs have been acknowledged as a means of recruiting, developing, and retaining academics in dental education.ObjectiveThis protocol is for a scoping review that aims to identify the goals of mentoring programs for academic staff in dental faculties and determine how these programs were structured, delivered, and evaluated.MethodsThe review will be performed in accordance with the Joanna Briggs Institute’s methodology for scoping reviews, which covers both qualitative and quantitative scientific literature as well as grey literature written in English and published between 2000 and 2020. The databases will include PubMed, Ovid, the Educational Resources Information Center database, Science Direct, Scopus, Google Scholar, Trove, Web of Science, Openthesis.org, and the website of the American Dental Education Association. A manual search will also be conducted by using the reference lists of included studies to identify additional articles. Working independently, the authors will participate iteratively in literature screening, paper selection, and data extraction. Disagreements between the reviewers will be resolved by discussion until a consensus is reached or after consultation with the research team. Key information that is relevant to the review questions will be extracted from the selected articles and imported into a Microsoft Excel file. The PRISMA-ScR (Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews) will be used to guide the reporting of this protocol.ResultsThe search for appropriate literature has commenced, and we aim to present the results before the end of the 2021 academic year.ConclusionsThe development of formal mentorship programs for academics in dental education will enhance the retention of academic staff.International Registered Report Identifier (IRRID)PRR1-10.2196/27239

Evidence-based Guidelines on the Use of Virtual Surgical Education Pertaining to the Domains of Cognition and Curriculum, Psychomotor Skills Training, and Faculty Development and Mentorship.

To identify, categorize, and evaluate the quality of literature, and to provide evidence-based guidelines on virtual surgical education within the cognitive and curricula, psychomotor, and faculty development and mentorship domains. During the coronavirus disease 2019 pandemic, utilizing virtual learning modalities is expanding rapidly. Although the innovative methods must be considered to bridge the surgical education gap, a framework is needed to avoid expansion of virtual education without proper supporting evidence in some areas. The Association for Surgical Education formed an ad-hoc research group to evaluate the quality and methodology of the current literature on virtual education and to build evidence-based guidelines by utilizing the SiGN methodology. We identified patient/problem-intervention-comparison-outcome-style questions, conducted systematic literature reviews using PubMed, EMBASE, and Education Resources information Center databases. Then we formulated evidence-based recommendations, assessed the quality of evidence using Grading of Recommendations, Assessment, Development, and Evaluation, Newcastle-Ottawa Scale for Education, and Kirkpatrick ratings, and conducted Delphi consensus to validate the recommendations. Eleven patient/problem-intervention-comparison-outcome-style questions were designed by the expert committees. After screening 4723 articles by the review committee, 241 articles met inclusion criteria for full article reviews, and 166 studies were included and categorized into 3 domains: cognition and curricula (n = 92), psychomotor, (n = 119), and faculty development and mentorship (n = 119). Sixteen evidence-based recommendations were formulated and validated by an external expert panel. The evidence-based guidelines developed using SiGN methodology, provide a set of recommendations for surgical training societies, training programs, and educators on utilizing virtual surgical education and highlights the area of needs for further investigation.

A Descriptive Analysis of the Literature on Educational Games Published Between 1965 and 2019

In the present study, the studies conducted on educational games between 1965 and 2019 were analyzed to determine the trends in research based on the year of publication, topic, publication type, country, target audience and the concepts included in the study title. In the study, 7141 studies that were accessed with "educational games" keyword on the ERIC (Education Resources Information Center) database were analyzed. The abstract data were classified by a software developed by the authors for analysis and the analysis was conducted in two stages. First, the studies on educational games were examined as a group, and then the most studied topics were analyzed separately. The study findings demonstrated that the number of studies on educational games was the highest in 2016 and the prominent topics included instructional methods, learning activities, simulations, and classroom activities. It was determined that digital games were investigated as a type of educational games extensively in studies conducted since 2000, the major type of publication was journal articles, and Australia was the leading country in publications. It was determined that practitioners were the major audience until 2000, and the studies on teachers were prominent since. It was determined that the most frequent concepts in study titles included learning, instruction, simulation, school, game-based, design, computer, science, and mathematics and games, respectively.

Higher Education during COVID-19 Pandemic: Distance Education and Online Learning

In response to COVID-19 pandemic, higher education institutions implemented distance education. Online learning was adopted as the mode of delivery in instruction. With this sudden change, there were learning inequalities and barriers that occurred that affected the quality of education students received. This study is a literature review of the experiences of higher education institutions in implementing distance education through online learning during COVID-19 pandemic. The purpose of this study is to make an overview of the experiences of universities and colleges during the pandemic. Twenty-three journal articles from the Education Resources Information Center database with specific key ERIC fields in the search work were utilized and subjected to analysis. The study discussed the different challenges and issues in the implementation of distance education. Also, the struggles of students, faculty, and staff were presented.

Evaluation strategies in active learning in higher education in health: integrative review.

to analyze scientific evidence on evaluation strategies for active learning methods in health undergraduate programs. integrative literature review in the Medical Literature Analysis and Retrieval System Online, Latin American and Caribbean Literature in Health Sciences, Nursing Database, Scopus, Web of Science and Education Resources Information Center databases. different evaluation strategies are used: Presentation of seminars, Self-evaluation, Evaluation of student performance in Tutotest-Lite tutoring, Peer Evaluation, Active Learning and Critical Thinking Self-evaluation Scale, Objective and Structured Clinical Exam, Portfolio, Progressive Disclosure Questions, Modified Dissertation Questions, Progression Test, Dissertation Test, Objective Test, Immediate Learning Checks, Clinical Case Resolution and Cumulative Test. evaluation strategies in active learning are used in combination, aiming at the affective, cognitive and psychomotor development of the student. However, studies with greater power of scientific evidence would be needed.

Strategies of active learning methodologies in nursing education: an integrative literature review.

to analyze the scientific evidence on the strategies of active learning methodologies used in the training of nurses, as well as their contributions and obstacles in training. integrative literature review conducted with 33 selected articles in the Medical Literature Analysis and Retrieval System Online, Latin American and Caribbean Literature in Health Sciences, Nursing Database, Scopus, Web of Science and Education Resources Information Center databases. among the strategies, simulation, problem-based learning and flipped classroom were highlighted. The active search, the integration of theory and practice and group work were examples of contributions to the training of nurses. However, the lack of preparation of the actors and the lack of structural support contribute to the dissatisfaction of the students. the active learning methodology places the student at the heart of the learning process, favors critical thinking and the ability to make decisions.

Trends in Multicultural Education Research: A Five-Year Content Analysis of Turkish and ERIC Databases

This study aims to determine trends in research on multicultural education in Turkish and Eric databases, to compare and to discuss them. Within the scope of the study, research on multicultural education in the International Education Resources Information Center (ERIC) and ULAKBİM TR Index (Turkey National Academic Network and Information Center) databases were included. In the study, 308 articles reached in ERIC database and 60 articles in ULAKBİM database were analyzed using content analysis. As a result of the analysis, it was determined that there has been an increase in multicultural education publications in ULAKBİM TR Index since 2015 and a decrease in the ERIC database. In Turkey, it is seen that there is a tendency to determine attitudes, perceptions and opinions towards multicultural education with larger sample groups; nevertheless, there is a tendency to multicultural education practices and experiences with smaller groups in the ERIC database.

Relationship between learning style and learning context: an integrative review

Background: Higher education in recent years has been marked by significant changes and has impacted on the educational process, requiring pedagogical and professional actions capable of translating performances that efficiently meet the challenges faced by professional practice in different contexts of the teaching-learning process.Methods: In order to investigate the relationship between students' learning style and learning context, a systematic review was performed according to both the available literature and the guiding question: what is the relationship between the student learning style and the learning context? Then, the descriptors were defined: learning style and learning context. The search was processed using the Education Resources Information Center database, which provided eleven articles selected by a defined inclusion and exclusion criteria. All items were organized and analyzed according to whether or not they have influence on the learning style and on the learning context.Results: Based on the guiding question, all articles were grouped into only one category: the relationship between the student learning style and the learning context. Thus, it was found that 73% (n = 8) showed a positive relationship between the student learning style and the learning context.Conclusion: This study demonstrated that there is a relevance between the student learning style andt he learning context, and this relationship helps teachers to provide satisfaction, autonomy and effectiveness regarding the student learning process. Moreover, it is important that teachers recognize this relationship so that they can propose new methods of teaching, learning and assessment that are appropriate to the identified styles.

Cultural Immersion in the Education of Healthcare Professionals: A Systematic Review.

PurposeWith the ever-changing cultural makeup of society, the ability to deliver culturally appropriate healthcare is essential. An educational method aimed at increasing cultural knowledge and sensitivity in the education of healthcare professionals is cultural immersion, which creates opportunities for transformational learning through direct interactions with culturally diverse populations. The purpose of this systematic review was to examine the qualitative effects of cultural immersion experiences on graduate-level healthcare professional students. MethodsA search of the CINAHL (Cumulative Index to Nursing and Allied Health Literature) and ERIC (Education Resources Information Center) databases was performed, utilizing search terms including cultural immersion, cultural sensitivity, educational outcomes, and healthcare professionals. The search was limited to publications within the last 10 years. The articles were screened according to title, abstract, and full-text following the application of inclusion/exclusion criteria. Themes identified within each article were collected and categorized, using a qualitative methodology, into 5 overarching domains to assess the educational experiences. Studies were scored for quality using the qualitative portion of the McGill Mixed Methods Appraisal Tool–2011. ResultsNine studies incorporating a total of 94 participants with experiences in 14 culturally diverse environments revealing 47 individually identified themes were included in the review. The results indicated that all cultural immersion experiences stimulated increased cultural awareness and sensitivity. ConclusionCultural immersion experiences produced a positive, multi-domain effect on cultural learning in students of the health professions. The results of this review provide support for implementing cultural immersion experiences into the education of healthcare professionals with the goal of increasing cultural sensitivity.

Assessment Practices for Dietetics Trainees: A Systematic Review

High-quality education is essential to produce competent graduates in the field of dietetics. Assessment is a fundamental component of education and driver of learning, yet little is known about methods used to assess dietetics trainees. The objective of this review is to evaluate the practices and outcomes of methods used to assess dietetics trainees. A systematic review of the literature was undertaken. MEDLINE, the Cumulative Index to Nursing and Allied Health Literature Plus, Embase, and the Education Resources Information Center databases were searched from inception until May 31, 2017, using key terms that identified studies reporting practices for the assessment of dietetics trainees. Abstract and title screening was completed by three independent reviewers followed by full-text screening using the eligibility criteria. Quantitative and qualitative data were extracted. Study outcomes were evaluated using Miller’s Pyramid, Kirkpatrick’s Hierarchy, and the principles of programmatic assessment. Thirty-seven studies were identified. Assessments targeted all levels of Miller’s Pyramid with the does level being the most prevalent (n=23). Most studies focussed on evaluating Level 1 (participation) (n=16) and Level 2b (n=16) (knowledge and skills) of Kirkpatrick’s Hierarchy. Studies described single assessment instruments that focussed on instrument validity and reliability. Few studies considered a program of assessment or the role of expert judgment. Six themes were identified from qualitative data: (1) assessment for learning and professional development, (2) assessment requires motivated and skilled assessors, (3) trainees value authentic and global assessment, (4) assessment is evolving and context-sensitive, (5) poor assessment has negative implications, and (6) assessment evokes an emotional response. Studies focused on the development and evaluation of single quantitative-based instruments applied in isolation, with low-level outcomes sought. There is room to improve practices and design programs of assessment that combine quantitative and qualitative data for meaningful trainee feedback and credible assessment decisions. Comprehensive evaluation of assessment practices is required and must consider the contribution to improved health outcomes in all practice settings.

Role of libraries in promoting education: a bibliometric analysis (2012-2016)

PurposeThe purpose of this paper is to investigate the authorship patterns and the relationship between them based on some statistical indices for the role of libraries in promoting education at the global level.Design/methodology/approachThe Education Resources Information Center (ERIC) database was searched for the peer-reviewed and full text available journal articles that contained specific words related to either libraries and education or libraries and e-learning in. Data were analysed based on certain statistical calculations to find out the degree of collaboration, collaborative coefficient, Shannon index, Simpson’s indices, Spearman’s coefficient and co-authorship pattern.FindingsThe criteria were met by 262 publications by 517 authors. The highest number of articles related with the role of libraries in education was published in the year 2013, and the highest numbers of articles were authored by a single author rather than multiple authors. The degree of collaboration was found to be highest in the year 2015 and 2016 with a value of 0.66, whereas the collaborative coefficient was highest in the year 2016 with a value 0.42. The Shannon’s diversity index was found to be 2.73705 with an evenness of 1.24568. The Simpson’s index, Simpson’s index of diversity and Simpson’s reciprocal index were found to be 0.299, 0.701 and 3.3444, respectively. The Spearman’s coefficient was found to be highest with a positive correlation of value 0.95 in the year 2013. Furthermore, six co-occurrences by eight authors were found.Research limitations/implicationsOnly the ERIC database was chosen for the study and only articles published from the year 2012 to 2016 were included in the analysis.Originality/valueThis study will be useful for researchers to get an insight into the collaborative research patterns demonstrated by the authors in understanding the role of libraries in education using different statistical approaches.

Examining the Factors That Influence Students’ Science Learning Processes and Their Learning Outcomes: 30 Years of Conceptual Change Research

Background:This study used content analysis to examine the most studied conceptual change factors that influence students’ science learning processes and their learning outcomes. The reviewed research included empirical studies published since Posner et al. proposed their conceptual change model 30 years ago (from 1982 to 2011).Material and methods:One hundred sixteen SSCI journal and full text articles were sampled from the Education Resources Information Center database. “Conceptual change” in the title of the articles was used for screening the articles.Results:The results showed that learning outcomes chiefly examined students’ conceptual change and their science achievement. The most studied factors influencing conceptual change were associated with instruction and personal reasoning ability. As for instruction, multiple instructional methods were usually integrated in the research, and “conceptual conflict” and “cooperative learning” were found to be gaining the most attention. In addition, certain instructional methods were more frequently linked to specific science subjects. In addition, fewer studies in the ERIC database have been reported in relation to theories on conceptual change in science education.Conclusions:Educators require knowledge of conceptual change theories and strategies. Such information should be more readily available in order to develop teachers’ pedagogical content knowledge and help them put it effectively into practice.

A Paradigm Shift in Medical, Dental, Nursing, Physiotherapy and Pharmacy Education: From Traditional Method of Teaching to Case-Based Method of Learning- A Review

Background: The most commonly used pedagogy in Nigeria and most other countries is the didactic method of teaching. This method is useful for covering underlying concepts, principles and systems. The traditional method of teaching places the burden of promoting learning fully on the teacher, unless it is integrated with other techniques such as problembased learning and case-based learning (CBL). However, the advantages of CBL over the traditional method of teaching have not been adequately evaluated and this also reflects on the dearth of available literature in this area. Aim: The purpose of this paper is to critically evaluate, analyze and synthesize the available literature evidence base about CBL in order to highlight its merits/benefits, barriers and possible shortcomings so as to guide Medical Colleges and Faculties of Pharmacy in Nigeria in taking a decision on whether or not to begin to explore the possibility of introducing CBL in their medical, dental, physiotherapy, nursing and pharmacy curricula. Methods: The study was literature-based. The review was focused on CBL for both preclinical and clinical health professional programmes including Medicine, Dentistry, Physiotherapy, Nursing and Pharmacy. Papers were required to have outcome data on Review Article Annual Research &Review in Biology, 4(13): 2053-2072, 2014 2054 effectiveness. The search covered the period from January 1990 to December 2013 and the following databases: MEDLINE, EMBASE, Cochrane Library, International Education Research Database, Web of Knowledge (WoK) and ERIC (Educational Resources Information Center) database. Results: The traditional modes of teaching of science and medical subjects focus mainly on the transmission of content by disciplinary experts. By nature, these teaching processes by themselves are not effective at equipping the students in the areas of communication, critical thinking, creativity, self-directed and collaborative learning. CBL adequately addresses most of these deficiencies in pedagogy. In their effort to find solutions and reach decisions through discussion, learners sort out factual data, apply analytic tools, articulate issues, reflect on their relevant experiences, and draw inferences they can relate to new situations that are often not given within the scope of a lecture but that could be very vital in professional practice. In the process, they acquire substantive knowledge, become innovative and develop analytic, collaborative and communication skills. Conclusion: Colleges and faculties of Medicine and Pharmacy should consider the inclusion of CBL in their curricula for the teaching of medicine, dentistry, physiotherapy, nursing, pharmacy and other allied programmes.

A systematic review of the effects of residency training on patient outcomes

BackgroundResidents are vital to the clinical workforce of today and tomorrow. Although in training to become specialists, they also provide much of the daily patient care. Residency training aims to prepare residents to provide a high quality of care. It is essential to assess the patient outcome aspects of residency training, to evaluate the effect or impact of global investments made in training programs. Therefore, we conducted a systematic review to evaluate the effects of relevant aspects of residency training on patient outcomes.MethodsThe literature was searched from December 2004 to February 2011 using MEDLINE, Cochrane, Embase and the Education Resources Information Center databases with terms related to residency training and (post) graduate medical education and patient outcomes, including mortality, morbidity, complications, length of stay and patient satisfaction. Included studies evaluated the impact of residency training on patient outcomes.ResultsNinety-seven articles were included from 182 full-text articles of the initial 2,001 hits. All studies were of average or good quality and the majority had an observational study design. Ninety-six studies provided insight into the effect of 'the level of experience of residents' on patient outcomes during residency training. Within these studies, the start of the academic year was not without risk (five out of 19 studies), but individual progression of residents (seven studies) as well as progression through residency training (nine out of 10 studies) had a positive effect on patient outcomes. Compared with faculty, residents' care resulted mostly in similar patient outcomes when dedicated supervision and additional operation time were arranged for (34 out of 43 studies). After new, modified or improved training programs, patient outcomes remained unchanged or improved (16 out of 17 studies). Only one study focused on physicians' prior training site when assessing the quality of patient care. In this study, training programs were ranked by complication rates of their graduates, thus linking patient outcomes back to where physicians were trained.ConclusionsThe majority of studies included in this systematic review drew attention to the fact that patient care appears safe and of equal quality when delivered by residents. A minority of results pointed to some negative patient outcomes from the involvement of residents. Adequate supervision, room for extra operation time, and evaluation of and attention to the individual competence of residents throughout residency training could positively serve patient outcomes. Limited evidence is available on the effect of residency training on later practice. Both qualitative and quantitative research designs are needed to clarify which aspects of residency training best prepare doctors to deliver high quality care.