Faculty Focus Groups Research Articles

Structured Debriefing to Assess Performance of Entrustable Professional Activities.

Background The medical workplace presents challenges for workplace-based learning. Structured debriefing of shared clinical experiences has been proposed as a way to take advantage of workplace-based learning in a setting that facilitates deep learning conversations. Objective To investigate faculty and learner acceptance of private, face-to-face, structured debriefing of performance of entrustable professional activities (EPAs). Methods During the 2020-2021 academic year, faculty at the University of Colorado (CU) and the University of Utah (UU) debriefed fellow performance of jointly selected EPAs in neonatal-perinatal medicine pertinent to shared 1- to 3-week clinical rotations. Private face-to-face debriefing was structured by a comprehensive EPA-specific list of behavioral anchors describing 3 levels of entrustment/accomplishment. Sessions ended with joint decisions as to level of entrustment/accomplishment and goals for improvement. We used thematic analysis of semistructured fellow interviews and faculty focus groups to identify themes illustrated with representative quotations. Results We interviewed 17 fellows and 18 faculty. CU participants debriefed after clinical rotations; UU usually debriefed during rotations. Debriefing sessions for 1 to 2 EPAs lasted 20 to 40 minutes. Themes represented in fellow interviews and faculty focus groups suggested that debriefing facilitated formative feedback along with shared understanding of clinical performance and assessment criteria. The standardized format and private conversations supported assessment of aspects of performance for which review might otherwise have been overlooked or avoided. The conversations also provided valuable opportunities for formative discussion of other matters of importance to fellows. Conclusions Structured debriefing of recently shared clinical experiences fostered formative assessment viewed positively by teachers and learners.

Diversity and Inclusion Through Collaboration: Co-Producing a Simulation Curriculum to Address Discrimination Against Trainees.

Discrimination toward trainees is a pervasive problem, with surveys showing it is often perpetrated by patients. For several years, residents and faculty in an internal medicine residency have participated in a workshop offering a framework for responding to discriminatory behavior by patients. As part of a larger effort to reinforce this teaching and promote an inclusive environment, the authors pursued a multi-pronged simulation curriculum that could be incorporated into graduate medical education programs across their institution. First, the authors conducted trainee and faculty focus groups to better understand their experiences. Qualitative data was collected, including recommendations for responding to discrimination, characteristics of the most common experiences, and trainees' own ideas for worthwhile simulation scenarios. Trainees and faculty were then brought together in a collaborative process to co-develop simulation cases that were later implemented in curricula across multiple learner levels, specialties, and contexts. Participants in these simulations reported improved comfort in responding to discrimination in the moment and/or in the wake of such incidents. Through trainee-faculty collaboration, the project yielded authentic and impactful simulation experiences for learners, while also giving trainees an opportunity to turn previous trauma into constructive learning opportunities that promote an inclusive environment.

Supporting graduate students’ skills with simulated experiences in a professional foundation course

The population’s health depends on a well-educated nursing workforce that includes graduate-prepared nurses. However, the nation’s demand for graduate nurses in advanced practice, teaching, and research roles surpasses the supply. Graduate nursing educators can support student success by creating positive learning experiences for students at the beginning of their study programs. Initially, we created a pilot writing orientation, which was implemented for new students. Although the results of the pilot study showed significance with paired t-tests (p < .000; Cohen’s d = 1.21), the writing skills were not applied in long-term coursework. Therefore, a seven-week course was created to provide students with small-scale assignments, preparing them for complex future graduate coursework. The study aimed to evaluate the effectiveness of the skills learned in the course using student (n = 15) and faculty (n = 9) focus groups. A qualitative design using thematic analysis showed the following student themes: tools to improve scholarly writing, magnitude and feasibility of the project, graduate-level writing and professional presentations, clear expectations of achieving program requirements, and professional development using a digital e-portfolio. Faculty focus groups compared the skills of students who had completed the course and those who had not. Faculty themes included stronger writing skills despite the variation, resource availability, tool use, APA format skills, and writing synthesis skills development. Overall, the participants’ perspectives shared positive feedback with insightful suggestions for future course improvement.

Perceptions of Communities of Practice and Sense of Belonging: Focus Groups of Academic Pediatric Faculty.

Providing the opportunity for collaboration around a central purpose to improve skills and exchange knowledge, the Community of Practice model can be useful for faculty development. A sense of belonging enhances the engagement in communities. Yet, the barriers and contributors to academic medicine faculty's sense of belonging in communities are not as well explored. Through focus groups with 21 academic pediatric faculty conducted between January and March 2023, this qualitative study examined knowledge of Communities of Practice and the factors that affect sense of belonging and engagement. The authors iteratively coded transcripts to generate themes. Community accessibility; opportunities for active engagement; working under a clear, shared purpose; and personal interactions enhanced faculty sense of belonging. Barriers to engagement included competing demands, process challenges, and uncertainty. Study results suggest strategies for the promotion of faculty sense of belonging and engagement in Communities of Practice. Consideration of contributors to a sense of belonging may enhance efforts to design and improve engaging faculty development programs.

Experiential learning in the master of public administration classroom: An application of the family-friendly campus toolkit

Public administrators can play a vital role in the articulation of demands emerging from the community and can serve to advance these demands by their position of authority, skills and knowledge to help facilitate the development of programs and projects to address public needs. This article describes the role that a small Master of Public Administration program and several of its faculty and students played to support a project which sought to aid the development of family-friendly policies and programs on the campus of the University of Massachusetts Lowell, a mid-sized, public university in the Northeastern United States. The article lays out the personal experience of the authors as they relate to their decision to participate in the program, a description of the project and the assistance that MPA students were able to render the initiative, the manner in which integrating the commitment to campus improvement for pregnant and parenting students influenced the content of several MPA courses, and the synergies which developed as students worked to develop skills in communication, focus-group moderation, qualitative data analysis, presentation delivery and report-writing.

SUCCESSFUL LEARNING EXPERIENCES OF OT AND PT STUDENTS: ENGAGING OLDER ADULTS IN THE USE OF ASSISTIVE DEVICES

Abstract The Arkansas Colleges of Health Education and the Arkansas Geriatric Education Collaborative collaborated on a project to use an authentic teaching/learning approach with occupational and physical therapy students about the use of assistive technologies (AT) through educating older adults. Twenty occupational and physical therapy students were mentored by faculty/staff to collaborate with community-dwelling older adults to research, develop, and disseminate 27 video vignettes shared via Facebook. The vignettes included demonstrations using AT for self-care, home management, community engagement, and leisure participation to help older adults live safely and independently. Through this authentic learning approach, the students learned about the use and benefits of AT, interprofessional practice, and the importance of collaborating with older adults. Viewers of the videos were encouraged to seek further information, providing yet another opportunity for students to acquire additional information about how to secure AT and engage with older adults. Focus groups of faculty & staff involved in the project were held to determine student learning themes arising from this project. Through these focus groups, faculty/staff expressed that students • conveyed AT recommendations without prompts for clients served in the ACHE on-campus clinic; • demonstrated a greater understanding of available non-medical AT; • revealed greater comfort levels working with older adults; • gained an appreciation and understanding of each other’s disciplines; • attained professional development goals. It was also noted that faculty involved in the project appreciated the authentic nature of the teaching approach as opposed to more traditional teaching styles such as lectures.

AGE-INCLUSIVE STRATEGIES TO ENHANCE LEARNING AND WORKPLACE ENVIRONMENTS IN U.S. HIGHER EDUCATION

Abstract This symposium reports on recent research to develop informed strategies to expand age-friendly campus practices related to institutional functions our previous study identified as areas of high-need and broad-impact within an age-friendly campus environment: Teaching and Learning, Personnel, and Student Affairs. The current research aimed to identify barriers and opportunities for age inclusivity as experienced by older campus members (faculty, staff, and students); identify challenges and strategies for implementing age-friendly campus practices; and recommend practical strategies to expand and enhance age-friendly practices. To this end, we drew on data collected from several sources: open-ended responses to the Age-Friendly Inventory and Campus Climate Survey (ICCS) administered to a sample of 23 U.S. members of the Age-Friendly University (AFU) network; responses from 16 focus groups of faculty, administrators/staff, and students; and 18 experts on a nationally selected Delphi panel of experts in higher education. Based on the focus group data, we generated over 50 strategy recommendations within the academic functions that were then evaluated by the Delphi panelists to assess their efficacy, feasibility, likelihood of implementation, and perceived impact. Silverstein will provide an overview of the research objectives, Bowen will discuss what the open-ended responses revealed about perceptions of campus age-inclusivity, Lin and Xu will describe the study samples, Whitbourne will describe the results of the focus group analyses, and Montepare will discuss the final set of recommendations based on the Delphi panel analyses. Berg-Weger will serve as Discussant.

Hospitalists' Perspective of Inpatient Care for Patients with Sickle Cell Disease and Areas for Improvement

Background Acute painful vasoocclusive episodes (VOEs) are the most common reason for hospitalization for adults with sickle cell disease (SCD) and significant predictors of mortality. The facilitators and barriers to providing quality care for adults with SCD in the inpatient setting are largely unknown. We aimed to explore inpatient SCD delivery models in the US, including access (or lack thereof) to quality care and sickle cell disease expertise. Methods We conducted a multi-site rapid qualitative research study in order to evaluate a construct informed by literature review and clinical experience: variability between hospitals in the characteristics on models of inpatient SCD care delivery. We used virtual focus groups of practicing hospitalists in partnership with the Hospital Medicine Reengineering Network from across the United States. We developed an interview guide with open-ended questions and prompts through an iterative process to explore how inpatient SCD care is currently delivered in US hospitals with a focus on how these models of care delivery affect hospitalist practice (Figure). The open-ended questions explored topics ranging from hospitalists' training and experienceto the design of the health care system. Trained facilitators conducted four semi-structured focus groups with 11 hospitalists and one patient and family advisory council member. The facilitators took observation notes. Moderators summarized their group's overall findings for report to the larger group, serving as an opportunity for member checking and pattern identification. The focus groups lasted 35 minutes and report-out summaries lasted an additional 15 minutes. Recordings were de-identified and transcribed. We used rapid qualitative methods to explore perspectives of hospital-based healthcare providers including: having facilitators with expertise in the content area, collecting and analyzing data via multiple team members, and using templated summaries for each focus group question. Group summaries and transcripts were analyzed with thematic coding by two independent coders with feedback from the focus group moderators. Results Participants were from 12 adult university-based or university-affiliated hospitals. All hospitalists had experience taking care of hospitalized patients with SCD during their career, but many described how a change in practice location resulted in only seeing 1-2 patients with SCD per year. Hospitalists described a range of inpatient SCD care models from no specific model to a specific cohorted unit with associated providers. Participants unanimously expressed having provider and unit continuity of SCD care, and having accessible SCD expertise, as an ideal state. Individualized care plans were cited as a helpful tool for inpatient SCD care, but there were considerable challenges to their routine use. Primary themes are presented in the Table with explanations and correlative illustrative quotes. Discussion and Future Directions Hospitalists described wide variation in inpatient SCD care models. More inpatient SCD care support and infrastructure like individualized care plans were more commonly referenced by those hospitalists whose patients had access to a sickle cell center or SCD expert. We are using these data to inform a national survey to further describe and understand inpatient SCD care, if and how care plans are used, and determine next steps for improving inpatient SCD care quality.

Integrating mentoring with P&T processes: A case study from the School of Public Service at Boise State

ABSTRACTIn 2018, SPS began developing and implementing an integrated approach to mentoring that combined elements of promotion & tenure (P&T) reviews, annual performance evaluations, and workload policies. This approach has led to a high level of success for junior faculty in terms of following a clear trajectory toward tenure. It has also come with numerous transaction costs, such as increased service loads, inconsistencies in mentoring practices, and conflicts in expectations. In this paper, we describe the SPS Mentoring Policy and provide background on its motivations and history. Using our own auto-ethnographical reflections from our administrative roles organizing and coordinating the mentoring process, and data from focus groups of faculty participating in the process, we then examine the trade-offs of this policy in comparison to a more traditional P&T policy, discuss lessons learned over the last five years, and consider future opportunities.

VALIDATING INTERACTIONS: HOW A SYSTEM OF LEARNERS, PEERS, AND POLICIES EXPLAINS FACULTY TEACHING NEEDS

Some institutions assess the professional development needs of teaching faculty by surveying their interests in teaching topics. In contrast, we sought an explanation of teaching needs that could inform a more comprehensive needs assessment addressing motivations for teaching, challenges from learners, preferred strategies to address challenges, and barriers to using them. We conducted three focus groups of faculty from a university and a feeder college. We found that faculty were motivated by validating interactions with learners and challenged by incoming cohorts with diverse attitudes and abilities. Faculty preferred to consult peers, experiment in class, and offload tasks, but they were undermined by poor communication, bureaucracy, risk management, and limited resources. Faculty persisted with existing approaches until they faced burnout. Female faculty disproportionately reported being motivated by learner impact and challenged by mixed ability classrooms and lack of time. Our model prompts institutions to define and explore faculty teaching needs in terms of validating interactions with learners that are enhanced or diminished by incoming cohorts, preferred strategies, and institutional barriers. As such, faculty development must address each of those multiple, interacting influences.

Praxis of cross-cultural social work practice (CCSWP): A critical discourse analysis of graduate student and faculty perspectives on cultural competence and relevant constructs

To examine how social work students and faculty perceive and embody cultural competence, we conducted five focus groups with graduate students ( N = 16) and faculty members ( N = 10) from Canadian schools of social work. We interrogated how different theoretical frameworks related to cross-cultural social work practice (CCSWP) have been circulated and reified in social work education, and how certain dominant frameworks have been translated to embodied cross-cultural interactions in social work practice. To examine the praxis of CCSWP, which is often subtle and embedded in the semantics of languages and discourses, we were informed by critical theories of power, language, and discourses to analyze the data. The interview transcripts of both student and faculty focus groups showed similar dominant discursive patterns: (1) critiquing the conceptual use of cultural competence, (2) having a preference for terms such as cultural humility, cultural safety, or other constructs, and (3) describing the embodied practice of these constructs mainly as a general practice and omitting cross-cultural work. Participants differed in their expressed opposition to cultural competence and the exact terms they preferred as an alternative. Overall, participants discursively changed from a critical debate on semantic and conceptual differences between these constructs to negating them altogether as meaningless, effacing the very notion of cross-cultural social work and its embodied practice. In the end, cultural competence was discounted as both oppressive and anti-oppressive, a position which is reflected in the contested scholarship on cultural competence.

Indicators of health in Down syndrome: A virtual focus group study with patients and their parents.

Down syndrome has a unique medical and psychological profile. To date, few studies have asked individuals with Down syndrome about their views of health. Eight focus groups of 20 parents and 8 individuals with Down syndrome, were conducted virtually via videoconferencing to obtain participants' views of health indicators. Focus group moderators employed some modifications for individuals with Down syndrome, including simplified language and use of graphics. Transcripts were coded using a hybrid inductive/deductive framework and thematically analysed using the Framework Method. We describe lessons learned in conducting virtual focus groups of individuals with Down syndrome and their parents. Individuals with Down syndrome could describe their views of health indicators and identified many of the same topics as their parents. Both groups discussed physical, mental, and social health components. However, people with Down syndrome gave a more restricted range of examples, but with different nuances than parents. Partcipants discussed physical, social, and mental well-being components of health in Down syndrome. Interviewing individuals with Down syndrome in virtual focus groups with appropriate modifications added important self-report health information.

Messaging preferences among Florida caregivers participating in focus groups who had not yet accepted the HPV vaccine for their 11- to 12-year-old child

BackgroundIn the United States, human papillomavirus (HPV) vaccination rates remain low. The President’s Cancer Panel suggests that effective messaging about the HPV vaccination focus on the vaccine’s safety, efficacy, ability to prevent cancer, and recommendation at ages 11- to 12-years. We aimed to develop messages about HPV vaccine that include the President Cancer Panel’s suggestions and were acceptable to caregivers of adolescents.MethodsFrom August to October 2020, we conducted one-hour, Zoom videoconference focus groups with caregivers who lived in Florida, had an 11- to 12-year-old child, and had not had any of their children receive the HPV vaccine. Focus group moderators asked caregivers to react to three videos of clinician (i.e., MD, DO, APRN, PA) recommendations and three text message reminders. Thematic analysis was conducted using the constant comparative method and led by one author with qualitative analysis expertise. Two additional authors validated findings.ResultsCaregivers (n = 25 in six groups) were primarily non-Hispanic white (84%) and educated (64% had at least an Associate’s degree). Approximately a third of caregivers had delayed (44%) or decided against a vaccine for their child (36%). Caregivers described six preferred message approaches: recognize caregivers’ autonomy, balanced benefits and risks, trustworthy sources, increased feasibility of appointment scheduling, information prior to decision point, and preferred personalized information. Caregivers expressed a desire to have the follow-up doses mentioned in the introduction.ConclusionsHPV vaccine messages, whether delivered by a clinician or via text message, will be more acceptable to caregivers if they approach HPV vaccination as the caregivers’ decision, and include information from trusted sources to help caregivers make an informed choice.

The impact of COVID-19 on student learning during the transition from remote to in-person learning: using mind mapping to identify and address faculty concerns.

The COVID-19 pandemic led to the suspension of in-person learning at many higher education institutions (HEIs) in March 2020. In response, HEIs transitioned most courses to online formats immediately and continued this mode of instruction through the 2020-2021 academic year. In fall 2021, numerous HEIs resumed in-person courses and some hybrid courses, and faculty began noting academic-related behavior deficiencies not previously observed in students. Focus groups of teaching faculty (n = 8) from one university department were conducted to gather information on changes in student academic-related behaviors attributed to the disruption of teaching and learning due to COVID-19 and to compare observed deficiencies with the university's undergraduate learning goals. Mind mapping software was utilized to capture themes and subthemes. Identified themes were related to problem-solving skills, grades, time management, attendance, and interpersonal communication, both in terms of student-to-student and student-to-faculty communication. For these identified areas, outcomes during the return to in-person learning were mostly undesirable. Based on these identified issues, suggested modifications that HEIs could use to modify course content and delivery to offset skill gaps and improve interpersonal communication were identified. Furthermore, observations may indicate that fully remote learning inhibited student learning and skill development during the 2020-2021 academic year. Future work should examine the effectiveness of the proposed modifications on student success.NEW & NOTEWORTHY This article contains information gathered from mind map-driven faculty focus group observations of student academic-related deficiencies resulting from transitioning from remote to in-person learning and how said deficiencies compare to university undergraduate learning goals.

A Qualitative Study of Women's Experiences with Hypoactive Sexual Desire Disorder in the United States

ABSTRACT Introduction Hypoactive Sexual Desire Disorder (HSDD) significantly impacts a woman's daily functioning and well-being (health-related quality of life, HRQoL) and is often undetected by the medical profession and dismissed by society. As a result, the profound and extensive impact of HSDD on the lives of women and their partners is underappreciated. Objective This qualitative study was conducted to identify defining symptoms and HRQoL impacts among women with HSDD. Methods Six virtual focus groups (90-minutes each) were conducted with 30 adult women to understand HSDD symptoms and HRQoL impacts. Two trained focus group moderators utilized a semi-structured interview guide to capture spontaneous and stated symptoms and impacts. All focus groups were transcribed verbatim, anonymized, coded by two independent researchers using Atlas.ti 9, and then analyzed employing a combination of semi-quantitative and qualitative data analytic methods to evaluate saturation. Elicited content was used to further refine a literature-derived HRQoL conceptual model of HSDD. Results A total of 15 pre-menopausal and 15 post-menopausal women participated in the focus groups between October 14 and 21, 2020. Participants reported a total of 10 symptom concepts during the focus group, including loss of spontaneous desire, sexual distress, disinterest in initiating sex, disinterest in engaging in sex, absence of pleasure, little to no sexy feelings, feeling asexual, sexual avolition, vaginal pain, and insomnia. The most frequently reported symptoms were loss of spontaneous desire (n=30, 100%) and sexual distress (n=23, 77%). A total of 41 impact concepts associated with HSDD across 9 domains were reported: partner impact, mental well-being, role functioning, social functioning, familial relationships, appearance, concentration, and overall quality of life and satisfaction with life. Women reported impairment to their mental well-being (n=30, 100%), partner relationship (n=29, 97%), overall quality of life (n=29, 97%), and life satisfaction (n=29, 97%), as well as described feeling stigmatized by healthcare providers, friends, and society as a whole (n=27, 90%). A literature-based conceptual model for HSDD was updated to reflect focus group results. Conclusions Women with HSDD report many relevant, important, and meaningful concepts that are inadequately evaluated in research and drug trials. HSDD profoundly and negatively impacts women's HRQoL. Greater awareness of these concepts, and the availability of HRQoL measures that accurately reflect symptoms and impacts are needed to “destigmatize” and improve medical care for women with HSDD. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: AMAG Pharmaceuticals, Inc., Astellas, Dare, Duchesnay, Ovoca, Field Trip, Palatin Technologies, Pfizer, Materna, Maddora, TherapeuticsMD, Strategic Science Technologies, and Lupin.

The Get Out of Clinic Card.

Learning in the ambulatory setting is an important part of residency training. However, the rapid pace of the clinic and the lack of continuity with supervising preceptors present challenges for learners in this setting.The fast pace of the ambulatory setting typically makes it difficult for faculty members to pause and reflect with residents on teaching points. The limited time for patient encounters means that residents are working to maintain efficiency and rarely have time to reflect on lessons learned.Additionally, unlike in the inpatient setting, where residents are embedded on a team with one attending for at least a few days at a time, the ambulatory setting typically has several faculty preceptors per week working with each resident during their clinic block. This lack of continuity makes giving feedback problematic, and feedback is therefore inconsistently given.We developed and piloted a low-tech, low-cost, easy to use system to address the 2 challenges outlined above, named the Get Out of Clinic (GOoC) Card. Essentially, at the beginning of each half-day in clinic, the supervising attending physician hands each resident a GOoC Card—a small, simple index card.On one side, the GOoC Card has the sentence: “One thing I learned in clinic today.” Residents are instructed to intentionally think about one thing they learned in clinic during that half-day. It can be anything, such as being reminded about a particular guideline, learning a new drug side effect, figuring out a new electronic medical record trick, etc. Before the residents leave clinic, they take 2 minutes to write down what they learned on the card and share it with their attending physician. The intentionality of thinking about, writing, and subsequently sharing a brief lesson learned helps focus and reinforce the educational experience.The other side of the GOoC Card has the term “Feedback” on it. After the resident shares their learning point with the attending physician at the end of clinic, the attending does their part by sharing feedback on the resident's performance during that half-day in clinic. The feedback is brief, specific, and timely. Having the term “Feedback” noted on the card is also a way of signposting that feedback is being given.To date, 102 GOoC Cards have been completed by 38 different residents, with feedback given each time a card was completed. Preliminary review of these cards shows a wide range of learning points documented by the residents, some being medical knowledge based, others being systems based, etc. Verbal feedback by residents regarding the GOoC Card has been very positive, noting the ease of use, the little time needed, and its educational value. Residents also noted that they tended to better remember learning points that they wrote and shared. Additionally, faculty members who have used this system have provided positive feedback.While these cards do not fully resolve the educational challenges in the clinic system that residents encounter, they present an easy, low-cost, time-efficient system that is a step in the right direction. They are also a nice way to supplement other educational endeavors in the clinic setting, such as didactics and academic half-days. Future plans include more formal data gathering around the effectiveness of the GOoC Cards, as well as resident and faculty focus groups on how to further fine-tune this system.

Development of effective messages to promote maternal immunization in Kenya

ObjectivesThis study evaluated messages and communication approaches for maternal immunization uptake in Kenya. We identified persuasive communication aspects that would inform maternal immunization attitudes, intent, and vaccine uptake. MethodsWe conducted a two-phased mixed methods study with pregnant women and their male partners in three regions of Kenya. Discussions were conducted in English and Swahili languages by trained focus group moderators. Baseline measures included a survey and discussions about potential messages and accompanying visuals. Follow-up focus groups with the same participants included a survey about previously discussed messages, visuals, and communication impressions. The second round of focus groups focused on message preferences developed from the first round, along with rank order discussion for final message selection. Following transcription of focus group discussions, we conducted analyses using NVivo software. Quantitative data analyses included frequencies, factor analyses, reliability assessment, regression modeling, and comparative assessment of rank order. ResultsThe sample (N = 118) included pregnant women (n = 91) and their partners (n = 27) from diverse Kenyan regions (Bondo/Lwak/Siaya, Mombasa, and Nairobi). A four-factor solution resulted from factor analyses that included subscales “positive ad attitudes” (n = 5 items, α = 0.82), “negative ad attitudes” (n = 4 items, α = 0.75), “ad indifference” (n = 2 items, α = 0.52), and “ad motivation” (n = 4 items, α = 0.71). Overall, the positive ad attitudes factor (β = 0.61, p = 0.03) was the only significant component in the overall model examining message selections (χ2(6) = 262.87, p = 0.17). Among the tested concepts, we found that source and situational cues had a strong influence on women’s attitude formation and intention to obtain recommended maternal vaccinations. With self-acknowledged variations in knowledge, participants were particularly attuned to images of relatable women, providers, and depictions in realistic or actual Kenyan clinical settings. ConclusionsThe results indicated that positive attitudes were shaped by incorporating highly relatable factors in messages. Implications for subsequent campaigns and research directions are discussed.

The advantages and downsides of online focus groups for conducting research on addictive online behaviours.

As the coronavirus disease (COVID)-19 pandemic prompted new ways of doing research, Englund et al. [1] highlight the benefits and challenges that online experiments bring to the scientific investigation of addictive behaviours. Likewise, this commentary further reflects on how online focus groups may constitute particularly sound opportunities for studying addictive online behaviours. Over the past decade, addiction research has been marked by increasing interest in examining the potentially harmful effects of excessive involvement in new forms of online activities (e.g. video gaming, cybersexual activities, social networking and streaming of TV series) [2-4]. There have been growing calls to conduct qualitative research to better understand maladaptive involvement in online behaviours [5-9]. Qualitative research is indeed needed to avoid perpetuating a ‘confirmatory approach’ that consists in focusing merely on the similarities between online addictive disorders and substance use disorders [5-7]. Such research is about exploring the unique characteristics pertaining to these emerging and possible disorders, thereby ensuring an appropriate understanding of their genuine phenomenological nature. Given its well-established proficiency at delivering rich qualitative insights into phenomena [10-12], the focus group method can be a valuable data collection strategy for this purpose, which, in our opinion, can be strategically implemented in a remote context. Specifically, online focus groups imply that, instead of gathering participants around a table with a focus group moderator and co-moderator as in a traditional in-person discussion session, everyone meets online on video-conferencing platforms, several of which (e.g. Zoom, Microsoft Teams and Webex) are still widely used for professional purposes in the post-COVID era. As in a typical face-to-face setting, participants are invited to share their thoughts and opinions on a number of topics. The advantages of performing online over in-person focus groups overlap with those of online experiments depicted by Englund et al. [1]. Specifically, they involve three main areas of benefit: money savings, time savings and increased research accessibility. Conducting online focus groups is indeed cost-effective. Because participants are asked to simply login on the video-conferencing platforms, common barriers associated with transportation and accessibility are removed, thereby resulting in notable cost savings on facility rental, travel fees and food and beverage for participants. Free from such logistical and budgetary constraints, online focus group studies can be implemented in a more flexible and efficient manner, and therefore, completed under more optimal time periods [13]. The time saved may allow researchers to relocate their energy to maximize the added value of the study. The lack of geographical limitations to recruit online focus groups can also greatly facilitate the process of involving niche audiences, such as those generally targeted by addiction research. A more specific benefit of online focus groups lays in the way the moderator and co-moderator can take advantage of various built-in functions in the online platform to optimize data gathering. Relevant examples include the easier audio/video recording of the group discussion, which is directly manageable through the interface; the possibility of using two screens or a split screen to take notes without disrupting the simultaneous observation of participants; and the availability of time-tracking monitors that could allow the moderator to check each participant's speaking time and number of times he or she entered the debate [13]. Of particular interest is the opportunity for the moderator and co-moderator to communicate through private chat during the online group discussion. The co-moderator, who is in charge of carefully observing participants' nonverbal reactions, can, therefore, directly assist the moderator in managing the group discussion most efficiently by sharing with him or her relevant live observations about participants, which is generally not feasible in a traditional face-to-face context. Finally, the potential anonymity of online focus groups allowed by the technical possibility for participants to turn their video off is another significant advantage, because it can make them feel more comfortable and more willing to take part in discussions on topics as sensitive as problematic online behaviours. Despite these merits, performing online focus groups has two notable downsides. As in online experiments [1], one disadvantage of conducting research remotely is that the participants' environment (e.g. home, office) may not be distraction-free, which can discourage engaged discussion among focus group members. A second disadvantage is that participants' body language (i.e. gestures, eye contact) is inevitably less easy to observe in an online context than in a face-to-face one [13, 14]. Open access funding provided by Universite de Lausanne. None. Maèva Flayelle: Conceptualization. Damien Brevers: Conceptualization. Joël Billieux: Conceptualization; supervision.

Coaching in Postgraduate Competency-Based Medical Education: a Qualitative Exploration of Three Models.

ObjectiveAs postgraduate medical education increasingly transitions to competency-based models, there is a growing need for faculty to help residents process increasing amounts of assessment data. It has been recommended that a designated resident advisor or coach take on this faculty role, but the literature surrounding coaching in medical education is sparse. The authors evaluated the implementation of different coaching models in a postgraduate psychiatry program to identify drivers and barriers to effective coaching.MethodsThe authors conducted semi-structured interviews in September 2019 with focus groups of residents and faculty to understand their experiences of coaching under different models. They identified major themes through a qualitative analysis of the transcribed focus groups, which took place from September to December 2020.ResultsThe authors identified four key themes associated with the implementation of coaching within a competency-based framework, namely role ambiguity, educational alliance, the “idealized coach,” and burden.ConclusionsWhile these findings highlight the barriers that can interfere with effective coaching, particularly in the context of widespread curriculum change, they also illuminate opportunities for the coaching role moving forward. Thus, they offer valuable guidance for present and upcoming competency-based programs as they implement coaching and seek to optimize the learning experience for residents.

The Disconnect in the Use and Purpose of the Syllabus Between Faculty and Students is REAL

The syllabus is a carefully crafted document which faculty rely on to inform students of expectations, deadlines and policies for their course. Throughout the course of the COVID‐19 pandemic there was growing evidence that students were not using the syllabus as intended and were looking elsewhere to locate important course information which often led to confusion, delays in beginning assignments and other missteps. The objective of this study was to investigate the disconnect between how students and faculty use the syllabus. To ensure inclusive representation, 20 different institutions from community college through professional school, private and public, from diverse regions of the USA were invited to participate in the study. A short 18 question survey with Likert scale, multiple choice, rank order and open response questions was created in Qualtrics. The invited faculty were emailed an invitation for students, a student survey link and a faculty survey link. Six faculty from 4y undergraduate universities (50%), community college (17%), private undergraduate professional school (17%), and medical school (17%) completed the survey. There were 162 student responses from community college (54%), public 4y undergraduate universities (46.4%), and medical school (.6%). Students identified as female (80.3%), male (19.1%) and other (0.6%). When asked What is a syllabus? a few students stated it is a learning tool (8%), a contract between faculty and student (19%), while the majority (73%) said both. However, most students agreed (60%) that the syllabus should be flexible, which contradicts the definition of the syllabus as a contract. Students (86%) agreed that the faculty keep the syllabus up to date which correlates with the faculty surveyed (100%) who stated they kept their syllabus up to date. Student use of the syllabus was demonstrated when over half agreed (59%) that they reached out to the faculty when they had a question orconcern in regard to the syllabus. Further investigation into the utilization of the syllabus was elucidated when students were asked to rank‐order items in the syllabus based on importance. The number one ranked item, defined as most important, was deadlines (45%), followed by faculty contact information (22%), textbook (13%), grading criteria (12%), attendance (6%). Few students selected extra credit (1%), late policy (1%), or exam late policy (0.5%). Yet evidence of the disconnect was shown when we asked students In your LMS, where do you most often look for assignment deadlines? only (9%) of students use the syllabus and instead looked at modules (33%), calendars (28%), assignments (21%) and gradebook (9%) for the deadlines. Students (92%) reported they preferred reminders of deadlines from the faculty and most (90%) wanted notifications sent to their phones which eliminates the use of the syllabus. In conclusion the disconnect between students and faculty is real as students are not using the syllabus as intended. Student and faculty focus groups will be held to investigate this issue more deeply.