Informal Curriculum Research Articles

Self-care perspective taking and empathy in a studentfaculty book club in the United States

PurposeWe aimed to study the impact of a combined faculty-student book club on education and medical practice as a part of the informal curriculum at the University of Florida College of Medicine in the United States.MethodsSixteen medical students and 7 faculties who participated in the book club were interviewed through phone and recorded. The interview was then transcribed and entered into the qualitative data analysis program QSR NVivo (QSR International, Burlington, MA, USA). The transcripts were reviewed, and thematic codes were developed inductively through collaborative iteration. Based on these preliminary codes, a coding dictionary was developed and applied to all interviews within QSR Nvivo to identify themes.ResultsFour main themes were identified from interviews: The first theme, the importance of literature to the development and maintenance of empathy and perspective-taking, and the second theme, the importance of the book club in promoting mentorship, personal relationships and professional development, were important to both student and faculty participants. The third and fourth themes, the need for the book club as a tool for self-care and the book club serving as a reminder about the world outside of school were discussed by student book club members.ConclusionOur study demonstrated that an informal book club has a significant positive impact on self-care, perspective-taking, empathy, and developing a “world outside of school” for medical school students and faculty in the United States. It also helps to foster meaningful relationships between students and faculty.

Optimizing Fit: Targeting a Residency Psychiatry Consultation-Liaison Rotation to Various Levels of Training

BackgroundDetermining the optimal timing and structure for a core residency rotation in consultation-liaison psychiatry (CLP) remains a key challenge for program directors and rotation leaders. Previous surveys have been conducted regarding these questions, and guidelines from national organizations have been issued, but practices remain varied among institutions.MethodsWe conducted a narrative review of the literature related to the timing of CLP rotations and generated consensus recommendations based on our experience as program directors, rotation leaders, and residents.ResultsExplicit goals of CLP training in residency include identifying and treating psychiatric manifestation of medical illness and communicating effectively with primary teams. Implicit goals of training may includeconflict management, limit setting, and “thinking dirty.”DiscussionAlthough CLP rotations earlier in residency often create a better fit within the overarching curriculum and allow for generating early interest in the field, significant amounts of supervision are required, and consultees may look to attendings as the primary consultant. Conversely, while later rotations are sometimes challenging to structure with other outpatient responsibilities, they allow for greater autonomy and may map better onto the informal curriculum. A hybrid model, with training spread across multiple years, is another approach that may mitigate some of the disadvantages of confining consultation-liaison training to a single year. Compelling arguments can be made for placing the core CLP rotation in postgraduate year 2 or 3 or using a hybrid model. Regardless of placement, program directors and rotation leaders should be mindful of tailoring the rotation to the trainees' developmental stage.

Blackface, Implicit Bias, and the Informal Curriculum: Shaping the Healthcare Workforce, and Improving Health

Blackface, Implicit Bias, and the Informal Curriculum: Shaping the Healthcare Workforce, and Improving Health. Background/PurposeHealth disparities disproportionately affect minority populations and are due to multiple factors including discrimination and implicit bias. Biases are ubiquitous throughout society, including the educational and healthcare environment. In health care it is at the patient-provider level that our biases play a major role in patient care exhibiting a rippling effect going beyond individual provider biases affecting not only patients and families but all members of the healthcare team. MethodsAlthough biases are in play across the entire medical school curriculum the most significant impact is during clerkships. During clerkships students are exposed to and prone to adopt and internalize identities and traits that may run counter to the basic tenants of medicine and the Hippocratic tradition of non-maleficence, beneficence, and compassion. Implicit biases develop early, are difficult to change and as shown by recent allegations of political figures appearing in blackface remain intact into adulthood. Conclusion/RecommendationsAt the institutional level biases can be addressed and mitigated through cultural humility and implicit bias training, training in culturally and linguistically appropriate services, increased workforce diversity through support of STEM- based enrichment programs and curriculum changes that include clinical vignettes emphasizing the effects of race, gender, sexual orientation, and ethnicity, on access and quality of care; reflective writing and small group sessions that provide safe spaces for students; and experiential learning in underserved communities. Resulting in an educational environment that directly addresses the role of implicit bias, racism, and discrimination in individual and population health.

"This Isn't Being a Doctor."-Qualitative Inquiry into the Existential Dimensions of Medical Student Burnout.

Recent studies report that up to 50% of medical students feel burned out. Medical student burnout has significant public health consequences-as students detach, the quality of patient care is impacted, and students themselves suffer, as evidenced by the increased risk in substance use and suicide. While some theorize that medical student burnout is due to an inability to confront suffering, death, and their own mortality, this hypothesis fails to explain why pre-clinical students also experience burnout despite having minimal clinical exposure. /r/medicalschool, a news-aggregating website for medical students, was queried for posts from the creation of the subreddit, December 11, 2009, to July 1, 2018, for the term "burnout" and its grammatical variations. Three hundred fifty-two posts and their comment threads were analyzed using a grounded theory approach. When the causes of burnout were interpreted using an existential psychodynamic framework, the predominant themes that arose were difficulties dealing with freedom (groundlessness), existential isolation, and meaninglessness, rather than death anxiety stemming from witnessing the suffering of patients. Students feel as if they are not living up to their own values of what a physician should be like and are troubled by the inconsistent values within the hidden, informal, and formal curriculum. Individualized interventions are temporary fixes that allow people to withstand their environment and complete their training; however, the learning environment needs change to better empower students to live a life full of existential meaning.

MP25: Assessing the learning impact of the Northern City of Heroes public exhibit on bystander cardiopulmonary resuscitation response

Innovation Concept: In Sudbury, ON 44% of out-of-hospital cardiac arrest (OHCA) patients receive bystander CPR (bCPR), and only 4.7% survive cardiac arrest. The Northern City of Heroes (NCH) community initiative was launched in April 2019 with a goal of improving survival from OHCA through hands-only bCPR in the municipality. One NCH initiative is an interactive exhibit at Science North, a science centre in Sudbury that hosts 250,000 visitors annually. The exhibit employs simulation trainers for CPR, accompanying signage and interactive elements. The goals of the exhibit are to activate bCPR, change and measure behaviours through exhibit interactions on how to deliver excellent CPR, and improve survival rates in OHCA patients. Methods: Data is being collected from 3000 visitors using self-reported surveying via SurveyGizmo to assess likelihood of performing bCPR, pre and post interacting with the exhibit. Visitor behaviour will be examined at the exhibit using video-recorded interactions and coding those behaviours using BORIS software. Behavioural data will be analyzed using the Visitor Engagement Framework (VEF) where initiation, transition and breakthrough learning-behaviours are coded and an exhibit Visitor Engagement Profile (VEP) is created. The VEF and VEP are tools used in informal learning settings to assess exhibit impacts on learning. Curriculum, Tool, or Material: The use of an easily-apprehendable, hands-on exhibit tool located in a public setting, such as a science centre, creates a platform for engaging large and diverse public audiences. This type of bCPR exhibitry has not been implemented in other similar environments. The informal learning setting allows the science centre staff to engage in personalized interactions that can solidify the quality of learning and confidence in employing the new skills developed. Conclusion: The NCH exhibit and new strategies for embedding informal curriculum are powerful tools to reach diverse audiences, build knowledge and skills, and have a measurable impact on bCPR and OHCA survival rates. Data is being captured and tracked by Health Sciences North around the City of Greater Sudbury's bCPR and OHCA survival rates to monitor long-term impacts of the NCH community initiatives. Limitations of the study may be found in the focused demographics as well as the nature of self-reported learning. Future research directions include broader geographical surveying to assess improvements in community response to OHCA as a direct result of an interactive bCPR exhibitry.

Views from Teachers, Children and Parents on the Reception of Refugees in Primary School in Greece

The refugee issue facing our country in recent years has triggered a heated debate in the social sciences about its impact on students. Most research focuses on the education of refugees and their smooth integration into society and the psychological support of families. However, there is a lack of interest in the research field for refugee reception about the teachers, pupils and parents' views and what their perspective is on this, as they directly and indirectly affect them. In this context, the present study focuses on the perspective of teachers, pupils and parents on the refugee issue, what they feel and how they perceive it, and we will examine whether the formal curriculum and informal curriculum through actions taken teachers can influence students' attitudes. In the direction indicated by the international literature, this research will be structured in a sample data collection (25 teachers, 25 students, 25 parents in Thessaloniki, Greece) through questionnaire and interview questions in primary school children on the perspective of teachers, students and parents on the refugee issue. The research findings are expected to illuminate the perspective of teachers, students, and parents on the current issue of refugee issue.

Informal sport and curriculum futures: An investigation of the knowledge, skills and understandings for participation and the possibilities for physical education

Internationally, patterns of participation in sport are changing, with so-called ‘informal’ participation displacing club-based and other formally structured involvement in sport. This paper reports research that is investigating changing forms of participation from an educational perspective. It directs attention to what physical education can learn from informal sport and how physical education can align pedagogically with contemporary participation trends, to help grow and sustain young people’s engagement in sport beyond schools. The paper presents findings from two sequential elements of an ongoing research project. The first is a systematic review of literature pertaining to informal participation that examined the skills, knowledge and understanding central to participation that occurs outside of traditional sport structures. Findings from this review highlight that social skills, cultural understandings, and knowledge relating to environment, alongside movement skills, are important in enabling participants to become engaged in, and maintain their involvement in, informal participation. The second element of the research involved documentary analysis to examine the alignment of contemporary curricula, and specifically, the Australian Curriculum Health and Physical Education (AC HPE), with the learning identified as important for informal participation. Findings illustrate clear opportunities for the AC HPE to bring to the fore knowledge, skills and understandings that may extend young people’s engagement with informal participation through their lives. The discussion addresses key issues for policy makers, teachers and teacher educators to consider in the light of this research, if they are to leverage the opportunities for teaching and learning that informal sport presents.

Reader response: Functional neurologic disorders: Bringing the informal and hidden curriculum to light.

I read with interest the editorial by Strom1 about functional neurologic disorders (FNDs). As a treating physician, I have struggled with the multiple diagnostic labels attached to these patients by physicians of different medical specialties during the course of their clinical disease presentation. A neurologist may assign a patient who presents with chronic fatigue the diagnostic labels of narcolepsy, idiopathic hypersomnia, or chronic Lyme disease. A rheumatologist may assign the label of collagen vascular disease, and a psychiatrist may diagnose depression. This diagnostic ambiguity is troublesome for patients and clinicians alike. I contend that even the term FND needs to be revisited. A patient should be broadly labeled as having a functional disorder and only after characterization sublabeled and referred to an appropriate specialty physician.

Author response: Functional neurologic disorders: Bringing the informal and hidden curriculum to light.

Dr. Sethi raises an excellent point about the term functional neurologic disorder (FND) in his comment on the editorial.1 It seems clear that reticence to use the term functional creates the ambiguity he mentions. Medically unexplained symptoms, categorized in the international classification of diseases as undifferentiated somatoform disorders, are a diagnosis that many providers are loathed to give. Whether that is because of concern about missing a diagnosis is not clear. Having evaluated and treated more than 400 of these individuals in the FND clinic at the University of Colorado, I can attest to the fact that patients arrive confused about their diagnosis. Multiple incorrect diagnoses, as Dr. Sethi points out, pack the medical histories of patients with FND, leading doctors and patients astray. I believe that the commentary by Perez et al.2 gives us the best chance for a way forward, by teaching a new generation of residents and fellows how to approach patients in a nonjudgmental and open-minded fashion. It took 30 years to add Functional Neurologic Disorder to the Diagnostic and Statistical Manual, and it is still parenthetical to the term Conversion.3 Stripping the diagnosis of FND of its stigma and empowering care providers to rule in functional disorders is an actionable step which should be taken.

The informal curriculum of family medicine \u2013 what does it entail and how is it taught to residents? A systematic review

BackgroundThe informal curriculum is a seemingly well-explored concept in the realm of medical education. However, it is a concept with multiple definitions and the term “the hidden curriculum” is often used interchangeably. In short, they both refer to the implicit learning taking place outside the formal curriculum, encompassing both a trickling down effect of organizational values and attitudes passed on by a mentor or colleague. While the informal curriculum is a recurrent theme in medical education literature; it is seldom discussed in Family Medicine. As the informal curriculum is likely to be highly influential in the forming of future family practitioners, our aim was to explore the area further, with respect to the following: which elements of the informal curriculum are applicable in a Family Medicine context and what educational interventions for Family Medicine residents, visualizing the various educational elements of it, have been performed?MethodsWe conducted a systematic review comprising iterative literature searches and a narrative synthesis of the results.ResultsTwenty articles, published between 2000 and 2019, were included in the analysis which resulted in three partly interrelated themes comprising the informal curriculum in Family Medicine: gaining cultural competence, achieving medical professionalism and dealing with uncertainty. The themes on cultural competence and uncertainty seemed to be more contextual than professionalism, the latter being discussed in relation to the informal curriculum across other medical disciplines as well. Formalized training for Family Medicine residents in aspects of the informal curriculum appeared to be lacking, and in general, the quality of the few interventional studies found was low.ConclusionsImportant aspects of being a family practitioner, such as cultural competence and dealing with uncertainty, are learned through a context-dependent informal curriculum. In order to ensure a more uniform base for all residents and to reduce the impact of the individual supervisor’s preferences, complementary formalized training would be beneficial. However, to date there are too few studies published to conclude how to best teach the informal curriculum.Trial registrationThe systematic review was registered with Prospero; registration number CRD42018104819.

Young Children’s Learning of Bioengineering with CRISPEE: a Developmentally Appropriate Tangible User Interface

Bioengineering represents an interdisciplinary field with the potential to engage young learners in science inquiry and engineering design in the context of real-world challenges. Although children encounter bioengineered products and solutions in their everyday lives, they are not introduced to bioengineering until much later in school, after stereotype threats about STEM engagement have crystallized. The purpose of this paper is to present an experimental tangible tool called CRISPEE and evidence from an intervention with young children who explored CRISPEE in the context of an informal bioengineering curriculum. In this design study, 25 children aged 4–7 years engaged in a 9-h workshop designed to introduce them to foundational bioengineering concepts of gene editing, engineering design, and bioethics. Children’s attitudes and content knowledge about life science, engineering, and bioengineering were assessed pre- and post-interventions. Mixed quantitative and qualitative results show that most children entered the intervention with pre-existing ideas about genes and attitudes about engineering and science. Post intervention, children demonstrated increased positive STEM attitudes and content knowledge, especially in the area of science inquiry, and also demonstrated an emerging curiosity about the purpose and effectiveness of bioengineering work, including bioethics. Implications for research and practice are discussed.

Same but Different: Exploring Mechanisms of Learning in a Longitudinal Integrated Clerkship.

Longitudinal integrated clerkships (LICs) are a widely used method of delivering clerkship curricula. Although there is evidence that LICs work and core components of LIC training have been identified, there is insufficient understanding of which components are integral to why they work. To address this question, this research explored how students experienced the first year of an LIC program. The aim was to use participants' understanding of their learning experiences to identify potential mechanisms of the LIC curriculum model. Thirty-two interviews were conducted with 13 University of Toronto students, 7 LIC and 6 block rotation students from the same site, from October 2014 to September 2015. A thematic analysis was performed iteratively to explore participants' understanding of their key learning experiences and outcomes. Participants in both cohorts described their key learning outcome as integration and application of knowledge during patient care. Experiences supporting this outcome were articulated as longitudinal variable practice and continuity of relationships with preceptors and patients. Critically, these experiences manifested differently for the 2 cohorts. For block students, these learning experiences appeared to reflect the informal curriculum, whereas for LIC students, learning experiences were better supported by the LIC formal curriculum. The results illustrate the importance of learning experiences that support longitudinality and continuity. By also emphasizing variability and knowledge integration, they align with literature on expert development. Notably, many of the learning experiences identified resulted from informal learning and thus support going beyond the formal curriculum when evaluating the effectiveness of curricula.

A case study investigating programming students’ peer review of codes and their perceptions of the online learning environment

Programming in schools is no longer a novel subject. It is now quite commonly found in our schools either in formal or informal curriculum. Programmers use creative learning tactics to solve problems and communicate ideas. Learning to program is generally considered challenging. Developing and implementing new methodologies in teaching programming is imperative to overcome the current challenges associated with teaching and learning of programming. This case study aims to contribute to the programming education in schools by investigating how students learn in an online programming while involved in peer review of codes. The study subsequently examines students’ perceptions of the pedagogical, social and technical design of the online programming learning environment. When students are involved in providing and receiving feedback and creating their own identity in a programming community, they may be better prepared for learning and applying programming in their undergraduate studies and their future career in the field.

Medical Education Podcasts: Where We Are and Questions Unanswered.

Social media, particularly podcasts, has become an influential modality within informal medical education. As podcasts continue to become more prevalent among learners of all types, clinical educators of the future must be able to help navigate this new pedagogy. Preliminary data demonstrates that medical students, residents, post-training physicians, and advanced practitioners all utilize podcasts for their own benefit. New data is discussed in the setting of the current literature on podcasting and important questions remain to determine how this new form of learning can and will be integrated into formal and informal medical curriculum.

MINISTERIAL FORMATION FOR SERVICE: INTEGRATIVE THEOLOGICAL EDUCATION AT JUSTO MWALE UNIVERSITY, ZAMBIA

In ministerial training, effective integration of academic excellence, spiritual formation and vocational training is critical to produce holistically trained Christian leaders. This article positions integration as an educational approach that attempts to coordinate and synthesise the major learning dimension and can bring about significant learning, since it takes account of the lifeworld of the student and engages a custom-designed curriculum. This article reports on an empirical research project on integrative theological education at Justo Mwale University, Zambia. It reports on various dimensions within the formal and informal curriculum in the residential Bachelor of Theology programme. The article provides key findings and a discussion on the contextual and institutional challenges that shaped curriculum design. It reflects on the learning gained through this action research and concludes with strategies to move towards a more integrative model of theological education.

Beyond Reconceptualization: Recontextualization/ Multicontextualization of Curriculum Studies in Iran (Toward New Curriculum Ecosystems)

The field of curriculum studies could be described as a young and emerging field that has revived around the world mainly with the attempts of the Curriculum Internationalization Movement. In this article, the researcher intends to describe the process of curriculum studies in Iran, with the aim of illustrating the challenges faced by the field. This article, starting with an overview of the status of curriculum studies in Iran, discusses several issues and problems, such as unemployment crisis of graduates in curriculum studies, the resistance of curriculum decision makers to the findings of the curriculum field, lack of serious movement for theorizing, translation and imitation mostly from American curriculum literature, and reproduction of the international curriculum discourses which are far from the real needs of Iranian educational community. Finally, the possible recommendations, which are to expand the field towards new curriculum ecosystems will be discussed. Such a perspective could be an experience and perhaps a solution from Iran for curriculum studies in other countries. This movement toward new curriculum ecosystems (such as the workplace curriculum, higher education curriculum, informal curriculum, and generally curriculum studies in non-public education) could be elaborated as a disciplinary immigration and moving beyond the reconceptualization which will shape the future of curriculum studies.

Towards Developing Tandem Learning in Formal Language Education

The present paper provides an insight into the use of a tandem learning approach as an active and flexible mode of learning to support Internationalisation at Home (IaH) (Beelen and Jones) in higher education. More specifically, it reports on a 25-year experience of tandem learning between international and home students in the context of a language exchange programme (informal curriculum), a translation class and an online forum (formal curriculum). The study outlines a major trend in the development of the tandem learning activities in the last ten years which has led to new grouping configuration. It then explores learners’ level of engagement in the learning process (Chen et al.), whether it is student involvement in tasks and subject knowledge or student commitment to partnership. Preliminary results point to the potential causal relationship between instructional strategies and students’ level of engagement in tandem learning.

Utilizing the foundation course period for sensitizing medical graduates about writing rational prescriptions

It won't be wrong to say that patients trust their doctors that they can cure them of their illnesses and will take steps to ensure their well-being, with majority of them not being aware about the impact of a pharmaceutical industry on medical practice. The attitude of a medical professional towards the pharmaceutical industry can form quite early in their medical training, keeping the fact that they are exposed to an informal curriculum from their teachers or even peers. The students have to be sensitized about all this throughout their medical under-graduation period and the best place to initiate this in the Foundation Course itself. Similar things can be dealt again as a part of the Early Clinical Exposure sessions, AETCOM sessions, during clinical postings and during the internship. In conclusion, in order to stop the practice of irrational prescriptions, the undergraduate students should be trained to deal with the pharmaceutical industries within their curriculum across the entire duration, so that they are empowered enough to not get unduly influenced by the industry.

Trio-preparation of Health Care Students for Digital Era in Universiti Malaysia Sabah – Case Study

Introduction: Creating an educational climate that engages the students in the digital era is crucial as it prepares them for the future.Objectives: The aim of this multiple case study is to highlight the impact of creative educational environment on the students’ awareness of digital era tools.Methods: In this study three activities were organized. Firstly, a brain storming seminar titled “Medical Practice in Artificial Intelligence Era” was held. The second event was E-poster competitions which challenged the students’ curiosity to address the health problems and to introduce innovative solutions to solve it. Medical and nursing students presented 32 posters. Third activity was MeDuino, a hands-on workshop to familiarize the students with arduino technology in medical practice.Results: Around 260 participants attended the seminar. In their feedback, 72% of students found the topics attractive and more than 60% found its theme relevant and beneficial. E-poster competition was evaluated using a modified rubric scale. The data was analysed by SPSS showed that only “creativity” and “practicality” merits scored little above the mean range. There was no statistically significant difference in the mean score of ‘creativity’ and ‘practicality’ between medical students and nursing students. However, in general medical students’ scores were higher compared to nursing students. 90% of students said that they improved cognitively and 85% found it fascinating. In Meduino workshop (Robotics), The 30 participants practiced mini projects. 86 % found it attractive, 81% expressed that it improve d their cognitive about technology as noted in comparing the pre and post- event questionnaires. The students’ concerns included the time constraints short time and lack of lecturers’ guidance during posters’ preparation.Conclusion(s): Transforming educational environment physically, emotionally and socially managed to address few aspects digital era. Allocating more time, facilities and training in the informal curriculum could enhance health-care students mastering of future tools.International Journal of Human and Health Sciences Supplementary Issue: 2019 Page: 31

OBJECTIVE-BASED VIGNETTES TO ENHANCE INTERNAL MEDICINE RESIDENT TEACHING ON THE CORONARY CARE UNIT

All core Internal Medicine residents at Dalhousie University rotate through the Coronary Care Unit (CCU) in their second year of training. In this busy environment, incorporating a component of dedicated formal teaching curriculum has been difficult. Education has previously been from informal curriculum and has recently been identified as a weakness of the rotation. We hypothesized that short, objective-based cardiology vignettes could enhance the educational experience of internal medicine residents while on CCU.