Limited Faculty Time Research Articles

Unleashing excellence: using a project management approach to effectively implement a simulation curriculum to improve residents’ preparedness

BackgroundIntegrating innovative, simulation-based training programs into medical curricula frequently encounters familiar challenges, including scepticism, limited faculty time, and financial constraints. Recognized for its success in business projects, the Harvard Project Management Theory emerges as a promising approach to optimizing the implementation process and achieving sustainable success. This study endeavours to elucidate the application of project management theory in our implementation process and assess its impact on the clinical preparedness of novice residents.MethodsThe research utilized a structured four-phase implementation strategy—Planning, Build-up, Execution, and Closing—to develop a simulation-based education curriculum. Incorporating project management tools like project charters and risk management tools played a crucial role in facilitating the effective implementation of standardized processes and improved clinical outcomes. Essential components of this innovative management approach encompass stakeholder engagement, milestone definition, and the alignment of institutional policies and processes.ResultsA collective of 395 residents actively engaged in eight monthly simulation-based events, reflecting an average participation rate of 39 residents per lecture (± 19). A noteworthy enhancement was observed in the average rating for knowledge gain, with a significant improvement from 5.9/10 to 8.8/10 (p = 0.0001). Participants highlighted the program’s considerable impact on future clinical practice (4.7/5) and teamwork (4.8/5) as particularly valuable aspects. The introduction of a novel organizational structure received favourable feedback from faculty members, with a notable rating of 4.8/5 for predictive time planning. Qualitative insights from the evaluation highlighted the significance of targeted incentive schemes in optimizing the implementation process.ConclusionThis project underscores the constructive influence of project management principles in designing simulation-based curricula, explicitly focusing on stakeholder engagement, faculty motivation, and data utilization. Adopting the Harvard Project Management Approach emerges as a catalyst for heightened success in curriculum design, contributing to enhanced emergency preparedness among novice residents. The positive outcomes observed in this study provide valuable insights for future implementations, offering a foundation for refining and optimizing medical education programs to meet the evolving needs of learners and stakeholders alike.

Near-peer teaching in simulation.

Development, implementation and evaluation of a simulation curriculum is time and resource intensive. Limited faculty time and training are cited as primary barriers to adopting simulation into medical education. Near-peer teaching is a potential solution to manage the increased teaching demands that occur with simulation use. In 2022, we implemented a near-peer simulation curriculum for teaching junior physical medicine and rehabilitation (PM&R) residents high-acuity low-opportunity events commonly seen on the inpatient rehabilitation unit. The curriculum was taught by senior residents to supplement faculty lectures. Senior residents completed facilitator training on simulator logistics, debriefing and formative assessment. Residents completed an end-of-course questionnaire evaluating teaching effectiveness and perceived knowledge acquisition. All items were scored on a 5-point Likert-type scale. Learners rated their near-peers as having good clinical teaching effectiveness (mean [SD], 4.66[0.38]). Senior residents (n = 6) disclosed feeling knowledgeable about the topics they instructed (baseline 3.9[3.2-4.4]; after 4.6[4.1-4.9]; p = 0.19), and junior residents (n = 6) felt they gained knowledge and improved their ability to manage patients as a result of the near-peer curriculum (baseline 2.4[2.3-2.5]; after 3.9[3.5-4.2]; p = 0.005). This educational programme is an example of how near-peer teaching can be used in simulation. Our simulation curriculum taught by near-peers was valued by learners as well taught and educational. Research is needed that directly compares the effectiveness of near-pear teaching to faculty instruction. We hope that by sharing our work, educators will feel inspired to use near-peer teachers for simulation instruction when faculty availability for teaching is scarce.

Framework for the Use of Extended Reality Modalities in AEC Education

The educational applications of extended reality (XR) modalities, including virtual reality (VR), augmented reality (AR), and mixed reality (MR), have increased significantly over the last ten years. Many educators within the Architecture, Engineering, and Construction (AEC) related degree programs see student benefits that could be derived from bringing these modalities into classrooms, which include but are not limited to: a better understanding of each of the subdisciplines and the coordination necessary between them, visualizing oneself as a professional in AEC, and visualization of difficult concepts to increase engagement, self-efficacy, and learning. These benefits, in turn, help recruitment and retention efforts for these degree programs. However, given the number of technologies available and the fact that they quickly become outdated, there is confusion about the definitions of the different XR modalities and their unique capabilities. This lack of knowledge, combined with limited faculty time and lack of financial resources, can make it overwhelming for educators to choose the right XR modality to accomplish particular educational objectives. There is a lack of guidance in the literature for AEC educators to consider various factors that affect the success of an XR intervention. Grounded in a comprehensive literature review and the educational framework of the Model of Domain Learning, this paper proposes a decision-making framework to help AEC educators select the appropriate technologies, platforms, and devices to use for various educational outcomes (e.g., learning, interest generation, engagement) considering factors such as budget, scalability, space/equipment needs, and the potential benefits and limitations of each XR modality. To this end, a comprehensive review of the literature was performed to decipher various definitions of XR modalities and how they have been previously utilized in AEC Education. The framework was then successfully validated at a summer camp in the School of Building Construction at Georgia Institute of Technology, highlighting the importance of using appropriate XR technologies depending on the educational context.

Simulation-based curriculum development: lessons learnt in Global Health education

BackgroundSimulation based medical education (SBME) allows learners to acquire clinical skills without exposing patients to unnecessary risk. This is especially applicable to Emergency Medicine training programs where residents are expected to demonstrate proficiency in the management of time critical, low frequency, and highly-morbidity conditions. This study aims to describe the process through which a SBME curriculum was created, in a limited simulation resource setting at a 4-year Emergency Medicine (EM) residency program at the American University of Beirut Medical Center.MethodsA case-based pilot simulation curriculum was developed following Kern’s 6 step approach to curriculum design. The curricular objectives were identified through an anonymous survey of the program’s residents and faculty. Curriculum outcomes were assessed, and the curriculum was revised to address curricular barriers. Evaluations of the revised curriculum were collected during the simulation sessions and through a whole revised curriculum evaluation at the end of the first year of its implementation.Results14/20 residents (70%) and 8/8 faculty (100%) completed the needs assessment from which objectives for the pilot curriculum were developed and implemented through 6 2-h sessions over a 1-year period. Objectives were not met and identified barriers included cost, scheduling, resources, and limited faculty time. The revised curriculum addressed these barriers and 24 40-min sessions were successfully conducted during the following year. The sessions took place 3 at a time, in 2-h slots, using the same scenario to meet the objectives of the different learners’ levels. 91/91 evaluations were collected from participants with overall positive results. The main differences between the pilot and the revised curricula included: a better understanding of the simulation center resources and faculty’s capabilities.ConclusionSimulation-based education is feasible even with limited-resources. However, understanding the resources available, and advocating for protected educator time are essential to implementing a successful EM simulation curriculum.

Perceived impact of faculty practice on nurse practitioner education

Faculty practice is believed to positively affect health education, however limited research exists on the impact of faculty practice on nurse practitioner education. The purpose was to explore the perceived impact of faculty practice on nurse practitioner education. A preliminary mixed methods approach was used to evaluate nurse practitioner student and faculty perspectives on the impact of faculty practice on nurse practitioner education. Student group interviews were conducted and practicing faculty were surveyed. Study findings included student and faculty-perceived benefits and challenges of faculty practice on nurse practitioner education. Specific benefits were increased access to faculty preceptors and clinical sites for nurse practitioner students, influencing faculty-developed education materials, increased number of real-world examples, faculty credibility, applying evidence-based practice, and overall improvement in the quality of teaching. Specific challenges were time, faculty availability to students, managing multiple roles, and clinical sites not conducive to precepting. This study provided preliminary information on the perceived impact of faculty practice on nurse practitioner education including the benefits and challenges. Findings support faculty practice as having a positive perceived impact on nurse practitioner education.

Implementation of a skills practical to first-year pharmacy students

Background and purposeObjective structured clinical examinations (OSCEs) are being implemented in pharmacy schools across the country. As part of a new curriculum, a practical with an OSCE component was implemented for the first time at the West Virginia University School of Pharmacy. Educational activity and settingA practical with an OSCE component was developed for first-year professional pharmacy students in a foundational pharmacy skills course. The OSCE component assessed insulin and inhaler counseling and blood pressure skills. A written exam covered material from throughout the semester. FindingsA total of 76 students completed the practical. The average grade was a 27.8 out of 30 points. A total of 62 faculty hours were needed for the implementation of this OSCE. Discussion and summaryAn OSCE that assessed a variety of foundational pharmacy skills was designed and implemented to first year pharmacy students using limited faculty time and resources.

Learning by viewing versus learning by doing: A comparative study of observer and participant experiences during an interprofessional simulation training

ABSTRACTLarger student groups and pressure on limited faculty time have raised the question of the learning value of merely observing simulation training in emergency medicine, instead of active team participation. The purpose of this study was to examine observers and hands-on participants’ self-reported learning outcomes during simulation-based interprofessional team training regarding non-technical skills. In addition, we compared the learning outcomes for different professions and investigated team performance relative to the number of simulations in which they participated. A concurrent mixed-method design was chosen to evaluate the study, using questionnaires, observations, and focus group interviews. Participants included a total of 262 postgraduate and bachelor nursing students and medical students, organised into 44 interprofessional teams. The quantitative data showed that observers and participants had similar results in three of six predefined learning outcomes. The qualitative data emphasised the importance of participating in different roles, training several times, and training interprofessionally to enhance realism. Observing simulation training can be a valuable learning experience, but the students’ preferred hands-on participation and learning by doing. For this reason, one can legitimise the observer role, given the large student groups and limited faculty time, as long as the students are also given some opportunity for hands-on participation in order to become more confident in their professional roles.

A Multi-Institutional Medical Educational Collaborative

Educational collaboratives offer a promising approach to disseminate educational resources and provide faculty development to advance residents' training, especially in areas of novel curricular content; however, their impact has not been clearly described. Advocacy training is a recently mandated requirement of the Accreditation Council for Graduate Medical Education that many programs struggle to meet.The authors describe the formation (in 2007) and impact (from 2008 to 2010) of 13 California pediatric residency programs working in an educational collaboration ("the Collaborative") to improve advocacy training. The Collaborative defined an overarching mission, assessed the needs of the programs, and mapped their strengths. The infrastructure required to build the collaboration among programs included a social networking site, frequent conference calls, and face-to-face semiannual meetings. An evaluation of the Collaborative's activities showed that programs demonstrated increased uptake of curricular components and an increase in advocacy activities. The themes extracted from semistructured interviews of lead faculty at each program revealed that the Collaborative (1) reduced faculty isolation, increased motivation, and strengthened faculty academic development, (2) enhanced identification of curricular areas of weakness and provided curricular development from new resources, (3) helped to address barriers of limited resident time and program resources, and (4) sustained the Collaborative's impact even after formal funding of the program had ceased through curricular enhancement, the need for further resources, and a shared desire to expand the collaborative network.

Simulation in Medical Student Education: Survey of Clerkship Directors in Emergency Medicine

IntroductionThe objective of this study is to identify (1) the current role of simulation in medical student emergency medicine (EM) education; (2) the challenges to initiating and sustaining simulation-based programs; and (3) educational advances to meet these challenges.MethodsWe solicited members of the Clerkship Directors in Emergency Medicine (CDEM) e-mail list to complete a Web-based survey addressing the use of simulation in both EM clerkships and preclinical EM curricula. Survey elements addressed the nature of the undergraduate EM clerkship and utilization of simulation, types of technology, and barriers to increased use in each setting.ResultsCDEM members representing 60 EM programs on the list (80%) responded. Sixty-seven percent of EM clerkships are in the fourth year of medical school only and 45% are required. Fewer than 25% of clerkship core curriculum hours incorporate simulation. The simulation modalities used most frequently were high-fidelity models (79%), task trainers (55%), and low-fidelity models (30%). Respondents identified limited faculty time (88.7%) and clerkship hours (47.2%) as the main barriers to implementing simulation training in EM clerkships. Financial resources, faculty time, and the volume of students were the main barriers to additional simulation in preclinical years.ConclusionA focused, stepwise application of simulation to medical student EM curricula can help optimize the ratio of student benefit to faculty time. Limited time in the curriculum can be addressed by replacing existing material with simulation-based modules for those subjects better suited to simulation. Faculty can use hybrid approaches in the preclinical years to combine simulation with classroom settings for either small or large groups to more actively engage learners while minimizing identified barriers.

Mathematical Biology at an Undergraduate Liberal Arts College

Since 2002 we have offered an undergraduate major in Mathematical Biology at Harvey Mudd College. The major was developed and is administered jointly by the mathematics and biology faculty. In this paper we describe the major, courses, and faculty and student research and discuss some of the challenges and opportunities we have experienced.

Rush Medical College

Rush Medical College

Telehealth Distance Mentoring of Students

The challenge to the healthcare system lies in maintaining an adequately trained home care workforce of healthcare professionals in a time when government funding for educational geriatrics programs is limited, and academic centers are emphasizing faculty productivity that may limit their time dedicated to teaching and training healthcare students. Telemedicine presents an opportunity to study its educational potential using limited faculty resources. Is telemedicine technology appropriate for teaching skills needed to obtain a history and perform a physical examination on the elderly who choose to remain living in the community? We used telemedicine instruments to enable faculty to study the potential for teaching students the skills needed to perform a history and physical examination in an elderly person. The distance mentoring study was designed as a pilot-based on limited faculty time available to determine the effectiveness of teaching students using telemedicine. Students were also surveyed regarding the experience of visiting an independent living facility and about the reliability and their level of comfort using telemedicine. Most students found telemedicine to be reliable, most gained confidence and an acceptable level of comfort using telemedicine instruments to interact with elderly volunteer residents of an independent living facility. Students improved their physical examination skills and gained confidence administering special questionnaires (geriatric depression scale, Mini Mental State Examination [MMSE], clock drawing test, Tinetti Assessment) to elderly volunteers and recommended that all Physician Assistant (PA) program students should visit an independent living facility (ILF).

CRITERION DEVELOPMENT FOR DELIVERING WEB-BASED PLANT IDENTIFICATION COURSES AT MURRAY STATE UNIVERSITY

Murray State University is developing an on-line delivery for the four plant identification courses offered in the horticulture option program. Reasons for developing this are to provide more efficient use of limited faculty time, to utilize new technologies in the delivering of courses, and to provide an interactive teaching assistance to students outside of class. The American Society for Horticultural Sciences (ASHS) was contacted for a listing of universities in the United States that offered horticulture programs. E-mails were sent to 109 universities and 44 surveys were received for a 40.4% return rate. None of the responding universities were using new technologies in the form proposed by MSU. Of the respondents, 27.3% were interested in a course of this type and thought it was a good idea to pursue whereas 11.4% were not interested in developing a course and 15.9% said a course of this kind would not have applications in their universities. Currently 25% are using computer-aided delivery for their horticulture courses. Macromedia Dreamweaver MX is being used for its versatile and accessible format over current Blackboard PowerPoint options.

Education of preventive medicine residents: Alcohol, tobacco, and other drug abuse

Background Generalist physicians’ addiction training is inadequate, but general preventive medicine residency (PMR) programs have not been studied. We determined PMR programs’ alcohol, tobacco, and other drug abuse (ATOD) training from 1995 to 2000 and identified barriers to this education. Methods Interviewer-administered telephone survey of program directors (PDs) of accredited PMR programs in the United States. Results We interviewed all 41 PMR PDs. While 78% of PMR PDs reported interest in increasing ATOD education, for 68% it was not a high educational priority. Tobacco ranked in the top third of preventive medicine topics by 58%, while alcohol and other drugs ranked in the bottom third by 48% and 52%, respectively. Twenty-two percent of programs required a clinical ATOD rotation, most commonly smoking-cessation clinics. Only 29% of PMR PDs felt that residents were well prepared in clinical aspects of ATOD, while 60% felt that residents were prepared in ATOD research and public health issues. The most commonly reported barriers to ATOD training were lack of resident interest and defined competencies (64% each); limited faculty time (59%); limited teaching time (54%); lack of available teaching materials (53%); and lack of faculty expertise (51%). Conclusions While the majority of PMR PDs recognize the importance of incorporating teaching about addictions into training, much of the ATOD education in PMRs focuses on tobacco alone. Setting educational standards, defining competencies, investing in faculty development, and creating ATOD curricular modules are important next steps toward preparing preventive medicine physicians to effectively reduce the public health toll of addictions.