Postgraduate Learning Research Articles

Medical learner perspectives on elements of an educational rural generalist pathway: survey outcomes

IntroductionThe Northern Ontario School of Medicine University (NOSM U) continues to be challenged in meeting its social accountability mandate of addressing the rural health human resource crises in its catchment of Northern Ontario. Its new educational initiative, the Rural Generalist Pathway (RGP) aims to graduate family physicians specifically prepared for rural practice. This study elicits the perspective of NOSM U learners on the various components being considered for this educational pathway.MethodsA mixed methods survey was created for each of two medical learner groups, undergraduate NOSM U students and its family medicine residents. Quantitative data was analyzed for frequencies and percentages and qualitative data underwent thematic analysis.ResultsWith a response rate of 24.6% for undergraduates and 37.9% for residents, the survey discovered undergraduates consider rural clinical rotations as the most valuable experiences in rural medicine. Among the findings, both the majority of medical students and residents (87.3% and 87.9% respectively) agreed that support for a resident’s family well-being and community integration was the element of the pathway most likely to influence them in pursuing the RGP. Mentorship by a practicing rural physician was an element highly supported by 81% of undergraduate and 81.8% of postgraduate learners as likely to influence them to take the RGP.DiscussionIncorporating learner perceptions into the development of the RGP could help focus institutional resources and enhance learner participation in this pathway, producing more rural family doctors to serve Northern Ontario.

An interprofessional postgraduate quality improvement curriculum: results and lessons learned over a 5-year implementation

ABSTRACT Problem Quality Improvement (QI) is interprofessional by nature; however, most academic QI programs occur in silos and do not leverage the opportunity to bring interprofessional learners together. Intervention To evaluate QI competencies of physician, nursing, pharmacy, behavioral health, and social work residents after participating in a longitudinal QI curriculum. Lessons learned are shared to guide educators in developing QI curriculum for interprofessional learners. Context Cohorts of graduate students over 5 years participated in a QI curriculum that aligned with each professions’ core quality competencies. Residents engaged in didactics and experiential learning in primary care clinics. Impact All learners (N = 74) demonstrated improvement in QI knowledge measured by the QIKAT-R and applied their skills demonstrated by completion of a QI project presented at the Institute for Healthcare Improvement annual forums. Participation in QI curriculum resulted in knowledge and skill improvement. Lessons learned An experiential QI curriculum is a natural place to bring diverse post-graduate learners together to improve QI knowledge and skills. Successful QI curriculum goals are to (a) align projects with institutional and stakeholder goals, (b) include coaches to promote teamwork and project management, (c) narrow project scope, (d) develop an improvement mindset that failures are learning opportunities, and (e) address needs for data access.

Musculoskeletal Learning and Knowledge Retention Among Postgraduate Physicians: Evaluating the Long-Term Impact of a New Preclerkship Curriculum at a Nationally Accredited Medical Program.

Musculoskeletal (MSK) injuries and disorders are exceptionally prevalent in the clinical setting. Despite this, physician training in MSK medicine has been historically inadequate contributing to a lack of MSK knowledge, confidence, and clinical skills among postgraduate physicians. The goal of this investigation was to examine the long-term impact of a new preclerkship MSK curriculum implemented by a nationally accredited medical program on postgraduate physician's learning and knowledge retention in the area of MSK medicine. Five hundred sixty-eight postgraduate physicians (years 1-6) who had previously completed the new curriculum over a 6-year period were recruited to complete a standardized and validated MSK examination that consisted of 30 multiple-choice questions on core or must-know topics in MSK medicine that could be directly mapped to learning objectives within the new preclerkship MSK curriculum. Ninety postgraduate physicians completed the examination, obtaining an average score of 75.0% (±10.2; range 57.0-100.0). Physicians who completed MSK-related electives during clerkship training or specialized in fields related to MSK medicine (i.e., orthopaedics, PM&R, sports medicine, and rheumatology) performed significantly better on the MSK examination (p ≤ 0.01). Data indicated that the program's new preclerkship curriculum supports high levels of MSK learning and knowledge retention among postgraduate physicians. These findings are expected to assist with the establishment of minimum curriculum standards and can be used to guide MSK curricular reform at other medical programs.

The Importance of Offline Options for Online Learners

The popularity of MOOCs and MOOC platforms prompted some universities to develop their first online courses, while others experimented with the format of existing online offerings. Despite the body of research identifying cognitive, metacognitive, and practical benefits of printed materials, there has been a shift towards an approach that privileges online resources, reducing opportunities to access resources offline or in printed form. Online courses can be produced more quickly and cheaply than those providing both printed and digital options. They can also benefit learners in a society that values digital skills and literacies. This paper, informed by the principles of universal design for learning (CAST 2018), asks ‘What are the benefits to students of offering downloadable/printable versions of online study materials and supporting offline study?’. It takes a phenomenological approach, exploring the experience of 100 postgraduate learners on an online course delivered on the FutureLearn platform. Data was extracted from a large dataset that included all the students’ course discussion postings (N = 17,158). Data analysis identified the importance of the online/offline divide and showed that, as students’ contexts change, the benefits and accessibility of online, offline and print versions shifts. Printed and digital materials support different ways of learning and can have an affective impact. These findings point to ways in which learning design, skills training, and technical changes might be used to increase the affordances of digital materials for learners.

Perceived Influence of Blended Teaching on Postgraduate Educational Management Students Learning in Rivers State Universities

The study investigated perceived influence of blended teaching on postgraduate educational management students learning in Rivers State Universities. The study adopted the descriptive survey research design. Two research questions and two hypotheses guided the study. The population of the study is 58. It consists of all lecturers in the Department of Educational Management in Rivers State owned universities. The sample size of the study was 58. Census sampling technique was used to sample the entire population of the study. A structured questionnaire titled perceived influence of blended teaching of postgraduate students learning questionnaire was used as instrument for data collection. Three experts validated the instructed and Cronbach Alpha Method was used to obtain an average reliability coefficient of 0.83. 58 copies of the questionnaire were administered, retrieved, and used for the study. The items were rated on a four (4) point rating scale; mean and standard deviation was used to analyze the research questions while z-test was used in testing the formulated hypotheses. The findings reviewed that, Educational Management postgraduate students learning was influenced by face-to-face and hybrid teaching to a high extent. The researcher recommended that lecturers should ensure that students or learners became active and not passive participants as this will help or make postgraduate Educational Management students to develop knowledge on their own and confident without the interference of the instructor or lecturer and measures should be adopted by lecturers on how online learning instruction could be used to achieve Educational Management courses having psychomotor objectives in Rivers State owned universities.

Resident and Fellow Perspectives on Family Planning and Building During Training

Physicians, especially surgeons, delay family building, and face age-related complications of pregnancy. To explore factors that are associated with family building decisions among residents and fellows and to understand their thoughts on accessing family building supports, workplace culture, and attitudes toward family planning. This qualitative study was conducted from May to August 2022 at postgraduate training sites across Ontario, Canada. Participants included 29 postgraduate learners. Purposive sampling from 80 eligible trainees was used to ensure diverse demographics, including sex, specialty, and institution. Semi-structured individual interviews lasting 30 to 90 minutes were conducted over a virtual platform. Participants were asked to share their thoughts and experiences on family planning in a medical career, family building goals, the role of mentorship, and knowledge of current family planning supports. Themes associated with residents' perception of family planning within the context of a medical career. Twenty-nine trainees, ages 25 to 37 years old (22 [75.9%] were female, 26 [89.7%] were heterosexual; median [range] age, 30 [25-37] years) from various institutions took part in this study. The participants included both 24 residents (82.8%) and 5 fellows (17.2%) and 8 (27.6%) were from surgical specialties, 3 (10.3%) from pediatrics and subspecialties, 4 (13.8%) from internal medicine and subspecialties, 2 (6.9%) from obstetrics and gynecology, 3 (10.3%) family medicine, 2 (6.9%) from anesthesia, and 7 (24.1%) other medical specialties. Four themes were identified: (1) tension between role as a physician and role as a parent; (2) impact of role models and mentorship on family planning choices; (3) family building is discouraged during training, especially in surgical specialties; and (4) need for tangible family planning supports in training. In this qualitative study of residents' and fellows' perspectives on family building, trainees did not perceive residency and fellowship programs as supportive for individuals who want to family build during training leading to personal and professional dissonance. Trainees identified that more tangible supports, transparent information, and mentorship may improve a trainees' feeling of support.

Negotiation in group interaction: Longitudinal evidence from Chinese postgraduate EFL learners

Negotiation serves to solve communication problems in second language (L2) learners’ peer interaction including negotiation of meaning (NoM), negotiation of form (NoF), negotiation of content (NoC) and negotiation of procedure (NoP). The four negotiation types are initiated through negotiation strategies. This study examined how negotiation types and negotiation strategies were distributed and how the distributions developed. The data came from five rounds of group interaction conducted by 52 Chinese postgraduate students in a semester. The findings reveal significant differences in the distributions of negotiation types and negotiation strategies. NoC occurred significantly more frequently than NoM and NoF. Each negotiation type had its major negotiation strategies and they had significantly higher percentages than the other negotiation strategies. Specifically, NoM was mostly initiated by clarification requests, NoF by recasts, NoC by explicit appeals for assistance, and NoP by direct negotiations. Both competitive and supportive growths occurred in the longitudinal trajectories. This study provides a comprehensive and developmental insight into negotiation in EFL learners’ peer interaction and offers significant pedagogical implications.

Insights into professional learning for intensive Block Model: Lessons from a participatory evaluation for capacity building

We share lessons gained through supporting an institution-wide curriculum innovation via a post-graduate professional learning program. At the inception of the innovation, an intensive Block Model (BM) was unfamiliar to both the institution and its professional learning facilitators. The Graduate Certificate of Tertiary Education was re-modelled with BM as the heart of professional learning so academics would encounter BM as students. The program modelled BM principles, reinforced by meta-conversations to provide students with a reflective, immersive experience. Through a participatory evaluation, professional learning facilitators’ individual reflections were distilled to generate collaborative insights into academics’ capacity building for BM. Their lessons inform strategies to cultivate institution-wide capability-building including their own professional growth. Lessons shape the study recommendations. Recommendations originate from effectively engaging time-poor, diverse cohorts. (1) In recognition of the ease with which students can fall behind, embedding strategies to manage their time and stress helps to maintain a realistic study pace. (2) Authentic assessments provide students with useful products for their teaching. (3) Peer-feedback and examples of students’ work exposes them to how their colleagues present their work and illustrates good BM practices. (4) Modelling BM principles must be reinforced by meta-conversations to provide students with a reflective, immersive experience of the pedagogical principals. We observed that well planned efficiencies for students often provide consequent efficiencies for staff. These insights are captured in a model for scalable institutional-based professional learning practice. Capability growth flourishes at the intersection of action, reflection and evaluation. Professional collegial conversations are the catalyst for developing context-relevant professional learning.

The potential of point-of-care ultrasound in UK general practice

Ultrasound has been described as the stethoscope for the 21st century. It can rapidly answer a specific clinical question or support a procedure. Use of point-of-care ultrasound (PoCUS) by doctors has increased in the UK and internationally over the past decade. Training in PoCUS is now a core part of some undergraduate and postgraduate learning curricula. The World Organization of Family Doctors (WONCA Europe) has endorsed use of PoCUS in general practice. The rapid uptake of PoCUS in primary care in other countries suggests that the UK may soon follow suit. This article aims to provide an overview of PoCUS in primary care, including what PoCUS is, its current and potential use within primary care, limitations, legal considerations, and resources to develop an interest and skill in PoCUS as a GP in the UK.

Assessing the hidden curriculum in medical education: a scoping review and residency program’s reflection

Background: While the hidden curriculum (HC) is becoming recognized as an important component of medical education, ideal methods of assessing the HC are not well known. The aim of this study was to review the literature for methods of assessing the HC in the context of healthcare education. Methods: We conducted a scoping review on methods to measure or assess the HC in accordance with the JBI Manual for Evidence Synthesis. Ovid MEDLINE, Ovid EMBASE, and ProQuest ERIC databases were searched from inception until August 2023. Studies which focused on healthcare education, including medicine, as well as other professions such as nursing, social work, pharmacy were included. We then obtained stakeholder feedback utilizing the results of this review to inform the ongoing HC assessment process within our own medical education program. Results: Of 141 studies included for full text review, 41 were included for analysis and data extraction. Most studies were conducted in North America and qualitative in nature. Physician education was best represented with most studies set in undergraduate medical education (n = 21, 51%). Assessment techniques included interviews (n = 19, 46%), cross-sectional surveys (n = 14, 34%), written reflections (n = 7, 17%), and direct observation of the working environment (n = 2, 5%). While attempts to create standardized HC evaluation methods were identified, there were no examples of implementation into an educational program formally or longitudinally. No studies reported on actions taken based on evaluation results. Confidential stakeholder feedback was obtained from postgraduate medical learners in our program, and this feedback was then used to modify our longitudinal HC assessment process. Conclusions: While the HC has as increasing presence in the medical education community, the ideal way to practically assess it within a healthcare education context remains unclear. We described the HC assessment process utilized at our program, which may be informative for other institutions attempting to implement a similar technique. Future attempts and studies would benefit from reporting longitudinal data and impacts of assessment results

Choose Your Own Adventure! An empirical study on gamification of postgraduate learning on research project design

It is difficult to teach complex topics such as academic research to student cohorts who are widely heterogeneous in prior knowledge, learning goals, and learning preferences. Exploratory, quest-like approaches show promise for increasing engagement, personalization, and autonomy, however, there is a lack of empirical data on which, if any, aspects of gamification can benefit learning. This paper presents analytics and qualitative responses to a Choose Your Own Adventure for postgraduate design of research projects. It focusses on non-linear navigation for self-directed personalization, digital badges, and the role of narrative within a gamified learning tool. Results highlight high user attrition, effective personalization of learning, high acceptance of gamification approaches, and much lower interest in some gamification elements, contributing value to the pedagogy of learning and teaching research skills.

How supervisors affect students’ academic gains and research ability: An investigation through a qualitative study

A supervisory system is an essential part of higher education and plays a vital role in cultivating the high-level talents needed for high-quality national development and social progress. This study aims to determine how supervisors affect students' academic gains and research ability. This study used a qualitative research method to select 10 postgraduate students and their 7 supervisors for in-depth interviews from May to July 2022. This study aims to address the following questions: 1. What are the modes of supervisor-student communication? 2. What impact do these modes have on students? 3. What factors affect these modes? Three discoveries were made in this study. When supervisors and students communicate only regarding the academic content and students tend to fully follow supervisors' instructions, students obtain more academic output in the short term but lack autonomy. When supervisors and students discuss academic issues and life trifles equally, it helps in promoting students' comprehensive quality. When students do not have much contact with their supervisors and they get along like strangers, it is beneficial to cultivate students' intellectual independence, but students grow slowly. The factors influencing the communication modes include the supervisors' educational philosophy, postgraduate learning attitude, and supervisory system. In conclusion, the three communication modes can coexist together in a group of students led by the same supervisor. Whether a communication mode can promote the growth of students depends on the awakening of the students’ self-awareness, and the supervisory system is the most implicit factor underlying communication.

Institutional Factors and Student Satisfaction of Post-graduate Adult Learners

In recent years, various stakeholders, including researchers, policymakers, and students, have displayed a growing interest in assessing the effectiveness and performance of higher education institutions. Although no single indicator is sufficient to describe the organizational quality of the university, student satisfaction is one of the most often used indicators. Extensive prior research has consistently demonstrated that high levels of student satisfaction positively influence crucial performance measures such as student retention and institutional graduation rates. Although student satisfaction has been extensively studied, particularly among undergraduate students, much less research has been done among adult learners returning to college. This paper aims to identify the key institutional factors that significantly impact the satisfaction of part-time postgraduate students. We hope that the insights of the study can help universities to allocate their limited resources and ultimately to enhance the well-being of the students.

Understanding the Use of Mobile E-Books among Mathematics Postgraduates

Objectives: The main objective of this study is to understand the factors that encourage the use of mobile ebooks among mathematics postgraduate students. Method: This study employed a qualitative case study approach. Eight mathematics postgraduate students from the algebra research group participated in the study. Data were collected via interview and analyzed by using constant comparative analysis. Results: Utilitarian, cognitive, affective, social norm, and content qualities were the main factors influencing the use of mobile ebooks among the participants. Conclusions: Mobile ebooks are easy to use and provide a meaningful platform to find information. In addition, the mobile ebook provides instant access to new information with a single finger click, thus enabling students to extract the needed information and make constructive comparisons on the subject matter. Theory and/or Practice Implications: Results expand understanding of the factors that motivate the use of mobile ebooks for learning activities among mathematics postgraduate students. In addition, the study also provides support for institutions planning to incorporate mobile ebooks as an important reference material for postgraduate learning and research activities.

Anchoring adult learners’ experiences through photovoice: Jamaican students’ meaning-making during COVID-19

ABSTRACT Within the Caribbean, the number of students pursuing postgraduate studies in higher education institutions (HEIs) has increased over the years. Consequently, locally contextualised epistemologies and empowering methods are needed to help adult learners in Caribbean higher education (HE) navigate their studies. This paper presents findings from a photovoice study undertaken with postgraduate adult learners at an HEI in Jamaica. Participants used photographs, written reflections and group discussions to explore their HE journey. Given the intervening nature of the pandemic in the immediate period after the study was conceptualised and participants engaged, this paper focuses on the ways in which photovoice offered participants opportunities to make meaning of their HE journey. Findings demonstrate that the use of photovoice was transformative in how it empowered participants through the opportunity to engage in self-discovery and discuss their thoughts and emotions, facilitated peer support, and how it enabled adult learners to forge resilience as they undertook their studies.

More than just an add-on: Enhancing discipline-specific employability skills and awareness via the virtual learning environment

While students tend to recognise the value of employability skills and training, they often do not prioritise this due to academic demands, lack of clarity regarding the most sought-after employment competencies, and challenges attaining these whilst studying. The benefits of tailored, discipline-specific employability training have been well documented. However, little guidance exists as to how to integrate employability within the core online curriculum, particularly in disciplines with highly diverse and rapidly evolving career landscapes. To address this gap, this postgraduate taught learning development project systematically identified discipline-specific employability competencies, and integrated them into the core online curriculum, which aimed to boost students’ employability skills, awareness and career management skills. The rich learning generated from this project is captured in a series of actionable prompts and recommendations for identifying and implementing meaningful and scalable employability practices.

Relationships between online self-regulation skills, satisfaction, and perceived learning among distance education learners

Distance Learning or Distance Education is one of the approaches of education to connect learners and educators or instructors with geographical barriers by using technologies. The nexus between learners’ online self-regulation skills, satisfaction and perceived learning continues to be an ongoing debate in distance education for developing countries. No study has looked at the relationships between online self-regulation skills, satisfaction, and perceived learning among postgraduate distance education learners in Ghana. This study purposed to identify the connections between self-regulation skills, learner satisfaction, and learning perceptions. The survey included a total of 1142 postgraduate distance education learners. The structural linkages were investigated using structural equation modelling analysis. The fit index values obtained from the analysis were X2/df = 2.60, CFI = 0.92, TLI = 0.91, and RMSEA = 0.059, all of which were satisfactory. Learners' online self-regulation skills are thought to be a predictor of their satisfaction. Also, learners' online self-regulation skills are recognised as a predictor of their perceived learning. Learners' satisfaction with the online distance learning setting or environment is considered a strong indicator of perceived learning.

Distance Learning Students’ Perspectives of Academic Procrastination: A Qualitative Investigation

This study explores academic procrastination among postgraduate distance learners, a topic that has received limited attention. Through qualitative interviews with participants, the authors conducted thematic analysis on their experiences. Three overarching themes emerged: perception, reasons, and reflection of academic procrastination among distance learners. Notably, participants frequently procrastinated, primarily due to study-life balance challenges. Surprisingly, participants expressed overall satisfaction with their academic performance despite procrastination tendencies. They considered procrastination a conscious choice, prioritizing other life commitments over studying. This study sheds light on the influence of external factors on procrastination behavior in distance learning. The findings suggest that academic procrastination is prevalent among distance learning students, with study-life balance being a significant predictor. Participants’ satisfaction with their academic performance suggests that procrastination may be a deliberate choice. This research highlights the need for tailored interventions to address procrastination in distance education settings.

IMPACT OF PUNCTUALITY AND REGULARITY ON LEARNING BEHAVIORS AND CLINICAL SKILLS IN POST-GRADUATE RESIDENTS AT NISHTAR HOSPITAL MULTAN

: Punctuality and regularity are crucial traits in medical education that can significantly impact learning behaviors and clinical skills development. However, there is a lack of empirical evidence investigating their impact on postgraduate residents in the Pakistani healthcare system. This qualitative study aims to explore the experiences and perceptions of doctoral residents regarding punctuality and regularity in their clinical and learning activities at Nishtar Hospital Multan. The study also seeks to identify the perceived effects of punctuality and regularity on residents' learning behaviors and clinical skills development, highlight any barriers or facilitators to maintaining punctuality and regularity in the residency program, and provide insights to inform future interventions or policies aimed at promoting punctuality and regularity among postgraduate residents. The study found that punctuality and regularity significantly enhance postgraduate residents' learning behaviors and clinical skills. Punctual and regular residents reported better time management skills, increased exposure to different cases, and improved academic performance in their clinical and learning activities. However, some residents faced barriers to maintaining punctuality and regularity, such as long working hours and inadequate supervisor support. The study suggests that interventions aimed at promoting punctuality and regularity should consider the unique challenges and opportunities of the Pakistani healthcare system and prioritize the needs and experiences of postgraduate residents.

Challenges faced by teachers of postgraduate health professions blended learning programs: a qualitative analysis

IntroductionBlended learning, which integrates classroom face-to-face teaching with both asynchronous and synchronous online learning elements, has swiftly gained acceptance in educational environments. However, the implementation of blended learning presents challenges that impact all stakeholders, necessitating thoughtful consideration. Teachers play a central role in shaping the instructional experience among these stakeholders. To fully realize the potential of comprehensive blended learning, it is imperative to identify the challenges faced by these teachers and develop strategies that sensibly address and overcome them.MethodologyA qualitative exploratory study was conducted with twelve teachers involved in the postgraduate blended learning health professions program at Khyber Medical University, Peshawar in 2022. One-on-one semi-structured Interviews were conducted via WhatsApp/ZOOM, transcribed by Otter AI, coded on NVivo & analyzed using Braun/Clarke’s Thematic Analysis.ResultsThree themes of challenges faced by teachers of postgraduate blended learning programs were constructed namely (1) Skills, such as (i) digital, (ii) instructional, and (iii) online class management, and (2) Administrative barriers in terms of (iv) resources (iv) training, and (3) Faculty resistance.ConclusionThis study provides profound insights into the daunting challenges that postgraduate blended learning program teachers encounter in terms of skills, administrative barriers, and faculty resistance. These findings offer a valuable opportunity for program directors to identify the critical requirements of these faculties in their pursuit of effective teaching and learning, ultimately transforming the landscape of blended education. This study emphasizes the need for ongoing faculty development and institutional support to address the identified challenges and improve the quality of postgraduate blended-learning programs.