Critical thinking is an essential skill for practising pharmacists. Critical self-reflections have been said to contribute to critical thinking, and formative feedback has been cited as improving student learning. We conducted a two-year study, using mixed methods research, with two cohorts of 1st to 4th year pharmacy students, 76 students in total, to improve their critical self-reflective skills as part of critical thinking. Our pedagogical approaches, unlike the pedagogy of didactic teaching that is historically associated with health professional education, included the writing of critical self-reflections and the use of formative assessment. Students wrote eight self-reflections over four semesters. We provided formative feedback after each self-reflection, which included individual written comments and whole class formative feedback during an explicit instruction class. However, to strengthen the study design we did not provide any feedback between the first and second reflections. Quantitative analysis using a rating scale for the components of knowledge, self-assessment, and critical thinking indicated that students improved in their self-reflections and in their critical thinking, although there were differences between the two cohorts. Qualitative analysis revealed that many students valued the formative feedback and thought it improved their learning, but not all students agreed. We suggest that these pedagogical approaches can cross disciplines.
Purpose: In 2017, the Discipline of Anesthesia implemented a new Competency by Design (CBD) curriculum. The first phase of implementation involved a Transition to Discipline (TTD) and was intended to orient new residents to the discipline. As part of TTD, faculty members in Anesthesia offered a “Sim Week” to provide a simulation-based introduction to Anesthesia and to ease the transition from student to resident. Sim Week was offered again in 2018. This project involves an evaluation of Sim Week to assess its benefit to learners along with their level of anxiety at the beginning of residency and their confidence in obtaining the CBD-based Entrustable Professional Activities (EPAs).
Poster (1E) Purpose: Pediatric and Adolescent Gynecology (PAG) is a subspecialty of Obstetrics and Gynecology focused specifically on the care of children and adolescents. This demographic differs from the adult population as they present with unique pathologies, have different anatomical variants, and are often challenging to examine. Despite this, residency programs in Canada have identified a pervasive lack of exposure to PAG during academic training. Fortunately, 3D printing provides an affordable way to design and construct models for use in simulation based medical education to provide a safe and effective environment, within which the development of these skills may be fostered. The aim of this study is to employ 3D printing technology to develop a vaginal training model in PAG that addresses a potential lack of patient exposure and enables learners to develop important skills including basic examination, vaginoscopy, and hymenectomy. Methods: This study is to be completed with staff and resident physicians in the specialty of Obstetrics and Gynecology. The first phase of model development is currently in progress and is to be completed in collaboration with a research assistant within the MUN MED 3D printing team. Vaginal models at various developmental phases will be constructed. Molds will be 3D printed, from which silicone models will be produced, which include realistic external genitalia and vaginal canals as well as anatomical variants (e.g. imperforate hymen) to simulate patient encounters. Phase two of this study will involve establishing validity of the model during dedicated resident simulation labs. Residents and staff physicians will be asked to complete a qualitative questionnaire that asks participants to assess the model on measures of face validity including appearance and functionality during simulated procedures. Next Steps: This study is currently in progress as the models are undergoing development for future testing. This development is being carried out in collaboration with staff Obstetrician/Gynecologists and representatives from MUN MED 3D. Once the initial models are completed, we will proceed to the second phase of this project which involves validity testing by Obstetrician/Gynecology residents of various postgraduate levels in a simulated skills session. We hope to demonstrate the value of integrating 3D printing technology and simulation into medical education initiatives in the field of PAG.
Purpose: Self-directed learning (SDL) activities are a recognized type of informal adult learning across many continuing professional development systems. The expansive growth of DSMTs has created new opportunities for connecting with information and colleagues. The purpose of this survey is to explore adult learners’ perceptions and experiences with SDL and continuing professional education (CPE).
Poster (3D) Purpose: The concept of self-reflection involves critical analysis of one’s actions and decisions. Self-reflection is a process that involves the use of various self-reflective methods, including guided reflection (peer group or supervisor/mentor setting), independent reflection, written/audio diaries, and reflective storytelling/writing. Our literature review examines the application of self-reflection and self-reflective methods to resident Entrustable Professional Activities (EPA) performance, a relatively unexplored area of residency education research. Furthermore, our literature review reveals a significant gap in the literature: the absence of studies that compare the effectiveness of the aforementioned selfreflective methods and determines whether or not the practice of repeated self-reflection is effective at improving EPA performance. The ultimate goal of our research is to devise and conduct a study that addresses this gap. Methods: A search was conducted for relevant articles related to the topics of medical reflection, EPAs, and reflection upon EPA performance. The databases consulted were PubMed and Embase, and the keyword/search term entries were “reflection,” “entrustable professional activity,” “competency,” and “milestone.” We limited the results to English-language articles. Each article was examined and evaluated for its relevancy and appropriateness to our aforementioned research interests. Some articles do not include every search term but rather focus on either self-reflective methods or EPA performance evaluation. Results: Our database search returned twenty-one articles in total. We excluded nine articles based on our inclusion and exclusion criteria. The number of examined studies that utilize the aforementioned self-reflective methods is as follows: guided reflection (five), independent reflection (seven), written/ audio diaries (four), and reflective storytelling (two). Eleven of these studies used more than one selfreflective method. Our key findings include the following: no study compared the effectiveness of the various reflective methods, and no study examined the effect of repeated self-reflective exercises using these methods. Conclusion: Our review demonstrates that there is limited literature on this subject, indicating a need for further study and research on repeated self-reflection of EPA performance by post-graduate medical learners. The next step is to conduct a systematic and scoping review of the literature. We will continue to explore further research and suggestions for EPA reflection activities in order to create a successful study.
