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Introduction: Mentors in programmatic assessment support mentees with low-stakes feedback, which often also serves as input for high-stakes decision making. That process potentially causes tensions in the mentor-mentee relationship. This study explored how undergraduate mentors and mentees in health professions education experience combining developmental support and assessment, and what this means for their relationship. Methods: The authors chose a pragmatic qualitative research approach and conducted semi-structured vignette-based interviews with 24 mentors and 11 mentees that included learners from medicine and the biomedical sciences. Data were analyzed thematically. Results: How participants combined developmental support and assessment varied. In some mentor-mentee relationships it worked well, in others it caused tensions. Tensions were also created by unintended consequences of design decisions at the program level. Dimensions impacted by experienced tensions were: relationship quality, dependence, trust, and nature and focus of mentoring conversations. Mentors and mentees mentioned applying various strategies to alleviate tensions: transparency and expectation management, distinguishing between developmental support and assessment, and justifying assessment responsibility. Discussion: Combining the responsibility for developmental support and assessment within an individual worked well in some mentor-mentee relationships, but caused tensions in others. On the program level, clear decisions should be made regarding the design of programmatic assessment: what is the program of assessment and how are responsibilities divided between all involved? If tensions arise, mentors and mentees can try to alleviate these, but continuous mutual calibration of expectations between mentors and mentees remains of key importance. ispartof: Perspectives on Medical Education vol:12 issue:1 pages:271-281 ispartof: location:Netherlands status: In preparation

Background: During placements abroad, healthcare students are confronted with different personal and professional challenges, related to participation in practice. This study investigates when and how students respond to such challenges, and which coping and support mechanisms students use to overcome these. Methods: Twenty-five international students shared their experiences about physiotherapy placement in The Netherlands. Using a critical incident technique, we asked participants to recall events where participation was affected by an unforeseen situation, in or outside the clinic. Further, we explored students’ strategies of seeking support within their social network to overcome individual challenges. Two researchers applied thematic analysis to the interview data, following an iterative approach. Team discussions supported focused direction of data collection and analysis, before conceptualizing results. Results: Participants described a wide range of challenges. The scope and impact level of challenges varied widely, including intercultural differences, language barriers and inappropriate behaviour in the workplace, students’ personal context and wellbeing. Mechanisms employed by students to overcome these challenges depended on the type of event (personal or professional), making purposeful use of their available network. Conclusion: Students involve clinical staff, peers, family and friends during placement abroad, to make deliberate use of their support network to overcome challenges in participation, whereas the academic network remains distant. Findings may help reflect on the roles and responsibilities of academic staff and other professionals involved with placements abroad. Healthcare programmes should ensure support before, during and after placement is within students’ reach.

Additional file 2: Supplementary Table 1. Percentages of first-, second-, and third-year students engaging others in their co-regulatory networks for five regulatory purposes.

Additional file 1.

Additional file 1. Self-Regulated Learning at Work Questionnaire.

Additional file 1. MERIT survey questions.

Additional file 2: Table 1. Personal characteristics of the 228 respondents to the MERIT survey. Table 2. Mentoring and mentor setting characteristics of the 228 respondents to the MERIT survey. Table 3. Mean, median, mode and SD on item level, frequencies of answers given per MERIT item. List ordered from highest to lowest average.

ObjectiveSince physicians’ behaviour determines up to 80% of total healthcare expenditures, training residents to deliver high-value, cost-conscious care is essential. Residents acknowledge the importance of high-value, cost-conscious care-delivery, yet perceive training to be insufficient. We designed an observational study to gain insight into how the workplace setting relates to residents’ high-value, cost-conscious care-delivery.DesignThis ethnographic study builds on 175 hours of non-participant observations including informal interviews, 9 semi-structured interviews and document analysis.SettingDepartment of obstetrics and gynaecology in an academic hospital in the Netherlands. Population or sample: 21 gynaecology residents.MethodsIterative analysis process of fieldnotes, interview transcripts and documents, including open-coding, thematic analysis and axial analysis by a multidisciplinary research team.ResultsResidents rarely consider health care costs, and knowledge regarding costs is often absent. Senior consultants guide residents while balancing benefits, risks and costs, with or without explicating their decision-making process. Identified learning opportunities are elaboration on questions raised concerning high-value, cost-conscious care, checking information about costs that are used in discussions about high-value, cost-conscious care, and having a more open and explicit discussion about high-value, cost-conscious care.ConclusionOur study emphasizes that the opportunities and potential to train residents to deliver high-value, cost-conscious care in the workplace are present. The challenge resides in capitalizing on these opportunities. We suggest departments to consult external experts to facilitate discussions regarding high-value, cost-conscious care to contribute to informal learning and to create a workplace setting in which high-value, cost-conscious care-delivery is prioritized.Fundingnone

Introduction Engaging in scientific misconduct and questionable research practices (QRPs) is a noted problem across fields, including health professions education (HPE). To mitigate these practices, other disciplines have enacted strategies based on researcher characteristics and practice factors. Thus, to inform HPE, this study seeks to determine which researcher characteristics and practice factors, if any, might explain the frequency of irresponsible research practices.Method In 2017, a cross-sectional survey of HPE researchers was conducted. The survey included 66 items adapted from three published surveys: two published QRP surveys and a publication pressure scale. The outcome variable was a self-reported misconduct score, which is a weighted mean score for each respondent on all misconduct and QRP items. Statistical analysis included descriptive statistics, reliability and correlation analysis, and multiple linear regression modelling.Results and Discussion In total, 590 researchers completed the survey. Results from the final regression model indicated that researcher age had a negative association with the misconduct score (b = -0.01, beta = -0.22, t = -2.91, p

This poster was presented at the Association of American Medical Colleges' Learn, Serve, Lead Conference in Austin Texas in November 2018.For more information on this study, please see: Artino, J. A., Driessen, E. W., & Maggio, L. A. (2018). Ethical Shades of Gray: International Frequency of Scientific Misconduct and Questionable Research Practices in Health Professions Education. Acad Med. 10.1097/ACM.0000000000002412 Note: The views expressed in this article are those of the authors and do not necessarily reflect the official policy or position of the Uniformed Services University, the U.S. Navy, the Department of Defense, or the U.S. Government.

Competency-based education has become central to the training and assessment of post-graduate medical trainees or residents [ref:1]. In competency-based education, there is a strong focus on outcomes and professional performance. Typically, holistic tasks are used to train, practice and assess the defined outcomes or competencies. In residency training, these tasks are part of the day-to-day clinical practice. The performance of residents in the workplace needs to be captured and stored. A portfolio has been used as an instrument for storage and collection of workplace-based assessment and feedback in various countries, like the Netherlands and the United States. The collection of information in a portfolio can serve or be used for a variety of purposes. These are: The collection of work samples, assessment, feedback and evaluations in a portfolio enables the learner to look back, analyze and reflect. The content is used for assessment or making decisions about progress. And the portfolio is used as an instrument for quality assurance processes. In post-graduate medical education, these purposes can be combined but this is not always reported transparently. In this paper, we will discuss the different perspectives, how a portfolio can serve these three purposes and what are opportunities and challenges of combining multiple purposes., Die kompetenzbasierte Ausbildung ist zum zentralen Element in der Weiterbildung und Beurteilung von postgraduierten medizinischen Auszubildenden oder Assistenzärzten geworden [ref:1]. In kompetenzbasierter Ausbildung gibt es eine klare Fokussierung auf Ergebnisse und professionelle Leistungen. Typischerweise werden holistische Aufgaben verwendet, um definierte Ergebnisse oder Kompetenzen zu üben, zu praktizieren und zu bewerten. Während der Facharztausbildung sind diese Aufgaben Teil des klinischen Alltags. Die Leistung der Assistenzärzte am Arbeitsplatz muss erfasst und dokumentiert werden. Ein Portfolio ist als Instrument für die Speicherung und Sammlung von Beurteilung und Feedback am Arbeitsplatz in verschiedenen Ländern, wie den Niederlanden und den Vereinigten Staaten, verwendet worden. Die Sammlung von Informationen in einem Portfolio kann verschiedenen Zwecken dienen oder für verschiedene Zwecke verwendet werden. Diese sind: Die Sammlung von Arbeitsproben, Beurteilungen, Feedback und Evaluationen in einem Portfolio ermöglicht dem Lernenden zurückzublicken, zu analysieren und zu reflektieren. Der Inhalt dient der Bewertung oder den Entscheidungen über den Fortschritt. Und das Portfolio wird als Instrument für Qualitätssicherungsprozesse verwendet. Innerhalb der postgraduierten medizinischen Weiterbildung können diese Zwecke kombiniert werden, aber dies wird nicht immer transparent berichtet. In diesem Artikel werden die verschiedenen Perspektiven erörtert, wie ein Portfolio diese drei Zwecke erfüllen kann und was die Möglichkeiten und Herausforderungen sind, um verschiedene Nutzungen zu kombinieren., GMS Journal for Medical Education; 34(5):Doc57

Students in many teacher education programmes experience confusion about portfolios. This study investigated whether using an analogy in the introduction of a portfolio helps teacher education students understand both the purpose of a portfolio and how to compile it. It was also investigated whether these students' understanding correlates with their appreciation of portfolios. In the analogy, portfolios were compared with job application letters, curricula vitae and the references that are common in selection procedures for new employees. This analogy was helpful in promoting students' understanding. Their understanding correlated with their appreciation of this instrument. © 2007 Elsevier Ltd. All rights reserved.

AIM: Portfolios are often used as an instrument with which to stimulate students to reflect on their experiences. Research has shown that working with portfolios does not automatically stimulate reflection. In this study we addressed the question: What are the conditions for successful reflective use of portfolios in undergraduate medical education? METHODOLOGY/RESEARCH DESIGN: We designed a portfolio that was aimed at stimulating reflection in early undergraduate medical education, using experiences described in the medical education literature and elsewhere. Conditions for reflective portfolio use were identified through interviews with 13 teachers (mentors), who were experienced in mentoring students in the process of developing their portfolios. The interviews were analysed according to the principles of grounded theory. RESULTS: The conditions for successful reflective use of portfolios that emerged from the interviews fell into 4 categories: coaching; portfolio structure and guidelines; relevant experiences and materials, and summative assessment. According to the mentors, working with a portfolio designed to meet these conditions will stimulate students' reflective abilities. CONCLUSION: This study shows that portfolios are a potentially valuable method of assessing and developing students' reflective skills in undergraduate medical training, provided certain conditions for effective portfolios are recognised and met. Portfolios have a strong potential for enhancing learning and assessment but they are very vulnerable and may easily lead to disappointment. Before implementing portfolios in education, one should first consider whether the necessary conditions can be fulfilled, including an appropriate portfolio structure, an appropriate assessment procedure, the provision of enough new experiences and materials, and sufficient teacher capacity for adequate coaching and assessment. © Blackwell Publishing Ltd 2005.