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  1. AU="Merkebu, Jerusalem"
  2. AU="Han, Junhyek"
  3. AU="Muneoka, Yusuke"
  4. AU="Griggs, Lisa"
  5. AU="Klauck, Sabine M"
  6. AU="Turton, James A"
  7. AU="Patel, Abhijit A"
  8. AU="Shankowsky, Heather A"
  9. AU="Płóciennik, Przemysław"
  10. AU="Marchesi, Pietro"
  11. AU="Kim Je Hyoung"
  12. AU="Huber, Ingrid"
  13. AU="Hasuko, K."
  14. AU="Yao, Weigen"
  15. AU="Huang, Xiao-Fan"
  16. AU=Zuo Chuantian
  17. AU="Varchetta, Veronica"
  18. AU="Zhang, Lingye"
  19. AU="Venko, Katja"
  20. AU="Kasthuri, Thirupathi"
  21. AU="Pirtskhalava, Tamar"
  22. AU="Saridakis, E N"
  23. AU="Vithana, Eranga N"
  24. AU="Suárez-Lledó, M"
  25. AU="Olivo-Marston, Susan"
  26. AU="Denise P Momesso"
  27. AU="Obrecht-Sturm, Denise"

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  1. Artikel ; Online: The case for metacognitive reflection: a theory integrative review with implications for medical education.

    Merkebu, Jerusalem / Veen, Mario / Hosseini, Shera / Varpio, Lara

    Advances in health sciences education : theory and practice

    2024  

    Abstract: The concepts of metacognitive reflection, reflection, and metacognition are distinct but have undergone shifts in meaning as they migrated into medical education. Conceptual clarity is essential to the construction of the knowledge base of medical ... ...

    Abstract The concepts of metacognitive reflection, reflection, and metacognition are distinct but have undergone shifts in meaning as they migrated into medical education. Conceptual clarity is essential to the construction of the knowledge base of medical education and its educational interventions. We conducted a theoretical integrative review across diverse bodies of literature with the goal of understanding what metacognitive reflection is. We searched PubMed, Embase, CINAHL, PsychInfo, and Web of Science databases, including all peer-reviewed research articles and theoretical papers as well as book chapters that addressed the topic, with no limitations for date, language, or location. A total of 733 articles were identified and 87 were chosen after careful review and application of exclusion criteria. The work of conceptually and empirically delineating metacognitive reflection has begun. Contributions have been made to root metacognitive reflection in the concept of metacognition and moving beyond it to engage in cycles of reflection. Other work has underscored its affective component, transformational nature, and contextual factors. Despite this merging of threads to develop a richer conceptualization, a theory of how metacognitive reflection works is elusive. Debates address whether metacognition drives reflection or vice versa. It has also been suggested that learners evolve along on a continuum from thinking, to task-related reflection, to self-reflection, and finally to metacognitive reflection. Based on prior theory and research, as well as the findings of this review, we propose the following conceptualization: Metacognitive reflection involves heightened internal observation, awareness, monitoring, and regulation of our own knowledge, experiences, and emotions by questioning and examining cognition and emotional processes to continually refine and enhance our perspectives and decisions while thoughtfully accounting for context. We argue that metacognitive reflection brings a shift in perspective and can support valuable reconceptualization for lifelong learning.
    Sprache Englisch
    Erscheinungsdatum 2024-02-12
    Erscheinungsland Netherlands
    Dokumenttyp Journal Article ; Review
    ZDB-ID 1352832-4
    ISSN 1573-1677 ; 1382-4996
    ISSN (online) 1573-1677
    ISSN 1382-4996
    DOI 10.1007/s10459-023-10310-2
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  2. Artikel ; Online: Occupying liminal spaces: The figured worlds of student affairs senior leaders in the United States.

    McOwen, Katherine S / Konopasky, Abigail W / Merkebu, Jerusalem / Varpio, Lara

    Medical education

    2024  

    Abstract: Introduction: Student Affairs Senior Leaders (SASLs) in the United States lead offices responsible for academic advising, administrative documentation, scheduling, student health, financial aid, and transition to residency, yet they infrequently draw ... ...

    Abstract Introduction: Student Affairs Senior Leaders (SASLs) in the United States lead offices responsible for academic advising, administrative documentation, scheduling, student health, financial aid, and transition to residency, yet they infrequently draw attention in the field's literature. We explore the role of SASLs and how they describe the social space of medical education.
    Methods: Using a constructivist approach informed by Figured Worlds theory, we conducted a sequential narrative and thematic analysis of the stories SASLs tell about their roles and experiences in the world of medical education.
    Results: SASLs inhabit complex roles centred on advocating for medical students' academic, personal and social well-being. Their unique position within the medical school allows them to see the harm to vulnerable students made possible by misalignments inherent within medical education. Yet even with the challenges inherent in the environment, SASLs find reasons for hope.
    Conclusion: SASLs' identities are full of potential contradictions, but they have a unique view into the often-chaotic world of medical education.
    Sprache Englisch
    Erscheinungsdatum 2024-04-10
    Erscheinungsland England
    Dokumenttyp Journal Article
    ZDB-ID 195274-2
    ISSN 1365-2923 ; 0308-0110
    ISSN (online) 1365-2923
    ISSN 0308-0110
    DOI 10.1111/medu.15389
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  3. Artikel ; Online: Physiologic measurements of cognitive load in clinical reasoning.

    Mullikin, Dolores R / Flanagan, Ryan P / Merkebu, Jerusalem / Durning, Steven J / Soh, Michael

    Diagnosis (Berlin, Germany)

    2024  Band 11, Heft 2, Seite(n) 125–131

    Abstract: Objectives: Cognitive load is postulated to be a significant factor in clinical reasoning performance. Monitoring physiologic measures, such as heart rate variability (HRV) may serve as a way to monitor changes in cognitive load. The pathophysiology of ... ...

    Abstract Objectives: Cognitive load is postulated to be a significant factor in clinical reasoning performance. Monitoring physiologic measures, such as heart rate variability (HRV) may serve as a way to monitor changes in cognitive load. The pathophysiology of why HRV has a relationship to cognitive load is unclear, but it may be related to blood pressure changes that occur in a response to mental stress.
    Methods: Fourteen residents and ten attendings from Internal Medicine wore Holter monitors and watched a video depicting a medical encounter before completing a post encounter form used to evaluate their clinical reasoning and standard psychometric measures of cognitive load. Blood pressure was obtained before and after the encounter. Correlation analysis was used to investigate the relationship between HRV, blood pressure, self-reported cognitive load measures, clinical reasoning performance scores, and experience level.
    Results: Strong positive correlations were found between increasing HRV and increasing mean arterial pressure (MAP) (p=0.01, Cohen's d=1.41). There was a strong positive correlation with increasing MAP and increasing cognitive load (Pearson correlation 0.763; 95 % CI [; 95 % CI [-0.364, 0.983]). Clinical reasoning performance was negatively correlated with increasing MAP (Pearson correlation -0.446; 95 % CI [-0.720, -0.052]). Subjects with increased HRV, MAP and cognitive load were more likely to be a resident (Pearson correlation -0.845; 95 % CI [-0.990, 0.147]).
    Conclusions: Evaluating HRV and MAP can help us to understand cognitive load and its implications on trainee and physician clinical reasoning performance, with the intent to utilize this information to improve patient care.
    Mesh-Begriff(e) Humans ; Cognition/physiology ; Heart Rate/physiology ; Female ; Male ; Blood Pressure/physiology ; Clinical Reasoning ; Adult ; Internal Medicine ; Clinical Competence ; Electrocardiography, Ambulatory ; Internship and Residency ; Middle Aged ; Stress, Psychological/physiopathology ; Stress, Psychological/diagnosis ; Psychometrics
    Sprache Englisch
    Erscheinungsdatum 2024-01-29
    Erscheinungsland Germany
    Dokumenttyp Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 2194-802X
    ISSN (online) 2194-802X
    DOI 10.1515/dx-2023-0143
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  4. Artikel: Picking Apart a Program Evaluation Committee: A Multiple Case Study Characterizing Primary Care Residency Program Evaluation Committee Structure, Program Improvement, and Outcomes.

    Lowry, Lacy E / Merkebu, Jerusalem / Schall, Sarah E / Neubauer, Brian E / Battista, Alexis

    Cureus

    2024  Band 16, Heft 4, Seite(n) e57439

    Abstract: Background: As of 2014, the Accreditation Council for Graduate Medical Education (ACGME) mandates initiating a Program Evaluation Committee (PEC) to guide ongoing program improvement. However, little guidance nor published reports exist about how ... ...

    Abstract Background: As of 2014, the Accreditation Council for Graduate Medical Education (ACGME) mandates initiating a Program Evaluation Committee (PEC) to guide ongoing program improvement. However, little guidance nor published reports exist about how individual PECs have undertaken this mandate.
    Objective: To explore how four primary care residency PECs configure their committees, review program goals and undertake program evaluation and improvement.
    Methods: We conducted a multiple case study between December 2022 and April 2023 of four purposively selected primary care residencies (e.g., family medicine, pediatrics, internal medicine). Data sources included semi-structured interviews with four PEC members per program and diverse program artifacts. Using a constructivist approach, we utilized qualitative coding to analyze participant interviews and content analysis for program artifacts. We then used coded transcripts and artifacts to construct logic models for each program guided by a systems theory lens.  Results: Programs adapt their PEC structure, execution, and outcomes to meet short- and long-term needs based on organizational and program-unique factors such as size and local practices. They relied on multiple data sources and sought diverse stakeholder participation to complete program evaluation and improvement. Identified deficiencies were often categorized as internal versus external to delineate PEC responsibility, boundaries, and feasibility of interventions.
    Conclusion: The broad guidance provided by the ACGME for PEC configuration allows programs to adapt the committee based on individual needs. However, further instruction on program evaluation and organizational change principles would augment existing PEC efforts.
    Sprache Englisch
    Erscheinungsdatum 2024-04-02
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ZDB-ID 2747273-5
    ISSN 2168-8184
    ISSN 2168-8184
    DOI 10.7759/cureus.57439
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  5. Artikel ; Online: Understanding State-of-the-Art Literature Reviews.

    Barry, Erin S / Merkebu, Jerusalem / Varpio, Lara

    Journal of graduate medical education

    2022  Band 14, Heft 6, Seite(n) 659–662

    Mesh-Begriff(e) Humans ; Internship and Residency
    Sprache Englisch
    Erscheinungsdatum 2022-12-15
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ZDB-ID 2578612-X
    ISSN 1949-8357 ; 1949-8357
    ISSN (online) 1949-8357
    ISSN 1949-8357
    DOI 10.4300/JGME-D-22-00705.1
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  6. Artikel ; Online: How to Conduct a State-of-the-Art Literature Review.

    Barry, Erin S / Merkebu, Jerusalem / Varpio, Lara

    Journal of graduate medical education

    2022  Band 14, Heft 6, Seite(n) 663–665

    Mesh-Begriff(e) Humans ; Internship and Residency ; Art
    Sprache Englisch
    Erscheinungsdatum 2022-12-15
    Erscheinungsland United States
    Dokumenttyp Journal Article
    ZDB-ID 2578612-X
    ISSN 1949-8357 ; 1949-8357
    ISSN (online) 1949-8357
    ISSN 1949-8357
    DOI 10.4300/JGME-D-22-00704.1
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  7. Artikel ; Online: State-of-the-art literature review methodology: A six-step approach for knowledge synthesis.

    Barry, Erin S / Merkebu, Jerusalem / Varpio, Lara

    Perspectives on medical education

    2022  Band 11, Heft 5, Seite(n) 281–288

    Abstract: Introduction: Researchers and practitioners rely on literature reviews to synthesize large bodies of knowledge. Many types of literature reviews have been developed, each targeting a specific purpose. However, these syntheses are hampered if the review ... ...

    Abstract Introduction: Researchers and practitioners rely on literature reviews to synthesize large bodies of knowledge. Many types of literature reviews have been developed, each targeting a specific purpose. However, these syntheses are hampered if the review type's paradigmatic roots, methods, and markers of rigor are only vaguely understood. One literature review type whose methodology has yet to be elucidated is the state-of-the-art (SotA) review. If medical educators are to harness SotA reviews to generate knowledge syntheses, we must understand and articulate the paradigmatic roots of, and methods for, conducting SotA reviews.
    Methods: We reviewed 940 articles published between 2014-2021 labeled as SotA reviews. We (a) identified all SotA methods-related resources, (b) examined the foundational principles and techniques underpinning the reviews, and (c) combined our findings to inductively analyze and articulate the philosophical foundations, process steps, and markers of rigor.
    Results: In the 940 articles reviewed, nearly all manuscripts (98%) lacked citations for how to conduct a SotA review. The term "state of the art" was used in 4 different ways. Analysis revealed that SotA articles are grounded in relativism and subjectivism.
    Discussion: This article provides a 6-step approach for conducting SotA reviews. SotA reviews offer an interpretive synthesis that describes: This is where we are now. This is how we got here. This is where we could be going. This chronologically rooted narrative synthesis provides a methodology for reviewing large bodies of literature to explore why and how our current knowledge has developed and to offer new research directions.
    Mesh-Begriff(e) Humans ; Publications ; Narration
    Sprache Englisch
    Erscheinungsdatum 2022-09-05
    Erscheinungsland Netherlands
    Dokumenttyp Review ; Journal Article
    ZDB-ID 2670231-9
    ISSN 2212-277X ; 2212-277X
    ISSN (online) 2212-277X
    ISSN 2212-277X
    DOI 10.1007/s40037-022-00725-9
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  8. Artikel ; Online: Cognitive biases in internal medicine: a scoping review.

    Loncharich, Michael F / Robbins, Rachel C / Durning, Steven J / Soh, Michael / Merkebu, Jerusalem

    Diagnosis (Berlin, Germany)

    2023  Band 10, Heft 3, Seite(n) 205–214

    Abstract: Background: Medical errors account for up to 440,000 deaths annually, and cognitive errors outpace knowledge deficits as causes of error. Cognitive biases are predispositions to respond in predictable ways, and they don't always result in error. We ... ...

    Abstract Background: Medical errors account for up to 440,000 deaths annually, and cognitive errors outpace knowledge deficits as causes of error. Cognitive biases are predispositions to respond in predictable ways, and they don't always result in error. We conducted a scoping review exploring which biases are most prevalent in Internal Medicine (IM), if and how they influence patient outcomes, and what, if any, debiasing strategies are effective.
    Content: We searched PubMed, OVID, ERIC, SCOPUS, PsychINFO, and CINAHL. Search terms included variations of "bias", "clinical reasoning", and IM subspecialties. Inclusion criteria were: discussing bias, clinical reasoning, and physician participants.
    Summary: Fifteen of 334 identified papers were included. Two papers looked beyond general IM: one each in Infectious Diseases and Critical Care. Nine papers distinguished bias from error, whereas four referenced error in their definition of bias. The most commonly studied outcomes were diagnosis, treatment, and physician impact in 47 % (7), 33 % (5), and 27 % (4) of studies, respectively. Three studies directly assessed patient outcomes. The most commonly cited biases were availability bias (60 %, 9), confirmation bias (40 %, 6), anchoring (40 %, 6), and premature closure (33 %, 5). Proposed contributing features were years of practice, stressors, and practice setting. One study found that years of practice negatively correlated with susceptibility to bias. Ten studies discussed debiasing; all reported weak or equivocal efficacy.
    Outlook: We found 41 biases in IM and 22 features that may predispose physicians to bias. We found little evidence directly linking biases to error, which could account for the weak evidence of bias countermeasure efficacy. Future study clearly delineating bias from error and directly assessing clinical outcomes would be insightful.
    Mesh-Begriff(e) Humans ; Bias ; Clinical Reasoning ; Internal Medicine ; Medical Errors ; Cognition
    Sprache Englisch
    Erscheinungsdatum 2023-04-21
    Erscheinungsland Germany
    Dokumenttyp Journal Article ; Review
    ISSN 2194-802X
    ISSN (online) 2194-802X
    DOI 10.1515/dx-2022-0120
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  9. Artikel ; Online: The SOAP Feedback Training Program.

    Chokshi, Binny / Battista, Alexis / Merkebu, Jerusalem / Hansen, Shana / Blatt, Benjamin / Lopreiato, Joseph

    The clinical teacher

    2023  Band 20, Heft 6, Seite(n) e13611

    Abstract: Background: Accessible and efficient opportunities for health professional faculty to hone feedback skills are limited. In addition, feedback models to apply to the objective structured clinical examination (OSCE) setting are lacking.: Approach: ... ...

    Abstract Background: Accessible and efficient opportunities for health professional faculty to hone feedback skills are limited. In addition, feedback models to apply to the objective structured clinical examination (OSCE) setting are lacking.
    Approach: Annually, paediatric interns from Children's National Hospital and Walter Reed National Military Medical Center participate in an OSCE, which includes faculty observation and immediate feedback to trainees. In 2018, we incorporated the subjective, objective, assessment, plan (SOAP) Feedback Training Program during 20 min of the pre-OSCE faculty orientation. The SOAP Feedback Training Program introduced the SOAP feedback model (subjective, objective, assessment, plan), facilitated practice in pairs and distributed a cognitive aid referencing the model. We evaluated the quality of faculty feedback exchanges during the 2018 OSCE via retrospective video review using the Direct Observation of Clinical Skills Feedback Scale (DOCS-FBS). We compared the results to the 2015 initial evaluation and used focus groups to understand how and why faculty feedback changed.
    Evaluation: Comparison of the initial evaluation to the post-SOAP Feedback Training Program intervention data using a Wilcoxon signed rank test showed statistically significant improvement in six of eight feedback items on the DOCS-FBS. Causal coding of focus group transcripts revealed that the SOAP Feedback Training Program evoked affective responses, reinforced prior practice in feedback delivery, improved feedback organisation and increased feedback delivery preparation.
    Implications: The SOAP Feedback Training Program is an effective intervention to teach the SOAP feedback model and improve faculty feedback quality in an OSCE setting. It is efficient and low resource, facilitating its potential use in settings beyond the OSCE.
    Mesh-Begriff(e) Humans ; Child ; Feedback ; Retrospective Studies ; Educational Measurement ; Program Development ; Clinical Competence ; Faculty, Nursing
    Sprache Englisch
    Erscheinungsdatum 2023-08-30
    Erscheinungsland England
    Dokumenttyp Journal Article
    ZDB-ID 2151518-9
    ISSN 1743-498X ; 1743-4971
    ISSN (online) 1743-498X
    ISSN 1743-4971
    DOI 10.1111/tct.13611
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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  10. Artikel ; Online: Clinical Reasoning Curricula in Preclinical Undergraduate Medical Education: A Scoping Review.

    Hawks, Matthew K / Maciuba, Joseph M / Merkebu, Jerusalem / Durning, Steven J / Mallory, Renee / Arnold, Michael J / Torre, Dario / Soh, Michael

    Academic medicine : journal of the Association of American Medical Colleges

    2023  Band 98, Heft 8, Seite(n) 958–965

    Abstract: Purpose: Clinical reasoning is the process of observing, collecting, analyzing, and interpreting patient information to arrive at a diagnosis and management plan. Although clinical reasoning is foundational in undergraduate medical education (UME), the ... ...

    Abstract Purpose: Clinical reasoning is the process of observing, collecting, analyzing, and interpreting patient information to arrive at a diagnosis and management plan. Although clinical reasoning is foundational in undergraduate medical education (UME), the current literature lacks a clear picture of the clinical reasoning curriculum in preclinical phase of UME. This scoping review explores the mechanisms of clinical reasoning education in preclinical UME.
    Method: A scoping review was performed in accordance with the Arksey and O'Malley framework methodology for scoping reviews and is reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis for Scoping Reviews.
    Results: The initial database search identified 3,062 articles. Of these, 241 articles were selected for a full-text review. Twenty-one articles, each reporting a single clinical reasoning curriculum, were selected for inclusion. Six of the reports included a definition of clinical reasoning, and 7 explicitly reported the theory underlying the curriculum. Reports varied in the identification of clinical reasoning content domains and teaching strategies. Only 4 curricula reported assessment validity evidence.
    Conclusions: Based on this scoping review, we recommend 5 key principles for educators to consider when reporting clinical reasoning curricula in preclinical UME: (1) explicitly define clinical reasoning within the report, (2) report clinical reasoning theory(ies) used in the development of the curriculum, (3) clearly identify which clinical reasoning domains are addressed in the curriculum, (4) report validity evidence for assessments when available, and (5) describe how the reported curriculum fits into the larger clinical reasoning education at the institution.
    Mesh-Begriff(e) Humans ; Education, Medical, Undergraduate ; Curriculum
    Sprache Englisch
    Erscheinungsdatum 2023-03-01
    Erscheinungsland United States
    Dokumenttyp Systematic Review ; Review ; Journal Article
    ZDB-ID 96192-9
    ISSN 1938-808X ; 1040-2446
    ISSN (online) 1938-808X
    ISSN 1040-2446
    DOI 10.1097/ACM.0000000000005197
    Datenquelle MEDical Literature Analysis and Retrieval System OnLINE

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