For Your Review: Mixed Bag of Mixed Methods?

Impact of interprofessional education on collaboration attitudes, skills, and behavior among primary care professionals.  Robben S, Perry M, van Nieuwenhuijzen L, van Achterberg T, Rikkert MO, Schers H, Heinen M, Melis R. J Continuing Ed Health Prof. 2012; 32(3): 196-204. Available online from the Baystate Health Sciences Library, or from PubMed at your institution.

Robben and colleagues offer a perfect platform for discussion with this article outlining a program evaluation of an interprofessional educational intervention in the Netherlands. As if the application of social cognitive theory and Kirkpatrick's levels of program evaluation outcomes weren't enough, we are also invited to enjoy the design and analysis of a mixed-methods approach to evaluation. 

So we're good, right? Not quite. Similar to the way that my computer's Spellcheck--er, Spell-check feature still questions me when I write "interprofessional" as a non-hyphenated word even though I do it on purpose, so too must we continue to question educational research even though it is published. 

I do not profess to say that this study is flawed (or that it isn't). But it does require exploration into key concepts. For example, the tools used for the quantitative exploration of this study are noted to produce valid scores; but where's the evidence? Also, the qualitative data support many themes in the results, but no data (direct quotes) are provided? And I dare you to read this article without Googling "human movement scientist" and "Hawthorne effect."  All in all, this article is a stone on which to sharpen your critical analysis teeth. Dig in.  

Bottom Line:

Excellent example of a mixed-methods program evaluation or novice term paper filled with fancy words but little substance? You decide. The interprofessional inter-professional nature of the content is just the cherry on top. 

How Does Your Research Measure Up?

Association between funding and quality of published medical education research.  Reed DA, Cook DA, Beckman TJ, Levine RB, Kern DE, Wright SM. JAMA. 2007; 298(9): 1002-1009. Available online from the Baystate Health Sciences Library, or from PubMed at your institution. 

In their quest for determining the quality of funded versus non-funded educational research, Reed and his colleagues could not find in the literature a tool to measure the quality of medical education research. SO, they did what each of us would have done in the same situation - they developed and validated one. 

Thus, this article double dips as a call for funding in medical education research (yay!) and a tool that holds us researchers accountable for producing higher quality research (wait, what?). 

Those of us who are familiar with Reed and Cook in the literature have likely already dog-eared and highlighted this synopsis of rigorous quantitative research. The tool (medical education research study quality instrument, or MERSQI) and the description of its development boil down elements of rigorous research that should guide our work. 

In fact, what the MERSQI lacks in snappy name recognition, it makes up for in utility. Consider the emphasis on study design, data analysis, and validity. Admittedly, the authors omit "subjective" criteria from their MERSQI, such as relevance of the research question and appropriateness (and use!) of a conceptual framework. Also, the MERSQI should not be used with qualitative research. Additional side effects may include the urge to rely too heavily on a recipe that may not be appropriate for your research question. 

Ultimately, having access to a tool like this and knowing how to use it are the aspects that make research difficult (and great). 

Bottom Line:  

The medical education research study quality instrument (MERSQI) - developed to help the authors answer their research question - is the real meat of this article. Use it like guard rails on the highway to keep your research on the right path. 

From the Field: Put Your Troops in Groups

ABC of teaching and learning in medicine: Teaching small groups. Jaques D. BMJ. 2003; 326(1): 492-494. Available online. 

This guest post (a feature I'm calling "from the field") was written by Lauri Meade, associate program director for internal medicine at Baystate, and her colleagues from the department of internal medicine; Reham Shaaban, Chris LaChance, Jasmine Padaam, Siva Natanasabapathy, Raquel Belforti, Michael Picchioni, and Christine Bryson.  
This group of medical educators offered their residents and faculty some great ways to spruce up small groups, and they have graciously allowed me to share their tips with you. Consider engaging your colleagues with these tricks during other faculty development opportunities, such as grand rounds or faculty meetings. Cheers to the medicine faculty - now dig in!

As teaching faculty, we are often teaching in small groups (i.e. attending rounds and noon lecture). Here are some great basic tips to small group teaching:

  * conduct dialogue rather than give a lecture

  * get the learner talking more than the teacher

  * get the learners to talk to each other

  * learners should be able to prepare for the learning session

  * be wary of one learner dominating the discussion

In addition, we can also use innovative methods in small groups:

  * Show a TED Talk during rounds – such as this one from Sal Khan, an educator who spoke at the AAMC conference this year

  * Get everyone to ‘race to the correct answer' on their iPhone

  * Use Google images to illustrate a point

  * Orchestrate abstract browsing: Browse recent or topical literature. Together in the session read an abstract silently for 1 minute then talk for 4 minutes.  Repeat this for 6 abstracts and then choose the full paper you want to read.

  * Use Twitter to engage the learner

  * Take a field trip (go as a group to a hospital area, such as radiology or the micro lab)

Homework: 

  We challenge you to go to ‘TED Talks healthcare’ and learn in 8-12 minutes.

  Try splitting into pairs to answer a clinical question, then have the pairs teach the group.

  How do you help your resident engage the learner at attending rounds?

Bottom Line:

A group of internal medicine faculty from Baystate offer these tips to get your learners engaged in their small groups. A little technology and some creative teaching strategies go a long way.