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      Intervention Descriptions in Medical Education: What Can Be Improved? A Systematic Review and Checklist

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          Abstract

          Supplemental Digital Content is available in the text.

          Abstract

          Purpose

          Many medical education studies focus on the effectiveness of educational interventions. However, these studies often lack clear, thorough descriptions of interventions that would make the interventions replicable. This systematic review aimed to identify gaps and limitations in the descriptions of educational interventions, using a comprehensive checklist.

          Method

          Based on the literature, the authors developed a checklist of 17 criteria for thorough descriptions of educational interventions in medical education. They searched the Ovid MEDLINE, Embase, and ERIC databases for eligible English-language studies published January 2014–March 2016 that evaluated the effects of educational interventions during classroom teaching in postgraduate medical education. Subsequently, they used this checklist to systematically review the included studies. Descriptions were scored 0 (no information), 1 (unclear/partial information), or 2 (detailed description) for each of the 16 scorable criteria (possible range 0–32).

          Results

          Among the 105 included studies, the criteria most frequently reported in detail were learning needs (78.1%), content/subject (77.1%), and educational strategies (79.0%). The criteria least frequently reported in detail were incentives (9.5%), environment (5.7%), and planned and unplanned changes (12.4%). No article described all criteria. The mean score was 15.9 (SD 4.1), with a range from 8 (5 studies) to 25 (1 study). The majority (76.2%) of articles scored 11–20.

          Conclusions

          Descriptions were frequently missing key information and lacked uniformity. The results suggest a need for a common standard. The authors encourage others to validate, complement, and use their checklist, which could lead to more complete, comparable, and replicable descriptions of educational interventions.

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          Most cited references115

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          Description, justification and clarification: a framework for classifying the purposes of research in medical education.

          Authors have questioned the degree to which medical education research informs practice and advances the science of medical education. This study aims to propose a framework for classifying the purposes of education research and to quantify the frequencies of purposes among medical education experiments. We looked at articles published in 2003 and 2004 in Academic Medicine, Advances in Health Sciences Education, American Journal of Surgery, Journal of General Internal Medicine, Medical Education and Teaching and Learning in Medicine (1459 articles). From the 185 articles describing education experiments, a random sample of 110 was selected. The purpose of each study was classified as description ('What was done?'), justification ('Did it work?') or clarification ('Why or how did it work?'). Educational topics were identified inductively and each study was classified accordingly. Of the 105 articles suitable for review, 75 (72%) were justification studies, 17 (16%) were description studies, and 13 (12%) were clarification studies. Experimental studies of assessment methods (5/6, 83%) and interventions aimed at knowledge and attitudes (5/28, 18%) were more likely to be clarification studies than were studies addressing other educational topics (< 8%). Clarification studies are uncommon in experimental studies in medical education. Studies with this purpose (i.e. studies asking: 'How and why does it work?') are needed to deepen our understanding and advance the art and science of medical education. We hope that this framework stimulates education scholars to reflect on the purpose of their inquiry and the research questions they ask, and to strive to ask more clarification questions.
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            Development and validation of the guideline for reporting evidence-based practice educational interventions and teaching (GREET)

            Background The majority of reporting guidelines assist researchers to report consistent information concerning study design, however, they contain limited information for describing study interventions. Using a three-stage development process, the Guideline for Reporting Evidence-based practice Educational interventions and Teaching (GREET) checklist and accompanying explanatory paper were developed to provide guidance for the reporting of educational interventions for evidence-based practice (EBP). The aim of this study was to complete the final development for the GREET checklist, incorporating psychometric testing to determine inter-rater reliability and criterion validity. Methods The final development for the GREET checklist incorporated the results of a prior systematic review and Delphi survey. Thirty-nine items, including all items from the prior systematic review, were proposed for inclusion in the GREET checklist. These 39 items were considered over a series of consensus discussions to determine the inclusion of items in the GREET checklist. The GREET checklist and explanatory paper were then developed and underwent psychometric testing with tertiary health professional students who evaluated the completeness of the reporting in a published study using the GREET checklist. For each GREET checklist item, consistency (%) of agreement both between participants and the consensus criterion reference measure were calculated. Criterion validity and inter-rater reliability were analysed using intra-class correlation coefficients (ICC). Results Three consensus discussions were undertaken, with 14 items identified for inclusion in the GREET checklist. Following further expert review by the Delphi panelists, three items were added and minor wording changes were completed, resulting in 17 checklist items. Psychometric testing for the updated GREET checklist was completed by 31 participants (n = 11 undergraduate, n = 20 postgraduate). The consistency of agreement between the participant ratings for completeness of reporting with the consensus criterion ratings ranged from 19 % for item 4 Steps of EBP, to 94 % for item 16 Planned delivery. The overall consistency of agreement, for criterion validity (ICC 0.73) and inter-rater reliability (ICC 0.96), was good to almost perfect. Conclusion The final GREET checklist comprises 17 items which are recommended for reporting EBP educational interventions. Further validation of the GREET checklist with experts in EBP research and education is recommended. Electronic supplementary material The online version of this article (doi:10.1186/s12909-016-0759-1) contains supplementary material, which is available to authorized users.
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              Getting off the "gold standard": randomized controlled trials and education research.

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                Author and article information

                Journal
                Acad Med
                Acad Med
                ACM
                Academic Medicine
                Published for the Association of American Medical Colleges by Lippincott Williams & Wilkins
                1040-2446
                1938-808X
                February 2019
                28 August 2018
                : 94
                : 2
                : 281-290
                Affiliations
                [1 ] J.G. Meinema is a PhD student, Department of General Practice/Family Medicine, Academic Medical Center–University of Amsterdam, Amsterdam, the Netherlands; ORCID: https://orcid.org/0000-0003-3706-1360.
                [2 ] N. Buwalda is a PhD student, Department of General Practice/Family Medicine, Academic Medical Center–University of Amsterdam, Amsterdam, the Netherlands; ORCID: https://orcid.org/0000-0003-2635-2912.
                [3 ] F.S. van Etten-Jamaludin is clinical librarian, Academic Medical Center–University of Amsterdam, Amsterdam, the Netherlands.
                [4 ] M.R.M. Visser is senior researcher, Department of General Practice/Family Medicine, Academic Medical Center–University of Amsterdam, Amsterdam, the Netherlands.
                [5 ] N. van Dijk is professor of general practice/family medicine, Academic Medical Center–University of Amsterdam, Amsterdam, the Netherlands.
                Author notes
                Correspondence should be addressed to Jennita G. Meinema, Academic Medical Center, Meibergdreef 9, 1105 AZ Amsterdam, the Netherlands; telephone: (+31) 20-5667188; e-mail: j.g.meinema@ 123456amc.uva.nl .
                Article
                00036
                10.1097/ACM.0000000000002428
                6365274
                30157087
                aa3d23ae-ee23-406f-b999-2cb33c069673
                Copyright © 2018 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Association of American Medical Colleges.

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

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