Tai Lockspeiser - Academia.edu (original) (raw)

Papers by Tai Lockspeiser

Critical Care Medicine, 2016

Teaching and Learning in Medicine, 2020

Abstract Phenomenon: The phenomenon of individualized education, an essential component of compet... more Abstract Phenomenon: The phenomenon of individualized education, an essential component of competency-based medical education, addresses individual learner needs while working toward standardized learning outcomes. One challenge with broadly implementing individualized education is the lack of a pragmatic operational definition. To formalize expectations for individualized education, the Accreditation Council of Graduate Medical Education in 2013 began requiring six months of individualized curriculum (IC) during pediatric residency; however, there is not a national standard of formal curricular goals for the IC as an educational entity. Examining and describing the overarching curricular goals of IC could provide a framework for discourse about and further study of individualized education in medicine across disciplines and the continuum of medical education. Thus, we aimed to describe the phenomenon of individualized education through the lens of the goals of the IC in pediatric residency in the United States. Approach: In 2017, a purposeful sample of Pediatric Residency leaders were recruited to represent a diverse sample of program sizes, regions of the country, and importance of the IC to the program leadership. They completed an online survey with open-ended questions describing formal and implicit goals of their program’s IC. The authors analyzed responses initially using conventional content analysis, then investigated whether the themes for program goals aligned with any existing educational theory. The concepts and language aligned with the principles of self-determination theory (SDT); therefore, the IC goals were subsequently grouped using the SDT domains of relatedness, autonomy, and competence. A focus group with a subset of survey respondents was conducted for member checking and elaboration of concepts. Findings: Program leaders from a diverse sample of 36 programs participated in the survey and a subset of 11 programs participated in the focus group. The common goals across all programs are listed in parentheses and organized by domains of SDT: 1) Relatedness goals (engage in mentorship, select a career) cultivate resident’s professional identity based on their desired future career path; 2) autonomy goals (create a learning plan, practice accountability) help residents plan their path; and fulfillment of their plans lead to 3) competence goals (develop targeted clinical skills and knowledge, ensure comprehensive exposure, address learning gaps), ensuring they have a comprehensive skill set for their chosen identity. Insights: This study provides a framework to describe the phenomenon of individualized education through the lens of IC curricular goals in pediatric residency. The goals for IC that emerged from this study serve as a pragmatic framework for implementation of individualized education. They provide a common language and structure to promote more rigorous and collaborative study of individualized education across programs, disciplines, and settings in medicine. They may function as a roadmap for learners to navigate educational activities and for programs to help shape the experiences of their learners and examine outcomes of individualized education in their programs. The framework can also help individual pediatric residency programs structure improvements to their IC. Disciplines beyond pediatrics may also use this framework to better structure elective experiences to capitalize on the benefits of individual education.

Academic Medicine, 2020

Please answer these questions based on your experiences in core clerkships • In general, if there... more Please answer these questions based on your experiences in core clerkships • In general, if there are certain kinds of situations or settings that make you conscious of your race or ethnicity during clerkships. Can you tell me about that? a. How do you feel in these situations? b. Can you describe any common reactions that you have when this happens? c. Have you ever felt you had to prove or disprove something about your race/ethnicity? Can you tell me about that?

Teaching and Learning in Medicine, 2020

Theory: Self-regulated learning theory suggests that individualized learning plans can benefit me... more Theory: Self-regulated learning theory suggests that individualized learning plans can benefit medical trainees by providing a structured means of goal setting, self-monitoring, and self-evaluation. External feedback also plays an important role in affecting learner motivations, perceptions, and self-evaluations. Accordingly, having learners share individualized learning plans with preceptors might promote self-regulated learning by helping align the feedback they receive with their learning goals. Hypothesis: We hypothesized having medical students share individualized learning plans with attendings and residents would improve the quality of the feedback they received, increase the likelihood that feedback correlated to their learning goals, and improve their perceptions of feedback received. Method: In this multisite study, third-year medical students on their pediatric clerkship created individualized learning plans and shared them with residents and attendings by writing a learning goal on at least one of their required faculty feedback forms. The quality of feedback on forms with versus without a learning goal written on top was scored using a validated scoring tool and compared using a Wilcoxon signed-ranks test, and the frequency with which feedback directly correlated to a student learning goal on forms with versus without a learning goal written on top was compared using a chi-square test. Students completed a post-clerkship survey rating the quality of feedback and teaching they received, perceptions of the individualized learning plans, progress toward achieving learning goals, and whether or not they received teaching and/or feedback related to learning goals. Results: Thirty-six students completed a total of 108 learning goals and 181 feedback forms, of which 42 forms (23.2%) had a learning goal written on top. The mean (SD) feedback score between forms with [3.9 (0.9)] versus without [3.6 (0.6)] a learning goal written on top was not different (p ¼ .113). Feedback on forms with a learning goal written on top was more likely to correlate to a student learning goal than feedback on forms without a learning goal (92.9% vs 23.0% respectively, p < .001). Student perceptions of the usefulness of learning goals did not differ between students who reported receiving teaching or feedback related to a learning goal and those who did not. Conclusions: Sharing individualized learning plans with preceptors helped align feedback with learning goals but did not affect the quality of feedback. Further research should examine the bidirectional relationship between individualized learning plans and feedback in light of other contextual and interpersonal factors.

Academic Pediatrics, 2020

Pediatric educators desire to and should strive to incorporate current educational methods and id... more Pediatric educators desire to and should strive to incorporate current educational methods and ideas into their professional practices. The overwhelming volume of medical education literature makes this difficult. This article provides an overview of 18 key articles from the 2018 literature that the authors consider to be impactful for the field of pediatric medical education. The author group has extensive combined leadership experience and expertise across the continuum of pediatric medical education and used an iterative, staged process to review 2270 abstracts from 13 medical education-related journals. This process aimed to identify a subset of articles that were most relevant to educational practice and scholarship and most applicable to pediatric medical education. Author pairs independently reviewed and scored abstracts and reached consensus to identify the abstracts that best met these criteria. Selected abstracts were discussed using different author pairs to determine the final articles included in this review. The 18 articles selected are summarized. The results showed a cluster of studies related to assessment, learner education and teaching, communication, and culture and climate. This review offers a summary for educators interested in remaining knowledgeable and current regarding the most relevant and valuable information in the field of medical education.

Academic Medicine, 2019

Purpose: To examine medical students' perceptions of the fairness and accuracy of core clerkship ... more Purpose: To examine medical students' perceptions of the fairness and accuracy of core clerkship assessment, the clerkship learning environment and their relationship to students' achievement. Approach/Methods: Fourth-year medical students at six institutions completed a survey in 2018 assessing perceptions of the fairness and accuracy of clerkship evaluation and grading, perceptions of the learning environment including clerkship goal structures (mastery-or performance-oriented), racial/ethnic stereotype threat, and student performance (honors earned). Factor analysis of five-point Likert items (1=strongly disagree, 5=strongly agree) provided scale scores of perceptions. Using multivariable regression, investigators examined predictors of honors earned. Qualitative content analysis of responses to an open-ended question yielded students' recommendations to improve clerkship grading. Results/Outcomes: Overall response rate was 71% (666/937). Students believed that being liked and particular supervisors most influenced final grades. Only 44.4% of students agreed that grading was fair. Students felt the clerkship learning environment promoted both mastery and performance avoidance behaviors (88.0%, 85.6%, respectively). Students from backgrounds underrepresented in medicine were more likely to experience stereotype threat vulnerability (55.7% vs 10.9%, P<.0005). Honors earned was positively associated with perceived accuracy of grading and interest in competitive specialties while negatively associated with stereotype threat. Students recommended strategies to improve clerkship grading, such as eliminating honors, training evaluators, and rewarding improvement on clerkships. Conclusions: Many medical students have concerns around the fairness and accuracy of clerkship evaluation and grading and potential bias. Students expressed a need to redefine the culture of assessment on core clerkships to create more favorable learning environments for all students.

Academic Pediatrics, 2018

following program completion. They were asked to indicate their level of agreement with statement... more following program completion. They were asked to indicate their level of agreement with statements concerning their knowledge, skills, and attitudes towards cancer survivorship topics both before and after their curricular session. Responses were examined using paired t-tests and one-sided binomial tests. RESULTS: Thirty-seven participants completed the curriculum evaluation for a response rate of 84.1%. Each assessment item showed a significant increase from prior to post-curriculum; P < .05. At least 20% of residents showed improvement in each survey item, and several items showed upwards of 30% improvement postcurriculum; P < .05. Residents believed this curriculum enhanced their overall pediatric knowledge base (M = 3.27; SD = 0.65) and would recommend it to residents at other pediatric residency programs; M = 3.30; SD = 0.70. CONCLUSIONS: This curriculum represents one method to deliver training on cancer survivorship issues. Future directions include adaptation of this curriculum to educate additional pediatric providers, such as medical students, nurses, and faculty, as well as providers in other medical specialties.

Journal of graduate medical education, 2018

While leadership training is increasingly incorporated into residency education, existing assessm... more While leadership training is increasingly incorporated into residency education, existing assessment tools to provide feedback on leadership skills are only applicable in limited contexts. We developed an instrument, the Leadership Observation and Feedback Tool (LOFT), for assessing clinical leadership. We used an iterative process to develop the tool, beginning with adapting the Leadership Practices Inventory to create an open-ended survey for identification of clinical leadership behaviors. We presented these to leadership experts who defined essential behaviors through a modified Delphi approach. In May 2014 we tested the resulting 29-item tool among residents in the internal medicine and pediatrics departments at 2 academic medical centers. We analyzed instrument performance using Cronbach's alpha, interrater reliability using intraclass correlation coefficients (ICCs), and item performance using linear-by-linear test comparisons of responses by postgraduate year, site, and ...

Academic pediatrics, Jan 5, 2017

Rigorous medical education research is critical to effectively develop and evaluate the training ... more Rigorous medical education research is critical to effectively develop and evaluate the training we provide our learners. Yet many clinical medical educators lack the training and skills needed to conduct high-quality medical education research. We offer guidance on conducting sound quantitative medical education research. Our aim is to equip readers with the key skills and strategies necessary to conduct successful research projects, highlighting new concepts and controversies in the field. We utilize Glassick's criteria for scholarship as a framework to discuss strategies to ensure that the research question of interest is worthy of further study and how to use existing literature and conceptual frameworks to strengthen a research study. Through discussions of the strengths and limitations of commonly used study designs, we expose the reader to particular nuances of these decisions in medical education research and discuss outcomes generally focused on, as well as strategies f...

Academic Pediatrics, 2016

MedEdPORTAL Publications, 2013

Journal of Graduate Medical Education

Advances in Health Sciences Education, 2008

Background Medical schools use supplemental peer-teaching programs even though there is little re... more Background Medical schools use supplemental peer-teaching programs even though there is little research on students' actual experiences with this form of instruction. Purpose To understand the student experience of being taught by peers instead of by faculty. Methods We conducted focus groups with first-and second-year medical students participating in a supplemental peer-teaching program at one institution. From the learner focus group themes, we developed a questionnaire and surveyed all first-year students. Results Focus groups revealed four learner themes: learning from near-peers, exposure to second-year students, need for review and synthesis, teaching modalities and for the peer-teachers, the theme of benefits for the teacher. Factor analysis of the survey responses resulted in three factors: second-year students as teachers, the benefit of peer-teachers instead of faculty, and the peer-teaching process. Scores on these factors correlated with attendance in the peer-teaching program (P < .05). Conclusions Students valued learning from near-peers because of their recent experience with the materials and their ability to understand the students' struggles in medical school. Students with the highest participation in the program valued the unique aspects of this kind of teaching most. Areas for improvement for this program were identified.

Journal of pediatric and adolescent gynecology, 2016

Individualized learning plans (ILPs) are helpful tools that can facilitate learner-centered educa... more Individualized learning plans (ILPs) are helpful tools that can facilitate learner-centered education and can be used with all levels of learners. We introduce the concept of ILPs, the rationale for their use in pediatric and adolescent gynecology education, and review the challenges that learners might face in creating ILPs, and describes how educators can support learners during this process.

Academic Pediatrics, 2016

Critical Care Medicine, 2016

Teaching and Learning in Medicine, 2020

Abstract Phenomenon: The phenomenon of individualized education, an essential component of compet... more Abstract Phenomenon: The phenomenon of individualized education, an essential component of competency-based medical education, addresses individual learner needs while working toward standardized learning outcomes. One challenge with broadly implementing individualized education is the lack of a pragmatic operational definition. To formalize expectations for individualized education, the Accreditation Council of Graduate Medical Education in 2013 began requiring six months of individualized curriculum (IC) during pediatric residency; however, there is not a national standard of formal curricular goals for the IC as an educational entity. Examining and describing the overarching curricular goals of IC could provide a framework for discourse about and further study of individualized education in medicine across disciplines and the continuum of medical education. Thus, we aimed to describe the phenomenon of individualized education through the lens of the goals of the IC in pediatric residency in the United States. Approach: In 2017, a purposeful sample of Pediatric Residency leaders were recruited to represent a diverse sample of program sizes, regions of the country, and importance of the IC to the program leadership. They completed an online survey with open-ended questions describing formal and implicit goals of their program’s IC. The authors analyzed responses initially using conventional content analysis, then investigated whether the themes for program goals aligned with any existing educational theory. The concepts and language aligned with the principles of self-determination theory (SDT); therefore, the IC goals were subsequently grouped using the SDT domains of relatedness, autonomy, and competence. A focus group with a subset of survey respondents was conducted for member checking and elaboration of concepts. Findings: Program leaders from a diverse sample of 36 programs participated in the survey and a subset of 11 programs participated in the focus group. The common goals across all programs are listed in parentheses and organized by domains of SDT: 1) Relatedness goals (engage in mentorship, select a career) cultivate resident’s professional identity based on their desired future career path; 2) autonomy goals (create a learning plan, practice accountability) help residents plan their path; and fulfillment of their plans lead to 3) competence goals (develop targeted clinical skills and knowledge, ensure comprehensive exposure, address learning gaps), ensuring they have a comprehensive skill set for their chosen identity. Insights: This study provides a framework to describe the phenomenon of individualized education through the lens of IC curricular goals in pediatric residency. The goals for IC that emerged from this study serve as a pragmatic framework for implementation of individualized education. They provide a common language and structure to promote more rigorous and collaborative study of individualized education across programs, disciplines, and settings in medicine. They may function as a roadmap for learners to navigate educational activities and for programs to help shape the experiences of their learners and examine outcomes of individualized education in their programs. The framework can also help individual pediatric residency programs structure improvements to their IC. Disciplines beyond pediatrics may also use this framework to better structure elective experiences to capitalize on the benefits of individual education.

Academic Medicine, 2020

Please answer these questions based on your experiences in core clerkships • In general, if there... more Please answer these questions based on your experiences in core clerkships • In general, if there are certain kinds of situations or settings that make you conscious of your race or ethnicity during clerkships. Can you tell me about that? a. How do you feel in these situations? b. Can you describe any common reactions that you have when this happens? c. Have you ever felt you had to prove or disprove something about your race/ethnicity? Can you tell me about that?

Teaching and Learning in Medicine, 2020

Theory: Self-regulated learning theory suggests that individualized learning plans can benefit me... more Theory: Self-regulated learning theory suggests that individualized learning plans can benefit medical trainees by providing a structured means of goal setting, self-monitoring, and self-evaluation. External feedback also plays an important role in affecting learner motivations, perceptions, and self-evaluations. Accordingly, having learners share individualized learning plans with preceptors might promote self-regulated learning by helping align the feedback they receive with their learning goals. Hypothesis: We hypothesized having medical students share individualized learning plans with attendings and residents would improve the quality of the feedback they received, increase the likelihood that feedback correlated to their learning goals, and improve their perceptions of feedback received. Method: In this multisite study, third-year medical students on their pediatric clerkship created individualized learning plans and shared them with residents and attendings by writing a learning goal on at least one of their required faculty feedback forms. The quality of feedback on forms with versus without a learning goal written on top was scored using a validated scoring tool and compared using a Wilcoxon signed-ranks test, and the frequency with which feedback directly correlated to a student learning goal on forms with versus without a learning goal written on top was compared using a chi-square test. Students completed a post-clerkship survey rating the quality of feedback and teaching they received, perceptions of the individualized learning plans, progress toward achieving learning goals, and whether or not they received teaching and/or feedback related to learning goals. Results: Thirty-six students completed a total of 108 learning goals and 181 feedback forms, of which 42 forms (23.2%) had a learning goal written on top. The mean (SD) feedback score between forms with [3.9 (0.9)] versus without [3.6 (0.6)] a learning goal written on top was not different (p ¼ .113). Feedback on forms with a learning goal written on top was more likely to correlate to a student learning goal than feedback on forms without a learning goal (92.9% vs 23.0% respectively, p < .001). Student perceptions of the usefulness of learning goals did not differ between students who reported receiving teaching or feedback related to a learning goal and those who did not. Conclusions: Sharing individualized learning plans with preceptors helped align feedback with learning goals but did not affect the quality of feedback. Further research should examine the bidirectional relationship between individualized learning plans and feedback in light of other contextual and interpersonal factors.

Academic Pediatrics, 2020

Pediatric educators desire to and should strive to incorporate current educational methods and id... more Pediatric educators desire to and should strive to incorporate current educational methods and ideas into their professional practices. The overwhelming volume of medical education literature makes this difficult. This article provides an overview of 18 key articles from the 2018 literature that the authors consider to be impactful for the field of pediatric medical education. The author group has extensive combined leadership experience and expertise across the continuum of pediatric medical education and used an iterative, staged process to review 2270 abstracts from 13 medical education-related journals. This process aimed to identify a subset of articles that were most relevant to educational practice and scholarship and most applicable to pediatric medical education. Author pairs independently reviewed and scored abstracts and reached consensus to identify the abstracts that best met these criteria. Selected abstracts were discussed using different author pairs to determine the final articles included in this review. The 18 articles selected are summarized. The results showed a cluster of studies related to assessment, learner education and teaching, communication, and culture and climate. This review offers a summary for educators interested in remaining knowledgeable and current regarding the most relevant and valuable information in the field of medical education.

Academic Medicine, 2019

Purpose: To examine medical students' perceptions of the fairness and accuracy of core clerkship ... more Purpose: To examine medical students' perceptions of the fairness and accuracy of core clerkship assessment, the clerkship learning environment and their relationship to students' achievement. Approach/Methods: Fourth-year medical students at six institutions completed a survey in 2018 assessing perceptions of the fairness and accuracy of clerkship evaluation and grading, perceptions of the learning environment including clerkship goal structures (mastery-or performance-oriented), racial/ethnic stereotype threat, and student performance (honors earned). Factor analysis of five-point Likert items (1=strongly disagree, 5=strongly agree) provided scale scores of perceptions. Using multivariable regression, investigators examined predictors of honors earned. Qualitative content analysis of responses to an open-ended question yielded students' recommendations to improve clerkship grading. Results/Outcomes: Overall response rate was 71% (666/937). Students believed that being liked and particular supervisors most influenced final grades. Only 44.4% of students agreed that grading was fair. Students felt the clerkship learning environment promoted both mastery and performance avoidance behaviors (88.0%, 85.6%, respectively). Students from backgrounds underrepresented in medicine were more likely to experience stereotype threat vulnerability (55.7% vs 10.9%, P<.0005). Honors earned was positively associated with perceived accuracy of grading and interest in competitive specialties while negatively associated with stereotype threat. Students recommended strategies to improve clerkship grading, such as eliminating honors, training evaluators, and rewarding improvement on clerkships. Conclusions: Many medical students have concerns around the fairness and accuracy of clerkship evaluation and grading and potential bias. Students expressed a need to redefine the culture of assessment on core clerkships to create more favorable learning environments for all students.

Academic Pediatrics, 2018

following program completion. They were asked to indicate their level of agreement with statement... more following program completion. They were asked to indicate their level of agreement with statements concerning their knowledge, skills, and attitudes towards cancer survivorship topics both before and after their curricular session. Responses were examined using paired t-tests and one-sided binomial tests. RESULTS: Thirty-seven participants completed the curriculum evaluation for a response rate of 84.1%. Each assessment item showed a significant increase from prior to post-curriculum; P < .05. At least 20% of residents showed improvement in each survey item, and several items showed upwards of 30% improvement postcurriculum; P < .05. Residents believed this curriculum enhanced their overall pediatric knowledge base (M = 3.27; SD = 0.65) and would recommend it to residents at other pediatric residency programs; M = 3.30; SD = 0.70. CONCLUSIONS: This curriculum represents one method to deliver training on cancer survivorship issues. Future directions include adaptation of this curriculum to educate additional pediatric providers, such as medical students, nurses, and faculty, as well as providers in other medical specialties.

Journal of graduate medical education, 2018

While leadership training is increasingly incorporated into residency education, existing assessm... more While leadership training is increasingly incorporated into residency education, existing assessment tools to provide feedback on leadership skills are only applicable in limited contexts. We developed an instrument, the Leadership Observation and Feedback Tool (LOFT), for assessing clinical leadership. We used an iterative process to develop the tool, beginning with adapting the Leadership Practices Inventory to create an open-ended survey for identification of clinical leadership behaviors. We presented these to leadership experts who defined essential behaviors through a modified Delphi approach. In May 2014 we tested the resulting 29-item tool among residents in the internal medicine and pediatrics departments at 2 academic medical centers. We analyzed instrument performance using Cronbach's alpha, interrater reliability using intraclass correlation coefficients (ICCs), and item performance using linear-by-linear test comparisons of responses by postgraduate year, site, and ...

Academic pediatrics, Jan 5, 2017

Rigorous medical education research is critical to effectively develop and evaluate the training ... more Rigorous medical education research is critical to effectively develop and evaluate the training we provide our learners. Yet many clinical medical educators lack the training and skills needed to conduct high-quality medical education research. We offer guidance on conducting sound quantitative medical education research. Our aim is to equip readers with the key skills and strategies necessary to conduct successful research projects, highlighting new concepts and controversies in the field. We utilize Glassick's criteria for scholarship as a framework to discuss strategies to ensure that the research question of interest is worthy of further study and how to use existing literature and conceptual frameworks to strengthen a research study. Through discussions of the strengths and limitations of commonly used study designs, we expose the reader to particular nuances of these decisions in medical education research and discuss outcomes generally focused on, as well as strategies f...

Academic Pediatrics, 2016

MedEdPORTAL Publications, 2013

Journal of Graduate Medical Education

Advances in Health Sciences Education, 2008

Background Medical schools use supplemental peer-teaching programs even though there is little re... more Background Medical schools use supplemental peer-teaching programs even though there is little research on students' actual experiences with this form of instruction. Purpose To understand the student experience of being taught by peers instead of by faculty. Methods We conducted focus groups with first-and second-year medical students participating in a supplemental peer-teaching program at one institution. From the learner focus group themes, we developed a questionnaire and surveyed all first-year students. Results Focus groups revealed four learner themes: learning from near-peers, exposure to second-year students, need for review and synthesis, teaching modalities and for the peer-teachers, the theme of benefits for the teacher. Factor analysis of the survey responses resulted in three factors: second-year students as teachers, the benefit of peer-teachers instead of faculty, and the peer-teaching process. Scores on these factors correlated with attendance in the peer-teaching program (P < .05). Conclusions Students valued learning from near-peers because of their recent experience with the materials and their ability to understand the students' struggles in medical school. Students with the highest participation in the program valued the unique aspects of this kind of teaching most. Areas for improvement for this program were identified.

Journal of pediatric and adolescent gynecology, 2016

Individualized learning plans (ILPs) are helpful tools that can facilitate learner-centered educa... more Individualized learning plans (ILPs) are helpful tools that can facilitate learner-centered education and can be used with all levels of learners. We introduce the concept of ILPs, the rationale for their use in pediatric and adolescent gynecology education, and review the challenges that learners might face in creating ILPs, and describes how educators can support learners during this process.

Academic Pediatrics, 2016