Validity evidence for a novel instrument assessing medical student attitudes toward instruction in implicit bias recognition and management

Background Implicit bias instruction is becoming more prevalent in health professions education, with calls for skills-based curricula moving from awareness and recognition to management of implicit bias. Evidence suggests that health professionals and students learning about implicit bias (“learners”) have varying attitudes about instruction in implicit bias, including the concept of implicit bias itself. Assessing learner attitudes could inform curriculum development and enable instructional designs that optimize learner engagement. To date, there are no instruments with evidence for construct validity that assess learner attitudes about implicit bias instruction and its relevance to clinical care. Methods The authors developed a novel instrument, the Attitude Towards Implicit Bias Instrument (ATIBI) and gathered evidence for three types of construct validity- content, internal consistency, and relationship to other variables. Results Authors utilized a modified Delphi technique with an interprofessional team of experts, as well as cognitive interviews with medical students leading to item refinement to improve content validity. Seven cohorts of medical students, N = 1072 completed the ATIBI. Psychometric analysis demonstrated high internal consistency (α = 0.90). Exploratory factor analysis resulted in five factors. Analysis of a subset of 100 medical students demonstrated a moderate correlation with similar instruments, the Integrative Medicine Attitude Questionnaire (r = 0.63, 95% CI: [0.59, 0.66]) and the Internal Motivation to Respond Without Prejudice Scale (r = 0.36, 95% CI: [0.32, 0.40]), providing evidence for convergent validity. Scores on our instrument had low correlation to the External Motivation to Respond Without Prejudice Scale (r = 0.15, 95% CI: [0.09, 0.19]) and the Groningen Reflection Ability Scale (r = 0.12, 95% CI: [0.06, 0.17]) providing evidence for discriminant validity. Analysis resulted in eighteen items in the final instrument; it is easy to administer, both on paper form and online. Conclusion The Attitudes Toward Implicit Bias Instrument is a novel instrument that produces reliable and valid scores and may be used to measure medical student attitudes related to implicit bias recognition and management, including attitudes toward acceptance of bias in oneself, implicit bias instruction, and its relevance to clinical care.

The micro revolution: effect of Bite-Sized Teaching (BST) on learner engagement and learning in postgraduate medical education

Context Bite-sized learning is an instructional method that utilizes brief, focused learning units. This approach may be beneficial in medical education given demands on learner time and cognitive load. This study aims to assess the impact of this approach on knowledge acquisition and learner attitudes in postgraduate medical education. Methods An instructional method, termed Bite-Sized Teaching (BST), was implemented within the curriculum at a US Internal Medicine postgraduate training program. In BST, content is distilled into manageable units focused on relevant schemas and delivered via brief peer teaching. A two-fold assessment of BST was performed that included cross sectional survey to assess learner attitudes and experiences and a controlled study to assess knowledge acquisition with BST and case-based teaching control. Results One hundred and six of 171 residents (62% response rate) completed the survey. Most residents (79.8%) reported BST was among the best conference types in the curriculum. Important components of BST cited by residents include the distilled content, multiple short talk format and peer teaching. Residents report incorporating what they learned via BST into their teaching (76.1%) and clinical practice (74.1%). Resident who had participated as speaker were significantly more likely to report incorporating learning from BST into their teaching (87.2% vs 63.0%, p < 0.01, Cramer’s V effect size = 0.37) and clinical practice (89.7% vs 65.3%, p = 0.02, Cramer’s V effect size 0.28). Fifty-one residents participated in the knowledge assessment. Residents taught via BST scored significantly higher on immediate post-test compared to case-based teaching (score [SE] 62.5% [1.9] vs 55.2% [2.4], p = 0.03, Hedges g effect size 0.66). While both groups improved over pretest, there was no significant difference in scores between BST and case-based teaching at two (score [SE] 57.1 [2.1] vs 54.8 [2.5], p = 0.54) and six weeks (score [SD] 55.9 [2.1] vs 53.0 [2.9], p = 0.43). Conclusions Teaching via brief, focused learning units delivered by peers is well received by learners and appears to have a significantly greater impact on immediate knowledge recall than case-based teaching. Further study on long term knowledge retention and behaviors is needed. Bite-Sized Teaching may be a promising instructional approach in medical education.

Learner attitudes and attention to form in peer interaction: A proposal to replicate Adams et al. (2011) and Philp et al. (2010)

Research into peer interaction continues to grow and new findings with new designs have been reported. However, there remain theoretical and methodological issues that replication studies can address. In this article, I first discuss theoretical frameworks that have been used to investigate peer interaction, namely, interactionist, sociocultural, and psychological. I explain that, regardless of theoretical frameworks, peer interaction effectiveness has been at least partly accounted for by the ways in which learners temporarily shift their attention to linguistic issues during meaningful interaction, via peer feedback or language-related episodes (LREs). Current research also suggests that learner attitudes mediate this interactional behavior. To fill the gaps in this issue, I make methodological suggestions for replication research of Adams, Nuevo, & Egi (2011) and Philp, Walter, & Basturkmen (2010), including intervention materials, transcript analysis, statistical design, and internal validity control. I conclude the paper with pedagogical implications that may arise from replication studies.

STUDENTS’ ATTITUDES TOWARD TEACHERS’ CORRECTIVE FEEDBACK

Recently we have done some research about feedback and student’s attitude toward it. The objective of the research is to explore learner attitudes to correction of mistakes or feedback as a language learning tool in oral, electronically- and paper-written work as well as peer correction of mistakes. Feedback is a method used in the teaching of languages to improve performance by sharing observations, concerns and suggestions with regard to written work or oral presentation. It includes not only correcting learners, but also assessing them. Both correction and assessment depend on mistakes being made, reasons for mistakes, and class activities. Recently the value of feedback in language studies has been a matter of debate among language teaching practitioners. The research into the effects of feedback is far from conclusive. Teachers’ and students’ expectations toward feedback are found to be opposing, and the most frequent reason given its negative impact on students’ confidence and motivation. However, at the university level the issue of feedback has been examined in passing and there is insufficient research into learner attitudes to feedback in English for Specific Purposes. The hypothesis for the present study is to find out whether criticism has a negative impact on student confidence and whether perceptions of feedback depend on professional specialization

On language learner attitudes and achievement, and their relation with motivation

On language learner attitudes and achievement, and their relation with motivation