BACKGROUND AND OBJECTIVE

Self-assessment and metacognition can be practiced with an exam wrapper (EW). EW is a structured, metacognitive, and self-regulated learning strategy that involves guided self-reflection on an exam already taken to improve study habits. This research describes how internal medicine (IM) residents at two tertiary private hospitals performed in written examinations using an EW. The relationship between the residents' metacognition, the exam wrapper, and exam performance was also determined.

This study employed a pre-experimental pre- and post-test design. The EW was constructed and tested for validity and reliability. It included (1) a description of study habits, (2) accuracy in self-efficacy perception and exam score prediction, (3) perceived reasons for exam mistakes, and (4) future study plans of residents. A complete enumeration of 24 IM residents was conducted. Respondents completed the Metacognitive Awareness Inventory (MAI) at the beginning of the study. The intervention consisted of (1) residents taking Exam 1: Gastroenterology, followed by EW; (2) Exam 2: Endocrinology and EW; then (3) Exam 3: Oncology, EW, and MAI. Scores were compared using a paired t-test or analysis of variance (ANOVA). The relationships between metacognition scores, the EW, and exam performance were determined using the Pearson correlation coefficient. The level of significance was set at p < 0.05.

The final EW comprises 16 items, with overall indices of content validity ratio of 0.72 and item-rated content validity of 0.8. The internal consistency coefficient is 0.65 (Kuder-Richardson 20). Nineteen out of 24 residents (79.17%) completed the study. Mean exam percentage scores were 57.97%, 42%, and 51.16% for Exams 1, 2, and 3, respectively. Exam 2 differed significantly from the other two exams (p = 0 and p = 0.04). EWs for the first two exams were not significantly different and revealed: (1) top study habits included studying right before an exam and skimming the textbook; (2) 68.42% vs. 63.16% accuracy of selfefficacy perception; (3) 26.32% vs. 31.58% accuracy of grade estimation; (4) 31.58% vs. 26.32% accuracy of error analysis; (5) most errors were due to not reading about the topic, and (6) most planned to “read more." Mean MAI scores were 36.79 ± 9.10 (pretest) and 36.05 ± 9.44 (post-test) (p = 0.81). All correlations were not statistically significant.

Residents performed poorly during exams, crammed their studies, preferred low-impact learning strategies, and lacked self-reflection skills and metacognition monitoring. Time issues related to reading or studying were common. There is no significant relationship between metacognition score and exam wrapper use or exam performance in IM residency trainees.

BACKGROUND AND OBJECTIVE

There is a call for changes in health professions education to help address current and future challenges. For the effective management of change in institutions involved with health professions education, it is important to consider organizational readiness for change and psychological safety. In organizations, the presence of psychological safety facilitates learning that is integral in organizational development, especially those undergoing changes. There are tools available to measure organizational readiness to change and psychological safety but they are separate and tend to be lengthy. The study developed and validated a brief, straightforward tool that integrates psychological safety in the measurement of organizational readiness for change. It can be useful in the assessment of academic organizations undergoing change in order to facilitate implementation and promote effective change.

The study used a sequential exploratory mixed methods design. A conceptual framework on organizational readiness to change which included psychological safety was developed from a review of literature. Relevant constructs were defined and corresponding questions were constructed and scaled. Five content experts qualitatively assessed the scale and removed items which were redundant, lacked clarity, or were irrelevant. The items were then reviewed by selected participants to ensure face validity. Finally, the questionnaire was administered to members of a unit (N=89) which was undergoing organizational change to ensure construct validity. Construct validity, internal consistency, convergent validity, and discriminant validity were determined using PLS-SEM and yielded acceptable results.

The scale developed addressed components of organizational readiness to change and psychological safety. The scale was deemed to have good content validity by five experts, good face validity as tested by a small pilot group, and acceptable construct validity, internal consistency, convergent validity, and discriminant validity.

The quantitative scale developed for measuring readiness to change was assessed qualitatively and quantitatively, and deemed to have relevance and validity. It can be used by academic units embarking on change initiatives to assess organizational readiness with due consideration for psychological safety. Quantitative results from the tool can be supplemented with qualitative measures such as observations, interviews or focused group discussions to better identify and address areas needing attention. The study has the potential to make a significant contribution to both the theory and practice of change management.

BACKGROUND AND OBJECTIVE

There is a call for changes in health professions education to help address current and future challenges. For the effective management of change in institutions involved with health professions education, it is important to consider organizational readiness for change and psychological safety. In organizations, the presence of psychological safety facilitates learning that is integral in organizational development, especially those undergoing changes. There are tools available to measure organizational readiness to change and psychological safety but they are separate and tend to be lengthy. The study developed and validated a brief, straightforward tool that integrates psychological safety in the measurement of organizational readiness for change. It can be useful in the assessment of academic organizations undergoing change in order to facilitate implementation and promote effective change.

The study used a sequential exploratory mixed methods design. A conceptual framework on organizational readiness to change which included psychological safety was developed from a review of literature. Relevant constructs were defined and corresponding questions were constructed and scaled. Five content experts qualitatively assessed the scale and removed items which were redundant, lacked clarity, or were irrelevant. The items were then reviewed by selected participants to ensure face validity. Finally, the questionnaire was administered to members of a unit (N=89) which was undergoing organizational change to ensure construct validity. Construct validity, internal consistency, convergent validity, and discriminant validity were determined using PLS-SEM and yielded acceptable results.

The scale developed addressed components of organizational readiness to change and psychological safety. The scale was deemed to have good content validity by five experts, good face validity as tested by a small pilot group, and acceptable construct validity, internal consistency, convergent validity, and discriminant validity.

The quantitative scale developed for measuring readiness to change was assessed qualitatively and quantitatively, and deemed to have relevance and validity. It can be used by academic units embarking on change initiatives to assess organizational readiness with due consideration for psychological safety. Quantitative results from the tool can be supplemented with qualitative measures such as observations, interviews or focused group discussions to better identify and address areas needing attention. The study has the potential to make a significant contribution to both the theory and practice of change management.

BACKGROUND

Lesbian, gay, bisexual, and transgender (LGBT) individuals continue to experience health disparities related to discrimination and health professional inadequacies despite increasing social acceptance of the LGBT community in society. Understanding the knowledge, attitudes, and practices concerning the healthcare of LGBT individuals among healthcare professionals can enable gender-affirming healthcare for the LGBT community. However, there is a need for a culturally relevant and updated tool to describe healthcare professionals' interactions with the LGBT community.

The objective of this study is to describe the development of the Knowledge, Attitudes, and Practices towards LGBT in Healthcare Questionnaire (KAP-LHQ) and demonstrate its content and face validity.

The KAP-LHQ was developed using a two-phase process. Phase 1 involved the generation of items through a literature review and discussions among the authors Phase two included the evaluation of its content and face validity. Content validity was determined by six experts using the Content Validity Index, while ten healthcare professionals evaluated the tool for face validity.

The KAP-LHQ demonstrated good content and face validity. Content validity indices were high. Item-Level CVI (I-CVI) ranges from 0.83 to 1.00 for the items under the Knowledge section and has a Scale-Level CVI (S-CVI) of 0.97. The Attitude section items scored an I-CVI of 0.83 to 1.00 and a S-CVI of 0.99, while most of the Practices section items scored an I-CVI of 1.00 with an overall S-CVI of 0.94. One item was omitted on the final version for having an I-CVI of 0.67. Face validity of the final questionnaire across parameters has a median of 4 out of 4, reflecting the appropriateness, comprehensibility, and relevance of the questionnaire.

The KAP-LHQ appears to be a valid tool that has the potential for assessing the KAP of health professions to improve training and increasese healthcare outcomes for the LGBT community. Using the tool on a larger population can firmly establish its efficacy, further validity, and even reliability.

Background: Healthcare workers remain the key players in the delivery of healthcare services. Their supply and distribution must be carefully monitored and taken care of. Objectives: To describe the stock of doctors, nurses, and midwives in the Philippines in 2020. Methods: This study employed a descriptive ecologic design and involves a secondary-data analysis where the relevant statistical data were retrieved from the public database in the country’s Department of Health. The data source also provides the statistics of other health professions such as medical technologists, nutritionists/dieticians, pharmacists, and dentists. However, this study limited the numerical data of the doctors, nurses, and midwives because there are readily available data for comparison. Descriptive statistics such as frequency counts, percentages, and population density were used to analyze the data. Results: The available density of health workers (14.76 per 10,000 population) composed of doctors, nurses, and midwives in the country remains at par with the recommendation of the World Health Organization (44.5 per 10,000 population). Likewise, data showed maldistribution of the health workforce still exists where a greater number of them are found in urban areas such as the National Capital Region (NCR) and CALABARZON. Majority of them are also working in the hospitals (doctors = 86.64%, nurses = 76.75%, and midwives = 48.46%) than in the primary healthcare facilities (doctors = 13.36%, nurses = 23.25%, and midwives = 51.54%). Conclusions The study revealed that maldistribution and shortage of doctors, nurses, and midwives prevail in the country. Likewise, the available workers in the country remain at par with the recommendations to meet the targets of the sustainable development goals (SDGs). The health agency and policymakers must focus on strategies to accelerate the number of health workers required in the country and redistribute them according to the areas in dire need.
Midwifery ; Nurses ; Philippines

Background: Occupational therapy (OT) academic educators are vital in building the workforce and advancing the profession. With the retirement of senior faculty, hiring of new OT faculty members have increased. There have also been changes in national and global policy guidelines in OT education. These changes have brought forth a compelling need to examine the profile of Filipino OT educators. To this date, there has been no formal analysis of the Philippine OT academic education workforce. A study aiming at understanding this profile is important to inform OT educators, administrators, and policymakers on the development of strategic approaches that may address their needs and help build the capacity of this workforce.

Objectives: We aimed to establish an occupational profile of OT educators in the Philippines and to recommend capacity-building strategies for next-generation Filipino OT educators.

Methods: A cross-sectional survey was conducted using the Adaptation Process in Academia Questionnaire. OT educators were recruited through their institutional affiliations.

Results: Ninety (53%) of the estimated 170 educators participated in the study, representing 16 schools with OT programs in the country. The median age is 26 years, majority female, and single. The academic profile shows that the majority have a bachelor's as their highest educational degree, work part-time, hold the instructor rank, nontenured, and have been in academia for 5+ years. Teaching is the primary role, and >50% of the time is spent on teaching tasks. The most frequently experienced challenges are balancing multiple roles and the need to develop competence in research skills. Most effective institutional resources are the availability of teaching resources and orientation programs. Excellent communication between university management and academic staff and the opportunity to participate in decision-making are perceived to be the most useful relationship support. Productivity in teaching is higher than in research and service.

Conclusion: The current OT academic workforce based on this study is young, in the early career stage, and expected to assume many roles, primarily teaching. They are most challenged in balancing multiple roles and how to advance their academic careers. Institutional resources and relationship supports are available but need to be reinforced and accessed. Strategic initiatives to build capacity include the development of communities of practice, increasing research engagement and productivity, increasing access to professional development programs, and faculty development initiatives.

Objectives. The Association of Philippine Medical Colleges (APMC) responded to the global call for transformative learning by conducting a series of Faculty In-service Training. This study was commissioned to determine faculty trainees' perceptions of the program in terms of relevance, comprehensiveness, and quality. It also described their applications of the program in their delivery of instruction, assessment, organization, and management skills.

Methods. This is a sequential explanatory mixed-method research. The quantitative phase refers to the analysis of the rating scale accomplished by participants as feedback. The qualitative phase includes analysis of focus group discussion results and actual course syllabi used by selected participants, including medical schools' documents. Both data were integrated using a combination of descriptive statistics, measures of central tendency and dispersion, as well as joint displays.

Results. APMC conducted six in-service trainings from 2015 to 2018. Themes focused on medical teachers' roles as instructional designers, facilitators, assessors of learning, and as leaders and managers. Respondents perceived the programs as most relevant, comprehensive, and interesting. The syllabi, instructional resources, and assessment instruments and practices were consistent with the standards of the Commission on Higher Education. Medical teachers showed that they use innovative teaching and assessment strategies, and are dealing with medical education's continuous challenges.

Conclusion. Faculty participants perceived the APMC in-service training programs most favorably for capacitating them to enhance their teaching skills and inculcate the culture of quality in medical schools. APMC's training also reflects the organization's commitment to social accountability.

Background: Andragogy, the theory of adult learning is relevant to medical education especially in the clinical internship learning context. It focuses on the students, faculty, and patients interacting together while developing competencies as future practitioners. Medical interns are active adult learners, enhancing their development of knowledge, skills, and positive attitudes, and pursuing professionalism as they participate in case-based discussions (CBD). Objectives: The study sought to identify the basic principles of andragogy while medical interns participate in case-based discussions including the end-of-course satisfaction. It also determined the selected demographic factors associated with the andragogic principles. Methodology: Respondents included 80 interns by convenience sampling who rotated at the Department of Ophthalmology and Visual Sciences in a tertiary referral hospital. The study used a combination of descriptive quantitative and qualitative research design. A valid instrument using the Adult Learning Principles Design Elements Questionnaire (ALPDEQ) was used to measure the medical intern's andragogic orientation as well as end-of-course satisfaction. A direct, non-participant observation of case-based discussions conducted at the department was done by the researcher and research associate. Results and Conclusion The occurrence of andragogic principles specifically motivation, experience, need to know, readiness, and self-directedness was observed during the conduct of case-based discussion. There was no association between principles of andragogy and demographic factors such as age, gender, civil status, medical school, preparatory medical course, and place of origin. CBD is an effective learning strategy, which provides medical interns adequate venues to be self-directed and apply the principles of andragogy in a workplace-based setting.
Internship and Residency

Background: Staff development is essential in sustaining organizational efficiency. In 2016, the University of the Philippines Manila started conducting the “Awakening Seminars” among administrative personnel to foster smooth interpersonal relationships and operational efficiency. Objectives: This study was commissioned to determine the value of the seminars. It evaluated the trainees' perceived reactions, learning, and overall change in behaviors towards their work at the university. Methodology: Out of 321 personnel who completed the seminars, 96 were calculated as sample size. Participants accomplished a survey questionnaire and 67 valid responses were collected. Data were analyzed using means and standard deviations according to Kirkpatrick's Evaluation Model from Level 1: Reactions, Level 2: Learning, to Level 3: Behavior. Different ratings were compared with selected variables using analysis of variance. Results: Seven seminars were conducted from March 2016 to January 2017. Mean ratings showed that the seminars were well organized, relevant, and helped them appreciate their work, colleagues, and their workplace environment. Participants have high morale and felt privileged being in UP. Analysis of variance tests showed that evaluation ratings did not differ significantly with monthly take-home pay, tenure, performance, and job category. While these ratings are not directly translated as operational efficiency, results suggest participants' commitment to the university's goals. Conclusion UP Manila personnel appreciated the “Awakening” staff development program and can be replicated to all support personnel of the colleges.
Workplace ; Staff Development

Objective: The process of adaptation in academia can best be understood and measured using valid and reliable tools. To understand how occupational therapy educators adapt to academic roles and how they use adaptation to build academic careers, the Adaptation Process in Academia Questionnaire (APA-Q) was developed. The APA-Q is a 199-item tool with four sections: academic experiences (104 items); contexts (16 items); adapting responses (13 items); and adaptation outcomes (66 items). This study described the development and the process of determining the content validity of the APA-Q. Method: We conducted an extensive review of literature and the available faculty instruments in developing the APA-Q items. Six content experts were recruited to rate the 199-item and scale relevance of the instrument. Qualitative feedback were provided from open-ended questions. Item and scale content validity indices (I-CVI/S-CVI) were calculated. CVI and qualitative assessment informed questionnaire revisions. Results: Content experts rated 161 of the items (81%) to be highly relevant. The I-CVI of 30 items was acceptable (0.83). Eight items were rated irrelevant (0.5-0.66). S-CVI was excellent (0.97). In terms of constructs, experts agreed on the relevance of items (>0.80): academic experiences (99 or 95%); contexts (16 or 100%); adapting responses (12 or 92%); and adaptation outcomes (63 or 95%). Qualitative assessment indicated a lack of clarity in some items and instructions, redundancy in some of the items, the use of jargon, and missing items. Based on I-CVI and qualitative assessment, 12 items were deleted, 13 items were revised, and 10 items were added. Conclusion Context experts deemed the APA-Q to be relevant. Further establishment of its construct validity and reliability is warranted.
Occupational Therapy