Blog post by Katherine Moreau, PhD

The Demand for Well-Educated, Clinically Proficient Healthcare Professionals

The demand for well-educated and proficient healthcare professionals is at an all-time high. Health professions educators are under increasing pressure to ensure that graduates achieve the goals and objectives of their programs. Today’s healthcare systems require professionals to be technically skilled, critical thinkers, problem-solvers, and multidisciplinary. Innovative teaching methods and strategies are essential. Current teaching methods and techniques may not sufficiently meet the demands of today’s healthcare systems. While many healthcare education programs focus heavily on theoretical instruction and standardized assessments, these approaches may fail to develop the clinical judgment, interpersonal skills, and lifelong learning habits required in practice. Although the Montessori approach is widely recognized for its effectiveness in various educational settings, its application in the training of healthcare professionals remains underexplored.

The Montessori Approach

Maria Montessori, the founder of the Montessori educational approach, was the first female to attend an Italian medical school and the first female physician in Italy. Her career began in psychiatry and pediatrics before she dedicated herself to education (Marshall, 2017). Originally designed for children with intellectual disabilities, the Montessori method has evolved over the past century and is now utilized globally. It features multi-age and -level classrooms, hands-on learning materials, learner-chosen activities, and a focus on social and practical life skills. While traditionally applied in early childhood education, the Montessori approach has been adapted in clinical healthcare settings with patients to enhance patient engagement and sensory perceptions.

In training healthcare professionals, Montessori principles could offer a new paradigm for developing the qualities essential to clinical practice. It could help enhance self-directed learning, hands-on skill acquisition, and collaborative problem-solving.

Montessori in Clinical Healthcare

Research has primarily investigated the Montessori approach in dementia clinical care settings. Hitzig and Sheppard (2017) conducted a scoping review and found significant variability in implementing the Montessori approach. They highlighted a lack of standardized guidelines and best practices in using the Montessori approach in clinical healthcare. Similarly, Sheppard, McArthur, and Hitzig (2016) found that while Montessori activities improved eating abilities in individuals with dementia, they had minimal impact on overall cognition. They called for further research into the long-term benefits of these activities. Conversely, other studies have shown that the Montessori approach can effectively enhance cognitive, motor, and sensory functions and social skills in dementia patients (Hanna, Donnelly, & Aggar, 2018). It also appears to foster greater clinician engagement and compassion while reducing burnout among caregivers (Judge, Camp, & Orsulic-Jeras, 2000).

Gaps in Current Research

While existing research focuses on the Montessori approach in clinical care settings, studies on its use and outcomes in other healthcare environments, including health professions education, are lacking. To fully understand and leverage this approach, researchers, administrators, clinicians, patients, and other stakeholders must examine and learn from the experiences of those who have applied or studied it in various health contexts. Applying the Montessori approach in the education of healthcare professionals could address some of the gaps in current training practices. For example, self-directed and hands-on learning could help learners develop technical competence and the critical thinking and interpersonal skills necessary for effective patient care. In a Montessori-inspired curriculum, learners could also choose projects, conduct research, and engage in interdisciplinary collaboration, encouraging them to take ownership of their learning while fostering teamwork. Many of these aspects are like competency-based medical education.

Moreover, a collaborative learning environment in which learners from various healthcare disciplines collaborate on example case studies could provide a better understanding of team dynamics. This approach would reflect real-world healthcare delivery, where interdisciplinary teams are often required to solve complex health issues. The flexibility to explore different aspects of healthcare, whether through elective courses or clinical rotations, would also allow learners to gain a deeper understanding of their field while promoting interprofessional learning and communication skills. 

Conclusion

The Montessori approach’s focus on hands-on learning, intrinsic motivation, and collaborative problem-solving has the potential to revolutionize the training of healthcare professionals. By integrating these principles into training programs, we can cultivate a generation of technically proficient health professionals who are empathetic, self-directed, and adaptable to the needs of diverse patient populations. As research into the Montessori approach in healthcare settings, including health professions education, continues to grow, it may provide valuable insights into how education can be better aligned with the real-world demands of the healthcare profession.

References

1. Hanna, A., Donnelly, J., & Aggar, C. (2018). Study protocol: A Montessori approach to dementia-related, non-residential respite services in Australia. Archives of Gerontology and Geriatrics, 77, 24–30. https://doi.org/10.1016/j.archger.2018.03.013
2. Hitzig, S. L., & Sheppard, C. L. (2017). Implementing Montessori methods for dementia: A scoping review. The Gerontologist, 57(5), e94–e114. https://doi.org/10.1093/geront/gnw147
3. Judge, K., Camp, C., & Orsulic-Jeras, S. (2000). Use of Montessori-based activities for clients with dementia in adult day care: Effects on engagement. American Journal of Alzheimer’s Disease and Other Dementias, 15(1), 42–46. https://doi.org/10.1177/153331750001500106
4. Marshall, C. (2017). Montessori education: A review of the evidence base. NPJ Science of Learning, 2, 11. https://doi.org/10.1038/s41539-017-0012-7
5. Sheppard, C. L., McArthur, C., & Hitzig, S. L. (2016). A systematic review of Montessori-based activities for persons with dementia. Journal of the American Medical Directors Association, 17(2), 117–122. https://doi.org/10.1016/j.jamda.2015.10.006

Blog Post by Elise Guest, PhD Candidate

In the context of education, accreditation is the formal process of recognizing program quality (Harvey, 2004). Accreditation is an assessment of a program against predetermined standards and criteria. In Canada, the term is usually applied to individual programs striving to demonstrate excellence (Weinrib & Jones, 2014). Health profession education (HPE) programs in Canada have robust experience with accreditation. The Association of Accrediting Agencies of Canada (AAAC) is a community of practice that supports educational program accreditors across the country; of its 23 members, 11 come from allied health fields such as nursing, occupational therapy, and dentistry.

On the surface, many assume that accreditation and program evaluation are interchangeable processes, as they both seek to understand the nuances of a program to improve quality. Program evaluation, however, is distinct from accreditation. It’s the systematic collection of information about the intentions, operations, and outcomes of a program (Shawer, 2003); it creates new knowledge about it (Yarbrough et al., 2010).

The key to understanding the distinction between accreditation and program evaluation is scope: scope of authority, scope of intent, and scope of outcomes. With regards to the scope of authority, accreditation of healthcare programs is generally organized by members of the discipline – it’s a way for a program to confirm for its interest holders that it has been peer reviewed and meets the expectations of members of the profession. While accreditation is an external process, program evaluation is internal. The scope of authority rests within the program and so the validation that results is narrowly understood as only those with a vested interested in the outcomes have been consulted. Not that there’s anything wrong with that!  Program evaluations are critical opportunities for self-reflection and confirmation of strength or needs for improvement.

The scope of the intent of accreditation is different from the scope of the intent of program evaluation. Accreditation looks at a wide variety of elements of program delivery, from policies to program environment, to graduate outcomes. By holding all programs in a discipline to the same set of criteria, accreditation creates a series of benchmarks, elevating the discipline in question nationally. Program evaluation is an insular exercise – it’s one program looking at how it delivers itself to ensure its goals are met. Accreditation intends to show a program how it meets national standards, whereas program evaluation intends to show a program if it’s meeting its own intended outcomes.

Finally, the scope of the outcomes between accreditation and program evaluation are very different. An accredited program is responsible to the external accrediting body to ensure it meets the terms of its accreditation – this may involve interim reporting, changes in program environment and delivery, shorter or longer accreditation terms, etc. The scope of the outcome of a program evaluation depends on the people within the program – as an internal exercise, changes are only made when internal pressure requires them to be.

So why does your accredited program need program evaluation?  While accreditation and program evaluation are two distinct processes, they are not divested from each other. Many accreditors look for program evaluation plans in the programs they are assessing. There is a recognition that continuous improvement needs to be internally motivated (program evaluation) as much as it is externally motivated (accreditation). Health professional education programs should embrace both processes, while recognizing the similarities and differences, to strengthen the quality of their program. Because, after all, quality HPE programming is always the goal.

References

Harvey, L. (2004). The power of accreditation: Views of academics. Journal of Higher Education Policy and Management, 26(2), 207–223. https://doi.org/10.1080/1360080042000218267

Shawer, S. (2013). Accreditation and standards-driven program evaluation: Implications for program quality assurance and stakeholder professional development. Quality and Quantity, 47(5), 2883–2913. https://doi.org/10.1007/s11135-012-9696-1

Weinrib, J., & Jones, G. A. (2014). Largely a matter of degrees: Quality assurance and Canadian universities. Policy and Society, 33(3), 225–236. https://doi.org/10.1016/j.polsoc.2014.07.002

Yarbrough, D. B., Shulha, L. M., Hopson, R. K., & Caruthers, F. A. (2010). The program evaluation standards: A guide for evaluators and evaluation users. SAGE.