Introduction
What is person-centred analysis?
Variable-centred analysis | Person-centred analysis | |
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Research question | How is empathy in HPE students associated with clinical performance? | How is empathy in HPE students associated with clinical performance? |
Method and analysis that can be used | Collect scores on empathy using Jefferson’s Scale of Physician Empathy, collect clinical performance scores, run statistical analysis for association between the independent and dependent variables for the whole sample | Collect scores on empathy using Jefferson’s Scale of Physician Empathy, collect clinical performance scores, divide the sample into sub-groups of similar scoring students using a cluster analysis, run statistical analysis for association between subgroup membership as an independent variable and clinical performance as the dependent variable |
Implications of findings for educational practice | Leads to general implications—If the association between empathy and clinical performance is positive, this can lead to an evidenced-based implication that training to foster empathy among students will help in better clinical performance (“One size fits all” approach) | Can lead to nuanced implications per subgroup—If the findings show that the groups with high and moderate empathy scores have good clinical performance and the low empathy score subgroup has poor performance scores, the implication would be that students with low, moderate and high empathy scores could receive different training programmes: modularization of education. (Personalized or “One size does not fit all” approach) |
Possible further research | Provide empathy training to all students in the same manner and study the effects | Provide tailor-made empathy training to the students in each subgroup and study the effects of this personalized approach |
How to conduct person-centred analysis including concrete examples from the literature
Cluster analysis
Latent class analysis
Q-sort analysis
Comparisons, advantages and disadvantages of the three methods for person-centred analysis
Cluster analysis | Latent class analysis | Q‑sort analysis |
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Jacobs et al. 2014 [5] | Boscardin et al. 2012 [11] | Fokkema et al. 2014 [19] |
Generated 5 profiles of teachers on the basis of their conceptions of learning and teaching, which had implications in the form of personalized faculty development activities | Generated 3 profiles based on students’ clinical performance which were used to customize remediation activities for improvement of performance | Generated 5 profiles on the basis of residents’ and physicians’ perceptions of workplace based assessments and made personalized recommendations for introduction of innovations in workplace based assessments |
Kusurkar et al. 2013 [2] | Mak-van der Vossen et al. 2016 [12] | Dotters-Katz et al. 2016 [20] |
Generated 4 profiles of students on the basis of the combination of their intrinsic and controlled motivation which had implications for academic performance, exhaustion from study and learning approaches | Generated 3 profiles of unprofessional behaviours of undergraduate students which gave an insight into what customized remediation measures could be used for each profile | Generated 3 medical graduate profiles on the basis of their attitude and motivation to teach in order to customize faculty development activities |
Orsini et al. 2018 [6] | Lambe and Bristow 2011 [13] | Berkhout et al. 2017 [21] |
Generated 4 profiles of students on the basis of the combination of their intrinsic and controlled motivation which had implications for study success and well-being | Generated 3 student profiles based on prior academic achievement and interview rating at the time of medical school admission to identify students who are most likely to need learning support | Generated 5 student profiles on self-regulation of their clinical learning in order to personalize support and supervision |
Cluster analysis | Latent Class analysis | Q‑sort analysis | |
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Type of data | Can be used for continuous or categorical data | Can be used for continuous or categorical data | Can be used for a combination of rank-ordered statements and interview data |
Required sample size | A good sample size is important for cluster stability. A thumb rule is a sample size of minimum 100 | Medium size (at least 70 samples) as well as (very) large sample sizes can be handled, depending of the number of indicators in a given sample | |
Advantages | – Provides more generalizable findings owing to the nature of the data and the ability to handle large sample sizes – Can lend itself to longitudinal follow-up of profiles to see if they change over time | – Flexibility of the model specification in LCA provides advantage over cluster analysis, which may not yield an optimal representation of the profiles [19] – Can lend itself to longitudinal follow-up of profiles to see if they change over time – Statistical and interpretational criteria are used to determine the optimum number of clusters, which means that researchers themselves can determine the number of classes and determine an understandable and practical to use ‘latent factor’ that describes the difference between classes | – This is a robust and systematic way of studying subjectivity. It can be precise and rigorous (depending on the choices made while conducting the analysis), and yet keeps the richness of descriptive data by including post Q‑sort questions or interviews |
Disadvantages | – Because of its exploratory nature, it may be random and not generate similar profiles in different samples – Cannot be used for small sample sizes | – Limited generalizability – Sample size should not be too small, especially if there is a large number of indicators. This problem might be solved by using a penalty parameter while statistically estimating the latent class model | – Limited generalizability. Q‑studies are not designed for generalizability purposes, they are for uncovering authentic viewpoints within the sample (and sample should be high quality). From there, if desired, prevalence of viewpoints can be tested in larger population through other methods – Difficult to study change in profiles over time |
Limitations and ethical considerations of person-centred analysis
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Explain the background and rationale for conducting such an analysis;
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Explain how the results of this analysis should be interpreted, especially keeping in mind its context; and
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Make a declaration that the results of such research should be used in a constructive way to customize interventions and not to stigmatize certain groups.
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Have the researchers provided a good rationale for using person-centred analysis?
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Are the researchers actually using the generated profiles for tailor-made or personalized interventions?
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How have the researchers clarified how they will treat the findings from this analysis?