Medical Education最新文献

{"title":"\"As a resistor, you are not alone\": Locating the collective in uncoordinated acts of professional resistance.","authors":"Tasha R Wyatt, Emily Scarlett, Vinayak Jain, TingLan Ma","doi":"10.1111/medu.70055","DOIUrl":"https://doi.org/10.1111/medu.70055","url":null,"abstract":"<p><strong>Introduction: </strong>When trainees encounter social harm and injustice in clinical and educational settings, they engage in acts of professional resistance. These efforts can either be coordinated or uncoordinated and implemented as individuals or collectives. Although it is easy to see the relationship between the collective and individuals in coordinated acts, it is unclear what role a collective plays in uncoordinated resistance efforts. This study investigated the role of a larger collective, including whether such a collective exists, among a group of trainees engaged in professional resistance. Specifically, we were interested in what trainees contribute to and draw from these collectives as they address social harm and injustice within medical education.</p><p><strong>Methods: </strong>Trainees were recruited through professional networks and snowball sampling, with in-depth interviews conducted in two phases. Phase one included interviews with 18 trainees from the U.S. and Canada, and phase two involved re-interviewing 13 of them. We used constant comparative analysis and a social movements framework (collective identity, framing processes, resource mobilization and strategies) to analyse the data.</p><p><strong>Results: </strong>Despite a lack of coordination, trainees consistently narrated a reliance on a larger collective, which they actively curated to include individuals from outside of medicine. Trainees drew from this collective a shared identity and a unifying 'injustice frame' for understanding social harm. In return, they contributed new strategies and tactics, which they shared with their colleagues. However, trainees did not receive emotional support or resource mobilization from these collectives. A few trainees expressed a desire for more coordinated action, whereas one reported feeling alienated by it.</p><p><strong>Discussion: </strong>Our findings demonstrate that uncoordinated resistance is not an isolated endeavour but is sustained by a dynamic, reciprocal relationship with a broader, self-curated collective. Although this collective provides a shared identity and a steady influx of new strategies, it may not be able to offer the emotional support and resource mobilization necessary for more sustained, coordinated change.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-10-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145337127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Virtual reality in surgical training: Ethical considerations for competence and data use.","authors":"Hana Abbasian","doi":"10.1111/medu.70075","DOIUrl":"https://doi.org/10.1111/medu.70075","url":null,"abstract":"","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145337092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Enhancing orthopaedic education: Taking the operating theatre online.","authors":"M Clare Gabrielle, Tiam Sahraie, Abdrahman Yu, Katie Hughes","doi":"10.1111/medu.70067","DOIUrl":"https://doi.org/10.1111/medu.70067","url":null,"abstract":"","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145337106","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The development of medical students' professional identities in rural settings: A scoping review.","authors":"Catherine Garnsey, Brie Turner, Lynn Valerie Monrouxe","doi":"10.1111/medu.70052","DOIUrl":"https://doi.org/10.1111/medu.70052","url":null,"abstract":"<p><strong>Background: </strong>Major documented disparities exist in health equity between individuals living in rural and metropolitan areas. Recruiting and retaining doctors in rural areas remains a considerable challenge. Students' exposure to rural experiences facilitates their development of professional identities aligned to this specific community of practice. Although previous studies have explored medical students' identity development in rural settings, a comprehensive picture of the development of medical students' professional identities in rural settings is yet to be established. Our study aims to address this, and as such, a scoping review was conducted to map the existing literature in this area.</p><p><strong>Methods: </strong>Our review follows the Joanna Briggs Institute methodology, with reporting being guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews. We searched MEDLINE, Embase, Web of Science and PsycINFO databases. We use inductive thematic analysis to synthesise the evidence with reference to the review questions. We present our results based on our developed framework.</p><p><strong>Results: </strong>We identified 1085 publications with 20 fully meeting the inclusion criteria. The majority of included studies were published in the last 9 years, originating from Australia, South Africa and the United States. These are based on voluntary rural medical placements, with the commonest placement duration being 12 months. Included publications predominantly use qualitative methodologies, most commonly individual and/or group interviews. Only two of the included studies use an approach informed by established theories of identity development. We used inductive thematic analysis of the included studies, identifying three related themes: Acting Up, Rural Community and Feeling of Fit. Fewer than half of the included studies referenced students' future intention to practice rurally, and no paper specifically examined an association between students' professional identity and intention to practice rurally.</p><p><strong>Discussion: </strong>It is a core remit of medical education to include professional identity as a key outcome. In a rural context, understanding the role that professional identity plays in medical students' future career choices may be key to understanding workforce maldistribution. Existing medical student identities research tends to lack theoretical grounding and alignment; subsequently failing to comprise a homogenous body of literature essential for facilitating our comprehensive understanding of professional identity, which is necessary for advancements within this field.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145337087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Widening access for graduates: Policies, pathways and technology.","authors":"Kirsty Alexander, Dylan Smith, Joshua Cleaver, Anton Zhyzhyn","doi":"10.1111/medu.70069","DOIUrl":"https://doi.org/10.1111/medu.70069","url":null,"abstract":"","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Scaffolding during surgical procedures: Guidance with baby steps or giant leaps?","authors":"Bart Lambert, Martine C Keuning, Paul C Jutte, Patrick Nieboer, Mike Huiskes","doi":"10.1111/medu.70074","DOIUrl":"https://doi.org/10.1111/medu.70074","url":null,"abstract":"<p><strong>Introduction: </strong>Scaffolding refers to the dynamic support teachers provide to help learners complete tasks they cannot yet do independently. This is often done by breaking tasks into smaller, manageable steps and adjusting the support based on the learner's performance. In the operating room (OR), attending surgeons apply scaffolding to guide residents in performing tasks that they are not yet able to do on their own. However, the OR poses a unique challenge: attending surgeons must balance resident learning with patient safety, and procedures consist of multiple tasks for which the learner's expertise varies. Little is known about how surgeons determine and adjust the appropriate level of support during procedures. This study aims to explore how attending surgeons scaffold residents' learning throughout surgical procedures and the strategies they use to adjust their support on a moment-to-moment basis.</p><p><strong>Methods: </strong>We conducted a qualitative analysis of 34 instances of step-by-step coaching from transcripts of 16 surgical procedures in which residents performed surgeries under the supervision of an attending surgeon. We used conversation analysis to examine scaffolding in the OR and identify the contexts in which it occurs.</p><p><strong>Results: </strong>We found that attending surgeons break down procedures into small steps to guide residents. We identified four components that attendings use, which together form the basic grammar of intraoperative scaffolding. These components are: instructing the resident what the next step is, instructing the resident how to perform the next step, providing an explanation about the step and evaluating the performed step. We described scaffolding as baseline supervision and examined two contexts in which attendings reduce step size: when introducing a new technique and in response to suboptimal task performance.</p><p><strong>Discussion: </strong>The findings highlight the underlying structure of scaffolding in the OR, with attending surgeons navigating when to intervene and when to allow greater autonomy. Understanding how attendings adjust their support can improve alignment with residents' learning needs and foster discussions about shared educational goals.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145292717","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Implementing recommendations to optimise professional support in the medical workplace: A participatory approach.","authors":"E Reynolds, H Lloyd, J Cleland, G Wong, L Withers, T Price, T Gale, N Brennan","doi":"10.1111/medu.70054","DOIUrl":"https://doi.org/10.1111/medu.70054","url":null,"abstract":"<p><strong>Introduction: </strong>The professional support (including remediation) of practising doctors has not been widely researched, and there have been no studies to date that have implemented evidence-based recommendations about support and remediation in the medical workplace. Our goal was to bridge the gap between research and practice in respect of optimising the delivery of professional support programmes for doctors in their workplace.</p><p><strong>Methods: </strong>We used a participatory-action research (PAR) approach to implement recommendations from a previous study, RESTORE 1, in five UK sites: two hospitals, two professional support units and a professional support body. Informed by observations and interviews, we conducted a series of workshops (12 in total, with 35 relevant stakeholders [doctors, professional support leads, coaches etc.]). These were recorded and transcribed for analysis. Analysis was deductive, using the Promoting Action on Research Implementation in Health Services (i-PARIHs) framework, the core constructs of which are innovation, recipient, context and facilitation.</p><p><strong>Results: </strong>Important aspects of innovation related to the perspective, language and tone of the recommendations and the finding that recipients often valued other types of evidence rather than research. In terms of the recipients, sites' motivation for engagement in the study was crucial. We identified a variety of enabling/constraining contextual factors including resources, type and role of organisation and responsibilities of the professional support programme, as well as macro-level changes. The extent to which participants adopted the recommendations (facilitation) was limited.</p><p><strong>Discussion: </strong>The successful implementation of research into practice is challenging. However, new learning, shifts in relationships and increased awareness are equally valuable outcomes. 'On-the-ground' change takes time, depending on trust, relationships, partnership working and understanding context. Unfortunately, this does not align well with research systems that privilege studies with measurable outcomes produced within a set timeframe. We call for more discussion in medical education about the process of implementing research findings into practice.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286249","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Empowering educators to create AI-based pedagogical apps.","authors":"Minyang Chow, Pao Hup Lim, Yng Miin Loke, Olivia Ng","doi":"10.1111/medu.70070","DOIUrl":"https://doi.org/10.1111/medu.70070","url":null,"abstract":"","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145286228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"November in this issue","authors":"","doi":"10.1111/medu.70057","DOIUrl":"https://doi.org/10.1111/medu.70057","url":null,"abstract":"&lt;p&gt;Can virtual reality transform simulation-based training? This paper offers new insights from leaders and experts in simulation and debriefing by presenting a qualitative study outlining how they see the future of immersive virtual reality in simulation-based training. What are the potentials? What are the pitfalls? Find out how specific virtual reality features align with various learning goals, and explore practical strategies to enhance learning in virtual reality-based training!&lt;/p&gt;&lt;p&gt;\u0000 &lt;span&gt;Andersen, A-M&lt;/span&gt;, &lt;span&gt;Kjærgaard, J&lt;/span&gt;, &lt;span&gt;Hoffman, IM&lt;/span&gt;, &lt;span&gt;Chang, T&lt;/span&gt;, &lt;span&gt;Poulsen, A&lt;/span&gt;, &lt;span&gt;Lee, JY&lt;/span&gt;, &lt;span&gt;Gjærde, LK&lt;/span&gt;, &lt;span&gt;Lund, S&lt;/span&gt;, &lt;span&gt;Paulsen, L&lt;/span&gt;, &lt;span&gt;Sorensen, J&lt;/span&gt;, &lt;span&gt;Overbeck, G&lt;/span&gt;. &lt;span&gt;Immersive virtual reality training: addressing challenges and unlocking potentials&lt;/span&gt;. &lt;i&gt;Med Educ&lt;/i&gt;. &lt;span&gt;2025&lt;/span&gt;; &lt;span&gt;59&lt;/span&gt;(&lt;span&gt;11&lt;/span&gt;): &lt;span&gt;1222&lt;/span&gt;–&lt;span&gt;1234&lt;/span&gt;. doi:10.1111/medu.15748&lt;/p&gt;&lt;p&gt;Feedback is essential to learning and performance yet remains a conceptually fragmented area in medical education. This study compares 11 feedback models using a novel pattern system. While key elements like judgement and assessment recur across models, the analysis also revealed striking variation in how feedback is conceptualised and applied. By highlighting both convergence and divergence, the study suggests that pattern theory may offer a unifying lens to navigate the complexity of feedback and support the development of a shared language for research and practice.&lt;/p&gt;&lt;p&gt;\u0000 &lt;span&gt;Patocka, C&lt;/span&gt;, &lt;span&gt;Cooke, L&lt;/span&gt;, &lt;span&gt;Ma, I&lt;/span&gt;, &lt;span&gt;Ellaway, R&lt;/span&gt;. &lt;span&gt;Untangling feedback: mapping the patterns behind the practice&lt;/span&gt;. &lt;i&gt;Med Educ&lt;/i&gt;. &lt;span&gt;2025&lt;/span&gt;; &lt;span&gt;59&lt;/span&gt;(&lt;span&gt;11&lt;/span&gt;): &lt;span&gt;1196&lt;/span&gt;–&lt;span&gt;1203&lt;/span&gt;. doi:10.1111/medu.15706&lt;/p&gt;&lt;p&gt;Residents face unique challenges when patients file complaints during their medical training. This study explores how physicians' narratives about receiving complaints during residency shaped their professional identity and career paths. Through interviews with 35 physicians who experienced complaints during training, researchers identified common emotional journeys—from initial shock and isolation to eventual reframing of these experiences as opportunities for growth. The findings reveal how these pivotal moments influenced specialty choices, clinical boundaries and communication approaches long after residency ended. By understanding these experiences, medical education programmes can better support residents in navigating complaints constructively, transforming potentially destabilising events into catalysts for professional development while maintaining focus on patient safety.&lt;/p&gt;&lt;p&gt;\u0000 &lt;span&gt;McDougall, A&lt;/span&gt;, &lt;span&gt;Claudio, F&lt;/span&gt;, &lt;span&gt;Pound, C&lt;/span&gt;, &lt;span&gt;Pacheco, K&lt;/span&gt;, &lt;span&gt;Fortier, J&lt;/span&gt;, &lt;span&gt;Garber, G&lt;/sp","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"59 11","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://asmepublications.onlinelibrary.wiley.com/doi/epdf/10.1111/medu.70057","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145272999","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Coping with generative AI's (GenAI) perpetuation of epistemic uncertainties.","authors":"Olivia Ng, Siew Ping Han, Minyang Chow","doi":"10.1111/medu.70068","DOIUrl":"https://doi.org/10.1111/medu.70068","url":null,"abstract":"","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145258569","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}