Medical Education最新文献

{"title":"The tip of the iceberg and beyond: Here's to all those who enable health professional education","authors":"Kevin W. Eva","doi":"10.1111/medu.15759","DOIUrl":"10.1111/medu.15759","url":null,"abstract":"<p>Where does the time go?! As we move into the latter parts of 2025, another great meeting of the Association for the Study of Medical Education brings the announcement of our annual award winners. I am thrilled, as a result, to again share news about groups that made particularly strong contributions to <i>Medical Education</i> this past year. Of course, these individuals are just the tip of the iceberg in terms of the many to whom we are grateful for enabling such a stimulating field of scholarship, but these successes stood out.</p><p><b>Harrison C Lucas, Jeffrey S Upperman and Jamie R Robinson</b> received the Silver Quill Award, granted annually to the article that is downloaded most often, for their paper entitled <i>A systematic review of large language models and their implications in medical education</i>.<span><sup>1</sup></span> The Henry Walton Prize, similarly awarded for Really Good Stuff papers, went to <b>Billy Ho Hung Cheung, Calvin Cheung, Jason Chan, Emmanuel Chun Ka Wong, Joshua Wing Kei Ho and Kui Kai Gary Lau</b> for their work entitled <i>Synergy and collaboration with young educators and students: Insights from an open forum on generative artificial intelligence in medical education</i>.<span><sup>2</sup></span> I suppose it is no surprise that Artificial Intelligence appears to have been the topic of the year, but seeing those two winners suggests this to be a useful moment to draw attention to the journal's perspective, summarised at the bottom of the Author Guidelines at mededuc.com, for those who have not already seen it.<span><sup>3</sup></span></p><p>Moving from artificial to real intelligence, we were again fortunate to derive insight from the dedication and wisdom of over 850 peer reviewers.<span><sup>4, 5</sup></span> For lifetime contributions, the Peer Reviewer Hall of Fame at mededuc.com has been updated. For the past year, we offered Choice Critics Awards to a few individuals who were especially active and influential. This year's winners are <b>Danette McKinley</b> (National Conference of Bar Examiners, US), <b>Jill Morrison</b> (University of Glasgow, Scotland), <b>Ligia Ribeiro</b> (University Medical Centre Groningen, the Netherlands), <b>Megan Brown</b> (Imperial College London, England) and <b>Stuart Pattinson</b> (University of Witwatersrand, South Africa). Honorary mention also goes out to the dozens of people who have signed onto the Really Good Stuff (RGS) reviewer panel, enabling RGS to now be published monthly rather than bi-annually.<span><sup>6</sup></span></p><p>I am personally excited to have the opportunity to work with the 13th cohort of editorial interns: <b>Takedza Munangatire</b> (University of Namibia, Namibia), <b>Marwa Schumann</b> (Charité University of Medicine, Germany) and <b>You You</b> (Peking University, China). In exchange for our editors going beyond the call of duty to support interns to develop their understanding of journal operations, we annually ask them to pay forward, i","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"59 8","pages":"779-780"},"PeriodicalIF":5.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/medu.15759","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144317308","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":"Tolerance of ambiguity and psychological wellbeing in newly qualified doctors: An analysis over multiple time points","authors":"Jason Hancock,&nbsp;Obioha C. Ukoumunne,&nbsp;Bryan Burford,&nbsp;Gillian Vance,&nbsp;Thomas Gale,&nbsp;Karen Mattick","doi":"10.1111/medu.15743","DOIUrl":"10.1111/medu.15743","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>There is evidence of an association between tolerance of ambiguity and psychological wellbeing in doctors, but this relationship is not well understood. We explored this relationship, and the individual or workplace factors moderating it, in a population of newly qualified doctors.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We examined the experiences of newly qualified doctors in the UK as they started a novel interim role (Time 1) and later moved into foundation year 1 roles (Times 2 and 3) during the COVID-19 pandemic. Doctors completed the Tolerance of Ambiguity of Medical Students and Doctors scale (TAMSAD Range: 0–100), the Perceived Stress Scale (PSS: 0–40), the Hospital Anxiety and Depression Scale (HADS: 0–21) and the Copenhagen Burnout Inventory (CBI: 0–100), over four months. Cross-sectional and longitudinal relationships between tolerance of ambiguity (TAMSAD) and wellbeing outcomes (PSS, HADS, CBI) were examined and potential moderators (age, gender, recent change in working environment) were explored.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>A total of 451 participants completed the survey at Time 1, 214 at Time 2, 172 at Time 3. Higher tolerance of ambiguity was associated with lower levels of stress (regression coefficient: -0.09, R2 = 1.6%, p = 0.008), anxiety (−0.06, R2 = 1.6%, p = 0.009), depression (−0.03, R2 = 1.1%, p = 0.03) and workplace burnout (−0.40, R2 = 3.9%, p &lt; 0.001) at Time 1. It was associated with lower levels of anxiety (−0.08, R2 = 2.4%, p = 0.03) at Time 2 and stress (−0.16, R2 = 3.4%, p = 0.02) at Time 3. Individual factors (being over 25 years, being female) and workplace factors (not moving location) seemed to strengthen the relationship between tolerance of ambiguity and psychological wellbeing.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>There appears to be a longitudinal relationship between lower tolerance of ambiguity and reduced psychological wellbeing in early career doctors within the UK. This study emphasises the importance of supporting all graduating doctors to navigate clinical ambiguity however further research is needed outside of the context of COVID-19.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"59 10","pages":"1094-1104"},"PeriodicalIF":5.2,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12438002/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310166","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":"Is ultrasound training sustainable? A systematic review of competency retention in healthcare trainees.","authors":"Liang-Wei Wang, Cheng-Heng Liu, Wen-Yi Li, Wen-Chu Chiang, Yen-Lin Chiu, Matthew Huei-Ming Ma, Huey-Ling Chen, Chih-Wei Yang","doi":"10.1111/medu.15751","DOIUrl":"https://doi.org/10.1111/medu.15751","url":null,"abstract":"<p><strong>Purpose: </strong>Despite Point-of-Care Ultrasound (PoCUS) emerging as an essential clinical skill, evidence regarding practitioners' knowledge retention and competence remains poorly synthesized. This systematic review sought to evaluate PoCUS competency retention patterns using the Indication, Acquisition, Interpretation, Medical decision-making (I-AIM) framework following various educational interventions and to identify factors influencing long-term skill retention among healthcare professional trainees.</p><p><strong>Methods: </strong>The authors conducted a systematic review by searching PubMed, the Cochrane Library and Embase databases (1990-2024) for studies evaluating PoCUS educational interventions with objective competency measures and retention assessment. Data were analysed based on educational strategies, course duration and retention patterns across I-AIM domains.</p><p><strong>Results: </strong>Thirty-one studies met the inclusion criteria, comprising 1638 participants (38.6% medical students, 20.5% attending physicians). Most studies employed a single-group pretest-posttest design (54.8%) and demonstrated moderate-to-high methodological quality (Medical Education Research Study Quality Instrument median: 12.5, interquartile range [IQR]: 11.0 to 13.0). Within the I-AIM framework analysis, all domains of competency retention demonstrated a decline over a 1-12-month follow-up period. The Acquisition domain showed the most significant decline with median percentage changes of -11.8% (IQR: -16.5% to -6.4%), followed by Interpretation, Medical decision-making and Indication. Short-course programs (≤4 h) demonstrated greater competency decline (median: -11.8%, IQR: -16.9% to -4.4%) compared to long-course programs (median: -2.6%, IQR: -6.8% to 1.3%). Hands-on practice with high-fidelity simulation and clinical context integration were associated with superior retention outcomes across multiple domains.</p><p><strong>Conclusions: </strong>Ultrasound competence retention showed variable decay patterns across I-AIM domains, with Acquisition skills showing the most pronounced deterioration, particularly following short-course programs. Comprehensive training programs integrating high-fidelity hands-on practice and clinical context may enhance PoCUS retention for healthcare providers.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310147","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":"Equity begins with everyone: Bridging the divide","authors":"Benjamin Mba,&nbsp;Cayetana Navarro,&nbsp;Sarah Ngongi-Wumba","doi":"10.1111/medu.15735","DOIUrl":"10.1111/medu.15735","url":null,"abstract":"","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"59 11","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302482","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":"When I say … interprofessional collaboration","authors":"Zubin Austin,&nbsp;Walter Eppich,&nbsp;Tina Brock","doi":"10.1111/medu.15753","DOIUrl":"10.1111/medu.15753","url":null,"abstract":"&lt;p&gt;In &lt;i&gt;The Ethics of Rhetoric&lt;/i&gt;, Weaver introduced the concept of a ‘god-term’—statements deemed inherently persuasive and beyond debate.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; In health professions education (HPE), ‘collaboration’ has reached god-term status, regarded as a universally good practice within and across disciplines. For over a generation, educators have reinforced the god-term status of collaboration and its undisputed value through growing efforts in curricula, experiential learning and professional socialisation. Alongside this, interprofessional education (IPE) has become an accreditation requirement for most programmes. Various practices of learning about, from and with other professions are meant to win the hearts and minds of students with respect to the intrinsic value and importance of &lt;i&gt;interprofessional collaboration&lt;/i&gt; in both learning and practice. Unfortunately, the god-term status of ‘collaboration’ has narrowed opportunities for critical reflection and drawn attention to IPE curricula that meet mandatory accreditation standards without a clear-eyed focus on the value the relational process of interprofessional collaboration creates.&lt;/p&gt;&lt;p&gt;Haddara and Lingard have raised a critical voice that highlights the lack of a single, coherent definition of interprofessional collaboration in HPE.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; In addition, varied and disparate mental models create tensions in IPE's conceptualisation, implementation and assessment. These divergent foundations, described as emancipatory and utilitarian visions of collaboration, foster mixed messaging and confusion at the coalface. Gunaldo et al. also suggest lack of clarity in terminology has impeded progress and potentially lead to confusion about research in the interprofessional field.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;IPE proponents seek to enhance collaborative practice through system-level solutions—expanding scopes of practice, removing legal barriers, improving shared records, or updating reimbursement models. While valuable, so far, the evidence that IPE leads to meaningful, sustainable changes in practice is limited.&lt;span&gt;&lt;sup&gt;4, 5&lt;/sup&gt;&lt;/span&gt; For many health professionals, experiences of interprofessional collaboration remain suboptimal.&lt;/p&gt;&lt;p&gt;IPE emphasises concrete models of collaboration, making it more practical than theoretical, which helps students envision day-to-day collaborative practice. However, presenting collaboration as an idealised ‘destination’ reinforces unrealistic expectations. Non-physician professionals may expect their opinions to be instantly valued due to IPE principles, then feel disillusioned when they must first earn trust from physician colleagues. Conversely, physicians may feel burdened by the extra time and emotional effort required to engage across professions, sometimes with limited perceived benefit.&lt;/p&gt;&lt;p&gt;This disconnect may stem from framing interprofessional collaboration as a fixed state achieved through education, rather than a fl","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"59 11","pages":"1154-1155"},"PeriodicalIF":5.2,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://asmepublications.onlinelibrary.wiley.com/doi/epdf/10.1111/medu.15753","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144310167","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":"Beyond the ‘tick-box’: Redesigning a course review process that fosters dialogue and exchange of ideas","authors":"Louise Beckingsale,&nbsp;Anthony Ali,&nbsp;Lutz Beckert","doi":"10.1111/medu.15754","DOIUrl":"10.1111/medu.15754","url":null,"abstract":"&lt;p&gt;Quality enhancement processes nurture academic programmes including medicine; however, educator engagement with these processes can be variable. Educators may view these processes as a ‘tick-box’ activity that competes with teaching and research time. When educators engage more deeply with quality enhancement, and structural elements support collaboration, a quality culture is fostered.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Our institution requires educators submit a course report every 3 years. Educators synthesise information that evaluates the quality of their learning environment, identify areas for improvement and outlined strategies for enhancing learning. Information sources can include students, teachers, course documents and assessment results. Historically, up to 10 educators submitted their respective reports to one end of year curriculum committee meeting dedicated to quality enhancement. The committee chair would attempt to facilitate the discussion about all submitted reports by inviting committee members, including student representatives and other educators, to ask questions and provide comments. However, this large volume of content in one single meeting often resulted in superficial discussion with little input from students or other educators.&lt;/p&gt;&lt;p&gt;Here, we report on redesigning an established course review process to encourage dialogue and the exchange of ideas among educators, students, and programme leaders.&lt;/p&gt;&lt;p&gt;The process was evaluated by reviewing meeting minutes before and after these changes were made. Evaluation data also included a voluntary anonymous survey completed by curriculum committee members including student education reps after the second year of the new process.&lt;/p&gt;&lt;p&gt;Content analysis of the meeting minutes shows that limiting discussions to two reports per meeting allows for more in-depth discussion of teaching and learning practices. More time is spent reflecting on successes and challenges, fostering shared learning, and actionable improvements. Students have gained a voice in the process and having a facilitator from another course increases educator engagement.&lt;/p&gt;&lt;p&gt;Survey results indicated educators and students value the redesigned process. Educators appreciate time for dialogue, learning from peers and being part of a group of academic educators. Students appreciate the opportunity to contribute to the discussion in a meaningful way. While educators value student input, some suggest allowing students to comment on challenges or less positive aspects for a balanced conversation. Additionally, some educators feel there is now not enough time to discuss other meeting agenda items, so balancing report discussions with other meeting business remains a consideration for future improvements.&lt;/p&gt;&lt;p&gt;Making small but meaningful changes to an established quality enhancement process has nurtured a quality culture in our institution. The increased dialogue and exchange of ideas among educators, students, and pro","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"59 11","pages":"1252-1253"},"PeriodicalIF":5.2,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://asmepublications.onlinelibrary.wiley.com/doi/epdf/10.1111/medu.15754","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302481","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":"Immersive virtual reality training: Addressing challenges and unlocking potentials","authors":"Amalie Middelboe Sohlin,&nbsp;Jesper Kjærgaard,&nbsp;Ida Madeline Hoffman,&nbsp;Todd P. Chang,&nbsp;Anja Poulsen,&nbsp;Joy Yeonjoo Lee,&nbsp;Line Klingen Gjærde,&nbsp;Stine Lund,&nbsp;Lone Paulsen,&nbsp;Jette Led Sørensen,&nbsp;Gritt Overbeck","doi":"10.1111/medu.15748","DOIUrl":"10.1111/medu.15748","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Simulation-based training has significantly improved healthcare professionals' skills and patient outcomes. Immersive virtual reality is gaining attention in this field and offers potential educational benefits. However, little is known about how key stakeholders in simulation-based training and debriefing receive a complex intervention like immersive virtual reality. This study explores the enablers, barriers and applied debriefing strategies involved in using immersive virtual reality in simulation-based training.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We purposefully sampled simulation centre directors, course leaders and researchers within debriefing, simulation-based emergency training and immersive virtual reality. First, they observed and debriefed an online immersive virtual reality-based emergency training. Then, they participated in an individual semi-structured interview that was audio recorded and transcribed. We coded and analysed the data based on a reflexive thematic analysis method with a constructionist framing, guided by normalisation process theory as a theoretical lens. All co-authors informed and validated the identified themes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We conducted 10 individual semi-structured interviews and generated five main themes on factors that supported or impeded the normalisation of immersive virtual reality for simulation-based training: understanding, engagement, strategies in action, appraisal and psychological safety.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Immersive virtual reality contains unique challenges and potential for simulation-based training. Its strengths and limitations should be carefully considered in relation to learning goals, the target group and context. This study explored the advantages and disadvantages of various immersive virtual reality features in relation to different learning objectives and proposed practical strategies for enhancing learning in immersive virtual reality simulation-based training.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"59 11","pages":"1222-1234"},"PeriodicalIF":5.2,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://asmepublications.onlinelibrary.wiley.com/doi/epdf/10.1111/medu.15748","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302483","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":"Navigating the research landscape: How paradigms shape health professions education research.","authors":"Meredith Young, Lara Varpio","doi":"10.1111/medu.15752","DOIUrl":"https://doi.org/10.1111/medu.15752","url":null,"abstract":"<p><strong>Context: </strong>The rich and varied landscape of Health Profession Education (HPE) research includes many different approaches to research practice, often reflecting different research paradigms and different ontological, epistemological and axiological positions. The coexistence of different approaches to research practice and the valuing of interdisciplinary research means those conducting research in HPE must not only be able to situate their work within this landscape but also have an appreciation of similarities and differences across research practices in order to conduct or engage with interdisciplinary scholarship. To support HPE scholars and researchers in navigating the interdisciplinary HPE research landscape, we provide an overview of six paradigms used in HPE research and provide several means through which to compare and contrast their attributes.</p><p><strong>Method: </strong>Using a metaphor of mapping the HPE research landscape, we present three maps through which to examine the similarities, differences and areas of overlap across six key paradigms in HPE research. Focusing on the ontological, epistemological and axiological elements of these different paradigms, we provide an opportunity for readers to consider these paradigms concurrently.</p><p><strong>Discussion: </strong>These three means of mapping can be reflective aids for those engaging in HPE research; allowing for a nuanced consideration of ontological, epistemological and axiological position for a given research practice. Having an understanding of research practices and approaches that span multiple paradigms can help support individual scholars to situate their work within the HPE landscape and help research teams engaging in interdisciplinary research navigate important paradigmatic differences. We hope that these maps provide tools and terminology to better navigate research landscapes while recognizing that maps can never accurately reflect the full complexity, nuance and detail of the territory.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302484","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":"‘I don't know’—reclaiming not-knowing in medical transitions","authors":"Yvonne Carlsson,&nbsp;Matilda Liljedahl","doi":"10.1111/medu.15757","DOIUrl":"10.1111/medu.15757","url":null,"abstract":"&lt;p&gt;Dineen and colleagues offer an insightful exploration of how newly qualified doctors experience and respond to uncertainty during their transition to internship.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; By centring the voices of interns and drawing on the integrative uncertainty tolerance (UT) model, they provide a nuanced account of challenges encountered during this transition—not only in delivering patient care but also in navigating unfamiliar environments, unclear roles and shifting professional identities. Their findings show that uncertainty is not only about clinical ambiguity, but deeply tied to role, context and relational dynamics.&lt;/p&gt;&lt;p&gt;Although uncertainty is often understood as a psychological or cognitive challenge, Dineen et al.'s findings suggest that it can also reflect deeper cultural expectations within the medical profession—such as knowing the etiquette and unwritten rules. We would like to build on this by drawing attention to how uncertainty may not only arise from what is unknown, but also from what is unspoken: the norms, ideals and ideologies shape what it means to know, to act and to be seen as competent. When a newly qualified doctor pauses before escalating care or hesitates to order a test, their internal dialogue is rarely just about uncertainty in terms of ‘How should I act?’. More often it is: ‘Can I act? Am I allowed to act? Do I know enough to act? How would I look if I acted?’. These are not simply individual reflections; they are shaped by team dynamics, workplace culture and expectations about what competent doctors do.&lt;/p&gt;&lt;p&gt;If uncertainty is shaped by unspoken norms and professional expectations, then we must also question the frameworks we use to study it. This brings us to the UT framework itself. It might offer a helpful way to describe how people experience uncertainty. But the framework stems from psychological traditions—especially cognitive and personality research—and focuses mostly on individual traits.&lt;span&gt;&lt;sup&gt;2, 3&lt;/sup&gt;&lt;/span&gt; That makes us wonder: what might we miss when we frame uncertainty primarily as something to be ‘tolerated’? Does the language of tolerance and coping—though useful—subtly reinforce the idea that uncertainty is inherently negative, something to be endured and mitigated? For a reason, the field of health professions education has made a significant move towards acknowledging social aspects of learning that consider how uncertainty is shaped by culture, power, identity and the design of clinical work.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Taking a sociocultural perspective invites us to consider uncertainty not only as a problem to be managed, but as an integral part of the transition from student to doctor.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; From this view, while uncertainty might feel uncomfortable, it can also be an important signal that learning and development are underway. Instead of considering how to better prepare students and newly qualified doctors to tolerate uncertainty, we might ask: What","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"59 10","pages":"1024-1025"},"PeriodicalIF":5.2,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12437995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293998","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":"Lessons on applying a trauma-informed research approach in health professions education scholarship.","authors":"Helen Anne Nolan","doi":"10.1111/medu.15745","DOIUrl":"https://doi.org/10.1111/medu.15745","url":null,"abstract":"<p><strong>Background: </strong>Health professions education (HPE) research routinely explores trauma-related subjects, yet trauma impacts may remain overlooked. Trauma-informed approaches and guiding principles provide a framework for interactions with those affected by trauma and advocate for accommodation of trauma impacts to promote recovery and inclusion. My own reflections on experiences of trauma-related research in medical education led to consideration of how trauma-informed approaches may be applied in qualitative research. This paper identifies and discusses strategies that may be implemented in HPE research.</p><p><strong>Approach: </strong>The paper begins by exploring the rationale for trauma-informed approaches and how these relate to contemporary HPE research. Examples of emergent approaches from published literature in various disciplines, and how these can accommodate the needs of groups and individuals impacted by trauma and promote inclusion to enhance research outcomes, are identified and discussed. Approaches are situated in key aspects of the research process.</p><p><strong>Findings: </strong>Trauma-informed research has been recently adopted in various disciplines and may act as an effective adjunct to established ethics protocols, although no published accounts in HPE research were identified. Application of trauma-informed approaches and reflexivity in research design may pre-emptively identify trauma-related needs. Trauma-informed approaches can be applied to create safety, trust and empowerment during data collection interactions. Measures to manage participant distress are discussed. Principles for community engagement and participation and their role in in HPE research are considered, exploring how these overcome trauma impacts (e.g. by sharing power and supporting inclusion), and enhance research outputs. Implications of trauma for researcher wellbeing and research culture are also acknowledged, and trauma-informed approaches may systematically support these needs. Approaches to research dissemination should acknowledge existing oppressive structures and consider alternatives, in partnership with affected communities.</p><p><strong>Conclusions: </strong>This paper considers an emergent area of research practice, highlighting strategies that are currently under-explored and may enhance HPE research by addressing trauma impacts, and supporting stakeholder collaboration in research. Approaches may be readily implemented and adapted to the research context. Adoption of these approaches should be supported by trauma-informed research training to enhance research culture, and institutions more widely.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293999","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}