Medical Education最新文献

{"title":"January in this issue","authors":"","doi":"10.1111/medu.15582","DOIUrl":"10.1111/medu.15582","url":null,"abstract":"<p>This paper offers a novel conceptual framework outlining factors that are critical for successfully establishing new medical schools in medically under-served areas and beyond. The authors note that establishing a medical school is a significant venture involving many complex and multi-faceted considerations, yet there is limited research and theory available to guide leaders and stakeholders engaged in the process. In this original research, critical realist ways of knowing are adopted, underpinned by emphasis on social accountability, to examine case study medical schools across three continents. Institutional Entrepreneurship theory is then adapted from the business domain to derive the ‘Eight C's Framework’.</p><p>\u0000 <span>Kirubakaran, S</span>, <span>Kumar, K</span>, <span>Worley, P</span>, <span>Pimlott, J</span>, <span>Greenhill, J</span>. <span>Establishing new medical schools in diverse contexts: a novel conceptual framework for success</span>. <i>Med Educ.</i> <span>2025</span>; <span>59</span>(<span>1</span>): <span>25</span>-<span>36</span>. doi:10.1111/medu.15421.</p><p>Online learning offers opportunities to expand equitable access to medical education worldwide but risks deepening digital inequalities between the global North and South. This cross-cultural dialogue examines the historical underrepresentation of the global South in designing online medical education, highlighting resulting challenges and proposing solutions. Barriers include socioeconomic disparities and systemic digital inequalities rooted in Northern dominance. The absence of Southern perspectives limits the relevance and sustainability of digital learning tools. The authors advocate for equitable partnerships that prioritize local input and expertise while balancing global standards with local needs, aiming to create more inclusive and effective online education for diverse populations.</p><p>\u0000 <span>Han, SP</span>, <span>Kumwenda, B</span>. <span>Bridging the digital divide: promoting equal access to online learning in an unequal world</span>. <i>Med Educ.</i> <span>2025</span>; <span>59</span>(<span>1</span>): <span>56</span>-<span>64</span>, doi:10.1111/medu.15455.</p><p>This article explores inclusive assessment in health professions education by integrating diverse perspectives from three countries. It highlights the importance of fostering an inclusive assessment culture for equitable education while addressing challenges such as misconceptions about lowering standards, concerns over reliability, and the vague definition of inclusion. The authors emphasize the need to recognize intersectionality in designing assessments and propose practical considerations for health professional education practitioners. These suggestions span global, national, institutional, programmatic, and individual levels, aiming to guide the development of well-contextualized, inclusive assessment practices applicable across the educational continuu","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"59 1","pages":"1"},"PeriodicalIF":4.9,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/medu.15582","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872518","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":"Social connections, social capital and social hierarchies in medicine","authors":"Caragh Brosnan,&nbsp;Sarah R. Wright","doi":"10.1111/medu.15587","DOIUrl":"10.1111/medu.15587","url":null,"abstract":"<p>Theories of social capital are used to advance understanding of different types of social connections, the hierarchical space in which they are formed in medicine, and the interdependence of social and cultural capital.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"59 3","pages":"267-269"},"PeriodicalIF":4.9,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872515","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":"Physician, know thyself: Applying brand management principles to professional identity in academic medicine.","authors":"Jeremy Branzetti, Michael A Gisondi, Laura R Hopson, Linda Regan, Simona Botti","doi":"10.1111/medu.15601","DOIUrl":"https://doi.org/10.1111/medu.15601","url":null,"abstract":"<p><strong>Context: </strong>A career in medicine is a journey of countless opportunities, challenges and choices. Determining the \"right\" decision for any given career choice ultimately must come from within; thus, a clear understanding of a physician's core professional identity is critical. Existing conceptualizations of professional identity within medicine focus primarily on medical training; however, it is clear that professional identity evolves throughout one's career. We propose the use of brand management principles as a novel means of understanding and expressing a physician's evolving professional identity throughout their career.</p><p><strong>Methods: </strong>We propose a conceptual framework for managing academic physician professional identity based upon brand management principles derived from marketing and consumer research literature. The four key framework elements include brand identity (\"Who am I?\"), brand delivery (\"What actions do I choose to present myself to others\"), brand experience (\"How are my actions experienced by others?\") and brand image (\"How do others see me?\"). Successful management of one's brand starts with understanding the core professional brand identity, then determining the best way to deliver this identity through specific actions experienced by target audiences (e.g., patients, collaborators, colleagues, employers, learners, promotion committees, etc.), and ends with the target audience having a clear and compelling brand image that reflects the underlying professional identity. Alignment of these components results in an array of benefits; misalignment can result in feelings of burnout or career stalling.</p><p><strong>Conclusions: </strong>We contend that physicians can and should see themselves as their own unique brand. Though often confused with naked self-promotion, developing a professional brand is an identity exploration and reflection experience that allows individuals to better control the course of their careers. A strong personal brand has numerous practical applications; three key examples presented herein include navigating promotion through the professoriate, managing one's reputation and achieving professional fulfilment.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872513","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":"Pedagogies of discomfort and disruption: A meta-narrative review of emotions and equity-related pedagogy.","authors":"Javeed Sukhera, Tess Atkinson, Shawn Hendrikx, Erin Kennedy, Michael Panza, Susan Rodger, Chris Watling","doi":"10.1111/medu.15603","DOIUrl":"https://doi.org/10.1111/medu.15603","url":null,"abstract":"<p><strong>Introduction: </strong>Discussions about equity in professional education can evoke a range of complex emotions. Approaches to emotionally challenging pedagogies may vary across professions. Comparative explorations of these approaches may yield fresh insights that could enhance our teaching and learning strategies within health professions education. Therefore, the authors sought to explore how the professional contexts of medicine, nursing and teacher education approach the role of emotions in equity-related pedagogy.</p><p><strong>Methods: </strong>A meta-narrative approach was utilised to synthesise existing research on the relationship between emotions and equity-related pedagogy in three different professions. Six databases were searched using key terms yielding 3102 titles. After screening, 58 articles were selected for extraction. Through coding and analysis, the authors sought to gain a deeper understanding of why emotions are relevant to equity-related pedagogy in each profession, and how each profession grapples with emotional dissonance.</p><p><strong>Results: </strong>There were both contrasting and complimentary meta-narratives about emotions and equity-related learning in medicine, nursing and teacher education. All three professions viewed emotions as relevant and essential for equity-related learning. Medicine and nursing sought to make emotions accessible and explicit, while foregrounding the need for learners to build skills to understand and address emotions such as critical reflection and dialogue. Meta-narratives in teacher education were similar to medicine and nursing; however, teacher education further emphasised the role of emotions in fostering community, trust and empathy.</p><p><strong>Discussion: </strong>Existing meta-narratives regarding emotions and equity-related pedagogy in health professions suggest that medicine and nursing have acknowledged the intrinsic role that emotions play in equity-related learning yet lag behind teacher education in considering the role of emotions as a socio-cultural connector and mediator.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872495","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":"ADAPTing to participant distress: A protocol for applied improvisation in healthcare.","authors":"Clare Whitney, Elizabeth Bojsza, Shaun Besch, Heidi Preis, Xia Zheng, Susmita Pati","doi":"10.1111/medu.15602","DOIUrl":"https://doi.org/10.1111/medu.15602","url":null,"abstract":"<p><strong>Introduction: </strong>Applied improvisation (improv) is an emerging innovative approach to clinical education and requires the cultivation of a highly engaged learning environment. With highly interactive and engaging forms of learning, it is critical to address participant distress and psychological safety in an improv learning environment in order to prevent damage to the learning capacities of individual participants as well as the group as a whole. However, little is available to guide applied improv practitioners to navigate the socially complex dynamics of participant distress during an improv session. The purpose of this project was to develop a distress protocol, tailored for improvisation-based interprofessional clinical communication training curricula, aiming to characterise, anticipate, prevent and address participant distress during sessions.</p><p><strong>Methods: </strong>Using an interpretive descriptive approach, we analysed qualitative data including previously collected interview data and primary field notes taken during improv simulations in order to develop the Addressing Distress in Applied Improvisation Participants Tool (ADAPT).</p><p><strong>Results: </strong>Analysis revealed two key distress manifestations (resistant distress and reactive distress) as well as three distress profiles (primary distress, secondary distal distress and secondary proximal distress) that may occur during an improv session. The ADAPT guides facilitators through four phases of attending to participant distress during applied improvisation sessions. These four phases include Redirecting the Spotlight, Responding to Distress, Reintegrating the Group and Reflecting on the Distress.</p><p><strong>Discussion: </strong>The ADAPT is the first of its kind as a general guide for addressing participant distress and can be customised and tailored to other applied improv curricula and experiential learning activities. Future inquiry should evaluate the utility and effectiveness of the ADAPT for responding to in situ participant distress in applied improv or other similar active learning environments.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-12-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142872490","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":"Continuity of supervision: Balancing continuous and episodic relationships for assessment and learning.","authors":"Ann Lee, Anoushka Jere, Lihani Du Plessis, Pascal W M Van Gerven, Sylvia Heeneman, Shelley Ross","doi":"10.1111/medu.15595","DOIUrl":"https://doi.org/10.1111/medu.15595","url":null,"abstract":"<p><strong>Introduction: </strong>Meaningful supervisor-resident relationships enhance feedback and learning, yet not all relationships reach this potential. While there is increasing interest in continuity of supervision (CoS) to build relationships that support feedback and promote learning, there remains a limited understanding of how relationships develop and influence assessment over time. The aim of this study was to explore how supervisors and learners in postgraduate medical education perceive CoS relationships and their impact on feedback and assessment.</p><p><strong>Methods: </strong>We used constructivist grounded theory informed by the educational alliance to develop insight into how supervisor and resident perceptions of episodic and continuous relationships impact feedback and assessment. We interviewed 22 participants, including 14 family medicine residents and eight faculty advisors. We iteratively analysed the data concurrently with data collection.</p><p><strong>Results: </strong>In episodic relationships, participants accepted superficiality for variety and diversity in feedback. In continuous relationships, we identified four sub-types. Our participants described how each of these relationships impacted their perceptions of the feedback and assessment information given or received and resulted in different steps taken in response to their perceptions: (i) Not developing-tolerate feedback and seek out additional assessors, (ii) deteriorating-avoid feedback and seek out alternative assessors, (iii) developing-value and tailor feedback and (iv) becoming a friendship-question bias in feedback and advocate for more assessors.</p><p><strong>Conclusions: </strong>Episodic and continuous relationships offered feedback and assessment value. However, deeper analysis of the continuous relationships revealed additional complexity. Understanding the nuances of CoS relationships is important for supporting successful relationships and improving feedback and assessment.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854368","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":"Integrating digital technologies into teaching embodied knowledge in the context of physical examination.","authors":"Jessica Lees, Torsten Risǿr, Linda Sweet, Margaret Bearman","doi":"10.1111/medu.15599","DOIUrl":"https://doi.org/10.1111/medu.15599","url":null,"abstract":"<p><strong>Background: </strong>There is a growing presence of digital technologies in clinical learning environments. However, there is little research into how such technologies shape embodied teaching and learning for health professional students. This study aims to explore current teaching practices in health disciplines to illuminate how digital technologies are used to facilitate the development of embodied knowledge during student learning of physical examination.</p><p><strong>Methods: </strong>A qualitative interpretive approach was undertaken, sensitised by body pedagogics as a theoretical frame. In-depth interviews with 18 clinical educators across the disciplines of medicine, physiotherapy, midwifery and nursing were held. These interviews explored their current practices for teaching physical examination. The data was analysed using reflexive thematic analysis combined with a 'thinking with theory' approach, in which the theoretical framework of body pedagogics was central to guiding the reflexive and interpretative process.</p><p><strong>Results: </strong>We interpreted a framework of five approaches where digital technologies are used to develop bodily knowledge: for sensate knowing; for modelling; for rehearsing; for guiding practice and for providing feedback information.</p><p><strong>Conclusion: </strong>Findings suggest that in current teaching practices, digital technology may be used to facilitate multiple essential elements of physical examination instruction. We conceptualised a framework that extends body pedagogics, where we recognise the multiple roles of digital technology for developing bodily knowledge in the context of physical examination.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854470","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 nature of a specialty","authors":"Jeff Myers","doi":"10.1111/medu.15593","DOIUrl":"10.1111/medu.15593","url":null,"abstract":"&lt;p&gt;An essential component of competency-based frameworks within postgraduate medical training programmes is the Clinical Competency Committee (CCC). Enabling more structured, transparent and objective approaches to assessing learner performance, the primary purpose of a CCC is to ensure that programme graduates deliver high-quality and safe patient care.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; This is accomplished through regular review and interpretation of each trainee's assessment data. Ideally this process leads to recommendations that support an individual trainee's development, outline a level of supervision the trainee requires and clarify the trainee's readiness for progression to the next stage of training or for practice.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; CCCs are comprised of programme directors, faculty members and clinician educators who review and use assessment data to make prospective entrustment decisions.&lt;/p&gt;&lt;p&gt;Aiming to theorize how these prospective entrustment decisions unfold in real-world CCC settings, Schumacher et al conducted a realist literature synthesis.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; The theoretical model that resulted was anchored by the finding that CCC decision making was rarely deliberative and most often occurred by default. Decisions about progression were found to frequently occur automatically, and when a deliberative process was utilized, it was in response to red flags having been identified.&lt;/p&gt;&lt;p&gt;To examine their theoretical model against empirical data, Schumacher et al. recently elaborated on the deliberative process undertaken by CCCs through a realist inquiry of committee structure and function among eight paediatric training programmes.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; The authors found evidence of deliberation during CCC meetings however this was not for the purpose of guiding progression decisions. Rather, deliberation occurred when focus was on the developmental needs of trainees. When making progression decisions, the authors confirmed the predominant use of defaulting. This led to the recommendation that CCCs shift to more deliberate rather than passive processes when making progression decisions. Although the importance of optimizing strategies that improve the deliberative processes of a CCC (e.g., ensuring clarity on both committee terms of reference and shared mental models among a diverse membership) is inarguable, this recommended shift may not be as straightforward.&lt;/p&gt;&lt;p&gt;An important question to consider is why certain programmes may be less likely or less able to integrate deliberative processes into progression decisions. A rarely explored variable in the implementation of competency-based education in general is the underlying nature of a specialty, that is, procedure based, non-procedure based, or relational. The nature of a specialty may have direct implications for several implementation domains, one being the deliberative processes of CCC progression decisions.&lt;/p&gt;&lt;p&gt;Procedural specialties, including surgery, anaesthe","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"59 3","pages":"264-266"},"PeriodicalIF":4.9,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/medu.15593","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818583","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":"Exploring the boundaries between clinician and teacher","authors":"Irene Alexandraki","doi":"10.1111/medu.15586","DOIUrl":"10.1111/medu.15586","url":null,"abstract":"<p>Noting that clinician teachers are vital in medical education but face challenges in balancing teaching and clinical roles, Alexandraki reflects how support, recognition, and resources are key to navigating the tension.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"59 2","pages":"136-138"},"PeriodicalIF":4.9,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813694","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":"Navigating impostorism: The role of clinical learning environments and trainees' general causality orientation.","authors":"Cesar Orsini, Adam Neufeld","doi":"10.1111/medu.15592","DOIUrl":"https://doi.org/10.1111/medu.15592","url":null,"abstract":"","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829070","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}