Medical Education最新文献

{"title":"Beyond warnings: Leveraging AI disagreement as a catalyst for reflective clinical reasoning.","authors":"Yu Xiao, Yuan-Xin Guo, Liang Liu, Zhong-Rui Ma","doi":"10.1111/medu.70203","DOIUrl":"10.1111/medu.70203","url":null,"abstract":"","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":"1058-1059"},"PeriodicalIF":6.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13441208/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147390371","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":"Asynchronous learning pearls: Building a learning community.","authors":"Fa'iz Bayo-Awoyemi","doi":"10.1111/medu.70312","DOIUrl":"https://doi.org/10.1111/medu.70312","url":null,"abstract":"","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148874338","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've been here before, but never looked at the ceiling': Narratives of medical trainees who took illness-based leaves.","authors":"Daniela Keren, Martina Kelly, Lorelei Lingard, Pim Teunissen, Taryn Taylor","doi":"10.1111/medu.70302","DOIUrl":"https://doi.org/10.1111/medu.70302","url":null,"abstract":"<p><strong>Introduction: </strong>Medical training is commonly imagined as a linear, uninterrupted progression, yet many trainees experience illness that necessitates a leave of absence (LOA). Illness-based leaves may be especially fraught given stigma, opaque processes and training cultures that prioritise endurance. Little is known about how trainees experience illness and illness-based leaves.</p><p><strong>Methods: </strong>We conducted a narrative inquiry using Riessman's narrative analysis framework. Canadian physicians who had taken an illness-based LOA during medical school or residency were recruited nationwide. Semi-structured, in-depth interviews were completed between December 2022 and July 2023, audio-recorded, and transcribed verbatim. Analysis was inductive and iterative, examining narrative content and structure to understand participants' meaning-making and shifting positioning within their stories. Rigour was supported through reflexive practice, collaborative team analysis and Criteria for Reporting Qualitative Research (COREQ)-informed reporting.</p><p><strong>Results: </strong>Seven participants shared the stories of their illness-based leaves because of diverse conditions (including rheumatologic disease, malignancy, mental illness, traumatic brain injury and a movement disorder). Narratives followed common threads: (1) identity disruption, as illness fractured self-concepts built on competence and grit and shifted trainee identities from clinician to patient; (2) loss of narrative control with shifting protagonists, as administrative and service demands shaped decisions and timelines, often intensifying vulnerability; (3) isolation and perceived illegitimacy, compounded by cohort separation, stigma and the need to justify both 'visible' and 'invisible' illness; (4) misalignment between individual needs and structural expectations, marked by unclear processes, limited accommodations, and reliance on informal workarounds or external advocacy; and (5) meaning-making and purpose-greater humanism and advocacy-coexisting with residual disillusionment when systems remained unchanged.</p><p><strong>Conclusion: </strong>Illness-based leaves in medical training are narrated as profound identity disruptions, shaped by structural rigidity and cultural expectations of uninterrupted productivity. Training programmes should develop transparent, compassionate leave and accommodation processes, normalise vulnerability within professional identity formation and incorporate trainees' voices into policy to better support learners who become ill. This will retain the perspectives they bring to patient care and teaching.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-08-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840588","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":"Testing Complementarity Between Reflective Practice and Self-Reflection in Professional Identity Formation.","authors":"Victor N Oboli","doi":"10.1111/medu.70305","DOIUrl":"https://doi.org/10.1111/medu.70305","url":null,"abstract":"","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148829853","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 … faculty development.","authors":"Heather Buckley, Rola Ajjawi","doi":"10.1111/medu.70301","DOIUrl":"https://doi.org/10.1111/medu.70301","url":null,"abstract":"","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-08-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148840612","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":"Normalising vulnerability, Recognising risk: What if vulnerability is pedagogically desirable but structurally unsafe?","authors":"Beatrice Tabitha Bassier Preti","doi":"10.1111/medu.70303","DOIUrl":"10.1111/medu.70303","url":null,"abstract":"","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148819054","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 impact of role conflict on retention intentions of trainees participating in standardised residency training: A moderated mediation model.","authors":"Ruiyin Liang, Leilei Zhan, Linyi Luo","doi":"10.1111/medu.70297","DOIUrl":"https://doi.org/10.1111/medu.70297","url":null,"abstract":"<p><strong>Introduction: </strong>The standardised residency training stage involves high work demands and multiple role pressures, which may threaten the retention of residency trainees. Based on Conservation of Resources theory, either the mediating processes (resource depletion) or the moderating processes (resource compensation) may explain how role-related sources of stress influence the retention intention of residency trainees, although how these processes operate within the structural design of residency training has not been well explored.</p><p><strong>Methods: </strong>In a cross-sectional survey, 350 residents in standardised residency training at People's Hospital in China were included (response rate 94.1%). Role conflict, burnout, salary satisfaction and retention intention were surveyed. PROCESS Models 4 and 15 with bootstrap confidence intervals were used to examine the mediation and moderation effects.</p><p><strong>Results: </strong>Role conflict was negatively associated with retention intention and was indirectly associated with lower retention intention through burnout; the indirect effect accounted for 26.5% of the total effect. The negative relationship between role conflict and retention intention was stronger at higher levels when the level of salary satisfaction was higher; the negative relationship between burnout and retention intention was less strong and non-significant.</p><p><strong>Conclusion: </strong>Structural pressures and modifications in psychological resources correlate with retention intention in standardised residency training with varying patterns at different stress stages. The context-dependent resource of salary satisfaction exhibits both a buffering and a reinforcing effect in the process of stress. The results indicate that, practically, the optimisation of the role structure, reduction of burnout and enhancement of coordination between the compensation and training systems could contribute to the stable functioning of the residency training system and sustainable evolution of the medical workforce.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808811","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":"Error replication as an instructional strategy in simulation-based procedural learning.","authors":"Jacob Faurholdt, Mads Emil Jacobsen, Martin Grønnebæk Tolsgaard, Amandus Gustafsson","doi":"10.1111/medu.70290","DOIUrl":"https://doi.org/10.1111/medu.70290","url":null,"abstract":"<p><strong>Background: </strong>Errors are an inevitable part of clinical learning, yet procedural training commonly emphasises error avoidance. This study examined the effect of deliberate replication of predefined procedural errors (Error Replication; ER), compared with error avoidance training (EAT), on post-test performance, retention and transfer in surgical simulation.</p><p><strong>Methods: </strong>In this randomised controlled trial, 70 medical students with no prior simulation-based osteosynthesis experience completed a pre-test of simulated dynamic hip screw (DHS) fixation before 60 min of ER or EAT training. ER participants deliberately reproduced predefined, clinically relevant errors, whereas EAT participants used simulator feedback to improve performance and minimise errors across successive iterations. Participants then completed an immediate DHS post-test, a DHS retention test after 6-10 days and a transfer test involving antegrade femoral nailing. Transfer-test performance was the primary outcome. Secondary outcomes included performance trajectories across pre-test, post-test and retention test; completed DHS iterations; self-perceived dexterity and spatial awareness; and perceived training efficacy.</p><p><strong>Results: </strong>Complete data were available for 68 participants. Performance improved substantially over time in both groups (p < 0.001, η² _p = 0.606), with no significant group-by-time interaction (p = 0.44). Transfer scores were 52.6 (SD 24.7) for EAT and 51.0 (SD 33.9) for ER (p = 0.82; d = 0.06, 95% CI - 0.42 to 0.53). No statistically significant differences were detected in the remaining secondary outcomes.</p><p><strong>Conclusions: </strong>Participants improved following both instructional approaches, although those in the ER group spent most of the training period deliberately reproducing predefined errors. No statistically significant differences between ER and EAT were detected in post-test performance, retention or transfer. These findings suggest that structured exposure to clinically relevant procedural errors warrants further study as a distinct instructional modality.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-08-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808767","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":"Student perceptions of written, AI and coached reflection.","authors":"Raven R Piercey, Thaddeus Salmon, Matthew Bernard, Claire D Clark","doi":"10.1111/medu.70299","DOIUrl":"https://doi.org/10.1111/medu.70299","url":null,"abstract":"","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148795196","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 … essentially contested concept.","authors":"Matthew Bowker, Michael Atkinson","doi":"10.1111/medu.70291","DOIUrl":"https://doi.org/10.1111/medu.70291","url":null,"abstract":"","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148761287","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}