Medical Education最新文献

{"title":"Endless justification: A scoping review of team-based learning research in medical education","authors":"Jennifer Anne Cleland,&nbsp;Anita Pienkowska,&nbsp;Simon Collingwood Kitto","doi":"10.1111/medu.70041","DOIUrl":"10.1111/medu.70041","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>As team-based learning (TBL's) popularity and implementation have expanded in medical education, so too have TBL studies and accompanying research syntheses. However, earlier reviews hint that the scope of TBL research is narrow and our own observation is that it seems to lack progression. To examine this, our research question was: What is the state of TBL scholarship in medical education, and how has empirical research on TBL in medical education changed over time?</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted a scoping review of published research. On 4 April 2024, we performed a search across multiple databases (Medline, Embase, PubMed, CINAHL, Web of Science, ERIC, and Scopus). We included empirical studies published in English that reported on TBL in medical education. The studies were analysed for study characteristics, research foci and research type (description, justification and clarification).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>We identified and analysed 288 empirical studies. These primarily used quantitative descriptive methods, most commonly surveys. Research often focussed on comparing TBL to other learning approaches. Most studies examined individual characteristics, learning outcomes and/or student engagement. Descriptive studies were commonplace (33%), but the field was largely dominated by justification studies (52%). In contrast, clarification studies, those examining ‘how’ and ‘why’ TBL works, were relatively rare (15%) overall, and remained proportionally fewer over time than descriptive and justification studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>While we can safely say that TBL is just as effective as other educational approaches in terms of learning outcomes, key claims about TBL remain largely unexplored. Instead, TBL research seems to be stuck in justification rather than following a scientific line of pedagogical inquiry where one study is the foundation for the next. Critical examination of TBL is long overdue to bring greater understanding of the nature and effects of this pedagogical intervention on teaching and learning processes in different contexts.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"60 4","pages":"369-380"},"PeriodicalIF":5.2,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12956762/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145054737","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":"Enhancing orthopaedic education: Taking the operating theatre online","authors":"M. Clare Gabrielle,&nbsp;Tiam Sahraie,&nbsp;Abdrahman Yu,&nbsp;Katie Hughes","doi":"10.1111/medu.70067","DOIUrl":"10.1111/medu.70067","url":null,"abstract":"","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"60 4","pages":"465-466"},"PeriodicalIF":5.2,"publicationDate":"2026-03-03","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":"When I say autonomy","authors":"Adam Neufeld","doi":"10.1111/medu.70051","DOIUrl":"10.1111/medu.70051","url":null,"abstract":"&lt;p&gt;Autonomy is a cornerstone of medical ethics.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Equally foundational are beneficence and non-maleficence. Yet, most scholarship in medical education still centres on learners—how trainees navigate supervision and identity—while giving little attention to how clinicians support autonomy in patients. When autonomy appears in curricula, it is usually framed narrowly: if patients get the final say, autonomy is presumed intact. This overlooks situations where patients feel overwhelmed or disconnected, even when choices are offered. In self-determination theory (SDT), autonomy is not the same as decision-making power—it is the experience of acting with volition, which clinicians can support or thwart. Without concrete guidance, learners may offer choices but still fail to create environments that truly support autonomy, sometimes even undermining it in ways that quietly, but meaningfully, cause psychological harm.&lt;/p&gt;&lt;p&gt;Decades ago, Williams and Deci found that medical students with autonomy-supportive supervisors reported greater motivation and delivered higher-quality care.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; Later, they argued that modeling autonomy support was both educationally and ethically essential.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; These early SDT-informed papers showed that what learners experience affects patient outcomes but said little on how to teach clinicians to support patient autonomy. The result is a lingering conceptual muddle: autonomy is still confused with independence or reduced to informed consent.&lt;/p&gt;&lt;p&gt;Entwistle and colleagues highlighted relational autonomy, arguing that focusing on discrete ‘decision moments’ ignores the interpersonal conditions that make autonomy possible.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; Subsequent work has deepened our understanding of how training structures shape autonomy, yet a paradox endures: medicine's core ethic is respect for patient autonomy, but learners receive little instruction on what autonomy is or how to support it. Bioethical principles remain abstract ideals rather than teachable, evidence-based skills.&lt;/p&gt;&lt;p&gt;SDT is one of the most empirically supported theories of human motivation, with over four decades of research spanning across disciplines.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; It identifies three universal psychological needs—autonomy, competence, and relatedness—which, when supported, foster engagement, well-being, and internalization, and when thwarted, contribute to stress, disengagement and harm. SDT also offers validated tools, such as the Healthcare Climate Questionnaire, enabling educators to move beyond rhetoric and assess climate and communication in meaningful ways. Autonomy, in this view, is not a standalone principle but a condition of volition—one nourished by support for competence and relatedness, without which it cannot fully flourish.&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt; The SDT literature has long recognized the role of autonomy support in health care and education, including comprehensive ","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"60 4","pages":"366-368"},"PeriodicalIF":5.2,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12956755/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145149463","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":"When I say … space","authors":"Tim Mickleborough","doi":"10.1111/medu.70032","DOIUrl":"10.1111/medu.70032","url":null,"abstract":"&lt;p&gt;We often think of health care spaces as something neutral—nothing more than an empty container filled with people and objects related to our work.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; And although we exist in space, it is normally something that sits outside our consciousness—so, if space is ubiquitous and unassuming, why bother questioning it at all? What can we learn by problematising space, and how might it expand our current understandings of health professions education and practice? One way to think spatially is to reflect on our environment and ask questions about how we occupy space: Who inhabits the corner office, who works in the new wing of the hospital, who does not have a proper space to work on the ward, who works in the inner city, or who seems out of place in the surgery? The reality is that professionals do not occupy space in the same way. My own experience as a White Canadian-educated pharmacist is much different than my colleagues who trained outside of Canada. My ‘Canadianness’ firmly emplaces me as a ‘natural’ occupant of professional space, while others report how their legitimacy is always questioned and their right to occupy space must always be proven, even when they have been granted a licence to practise in Canada.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; This type of problematisation of space can be very generative in social justice projects that aim to understand how White Eurocentric dominance is structurally encoded in health care practices. It is only then that reform projects, which examine the reproduction of social inequities in health care systems, can chip away at systematic discrimination.&lt;/p&gt;&lt;p&gt;Health professions spaces are social constructions and are crucial for the enactments of power that take place within them. Foucault described space as being part of the ‘history of powers’ whose influence stretched ‘from the great strategies of geopolitics’ to the micro-spaces of the home, the classroom, and the hospital.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt;&lt;sup&gt;(p149)&lt;/sup&gt; By examining how power operates through the micro spaces of health care such as wards, clinics or pharmacies, we can uncover how space has become an important mechanism that historically serves to maintain the racial social order by emplacing White professionals as ‘rightful’ citizens while at the same time marginalising Others. Professional cultures have historically and tacitly reflected the dominant White patriarchal culture with its norms and values embedded in the ways that we train professionals&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; and also how we construct professional identities.&lt;span&gt;&lt;sup&gt;1, 4, 5&lt;/sup&gt;&lt;/span&gt; Although professional identity suggests a certain homogeneity amongst &lt;i&gt;all&lt;/i&gt; members of the group,&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; feminist and anti-racist scholars, Fellows and Razack, (re)define identity as being more aligned with &lt;i&gt;difference&lt;/i&gt; rather than sameness.&lt;span&gt;&lt;sup&gt;6&lt;/sup&gt;&lt;/span&gt; They argue that being a member of the dominant group means that one's identity goes unm","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"60 4","pages":"364-365"},"PeriodicalIF":5.2,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12956759/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145023666","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":"Empowering educators to create AI-based pedagogical apps","authors":"Minyang Chow,&nbsp;Pao Hup Lim,&nbsp;Yng Miin Loke,&nbsp;Olivia Ng","doi":"10.1111/medu.70070","DOIUrl":"10.1111/medu.70070","url":null,"abstract":"","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"60 4","pages":"467-468"},"PeriodicalIF":5.2,"publicationDate":"2026-03-03","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":"Mental health longitudinal trajectories and predictors in medical students: Latent growth mixture model analysis","authors":"Yinhai Chen,&nbsp;Xu Ran,&nbsp;Tong Zhou,&nbsp;Rong Huang,&nbsp;Lin Su,&nbsp;Xiong Ke","doi":"10.1111/medu.70047","DOIUrl":"10.1111/medu.70047","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The high-pressure environment of medical education presents significant challenges to the long-term psychological well-being of medical students. Although anxiety and depression are well-documented among medical students, few studies have explored the developmental trajectories of these symptoms over time. This study aims to explore the two-year developmental trajectories of anxiety and depression symptoms in medical students and identify key predictors of these trajectories.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This longitudinal study involved 810 medical students from a Chinese medical school, with data collected over four waves spanning two years. A total of 730 students completed the baseline survey and were included in the analysis, yielding a valid response rate of 90.1%. Participants completed the Patient Health Questionnaire-9 (PHQ-9) for depression and the Generalized Anxiety Disorder-7 (GAD-7) scale for anxiety. Latent Growth Mixture Modelling (LGMM) was used to identify the latent trajectories of depression and anxiety symptoms, with full information maximum likelihood estimation applied to handle missing follow-up data. Regression analysis was conducted to determine predictors of these trajectories.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The four waves of data for both depression and anxiety symptoms fit the model well. Depression followed two trajectories: a slowly decreasing group (92.0%) and a significantly increasing group (8.0%). Anxiety exhibited three trajectories: a low level-slow decreasing group (72.7%), a high level-significantly decreasing group (21.2%) and a low level-significantly increasing group (6.1%). Significant predictors of these trajectories included family structure, quality of relationships with parents and roommates, social support, past suicidal ideation and self-harming behaviour. Higher levels of social support were associated with decreasing symptom trajectories, whereas poor family relationships and past suicidal ideation predicted increasing symptoms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Depression and anxiety symptoms in medical students follow distinct developmental trajectories, providing a basis for targeted psychological interventions. Strengthening social support should be a priority for educational institutions and policymakers.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"60 4","pages":"418-430"},"PeriodicalIF":5.2,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145199854","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":"An exercise for education of patient involvement in biomedical research","authors":"Casper G. Schoemaker,&nbsp;Wendy Wagenaar,&nbsp;Sophie Kemper,&nbsp;Eva Vroonland","doi":"10.1111/medu.70050","DOIUrl":"10.1111/medu.70050","url":null,"abstract":"&lt;p&gt;Many early-career biomedical researchers are internally motivated to involve patients in research. Others feel external pressure from funders to do so, which may feel unfamiliar and even uncomfortable—some question how individuals without formal biomedical training could contribute meaningfully to scientific research. Across the spectrum, researchers often lack a clear understanding of what patient involvement entails at different phases of the research process. As educators on patient involvement, we struggled to address the value of involvement while researchers might still be unfamiliar, uncomfortable or hesitant. To support both the curious and the cautious, we developed an exercise to challenge researchers to explore the value of patient involvement in biomedical research.&lt;/p&gt;&lt;p&gt;We designed a 40-minute exercise inspired by a table from The Lancet series ‘Increasing Value, Reducing Waste’.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; The trainer introduces the table outlining 15 causes of research waste, grouped across five phases of research: conceptualisation, study design, research management, reporting and dissemination. Examples of the issues in the table are as follows: low-priority research questions addressed, inadequate statistical power, burdensome regulatory processes, publication bias and unclear intervention description. In this brief introduction, participants learn that up to 85% of biomedical research is considered wasteful. This alarming figure often diffuses initial scepticism or defensiveness about involving patients.&lt;/p&gt;&lt;p&gt;Participants are divided into groups of three or four and given an A3 printout of the table, along with two green and two red stickers per group. Their task is to place green stickers where they believe patient involvement could reduce research waste and red stickers where it might be less helpful.&lt;/p&gt;&lt;p&gt;Groups discuss their choices for 15 minutes, then present their reasoning in a whole-group discussion. As trainers, we emphasise that there are no right or wrong answers and avoid making evaluative comments.&lt;/p&gt;&lt;p&gt;Participants consistently place green stickers in the early phases, particularly on items related to low-priority research questions and unaddressed important outcomes. Dissemination (the final phase) also attracts green stickers. Some participants even propose adding implementation as an extra phase after dissemination, where patients could play a role. Red stickers tend to be placed on more technical and administrative challenges, such as insufficient statistical power, regulatory hurdles and publication bias. These patterns fuel rich, reflective discussions.&lt;/p&gt;&lt;p&gt;Most groups conclude that patient involvement is most feasible and valuable in the early stages of research and more challenging—but not impossible—as projects become more technical. This view aligns with published literature.&lt;/p&gt;&lt;p&gt;Participants value the hands-on, discussion-based format of the exercise. They appreciate its non-judgmental approach","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"60 4","pages":"461-462"},"PeriodicalIF":5.2,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://asmepublications.onlinelibrary.wiley.com/doi/epdf/10.1111/medu.70050","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145124768","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":"Understanding dropout intentions in medical education: The role of burnout, demands, and resources","authors":"Anke Boone,&nbsp;Jonas Steel,&nbsp;Olivia Lavreysen,&nbsp;Marie-Claire Lambrechts,&nbsp;Sofie Vandenbroeck,&nbsp;Lutgart Braeckman,&nbsp;Nele Michels,&nbsp;Dirk Devroey,&nbsp;Ann Roex,&nbsp;Hanne Kindermans,&nbsp;Lode Godderis","doi":"10.1111/medu.70086","DOIUrl":"10.1111/medu.70086","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Medical education is associated with considerable demands, often resulting in increased burnout risk and higher dropout intentions. However, longitudinal evidence on how these factors evolve and interact across different stages of training remains limited. This study examines the evolution of dropout intentions throughout medical education, identifies the learning stages most at risk, and investigates the roles of demands, resources, and burnout (i.e. emotional exhaustion and cynicism) in influencing these dropout intentions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>In a longitudinal cohort study, medical students and residents (<i>n</i> = 1.257) from five Flemish universities completed annual online surveys over three consecutive years (T0–T2). Dropout intentions were assessed as the outcome variable, with emotional exhaustion and cynicism integrated as mediators. Key demands and resources included workload, work–home conflict, meaningfulness, learning opportunities, and the learning environment. Linear Mixed-Effects Models examined changes in dropout intentions across stages, and Structural Equation Modelling tested direct and indirect pathways via emotional exhaustion and cynicism.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The results showed a progressive increase in dropout intentions, with the highest levels during residency. Workload and work–home conflict were consistently associated with emotional exhaustion and cynicism, while meaningfulness showed protective effects. Cynicism was the strongest determinant of dropout intentions among students, whereas both cynicism and emotional exhaustion were related to intentions among residents. Indirect effects indicated that workload, work–home conflict, and meaningfulness influenced dropout intentions primarily through cynicism in students, and through both burnout complaints in residents.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Dropout intentions in medical education are influenced by distinct stage-specific pathways of demands, resources, and burnout complaints. Interventions should target reducing workload and work–home conflict and enhancing meaningful tasks with academic and clinical tasks.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"60 4","pages":"442-452"},"PeriodicalIF":5.2,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145489194","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":"Breaking the silence: Revealing drivers and barriers to medical students' speaking up in medical error","authors":"Jen-Chieh Wu,&nbsp;Hung-Chen Chen,&nbsp;Enoch Yi-No Kang,&nbsp;Hung-Wei Tsai,&nbsp;Yi-Chun Chen,&nbsp;Hao-Yu Chen,&nbsp;Hui-Wen Chen,&nbsp;S. Barry Issenberg","doi":"10.1111/medu.70030","DOIUrl":"10.1111/medu.70030","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Speaking up about medical errors is a critical behaviour for medical students, as it plays a vital role in enhancing patient safety. Few studies have explored the drivers and barriers affecting their willingness to speak up in clinical training, particularly within hierarchical Asian cultures. The purpose of this study was to explore drivers and barriers shaping medical students' speaking up behaviours about medical errors to inform education, mentorship and patient safety practices.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>This qualitative study using a descriptive phenomenological approach was conducted at a teaching hospital in Northern Taiwan between October 2023 and April 2024. Sixth-year medical students, with 20 months of clinical rotations and simulated speaking-up training, were invited to participate in semi-structured interviews. The interview process was concluded after the 10th participant, as data saturation had been achieved. Data were analysed using thematic analysis to explore factors influencing students' willingness and behaviour to speak up in clinical settings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Three main themes were observed: (1) <i>predisposing features</i>, such as personal traits and prior experiences, which may influence students' speaking up behaviour; (2) <i>psychological processes</i>, highlighting the role of professional knowledge, attitudes towards clinical work and ethical and legal considerations; and (3) <i>contextual interaction</i>, emphasising the influence of patient urgency, supervisor characteristics and team atmosphere. The research team also found that the themes are interconnected and collectively influence novices' speaking-up behaviours when faced with a medical error.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Confidence and responsibility promote speaking up, but barriers such as hierarchy and fear of criticism hinder it. Although ethical and legal training is designed to promote patient advocacy, it may unintentionally prioritise self-preservation, thereby discouraging speaking-up behaviour in medical error events. These findings may prompt medical educators to re-evaluate the hidden curriculum within ethical and legal training as well as clinical rotations.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"60 4","pages":"399-409"},"PeriodicalIF":5.2,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145030071","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":"Speaking up for patient safety … and student learning","authors":"Jeffrey D. Krimmel-Morrison,&nbsp;Adelaide H. McClintock","doi":"10.1111/medu.70132","DOIUrl":"10.1111/medu.70132","url":null,"abstract":"<p>Want medical students to speak up? Build psychological safety and treat clinical reasoning as a shared, social process.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"60 4","pages":"358-360"},"PeriodicalIF":5.2,"publicationDate":"2026-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145757001","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}