Medical Education最新文献

{"title":"Situational judgement testing at different stages of undergraduate medical training and the risk of professionalism lapses: A cohort study.","authors":"Gurvinder Sahota, Paul A Tiffin, Daniel Smith, Edward Tyrrell, Mandy Hampshire, Jaspal Taggar","doi":"10.1111/medu.70020","DOIUrl":"https://doi.org/10.1111/medu.70020","url":null,"abstract":"<p><strong>Introduction: </strong>Identifying medical students at risk of professionalism lapses is critical for future patient safety. Situational Judgement Tests (SJTs) are commonly used to assess procedural knowledge of professionalism. Evidence suggests SJT scores can predict professionalism lapses, though longitudinal data across different stages of medical training are lacking. This study investigates the relationship between SJT performance at three points in pre-qualification medical education and professionalism lapses.</p><p><strong>Methods: </strong>A longitudinal study was conducted using linked data from the UK Medical Education Database (UKMED) and the University of Nottingham. Data were available for 705 students who sat a professionalism-focused SJT in their second year (2016 to 2018). Professionalism lapses were identified using concern forms. The study used scores from three SJTs administered at different stages: the University Clinical Aptitude Test (UCAT) at application; a Nottingham Medical School (NMS) test mid-training, and the UK Foundation Programme (UKFP) SJT, at the end of medical school. The relationship between SJT scores and the odds of a professionalism lapse was modelled using logistic regression.</p><p><strong>Results: </strong>Performance on the NMS SJT was statistically significantly associated with the odds of professionalism lapses (Odds Ratio [OR] 0.64, p = 0.001) even after adjusting for educational and cognitive performance (OR 0.68, p = 0.005). The UKFP SJT scores showed a univariable (0.66, p = 0.006) but not an independent relationship with the outcome (OR 0.77, p = 0.14). The UCAT SJT scores were not statistically significantly predictive of professional lapses, on univariable (OR 0.85, p = 0.34) or multivariable analysis (OR 0.92, p = 0.66).</p><p><strong>Conclusions: </strong>SJTs can support medical professionalism in students. They are likely to be most effective in this context when they are administered during training, rather than as a selection measure for entry to medical school. Moreover, SJTs designed to have specific, professionalism-focused content and a limited cognitive load are most likely to add unique value in this respect.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144960380","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 influence of narrative medicine on medical students' readiness for holistic care practice: A realist synthesis.","authors":"Chien-Da Huang, Rahma Novita Asdary, Yosika Septi Mauludina, Yufrica Huang, Lynn Monrouxe","doi":"10.1111/medu.70024","DOIUrl":"https://doi.org/10.1111/medu.70024","url":null,"abstract":"<p><strong>Background: </strong>The increasing focus on technical skills and efficiency in medical education often overshadows humanistic aspects, creating gaps in preparing clinicians for holistic patient care. Narrative Medicine, integrating storytelling and reflective practices, offers a promising approach to addressing these challenges.</p><p><strong>Objective: </strong>This study explores how Narrative Medicine interventions influence medical students' readiness for holistic care by examining the mechanisms, contexts and outcomes that underpin its effectiveness.</p><p><strong>Methods: </strong>A realist synthesis was conducted following Pawson's five-stage methodology with a two-phase search strategy across four databases and grey literature. Phase 1 (2008-2018) yielded 10 studies; Phase 2 (2018-2025) added 3, totalling 13. Studies were included if they focused on Narrative Medicine interventions, involved medical students and examined holistic care outcomes. Studies were assessed for credibility, theoretical depth and trustworthiness. Context-Mechanism-Outcome (CMO) configurations were iteratively synthesised using ATLAS.ti, ensuring rigour and consistency in accordance with RAMESES standards.</p><p><strong>Results: </strong>A total of 13 studies, predominantly from U.S. medical schools and hospitals and one from the Netherlands, involving 1158 participants, were analysed. Nine CMO configurations were identified across three contexts: Storytelling Activities, Storytelling Skills and Engaging with Stories. These contexts activated mechanisms such as Deep Observation, Reflection, and Peer Learning, which contributed to outcomes including Enhanced Holistic Patient Connection, Improved Patient Care and Enhanced Self-Perspective. Notably, Peer Learning showed a weaker linkage to these outcomes, reflecting variability in the effectiveness of Narrative Medicine interventions. Emotional resistance, including avoidance and disengagement, highlighted challenges in implementing Narrative Medicine effectively.</p><p><strong>Conclusion: </strong>Narrative Medicine enhances relational competence, empathy and reflective practice, aligning with the principles of holistic care. Addressing barriers such as emotional discomfort and variability in outcomes requires adaptable formats and supportive environments. This study underscores Narrative Medicine's transformative potential in medical education and offers actionable insights for its integration into diverse learning contexts.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144959135","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":"Designing effective clinical education spaces: A scoping review.","authors":"Megan Phelps, Pippa Yeoman, Lynn V Monrouxe","doi":"10.1111/medu.70002","DOIUrl":"https://doi.org/10.1111/medu.70002","url":null,"abstract":"<p><strong>Introduction: </strong>Clinical education in health facilities is critical for health professional student learning. However, consideration of health professional students' learning when designing and building hospitals appears to be neglected. Evidence-based health facility design may encourage student learning and add value to the investment in facilities. We ask, 'What does the literature say about the consideration of health professional students' education when designing health facilities?'</p><p><strong>Methods: </strong>We developed a scoping review protocol following Arksey and O'Malley's Guidelines. Our search strategy employed the following concepts: Health Facilities, Facility design, Health professional students, Learning and teaching and health professional education. Forty articles were identified for inclusion. Databases comprised Medline, Art and Architecture Archive, Avery Index to Architecture and Periodicals (EBSCO), CINAHL, ERIC, Scopus, Proquest Central and Web of Science.</p><p><strong>Results: </strong>Articles were published between 1963 and 2023. There was a range of publication types originating mostly from North America and the United Kingdom (UK). Only four articles describe original research. Medical students are the most reported individual student group. Links are made between principles of learning and the built environment (45% of articles). Recognised features supporting learning include floor space, various building elements and their attributes, environmental features and furniture, fittings and equipment. Evaluation is lacking, and building codes and standards are noted in only three publications.</p><p><strong>Discussion: </strong>The review reveals a scarcity of published evidence documenting how health professional student learning is considered in health facility design. While design professionals may address these needs in practice, the lack of accessible literature limits evidence-based approaches. Opportunities exist for educators and administrators to advocate for the inclusion of students and their learning needs in collaboration with colleagues from other disciplines such as architecture and design. Documenting and publishing these collaborations will strengthen the evidence base, ensuring learning is more intentionally integrated in clinical settings.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-08-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144960322","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":"A Fellow-Led Orientation to Mitigate Microaggressions in the Intensive Care Unit.","authors":"David E Rink, Rosemary Adamson, Laura Granados, Kristine L Cueva, Tyler J Albert","doi":"10.1111/medu.70014","DOIUrl":"https://doi.org/10.1111/medu.70014","url":null,"abstract":"","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144960398","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":"Visual-spatial abilities enhancement and spatial anatomy learning: A systematic review.","authors":"Lara Nokovitch, Houssein El Hajj, Sophie Deneuve, Vincent De Andrade, Rémi Gagnayre, Aurore Margat","doi":"10.1111/medu.70022","DOIUrl":"10.1111/medu.70022","url":null,"abstract":"<p><strong>Introduction: </strong>Student's visual-spatial abilities appear to be an important predictor of learning time, performance and knowledge in anatomy. The objective of this systematic review was to assess the relationship between spatial abilities enhancement and spatial learning of anatomy.</p><p><strong>Materials and methods: </strong>A systematic literature search of databases (MEDLINE, Embase, ERIC, Scopus and Web of Science) was undertaken using relevant keywords. The search included citations published from inception to December 31st, 2024. The transferability of spatial abilities enhancement to spatial learning of anatomy was assessed using a 2 × 2 classification of spatial skills, in which each visual-spatial task was coded in terms of both intrinsic-extrinsic and static-dynamic dimensions. A qualitative analysis of the results was performed.</p><p><strong>Results: </strong>The search yielded 2135 results, which narrowed down to 8 articles after application of exclusion criteria. Significant relationships between spatial abilities and the spatial learning of anatomy were observed in five studies. Among studies reporting a positive correlation between spatial abilities and spatial learning of anatomy, within-cell transfer was observed for four studies, and across-cell transfer for one study.</p><p><strong>Conclusions: </strong>Enhanced spatial abilities seem to transfer mainly to similar tasks related to spatial learning of anatomy. However, the spatial abilities tests used to evaluate spatial abilities were all intrinsic × dynamic. A future study using different spatial abilities tests could evaluate if spatial abilities engaging different dimensions of spatial cognition could be related to different spatial anatomy tasks.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-08-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144883153","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":"September in this issue","authors":"","doi":"10.1111/medu.70015","DOIUrl":"10.1111/medu.70015","url":null,"abstract":"&lt;p&gt;This ethnographic exploration focusses on the emotionally charged processes in the interprofessional educational space of the clinical learning environment. Study findings reveal how nurses strived to maintain the sentimental order on the wards, through generously gifting emotional support to students and doctors. However, workplace stresses such as time pressures and staff shortages created interprofessional tensions, generating negative emotions. The authors illuminate this largely invisible dimension of the nursing role to project emotions as directly influencing student experience and interprofessional working.&lt;/p&gt;&lt;p&gt;Gupta, S, Howden, S, Moffat, M, Pope, L, Kennedy, C. Role of nurses in moderating the emotional dynamics in the clinical learning environments: Implications for medical students' experience. &lt;i&gt;Med Educ&lt;/i&gt;. 2025;59(9):960-971. doi: 10.1111/medu.15728&lt;/p&gt;&lt;p&gt;Traditionally, guidance for workplace learning has been framed as an intraprofessional responsibility (e.g., physicians guide physicians-in-training); however, interprofessional guidance (e.g., nurses and advance practice clinicians guiding physicians-in-training) offers an insufficiently tapped resource. This constructivist interview study with medical trainees, nurses, advance practice clinicians and attending physicians suggests that guidance on interprofessional collaboration is provided, but is limited, informal, implicit and hampered by hierarchical professional boundaries. Empowering the full membership of the interprofessional healthcare team to support medical education—especially about interprofessional collaboration—is a promising opportunity strangled by socially and politically upheld professional silos.&lt;/p&gt;&lt;p&gt;Stalmeijer, R, de Grave, W, Smeenk, F, Varpio, L. Guiding Medical Trainees' Workplace Learning for Interprofessional Collaboration - Looking to Physicians or Seeing Nurses? &lt;i&gt;Med Educ&lt;/i&gt;. 2025;59(9):950-959. doi: 10.1111/medu.15617&lt;/p&gt;&lt;p&gt;Learners have the potential to drive their own learning. However, knowledge gaps remain in how best to promote agentic learning (AL). In this paper, we shed new light on how AL manifests and can be promoted through the unique theoretical lens of Transformative Agency through Double Stimulation. By designing sufficiently challenging yet well-facilitated learning experiences, learners are encouraged to ‘hold the tension’ between creatively resolving challenges and maintaining professional credibility. This process is shaped by participation in a social group and influenced by the transformation of activities within that group. Embodying change provides a deep-seated message that learners can take to their future practice.&lt;/p&gt;&lt;p&gt;Carr, D, Kajamaa, A, Gormley, G, Spence, A. ‘Overcoming and owning challenges’: A qualitative study exploring the manifestation of agency in learners. &lt;i&gt;Med Educ&lt;/i&gt;. 2025;59(9):972-982. doi: 10.1111/medu.15631&lt;/p&gt;&lt;p&gt;Successful integration of wisdom concepts into established U.S. medical competenc","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"59 9","pages":"893-894"},"PeriodicalIF":5.2,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://asmepublications.onlinelibrary.wiley.com/doi/epdf/10.1111/medu.70015","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144843742","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":"The hero's journey in medical education: Reframing imperfection as virtue.","authors":"Leonardo Y Kasputis Zanini, Gabriela C L Martins, Diego Adão","doi":"10.1111/medu.70029","DOIUrl":"https://doi.org/10.1111/medu.70029","url":null,"abstract":"","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855759","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 transformative power of a change laboratory: Experiences from an assessment re-design project in Oman.","authors":"Raghdah Al-Bualy, Sylvia Heeneman, Mads Skipper, Marjan Govaerts","doi":"10.1111/medu.70012","DOIUrl":"https://doi.org/10.1111/medu.70012","url":null,"abstract":"<p><strong>Introduction: </strong>Research on educational change consistently shows that the success of any implementation process depends on the involvement of stakeholders. The Change Laboratory (CL) is a method that involves stakeholders in co-creating their work practice. Its application in medical education has been proven to result in improvement of learning environments. The aim of this study is to explore participants' perceptions on how the use of the CL impacts their commitment to change.</p><p><strong>Methods: </strong>We conducted a qualitative study to explore participants' experiences with a CL intervention focused on redesigning a workplace-based assessment program in postgraduate medical training in Oman. Semi-structured interviews with nine participants (residents, faculty and administrators) were conducted to examine how the CL process influenced their commitment to change, focusing on learning and agency. Data collection and analysis followed an iterative process. We used a reflexive thematic analysis approach and constructed a model of how the CL intervention resulted in transformative changes at the individual, team and organization levels.</p><p><strong>Results: </strong>Participants' intrinsic motivation to actively engage in assessment re-design was driven by perceptions of a shared understanding of tensions in the assessment system and the realization that, as a group, they would be able to initiate meaningful change. Three shifts experienced by participants while progressing through the CL were identified: from individual learning to collective competence; from individual responsibility to collective agency; and, from collective agency to organizational learning, reflecting engagement in change processes beyond participants' residency training program.</p><p><strong>Conclusion: </strong>By illustrating how a CL intervention fosters transformative shifts in learning and agency, at individual, collective and organizational levels, this study extends prior work on participatory design in medical education. It provides empirical evidence that co-creation supports both personal and professional development, fostering stakeholders' competencies to collaboratively navigate and lead educational change processes.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144855760","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Widening access to medicine: A realist review.","authors":"Emma Bartle, Sandra E Carr, Rebecca Olson, Lise Mogensen, Sarah Hyde, Nicole Shepherd, Wendy Hu, Alexia Pena, Philip Roberts, Natalie Downes, Scott McCoombe, Jennifer Cleland","doi":"10.1111/medu.70017","DOIUrl":"https://doi.org/10.1111/medu.70017","url":null,"abstract":"<p><strong>Introduction: </strong>Despite policy drivers and \"on-the-ground\" activity to encourage applicants from under-represented minority groups (URMs) into medicine, their representation remains limited because of the challenge of overcoming complex societal and systemic barriers. This realist review sought to review the existing literature to identify underlying CIMOs with respect to widening access (WA) to medical school.</p><p><strong>Method: </strong>We conducted a realist literature review informed by Pawson's five iterative strategies and consistent with RAMESES standards. We searched eight electronic databases (MEDLINE, EMBASE, CINAHL Plus, PsycInfo, JBI EBP, ERIC, Scopus, Proquest Public Health) to identify studies published from 1990 to April 2023 on WA pathways into medical school. We used a realist logic of analysis to examine how the mechanisms of action (M) identified for each WA intervention (I) triggered outcomes (O) related to widening access, and thus increasing cohort diversity, in different contexts (C).</p><p><strong>Results: </strong>Thirty-two of 6300 studies identified and screened met the inclusion criteria. Most papers were from Global North countries (31/32). They reported five types of WA interventions: Minimising Bias; Modifying selection criteria; Community Collaboration; Preparing applicants for selection and studying medicine; Combining College with Medical School. Mechanisms were categorised as addressing institutional, situational, or dispositional barriers to studying medicine. Interventions were classified as addressing WA at a system-level or individual-level. There were four outcomes of interest: established widened selection pathways; an increased number of pathway applications for medical school; a change in offers for medical school, and increased cohort diversity.</p><p><strong>Conclusions: </strong>This review highlights that issues with access to medical education are still being seen as individual not systemic, with most reported WA interventions focussing predominantly on addressing situational and dispositional 'barriers' to medical education. The dominant implicit positioning of the applicant as the only aspect in the WA process in need of change reinforces the status quo.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799563","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 cultural currency of Nicholas Cage: Does it matter for teaching medicine?","authors":"Pip Garner, Stacy-Paul Wilshaw, Matthew E Hardy","doi":"10.1111/medu.15744","DOIUrl":"10.1111/medu.15744","url":null,"abstract":"<p><p>[14 August 2025]: This article was published in Early View in error. The article is under embargo and will republish in December 2025.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-08-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144804421","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}