Medical Education最新文献

{"title":"Pragmatism: The 'easy choice' for early career medical education researchers?","authors":"Emma Claire Phillips","doi":"10.1111/medu.70218","DOIUrl":"10.1111/medu.70218","url":null,"abstract":"","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":"1166"},"PeriodicalIF":6.2,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13569130/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147593186","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":"Seeing health and social care work through the lens of 'connective professionalism': Implications for interprofessional education.","authors":"Sanne Kaas-Mason, Paula Rowland","doi":"10.1111/medu.70328","DOIUrl":"https://doi.org/10.1111/medu.70328","url":null,"abstract":"<p><strong>Background: </strong>The field of interprofessional education provides educational preparedness for collaborative work. In this cross-cutting edge paper, we argue that aligning educational offerings to diverse current and future configurations of collaborative work is both a goal and a challenge for educators. To continue to move towards this goal, we draw from recent debates in the fields of organizational studies and sociology of professions. In response to the historical focus on protective professionalism, theorists in the intersections of those two fields have begun to debate the concept of 'connective professionalism'. Analytical contribution: Connective professionalism offers a lens to view the diversity of collaborative work that occurs across the health and social care system. It challenges a static notion of professionalism, roles and boundaries and instead treats professional work as a continually negotiated accomplishment. This lively theoretical debate is happening outside of health professions education journals but is particularly relevant for the domain of interprofessional education. We argue that interprofessional education (IPE), when underpinned by an understanding of connective professionalism, could contribute to the educational production of graduates who encompass core interprofessional competencies and who can relate to and navigate social, historical, cultural and economic contexts that structure the practice settings in ongoing ways. By employing the concept of connective professionalism, we broaden the lens on what it means to work together and offer a conceptual structure for IPE educators who prepare learners for a diversity of collaborative work constellations.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-09-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075154","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":"Becoming a physician-scientist: Early research participation as an identity sandbox for preclinical medical students.","authors":"Maria Eduarda da Silva, Wieke E van der Goot, Dineke S Verbeek, Marco A de Carvalho-Filho","doi":"10.1111/medu.70324","DOIUrl":"https://doi.org/10.1111/medu.70324","url":null,"abstract":"<p><strong>Introduction: </strong>Early participation in research is a widely used strategy to encourage medical students to pursue physician-scientist careers. Yet its influence on professional identity formation (PIF) remains poorly understood. We explored how participation in an extracurricular research programme during preclinical education influenced students' emerging professional identities, aiming to inform programmes that support students' PIF as physician-scientists alongside research skill development.</p><p><strong>Method: </strong>We conducted a cross-sectional qualitative study at a Dutch medical school offering an extracurricular research programme for preclinical medical students. Twelve medical students created a Rich Picture depicting a memorable programme experience that influenced their personal and professional development and were subsequently interviewed. Rich Pictures and interview transcripts were analysed using reflexive thematic analysis, with Communities of Practice concepts incorporated iteratively to deepen interpretation.</p><p><strong>Results: </strong>We constructed three themes explaining how early research participation informed participants' emerging professional identities: (a) demystification of research: day-to-day research participation revised preconceptions of research as a practice 'reserved for a few' to one that is achievable, enjoyable and able to accommodate different interests and ambitions; (b) research as connection: responsive supervisors and inclusive teams supported belonging, recognition and confidence, whereas distant relationships and limited support contributed to marginalisation and disengagement; and (c) research as an identity sandbox: early, low-stakes participation enabled participants to explore interests, test fit, and consider whether and how research might belong within their future professional lives.</p><p><strong>Discussion: </strong>Early research experiences became identity relevant when students participated meaningfully, were supported and recognised within their teams, and could explore physician-scientist futures without premature commitment. We conceptualise this exploratory space as an identity sandbox: a provisional and revisable context for assessing whether research felt achievable, meaningful and sustainable. Programmes may support PIF through legitimate participation, relational inclusion and flexible structures that help students evaluate research as part of their future professional lives.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075245","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":"Validity in competency-based health professions education.","authors":"Benjamin Kinnear, Meredith Young, Michael S Ryan, Jean-Sébastien Renaud","doi":"10.1111/medu.70325","DOIUrl":"https://doi.org/10.1111/medu.70325","url":null,"abstract":"<p><strong>Introduction: </strong>Validity is a term that carries significant weight within health professions education (HPE), particularly with regard to learner assessment. Validity theory has changed significantly over the last century, transforming in concert with education, measurement and assessment practices. Most recently, HPE has adopted the conceptualisation of validity as an argument supporting the interpretation (and sometimes uses) of assessment data. The spread of competency-based education and programmatic assessment has introduced new tensions and opportunities for operationalising argument-based approaches to validity.</p><p><strong>Methods: </strong>The authors used a selective interpretive synthesis of the literature to explore how current argument-based validity frameworks can be extended to support the complexity of programmatic assessment and to meet the social imperative of public protection that is core to competency-based education.</p><p><strong>Results: </strong>The authors advocate that argument-based frameworks, such as those of Messick or Kane, are useful in applying validity theory to competency-based education, particularly when navigating the complexity of programmatic assessment and the increasing emphasis on consequences of assessment decisions. The authors propose three ways that can help with validity and validation in competency-based systems: argumentation theory, integration of qualitative principles in validation and evidence-centred design.</p><p><strong>Discussion: </strong>Argument-based validity conceptualisations provide flexibility to accommodate competency-based assessment systems and allow for the foregrounding of consequences of assessment decisions during validation.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149039288","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 … pseudo-haptics.","authors":"Priyamvada Tripathi, Bill Kapralos","doi":"10.1111/medu.70332","DOIUrl":"https://doi.org/10.1111/medu.70332","url":null,"abstract":"","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-09-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149062320","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":"Brittle threshold: When adaptive success is the warning sign.","authors":"Sayra M Cristancho","doi":"10.1111/medu.70322","DOIUrl":"https://doi.org/10.1111/medu.70322","url":null,"abstract":"<p><strong>Context: </strong>What happens when a system keeps working-not because it is well designed but because people keep absorbing the strain? That question stayed with me after studying a community-led vaccination clinic during the COVID-19 pandemic. It delivered hundreds of vaccinations a day, with no formal chain of command or protocols. By any measure, it was a success. What it cost to sustain that success was never examined. Across my empirical work, I kept encountering the same pattern: systems functioning because people stretched roles, coordinated through workarounds and relied on relationships that were not designed to carry the full load. These adaptations were effective. Yet they were also hiding strain.</p><p><strong>Conceptual contribution: </strong>In this paper, I introduce Brittle Threshold as a concept for attending to this condition. Rather than treating adaptive action as evidence of success, Brittle Threshold frames adaptive action as diagnostic information: evidence of how a system is coping and how close it may be operating to its limits. Drawing on resilience engineering and on empirical patterns from studies of team adaptation and community crisis response, I argue that adaptive success and vulnerability regularly coexist. The more smoothly work appears to run, the more it may depend on fragile support.</p><p><strong>Implications: </strong>Brittle Threshold offers three contributions. It translates what adaptive success conceals in health professions education, it shifts what counts as evidence of system strain and it unsettles the moralisation of endurance as professional virtue. The question it opens is not why systems fail, but when is endurance no longer enough?</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149025253","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":"Scripted success, unscripted consequences: How assessments in undergraduate medical education shape physician identity formation.","authors":"Justin Boyle, Shiphra Ginsburg","doi":"10.1111/medu.70321","DOIUrl":"https://doi.org/10.1111/medu.70321","url":null,"abstract":"<p><strong>Introduction: </strong>Professional identity formation (PIF) is increasingly understood not only as becoming a physician but as a matter of being and belonging within the profession. The development of a holistic professional identity can enhance a physician's confidence, wellbeing and performance. Assessment is a central site of the socialisation through which PIF occurs, yet how learners experience assessment when it is felt to be biassed or exclusionary, and what this means for their identity formation, is not well understood. We aimed to explore if and how medical students experience identity-related challenges, including microaggressions, through assessment and how these experiences shape their developing professional identities.</p><p><strong>Methods: </strong>We conducted a constructivist qualitative study using semi-structured interviews, analysed through reflexive thematic analysis. Medical students at a single Canadian institution who self-identified in response to an emailed invitation as having had uncomfortable, unsettling or identity-related experiences with assessment were interviewed. Interpretation was guided by identity-threat and identity-safety as sensitising concepts and by an intersectional reading of participants' accounts.</p><p><strong>Results: </strong>We interviewed 22 students (16 pre-clerkship and 6 clerkship), 18 of whom identified as members of underrepresented communities. Participants described assessment as an identity-laden encounter that could threaten belonging and shape professional identity formation. Students from underrepresented communities described experiencing microaggressions through assessment. However, even participants who did not report microaggressions described negative assessment experiences that eroded their sense of belonging. Participants also described how assessment could reinforce harmful biases with the potential to affect patient care.</p><p><strong>Discussion: </strong>Negative experiences with assessment may be a barrier to trainees' socialisation into the medical profession and can affect patient care through reinforcing harmful stereotypes. Education about microaggressions, professional development on constructing assessment and structuring feedback, access to mentors and safe spaces to debrief may help mitigate these impacts on professional identity formation.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-09-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149025215","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":"73 days?! Examining the rate at which medical knowledge doubles and its implications.","authors":"Kevin W Eva","doi":"10.1111/medu.70323","DOIUrl":"https://doi.org/10.1111/medu.70323","url":null,"abstract":"<p><strong>The issue: </strong>'Knowledge is accumulating faster than human-beings have the capacity to assimilate it'. According to popular estimate, knowledge now doubles every 73 days, roughly the lifespan of a housefly. We need, therefore, to stop thinking of health professional education in terms of transmission of knowledge. Instead, we need to focus training programmes on enabling learners to use the increasingly powerful technologies that are revolutionizing how health care is practiced. And we need to stop using assessments that seem increasingly inauthentic by virtue of precluding learners from using such technologies.</p><p><strong>Reflections: </strong>Do we? Do we really? This Medical Education Mythology paper explores the origin of the prominent claim that medical knowledge doubles every 73 days, offers an empirical assessment of its veracity and outlines several repercussions that can arise if we accept the estimate without critical appraisal. In doing so, we encourage reflection on the implications of the exponential rate at which knowledge is increasing at the same time as urging caution against panic-driven education practices. In doing so, we conclude that the lack of defensible basis for such an extreme estimate highlights the importance of continued evolution in our education and clinical practices rather than catastrophe-motivated transformation.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017284","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":"Simulation Reports Catalyse Collaboration and Drive System Learning.","authors":"Mariju Baluyot, Daniel Saadeh, Adam Payne, Lauren Falvo","doi":"10.1111/medu.70327","DOIUrl":"https://doi.org/10.1111/medu.70327","url":null,"abstract":"","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-09-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149017319","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":"Looking beyond the individual: Conceptualizing assessment validity as interdependence within teams.","authors":"Liem M Nguyen, Daniel Tawfik, Martina Del Gaudio, Aaron Kline, Stefanie S Sebok-Syer","doi":"10.1111/medu.70318","DOIUrl":"https://doi.org/10.1111/medu.70318","url":null,"abstract":"<p><strong>Validity: </strong>Over the last century, validity theory has evolved from Kelley's foundational work on educational measurement through Cronbach and Meehl's construct validation, to Messick's unified framework and, finally, Kane's argument-based approach. Throughout this evolution, one premise remained neglected: The unit of analysis is the individual. Focusing primarily on the individual is problematic, especially in Medicine where constructs like clinical competence are treated as a possession of an individual, and contextual factors such as team configurations are considered statistical nuisances. The clinical landscape has also evolved: Modern patient care is delivered by large, interprofessional teams whose collective competence provides care that no single individual could alone. The disconnect between the primacy of independent performance and the interdependent nature of healthcare delivery poses a validity threat to assessment systems that routinely attribute performance to an individual but fail to account for interdependence, teams and context.</p><p><strong>Interdependence: </strong>Growing evidence suggests that the interdependence of clinical work is not noise obscuring one's 'true' competence, but rather a fundamental part of how competence emerges and shifts over time. If competence is relationally situated, then identifying who is on a team becomes a foundational inference. Our work developing team identification approaches in inpatient settings demonstrates the difficulty of this inference, as there is often no granular and accurate record of patients' care teams available. Electronic health records and their associated metadata may provide a way forward.</p><p><strong>Future directions: </strong>The next century of validity theory must grapple with inferences about individuals embedded within teams. Medical education needs to understand that looking beyond the individual is necessary to ensure valid interpretations of one's competence. Starting with generalizability studies that incorporate team composition as a measurement facet, expanding conceptual work about relational competence, and investigating the extent to which team identification can directly measure relational competence, all position medical education to accurately measure individual competence by considering the teams that surround and contribute to the performance of individuals.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149002045","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}