Medical Education最新文献

{"title":"Two validity conversations in a time of AI.","authors":"Phillip Dawson","doi":"10.1111/medu.70320","DOIUrl":"https://doi.org/10.1111/medu.70320","url":null,"abstract":"","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148983038","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":"'Tell me what you know': Written recall as a window into illness script quality.","authors":"Fernando Salvetti Valente, Ligia Maria Cayres Ribeiro, Andre Santanchè, Hassan Rahhal, Silvia Mamede, Pedro Tadao Hamamoto Filho, Marco Antonio de Carvalho Filho","doi":"10.1111/medu.70314","DOIUrl":"https://doi.org/10.1111/medu.70314","url":null,"abstract":"<p><strong>Introduction: </strong>Illness scripts (mental representations of disease knowledge) are central to diagnostic expertise, yet structured methods to examine their quality across medical training are lacking. This exploratory study investigated whether textual indicators derived from free-recall protocols could reveal aspects of illness script quality in medical students.</p><p><strong>Methods: </strong>In this cross-sectional study, students from years one through six at seven Brazilian medical schools completed a free-recall task for chronic obstructive pulmonary disease (COPD) and myocardial infarction (MI) after a progress test. Written responses were segmented into idea units (IUs) and analysed for accuracy (correct idea units), scope (number of disease dimensions), organisation (balanced adjusted ratio of clustering) and encapsulation (higher-order summary terms). Differences across training years were examined using Kruskal-Wallis and Dunn tests.</p><p><strong>Results: </strong>Accuracy and scope increased significantly across training years for both diseases (median correct ideas for COPD: 3 in year 1 versus 14 in year 5, p < 0.01; for MI: 8 versus 18, p < 0.01). Most gains occurred between years 1-2 and 3, with limited differentiation thereafter. Organisation increased from 0.31 in year 1 to 0.61 in year 5 for COPD and from 0.28 to 0.60 for MI (range -1 to +1; both p < 0.01). Encapsulated and incorrect ideas were infrequent at all training levels. Progress test scores correlated positively with the number of correct ideas (COPD rho = 0.56; MI rho = 0.46; p < 0.01).</p><p><strong>Conclusions: </strong>Free-recall protocols analysed along theoretically grounded dimensions detected differences in accuracy, scope and organisation across training years. Constraints, such as a time-imposed ceiling effect and limited sensitivity to encapsulated knowledge, should guide future methodological refinement. Despite its preliminary nature, this methodology may contribute to research on clinical expertise by offering a novel approach to studying illness scripts across training levels.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148983021","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":"Learning to 'Design for All': Medical students auditing the inclusiveness of health care settings for people with disabilities.","authors":"Giusy D'Alterio, Giovanni Emanuele Ricciardi, Stephany Rengifo, Arjun Sarabhai Verma, Silvia Mangili, Andrea Rebecchi, Stefano Capolongo, Carlo Signorelli, Cristina Renzi","doi":"10.1111/medu.70316","DOIUrl":"https://doi.org/10.1111/medu.70316","url":null,"abstract":"","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148990473","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":"Patient and public engagement in the CanMEDS framework: Which patients? Which publics?","authors":"Brett Schrewe, Maria Athina Martimianakis, Claudia W Ruitenberg","doi":"10.1111/medu.70306","DOIUrl":"https://doi.org/10.1111/medu.70306","url":null,"abstract":"<p><strong>Introduction: </strong>Medical education institutions increasingly employ patient and public engagement (PPE) to inform their learning activities. While this shift is highly welcome, it is equally important to consider whether and how patient and public perspectives have been incorporated in globally influential texts, such as the CanMEDS 2015 Physician Competency Framework, that govern the contexts in which these activities play out, particularly as this framework undergoes revision.</p><p><strong>Methods: </strong>We explored PPE in the creation and revision of CanMEDS, applying textual analysis to an archive that included the current framework, its drafts and revision documents, earlier iterations (e.g. CanMEDS 2005 and 2000) and ancillary texts. We specifically examined patient and public involvement on committees, in expert working groups and in consultation processes.</p><p><strong>Results: </strong>Findings indicate that despite stated desires to include 'the perspectives of the people who depend on Canadian physicians for their health care', there was minimal PPE in the 3-year revision process that led to CanMEDS 2015. Although data on patient and public perspectives were included in the original CanMEDS 2000 framework, these were imported from a provincially focused project from more than 30 years ago.</p><p><strong>Conclusion: </strong>If competency-based medical education systems wish to realise their promise of meeting societal needs, they must embrace strategies that regularly centre the perspectives of the patients and publics who comprise that society in the design and content of their foundational frameworks. To do so effectively, it may be productive for the field to untangle patient engagement from public engagement and more purposefully apply the wisdom that each of these modalities offers.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148977080","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":"Writing less, learning more.","authors":"Nurhan Abbud, Nashreen Oozeer, M M C Yaneza, John Sandars","doi":"10.1111/medu.70319","DOIUrl":"https://doi.org/10.1111/medu.70319","url":null,"abstract":"","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148969951","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":"Myths we tell ourselves about validity: A justice-oriented reckoning in medical education.","authors":"Hannah L Kakara Anderson, Neera Jain, Benjamin Kinnear, Daniel C West, Jennifer Randall","doi":"10.1111/medu.70315","DOIUrl":"https://doi.org/10.1111/medu.70315","url":null,"abstract":"<p><strong>Background: </strong>Medical education has moved beyond debating whether objectivity in assessment is achievable, acknowledging that assessment is inherently subjective. Yet the pursuit of objectivity, through standardisation, bias reduction and statistical rigour, remains a cherished goal. This paper argues that this lingering pursuit of objectivity undermines strong validity arguments and produces assessments that fail to engage meaningfully with the lived realities and possible futures of marginalised learners and patients.</p><p><strong>Theoretical framework: </strong>Drawing on justice-oriented assessment validity (JAV) frameworks and disability critical race theory (DisCrit), we examine four pervasive myths in medical education assessment: (1) Constructs are universal and stable, (2) removing bias from assessment is sufficient, (3) flexibility decreases rigour and (4) numbers are neutral. These myths allow educators to make validity arguments that ignore or explain away harm. We demonstrate how each myth, when examined from the standpoint of disabled, racially and ethnically marginalised learners, reveals itself as both inaccurate and harmful.</p><p><strong>Conclusions: </strong>We argue that validity arguments are not merely technical exercises but moral endeavours that determine whose knowledge counts and who is centred or excluded in defining competence. Rooted in the eugenic origins of educational measurement, contemporary assessment practices continue to privilege dominant group norms while systematically disadvantaging marginalised individuals and groups. A justice-oriented approach, informed by JAV and DisCrit, requires centring marginalised perspectives, embracing flexibility as essential for accurate measurement, critically examining how numbers can obscure inequities and demonstrating that assessments work for those most likely to be harmed by them.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-09-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148969989","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":"Reprioritising consultation in scoping reviews: Clarifying purposes and practices","authors":"Marco Zaccagnini,&nbsp;Lauren A. Maggio,&nbsp;Christina St-Onge,&nbsp;Tim V. Dubé","doi":"10.1111/medu.70211","DOIUrl":"10.1111/medu.70211","url":null,"abstract":"<p>The consultation stage of scoping reviews, originally proposed by Arksey and O'Malley and further developed by Levac et al and the Joanna Briggs Institute, remains a conceptually ambiguous and inconsistently applied component of knowledge synthesis. In this context, consultation refers to the planned, purposeful engagement with knowledge users to elicit input on priorities, interpretation and gaps and to inform dissemination strategies. Although consultation has been framed as a means to validate findings or inform dissemination, it is often treated as an optional or peripheral activity, if included at all. In this manuscript, we revisit the consultation stage as an integral, collaborative and methodologically embedded feature of scoping reviews, one that warrants the same reflexivity, rigour and transparency as other stages of the process. Drawing from recent critiques in the health professions education literature and our own experience conducting knowledge syntheses, we position consultation not as a standalone study or superfluous add-on but as a dialogical, contextually responsive strategy for engaging knowledge users meaningfully. We offer practical guidance on how to design and execute consultations with methodological intentionality, aligned with the scoping review's epistemological stance and research objectives. Through case examples from our work and additional strategies drawn from the literature, we highlight how consultation can enhance the credibility, usability and relevance of review findings. We also reflect on the ethical and epistemic considerations of consultation, including issues of authorship and the challenges that arise when feedback diverges from review findings. In doing so, we call for a shift in how the consultation stage is conceptualised, designed and reported in scoping reviews. Rather than viewing consultation as a symbolic or confirmatory gesture, we argue that it should be embraced as a dynamic, humanising process that deepens interpretation, challenges assumptions and expands the real-world applicability of scoping review findings.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"60 10","pages":"1084-1091"},"PeriodicalIF":6.2,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/medu.70211","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147499478","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 myth that slow test-takers are worse students: Implications for time-limited testing","authors":"Saul J. Weiner,&nbsp;Yoon Soo Park,&nbsp;Morton Ann Gernsbacher,&nbsp;Kristina H. Petersen","doi":"10.1111/medu.70215","DOIUrl":"10.1111/medu.70215","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Problem</h3>\u0000 \u0000 <p>Time-limited testing, a form of assessment in which participants have a fixed amount of time to complete an exam, remains a global standard across the medical education continuum from admissions through licensure and board certification. A wide-ranging literature, however, documents how speededness, the extent to which a test's time limit alters individual performance, poses a threat to both validity and equity. Specifically, some students require more time than allotted to complete an exam. When afforded more time, they perform as well as or better than those who complete it within the time constraints. While some students who need more time seek and obtain accommodations, many others—because of stigma or a lack of awareness that they have a disability—fall outside this group. Among those who seek accommodation, some are denied despite a diagnosed disability because they lack childhood documentation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Myth</h3>\u0000 \u0000 <p>There is a lack of sufficient research evidence that people who complete academic tests rapidly are better at making appropriate clinical decisions or acting under time pressure, such as when a patient is bleeding into a surgical field. Rather, studies show experts know when to slow down to better manage a complex situation.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications</h3>\u0000 \u0000 <p>Eliminating speededness on exams could be accomplished through power tests that functionally eliminate time pressure for virtually all test takers. At a practical level, this could be achieved by giving all examinees maximum accommodation, which is typically double time. Leveraging new technology and optimizing test design, including utilizing computerized adaptive testing, shortening stems, providing fewer response items and allowing remote proctoring, could partially off-set the added time and associated testing centre costs. Given the critical need to accurately and equitably assess performance on these gatekeeping exams, we recommend eliminating time limits expeditiously.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"60 10","pages":"1078-1083"},"PeriodicalIF":6.2,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13113617/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147574642","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 the success of undergraduate medical student research through a dual mentorship model","authors":"Long Bao Hoang,&nbsp;Siaw Cheok Liew","doi":"10.1111/medu.70209","DOIUrl":"10.1111/medu.70209","url":null,"abstract":"&lt;p&gt;Undergraduate medical students are increasingly expected to engage in research. Despite having received didactic courses in research methodology during the early years of medical school, they lack hands-on experience in conducting research and managing data, hindering their ability to independently conduct meaningful research. Traditional models of research supervision often rely on content experts who may not have sufficient expertise in study design, data management and statistical analysis.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Supervisors equally adept in both clinical practice and research methodology are scarce. This creates a mismatch between students' expectations and the support they receive when doing research.&lt;/p&gt;&lt;p&gt;Our institution implemented a 1.5-year structured research course sequence, the Scholarly Project (SP) 1 to 3 courses, for Years 4 and 5 medical students. Prior to entering SP1, students are introduced to research methodology during Years 1 to 3.&lt;/p&gt;&lt;p&gt;In SP1, students identify their clinical subject-matter (CSM) supervisor whose current research projects match students' research interests and develop their own research plan, which is then jointly reviewed by the course director (a research faculty member with expertise in research design and data analysis). In SP2, students develop their research proposal and apply for ethics approval. In SP3, they carry out data collection, analysis, develop research abstracts and presentations, and for some, draft a manuscript for publication. Throughout SP1–3, students receive continuous guidance from both CSM supervisor and course director.&lt;/p&gt;&lt;p&gt;To complete SP3, students communicate their research in a 3-Minute Thesis (3MT) format. They also submit a written reflection to highlight key learning experiences, challenges encountered and personal growth throughout their research journey in SP courses. To date, course outputs include one student conference abstract, four manuscript submissions (one published in a peer-reviewed journal) and a mean student satisfaction course score of 4.63/5, providing illustrative indicators of research competency development and course impact.&lt;/p&gt;&lt;p&gt;The effectiveness of the model was evident during the 3MT presentation. Research projects were praised for their clarity, scientific rigour and relevance. Feedback from reviewers, including senior scholars, indicated that many projects achieved standards comparable to undergraduate research outputs in established international medical programmes, although these observations were formative rather than part of a formal evaluation process. In their reflections, students expressed appreciations for the dual support, the opportunity to explore meaningful topics of interest and the deepening in understanding of research and its value. CSM supervisors reported improved clarity in project development and better student engagement in research activities.&lt;/p&gt;&lt;p&gt;The main challenge was the limited number of research faculty availabl","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"60 10","pages":"1160-1161"},"PeriodicalIF":6.2,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/medu.70209","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147486419","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":"Selecting our selection tools: Using discourse to push beyond rhetoric.","authors":"Kevin W Eva, Samantha Yudin","doi":"10.1111/medu.70313","DOIUrl":"https://doi.org/10.1111/medu.70313","url":null,"abstract":"","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":6.2,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148945249","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}