Medical Education最新文献

{"title":"Beyond the 'tick-box': Redesigning a course review process that fosters dialogue and exchange of ideas.","authors":"Louise Beckingsale, Anthony Ali, Lutz Beckert","doi":"10.1111/medu.15754","DOIUrl":"https://doi.org/10.1111/medu.15754","url":null,"abstract":"","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302481","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":"Immersive virtual reality training: Addressing challenges and unlocking potentials.","authors":"Amalie Middelboe Sohlin, Jesper Kjærgaard, Ida Madeline Hoffman, Todd P Chang, Anja Poulsen, Joy Yeonjoo Lee, Line Klingen Gjærde, Stine Lund, Lone Paulsen, Jette Led Sørensen, Gritt Overbeck","doi":"10.1111/medu.15748","DOIUrl":"https://doi.org/10.1111/medu.15748","url":null,"abstract":"<p><strong>Background: </strong>Simulation-based training has significantly improved healthcare professionals' skills and patient outcomes. Immersive virtual reality is gaining attention in this field and offers potential educational benefits. However, little is known about how key stakeholders in simulation-based training and debriefing receive a complex intervention like immersive virtual reality. This study explores the enablers, barriers and applied debriefing strategies involved in using immersive virtual reality in simulation-based training.</p><p><strong>Methods: </strong>We purposefully sampled simulation centre directors, course leaders and researchers within debriefing, simulation-based emergency training and immersive virtual reality. First, they observed and debriefed an online immersive virtual reality-based emergency training. Then, they participated in an individual semi-structured interview that was audio recorded and transcribed. We coded and analysed the data based on a reflexive thematic analysis method with a constructionist framing, guided by normalisation process theory as a theoretical lens. All co-authors informed and validated the identified themes.</p><p><strong>Results: </strong>We conducted 10 individual semi-structured interviews and generated five main themes on factors that supported or impeded the normalisation of immersive virtual reality for simulation-based training: understanding, engagement, strategies in action, appraisal and psychological safety.</p><p><strong>Discussion: </strong>Immersive virtual reality contains unique challenges and potential for simulation-based training. Its strengths and limitations should be carefully considered in relation to learning goals, the target group and context. This study explored the advantages and disadvantages of various immersive virtual reality features in relation to different learning objectives and proposed practical strategies for enhancing learning in immersive virtual reality simulation-based training.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302483","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":"Navigating the research landscape: How paradigms shape health professions education research.","authors":"Meredith Young, Lara Varpio","doi":"10.1111/medu.15752","DOIUrl":"https://doi.org/10.1111/medu.15752","url":null,"abstract":"<p><strong>Context: </strong>The rich and varied landscape of Health Profession Education (HPE) research includes many different approaches to research practice, often reflecting different research paradigms and different ontological, epistemological and axiological positions. The coexistence of different approaches to research practice and the valuing of interdisciplinary research means those conducting research in HPE must not only be able to situate their work within this landscape but also have an appreciation of similarities and differences across research practices in order to conduct or engage with interdisciplinary scholarship. To support HPE scholars and researchers in navigating the interdisciplinary HPE research landscape, we provide an overview of six paradigms used in HPE research and provide several means through which to compare and contrast their attributes.</p><p><strong>Method: </strong>Using a metaphor of mapping the HPE research landscape, we present three maps through which to examine the similarities, differences and areas of overlap across six key paradigms in HPE research. Focusing on the ontological, epistemological and axiological elements of these different paradigms, we provide an opportunity for readers to consider these paradigms concurrently.</p><p><strong>Discussion: </strong>These three means of mapping can be reflective aids for those engaging in HPE research; allowing for a nuanced consideration of ontological, epistemological and axiological position for a given research practice. Having an understanding of research practices and approaches that span multiple paradigms can help support individual scholars to situate their work within the HPE landscape and help research teams engaging in interdisciplinary research navigate important paradigmatic differences. We hope that these maps provide tools and terminology to better navigate research landscapes while recognizing that maps can never accurately reflect the full complexity, nuance and detail of the territory.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144302484","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"‘I don't know’—reclaiming not-knowing in medical transitions","authors":"Yvonne Carlsson,&nbsp;Matilda Liljedahl","doi":"10.1111/medu.15757","DOIUrl":"10.1111/medu.15757","url":null,"abstract":"&lt;p&gt;Dineen and colleagues offer an insightful exploration of how newly qualified doctors experience and respond to uncertainty during their transition to internship.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; By centring the voices of interns and drawing on the integrative uncertainty tolerance (UT) model, they provide a nuanced account of challenges encountered during this transition—not only in delivering patient care but also in navigating unfamiliar environments, unclear roles and shifting professional identities. Their findings show that uncertainty is not only about clinical ambiguity, but deeply tied to role, context and relational dynamics.&lt;/p&gt;&lt;p&gt;Although uncertainty is often understood as a psychological or cognitive challenge, Dineen et al.'s findings suggest that it can also reflect deeper cultural expectations within the medical profession—such as knowing the etiquette and unwritten rules. We would like to build on this by drawing attention to how uncertainty may not only arise from what is unknown, but also from what is unspoken: the norms, ideals and ideologies shape what it means to know, to act and to be seen as competent. When a newly qualified doctor pauses before escalating care or hesitates to order a test, their internal dialogue is rarely just about uncertainty in terms of ‘How should I act?’. More often it is: ‘Can I act? Am I allowed to act? Do I know enough to act? How would I look if I acted?’. These are not simply individual reflections; they are shaped by team dynamics, workplace culture and expectations about what competent doctors do.&lt;/p&gt;&lt;p&gt;If uncertainty is shaped by unspoken norms and professional expectations, then we must also question the frameworks we use to study it. This brings us to the UT framework itself. It might offer a helpful way to describe how people experience uncertainty. But the framework stems from psychological traditions—especially cognitive and personality research—and focuses mostly on individual traits.&lt;span&gt;&lt;sup&gt;2, 3&lt;/sup&gt;&lt;/span&gt; That makes us wonder: what might we miss when we frame uncertainty primarily as something to be ‘tolerated’? Does the language of tolerance and coping—though useful—subtly reinforce the idea that uncertainty is inherently negative, something to be endured and mitigated? For a reason, the field of health professions education has made a significant move towards acknowledging social aspects of learning that consider how uncertainty is shaped by culture, power, identity and the design of clinical work.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;Taking a sociocultural perspective invites us to consider uncertainty not only as a problem to be managed, but as an integral part of the transition from student to doctor.&lt;span&gt;&lt;sup&gt;5&lt;/sup&gt;&lt;/span&gt; From this view, while uncertainty might feel uncomfortable, it can also be an important signal that learning and development are underway. Instead of considering how to better prepare students and newly qualified doctors to tolerate uncertainty, we might ask: What","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"59 10","pages":"1024-1025"},"PeriodicalIF":5.2,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12437995/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293998","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":"Lessons on applying a trauma-informed research approach in health professions education scholarship.","authors":"Helen Anne Nolan","doi":"10.1111/medu.15745","DOIUrl":"https://doi.org/10.1111/medu.15745","url":null,"abstract":"<p><strong>Background: </strong>Health professions education (HPE) research routinely explores trauma-related subjects, yet trauma impacts may remain overlooked. Trauma-informed approaches and guiding principles provide a framework for interactions with those affected by trauma and advocate for accommodation of trauma impacts to promote recovery and inclusion. My own reflections on experiences of trauma-related research in medical education led to consideration of how trauma-informed approaches may be applied in qualitative research. This paper identifies and discusses strategies that may be implemented in HPE research.</p><p><strong>Approach: </strong>The paper begins by exploring the rationale for trauma-informed approaches and how these relate to contemporary HPE research. Examples of emergent approaches from published literature in various disciplines, and how these can accommodate the needs of groups and individuals impacted by trauma and promote inclusion to enhance research outcomes, are identified and discussed. Approaches are situated in key aspects of the research process.</p><p><strong>Findings: </strong>Trauma-informed research has been recently adopted in various disciplines and may act as an effective adjunct to established ethics protocols, although no published accounts in HPE research were identified. Application of trauma-informed approaches and reflexivity in research design may pre-emptively identify trauma-related needs. Trauma-informed approaches can be applied to create safety, trust and empowerment during data collection interactions. Measures to manage participant distress are discussed. Principles for community engagement and participation and their role in in HPE research are considered, exploring how these overcome trauma impacts (e.g. by sharing power and supporting inclusion), and enhance research outputs. Implications of trauma for researcher wellbeing and research culture are also acknowledged, and trauma-informed approaches may systematically support these needs. Approaches to research dissemination should acknowledge existing oppressive structures and consider alternatives, in partnership with affected communities.</p><p><strong>Conclusions: </strong>This paper considers an emergent area of research practice, highlighting strategies that are currently under-explored and may enhance HPE research by addressing trauma impacts, and supporting stakeholder collaboration in research. Approaches may be readily implemented and adapted to the research context. Adoption of these approaches should be supported by trauma-informed research training to enhance research culture, and institutions more widely.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-06-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144293999","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":"We should nudge clinicians and trainees to participate in health professions education programmes.","authors":"Lea Harper, Sylvain Coderre, Kirstie Lithgow, Kenna Kelly-Turner, Melinda Davis, Kevin McLaughlin","doi":"10.1111/medu.15749","DOIUrl":"https://doi.org/10.1111/medu.15749","url":null,"abstract":"<p><p>Health Professional Education (HPE) programmes, such as mentorship, are widely regarded as being advantageous to the personal and professional development of clinicians and trainees. Involvement in a mentoring relationship is associated with positive outcomes for both mentees and mentors, including improved career preparation, increased career success, higher job satisfaction and reduced risk of burnout. Despite these data, a minority of trainees report having a mentor. In this Cross-Cutting Edge article, the authors focus on an impediment to participation in HPE programmes that they feel are both highly prevalent and modifiable: habit. Taking the example of mentorship, they use dual processing as their theoretical framework and describe how we use both System 1 and System 2 processing to make decisions that, in turn, promote habitual and goal-directed actions, respectively. The authors discuss the relationship between habitual and goal-directed actions and suggest that habits can both facilitate and hinder our goals. Drawing on the clinical literature on adherence to clinical practice guidelines, they describe how habits and contextual factors can interfere with clinical goals and how manipulating the clinical environment can move behaviour in the desired direction. They then branch into behavioural economics to describe the features of a nudge (and a sludge) and review the literature on the effectiveness of this type of intervention - including potential ethical concerns around the use of nudges as behavioural interventions. Using the MINDSPACE mnemonic/framework they suggest different types of transparent and non-transparent nudges that could be used to increase participation in mentorship. Recognizing that mentorship is complex and the impact of a single nudge on behaviour may be ineffective or wane over time, the authors propose a process of ongoing programme evaluation and quality improvement that could help create and maintain a culture of mentorship and that can also be applied to other HPE programmes.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144285398","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":"Introducing the intruder paradox: “It's not the imposter syndrome, it's you don't want me in the field”","authors":"Kori A. LaDonna,&nbsp;Lindsay Cowley,&nbsp;Emily Field,&nbsp;Shiphra Ginsburg,&nbsp;Christopher Watling,&nbsp;Rachael Pack","doi":"10.1111/medu.15741","DOIUrl":"10.1111/medu.15741","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Imposter phenomenon (IP) or syndrome is typically framed as a personal problem rooted in low self-esteem or anxiety that an individual must overcome to succeed. Critics argue that this framing overlooks external forces, such as discrimination, that engender feelings of inadequacy. Since women in medicine disproportionately experience both IP and workplace harms, our purpose was to examine the link between gender-based discrimination and IP from their point of view.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Women training and practicing across Canada were invited to participate via Twitter/X. Forty consented (n = 13 Faculty Physicians; 27 Trainees). During semi-structured interviews, participants discussed their imposter experiences, including how discrimination influenced perceptions of their competence. Data were analysed using constructivist grounded theory, with constant comparative analysis employed across three coding stages.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The link between workplace discrimination and IP is complex. Some perceived no link whereas others described IP as a trauma response to repeated instances of gender-based harms. Most participants experienced discrimination, although subtle instances led some to question whether they were overreacting. Others suggested that perceptions of incompetence were externally imposed rather than internally generated. Some also wondered if they were being “gaslighted” or manipulated by others into questioning their competence. Although some participants endorsed experiencing IP, others pushed back, rejecting the imposter label altogether: “it's not the imposter syndrome, it's you don't want me in the field.” Based on participants' experiences, we developed a theoretical model called the Intruder Paradox (IPx) to nuance understanding about IP in medicine.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>We define IPx as a form of gaslighting used against those who do not fit sociocultural norms. Although it may co-exist with IP, IPx appears to be a distinct, overlooked barrier to personal well-being and professional advancement in medicine. Addressing IP and IPx, and achieving equity, depends on acknowledging the complex sociocultural factors that can trigger imposter feelings and be weaponized against intruders.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"59 10","pages":"1058-1066"},"PeriodicalIF":5.2,"publicationDate":"2025-06-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12438053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144285386","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":"Reconciling the tension between the ‘global’ and the ‘local’ in medical education","authors":"Birgit H. Fruhstorfer,&nbsp;Colin F. Macdougall","doi":"10.1111/medu.15740","DOIUrl":"10.1111/medu.15740","url":null,"abstract":"&lt;p&gt;Globalisation has clearly had an impact on how medical education is delivered. Medical schools now compete for applicants in a global space, and there is rapid flow of knowledge between distant institutions.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; In this issue of &lt;i&gt;Medical Education&lt;/i&gt;, Edwards et al.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; offer a valuable contribution to the literature by reviewing the empirical evidence on the utility of transnational medical education programmes from the perspective of graduates from such programmes. In order to do so, the authors have broadened the definition of ‘transnational education’, which traditionally refers to the provision of education on a branch campus, by also including programmes with the primary goal to prepare students for practice in countries other than the country of study. Their work highlights the challenge of matching the curriculum content to the location of practice, which raises concerns about adequate preparedness for practice. More positively, findings also indicate that learning in an international context gives students the opportunity to develop intercultural skills, which are important competencies for professional practice anywhere in the world.&lt;/p&gt;&lt;p&gt;This study prompts us to revisit strong opposing forces that are at play in decisions on educational policy and curriculum design. In this commentary, we explore this tension from the perspectives of internationalisation and social accountability, which have been the subject of debate particularly over the past decade, with the aim to illuminate how this influences the understanding of what preparation for practice should entail.&lt;/p&gt;&lt;p&gt;The primary mandate of medical schools is to equip students with the competencies that enable them to provide safe and effective healthcare. Globalisation has had considerable implications for the work of health professionals who are now expected to address the health needs of diverse populations locally but who also have the opportunity to move across the world during their professional lives. As a result, Harden&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; argued that insular models in which education considers medical practice only in relation to the local context are no longer appropriate to prepare students for medical practice in the 21st century. Instead, he argues that content of the curriculum should be ‘exemplified in the global context rather than that of a single country or locality’.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; The interconnectedness between distant communities means that there is a close relationship between local problems and global consequences, which needs considered to explain and find solutions for local health issues.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; Furthermore, graduates are expected to collaborate in multiprofessional teams to deliver healthcare to and across multicultural communities. Therefore, programmes also need to ensure that students develop attributes as a global citizen including global awareness and intercultural skills.","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"59 9","pages":"898-900"},"PeriodicalIF":5.2,"publicationDate":"2025-06-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://asmepublications.onlinelibrary.wiley.com/doi/epdf/10.1111/medu.15740","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144275317","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":"Implementing e-portfolio with Microsoft teams in preclinical medical years.","authors":"Nourhan F Wasfy, Fatma Mohamed, Mai Mahmoud, Ranya Hassan","doi":"10.1111/medu.15734","DOIUrl":"https://doi.org/10.1111/medu.15734","url":null,"abstract":"","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225879","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":"Challenging the norm: Length of exams determined by classification accuracy or reliability.","authors":"Stefan K Schauber, Matt Homer","doi":"10.1111/medu.15742","DOIUrl":"https://doi.org/10.1111/medu.15742","url":null,"abstract":"<p><strong>Purpose: </strong>This paper challenges the notion that reliability indices are appropriate for informing test length in exams in medical education, where the focus is on ensuring defensible pass-fail decisions. Instead, we argue that using classification accuracy instead better suited to the purpose of exams in these cases. We show empirically, using resampled test data from a range of undergraduate knowledge exams, that this is indeed the case. More specifically, we address the hypothesis that the use of classification accuracy results in recommending shorter test lengths as compared to when using reliability.</p><p><strong>Method: </strong>We analysed data from previous exams from both pre-clinical and clinical phases of undergraduate medical education. We used a re-sampling procedure in which both the cut-score and test length of repeatedly generated synthetic exams were varied systematically. N = 52 500 datasets were generated from the original exams. For each of these both reliability and classification accuracy indices were estimated.</p><p><strong>Result: </strong>Results indicate that only classification accuracy, not reliability, varies in relation to the cut-score for pass-fail decisions. Furthermore, reliability and classification accuracy are differently related to test length. The optimal test length for using reliability was around 100 items, independent of pass-rates. For classification accuracy, recommendations are less generic. For exams with a small percentage of failed decisions (i.e., 5% or less), an item size of 50 did, on average, achieve an accuracy of 95% correct classifications.</p><p><strong>Conclusions: </strong>We suggest a move towards the employment of classification accuracy using existing tools, whilst still using reliability as a complement. The benefits of re-thinking current test design practice include minimizing the burden of assessment on candidates and test developers. Item writers could focus on developing fewer, but higher quality, items. Finally, we stress the need to consider the effects of the balance false positive and false negative decisions in pass/fail classifications.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144225878","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}