Medical Education最新文献

{"title":"Using dialogue to teach critical consciousness: An orientation to equity for postgraduate trainees","authors":"Justin T. H. Lam,&nbsp;Victor Do,&nbsp;Ashna Asim,&nbsp;Caitlyn Hui,&nbsp;Catherine Diskin","doi":"10.1111/medu.15636","DOIUrl":"10.1111/medu.15636","url":null,"abstract":"<p>Residency and fellowship training programmes have started prioritising equity, diversity and inclusion (EDI) training for learners, with focus on increasing awareness. Awareness of EDI issues does not automatically translate into clinical practice change, including identifying and mitigating equity issues impacting care. Fostering critical consciousness supports the development of a reflective awareness of power differences and the inequities embedded in social relationships, strengthening one's commitment to social justice, anti-racism and anti-oppression in practice.</p><p>We developed and facilitated an educational session using dialogue as a pedagogical tool to foster critical consciousness in postgraduate trainees. The session was rooted in the principle of conscientisation, which involves unlearning previous assumptions and reorienting one's worldview towards social justice.</p><p>The session commenced with a clear statement of objectives: to develop an orientation towards social justice and address racism in clinical practice. Facilitators then overviewed key concepts such as anti-Black and anti-indigenous racism. Subsequently, participants shared narratives describing their experiences of racism in clinical care. Complex case examples fostered dialogue exploring equitable care and addressing racism while addressing critical tensions, including workplace pressures of efficiency and power differentials between healthcare providers and patients. Participants discussed potential practice changes.</p><p><b>Justin T.H. Lam:</b> Conceptualization; methodology; writing—original draft; writing—review and editing; supervision. <b>Victor Do:</b> Conceptualization; methodology; writing—review and editing. <b>Ashna Asim:</b> Conceptualization; methodology; writing—review and editing. <b>Caitlyn Hui:</b> Conceptualization; writing—review and editing; methodology. <b>Catherine Diskin:</b> Conceptualization; writing—review and editing; methodology; supervision.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"59 6","pages":"654-655"},"PeriodicalIF":4.9,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/medu.15636","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557230","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":"SIMLive! Scaling-up simulation for contextually rich clinical reasoning.","authors":"Leah Williams","doi":"10.1111/medu.15649","DOIUrl":"https://doi.org/10.1111/medu.15649","url":null,"abstract":"","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-03-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143557227","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":"Technology-enhanced concept mapping enhances collaborative learning","authors":"Sam Annie Jeyachristy,&nbsp;Swarupa Bhagwat","doi":"10.1111/medu.15638","DOIUrl":"10.1111/medu.15638","url":null,"abstract":"&lt;p&gt;Integrated learning activity (ILA) uses complex real-world problems to promote the learning of concepts and principles. It is adopted to integrate basic sciences with clinical problems. Medical students often face challenges in achieving meaningful and deeper learning, particularly in integrating basic sciences with the clinical problem during pre-clinical years that may hinder knowledge transfer to clinical training, potentially impacting future clinical practice.&lt;/p&gt;&lt;p&gt;Hence, the aim of the project was to determine the effectiveness of using ‘Technology-enhanced concept map (TECM)’ in collaborative learning in preclinical medical education during an integrated learning activity.&lt;/p&gt;&lt;p&gt;Action research with intervention using quasi-experimental design with a mixed method approach was utilised in the study. MBBS year 1 students (n = 150) who consented to participate in the study were recruited using a non-probability (purposive) sampling method. The study was conducted after the approval from the Universiti Kuala Lumpur Ethics Committee from August 2023 to March 2024.&lt;/p&gt;&lt;p&gt;Concept mapping, a graphical tool to represent relationships between concepts, is an active, student-centred teaching-learning strategy that promotes meaningful and deep learning and develops cognitive and affective skills among students. In this study, TECM was implemented to facilitate learning and assess the students' knowledge gained by integrating basic sciences with the clinical problem in preclinical medical education.&lt;/p&gt;&lt;p&gt;Faculty (n = 15) and students (n = 150) were trained in using software to prepare concept maps prior to the intervention. Two ILA sessions were conducted: The first followed the usual method, while the second incorporated software for collaborative concept mapping for case-based discussions. Satisfaction with using TECM in the ILA session was evaluated using the feedback obtained from the faculty and students. Feedback responses are generalised using mean score (Strongly disagree: 1.0–1.8; Disagree: 1.9–2.6; Neutral: 2.7–3.4; Agree: 3.5–4.2; Strongly agree: 4.3–5.0). Students' performance was measured using the test scores and pre-validated concept map rubrics. Paired sample t-tests were used to compare assessment scores and evaluate pre- and post-test performance differences in the ILA sessions. Statistical analysis was conducted using SPSS (v22.0).&lt;/p&gt;&lt;p&gt;Training helped faculty gain confidence in preparing (mean [M] ± SD, 4.27 ± 0.45) and assessing TECM (3.93 ± 0.59), while helping students develop skills to prepare concept maps integrating basic sciences with clinical problems (4.61 ± 0.45). Students found TECM beneficial for learning and understanding (3.59 ± 0.58) during ILA. TECM facilitated visualising and understanding complex interrelationships (3.88 ± 0.67). Learning using TECM also aligned with their preferred visual, aural, read and kinaesthetic (VARK) learning style (3.66 ± 0.89). Students' test scores significantly improved (t = 3.15","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"59 5","pages":"554-555"},"PeriodicalIF":4.9,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/medu.15638","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542541","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":"Sentiment analysis to optimise CBME narrative feedback review.","authors":"Zier Zhou, Faraz Honarvar, Arsalan P Rizwan, Andrew D Chung, Nick Rogoza, Benjamin Y M Kwan","doi":"10.1111/medu.15651","DOIUrl":"https://doi.org/10.1111/medu.15651","url":null,"abstract":"","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143542578","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":"Doing justice when incorporating sustainability into pre-medical curricula","authors":"Christian Moro,&nbsp;Michelle McLean,&nbsp;Charlotte Phelps","doi":"10.1111/medu.15653","DOIUrl":"10.1111/medu.15653","url":null,"abstract":"&lt;p&gt;There are increasing calls from students, universities and accrediting bodies to embed Planetary Health (including sustainability) in health professions education. With limited formal guidance, academics have been trialling different approaches. Crammed health professions programmes make it difficult to undertake curriculum changes. Major changes also require curriculum committee approval, which can take months, even years.&lt;/p&gt;&lt;p&gt;As a stop-gap measure that minimally increased student workload, we included a Planetary Health ‘fact’ on the bottom of a single relevant PowerPoint slide in each 2-hour lecture across a 12-week pre-medical physiology subject, with references and links to further information relating to the health impacts of a changing climate. For example, the session introducing mucosal tissue highlighted the impact of pollution on the respiratory system. Other sessions discussed sports performance and outside temperature, disease outbreaks, or the environmental footprint of healthcare. To minimise any formal subject changes, the educator read the facts during lectures, but no time was devoted to discussion or assessment. The intention was to alert students to the environmental determinants of health and hopefully motivate them to follow up on the provided links. Towards the end of the 12-week semester, students were surveyed to check whether this stop-gap approach (the weekly fact) was sufficient to pique interest. Additionally, students were asked to define Planetary Health in an open-ended question, with experts evaluating the definitions for accuracy.&lt;/p&gt;&lt;p&gt;Only 30% (9 out of the 30 responders) of pre-medical students reported following up on these facts. Despite this, there appeared to be some benefit in providing facts, as exemplified in this student comment: ‘My actions, behaviours or thoughts have not changed, but the facts have made me more conscious of the effects.’ From feedback analysis, the students' ability to provide a definition of Planetary Health, and their understanding of its core concepts, were, however, not enhanced by the sole provision of facts. To address this, the next iteration of the subject incorporated a formal introduction to Planetary Health, which included a five-minute pre-class video and a 10-minute discussion in the first lecture.&lt;/p&gt;&lt;p&gt;Based on our experiences, we offer several recommendations for academics wanting to incorporate Planetary Health information within a subject. First, include a definition of Planetary Health at the outset, highlighting the interrelationship between the health of the planet and human health.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Second, link the included content to the relevant Sustainable Development Goal (SDG). For example, by highlighting the impact of increasing global temperatures on human body performance (SDG13: Climate Action). Third, incorporate facts throughout the lectures, but refer to the Planetary Health definition and advance this concept each time a new fact is i","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"59 6","pages":"658-659"},"PeriodicalIF":4.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/medu.15653","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531301","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":"Addressing groupthink in interprofessional clinical simulation.","authors":"Colin John Greengrass, Andrew Lund Guymon, Jared Francis Hueser, Valeriy Kozmenko","doi":"10.1111/medu.15646","DOIUrl":"https://doi.org/10.1111/medu.15646","url":null,"abstract":"","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531114","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":"'Overcoming and owning challenges': A qualitative study exploring the manifestation of agency in learners.","authors":"Andrew D Spence, Davina Carr, Anu Kajamaa, Gerard J Gormley","doi":"10.1111/medu.15631","DOIUrl":"https://doi.org/10.1111/medu.15631","url":null,"abstract":"<p><strong>Introduction: </strong>Educators strive to engage learners with their learning. At the heart of this process is empowering individuals to intentionally participate in educational opportunities afforded to them i.e. agentic learning (AL). Significant knowledge gaps remain in how best to promote AL in medical education. Increasingly, simulation is being used to research pedagogical phenomena. In our study, we used simulation as a context to address the following research question: How does individuals' agency manifest in their learning, and what conditions act as enablers for its development?</p><p><strong>Methods: </strong>Twelve medical students were recruited for this qualitative study. An acute medical simulation-based exercise was used as a learning context. Following the simulations, semi-structured interviews were conducted. Recordings of interviews, and simulation pre-briefs and debriefs were transcribed and thematically analysed using template analysis, drawing upon the Transformative Agency through Double Stimulation framework - to guide our analysis.</p><p><strong>Results: </strong>We constructed six themes that capture how AL manifests and is promoted. Learners invariably encounter challenges that impede progress in their learning. Such challenges can spur learners to think and act agentially. Feedback provides a mirror for learners to gain self-knowledge, deepening their commitment to take ownership of their actions and effect change. This process is enhanced by allowing learners to enact and embody new knowledge. Upholding learners' professional credibility and harnessing the social practice of learning - provides conditions for AL to flourish.</p><p><strong>Discussion: </strong>AL in medical education helps learners shift from pretending to becoming their future professional selves. By crafting sufficient and facilitated challenges, learners are allowed to 'hold the tension' between creatively resolving challenges and upholding their professional credibility. This process is shaped by participation in a social group and can be influenced by the transformation of activities within this group. Embodying changes provides a deep-seated message that learners can carry to their future.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531233","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":"3D colour multimodality fusion imaging and preoperative augmented reality for neurosurgeons training","authors":"Xiaolin Hou,&nbsp;Ruxiang Xu,&nbsp;Dongdong Yang,&nbsp;Dingjun Li","doi":"10.1111/medu.15639","DOIUrl":"10.1111/medu.15639","url":null,"abstract":"&lt;p&gt;Neurosurgery residents face significant challenges in acquiring comprehensive surgical skills due to limited cadaveric resources and demanding clinical schedules, while anatomy textbooks and neuroimaging remain valuable references. Developing a precise three-dimensional (3D) mental representation from two-dimensional (2D) neuroimaging remains a critical hurdle, even for experienced ones. 3D multimodality fusion imaging (MFI) and augmented reality (AR) techniques have made it easier to understand the complex anatomy of the brain and shorten the learning curve. Conventional 3D-MFI, while valuable, suffers from uniform coloration, obscuring anatomical boundaries and functional subdivisions critical for surgical planning. The 3D colour brain functional partitioning MFI is a new educational tool that has emerged as a transformative resource for neurosurgeons.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt;&lt;/p&gt;&lt;p&gt;3D colour brain segmentation technique was developed and applied to 33 patients with extracerebral tumours by integrating 3D-T1-weighted MRI, diffusion tensor imaging and CT angiography, named 3D-colour-MFI.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; A neurosurgical resident, trained in software, used 3DSlicer and FreeSurfer to generate conventional 3D and colour-MFI models for all patients, enabling accurate tumour localisation, identification of peritumoural structures, and clarification of neurovascular relationships.&lt;/p&gt;&lt;p&gt;Another 15 neurosurgical residents were trained to use 3DSlicer, allowing them to manipulate 3D-MFI models. They simulated surgeries with conventional 3D and colour-MFI models, respectively, comparing to intraoperative videos to assess anatomical accuracy and procedural realism between the two modalities, and the differences were documented in questionnaires. Additionally, surgical simulation screenshots were used to discuss procedures with experienced surgeons and conduct preoperative communication with patients.&lt;/p&gt;&lt;p&gt;Neurosurgery residents who viewed the intraoperative video noted that the 3D-colour-MFI model significantly enhanced their understanding of surgical anatomy, helping them accurately identify brain structures and functions and facilitating more effective communication with patients, increasing patient trust and reducing patient anxiety. Experienced surgeons also provided positive feedback, stating that the 3D-colour-MFI model improved their ability to visualise complex anatomical structures more clearly.&lt;/p&gt;&lt;p&gt;Integrating 3D neuroimaging with intraoperative observations is crucial for residents' learning and effective contributions during procedures. 3D-colour-MFI enhances surgical understanding and prepares trainees to become proficient neurosurgeons. This pilot project integrates 3D-colour-MFI into neurosurgical education, improving lesion localisation, peritumoural tissue assessment and patient communication. Although powerful free 3D medical software such as 3DSlicer, ITK-SNAP and FreeSurfer are available, proficiency in neuroimaging and n","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"59 5","pages":"556-557"},"PeriodicalIF":4.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/medu.15639","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143523723","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":"Teaching diabetes-specific patient-centered care using fictional pop-culture characters.","authors":"Heather P Whitley","doi":"10.1111/medu.15645","DOIUrl":"https://doi.org/10.1111/medu.15645","url":null,"abstract":"","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531236","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":"Importance of the past, future and being present: Undergraduate medical students with professionalism concerns reviewed by a competence committee","authors":"Lisa Shepherd,&nbsp;John Johnson","doi":"10.1111/medu.15652","DOIUrl":"10.1111/medu.15652","url":null,"abstract":"&lt;p&gt;Identification of medical students who struggle with professionalism issues is a challenging mandate for our Undergraduate Medical Education Competence Committee (UMECC). The numbers are small, relevant data is scarce and important narrative comments may be difficult to retrieve within existing education assessment platforms. However, if students grappling with professionalism can be identified early, they may benefit from coaching, mentorship and close follow-up.&lt;/p&gt;&lt;p&gt;An in-depth assessment review was undertaken at one Canadian medical school for all students brought forward to their UMECC with professionalism issues documented during one academic year. Of the 76 students discussed over the course of the year, approximately one quarter involved professionalism concerns including attendance, missed deadlines and other issues such as communication, disrespect and plagiarism. For each of the identified students, all assessments within that academic year as well as those 1 year before and after were reviewed where possible, looking for hints of professionalism challenges that either foreshadowed or continued after their UMECC presentation.&lt;/p&gt;&lt;p&gt;This review revealed four insights that can be used to help guide our UMECC's handling of professionalism concerns going forward. First, reviewing professionalism issues with a longitudinal lens was most useful. Outside of clerkship, where the richest data was provided by multiple assessors in multiple contexts, recurrent professionalism problems were rarely found in the course where the original issue was identified; they were seen most often within other courses that preceded or followed. This aligns with the suggestion that professionalism assessment should involve a longitudinal trajectory through medical school, post-graduate training and beyond.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Second, examination scores had minimal correlation with professionalism breaches. Retrieving and reviewing exam grades for students struggling with professionalism was not productive and should be discontinued. Time spent digging deeper for narrative rather than numeric information yielded much richer results. Third, attendance issues were the best signal of future professionalism challenges. Nuanced descriptive comments such as lateness and unexcused absences were scattered throughout the narrative comments of previous courses for some students; however, these were not considered to reach a threshold significant enough to bring forward to the UMECC at the time and remained unseen. Communication to all small group facilitators and course chairs needs to be encouraged—attendance issues, no matter how seemingly trivial, should be brought onto the radar of the UMECC for correlation across time and courses. Finally, our education assessment platform needs to be optimised to allow for access and presentation of narrative data in a useful, readable way. Conducting this in-depth review required a substantial investment of time that would b","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"59 6","pages":"662-663"},"PeriodicalIF":4.9,"publicationDate":"2025-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/medu.15652","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143531232","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}