Medical Education最新文献

{"title":"Clarifying and expanding equity in assessment by considering three orientations: Fairness, inclusion and justice.","authors":"Hannah L Kakara Anderson, Marjan Govaerts, Layla Abdulla, Dorene F Balmer, Jamiu O Busari, Daniel C West","doi":"10.1111/medu.15534","DOIUrl":"https://doi.org/10.1111/medu.15534","url":null,"abstract":"<p><strong>Context: </strong>Despite increasing discussion and scholarship, equity in assessment is rarely defined and distinguished in a way that allows for shared understanding in medical education. This paper seeks to clarify and expand the conversation about equity in assessment by critically reviewing three distinct and evolving orientations toward equity in assessment. Orientations refers to the positions, attitudes, interests or priorities individuals can hold toward equity in assessment. The three orientations include fairness-oriented assessment, assessment for inclusion and justice-oriented assessment. While fairness-oriented assessment is a prevailing orientation in medical education, assessment for inclusion and justice-oriented assessment, originally developed in other fields of education, deserve careful consideration.</p><p><strong>Methods: </strong>In this paper, the authors explore unique underpinning assumptions of each orientation by critically examining the foundational literature of each orientation. They reflect on the unique perspectives each orientation provides, including the actions one might take and what advantages and disadvantages might result from looking at equity in assessment from any one orientation.</p><p><strong>Conclusions: </strong>Informed by this reflection, the authors propose that to more effectively advance equity in assessment in medical education, those working in the field should clearly identify their respective orientations, intentionally choose methods, tools and measures aligned with their orientations and expand their work by exploring alternative orientations.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142290782","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":"Investigating feelings of imposterism in first-year medical student narratives.","authors":"Megan E Kruskie, Richard M Frankel, J Harry Isaacson, Neil Mehta, Jessica N Byram","doi":"10.1111/medu.15533","DOIUrl":"https://doi.org/10.1111/medu.15533","url":null,"abstract":"<p><strong>Introduction: </strong>Imposter phenomenon (IP), feeling as if a person does not belong, has been reported in medical students at various rates. In medical literature, this phenomenon has often been defined as a 'syndrome', but other studies have described it as a dynamic experience that can have various impacts on different people at different time points. Although studies have linked IP with other phenomena such as burnout in residents and physicians, no studies have examined its aetiology nor how these feelings are experienced by medical students.</p><p><strong>Methods: </strong>With the use of social identity theory as a framework, the authors analysed 233 reflective essays for elements of IP across eight cohorts of medical students from two institutions. Students responded to a prompt that asked: 'What was one part of your identity that you thought you would have to change in order to become a physician?' Included reflections were analysed using the framework method.</p><p><strong>Results: </strong>Elements of IP were identified in 121 reflections (52%) and were categorised into three major themes: (1) Comparing oneself to an idealised image of a medical student, (2) Comparing oneself to an idealised image of a physician and (3) Concerns about presentation of self to others. Each theme contained two or more sub-themes. Commonly, students discussed how their own personality traits, experiences, backgrounds and identities cast doubt on their sense of belonging in medicine.</p><p><strong>Discussion: </strong>The results of this study were consistent across both institutions, suggesting that imposter feelings are common among all first-year medical students. However, the extent of the impact of these feelings on their identity formation depends on the individual lived experiences of students and the context in which these feelings arise. Encouraging reflective journaling and sharing of stories from all stages of education can normalise imposter feelings during the development of the professional identity as a physician.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142290785","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":"Beyond the bedside: A scoping review of the experiences of non‐practising health care professionals in Health Professions Education","authors":"Helen R. Church, Megan E. L. Brown, Lynelle Govender, Deborah Clark","doi":"10.1111/medu.15529","DOIUrl":"https://doi.org/10.1111/medu.15529","url":null,"abstract":"IntroductionThe shortage of educators within Health Professions Education (HPE) threatens the optimal training of the future health care workforce. Furthermore, without recruitment of diverse and skilled faculty, targets to expand the workforce will not be possible. Non‐practising health care professionals offer extensive knowledge and qualifications within health care, without the competing clinical commitments of their clinical academic colleagues, and therefore are ideally positioned to support education and training initiatives. However, the limited available evidence suggests that these individuals face significant challenges transitioning from clinical to academic roles. The purpose of this scoping review is to address the research question ‘What is known about the career experiences of non‐practicing healthcare professionals (defined as individuals with clinical backgrounds who no longer engage in direct patient care) across various professions and internationally, within the field of health professions education?’. To do so, we aim to map the global experiences of non‐practising health care professionals from different specialties and disciplines transitioning to HPE, with a view to both current support strategies that aim to recruit and retain these individuals and fuel future research in this area.MethodsFollowing Arksey and O'Malley's scoping review guidelines, a research question was formulated focussing on exploring the career experiences of non‐practising health care professionals now working in HPE. Searching seven literature databases and grey literature identified 51 articles for analysis. Both quantitative and qualitative methods were utilised to chart and thematically analyse data to identify key themes.ResultsThere has been a rise in publications on this topic, with most studies originating from the United States and focusing on nursing. Transition to academia is marked by significant challenges, including identity shifts, renumeration and professional progression tensions, licencing issues and financial concerns. Support systems are crucial to navigating new roles alongside personal/professional development but often lacking.DiscussionThis scoping review highlights challenges and opportunities for non‐practising health care professionals in HPE. Additional support for making the transition to education, including structured onboarding processes and long‐term mentoring relationships, would be beneficial. Recognising the liminal space these professionals occupy might also facilitate more effective integration into academic roles, contributing to a more dynamic and inclusive HPE environment. Future research should explore these experiences from broader professional and geographical perspectives and employ an intersectional approach to fully understand and support this growing demographic in our field.","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"33 1","pages":""},"PeriodicalIF":6.0,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142266424","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, around and within cultural differences and dialogues across the open access ecosystem","authors":"Lucía Céspedes, Lauren A. Maggio","doi":"10.1111/medu.15527","DOIUrl":"https://doi.org/10.1111/medu.15527","url":null,"abstract":"","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"7 1","pages":""},"PeriodicalIF":6.0,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142216813","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":"Inclusive assessment in health professions education: Balancing global goals and local contexts","authors":"Gabrielle M. Finn, Joanna Tai, Vishna Devi Nadarajah","doi":"10.1111/medu.15535","DOIUrl":"https://doi.org/10.1111/medu.15535","url":null,"abstract":"ContextIn this article, we draw upon diverse and contextually different experiences of working on inclusive assessment, with the aim of bridging and enhancing practices of inclusive assessments for health professions education (HPE) within universities. Instead of juxtaposing our views from three countries, we combine our perspectives to advocate for inclusive assessment.DiscussionCreating an inclusive assessment culture is important for equitable education, even if priorities for inclusion might differ between contexts. We recognise challenges in the enactment of inclusive assessment, namely, the notion of lowering standards, harming reliability and robustness of assessment design and inclusion as a poorly defined and catchall term. Importantly, the lack of awareness that inclusion means recognising intersectionality is a barrier for well‐designed inclusive assessments. This is why we offer considerations for HPE practitioners that can guide towards a unified direction of travel for inclusive assessments. This article highlights the importance of contextual prioritisation and initiatives to be considered at the global level to national, institutional, programme and the individual level. Utilising experience and literature from undergraduate, higher education contexts, we offer considerations with applicability across the assessment continuum.ContextIn this state of science paper, we were set the challenge of providing cross‐cultural viewpoints on inclusive assessment. In this discursive article, we focus on inclusive assessment within undergraduate health professions education whilst looking to the wider higher education literature, since institutional policies and procedures frequently drive assessment decisions and influence the environment in which they occur. We explore our experiences of working in inclusive assessment, with the aim of bridging and enhancing practices of inclusive assessments for HPE. Unlike other articles that juxtapose views, we all come from the perspective of supporting inclusive assessment.We begin with a discussion on what inclusive assessment is and then describe our contexts as a basis for understanding differences and broadening conversations. We work in the United Kingdom, Australia and Malaysia, having undertaken research, facilitated workshops and seminars on inclusive assessment nationally and internationally. We recognise our perspectives will differ as a consequence of our global context, institutional culture, individual characteristics and educational experiences. (&lt;jats:italic&gt;Note that individual characteristics are also known as protected characteristics in some countries&lt;/jats:italic&gt;).Then, we outline challenges and opportunities associated with inclusive assessment, drawing on evidence within our contexts, acknowledging that our understanding of inclusive assessment research is limited to publications in English and currently tilted to publications from the Global North. In the final section, we then ","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"80 1","pages":""},"PeriodicalIF":6.0,"publicationDate":"2024-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142216812","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":"‘In their shoes now’—immersive video gameplay and design thinking for building grief literacy","authors":"Ki Sum Samson Wong","doi":"10.1111/medu.15506","DOIUrl":"10.1111/medu.15506","url":null,"abstract":"&lt;p&gt;Despite significant progress in palliative care education, ‘paediatric palliative care’ remains infrequently addressed across undergraduate medical curricula worldwide. As a result, medical graduates reported feeling unprepared to engage in difficult conversations with parents of paediatric cancer patients. Anticipatory grief (AG), referring to the emotional upheaval that families face upon realising impending, irrevocable death of their loved ones, are particularly daunting to family caregivers of terminally ill children. Most recently, ‘grief literacy’ has been increasingly recognised globally as a new competence referring to healthcare practitioners' responsiveness in identifying signs of grief and in supporting bereaved families. In this connection, I embedded a novel grief literacy training into a medical humanities curriculum.&lt;/p&gt;&lt;p&gt;&lt;i&gt;‘That Dragon, Cancer’(2016)&lt;/i&gt; is an award-winning, point-and-click, immersive video game created by two bereaved parents Ryan and Amy Green in real life, using visual metaphors, autobiographical voice-over, archival recordings to vividly re-tell their lived experience of losing their 5-year-old son to Atypical Teratoid Rhabdoid Tumor (AT/RT), a horribly aggressive brain cancer. Vignettes from this game have been appraised by medical journals such as JAMA for ringing true to complexities of families' emotions in clinical realities. Although nothing replaces true-life clinical exposure and role modelling in shaping students' professional attitudes and moral values, I sought to harness the potential of this novel modality for enhancing medical students' grief literacy of anticipatory grief in end-of-life care, by pairing the immersive experience with a tool adapted from design thinking.&lt;/p&gt;&lt;p&gt;In 2022–2024, 51 year-2 MBBS students participated in our 2.5-hour face-to-face workshop comprising a mini-lecture introducing AG in end-of-life settings, followed by a 50-minute, five-part, in-class immersive experience for students to synchronously walk through our carefully selected vignettes from ‘That Dragon, Cancer’. I focused on two critical junctures, namely (i) ‘relocation to hospice’ and (ii) ‘cessation of eating and drinking’, turning points in caring for a terminally ill where literature showed family caregivers would experience the most intense psychological pain. My pedagogical decision for students to collectively go through the immersive video game, as a group and in the same classroom, was informed by Mitchell et al.'s&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; experimental studies which found that collectively attending to others' narratives of pain in virtual contexts could promote cohesion and interpersonal closeness among participants through perceived emotional synchrony. Debriefing approach was guided by the P.O.E.M.S. observation framework (‘People, Objects, Environments, Messages, Services’) from design thinking. Akin to how product designers made use of P.O.E.M.S. for understanding ‘pain points’ of product user","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"58 11","pages":"1420-1421"},"PeriodicalIF":4.9,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/medu.15506","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142216838","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":"Whose voices are heard in health professions education validity arguments?","authors":"Georgina C. Stephens,&nbsp;Gabrielle Brand,&nbsp;Sharon Yahalom","doi":"10.1111/medu.15528","DOIUrl":"10.1111/medu.15528","url":null,"abstract":"&lt;p&gt;The construction of validity arguments for assessments in health professions education (HPE) has been likened to a lawyer preparing for and presenting a case.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Like a lawyer curates a brief of evidence with the aim of convincing a judge or jury to make a particular decision about their client, so are health professions educators required to provide validity evidence that supports a defensible decision about a student being assessed.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; Kane's argument-based validity framework,&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; now expanded by scholars in language testing and assessment (LTA), addresses challenges of prior conceptualisations of validity by providing a staged approach to building a validation argument according to ‘inferences’. Whereas Kane's original four inference model commences with scoring,&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; the expanded seven inference model as described in this issue by Dai et al.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; in LTA commences with a domain description.&lt;/p&gt;&lt;p&gt;The goal of the domain description is to ensure that the ‘selection, design and delivery of the test tasks takes the relevant target domain into account’.&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; Described sources of backing for this inference include interviews or surveys of domain insiders. Starting with a domain description should provide a solid foundation for subsequent inferences made about the assessment but also begs the question of who are considered domain insiders. And whether insights from diverse groups with insider perspectives can together build a more robust and nuanced validity argument. Returning to the analogy of the lawyer's decision-making processes, there may be multiple witnesses with evidence to share, but which witnesses are called upon to provide evidence in court? Or alternatively, which witnesses are not selected out of concern that their differing perspectives may threaten the lawyer's plan for the case?&lt;/p&gt;&lt;p&gt;Domain insiders could be considered ‘expert witnesses’, that is, those with subject matter expertise typically built through education and professional experience, such as health professions educators with clinical and/or pedagogical expertise. While subject matter expertise is important to understanding whether assessment tasks sufficiently reflect the domain being assessed, potential differences between expert and novice (i.e., student) understandings of a domain could disrupt a validity argument. Consider assessments of uncertainty tolerance (UT): Commonly used UT scales intended to measure UT in healthcare contexts engaged expertise during scale development in the form of interviews with health professionals, reviews of construct literature and consultation with medical educator peers.&lt;span&gt;&lt;sup&gt;4&lt;/sup&gt;&lt;/span&gt; One UT scale has been used by the Association of American Medical Colleges as part of routine matriculation and graduation surveys of medical students, with the intent that the results inform medical school programma","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"58 12","pages":"1429-1432"},"PeriodicalIF":4.9,"publicationDate":"2024-09-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/medu.15528","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142216837","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":"October In This Issue","authors":"","doi":"10.1111/medu.15493","DOIUrl":"https://doi.org/10.1111/medu.15493","url":null,"abstract":"&lt;p&gt;In this article, Danquah explores the hidden impact of ethnicity categorisation in healthcare. He acknowledges the argument that data support justice through highlighting inequalities. However, he also discusses evidence that such efforts may be hampered by the data being not only ‘dodgy’, but also dehumanising. Danquah uses lived experience of filling in ethnicity data surveys as a person of ‘mixed’ heritage, arguing that it is the mixed category that most readily highlights the deficiencies in this approach. He goes on to discuss the tensions between mitigating the damage and dispensing with ethnicity categorisation altogether, before sharing ways to rehumanise the data and conceive of ourselves and those we serve more fully.&lt;/p&gt;&lt;p&gt;\u0000 &lt;span&gt;Danquah, A.&lt;/span&gt; &lt;span&gt;Pigeonholes and Johari Windows: Rehumanising Ethnicity Categorisation in Healthcare&lt;/span&gt;. &lt;i&gt;Med Educ.&lt;/i&gt; &lt;span&gt;2024&lt;/span&gt;; &lt;span&gt;58&lt;/span&gt;(&lt;span&gt;10&lt;/span&gt;): &lt;span&gt;1178&lt;/span&gt;-&lt;span&gt;1184&lt;/span&gt;. 10.1111/medu.15395.&lt;/p&gt;&lt;p&gt;Cleland and colleagues scrutinise how six new UK medical schools translated government policy on widening participation (WP) to medicine, to increase the diversity of medical students, into practice. Via semi-structured interviews with Deans and Admissions staff, they found similarities and differences across the six schools. For example, some schools found themselves increasingly subjected to local and extra-local rule systems. There were also tensions between the new medical schools and the medical education “establishment”. They concluded that different contexts seem to influence the enactment of WP to medicine even in medical schools established at the same time.&lt;/p&gt;&lt;p&gt;\u0000 &lt;span&gt;Cleland, J&lt;/span&gt;, &lt;span&gt;Buxton, J&lt;/span&gt;, &lt;span&gt;Hughes, L&lt;/span&gt;, &lt;span&gt;Patterson, F&lt;/span&gt;. &lt;span&gt;Translating government policy into practice: How new UK medical schools enact widening participation&lt;/span&gt;. &lt;i&gt;Med Educ.&lt;/i&gt; &lt;span&gt;2024&lt;/span&gt;; &lt;span&gt;58&lt;/span&gt;(&lt;span&gt;10&lt;/span&gt;): &lt;span&gt;1247&lt;/span&gt;-&lt;span&gt;1256&lt;/span&gt;. 10.1111/medu.15403.&lt;/p&gt;&lt;p&gt;This paper describes the experiences of female medical students and doctors in the clinical workplace in a Scottish hospital. The socio-cultural dynamics in the selected wards are revealed through an ethnographic exploration involving observations and interviews. The authors use Bourdieu's theory, with its core concepts of field, capital, and habitus to interpret the participants' experiences and perspectives. Despite constituting the majority demographic of medical school, female students and doctors struggle to gain capital, and the differential experiences contribute to transforming their habitus. Their role-models, however, contributed to building confidence and self-efficacy, which proved valuable in navigating the gendered social order.&lt;/p&gt;&lt;p&gt;\u0000 &lt;span&gt;Gupta, S&lt;/span&gt;, &lt;span&gt;Howden, S&lt;/span&gt;, &lt;span&gt;Moffat, M&lt;/span&gt;, &lt;span&gt;Pope, L&lt;/span&gt;, &lt;span&gt;Kennedy, C&lt;/span&gt;. &lt;span&gt;Girls in Scrubs: An ethnogra","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"58 10","pages":"1137"},"PeriodicalIF":4.9,"publicationDate":"2024-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/medu.15493","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142170081","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":"A realist evaluation of prospective entrustment decisions in paediatric residency clinical competency committees.","authors":"Daniel J Schumacher, Abigail Martini, Catherine Michelson, David A Turner, Ariel S Winn, Benjamin Kinnear","doi":"10.1111/medu.15530","DOIUrl":"https://doi.org/10.1111/medu.15530","url":null,"abstract":"<p><strong>Purpose: </strong>Making entrustment decisions (granting more responsibility, advancement and graduation) are important actions in medical training that pose risks to trainees and patients if not done well. A previous realist synthesis of the existing literature revealed that clinical competency committees (CCCs) do not typically make deliberate entrustment decisions, instead defaulting to the promotion and graduation of trainees in the absence of red flags. This study sought further understanding of these areas through empirical data.</p><p><strong>Methods: </strong>The authors conducted a realist inquiry to better understand how CCC prospective entrustment decision-making is carried out in paediatric residency programs. They conducted four CCC meeting observations and 18 interviews with CCC members at eight sites in an effort to confirm, disconfirm, and elaborate an existing theory that was based on a literature synthesis.</p><p><strong>Results: </strong>The literature-based theory held up well against the empiric data collected in this study. Therefore, the authors did not modify that theory and instead developed three new demi-regularities (recurring patterns in data when conducting realist work) that add detail and nuance to their previous understanding of this model. These new demi-regularities focus on (i) expounding on how deliberate actions of CCCs focus more on resident development than on resident entrustment; (ii) elucidating that effortful work is not only about reconciling a paucity of data or incongruent data but also working hard to 'do the right thing' for residents; and (iii) describing how programs consider bias, equity and fairness, with a wide range of intentionality from being reactive to being proactive.</p><p><strong>Conclusion: </strong>This study offers evidence of deliberate CCC efforts to support resident development. Moving forward, a similar focus should be more consistently placed on equitable entrustment and advancement decisions to balance both of these foundational goals.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140502","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":"Putting ‘leader’ back into leadership training","authors":"Jacqueline Torti,&nbsp;Erin Kennedy","doi":"10.1111/medu.15531","DOIUrl":"10.1111/medu.15531","url":null,"abstract":"","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"58 11","pages":"1424"},"PeriodicalIF":4.9,"publicationDate":"2024-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142140503","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}