Medical Teacher最新文献

{"title":"Primary care physicians' understandings of patient-centred communication: A phenomenographic study.","authors":"Joel Freilich, Caroline Kappelin, Gunnar H Nilsson, Terese Stenfors","doi":"10.1080/0142159X.2026.2749537","DOIUrl":"https://doi.org/10.1080/0142159X.2026.2749537","url":null,"abstract":"<p><strong>Introduction: </strong>Patient-centred communication (PCC) is a key component of high-quality care. A persistent gap has been described between PCC as taught in classrooms and as enacted in clinical practice, often framed as a failure to transfer the skills taught. However, little is known about how physicians themselves understand PCC and how this shapes its enactment in everyday practice. Primary care is a particularly relevant setting for this question, given its central role in clinical communication training. The aim is to explore how primary care physicians (PCPs) understand PCC in clinical encounters.</p><p><strong>Methods: </strong>A phenomenographic approach was used to explore variations in primary care physicians' understandings of PCC. Eighteen general practitioners and residents from primary care in Stockholm, Sweden, participated in semi-structured interviews, which were analysed iteratively to develop an outcome space comprising four hierarchically related categories.</p><p><strong>Results: </strong>Four different and inclusively related ways of understanding PCC were identified [1]: <i>Pedagogical structure</i>: PCC as a structured, instrumental process aimed at eliciting and answering patient questions and providing clear information [2]; <i>Empathetic engagement</i>: PCC as an emotionally attuned stance emphasising listening and validation [3]; <i>Whole-person partnership</i>: PCC as a collaborative decision-making that integrates patients' life contexts and values; and [4] <i>Professional balance</i>: PCC as an ethically grounded orientation balancing patient preferences, medical judgment, and responsible resource use.</p><p><strong>Discussion: </strong>PCPs understand PCC in four qualitatively different ways, from pedagogical structure to professional balance. While the first three categories broadly align with established PCC models, professional balance extends beyond them, highlighting ethical and practical tensions in everyday practice. These categories could inform educational design: systematically varying emotional intensity, contextual complexity, and value conflicts may help learners progress from structured technique toward professional balance in practice. Educational designs that offer repeated encounters with the same patient or simulated patient may build the trust needed for difficult conversations.</p>","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"1-12"},"PeriodicalIF":4.0,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224445","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knowing your worth: alternative approaches to valuing educators.","authors":"Joshua Hughes, Marianna Przybylska","doi":"10.1080/0142159X.2026.2749547","DOIUrl":"https://doi.org/10.1080/0142159X.2026.2749547","url":null,"abstract":"","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"1"},"PeriodicalIF":4.0,"publicationDate":"2026-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149224501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Twelve tips for using implementation science to guide innovation in medical education.","authors":"Kayla M Marcotte, Rachel Gottlieb-Smith, Paula Y Thompson, Nikki L B Zaidi, Andrew E Krumm, Rajesh S Mangrulkar, Margaret Wolff","doi":"10.1080/0142159X.2026.2733154","DOIUrl":"https://doi.org/10.1080/0142159X.2026.2733154","url":null,"abstract":"<p><p>Medical education is undergoing rapid transformation driven by advances in technology, learning analytics, and competency-based frameworks; however, many educational innovations fail to achieve sustained impact in real-world settings. One key challenge is the limited application of implementation science, which offers systematic approaches to integrating innovations into practice. This article presents twelve practical tips to guide medical educators in applying implementation science to the design, implementation, evaluation, and sustainability of educational interventions. The purpose of these tips is to translate complex theoretical frameworks into actionable strategies that are accessible and relevant across diverse educational contexts. The tips are organized into four phases: (1) clarifying the intervention, (2) understanding stakeholders and context, (3) deliberately planning implementation, and (4) adapting, iterating, and sustaining interventions over time. Key concepts include defining core components, engaging stakeholders, selecting appropriate frameworks and strategies, measuring implementation outcomes, and planning for sustainability and scaling. By providing structured, practical guidance, these tips aim to enhance the effectiveness, adoption, and longevity of educational innovations. Ultimately, applying implementation science principles can help ensure that promising ideas lead to meaningful, scalable, and lasting improvements in medical and health professions education.</p>","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"1-9"},"PeriodicalIF":4.0,"publicationDate":"2026-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149216464","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"From workplace learning to professional identity formation: Examining the mediating role of belonging in medical students.","authors":"Indah Puspasari Kiay Demak, Marco Antonio de Carvalho-Filho, Johan Bruiyf Bension, Jelle Prins, Joke Fleer","doi":"10.1080/0142159X.2026.2747184","DOIUrl":"https://doi.org/10.1080/0142159X.2026.2747184","url":null,"abstract":"<p><strong>Introduction: </strong>Professional identity formation (PIF) is increasingly understood as a socially situated workplace learning process through which medical students develop identities and practices of physicians. Through participation in clinical work within the clinical learning environment (CLE), students learn what it means to become members of the profession. Within this context, a sense of belonging may be an important mechanism linking the CLE to PIF. However, quantitative evidence examining these relationships remains limited. This study examined whether sense of belonging mediates the relationship between the CLE and PIF.</p><p><strong>Methods: </strong>This cross-sectional study used data from 459 undergraduate clinical students in Indonesia collected between November 1 and December 15, 2024. Students completed three validated instruments: the Professional Identity Formation (PIF) questionnaire, the Undergraduate Clinical Education Environment Measure (UCEEM), and the Belongingness Scale-Clinical Placement Experience (BES-CPE). Structural equation modelling (SEM) was employed to assess whether sense of belonging functioned as a mediator between the CLE and PIF.</p><p><strong>Results: </strong>PIF showed a moderate positive correlation with both the CLE (<i>r</i> = 0.416; <i>p</i> < 0.001) and sense of belonging (<i>r</i> = 0.370; <i>p</i> < 0.001), while the CLE was strongly correlated to sense belonging (<i>r</i> = 0.578; <i>p</i> < 0.001). The SEM mediation model demonstrated good fit (SRMR = 0.038, CFI = 0.96, TLI = 0.94), indicating that belonging partially mediated the relationship between the CLE and PIF.</p><p><strong>Discussion: </strong>The findings reveal that PIF are positively linked to both CLE and a sense of belonging. In addition, sense of belonging functions as a significant statistical mediator in the pathway linking the CLE to PIF. These findings suggest that workplace learning experiences contribute to PIF not only directly but also through fostering students' sense of belonging. Creating supportive clinical environments that promote participation, inclusion, and membership may therefore strengthen medical students' PIF.</p>","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"1-12"},"PeriodicalIF":4.0,"publicationDate":"2026-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149207291","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"Finish the story…\": Qualitative story completion research methods in medical education.","authors":"Ameena Taher, Victor Do, Rami Kadri, Marghalara Rashid","doi":"10.1080/0142159X.2026.2746557","DOIUrl":"https://doi.org/10.1080/0142159X.2026.2746557","url":null,"abstract":"<p><strong>Context: </strong>Medical Education (ME) research seeks to understand and improve teaching and learning in medicine. It often explores sensitive topics related to the culture of medical education, such as the hidden curriculum, power dynamics, discrimination, bias, cultural competence, ethical dilemmas, and clinical errors. Expanding available ME research methods, we introduce qualitative story completion.</p><p><strong>Approach: </strong>Qualitative story completion is a research method originating in psychology, where participants are given the start of a fictional story (a \"story stem\") and are asked to complete the story. This method is particularly suited to exploring cultural understandings, social norms, and assumptions. Literature on utilizing this method within ME research remains scarce. In this methodological paper, we provide ME researchers and scholars with an overview of the history of the method, its theoretical foundations, practical steps in study design, and this method's implications for ME. By doing so, we hope to highlight the potential merit of this method in ME research and equip researchers to use qualitative story completion in their own work to uncover aspects of medical culture that otherwise remain hidden.</p><p><strong>Conclusion: </strong>Qualitative story completion is a flexible, rigorous, and unexplored method well-suited to understanding complex educational interventions and dynamics in ME research due to its third-person and fictional nature. Approaching ME research with the qualitative story completion method will allow researchers to gain novel insights into societal understandings and cultural discourses.</p>","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"1-9"},"PeriodicalIF":4.0,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182920","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceptions of medical school leaders towards widening participation: a Japanese survey.","authors":"Yasuyuki Suzuki, Osamu Nomura, Koji Tsunekawa, Yuko Takeda, Takuya Saiki","doi":"10.1080/0142159X.2026.2743051","DOIUrl":"https://doi.org/10.1080/0142159X.2026.2743051","url":null,"abstract":"<p><strong>Introduction: </strong>Medical school leaders play an important role in shaping admissions policy. However, how they understand diversity, merit, and fairness remains underexplored. This makes it difficult to explain why widening participation (WP) initiatives often struggle to move from principle into practice.</p><p><strong>Methods: </strong>We conducted a nationwide, cross-sectional survey in Japan. Participants included 328 faculty leaders from 82 medical schools, 183 allied health deans, and 58 education deans. The survey examined views on the socioeconomic background of medical students, support for WP, responses to citizen and educator perspectives on inequity, and the perceived importance of admissions criteria.</p><p><strong>Results: </strong>Responses were obtained from 131 medical school leaders (38.0%), 52 allied health deans (28.4%), and 16 education deans (27.6%). Medical school leaders who responded to this survey supported increasing socioeconomic diversity of students and agreed that WP initiatives are necessary. They also understood socioeconomic disparities in application to medical schools. Support for affirmative action (AA) was lower and more varied. Admissions decisions remained weighted towards cognitive and non-cognitive abilities, and contextual factors such as socioeconomic disadvantage and geographic background were given less emphasis. Allied health and education leaders showed stronger support for WP and AA. Within medical schools, directors of medical education were more supportive than deans. Prioritization of cognitive ability was not positively associated with support for diversity policies, while diversity-related attributes showed moderate positive correlations with diversity policies.</p><p><strong>Discussion: </strong>While medical school leaders appear to support students' diversity in principle, their approach to admissions appears to reflect established notions of merit. This suggests that the challenges of WP are not only technical but also relate to how merit and fairness are understood in practice. Addressing these challenges requires closer engagement with leadership perspectives and the institutional and professional cultures in which admissions decisions are made.</p>","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"1-10"},"PeriodicalIF":4.0,"publicationDate":"2026-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149182934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When feedback crosses professional boundaries: From interprofessional feedback to conflict management.","authors":"Samane Ghasemi, Sohrab Nosrati","doi":"10.1080/0142159X.2026.2746040","DOIUrl":"https://doi.org/10.1080/0142159X.2026.2746040","url":null,"abstract":"","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"1"},"PeriodicalIF":4.0,"publicationDate":"2026-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149168024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Twelve tips for using participatory action research in medical education research.","authors":"Najmeh Hamzavizarghani, Victor Do, Marghalara Rashid","doi":"10.1080/0142159X.2026.2746558","DOIUrl":"https://doi.org/10.1080/0142159X.2026.2746558","url":null,"abstract":"<p><p>Participatory action research (PAR) is a collaborative research approach that engages community members as equal partners to generate knowledge and drive meaningful change. Though common in healthcare, it remains relatively new in medical education. This paper uses a collaborative approach to synthesize a practical framework for using PAR among medical education researchers. The paper offers 12 practical tips covering critical steps: tip 1: Know the distinct boundaries between AR and PAR, Tip 2: Practice continuous positionality and reflexivity, Tip 3: Address ethical considerations, Tip 4: Build trusting relationships with community members before collecting data, Tip 5: Embed individual PAR projects within long-term partnerships, Tip 6: Identify the problem you can address with PAR, and co-create specific research questions, Tip 7: Take action to produce social change, Tip 8: Provide accessible research capacity building, Tip 9: Use different methodological approaches to collect data, Tip 10: Analyze collaboratively, reflect, and redefine the problem, Tip 11: Avoid using jargon in your research language, and Tip 12: Ensure participants are part of the dissemination process. PAR offers medical education researchers a rigorous approach to partnering with communities to address locally relevant challenges and translate research into meaningful action.</p>","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"1-7"},"PeriodicalIF":4.0,"publicationDate":"2026-10-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149169146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Teaching on demand: Exploring the role of AI in medical education podcasts.","authors":"Payal Guha, Oscar L Oglina, Celia A Brown, Courtney Krstic, Chukwuma Uduku, Layla Thurston, Risheka Walls, Amir H Sam","doi":"10.1080/0142159X.2026.2733139","DOIUrl":"https://doi.org/10.1080/0142159X.2026.2733139","url":null,"abstract":"<p><strong>Introduction: </strong>Artificial intelligence (AI)-generated educational content holds promise for scalable medical education, but evidence comparing AI and clinician-produced podcasts remains limited. We investigated whether AI-generated podcasts achieve comparable student satisfaction to clinician-recorded podcasts, enabling broader curriculum coverage without overburdening clinical educators, and explored students' attitudes towards AI-generated podcasts.</p><p><strong>Methods: </strong>Medical students were randomised into two groups, with group 1 receiving clinician-produced podcasts on type 1 diabetes (T1DM) and AI-generated podcasts on type 2 diabetes (T2DM). Group 2 received AI-generated podcasts on T1DM, and clinician-produced podcasts on T2DM. Students were blinded to the podcast types. The outcome measures included students' satisfaction (measured using the Student Satisfaction with Educational Podcasts Questionnaire (SSEQ)) and students' attitudes to AI using an open-ended survey. A Bonferroni correction was applied (α = 0.025).</p><p><strong>Results: </strong>One hundred and seventy-eight students participated in this study (Group 1 <i>n</i> = 93, Group 2 <i>n</i> = 85). Mean SSEQ scores (out of 50, reported as mean ± SD) showed no significant difference between clinician and AI podcasts in T1DM or T2DM (T1DM: 35.8 ± 6.80 vs 34.6 ± 7.19, <i>p</i> = 0.3025, T2DM: 33.2 ± 7.50 vs 35.5 ± 6.88, <i>p</i> = 0.0513). In the attitude survey (<i>n</i> = 165), 56% reported production method mattered, citing the sound of the voice, engagement of speaker, and ethical concerns as major issues with AI podcasts.</p><p><strong>Discussion: </strong>AI-generated podcasts achieved non-inferior satisfaction to clinician-recorded podcasts. However, students' psychological preference for human teaching and negative perceptions of AI pose a barrier to scalable benefits, necessitating efforts to build trust and acceptability.</p>","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"1-7"},"PeriodicalIF":4.0,"publicationDate":"2026-10-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149149361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Opening doors together:</i> Agentic engagement as a relational practice in medical education.","authors":"Alexandra Androni, Esther Andela, Joke Fleer, Johanna Schönrock-Adema","doi":"10.1080/0142159X.2026.2738746","DOIUrl":"https://doi.org/10.1080/0142159X.2026.2738746","url":null,"abstract":"<p><strong>Introduction: </strong>Agentic engagement is a practice describing students' constructive and influencing behaviours toward optimising their learning processes. Agentic engagement relies on students' interaction with their educators, study materials and/or each other. This study seeks a better understanding of the factors stimulating medical students' engagement in small-group learning settings. Findings may help educators to more effectively support students' agentic engagement and help students prepare for unforeseen, demanding (clinical) healthcare settings.</p><p><strong>Methods: </strong>We conducted 12 semi-structured interviews to explore factors stimulating and hindering medical students' agentic engagement in small-group pre-clinical classes. We analysed interview transcripts using template analysis, a form of thematic analysis.</p><p><strong>Results: </strong>We identified four main themes of factors influencing student agentic engagement: <i>the bold and the timid</i>, <i>navigating the (PBL) curriculum</i>, <i>paradoxes of collective learning</i>, and <i>tutors as gatekeepers</i>. Students also described how engaging agentically to achieve their own learning expectations could collide with and hinder their peers' learning experiences.</p><p><strong>Discussion: </strong>Medical students' agentic engagement is stimulated by individual qualities, social dynamics, emotional engagement and near-clinical exposure, while hindered by controlling teaching styles and curriculum ambiguities. Tutors' responses to students' agentic attempts prove crucial in either sustaining or suppressing such behaviours. To foster agentic engagement, educators should aim to create autonomy-supportive learning environments, involve students in curriculum dissemination, and integrate meaningful clinical experiences that empower students to tailor their learning trajectories. Such approaches may prepare them for navigating the complexities of clinical practice and lifelong learning.</p>","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"1-12"},"PeriodicalIF":4.0,"publicationDate":"2026-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149137508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}