{"title":"Simulation-based education's impact on medical students' tolerance of uncertainty: A grounded theory study.","authors":"Rebekah Cole, Carly Bowling, Xiao Ren, Leslie Vojta","doi":"10.1080/0142159X.2024.2438787","DOIUrl":"https://doi.org/10.1080/0142159X.2024.2438787","url":null,"abstract":"<p><p>The purpose of this grounded study was to explore how medical students encountered and managed uncertainty during a high-fidelity simulation. We interviewed 15 fourth year medical students as they progressed through the scenario and used constant comparative analysis to analyze our interview data. Three themes emerged from our data, which informed our theoretical framework: 1) Uncontrollable circumstances were the root of uncertainty; 2) uncertainty drove unhelpful responses evident in self and team; and 3) enhanced tolerance of uncertainty developed through cognitive restructuring and collaboration. Understanding how medical students successfully manage uncertainty during a high-fidelity simulation provides valuable insights for medical educators aiming to intentionally support and enhance students' uncertainty tolerance. Encouraging students to employ techniques such as cognitive restructuring and fostering social support during simulation can be valuable strategies for preparing them for the challenges of uncertainty in their future medical careers.</p>","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"1-5"},"PeriodicalIF":3.3,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813857","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}
Medical TeacherPub Date : 2024-12-11DOI: 10.1080/0142159X.2024.2436451
David C M Taylor, Trevor Gibbs, Dario Torre
{"title":"The AMEE Guides and their contribution to health professions education.","authors":"David C M Taylor, Trevor Gibbs, Dario Torre","doi":"10.1080/0142159X.2024.2436451","DOIUrl":"https://doi.org/10.1080/0142159X.2024.2436451","url":null,"abstract":"<p><p>AMEE Guides are clear and contemporary accounts of concepts in health professions education, which are written by experts, to be read and understood by someone new to the field. Over the years, they have responded to the needs of educators and researchers as the knowledge and practice of health professions education has grown. The Guides cover all domains of medical and health professions education. Some Guides remain classical works in their own right, but all domains are re-visited, as they come into focus. A spreadsheet with the details of all Guides to the end of 2024 is included in the supplementary material.</p>","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"1-3"},"PeriodicalIF":3.3,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813858","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}
Medical TeacherPub Date : 2024-12-11DOI: 10.1080/0142159X.2024.2436449
Laura Pickell, Heather MacDonald
{"title":"Preparing future healthcare professionals for evidence-based decision-making using health technology assessment as an experiential learning tool.","authors":"Laura Pickell, Heather MacDonald","doi":"10.1080/0142159X.2024.2436449","DOIUrl":"https://doi.org/10.1080/0142159X.2024.2436449","url":null,"abstract":"<p><p>The rapid evolution of healthcare, driven by the rise of new health technologies and the growing emphasis on evidence-based care, requires health professionals skilled in assessing and utilizing evidence to support decision-making. Health technology assessments (HTAs), which involve evidence synthesis and appraisal, analysis across various domains, and tailoring evidence to local contexts, can develop these skills. These skills are also part of medical competencies. However, there is a dearth of literature on teaching HTAs to health professionals and on how the skills learned through HTA align with medical competencies. We developed an innovative experiential project that had students conduct mini-HTAs for community partners considering new technologies. Students worked in teams to evaluate and synthesize evidence, delivering a website and brief to our partners justifying their recommendations. Success was achieved by providing authentic tasks and using supportive learning strategies. The project engaged students deeply, offering them valuable skills for post-graduation work and education. In this article, we demonstrate how the learning outcomes of the project align with the CANMEDS framework of medical competencies. Secondly, we demonstrate an effective, adaptable, and unique approach of using mini-HTAs to equip students with the knowledge and skills needed to navigate the rapidly evolving landscape of evidence and technologies, preparing them as our future healthcare professionals.</p>","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"1-3"},"PeriodicalIF":3.3,"publicationDate":"2024-12-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813856","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}
Medical TeacherPub Date : 2024-12-10DOI: 10.1080/0142159X.2024.2436452
David J Cipriano, José Franco, Robert Treat
{"title":"Pass/fail grading in preclinical courses and differential attainment between racially/ethnically minoritized groups and non-minoritized groups.","authors":"David J Cipriano, José Franco, Robert Treat","doi":"10.1080/0142159X.2024.2436452","DOIUrl":"https://doi.org/10.1080/0142159X.2024.2436452","url":null,"abstract":"<p><p>Many medical schools are transitioning to pass/fail grading from tiered grading systems which have been associated with increased competition, grade inflation, decreased wellness, and grading disparities along racial/ethnic lines. This retrospective cohort study followed two cohorts of students from one medical school for four years. One cohort was the last class to enter the school under a 5-point grading system for preclinical courses and the other was the first cohort to enter school under a pass/fail grading system for preclinical courses. Data was collected on various performance measures for the 501 students who comprised these two cohorts. Given the enduring problem of differential attainment between underrepresented in medicine (URiM) students to non-URiM students, we explored whether a change in grading systems impacted all students similarly. Overall students did as well or better in classroom performance, clerkship subject exams, and licensing exams following the change and the effect was essentially equal for URiM and non-URiM students alike. The most important finding was a decrease in differential attainment between URiM and non-URiM students after the change to pass/fail grading for the great majority of the performance measures studied.</p>","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"1-6"},"PeriodicalIF":3.3,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801412","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":"Using the theory of Threshold Concepts to identify troublesome knowledge in becoming a Master Clinical Teacher.","authors":"Stephanie Hale, Matei Petrescu, Melissa Carbajal, Moushumi Sur, Audrea Burns, Satid Thammasitboon","doi":"10.1080/0142159X.2024.2436454","DOIUrl":"https://doi.org/10.1080/0142159X.2024.2436454","url":null,"abstract":"<p><strong>Purpose: </strong>There is a wealth of literature describing the characteristics and proficiencies of clinical teachers, but no description exists of the obstacles that clinical teachers face when aspiring to become a Master Clinical Teacher (MCT). Using Threshold Concepts (TC) theory as an analytical framework can help investigate those potential challenges.</p><p><strong>Methods: </strong>This is a mixed-methods research integrating an exploratory survey and semi-structured interviews. The authors used a systematic approach to develop the survey and administered it to physicians in a large pediatrics department, using the results to inform the interview process. In the interview phase, the authors used purposive sampling of trainees, early-career clinical teachers, and departmentally recognized MCTs. The authors conducted reflexive thematic analysis on the qualitative data using TC as a framework, deriving areas of Troublesome Knowledge (TK) and subsequently conceptualizing TCs.</p><p><strong>Results: </strong>The survey phase yielded 143 responses with 303 narrative comments. The interview phase comprised three focus groups and eleven individual interviews with MCTs. Four themes were identified that conceptualize as TCs with associated areas of TK, including: Embracing continual personal and professional evolution; Cultivating shared vulnerability for authentic engagement and learning; Empowering learners for self-discovery and transformation; and Navigating the complexities of clinical teaching.</p><p><strong>Conclusions: </strong>The identified TCs and associated TKs provide insights into clinical teachers' experience in becoming MCTs. These findings can inform faculty development efforts and the individual career development of clinical teachers and also underscore the dynamic and multi-faceted nature of clinical teaching and the ongoing evolution required to excel in it.</p>","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"1-9"},"PeriodicalIF":3.3,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801415","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}
Medical TeacherPub Date : 2024-12-09DOI: 10.1080/0142159X.2024.2430362
Alastair Dodsworth, Hugh Alberti, David A Hirsh, Paul Paes, Jan Illing
{"title":"Longitudinal Integrated Clerkships, empathy and patient centredness: A prospective cohort study.","authors":"Alastair Dodsworth, Hugh Alberti, David A Hirsh, Paul Paes, Jan Illing","doi":"10.1080/0142159X.2024.2430362","DOIUrl":"https://doi.org/10.1080/0142159X.2024.2430362","url":null,"abstract":"<p><strong>Purpose: </strong>Ethical erosion literature describes medical students' patient centredness and empathy declines through their clinical years of training. Longitudinal Integrated Clerkships (LICs), an alternate clinical educational design, have been hypothesised to reduce ethical erosion. The authors aimed to measure change in medical students' patient centredness and empathy at an institution with the largest LIC worldwide.</p><p><strong>Method: </strong>Two whole LIC cohorts (LIC1 and LIC2) were invited to complete a questionnaire, which included patient centredness and empathy scales. Students completed the questionnaire at the start and end of each academic year. Block-rotation students (Non-LIC) were a comparator cohort. Complete cases data were analysed.</p><p><strong>Results: </strong>22 Non-LIC, 66 LIC1 and 33 LIC2 students responded. Non-LIC students experienced a significant decline in empathy ([start] 113.14 vs. [end] 102.68, <i>p</i><.001). Empathy did not significantly decline in the LIC cohorts. Patient centredness in LIC1 and LIC2 grew and reduced in the Non-LIC cohort, however, these changes were not statistically significant.</p><p><strong>Conclusions: </strong>This study supports the hypothesis LICs may reduce ethical erosion when compared to block-rotation placements. The results provide evidence that ethical erosion occurs in students who have completed block-rotation placements. This is the first study of UK-based medical students measuring empathy and patient centredness following completion of an LIC.</p>","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"1-8"},"PeriodicalIF":3.3,"publicationDate":"2024-12-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142801509","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}
Medical TeacherPub Date : 2024-12-06DOI: 10.1080/0142159X.2024.2436453
Hamrish Kumar Rajakumar
{"title":"Mentorship in medical research: Guiding the next generation.","authors":"Hamrish Kumar Rajakumar","doi":"10.1080/0142159X.2024.2436453","DOIUrl":"https://doi.org/10.1080/0142159X.2024.2436453","url":null,"abstract":"","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"1"},"PeriodicalIF":3.3,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142789472","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}
Medical TeacherPub Date : 2024-12-06DOI: 10.1080/0142159X.2024.2436445
Matthew J W Low, Danielle T Miller, Matthew D Zuckerman
{"title":"The number needed to teach: A framework for health professions education.","authors":"Matthew J W Low, Danielle T Miller, Matthew D Zuckerman","doi":"10.1080/0142159X.2024.2436445","DOIUrl":"https://doi.org/10.1080/0142159X.2024.2436445","url":null,"abstract":"<p><strong>What is the educational challenge?: </strong>Health professions education is continually limited by financial resources with increasing demands for accountability. Judicious resource allocation across competing demands rests on frameworks for analyzing and comparing costs and outcomes.</p><p><strong>What are the proposed solutions?: </strong>We suggest health professions educators use the number needed to teach (NNTe) for reporting and communicating such analyses for teaching and learning.</p><p><strong>What are the potential benefits to a wider global audience?: </strong>The NNTe has the potential to improve reporting and understanding of effectiveness of teaching and learning, similar to how the number needed to treat (NNTr) has improved communication of the effectiveness of clinical interventions. Prior widespread understanding of NNTr will likely allow NNTe to be easily grasped by most clinical educators and those responsible for resource allocation decisions. This article describes the origins of and parallels between NNTr and NNTe, which summarizes and presents in concrete terms to educators, learners, and institutional leadership the investment required to prevent or produce a specific outcome. The calculation and interpretation of NNTe is demonstrated using examples from published real-world data, and its potential benefits, limitations and applications are explored.</p><p><strong>What are the next steps?: </strong>Next steps include explorations of the variety of contexts and comparisons that can be interpreted using NNTe and its corollary, the Number Need to Harm, and how recipients interpret and act upon NNTe.</p>","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"1-3"},"PeriodicalIF":3.3,"publicationDate":"2024-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142789475","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}