Medical Teacher最新文献

{"title":"Building excellence in simulation programs: Experiences and examples from ASPIRE Award recipients and panellists.","authors":"Debra Nestel, Cathy M Smith, Nancy McNaughton, Paul O'Connor, Leizl Joy Nayahangan, Luke A Devine, Kristian Krogh, Ross Scalese","doi":"10.1080/0142159X.2026.2628958","DOIUrl":"10.1080/0142159X.2026.2628958","url":null,"abstract":"<p><p>Excellence in educational practice is recognised by the ASPIRE Award program at AMEE. The focus of this paper draws on exemplars from the ASPIRE-to-Excellence Award for Simulation to illustrate how excellence is built in simulation programs. Our focus is on institutional programs that support entry-level and practising clinicians in developing and maintaining clinical knowledge and skills, thereby impacting patient safety and quality of care. We briefly outline the history of the award and then describe the elements and criteria for the award. We position the award alongside the many standards of practice, professional guidelines, quality frameworks, accreditation and certification documents available to the healthcare simulation community. Selected sub-criteria are illustrated making explicit what excellence looks like. We then shift focus to characterise panellists' credentials and share their reflections on the process of reviewing applications, followed by reflections from awardees on the benefits of the award and their experience of preparing the application. We draw on all these reflections to offer tips for preparing an application. Institutional program review in comparison to established international standards for excellence can facilitate improvements to simulation programs, even if it does not progress to a formal submission or award.</p>","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"776-783"},"PeriodicalIF":3.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147283805","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":"'It hurts even when it's not about us.' Reframing microaggressions in medical education in Japan: Qualitative research.","authors":"Junki Mizumoto, Hirohisa Fujikawa","doi":"10.1080/0142159X.2025.2561209","DOIUrl":"10.1080/0142159X.2025.2561209","url":null,"abstract":"<p><p><b>Introduction:</b> Microaggressions are common in medical education but have been studied mainly in Western contexts. This study explored medical students' experiences of microaggressions in Japan to contextualize them within broader sociocultural structures. <b>Methods:</b> Participants were recruited through the Japan Association for Medical Student Societies (Igakuren), the sole nationwide representative body. Eligible individuals were current executive committee members or physicians within six years of graduation who had previously served. Data gained from in-depth online interviews were analyzed using a thematic analysis. <b>Results:</b> Twenty-one participants reported diverse microaggressions during clinical training. To capture these, the conventional microaggression triangle (source, recipient, bystander) was expanded with a fourth element: topic. Three themes emerged: (i) microaggressions about marginalized patients, (ii) hierarchy and dehumanization of students, and (iii) managing microaggressions. These findings highlight how hierarchical norms and structural inequities perpetuate microaggressions in medical education in Japan. <b>Discussion:</b> Microaggressions in Japan reflect structural inequities and entrenched hierarchies, including gender-based discrimination, rather than isolated interpersonal slights. Addressing them requires empowering students, preparing faculty for constructive intervention, and reforming hierarchical norms. This study provides a culturally grounded perspective to advance global discussions on equity in health professions education.</p>","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"803-811"},"PeriodicalIF":3.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145075834","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":"Equity and the \"pause\": Socioeconomic barriers to accessing out-of-programme opportunities in medical training.","authors":"Ashley V Simpson","doi":"10.1080/0142159X.2025.2592607","DOIUrl":"10.1080/0142159X.2025.2592607","url":null,"abstract":"","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"915"},"PeriodicalIF":3.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145573767","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 pointing and calling (Shisa Kanko) to reduce error and improve performance.","authors":"Efrem Violato, Mike Cheung","doi":"10.1080/0142159X.2025.2508281","DOIUrl":"10.1080/0142159X.2025.2508281","url":null,"abstract":"<p><p>Paramedics operate in high-stakes, cognitively demanding environments where lapses in attention can jeopardize patient safety. While team-based communication strategies are commonly taught, there is a need for self-directed methods that support situational awareness and error prevention. 'Pointing and Calling' (P&C) is a Japanese technique that uses verbal and physical cues to heighten conscious attention and reduce mistakes. P&C was integrated into the Advanced Care Paramedic curriculum over three weeks covering conceptual instruction, guided practice through low-stakes activities, and application in high-fidelity simulations. Students employed P&C during critical tasks and received feedback during debriefings. Evaluation using the Kirkpatrick framework showed positive engagement, skill uptake, and transfer to other learning contexts. Several key lessons were identified for implementing training on P&C, including clarifying that P&C is a personal cognitive tool, not a directive to others. P&C's simplicity, low cost, and existing evidence support implementation across healthcare settings. P&C can be effective in low and high-resource environments alike. P&C represents a practical, scalable approach to improving patient safety.</p>","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"754-756"},"PeriodicalIF":3.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144128153","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":"AI-assisted script concordance tests: Enhancing feasibility with customized ChatGPT.","authors":"Enjy Abouzeid, Moataz A Sallam","doi":"10.1080/0142159X.2025.2533405","DOIUrl":"10.1080/0142159X.2025.2533405","url":null,"abstract":"<p><strong>What was the educational challenge?: </strong>The Script Concordance Test (SCT) assesses clinical reasoning by evaluating responses to uncertain scenarios against expert clinician panels. Unlike traditional multiple-choice questions (MCQs), SCTs measure how examinees structure their knowledge in complex, evolving contexts. Grounded in script theory, SCTs capture the cognitive networks clinicians develop through experience, allowing assessment of real-world decision-making. Developing SCTs presents challenges, including crafting clinically relevant scenarios with appropriate ambiguity and ensuring expert panel reliability. Scoring depends on concordance with expert panels, requiring careful recruitment of 15-20 experts for validity. These logistical demands complicate SCT implementation, particularly in high-stakes assessments.</p><p><strong>What was the solution and how was it implemented?: </strong>To address these challenges, we leveraged artificial intelligence (AI), utilizing ChatGPT to generate and score SCTs in ophthalmology. We refined prompts to emulate medical educators, producing SCT vignettes aligned with curricular blueprints. A customized ChatGPT system was trained to assist SCT development, incorporating expert-derived scoring keys. We created one SCT test composed of 10 questions, each with three items assessed through a 5-point Likert scale.</p><p><strong>What lessons were learned and what are the next steps?: </strong>ChatGPT-generated SCTs effectively simulate clinical scenarios, structure scoring, and analyze response patterns. Future work will expand AI-assisted SCTs to other specialties, creating an archive of validated vignettes.</p>","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"757-760"},"PeriodicalIF":3.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144708064","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":"A cross-sectional study of psychological safety: Barriers and facilitators in a non-western clinical setting.","authors":"Fatima Msheik-El Khoury, Halah Ibrahim, Monique Chaaya, Carine Zeeni, Reine Obeid, Andrea Chedid, Patrick Maroun, Marianne El Khoury, Lea B Farhat, Anne Marie-Daou, Salah Zeineldine","doi":"10.1080/0142159X.2025.2603348","DOIUrl":"10.1080/0142159X.2025.2603348","url":null,"abstract":"<p><strong>Purpose: </strong>Psychological safety is a cornerstone of effective clinical learning. While extensively studied in Western contexts, little is known about its barriers and facilitators, as well as its relationship to feedback-seeking and competence development in high power-distance, non-Western residency programs. This study explored barriers and facilitators of psychological safety and examined its associations with residents' feedback-seeking behaviors and self-perceived clinical competence.</p><p><strong>Materials and methods: </strong>We conducted a cross-sectional study in a large Lebanese academic medical center. An online survey assessed psychological safety, feedback-seeking behaviors, and self-perceived clinical competence. Open-ended questions explored barriers and facilitators in the clinical environment. Descriptive statistics, correlation, and mediation analyses were performed, along with inductive qualitative 'conventional content analysis' of narrative responses.</p><p><strong>Results: </strong>Of 340 residents, 235 (69.1%) consented to participate, 204 (86.8%) completed the survey, and 160 (68.1%) provided narrative responses. Psychological safety was positively associated with direct feedback-seeking (<i>rho</i> = 0.194, <i>p</i>=.005) and perceived competence (<i>rho</i> = 0.184, <i>p</i>=.008). Adjusted mediation analysis suggested that direct inquiry may partially account for the association between psychological safety and competence (<i>b</i> = 0.2886, BootSE = 0.1479, 95% CI [0.0478, 0.6188]), whereas reflective appraisal and indirect inquiry were not significant mediators. Five themes shaped residents' sense of psychological safety [1]: hierarchy and psychological distance [2], social belonging and interpersonal safety [3], workload, burnout, and learning identity [4], leadership responsiveness and institutional climate, and [5] feedback and day-to-day communication.</p><p><strong>Discussion: </strong>Residents' experiences of psychological safety were linked to more proactive feedback-seeking, which was in turn associated with higher self-perceived competence. However, more passive feedback strategies appeared less sensitive to psychological safety, likely reflecting cultural norms and hierarchical barriers. These safety perceptions were shaped by interpersonal relationships, leadership accessibility, workload pressures, and broader institutional culture, with hierarchy emerging as a dominant concern. Multi-level interventions, including leadership training, faculty development, and structural reforms, are needed to foster psychologically safe learning environments that promote resident growth, team functioning, and patient safety.</p>","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"879-892"},"PeriodicalIF":3.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145794355","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":"Implementing entrustable professional activities: Practical lessons and legal considerations from an international interview study.","authors":"Marije P Hennus, Severin Pinilla, Claire Touchie, M J van Dam","doi":"10.1080/0142159X.2025.2559917","DOIUrl":"10.1080/0142159X.2025.2559917","url":null,"abstract":"<p><strong>Purpose: </strong>Entrustable professional activities (EPAs) provide a framework for supervising and assessing readiness for independent practice in postgraduate medical education. Their implementation has raised concerns about legal liability. This study explored practical and legal implications of EPA implementation across international contexts.</p><p><strong>Methods: </strong>Fifteen participants from various specialties and 12 countries across six continents, all involved in EPA implementation, participated in qualitative semi-structured interviews. Interviews focused on accountability, competence assessment, and legal considerations. Thematic analysis was conducted.</p><p><strong>Results: </strong>Five themes were identified: (1) <i>Shifting accountability</i>: EPAs shift accountability to trainees as competence increases, though supervision remains essential; (2) <i>Sharing responsibilities</i>: EPAs support role clarity and shared responsibility, with autonomy varying by setting; (3) <i>Ascertaining competence</i>: EPAs offer a transparent framework for competence assessment; (4) <i>(Mis-)conceptions of legal consequences</i>: legal concerns were largely unfounded as supervisors were still viewed as legally accountable; and (5) <i>Context matters</i>: implementation is shaped by institutional, regulatory, and cultural contexts, requiring local adaptation.</p><p><strong>Conclusions: </strong>Participants perceived EPAs as strengthening educational accountability and competence assessment without altering legal responsibilities. Successful implementation depends on alignment with local context, emphasizing their role as flexible educational tools rather than legal instruments. Continued research should examine their long-term legal and institutional impact in postgraduate training.</p>","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"794-802"},"PeriodicalIF":3.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145102797","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":"Beyond discomfort: When the wrong turn becomes the lesson.","authors":"Furqan Shahid, Nashwah Waheed","doi":"10.1080/0142159X.2025.2593494","DOIUrl":"10.1080/0142159X.2025.2593494","url":null,"abstract":"","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"917-918"},"PeriodicalIF":3.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145635814","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":"Learning and identity development during interprofessional hospital placements: A qualitative exploration using rich pictures.","authors":"Saskia C M Oosterbaan-Lodder, Edmée A Kipping, Jan-Jaap Reinders, Marco A C Versluis, Fedde Scheele, Rashmi A Kusurkar, Anne de la Croix","doi":"10.1080/0142159X.2025.2599328","DOIUrl":"10.1080/0142159X.2025.2599328","url":null,"abstract":"<p><strong>Context: </strong>Increasing numbers of healthcare students are trained within interprofessional hospital placements, where they learn to be part of the landscape of healthcare practice. Explicitly facilitating (inter)professional identity development has been recommended as a goal of these placements. We aimed to explore students' experiences during their placement, and its relation to their learning and identity development.</p><p><strong>Methods: </strong>In this multicenter qualitative study, nine medical students, six midwifery students, and six nursing students drew rich pictures of one satisfying and one challenging experience during their interprofessional placement, capturing complex, nonverbal elements of these experiences. We used semi-structured interviews to deepen understanding of students' experiences and their developing identities, adopting an inductive constructivist thematic analysis.</p><p><strong>Results: </strong>During their interprofessional encounters, a range of emotions supported or challenged students' learning and identity development. These emotions played a pivotal role throughout the three themes we identified: (1) Understanding and appreciating differences; (2) Navigating identity tensions; and (3) Gaining confidence in patient-centered learning and collaboration.</p><p><strong>Conclusions: </strong>During interprofessional placements, most students engage in learning about each other's responsibilities and values, enhancing knowledgeability. Tutors should be aware of students' emotions during interprofessional encounters, and stimulate reflection on them, as emotions can foster or hamper students' knowledgeability and identity development.</p>","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"866-878"},"PeriodicalIF":3.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145793735","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":"ASPIRE for Excellence in Student Assessment: Developing a quality programme of assessment.","authors":"Rikki Goddard-Fuller, Sandra Kemp, Katharine Boursicot","doi":"10.1080/0142159X.2026.2621215","DOIUrl":"10.1080/0142159X.2026.2621215","url":null,"abstract":"<p><p>A critical component of all programmes of instruction in Medical and Health Professions Education (MHPE) disciplines is the assessment of learning and assurance of clinical competency, spanning knowledge, clinical/technical performance skills, and professionalism. AMEE's ASPIRE-to-Excellence assessment framework draws together a series of key, evidence-based components of comprehensive assessment systems, providing a matrix to 'assess assessment' through the following stimulus questionsHow does an assessment programme serve and support the mission of the institution and the goal of MHPE globally in enhancing and improving the health of both populations and individuals?Does the assessment programme support, enhance, and create learning opportunities?How does the assessment programme ensure the competence of students as they progress?How is the assessment programme subject to a rigorous and continuous quality control process?How does the assessment programme demonstrate a commitment to scholarship and innovation, including the dissemination of good practice? In this paper, these elements are detailed together with descriptions of strategies that align with how each can be successfully demonstrated and evidenced. Drawing on details of assessment practices seen in a range of submissions to the ASPIRE award programme, from a range of jurisdictions and settings, the paper highlights strategies that align with success for excellence in assessment.</p>","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"769-775"},"PeriodicalIF":3.3,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146086280","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}