Medical Teacher最新文献

{"title":"Beyond performance metrics: Generative AI and clinical reasoning in medical education.","authors":"John Joseph D Zarate","doi":"10.1080/0142159X.2026.2681964","DOIUrl":"10.1080/0142159X.2026.2681964","url":null,"abstract":"","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"1823"},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148176272","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 measurement to meaning: Re-examining merit in medical school selection.","authors":"Andrea M Woltman, Dario Cecilio-Fernandes","doi":"10.1080/0142159X.2026.2669341","DOIUrl":"10.1080/0142159X.2026.2669341","url":null,"abstract":"","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"1821"},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148016376","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":"Co-creating patient safety education: Bridging learning, practice, and policy in emergency care.","authors":"Chiao-Ni Wen, Shu-Yu Peng, Chueh-Feng Wu, Yun-Hsin Kuan, Mei-Fen Lo, Mei-Chih Tseng, Hsing-Wei Hung, Chung-Guei Huang, Hsiao-Chen Ning","doi":"10.1080/0142159X.2026.2649219","DOIUrl":"10.1080/0142159X.2026.2649219","url":null,"abstract":"<p><strong>Background: </strong>Pre-analytical errors persist as the leading cause of laboratory errors despite technological advances, reflecting translational failures in continuing professional development (CPD). Traditional patient safety education, such as didactic lectures and online learning modules, achieves only temporary improvements, with error rates returning to baseline within months. Co-creation, where frontline professionals function as equal partners in educational design, offers a fundamentally distinct approach, yet evidence regarding operationalization, sustained clinical outcomes, and departmental policy integration remains limited.</p><p><strong>Aims: </strong>To evaluate a co-created CPD program addressing persistent pre-analytical errors in an emergency department where prior interventions had failed.</p><p><strong>Methods: </strong>We conducted a pre-post quasi-experimental design at a tertiary-care teaching hospital in Taiwan from August 2021 through August 2024. The co-created program involved nurses, medical technologists, educators, and administrators across four learning sessions: case-based learning, online modules, simulation, and three-stage structured practice improvement process. We employed the New World Kirkpatrick Model for comprehensive evaluation, analyzing 141,927 specimens over 25 months. Evaluation outcomes included engagement, satisfaction, knowledge, skills, procedural compliance, error rates, and departmental policy integration.</p><p><strong>Results: </strong>The program achieved sustained 50% reduction in pre-analytical error rates from 1.15% to 0.59% (<i>p</i> < 0.001) maintained over 10 months, representing 240 fewer errors. This was supported by exceptional engagement (85-100% participation), high satisfaction (mean ≥4.2/5.0), significant knowledge and skills gains (<i>p</i> < 0.05), and 50% reduction in non-compliance rates from 1.87% to 0.93% (<i>p</i> < 0.001). Critically, participant-generated innovations, including automated hemolysis surveillance system and revised procedures, were formally integrated into departmental standard operating procedures and training curricula.</p><p><strong>Conclusions: </strong>Co-creation achieved sustained patient safety improvements through behavior change and departmental policy integration. Interprofessional learning and three-stage structured practice improvement process demonstrate co-creation's effectiveness in transforming CPD learning. This study provides a replicable model for bridging gaps between patient safety knowledge and practice.</p>","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"1773-1790"},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147623162","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 teaching research skills in the age of agentic AI: A guide for health professions educators.","authors":"Neil Mehta, Jennifer Benjamin, Seysha Mehta, Sofia Valanci, Heather MacNeill, Ken Masters","doi":"10.1080/0142159X.2026.2681971","DOIUrl":"10.1080/0142159X.2026.2681971","url":null,"abstract":"<p><strong>Background: </strong>The recent advances in Generative Artificial Intelligence (GenAI), from task-specific assistants to autonomous agentic artificial intelligence (AI) are changing how research is conceived, conducted, and written. Across this spectrum AI can now assist with literature searches and synthesis, protocol drafting, statistical analysis, and manuscript preparation, particularly in computational domains. Yet AI outputs remain error-prone, opaque, and carry real stakes for patients, learners, and equitable outcomes, making strong foundational research skills more important than ever.</p><p><strong>Purpose: </strong>This article offers practical guidance for medical educators responsible for research training in an AI-augmented environment.</p><p><strong>Tips: </strong>Drawing on published work on biomedical research competencies and emerging scholarship on AI in medical education, and our own experience, twelve tips are organized around three themes: understanding the changing AI landscape, protecting non-delegable human responsibilities, and teaching new AI-era competencies.</p><p><strong>Conclusions: </strong>AI-augmented research does not reduce the need for research education; it changes which skills deserve the most attention. Medical curricula should now emphasize critical appraisal, ethical reasoning, verification of AI outputs, and assessment strategies that distinguish independent mastery from AI-assisted performance.</p>","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"1645-1656"},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148397258","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":"Before the first class: Engaging students early in curriculum design to support program reform.","authors":"Naomi Steenhof, Heather Abela, Sheena Ye, Andrew Vuong, Leanne Perry, Jamie Kellar, Jennifer Lake, Certina Ho, Natalie Crown","doi":"10.1080/0142159X.2025.2572994","DOIUrl":"10.1080/0142159X.2025.2572994","url":null,"abstract":"<p><p><b>What was the educational challenge?</b> Curriculum reform is often something done to students, not with them-particularly before implementation. This top-down model limits the responsiveness of reforms and risks overlooking student priorities and expectations that could otherwise improve curricula. <b>What was the solution and how was it implemented?</b> In the context of a transition to a 3-year PharmD curriculum underpinned by adaptive expertise, we developed a low-resource model to meaningfully engage students during early-stage curriculum design. Using orientation materials and facilitated focus groups, we captured student insights on draft curricular blocks before launch, yielding actionable improvements and a foundation for program evaluation. <b>What lessons were learned and what are the next steps?</b> Engaging students in curriculum design before implementation is both feasible and valuable. With minimal time, coordination, and materials, focused discussions provided actionable insights that improved clarity, organization, and alignment in the proposed curriculum. This approach is scalable, adaptable, and bridges a longstanding gap between design and lived experience-inviting students into upstream decision-making with minimal cost or infrastructure. Our future work will explore how this engagement model can be integrated at key milestones across the curriculum lifecycle and scaled to support continuous, collaborative curriculum renewal.</p>","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"1637-1640"},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145308633","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":"Academic performance of Brazilian medical students during internship: Regular path versus affirmative action system.","authors":"Claudia Regina Zaramella, Fábio Ferreira Amorim","doi":"10.1080/0142159X.2026.2634074","DOIUrl":"10.1080/0142159X.2026.2634074","url":null,"abstract":"<p><strong>Introduction: </strong>Affirmative action policies have been implemented to promote equitable access to higher education for socially vulnerable students, although their influence on student outcomes remains debated. This study compared the academic performance of students admitted through the regular path (RP) and affirmative action (AA) system, at a Brazilian public medical school.</p><p><strong>Methods: </strong>This prospective cohort study included 236 fifth-year medical students from the School of Health Sciences (ESCS), between 2022 and 2024. Sociodemographic and economic data were obtained from institutional and national databases. Academic performance was assessed through cognitive, practical, and professionalism evaluations, as well as the final annual grade.</p><p><strong>Results: </strong>Of 236 students, 134 (56.8%) entered <i>via</i> RP and 102 (43.2%) <i>via</i> AA. AA students were older, less often self-declared white, had lower parental education, and worse socioeconomic indicators (all <i>p</i> < 0.001). In univariate analyses, RP students scored higher in three of four evaluations (<i>p</i> < 0.001). After adjustment, admission type was not associated with performance. Cognitive scores correlated with younger age at admission (β: -0.039; 95% CI: -0.065 to -0.014; <i>p</i> < 0.001). Mini-CEX showed no significant associations. Professionalism scores were higher among female (β: 0.165; 95% CI: 0.013 to 0.316; <i>p</i> = 0.033), married (β: 0.589; 95% CI: 0.151 to 1.027; <i>p</i> = 0.009), those with a parent holding higher education (β: 0.242; 95% CI: 0.036 to 0.448; <i>p</i> = 0.021), and younger entrants (β: -0.033; 95% CI: -0.055 to -0.011; <i>p</i> = 0.003). Final grades were higher among female (β: 0.146; 95% CI: 0.032 to 0.261; <i>p</i> = 0.013), married (β: 0.376; 95% CI: 0.044 to 0.708; <i>p</i> = 0.027), and younger students (β: -0.032; 95% CI: -0.048 to -0.015; <i>p</i> < 0.001).</p><p><strong>Discussion: </strong>After adjusting for sociodemographic and economic factors, RP and AA students performed similarly, supporting AA as an effective inclusion policy.</p>","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"1664-1675"},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147290545","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 using entrustable professional activities thwarts basic psychological needs: A case study of residents' experience.","authors":"Julien-Carl Phaneuf, Carolin Sehlbach, Annaëlle Gauvin-Morin, Oussama Slimani, Catharine M Walsh, Sylvia Heeneman","doi":"10.1080/0142159X.2026.2649217","DOIUrl":"10.1080/0142159X.2026.2649217","url":null,"abstract":"<p><strong>Background: </strong>Entrustable professional activities (EPAs) were introduced to link competencies with clinical work and support residents' professional and competence development. Yet their implementation has raised concerns about burdensome documentation and limited educational value. Drawing on Self-Determination Theory (SDT), we examined how residents experienced EPAs in relation to their needs for autonomy, competence, and relatedness-needs essential for optimal motivation and professional development.</p><p><strong>Methods: </strong>We conducted an instrumental case study in a Canadian internal medicine residency program. Fourteen residents participated in semi-structured interviews. We used Braun and Clarke's six-phase thematic analysis, with SDT guiding our interpretation of how participants' narratives reflected their experiences of autonomy, competence, and relatedness.</p><p><strong>Results: </strong>Residents experienced EPAs as compliance exercises disconnected from meaningful professional development. Four interrelated themes captured how these experiences related to residents' basic psychological needs: (1) <i>A Documentation Imperative</i> demonstrated how external pressures to accumulate observation forms constrained residents' autonomy and discouraged formative use of feedback, undermining competence; (2) <i>Fleeting Convergences</i> captured how EPAs and competence development operated on largely separate trajectories, with only occasional moments of alignment; (3) <i>Electronic Barriers</i> highlighted how documentation platforms replaced feedback dialogue with impersonal transactions, weakening relatedness while reducing opportunities for autonomous engagement and understanding performance gaps, if any; and (4) <i>A Binding Burden</i> showed that shared bureaucratic struggles fostered peer solidarity among participants, though this relatedness centered on coping rather than collaborative learning.</p><p><strong>Conclusions: </strong>Current use of EPAs often fails to support the conditions necessary for meaningful engagement with EPAs and, in some cases, actively thwarts them. Documentation burdens constrained autonomy, competence was weakly supported, and relatedness was strained by transactional processes-a drift from EPAs as professional activities to fragmented assessment tasks. Addressing these challenges is essential if EPAs are to function as intended: units of professional practice to be entrusted to residents.</p>","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"1760-1772"},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148006037","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":"'Part of my humanity left me the day I walked into medical school': Navigating medical students' identity dissonance through the medical humanities.","authors":"Selena Kattick, Samantha Smoger, Ryan R Weber, Kate Lafferty-Danner, Amanda M Caleb","doi":"10.1080/0142159X.2026.2733140","DOIUrl":"https://doi.org/10.1080/0142159X.2026.2733140","url":null,"abstract":"<p><strong>Introduction: </strong>Medical humanities curricula offer a lens for understanding how medical learners construct meaning and professional identity. While intended to cultivate patient-centered physicians, this process can provoke identity dissonance rooted in the hidden curriculum, leading learners to suppress, compartmentalize, or defer emotional engagement. This study examines how a medical humanities exercise shaped learners' reflections on identity dissonance, affect, and professional identity formation. Through qualitative analysis of reflective narratives, we explored how students interpreted tensions between personal values, emotional experience, and professional expectations during the transition to residency. Within medical education, medical humanities function as a corrective to institutional cultures that sustain identity dissonance, offering space to reimagine what it means to be physicians.</p><p><strong>Methods: </strong>The research team conducted a qualitative cross-sectional analysis of medical humanities reflections in response to reading Anatole Broyard's 'Doctor, Talk to Me', submitted by 113 fourth-year medical students enrolled in the Transition to Residency course at Geisinger Commonwealth School of Medicine in 2024. Researchers employed a constructivist grounded theory methodology to independently code de-identified reflections and used triangulation to achieve consensus.</p><p><strong>Results: </strong>Researchers identified 23 codes that were categorized into four themes: (1) modulating personal assumptions and professional expectations, (2) fragmented self, (3) situating affect, with a subtheme of deferred empathy, and (4) connectivity through shared humanity. Students frequently described identity dissonance and tensions between emotional engagement and prevailing professional norms. Many articulated forms of deferred empathy, postponing deeper emotional connection until they perceived greater professional autonomy.</p><p><strong>Discussion: </strong>This study suggests that medical humanities encounters may help learners recognize and interpret identity dissonance while creating space to examine affective dimensions of professional identity formation. Medical humanities counter the tendency in medical training to manage difficult emotions through detachment by offering students tools to engage those emotions while remaining present with patients.</p>","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"1-8"},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111946","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 on how successfully fail at implementing Programmatic Assessment for Learning.","authors":"Dario Torre, Jennifer Anne Cleland, Lambert Schuwirth","doi":"10.1080/0142159X.2026.2733138","DOIUrl":"https://doi.org/10.1080/0142159X.2026.2733138","url":null,"abstract":"<p><p>Programmatic Assessment for Learning (PAL) has emerged as the conceptual evolution of programmatic assessment by explicitly positioning learning as the organizing principle of assessment design. Although its theoretical foundations are well established and international consensus statements have provided implementation guidance, many institutions continue to encounter substantial challenges when introducing PAL. These challenges often arise not from shortcomings of individual assessment methods, but from misalignment across curriculum, assessment, organizational culture, governance, leadership, and educational practices. This article adopts a deliberately ironic 'reverse-tips' approach to identify twelve common practices that inadvertently undermine successful implementation of PAL. Rather than presenting recommendations for what to do, each tip illustrates what organizations should avoid. In doing so, we expose the assumptions, structures, and organizational mechanisms that divert programs from the educational principles underpinning PAL. The tips emphasize that successful implementation depends on integrating assessment with curriculum design, longitudinal coaching, learner agency, meaningful interpretation of evidence, governance, faculty development, and intentional organizational culture change, while recognizing the tensions inherent in balancing learning with accountability. Collectively, these twelve (reverse) tips provide educators with a practical framework for recognizing implementation traps and critically examining whether their assessment systems remain aligned with the educational purposes of PAL.</p>","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"1-9"},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149112089","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":"Undergraduate medical students and artificial intelligence: A global systematic review and meta-analysis using a knowledge-attitude-practice framework.","authors":"Paolo Visci, Francesco Lupelli, Francesco Calò, Gianmarco Sirago, Biagio Solarino, Alessandro Dell'Erba, Davide Ferorelli","doi":"10.1080/0142159X.2026.2663855","DOIUrl":"10.1080/0142159X.2026.2663855","url":null,"abstract":"<p><strong>Background: </strong>Artificial intelligence (AI), including deep learning and large language models, is increasingly reshaping healthcare and medical education. Since the public release of generative AI tools such as ChatGPT, medical students have become a particularly exposed group, often engaging with these technologies without standardized curricular guidance. Although previous reviews have explored readiness, acceptance, or anxiety, the relationship between students' knowledge, attitudes, and practical engagement with AI has not been comprehensively synthesized. This study therefore examined undergraduate medical students' engagement with AI using a Knowledge-Attitude-Practice (KAP) framework.</p><p><strong>Methods: </strong>This systematic review and meta-analysis was reported in accordance with PRISMA 2020. The research question was structured using the PCC framework. PubMed, Scopus, and Web of Science were searched up to September 30, 2025. Eligible studies included cross-sectional and psychometric validation studies addressing AI-related perceptions among undergraduate medical students. Methodological quality was assessed using the AXIS tool. Because of substantial heterogeneity in instruments and reporting, quantitative synthesis was restricted to 11 studies using the MAIRS-MS scale and reporting comparable percentage-based outcomes. Pooled estimates were calculated using Freeman-Tukey double arcsine transformation and a random-effects DerSimonian-Laird model.</p><p><strong>Results: </strong>Forty-three studies met the inclusion criteria, including 37 cross-sectional and 6 psychometric validation studies. Attitudes were the most frequently explored dimension, followed by knowledge and practice. In the 11 studies included in the quantitative synthesis, pooled estimates showed moderate knowledge (0.55; 95% CI: 0.49-0.61), positive attitudes (0.64; 95% CI: 0.59-0.69), and comparable practice levels (0.63; 95% CI: 0.59-0.67). Heterogeneity remained high, while Egger's test showed no significant small-study effects.</p><p><strong>Conclusions: </strong>Medical students appear receptive to AI, but their knowledge remains moderate and their practical engagement reflects this limited preparation. These findings support the need for structured undergraduate AI curricula integrating theoretical, applied, and ethical-legal competencies.</p>","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"1791-1803"},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148138526","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}