Medical Teacher最新文献

{"title":"Broadening an understanding of learners who think differently in medical education.","authors":"Richard B Hays, David Hartman, Paula Heggarty, Jane Harte","doi":"10.1080/0142159X.2025.2606065","DOIUrl":"10.1080/0142159X.2025.2606065","url":null,"abstract":"","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"1617-1620"},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145912339","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":"Micro-Sim: Advancing antimicrobial Stewardship education through interprofessional simulation.","authors":"Miguel Vella, Li Ling Choo, Iram Lodhi","doi":"10.1080/0142159X.2025.2579098","DOIUrl":"10.1080/0142159X.2025.2579098","url":null,"abstract":"<p><p><b>What was the educational challenge?</b> Inappropriate antibiotic prescribing remains a persistent problem, with significant knowledge gaps among students and physicians. We evaluated 180 antibiotic prescriptions showing 68% were inconsistent with trust guidelines, highlighting the need for targeted interventions. <b>What was the solution and how was it implemented?</b> Participants undertook a week-long program comprising interactive presentations, charts, newsletters, and the Micro-Sim simulation. Acting as infection doctors, they managed bleeps and advised on ten structured cases including assessing a septic mannikin. Pre- and postintervention questionnaires assessed knowledge, supplemented by qualitative feedback. <b>What lessons were learned and what are the next steps?</b> Across 10 sessions (<i>n</i> = 105), questionnaire scores improved by 42% (<i>p</i> < 0.0005, Cronbach <i>a</i> > 0.8), and self-reported knowledge increased by 74% (<i>p</i> < 0.0001). Participants reported greater confidencein safe prescribing, with audit data showing improved adherence to antimicrobial policies. Micro-Sim proved adaptable across doctors, nurses, pharmacists, and students with potential for scalable, clinically meaningful impact worldwide. We now plan to train regional facilitators and develop a virtual version of Micro-Sim to enable international dissemination.</p>","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"1641-1644"},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145401131","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":"Simulated patient judgements of medical student performance in OSCEs: A realist evaluation.","authors":"Ansaam El-Sherif, Jun Jie Lim, Chris Roberts","doi":"10.1080/0142159X.2026.2641759","DOIUrl":"10.1080/0142159X.2026.2641759","url":null,"abstract":"<p><strong>Introduction: </strong>Simulated patients (SPs) are widely used in Objective Structured Clinical Examinations (OSCEs) and increasingly contribute to summative scoring in high-stakes clinical assessments. While their judgments inform pass-fail decisions, concerns remain about variability and potential bias. There is limited theory-driven evidence explaining how SP involvement contributes to assessment decisions, and under what conditions this supports fair and credible assessment. This study aimed to develop and refine a programme theory explaining how SP involvement contributes to decision-making in high-stakes OSCEs.</p><p><strong>Methods: </strong>We conducted a realist evaluation informed by an initial programme theory developed through a rapid realist review. Semi-structured interviews were undertaken with 19 SPs in a sequential OSCE at a UK medical school. Interviews explored how SPs approached scoring decisions and how features of the assessment environment shaped their judgments. Data were analysed iteratively using abductive and retroductive reasoning to identify context-mechanism-outcome configurations (CMOCs) and refine the programme theory.</p><p><strong>Results: </strong>Eighteen interrelated CMOCs were constructed across nine domains describing how SP judgments were shaped through interactions between assessment-related factors (including assessment tools, assessment focus, logistical environment, and the sequential format) and SP-related factors (including background and experience, training and benchmarking, role positioning, fatigue, and interaction with examiner). When SPs felt prepared, role clarity was established, and assessment tools and conditions were supportive, they reported making judgments experienced as fair and authentic. In contrast, high cognitive load, role ambiguity, fatigue and insufficient preparation activated mechanisms that increased perceived variability and potential for bias.</p><p><strong>Discussion: </strong>SP judgments in high-stakes OSCEs are complex and context-dependent. This programme theory provides an explanatory account of how SP judgments are produced and identifies conditions that support or undermine assessment. The findings offer practical implications for assessment design, SP training and faculty-SP collaboration to strengthen the use of SPs as assessors in high-stakes clinical examinations.</p>","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"1715-1724"},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147474527","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":"Fostering connections, psychological safety and meaningful relationships: The role of preclerkship learning communities in professional identity formation.","authors":"Elizabeth Ann Yakes, Thuy L Ngo, Marjorie D Wenrich, Alejandro Moreno, Jennifer Quaintance, Megan McVancel, Kurt Pfeifer, Mrinalini Kulkarni-Date, David Hatem","doi":"10.1080/0142159X.2026.2649221","DOIUrl":"10.1080/0142159X.2026.2649221","url":null,"abstract":"<p><strong>Introduction: </strong>Professional identity formation (PIF) in medicine is a developmental process of integrating personal and professional values, attributes, and practices into one's character. This process may be advanced through experiential learning, socialization, and role models, all of which are found in longitudinal integrated experiences such as learning communities (LCs). LCs, present in more than half of U.S medical schools, often function as communities of practice (CoP) that may promote PIF. To better understand the influences of LCs on PIF in the preclerkship phase, we conducted a qualitative, multi-institution study to determine the LC activities, relationships, and key experiences medical students perceived as impacting their PIF.</p><p><strong>Methods: </strong>Preclerkship students from five U.S. medical schools with LCs completed an open-ended survey eliciting perspectives on LC factors influencing their PIF. We used constant comparison to develop a codebook, code and analyze survey responses, and develop individual school and cross-school summaries.</p><p><strong>Results: </strong>A total of 208 students across the schools (29% of those recruited) completed the survey. LCs offered students opportunities for connections within psychologically safe environments; this combination promoted meaningful professional relationships that contributed to students' PIF. However, LCs may not impact the PIF of all students.</p><p><strong>Discussion: </strong>This study is the first to describe the interrelationship of three key structural elements in preclerkship LCs - facilitating multiple connections, building psychologically safe environments, and fostering meaningful relationships - that appear to lay a foundation for and scaffold student growth and PIF. Our study provides empirical support for the impact of LCs, functioning as CoP, on preclerkship students' PIF.</p>","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"1747-1759"},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147608933","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 active learning is not enough: Rethinking equity in team-based learning.","authors":"Mark Justine N Revano, Ronilo P Antonio","doi":"10.1080/0142159X.2026.2663863","DOIUrl":"10.1080/0142159X.2026.2663863","url":null,"abstract":"","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"1820"},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147840088","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":"Adapting to clinical responsibility: Challenges and learning environment in early practice-a longitudinal study.","authors":"Shou-De Ma, Sin Yee Patty Kwong, Grace Sambo, Shiuan-Ruey Yu, Yu-Che Chang, Ming-Ju Hsieh, Ji-Tseng Fang, Chung-Hsien Chaou","doi":"10.1080/0142159X.2026.2641761","DOIUrl":"10.1080/0142159X.2026.2641761","url":null,"abstract":"<p><strong>Introduction: </strong>The transition from medical student to doctor is widely recognized as a challenging period, yet most studies capture this transition at single time points and provide limited guidance on how educational environments can better support learners. Longitudinal insights are needed to understand how challenges emerge, how learners adapt, and where educational interventions may be most effective. This study aims to explore how medical students experience and adapt to increasing clinical responsibility across the transition from clerkship to the first postgraduate year (PGY1), interpreted through Gruppen's Learning Environment Framework.</p><p><strong>Methods: </strong>This longitudinal study was conducted between August 2017 and July 2020 using audio diaries collected from medical students as they progressed from clerkship through their first postgraduate year (PGY1). Participants recorded regular audio diaries reflecting on experiences that made them feel unprepared for clinical practice. Data were analyzed inductively to identify recurring challenges and coping strategies. Gruppen's learning environment framework was subsequently used as an analytic scaffold to organize findings across personal, social, and organizational domains and to inform intervention-oriented interpretation.</p><p><strong>Results: </strong>During clerkship, learners reported substantial challenges related to applying theoretical knowledge to patient care, limited participation within clinical teams, and uncertainty about professional roles and responsibilities. As learners transitioned into PGY1, they described adaptive processes including proactive engagement in clinical tasks, relationship-building with supervisors and team members, and increased self-reflection. Longitudinal analysis demonstrated both continuity and change across the transition: while some challenges persisted, learners' responses evolved as they assumed greater responsibility and autonomy.</p><p><strong>Discussion: </strong>This study illustrates how challenges during the transition to practice are shaped by learning environment factors and how learners adapt over time. Using a learning environment framework as an analytic and intervention-guiding tool, the findings offer practical insights for designing educational strategies to better support learners as they move from student to doctor.</p>","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"1725-1736"},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147499341","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":"Standardized patient gender influences diagnostic accuracy in undergraduate medical students' cardiac OSCE interviews.","authors":"Xavier Dubucs, Adeline Ruyssen-Witrand, Audrey Richard, Alessandra Bura Rivière, Emilie Montastier, Marie Faruch, Frédéric Balen, Odile Rauzy, Thomas Geeraerts, Charles Henri Houze-Cerfon, Sandrine Charpentier","doi":"10.1080/0142159X.2026.2631741","DOIUrl":"10.1080/0142159X.2026.2631741","url":null,"abstract":"<p><p><b>Introduction</b>: This study aimed to assess the influence of standardized patient and student gender on the undergraduate medical students' performance during the interview station of Objective Structured Clinical Examinations (OSCE). <b>Methods</b>: This study was conducted among fourth-year medical students during an OSCE at the University of Toulouse, France. Standardized patients, examiners, and students were blinded to the study design. Four gender-neutral clinical cases were developed, involving cardiac diagnoses: case 1: acute coronary syndrome; case 2: musculoskeletal chest pain; case 3: cardiac arrhythmias with acute coronary syndrome; case 4: vasovagal syncope. The primary outcome was the diagnostic hypothesis proposed by the student at the end of the standardized patient interview. <b>Results</b>: A total of 357 fourth-year students were assessed. The mean age of the students was 22 years (±2.6) and 225 (63.0%) were female. Ten standardized patients were involved, (7 female, median age: 51 [IQR 44-60]; 3 male, median age: 55 [IQR 50-59]). The rate of correct diagnostic hypotheses was significantly higher with male standardized patients (64.9% [95% CI, 55.0%-73.7%]) than with female standardized patients (45.6% [95% CI, 39.5%-51.8%]; <i>p</i> = 0.002). Female students were also less likely to propose correct diagnoses with female standardized patients (40% vs. 66.2%, <i>p</i> = 0.003) compared to male students (50% vs. 62%, <i>p</i> = 0.25). <b>Discussion</b>: Our study supports that diagnostic hypothesis proposed by undergraduate medical students at the interview station during OSCEs is influenced by standardized patient gender, with a higher likelihood of incorrect diagnoses when the standardized patient is female, despite gender-neutral clinical cases. Diagnostic accuracy may also be influenced by student gender. These findings suggest that gender bias exists from the early stages of medical training.</p>","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"1657-1663"},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146220293","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":"Correction.","authors":"","doi":"10.1080/0142159X.2025.2565963","DOIUrl":"10.1080/0142159X.2025.2565963","url":null,"abstract":"","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"1824"},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145176681","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":"Competing for clinician educators' time: A Bourdieuan perspective on faculty development participation.","authors":"Harm Peters, Marwa Schumann","doi":"10.1080/0142159X.2026.2738753","DOIUrl":"https://doi.org/10.1080/0142159X.2026.2738753","url":null,"abstract":"","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"1"},"PeriodicalIF":4.0,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149111851","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 across specialty lines: A systematic review informing curriculum design for intraprofessional education.","authors":"Lucy Moy, Jodie Servante, Asim Ali, Melanie Griffin","doi":"10.1080/0142159X.2026.2735287","DOIUrl":"https://doi.org/10.1080/0142159X.2026.2735287","url":null,"abstract":"<p><strong>Introduction: </strong>Effective patient care relies on collaboration across medical and surgical specialties, yet medical education trains doctors within specialty specific silos. Intraprofessional education (IntraPE), defined as structured learning bringing together doctors from different specialties or enabling medical students to learn across two or more specialty perspectives, may support coordinated care. Understanding how educational interventions support collaboration within medicine is essential for patient centred care in complex healthcare systems. This review synthesised structured IntraPE interventions and proposed evidence informed intended learning outcomes (ILOs).</p><p><strong>Methods: </strong>This systematic review was registered with PROSPERO (CRD420251143089) and followed PRISMA 2020. Five databases were searched for studies from 2014 to 2025. Eligible studies involved undergraduate medical students, postgraduate trainees or fully qualified specialists and reported quantitative, qualitative or mixed methods outcomes. Methodological quality was assessed using Critical Appraisal Skills Programme checklists. Findings were synthesised narratively.</p><p><strong>Results: </strong>Twenty-one studies across 33 specialties and 12 countries were included, comprising 9,628 participants among studies reporting sample sizes. Five approaches were identified: case-based learning, simulation based learning, clinical placement or work based models, consultation and advice models, and longitudinal integrated clerkships. Eight outcome domains emerged: clinical knowledge, collaboration, communication, attitudes towards other specialties, professional development, teamwork, patient care delivery and engagement with collaborative practice. Positive outcomes were reported across all approaches. However, heterogeneity in study design, intervention format and outcome assessment prevented comparison of relative effectiveness or analysis by learner stage. Few studies included long term follow up or examined how learning occurred.</p><p><strong>Discussion: </strong>Structured IntraPE may support learning across specialty boundaries, although heterogeneity limits conclusions about comparative effectiveness. The proposed ILOs provide a starting point for curriculum design and evaluation. Stakeholder refinement and longitudinal evaluation are needed to assess their relevance across learner stages and whether educational outcomes translate into collaborative practice and improved patient care.</p>","PeriodicalId":18643,"journal":{"name":"Medical Teacher","volume":" ","pages":"1-14"},"PeriodicalIF":4.0,"publicationDate":"2026-09-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149112006","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}