Clinical Teacher最新文献

{"title":"Simulation to Improve Medical Student Understanding of Doulas' Role","authors":"Caroline N. Goldfarb,&nbsp;Celeste Royce,&nbsp;Salvatore Daddario,&nbsp;Jeannette C. Myrick,&nbsp;Laura Pichardo,&nbsp;Kimberley Campbell,&nbsp;Elysia Larson","doi":"10.1111/tct.70085","DOIUrl":"https://doi.org/10.1111/tct.70085","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Birth doula services in the United States are increasingly covered by insurance and sought out by patients. To be effective team members on labour and delivery (L&amp;D), it is critical that medical students understand doulas' role and how to collaborate with doulas in patient care.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach</h3>\u0000 \u0000 <p>To this end, we developed an L&amp;D simulation for students to practice working with doulas. Preclinical medical students participated with an obstetrician, anesthesiologist, nurse and doula in a simulated patient birth and debrief.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Evaluation</h3>\u0000 \u0000 <p>A descriptive evaluation was conducted via presimulation and postsimulation surveys asking students to evaluate their comfort “caring for a patient with a doula” and understanding of the “doula [role] during a delivery” on a 7-point scale. Presimulation to postsimulation comparisons were done with linear regressions with clustering. This project received a nonhuman subjects research determination. In total, 255 students participated across 2 years; 212 students completed surveys. Of students who completed presimulation surveys (<i>N</i> = 201), 17.8% had previous L&amp;D experience. Participating in the simulation significantly increased both students' comfort collaborating with a doula (3.1 points) (95% confidence interval [CI]: 2.9–3.4) and their understanding of the doula role (3.2 points) (95% CI: 2.9–3.5). Presimulation, students with prior L&amp;D experience had higher understanding of doulas' role than those without experience (0.70 points, 95% CI: 0.09–1.3).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications</h3>\u0000 \u0000 <p>Including birth doulas in obstetric simulations is an effective method to improve preclinical medical students' awareness and understanding of the doula role, providing an important opportunity to improve L&amp;D collaboration and patient care.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47324,"journal":{"name":"Clinical Teacher","volume":"22 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143787174","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"‘It's the way I talk, y'knaa?’: Accent, Dialect, Assumptions and Bias in Medical Education","authors":"Mary Robinson,&nbsp;Karen Patrice Corrigan,&nbsp;James Fisher","doi":"10.1111/tct.70084","DOIUrl":"https://doi.org/10.1111/tct.70084","url":null,"abstract":"","PeriodicalId":47324,"journal":{"name":"Clinical Teacher","volume":"22 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741597","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Faculty Development for the People: Workplace-Based Solutions for Busy Clinicians","authors":"Erica C. Brode,&nbsp;Joey M. Bernal,&nbsp;Susannah B. Cornes,&nbsp;Lekshmi Santhosh,&nbsp;Josette A. Rivera,&nbsp;Shradha A. Kulkarni,&nbsp;Jennifer R. Mandal,&nbsp;Duncan M. Henry,&nbsp;Katherine S. Bartz,&nbsp;Sandrijn M. Van Schaik","doi":"10.1111/tct.70073","DOIUrl":"https://doi.org/10.1111/tct.70073","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Across clinical learning environments (CLEs), learners often encounter supervising clinicians who do not self-identify as educators and, therefore, may not seek out faculty development to augment their teaching skills. To reach those faculty, we conducted a proof-of-concept project framed by Billet's theory on workplace learning, bringing tailored faculty development to the clinical workplace.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach</h3>\u0000 \u0000 <p>We recruited 22 faculty champions from 8 clinical departments at our institution, reflecting a broad and diverse range of CLEs. We created core materials for faculty development around feedback skills, which the faculty champions adapted to meet the needs of their individual CLEs. They took a variety of different approaches, including online modules, instructional posters in the OR and brief workshops offered during existing meetings.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Evaluation</h3>\u0000 \u0000 <p>Between fall 2019 and summer 2022, this faculty development initiative reached a large number of faculty across departments, with the highest participation if activities were embedded in existing meetings. Based on available survey data, faculty satisfaction ratings with the offerings were high, and self-perceived competence increased. Despite successes, we also encountered challenges, including variable uptake dependent on departmental priorities, leadership buy-in and incentives offered.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications</h3>\u0000 \u0000 <p>This proof-of-concept project led to ongoing integration of workplace-based faculty development offerings at our institution, where a central ‘hub’ provides a broad array of activities and resources that can be adapted to different contexts (‘spokes’). The lessons learned from this work can inform other institutions in the development and implementation of initiatives aimed at augmenting the reach of faculty development for busy clinicians.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47324,"journal":{"name":"Clinical Teacher","volume":"22 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143741596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Community-Powered Learning: A Qualitative Analysis of Postgraduate Medical Trainee Development Through Journal Club","authors":"Anne L. Murray,&nbsp;Brian H. Walsh,&nbsp;Anél Wiese","doi":"10.1111/tct.70087","DOIUrl":"https://doi.org/10.1111/tct.70087","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Journal clubs are a core feature of postgraduate medical education. They are used to teach critical appraisal skills and evidence-based medicine to postgraduate trainees. Studies have been carried out examining the purpose and goals of journal club, but with minimal input from learners. Thus, the research question was devised, ‘why do postgraduate trainees find journal clubs effective for their continuous professional development and what underlying processes facilitate their learning and engagement in these settings?’</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A qualitative study was designed to capture the opinions of the learners when considering learning through journal club. Semi-structured interviews were felt to be most appropriate to allow participants to explore freely how they learn from journal club as well as the aspects of the club that support or hinder learning. Data were analysed using thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>21 interviews were conducted within two departments in adjoining hospitals. There were 6 consultants, 9 registrars and 6 SHOs interviewed. The median (IQR) interview time was 23.5 (19.5–27.3) minutes. The themes identified were committed participation, with subthemes of habit formation and positive environment, and transformative participation, with subthemes of emerging leaders and shared experience.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion/Conclusion</h3>\u0000 \u0000 <p>The themes identified from our interviews align with principles of communities of practice and legitimate peripheral participation. Regular meetings in a positive learning environment are vital. Mutual engagement and role modelling contribute hugely to trainee learning from journal club, through the development of relationships between junior and senior members in the preparation, delivery and discussion of literature.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47324,"journal":{"name":"Clinical Teacher","volume":"22 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/tct.70087","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143726864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Authentic Leadership in Clinical Education: A Neurodivergent Educator's Call for Change","authors":"Carl A. Frizell","doi":"10.1111/tct.70088","DOIUrl":"https://doi.org/10.1111/tct.70088","url":null,"abstract":"","PeriodicalId":47324,"journal":{"name":"Clinical Teacher","volume":"22 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143726807","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Triaging in Mass Casualty Incidents: A Simulation-Based Scenario Training for Emergency Care Senior Residents","authors":"Daisy Rotzoll,&nbsp;Claudia Pott,&nbsp;Robert Stöhr,&nbsp;Thomas Hartwig,&nbsp;André Gries","doi":"10.1111/tct.70083","DOIUrl":"https://doi.org/10.1111/tct.70083","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Mass casualty incidents (MCIs) are events where the number of patients may exceed the resources available for emergency management. In emergency departments (ED), MCIs go along with high patient allocation in a short time period. For ED staff, simulation-based immersive scenario training can be an effective tool to develop communicative and leadership competencies to manage these situations.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach</h3>\u0000 \u0000 <p>A novel simulation-based immersion experience was developed for senior residents in emergency care. To our knowledge, this is the first scenario training focusing on in-hospital triage and management of MCI in an ED using simulated patients, visual tracking, bodycams and active participant location tracking as educational tools. The participants were either directly involved by managing triage and allocation of in-hospital resources for 14 patients or in remote observation of the running scenario on an audiovisual basis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Evaluation</h3>\u0000 \u0000 <p>After implementation of the pilot MCI simulation-based scenario training, 13 participants completed surveys (48% response rate) including open-ended response items. Quantitative data and open-ended responses using an electronic response system were sequentially analysed to evaluate training feasibility and acceptability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications</h3>\u0000 \u0000 <p>We designed a novel simulation-based MCI scenario training focusing on learning objectives involving confidence gain in ED triage. Although this format is extremely resource and time consuming, the highly positive evaluation (participants strongly agreed or agreed that the simulation scenario was suitable for in-hospital MCI triage training) implies that this innovative education technique should be considered for future emergency medical services (EMS) training sessions.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47324,"journal":{"name":"Clinical Teacher","volume":"22 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/tct.70083","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143698829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Novel Postgraduate Diversity in Medical Education (DiME) Leadership Programme","authors":"Zivarna Murphy,&nbsp;Amelia Kehoe,&nbsp;Mousindha Arjunan,&nbsp;Fiona Bishop,&nbsp;Alice Pullinger,&nbsp;Robert Morgan Blizzard,&nbsp;Amaya Ellawala,&nbsp;Paul Crampton","doi":"10.1111/tct.70074","DOIUrl":"https://doi.org/10.1111/tct.70074","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Reduced retention and progression amongst ethnic minority staff is severely disrupting equality, diversity and inclusion (EDI) within healthcare with negative impacts on patient care. There is a lack of diversity in postgraduate leadership roles with systemic issues and insufficient support. To help address these issues at an individual level, we developed the Diversity in Medical Education (DiME) programme that aims to close the gap between ethnic minority individuals and training programme director (TPD) positions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach</h3>\u0000 \u0000 <p>Over 6 months, the programme consisted of a series of learning days on action learning sets and effective meetings, mock interviews with associate deans, networking events, mentoring, access to coaching and subsequently forming a peer network. Participants were recruited from a wide range of primary and secondary care specialties and ethnic minority backgrounds.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Evaluation</h3>\u0000 \u0000 <p>A qualitative evaluation was undertaken. Lessons learned included providing protected time to participate in professional development, facilitating flexibility of opportunities and enhancing understanding and encouragement for individuals to progress as an ethnic minority leader. Interviews revealed programme benefits, barriers and challenges participants faced in reaching leadership positions and suggested recommendations to enhance DiME. Benefits included the development of technical and non-technical skills, feeling valued and supported, and peer networking.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications</h3>\u0000 \u0000 <p>DiME is a novel postgraduate programme to support ethnic minority TPDs in overcoming barriers to leadership positions through building networks and sharing valuable skills. Systemic and institutional barriers impede ethnic minority individuals reaching senior leadership positions, yet this initiative provides a small step through the implementation of an innovative programme.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47324,"journal":{"name":"Clinical Teacher","volume":"22 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143698830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Walls Are Mirrors: Messages Delivered in Physical Environments","authors":"Heeyoung Han,&nbsp;Harini Rathinamanickam,&nbsp;Vidhya Prakash,&nbsp;Wendi El-Amin,&nbsp;Susan Hingle","doi":"10.1111/tct.70079","DOIUrl":"https://doi.org/10.1111/tct.70079","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Creating diverse, equitable and inclusive (DEI) environments is essential for thriving in academic medicine. However, it was unclear if and how physical environments in academic medicine convey DEI messages consistently. This study investigated how the physical environment at a medical school represents DEI values.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach</h3>\u0000 \u0000 <p>We adopted an autophotography research methodology where we took photos and shared experiences and emotions through group reflections. Photographs included pictures, statues, artwork and physical space arrangements of clinical, administrative and teaching sites. Researchers with diverse backgrounds reflected on the 190 photos during four group reflection sessions. Discussions were recorded, transcribed and analysed using thematic analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Evaluation</h3>\u0000 \u0000 <p>The physical environment was a mirror of the past and the present, representing what we value, who we are, what we do and whom we serve. The walls exclusively demonstrated the value of excellence, predominantly from one group, despite commonly shared DEI values throughout the school. Power inequality on the walls was apparent in subtle ways, including the size and permanence of photos or letters and the selection of words based on gender, position and race. Sterile spaces or walls with random, stock photographs were also observed. Some unintentionally inconsiderate physical environments were hurtful, undermined our values and sense of identity and weakened relationships.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications</h3>\u0000 \u0000 <p>This project was instrumental in leading to several meaningful changes at the school. Creating and sustaining inclusive learning environments are not possible without consistent messages in physical environments. We continue to implement changes that facilitate DEI values in our physical environment.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47324,"journal":{"name":"Clinical Teacher","volume":"22 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143690144","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical Student Perceptions of the Barriers to Entering Orthopaedic Surgery Differ by Gender","authors":"Bahar Entezari,&nbsp;Sarah Kerslake,&nbsp;Steve Mann,&nbsp;Jesse I. Wolfstadt,&nbsp;Wilma Hopman,&nbsp;Peter C. Ferguson,&nbsp;Laurie A. Hiemstra","doi":"10.1111/tct.70078","DOIUrl":"https://doi.org/10.1111/tct.70078","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>The value of gender representation has been increasingly recognised in medicine, yet women represent only 13.6% of orthopaedic surgeons in Canada. The primary objective of this study was to determine barriers identified by medical students considering pursuing a career in orthopaedic surgery. The secondary objective was to assess for gender-based differences in barriers identified by medical students.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional mixed-methods survey was distributed to final-year students at a Canadian medical school. Descriptive analyses were calculated for the study population and gender subgroups. To compare responses between gender subgroups, chi-square or Fisher's exact tests were employed for binary data, and non-parametric Mann–Whitney <i>U</i> tests for ordinal data. Open-text responses were reviewed for descriptions of students' experiences in orthopaedics.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Sixty-four medical students participated, representing a response rate of 59.3%. Male culture and the need for physical strength were identified as strong barriers to pursuing a career in orthopaedics. Additionally, women reported less exposure (<i>p</i> = 0.003), disproportionate constraints (i.e., scrutiny of performance based on gender, <i>p</i> = 0.001), less mentorship (<i>p</i> = 0.028), more concerns about verbal (<i>p</i> &lt; 0.001) and sexual abuse (<i>p</i> = 0.013), and higher rates of direct discouragement from pursuing orthopaedics than men (<i>p</i> = 0.035). Open-text responses indicated that orthopaedics was not considered welcoming to all medical students.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>This study is the first to characterise medical student perceptions of barriers to gender equity in orthopaedic surgery in Canada. Fostering a more equitable environment will necessitate a paradigm shift in the educational framework toward orthopaedic surgery.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47324,"journal":{"name":"Clinical Teacher","volume":"22 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/tct.70078","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143689629","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Future of Medicine Is Queer","authors":"Saffren Bibi Colbourne","doi":"10.1111/tct.70081","DOIUrl":"10.1111/tct.70081","url":null,"abstract":"","PeriodicalId":47324,"journal":{"name":"Clinical Teacher","volume":"22 3","pages":""},"PeriodicalIF":1.4,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143675031","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}