Tanya D. Murtha, Rachel R. Johnson, Matthew S. Ellman, Andrés S. Martin, Laura J. Morrison, Jaideep S. Talwalkar
{"title":"Experiences of Simulated Phone Death Notification","authors":"Tanya D. Murtha, Rachel R. Johnson, Matthew S. Ellman, Andrés S. Martin, Laura J. Morrison, Jaideep S. Talwalkar","doi":"10.1111/tct.13846","DOIUrl":"10.1111/tct.13846","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Physicians perform many difficult skills, but notifying loved ones about the death of a family member is a particularly challenging skill that requires specific training. Descriptions of such training are lacking in the literature. We developed a formative standardised patient encounter on death notification over the telephone for fourth-year medical students and evaluated their qualitative perspectives, including emotional safety.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach</h3>\u0000 \u0000 <p>Embedded within a fourth-year advanced communication skills workshop in 2019, a case was introduced to practice telephone death notification. Students had a preparatory didactic lesson, received formative peer feedback, and participated in faculty-led debriefs.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Evaluation</h3>\u0000 \u0000 <p>Eighty-eight medical students at one medical school in the United States participated in debriefing sessions after a communication skills workshop during the fourth-year capstone course. The debriefing sessions were audio-recorded and transcribed. Fifty-seven of those students completed postsession surveys. Transcripts and surveys were qualitatively analysed using content analysis to code responses, extract salient categories, and distil into themes. Three general themes emerged: communication challenges, emotional responses, and appreciation for the experience. Communication challenges included using language about death, experiences of silence, complications of distance and driving, and communication by phone. Students described the case as “challenging,” “uncomfortable,” “intense,” and “emotional.” Despite these strong feelings, students expressed appreciation for the experience, noting appropriateness of the preparation and debrief, a sense of safety, and realistic encounters.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications</h3>\u0000 \u0000 <p>Telephone death notification training was a valued, realistic, and emotionally safe experience. Students felt appropriately challenged, but adequately supported. These skills can be included in formative communication skills curricula.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47324,"journal":{"name":"Clinical Teacher","volume":"22 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142879026","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":"Modifying Personal Factors Causing Burnout—How Personal are They?","authors":"Stephanie Penswick","doi":"10.1111/tct.70001","DOIUrl":"10.1111/tct.70001","url":null,"abstract":"","PeriodicalId":47324,"journal":{"name":"Clinical Teacher","volume":"22 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142879033","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}
Christopher L. Klasson, Amal Shibli-Rahhal, Eric Ortiz, Ashrita Raghuram, Jay Behel, Ada Gregory, Carrie Bernat, Nicole del Castillo
{"title":"Restorative Justice Practices as a Foundation for Medical Education Innovation","authors":"Christopher L. Klasson, Amal Shibli-Rahhal, Eric Ortiz, Ashrita Raghuram, Jay Behel, Ada Gregory, Carrie Bernat, Nicole del Castillo","doi":"10.1111/tct.13852","DOIUrl":"10.1111/tct.13852","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Restorative justice (RJ) is an ethical lens that places emphasis on a community's connection and proliferative impact of actions, promoting communication and establishing methods for accountability. RJ practices can be applied on a spectrum, including proactive community-building practices, community discussions in response to an event, and restorative conferences addressing specific incidences of harm. This article describes an intervention that utilized RJ community-building practices within a medical education environment and evaluates its acceptability and feasibility.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach</h3>\u0000 \u0000 <p>During the summer of 2023, RJ interventions were planned, executed and assessed within two programmes involving pre–matriculant medical students, physician–assistant studies students and undergraduate students. The interventions utilized community-building circles within small group activities. Capacity building included training for facilitators. Ninety-five students participated in the RJ circles.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Evaluation</h3>\u0000 \u0000 <p>Evaluation included mixed methods pre- and post-intervention surveys as well as qualitative interviews. Ten students (11%) responded to the pre-intervention survey, and 17 responded to the post-intervention survey (18%). Seven responses were obtained from interviews and qualitative surveys. Overall, participant survey responses indicated increased feelings of connection and perceptions of mutual understanding and that the programme provided adequate space to share one's perspective. Qualitative content analysis emphasized community building through RJ circles and their ability to promote connection, meaningful vulnerability, foster peer support and a desire to continue these activities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications</h3>\u0000 \u0000 <p>RJ interventions within medical education environments are feasible and show considerable promise. Participants consistently noted the benefits of greater connection between peers, feelings of support and a desire for these practices to continue.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47324,"journal":{"name":"Clinical Teacher","volume":"22 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11663732/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877803","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}
Lyn Clearihan, Marilyn Baird, Wayne Hodgson, Janeane Dart, Charlotte Barber, Claire Palermo
{"title":"ProFESS: Changing the Way Multidisciplinary Student's Professional Behaviour Lapses Are Identified and Managed. An Evaluation of Educators' Perspectives","authors":"Lyn Clearihan, Marilyn Baird, Wayne Hodgson, Janeane Dart, Charlotte Barber, Claire Palermo","doi":"10.1111/tct.13845","DOIUrl":"10.1111/tct.13845","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Best practice evidence for identifying and managing professional behaviour lapses in a multidisciplinary context is lacking. This study aimed to evaluate multidisciplinary educators' attitudes and perceptions of the ProFESS (<span>Prof</span>essional standards, <span>E</span>thical Behaviour and <span>S</span>tudent <span>S</span>upport) framework and its companion Fitness for Practice model, designed and implemented at a large Australian university to address this using a behaviour change approach.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A 72-item survey based on the Context, Input, Process, Product evaluation framework was completed by 92 multidisciplinary faculty educators and analysed using descriptive and inferential statistics. Content analysis of open text responses occurred.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>ProFESS and Fitness for Practice were found to be acceptable irrespective of the discipline using them, providing a supportive, transparent, consistent approach for identifying and managing a professional behaviour lapse. Other key strengths of the framework included its student-centredness and fostering a sense of safety for respondents with potential to improve student-educator relationships.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Our findings suggest that ProFESS enhances educators' confidence in managing professional behaviour lapses and that its structural flexibility and adaptability underpin its acceptability for multidisciplinary educators. Many of its positive attributes address the failure to fail barriers. The ProFESS method provides opportunities for greater consistency of application as it does not require individual interpretation of behaviour but does require education and training to apply consistently.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>The acceptability of the ProFESS/FfP framework in a multidisciplinary healthcare education context is promising for integrating support and standards, fostering a safety culture for educators and reducing ‘failure to fail’ barriers.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47324,"journal":{"name":"Clinical Teacher","volume":"22 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142877798","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":"Bridging Clinical and Cultural Gaps: The Role of On-Call Simulation for International Medical Graduates","authors":"Jan M. Engel-Morton, Ashley V. Simpson","doi":"10.1111/tct.70003","DOIUrl":"10.1111/tct.70003","url":null,"abstract":"","PeriodicalId":47324,"journal":{"name":"Clinical Teacher","volume":"22 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142879021","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":"Beyond Medical School Admissions: Sustaining DEI in Medical Education","authors":"Melden Darrell Barcelona","doi":"10.1111/tct.70000","DOIUrl":"10.1111/tct.70000","url":null,"abstract":"","PeriodicalId":47324,"journal":{"name":"Clinical Teacher","volume":"22 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142879020","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":"How to … Overcome Challenges in Implementing Escape Rooms in Medical Education","authors":"Iris Lim","doi":"10.1111/tct.13849","DOIUrl":"10.1111/tct.13849","url":null,"abstract":"<div>\u0000 \u0000 <p>Escape rooms have emerged as a dynamic educational tool in medical education, offering immersive experiences that foster critical thinking, teamwork and practical skills. Despite their potential, the implementation of escape rooms faces significant challenges, including resource limitations, curricular integration and ensuring educational effectiveness. This paper presents practical tips to address these challenges, covering aspects such as securing resources, designing scalable and inclusive activities, leveraging technology and evaluating educational outcomes. These tips provide educators with a comprehensive guide to navigate the complexities of integrating escape rooms into medical curricula successfully. By adopting these strategies, educators can enhance the learning experience, making escape rooms a valuable component of medical education that prepares students for the complexities of healthcare practice.</p>\u0000 </div>","PeriodicalId":47324,"journal":{"name":"Clinical Teacher","volume":"22 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142879028","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}
Bani M. Ratan, Nital P. Appelbaum, Peter J. Boedeker, Sara G. McNeil, Robert C. Hausmann, Teri L. Turner
{"title":"Prioritising Competencies in Clinician Educator Training in Residency Programmes","authors":"Bani M. Ratan, Nital P. Appelbaum, Peter J. Boedeker, Sara G. McNeil, Robert C. Hausmann, Teri L. Turner","doi":"10.1111/tct.13848","DOIUrl":"10.1111/tct.13848","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Although Clinician Educator Tracks (CETs) have been developed for postgraduate trainees, more clarity is needed regarding which competencies are most relevant to resident and fellow physicians (housestaff) seeking to become Clinician Educators (CEs).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We used the Clinician Educator Milestones, an established framework for competencies at the faculty level, to perform a targeted needs assessment at a large academic institution from April–May 2023. Educational leaders in undergraduate (UME), graduate (GME) and senior medical education (SME) leadership roles were asked to prioritise the Clinician Educator Milestones subcompetencies for a 1-year track. Descriptive statistics and logistic regression analysis were performed; text comments underwent content analysis.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Of the 285 leaders, 118 (41%) completed the survey. The average length in educational leadership was 6.9 ± 5.6 years, with 33% having formal education training, 23% representing surgical specialities and 17% in SME roles. The subcompetencies of learner assessment and feedback were prioritised highest (86%), while change management was prioritised lowest (23%). Respondents in SME roles compared to UME and GME roles or those in educational leadership ≥ 6 years compared to < 6 years prioritised professionalism. Respondents without formal education training prioritised medical education scholarship more often than those with training. Surgical respondents more often prioritised administrative skills than nonsurgical respondents. Open-ended comments were generally positive towards a CET for housestaff, suggesting a hybrid format with flexible scheduling.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Teaching-oriented subcompetencies were highly prioritised for a CET targeted at housestaff. The prioritisation choices offer guidance for a CE's progression through the subcompetencies.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47324,"journal":{"name":"Clinical Teacher","volume":"22 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142879038","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":"“I Say I'm Kind of Out”: An Insider Qualitative Study of Queer Medical Students","authors":"Cate Goldwater Breheny, Dominic Lee, Daniel Ly, Holly Oliver, Anbreen Bi, Stephanie Bull","doi":"10.1111/tct.13847","DOIUrl":"10.1111/tct.13847","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>United Kingdom Queer medical students' experiences have only been explored in depth in one previous study, despite longstanding calls to address National Health Service queerphobia. The study aims to combine our participants' data with personal insights from the Queer medical student research team to both record Queer medical students' experiences and provide practical actions that can promote support, inclusivity and celebration for Queer medical students.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Individual semi-structured interviews were conducted with 12 participants across three medical schools in England and Scotland. Inductive thematic analysis was conducted. Insider insights were combined with analysis to generate practical advice for educators.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <div>Participants had a broad range of Queer identities, including non-binary, bisexual and asexual identities. Four themes were identified, as well as a table of practical advice:\u0000\u0000 <ol>\u0000 \u0000 <li>Developing a unified Queer medical student identity: the cognitive and emotional process of aligning Queer and medical student identities;</li>\u0000 \u0000 <li>A culture of discrimination: actions occurring at cultural, system and individual levels that result in negative queerphobic experiences;</li>\u0000 \u0000 <li>A counterculture of support: representation and support provided by Queer faculty and doctors and Queer friends, and in curriculum material;</li>\u0000 \u0000 <li>Belonging and not belonging: thoughts and feelings of acceptance and value within academic, clinical and social environments.</li>\u0000 </ol>\u0000 </div>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Queer medical students continue to experience discrimination despite calls for change. We suggest a deeper cultural reimagination of belonging as a Queer medical student, alongside practical support from educators to create this, is needed to improve Queer medical students' experiences.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47324,"journal":{"name":"Clinical Teacher","volume":"22 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11663728/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142879016","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}
Jessica R. Newman, Michael Rouse, Gage Davies, Roshan Bisarya, Emma Nguyen, Jennifer Fink
{"title":"Internal Medicine Student Chief Elective","authors":"Jessica R. Newman, Michael Rouse, Gage Davies, Roshan Bisarya, Emma Nguyen, Jennifer Fink","doi":"10.1111/tct.13851","DOIUrl":"10.1111/tct.13851","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>With increasing patient care responsibilities, administrative work and education demands, physicians may find it challenging to provide high-quality and engaging clinical education to third-year medical students on clerkships. Fourth-year students in the role of near-peer teachers can help fill this role, but they often also have competing responsibilities.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Approach</h3>\u0000 \u0000 <p>A 4-week Internal Medicine Student Chief (Student Chief) elective was created, designed such that fourth-year students would apply for dedicated time to serve as student leaders, coaches and educators for the third-year students on the Internal Medicine clerkship. They were provided an asynchronous medical education curriculum and conducted their own Medicine subject exam reviews, case conferences and feedback sessions.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Evaluation</h3>\u0000 \u0000 <p>Course evaluations by clerkship students did not detect a significant difference between the “quality” of the Internal Medicine clerkship and the “amount of formative feedback” from pre−post Student Chief elective introduction. Clerkship students' feedback regarding their interactions with and the ratings of the Student Chief, however, were excellent. Evaluations by the Student Chief suggested that the course provided rich opportunities for students interested in medical education to learn and practice skills in teaching, mentoring and coaching of Internal Medicine clerkship students.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Implications</h3>\u0000 \u0000 <p>Given overwhelmingly positive feedback, the Student Chief elective has continued. Student Chief responsibilities evolved based on feedback, and the Student Chiefs themselves develop their own learning goals for their experience. Future studies could include a more longitudinal evaluation of the program, expanding the scope of the Student Chief experience to other specialties and publication of an implementation toolkit.</p>\u0000 </section>\u0000 </div>","PeriodicalId":47324,"journal":{"name":"Clinical Teacher","volume":"22 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2024-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142879031","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}