{"title":"Can I Phone a Friend? Exploring the Use of Digital Devices in Clinical Exams","authors":"Hannah Gillespie, Helen Reid, Kathy Cullen","doi":"10.1111/tct.70007","DOIUrl":"10.1111/tct.70007","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Objective structured clinical examinations (OSCEs) are used globally to assess health professional learners' clinical skills and applied knowledge. Despite innovations with simulated participants, manikin technology and real patient involvement, there remains a gap between ‘real-life’ practice and ‘OSCE experience’. For example, although mobile phone use is increasingly common in clinical practice; however, it would represent a significant disruption to established assessment practices in OSCEs. We aimed to explore student use of mobile phones during OSCE assessment, with a focus on exam security, equity and relevance to practice.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Cultural Historical Activity Theory (CHAT) allows us to conceptualise and analyse complex systems such as those of OSCE assessment. We recruited a range of stakeholders in a UK medical school setting to participate in focus group interviews exploring our stated aim. Transcripts were analysed using CHAT as a theoretical lens to construct an activity system of assessment and identify emerging tensions around the use of a potentially disruptive technology: students' own mobile phones.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Findings</h3>\u0000 \u0000 <p>Seven examiners, 13 medical students, and two simulated participants participated in three focus groups. Three sources of tension were identified: between the tools of assessment and practice, of exam security and exam relevance, and of medical students as people and professionals.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion and Conclusion</h3>\u0000 \u0000 <p>This study exemplifies how a seemingly small disruption in a complex system (introducing a mobile phone—a tool used in everyday practice) can help us understand and describe the unwritten rules of assessment.</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/PMC11663726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142879024","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}
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}