Perspectives on Medical Education最新文献

{"title":"Health Justice and Systems of Care: A Required Longitudinal Course for MD Students.","authors":"Ronan Hallowell, Jacob Schreiber, Sonali Saluja, Danica Liberman, Donna Elliott","doi":"10.5334/pme.1325","DOIUrl":"10.5334/pme.1325","url":null,"abstract":"<p><strong>Problem & background: </strong>Medical education has acknowledged the impact of structural societal factors on health, prompting the need for curricula seeking to eliminate health inequities upstream while simultaneously caring for downstream effects of existing inequities. The Keck School of Medicine of USC (KSOM) implemented one such comprehensive curriculum, Health Justice and Systems of Care (HJSC), integrating health systems science, structural competency, and service-learning in a required course spanning the pre-clerkship and clerkship phases with an optional post clerkship elective.</p><p><strong>Approach: </strong>The HJSC course addresses topics including racism in medicine, health inequities, and health systems science. Using transformative learning theory, it fosters critical consciousness and structural competency. Assessments include case analyses, reflections, team-based learning sessions, and group projects related to social justice in healthcare. The program aims to instill cultural humility and practical application, fostering a holistic approach to medical education that implores physicians to become advocates for health justice.</p><p><strong>Outcomes of the innovation: </strong>Feedback from students indicated generally positive perceptions of the curriculum. Students provided overall positive comments about discussions with guest speakers. However, students expressed a desire for more concrete examples of how health inequities can be remedied. Some found small-group activities less engaging. Other challenges included providing students of different readiness levels with tailored experiences and seamlessly integrating HJSC content within basic and clinical sciences courses.</p><p><strong>Critical reflection: </strong>Next steps include continuing to integrate content into the science curriculum and clerkships, improving opportunities for meaningful student interactions, and enhancing faculty development to address health justice concerns in clinical settings.</p>","PeriodicalId":48532,"journal":{"name":"Perspectives on Medical Education","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11192091/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141443492","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Mixed Methods Study of Perceptions of Mental Illness and Self-Disclosure of Mental Illness Among Medical Learners.","authors":"Aliya Kassam, Benedicta Antepim, Javeed Sukhera","doi":"10.5334/pme.1152","DOIUrl":"10.5334/pme.1152","url":null,"abstract":"<p><strong>Introduction: </strong>Mental illness stigma remains rooted within medical education and healthcare. We sought to measure perceptions toward mental illness and explore perceptions of self-disclosure of mental illness in medical learners.</p><p><strong>Method: </strong>In a mixed-methods, sequential design, authors recruited medical learners from across Canada. Quantitative data included the Opening Minds Scale for Healthcare providers (OMS-HC), the Self Stigma of Mental Illness Scale (SSMIS), and a wellbeing measure. Qualitative data included semi-structured interviews, which were collected and analyzed using a phenomenological approach.</p><p><strong>Results: </strong>N = 125 medical learners (n = 67 medical students, n = 58 resident physicians) responded to our survey, and N = 13 participants who identified as having a mental illness participated in interviews (n = 10 medical students, n = 3 resident physicians). OMS-HC scores showed resident physicians had more negative attitudes towards mental illness and disclosure (47.7 vs. 44.3, <i>P</i> = 0.02). Self-disclosure was modulated by the degree of intersectional vulnerability of the learner's identity. When looking at self-disclosure, people who identified as men had more negative attitudes than people who identified as women (17.8 vs 16.1, <i>P</i> = 0.01) on the OMS-HC. Racially minoritized learners scored higher on self-stigma on the SSMIS (Geometric mean: 11.0 vs 8.8, <i>P</i> = 0.03). Interview data suggested that disclosure was fraught with tensions but perceived as having a positive outcome.</p><p><strong>Discussion: </strong>Mental illness stigma and the individual process of disclosure are complex issues in medical education. Disclosure appeared to become more challenging over time due to the internalization of negative attitudes about mental illness.</p>","PeriodicalId":48532,"journal":{"name":"Perspectives on Medical Education","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-06-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11160393/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141297086","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why It's Time to Reawaken Our Debates on the Aviation Analogy.","authors":"Sayra M Cristancho","doi":"10.5334/pme.1399","DOIUrl":"10.5334/pme.1399","url":null,"abstract":"","PeriodicalId":48532,"journal":{"name":"Perspectives on Medical Education","volume":null,"pages":null},"PeriodicalIF":4.8,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11160406/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141297087","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"‘Role Model Moments’ and ‘Troll Model Moments’ in Surgical Residency: How Do They Influence Professional Identity Formation?","authors":"Jeroen Bransen, M. Poeze, Marianne C. Mak-van der Vossen, K. Könings, Walther N.K.A. van Mook","doi":"10.5334/pme.1262","DOIUrl":"https://doi.org/10.5334/pme.1262","url":null,"abstract":"Introduction: Role models are powerful contributors to residents’ professional identity formation (PIF) by exhibiting the values and attributes of the community. While substantial knowledge on different attributes of role models exists, little is known about their influence on residents’ PIF. The aim of this study was to explore surgical residents’ experiences with role models and to understand how these contribute to residents’ PIF. Methods: Adopting a social constructivist paradigm, the authors used a grounded theory approach to develop an explanatory model for residents’ experiences with role models regarding PIF. Fourteen surgical residents participated in individual interviews. The authors iteratively performed data collection and analysis, and applied constant comparison to identify relevant themes. Results: Role model behavior is highly situation dependent. Therefore, residents learn through specific ‘role model moments’. These moments arise when residents (1) feel positive about a moment, e.g. “inspiration”, (2) have a sense of involvement, and (3) identify with their role model. Negative role model moments (‘troll model moments’) are dominated by negative emotions and residents reject the modeled behavior. Residents learn through observation, reflection and adapting modeled behavior. As a result, residents negotiate their values, strengthen attributes, and learn to make choices on the individual path of becoming a surgeon. Discussion: The authors suggest a nuance in the discussion on role modelling: from ‘learning from role models’ to ‘learning from role model moments’. It is expected that residents’ PIF will benefit from this approach since contextual factors and individual needs are emphasized. Residents need to develop antennae for both role model moments and troll model moments and acquire the skills to learn from them. Role model moments and troll model moments are strong catalysts of PIF as residents follow in the footsteps of their role models, yet learn to go their own way.","PeriodicalId":48532,"journal":{"name":"Perspectives on Medical Education","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-05-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141123290","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Nurturing the Human Dimension in Digital and Medical Spaces Through Pedagogy of Care – a Case of Creative Enquiry","authors":"L. Younie, Chie Adachi","doi":"10.5334/pme.1147","DOIUrl":"https://doi.org/10.5334/pme.1147","url":null,"abstract":"The COVID-19 pandemic ushered in digital learning experiences to front and centre of medical education in disruptive ways. As the pandemic subsides students and educators sigh in relief, longing to move away from the loneliness and disconnection and back to the norms of face-to-face learning and consulting. In the field of medical education however, the need for digital education has exponentially increased over the decade with strong evidence for future growth. We face the pressure of increasing student numbers on clinical placement and some students now desire or even need hybrid options for the flexibility of time, place, and pace. There is persistent criticism that digital education lacks human connection. This paper argues, however, that it is possible and vital to humanise the virtual learning experience, though particular attention needs to be given to digital pedagogy and relational aspects of learning and teaching. Drawing on Noddings’ pedagogies of care and her theoretical model, we unpack one case-study of a medical education elective course that transitioned online during the pandemic. The aim of this paper is to engage medical educators with the pedagogy of care and relational pedagogy literature, which are currently almost absent from the medical education literature, as applied to the digital education realm. Core themes include modelling care and connection, enabling dialogue, inviting student engagement and practice in caring for each other and supporting the deeper work of being present themselves and confirming each other. Limitations and implications for future research will also be explored.","PeriodicalId":48532,"journal":{"name":"Perspectives on Medical Education","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-05-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140972708","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Living on Site While Renovating; Flexible Instructional Design of Post-Graduate Medical Training","authors":"Peter K. H. Deschamps, Geke M. J. Beugels, J. Dudink, J. Frenkel, M. Hennus, Marijke B. Hofstra, Alexa X. Rutten, M. F. van der Schaaf","doi":"10.5334/pme.1198","DOIUrl":"https://doi.org/10.5334/pme.1198","url":null,"abstract":"Background: Developing theoretical courses for post-graduate medical training that are aligned to current workplace-based learning practices and adaptive to change in the field is challenging, especially in (sub) specialties where time for re-design is limited and needs to be performed while education continues. Approach: An instructional design method was applied based on flexible co-design to improve post-graduate theoretical courses in child and adolescent psychiatry (CAP) in the Netherlands. In four phases over a period of three years, courses were re-designed at a national level. Evaluation: Once common vision and learning goals were agreed upon and the prototype was developed (phases 1 and 2), the first courses could be tested in daily practice (phase 3). Phase 4 refined these courses in brief iterative cycles and allowed for designing additional courses building on and adding to previous experiences in brief iterative cycles. The resulting national theoretical courses re-allocated resources previously spent on a local level using easily accessible online tools. This allowed trainees to align content with their clinical rotations, personal preferences and training schedules. Reflection: The development of theoretical courses for post-graduate medical training in smaller medical (sub-)specialties with limited resources may profit from a flexible instructional design method. We consider the potential merit of such a method to other medical specialties and other (inter-)national efforts to develop theoretical teaching courses. A longer-term implementation evaluation is needed to show to what extent the investment made in the re-design proves to be future-proof and enables rapid adaptation to changes in the field.","PeriodicalId":48532,"journal":{"name":"Perspectives on Medical Education","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140985596","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical Students' General Beliefs and Specific Perceptions about Patient Feedback Before and after Training in a Clinical Context.","authors":"M Charlotte L Eijkelboom, Renske A M de Kleijn, Joost Frenkel, Marieke F van der Schaaf","doi":"10.5334/pme.1261","DOIUrl":"10.5334/pme.1261","url":null,"abstract":"<p><strong>Introduction: </strong>Despite its high potential, patient feedback does not always result in learning. For feedback to be effective students must engage with it, which partly depends on their perceptions of feedback. To better understand student engagement with patient feedback in a clinical context, this study explored the following research questions: 1) What are medical students' general beliefs about patient feedback and what are their specific perceptions of feedback messages? 2) What is the difference between these general beliefs and feedback message perceptions before and after patient feedback training?</p><p><strong>Methods: </strong>The study context was a 12-week clerkship combining Pediatrics and Gynecology, which included feedback training for students and asking for patient feedback. Ninety 4^th-year medical students completed pre- and post-clerkship questionnaires. The questionnaires (Beliefs about Patient Feedback Questionnaire, Feedback Perception Questionnaire) were adapted from validated peer-feedback questionnaires. Questionnaires were quantitatively analyzed.</p><p><strong>Results: </strong>Both pre- and post-clerkship, students had positive general beliefs about patient feedback and positive perceptions of the feedback messages they received. However, paired t-tests showed that students' general beliefs and feedback message perceptions became less positive after feedback training and experience.</p><p><strong>Discussion: </strong>Patient feedback is not an easy means to learn and students do not become feedback literate in terms of patient feedback overnight. We suggest that future researchers further explore reasons for the decline in positive perceptions of patient feedback. We suggest implementing longitudinal feedback training in medical curricula, where students are guided and supported in the complex task of learning from patients through feedback.</p>","PeriodicalId":48532,"journal":{"name":"Perspectives on Medical Education","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11086596/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913227","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Qualitative Questionnaires in Medical Education Research.","authors":"Michal Tombs, Heather Strange","doi":"10.5334/pme.1102","DOIUrl":"10.5334/pme.1102","url":null,"abstract":"<p><p>Most students in Health Profession Education courses are new to the world of qualitative research. Faced with the challenge of designing a research project, they are often drawn towards using the questionnaire as a data collection method, commonly assuming that utilising open-ended questions alone constitutes qualitative research design. Designing questionnaires that meet the standards of rigour is challenging, and this common assumption reflects inexperience with and misunderstandings of qualitative ontology, as well as the lack of methodological literature on designing and developing qualitative questionnaires. This paper is written with research supervisors as well as students in mind, as it is aimed to help elucidate the decision-making process and the justification for using a qualitative questionnaire. Drawing upon examples of research conducted by our students, and the wider literature, we demonstrate how qualitative questionnaires can produce rich and meaningful findings when they (1) prioritise qualitative research values, and (2) follow a rigorous design process when the questionnaire is developed. We conclude by offering a simple framework for developing rigorous qualitative questionnaires to those who may consider using this approach.</p>","PeriodicalId":48532,"journal":{"name":"Perspectives on Medical Education","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11086583/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140913228","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Preaching Through the Choir. What Interprofessional Education Can Learn From Choir Singing.","authors":"Juliëtte Anna Beuken, Felicitas Biwer","doi":"10.5334/pme.1182","DOIUrl":"https://doi.org/10.5334/pme.1182","url":null,"abstract":"<p><p>Collaboration between healthcare professionals from different backgrounds is a true art to be mastered. During interprofessional education (IPE), learners from different professions learn with, from and about each other. Landscape of Practice (LoP) theory can offer insight into social learning in IPE, but its application is rather complex. We argue that choir singing offers a helpful metaphor to understand different concepts in LoP (<i>brokers, engagement, imagination</i> and <i>alignment</i>) and how they are manifested in IPE. Based on similarities between choir singing and IPE, we present four lessons: 1) <i>The teacher sets the tone: a lesson for brokers;</i> 2) <i>You can only learn so much alone: a lesson for engagement;</i> 3) <i>Listening is not as easy as it sounds: a lesson for imagination</i> and 4) <i>A song is more than the sum of its parts: a lesson for alignment</i>. Moreover, we reflect on differences between choir singing and IPE, and insights from these differences.</p>","PeriodicalId":48532,"journal":{"name":"Perspectives on Medical Education","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-05-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11067977/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140867875","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"An Interprofessional Faculty Development Program for Workplace-Based Learning.","authors":"Eveline Booij, Marjel van Dam, Gersten Jonker, Lisette van Bruggen, Marije Lesterhuis, Marieke F van der Schaaf, Reinier G Hoff, Marije P Hennus","doi":"10.5334/pme.1242","DOIUrl":"https://doi.org/10.5334/pme.1242","url":null,"abstract":"<p><strong>Background: </strong>Most faculty development programs in health professions education, pivotal in cultivating competent and effective teachers, focus on systematic, planned and formal learning opportunities. A large part of clinical teaching however, encompasses ad-hoc, informal and interprofessional workplace-based learning whereby individuals learn as part of everyday work activities. To fully harness the educational potential embedded in daily healthcare practices, prioritizing interprofessional faculty development for workplace-based learning is crucial.</p><p><strong>Approach: </strong>Utilizing the 'ADDIE' instructional design framework we developed, implemented and evaluated an interprofessional faculty development program for workplace-based learning. This program, encompassing seven formal training sessions each with a different theme and five individual workplace-based assignments, aimed to support clinical teachers in recognizing and optimizing informal learning.</p><p><strong>Outcomes: </strong>The pilot program (n = 10) and first two regular courses (n = 13 each) were evaluated using questionnaires containing Likert scale items and open textboxes for narrative comments. The quality and relevance of the program to the clinical work-place were highly appreciated. Additional valued elements included practical knowledge provided and tools for informal workplace-based teaching, the interprofessional aspect of the program and the workplace-based assignments. Since its development, the program has undergone minor revisions twice and has now become a successful interprofessional workplace-based alternative to existing faculty development programs.</p><p><strong>Reflection: </strong>This faculty development program addresses the specific needs of healthcare professionals teaching in clinical settings. It stands out by prioritizing informal learning, fostering collaboration, and supporting integration of formal training into daily practice, ensuring practical application of learned knowledge and skills. Furthermore, it emphasizes interprofessional teaching and learning, enhancing workplace environments.</p>","PeriodicalId":48532,"journal":{"name":"Perspectives on Medical Education","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11067978/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140858652","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}