Perspectives on Medical Education最新文献

{"title":"Evaluating the Effectiveness of a Pre-Medical Pathway Program Containing Strengths-Based Innovations.","authors":"Gianna Giacomotto, Ricardo Antillon, Esmeralda Trejo, Gerardo Moreno, Eraka Bath, Gregg J Gold, Jennifer M Lucero","doi":"10.5334/pme.2330","DOIUrl":"10.5334/pme.2330","url":null,"abstract":"<p><strong>Background & need for innovation: </strong>Summer pathway programs are designed to support students from under-resourced communities aspiring to enter healthcare professions. This study evaluated the effectiveness of a program containing strengths-based components within the UCLA Pre-Med Enrichment Program (PREP), a six-week academic enrichment initiative. PREP aims to highlight and support the individual strengths students bring to the profession while reducing psychological barriers to success.</p><p><strong>Goal for innovation: </strong>Strengths-based components were incorporated into the 2022-2024 PREP curriculum to improve outcomes.</p><p><strong>Steps taken for development and implementation of innovation: </strong>Students participated in workshops focused on identifying and developing the strengths and experiences they bring to medicine, alongside traditional deficit-based activities emphasizing what students lack. Drawing from psychological literature, the additional curriculum was designed to shift mindsets and reduce barriers related to self-efficacy, stereotype threat, and imposter syndrome.</p><p><strong>Outcomes of innovation: </strong>The strengths-based components yielded positive outcomes. Post-program assessments found significant reductions in imposter syndrome and stereotype threat, and increased self-efficacy. No significant changes were found in gender identity, ethnic stigma consciousness, or math identification.</p><p><strong>Critical reflection on your process: </strong>Strengths-based components should be considered for pathway programs and may also hold value for undergraduate medical education. Integrating curricular elements that highlight students' strengths and promote positive self-perceptions can help reduce psychological barriers to academic and professional success. Future research should explore strategies to engage pre-medical students with low self-efficacy to help reduce attrition among aspiring medical professionals.</p>","PeriodicalId":48532,"journal":{"name":"Perspectives on Medical Education","volume":"15 1","pages":"697-704"},"PeriodicalIF":3.5,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13544046/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148897954","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":"How Are They Gonna Look at Me? A Constructivist Study of Medical Students' Categorisation and its Impact on Study Experiences.","authors":"Albertine Zanting, Janneke Frambach, Anja Krumeich, Agnes Meershoek","doi":"10.5334/pme.2249","DOIUrl":"10.5334/pme.2249","url":null,"abstract":"<p><strong>Introduction: </strong>Research shows that medical students from certain minoritised backgrounds often face discrimination and reduced belonging, harming wellbeing and performance. However, such research rarely justifies its focus on these backgrounds, taking the selected categories of minoritized students for granted, even though categorisation itself is neither neutral nor harmless. To offer an alternative perspective, we used theoretical perspectives of categorisation to examine categories students construct for themselves and others, what meanings they attribute to these constructions, and how this affects their study experiences.</p><p><strong>Method: </strong>Using a constructivist approach, we conducted semi-structured interviews with 11 students from two Dutch medical programmes. Students reflected on experiences from application to clinical rotations. Transcripts were coded using theoretical concepts of categorisation. The analysis focused on how and when students invoked categories, their attached meanings, and impact. Findings were synthesized into three crafted stories illustrating students' experiences.</p><p><strong>Results: </strong>Students described categorising themselves and others fluidly, shifting across time and context. Categories became salient when students deviated from an implicit norm (e.g., identifying as lesbian in heteronormative environments or Black among white peers). Students and others valued each other positively, yet sometimes overemphasized categories and negatives. Such dynamics shaped feelings of belonging and exclusion and, sometimes, contributed to dropout.</p><p><strong>Discussion: </strong>Improving students' learning experiences requires acknowledging categorisation's omnipresent nature and its interconnected dynamics. Focusing on individuals' experiences and implicit norms - rather than standard categories - in all stages of educational practice and research is essential for fostering diversity and inclusion in the learning and healthcare environment.</p>","PeriodicalId":48532,"journal":{"name":"Perspectives on Medical Education","volume":"15 1","pages":"687-696"},"PeriodicalIF":3.5,"publicationDate":"2026-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13523811/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851705","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":"Quiet Doubts: Exploring the Relationship between Introversion, Demographic Characteristics, and Imposter Phenomenon among Canadian Medical Students, Residents and Practicing Physicians.","authors":"Meghan M McConnell, Neera R Jain, Lindsay Cowley, Nancy L Dudek, Victoria Luong, Timothy J Wood, Kori A LaDonna","doi":"10.5334/pme.2917","DOIUrl":"10.5334/pme.2917","url":null,"abstract":"<p><strong>Introduction: </strong>Medicine often privileges extroverted traits such as confidence, assertiveness, and decisiveness. This 'extrovert ideal' may disadvantage introverted trainees and physicians, increasing vulnerability to imposter phenomenon (i.e., persistent feelings of inadequacy and self-doubt). However, the relationship between introversion and imposter phenomenon remains poorly understood, particularly among marginalized demographic groups who may already be more susceptible to imposter feelings. This study explored associations between introversion, imposter phenomenon, and demographic factors among Canadian undergraduate medical students (UGME), postgraduate residents (PGME), and practicing physicians.</p><p><strong>Methods: </strong>We conducted a cross-sectional survey. Introversion was measured using the McCroskey Introversion Scale and imposter phenomenon using the Clance Imposter Phenomenon Scale (CIPS). Demographic variables included gender, disability status, race/ethnicity, sexuality, first-generation medical student status, and training level (UGME, PGME, and practicing physicians).</p><p><strong>Results: </strong>The final sample included 578 participants. Multiple linear regression showed that higher introversion scores were associated with higher CIPS scores (B = 0.68, 95% CI [0.52, 0.84], p < 0.001). Participants identifying as women (B = 6.18 [3.28, 8.80], p < 0.001) or disabled (B = 4.93 [1.91, 7.95], p = 0.001) also reported higher CIPS scores. UGME students reported higher CIPS scores than practicing physicians (B = 3.74 [0.46, 7.01], p = 0.03). No significant interactions were observed between introversion and demographic variables.</p><p><strong>Discussion: </strong>Higher introversion was associated with greater imposter phenomenon across all stages of medical training and practice. Women, individuals with disabilities, and UGME trainees also reported greater imposter phenomenon. These findings highlight the need for further research into factors underlying the relationship between introversion and imposter phenomenon in medicine, and how professional cultures may shape imposter phenomenon experiences across diverse groups of trainees and physicians.</p>","PeriodicalId":48532,"journal":{"name":"Perspectives on Medical Education","volume":"15 1","pages":"663-674"},"PeriodicalIF":3.5,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13523804/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851690","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":"Building and Sustaining Scholarly Communities in Health Professions Education: Lessons from U.S. Academies.","authors":"Anthony R Artino, Zareen Zaidi, Farida Izzi, Shazia Samanani, Navin Sampathkumar, Ahdeah Pajoohesh-Ganji","doi":"10.5334/pme.3131","DOIUrl":"10.5334/pme.3131","url":null,"abstract":"<p><strong>Introduction: </strong>Academic health centers have invested in academies to promote health professions education scholarship, yet many struggle to sustain vibrant scholarly communities. We aimed to identify practices that support their development and long-term sustainability.</p><p><strong>Methods: </strong>Using a constructivist approach, we conducted a qualitative interview study in 2025 with leaders from all four geographic regions of the U.S. Inclusion criteria required that participants direct an academy or analogous institutional structure intended to promote educational scholarship, and that they could speak to building and sustaining this community in their local context. The Communities of Practice (CoP) framework informed interview guide development and data interpretation.</p><p><strong>Results: </strong>Twenty-one academy leaders described five interrelated forms of leadership work that shaped sustainable scholarly communities: (1) <i>building foundations that legitimize educational scholarship</i> by securing institutional investment, leadership buy-in, and succession planning; (2) <i>cultivating scholarly sanctuary to counter isolation</i> through psychologically safe, inclusive communities; (3) <i>making scholarship feasible under constraints</i> by creating low-barrier entry points, translating value to leaders, and addressing barriers; (4) <i>tending growth through layered, incremental development</i>, including cohort programs, consultation, mentoring, grants, and flexible participation; and (5) <i>making educational scholarship visible and valued</i> through recognition, dissemination, and outcome tracking.</p><p><strong>Discussion: </strong>Viewed through the CoP framework, the themes illuminate how leaders cultivated a shared <i>domain</i> of legitimate educational scholarship, a <i>community</i> of relational support, and a <i>practice</i> of tools, routines, and developmental infrastructure. The themes also reveal that sustainable communities of practice do not emerge from any single academy model, but from context-sensitive alignment of structure, culture, and incentives.</p>","PeriodicalId":48532,"journal":{"name":"Perspectives on Medical Education","volume":"15 1","pages":"675-686"},"PeriodicalIF":3.5,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13523800/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851747","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":"Understanding Undergraduate Medicines Optimisation Education and Its Importance; a Realist Evaluation.","authors":"Richard Bodington, Joanne Reeve, David Hepburn, Matthew Morgan, Paul E S Crampton","doi":"10.5334/pme.2450","DOIUrl":"10.5334/pme.2450","url":null,"abstract":"<p><strong>Introduction: </strong>Problematic polypharmacy (PP) is associated with risks and burdens for patients, and waste for healthcare systems. To overcome this challenge, clinicians must be able to tailor clinical decisions to patients' individual circumstances by integrating biomedical with biographical accounts of illness. This skillset has not been well defined or taught. Medicines optimisation (MO) is a key clinical activity in tackling PP and can exemplify the practical wisdom required for this integration. How and why MO education works is poorly understood. Our previous work, a realist review of published interventions, addressed this gap by explaining how undergraduate MO education could work but was limited by the thin descriptions available. Here, we develop and refine our explanatory model using primary data.</p><p><strong>Methods: </strong>This realist evaluation develops the programme theory from our review using primary data from individual realist interviews of clinical and educational MO experts. A realist configurational approach to analysis was employed. The study is conducted and reported in-keeping with RAMESES II standards.</p><p><strong>Results: </strong>Sixteen experts were interviewed; data were used to refine or refute our previous theorising. Analysis showed MO education which seeks to integrate interpretive practice into clinical decision-making must be sufficiently valued by stakeholders at all levels to garner the allocation of resources required for meaningful engagement with this education. Learners must feel they have permission to practice interpretive medicine when healthcare structures are organised to the contrary, this permission should be actively scaffolded by institutional and workplace context. A perception of critical mass within a community of practice may facilitate the required security in decision-making for ongoing practice.</p><p><strong>Discussion: </strong>We describe how and why undergraduate MO educational programmes can work to produce important outcomes in tackling the challenge of PP. We suggest how MO educational programmes may also act as practical gateways to routine interpretive practice in broader clinical areas.</p>","PeriodicalId":48532,"journal":{"name":"Perspectives on Medical Education","volume":"15 1","pages":"647-662"},"PeriodicalIF":3.5,"publicationDate":"2026-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13523806/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148850854","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":"Teaching medical undergraduates Skills for Eye Examination: Is Flipped Classroom with Mental Rehearsal as Effective as Face-to-Face Teaching?","authors":"Chee Chew Yip, Zheng Xian Thng, Yew Sen Yuen, Ray Manotosh, Jianbin Ding, Woon Teck Clement Tan, Johnson Choon Hwai Tan, Dujeepa Samareasekera","doi":"10.5334/pme.2234","DOIUrl":"10.5334/pme.2234","url":null,"abstract":"<p><strong>Introduction: </strong>The quality of face-to-face teaching (F2FT) of eye-examination is often suboptimal amidst busy clinics as it demands faculty time for teaching and feedback. Flipped Classroom (FC) and Mental Rehearsal (MR) are established methods to teach clinical skills. A learning module (Supplementary Clinical Ophthalmology Preparatory E-learning [SCOPE]) that combines FC and MR may address this practical problem. This quasi-experimental study compared the efficacy and Faculty Contact Time of SCOPE against F2FT in teaching fourth-year medical undergraduates eye-examination.</p><p><strong>Method: </strong>The SCOPE group (n = 95) received the same content as F2FT but delivered in deliberate sequence: e learning (instructional videos and Video Modelling Examples), followed by structured, audio guided MR, then face-to-face practice with feedback. The F2FT group (n = 51) learned in a single face-to-face session with live faculty demonstration and Video Modelling Examples, without instructional videos or MR.</p><p><strong>Results: </strong>Baseline pre-intervention mean Multiple Choice Questions (MCQ) scores were comparable (22.31 versus 22.24, independent t-test, p = .94). Post-learning cognitive assessments found the SCOPE group to have greater gain in total MCQ scores with higher estimated marginal means (p < .001), and higher mean End-of-Rotation Test scores (43.37 versus 40.85, independent t-test, p = .048). On psychomotor assessments, the SCOPE group had superior Micro-CEX performances (three skills, all <i>p</i> < .001, Fisher's Exact test). SCOPE also shortened Faculty Contact Time, saving on average 57.48 minutes (<i>p</i> < .001, independent t-test).</p><p><strong>Discussion: </strong>SCOPE improved psychomotor and cognitive performances, and was more faculty time-efficient than F2FT in teaching eye examination skills. These positive results may be attributed to the synergistic effects of its multiple learning components. SCOPE, which combined FC and MR, may better facilitate clinical skill development through deliberate practice than F2FT.</p>","PeriodicalId":48532,"journal":{"name":"Perspectives on Medical Education","volume":"15 1","pages":"633-646"},"PeriodicalIF":3.5,"publicationDate":"2026-08-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13523812/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148851730","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":"Ensuring Knowledge Transfer: The Critical Role of \"What-If\" Discussions in Virtual Patient Simulation.","authors":"Zhien Li, Maryam Asoodar, Tom Keulers, Desirée Joosten-Ten Brinke, Diana Dolmans","doi":"10.5334/pme.2363","DOIUrl":"10.5334/pme.2363","url":null,"abstract":"<p><strong>Background: </strong>Virtual Patient (VP) systems are widely used in medical education, yet evidence on how they support near and far transfer remains limited. This study investigates integrating VPs with role modelling, varied case practices, and \"what-if\" discussions. It aims to measure the students' overall experience with the intervention, improvement in performance scores on near- and far-transfer cases, and to explore how and why the intervention is perceived to enhance transfer.</p><p><strong>Methods: </strong>An exploratory mixed-methods study was conducted with 21 second-year undergraduate medical students enrolled in the course \"Personalised Medicine in Cancer Treatment and Care\". Students engaged in role modelling performed by an oncologist, worked through authentic cases with varying patient characteristics, and participated in structured \"what-if\" discussions. Perceptions about the overall experience were gathered through a 19-item survey (n = 21). Performance scores were evaluated using pre- and post-assessments involving VPs and paper-based cases designed to measure near transfer (Case D) and far transfer (Case E) (n = 21). Group interviews (n = 8) provided deeper insights into enhancing transfer.</p><p><strong>Results: </strong>Survey results revealed positive student perceptions of role modelling (M = 4.44), varied case practices (M = 4.35), and \"what-if\" discussions (M = 3.76). Significant improvements were observed in tumour-stage reasoning for both near and far transfer (p < .001), in initial patient impressions (p = .007) for far transfer, and in the total score (p = .018) for far transfer. Thematic analysis indicated that students benefited from a stepwise build-up in case complexity, recognition of similar reasoning steps across cases, reflective \"what-if\" discussions that highlighted underlying principles, and peer dialogue around VP feedback that supported concept abstraction.</p><p><strong>Conclusions: </strong>Students evaluated the VP session positively and performance data indicated significant improvements, suggesting that the intervention enhanced near and far transfer. Reflection through \"what-if\" discussions was perceived to deepen understanding of the underlying principles enabling transfer.</p>","PeriodicalId":48532,"journal":{"name":"Perspectives on Medical Education","volume":"15 1","pages":"633-643"},"PeriodicalIF":3.5,"publicationDate":"2026-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13450267/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148697849","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":"Assessment of Pediatric Residents in the United States by Sex, Ethnoracial and Intersectional Group.","authors":"Hannah L Kakara Anderson, Daniel C West, Alan J Schwartz, Laura Lockwood, Caroline E Rassbach, Ariel S Winn, Catherine D Michelson, Benjamin Kinnear, Jerome G Chen, Abigail Martini, David A Turner, Daniel J Schumacher","doi":"10.5334/pme.2862","DOIUrl":"10.5334/pme.2862","url":null,"abstract":"<p><strong>Introduction: </strong>Inequitable assessments in medical education disproportionately affect historically marginalized trainees and undermine development of a diverse physician workforce. With programs around the world incorporating competency-based medical education (CBME), understanding whether assessment disparities exist in specialty-specific competency frameworks is critical. This study examined disparities in program-reported performance assessments of pediatric residents across demographic groups in two pediatric-specific competency frameworks: the General Pediatrics Entrustable Professional Activities (EPAs) and Accreditation Council for Graduate Medical Education (ACGME) pediatric milestones.</p><p><strong>Methods: </strong>This prospective cohort study was conducted at 15 pediatric residency programs in the U.S. across the 2021-22, 2022-23, and 2023-24 academic years. Clinical Competency Committee-assigned entrustment-supervision levels for 5 EPAs and all milestone levels were collected twice yearly. Residents self-reported ethnoracial group and sex, analyzed as exposure to systems of racism and sexism. Time-to-event analysis and growth curve modeling with intersectional analytic approaches examined disparities across demographic groups.</p><p><strong>Results: </strong>475 of 803 (59%) residents completed demographic surveys, including 17.3% underrepresented in medicine (URiM), 22.9% Asian, 56.4% white, 70.7% female, and 27.8% male. Time-to-event analyses revealed significant differences for Asian and Asian female residents in reaching the highest EPA supervision level across all EPAs. Growth curve analyses showed Asian males had significantly flatter growth trajectories for EPA 15 (Lead an Interprofessional Team), resulting in lower estimated scores at graduation. URiM female residents had significantly lower scores on EPA 16 (Facilitate Handovers) at graduation. URiM residents showed lower Milestone growth curves for interpersonal communication, and Asian residents for systems-based practice.</p><p><strong>Discussion: </strong>Subtle but meaningful disparities exist in program-reported assessments of pediatric residents, with distinct patterns affecting Asian and URiM residents across both frameworks. These findings highlight the need for proactive attention to equity in competency-based medical education assessment systems.</p>","PeriodicalId":48532,"journal":{"name":"Perspectives on Medical Education","volume":"15 1","pages":"621-632"},"PeriodicalIF":3.5,"publicationDate":"2026-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13398601/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148585567","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":"Ethical Guidance for Medical Schools and Medical Students in High-Income Countries for Clinical Electives in Low- and Middle-Income Countries: A Systematic Review.","authors":"Judith van de Kamp, Lara Alessandra de Luca, Cato Elisabeth Andree Corsten, Joyce Linda Browne, Ross Upshur, Hannah Brown Amoakoh, Johannes van Delden, Rieke van der Graaf","doi":"10.5334/pme.2150","DOIUrl":"10.5334/pme.2150","url":null,"abstract":"<p><strong>Introduction: </strong>Academic interest in ethical guidance for medical students from High-Income Countries (HICs) undertaking clinical electives in Low- and Middle-Income Countries (LMICs) has increased. Earlier ethical frameworks laid important groundwork but predate contemporary debates on social justice in global health. This study reviews recent literature to assess how these debates shape and produce ethical guidance, distinguish between ethical student conduct and elective programs, and how such guidance is translated into practice.</p><p><strong>Methods: </strong>A systematic review was conducted on ethical guidance for HIC medical schools and students regarding LMIC electives. Articles published between January 2018 and October 2023 were identified from PubMed, Embase, and Global Health. Thematic synthesis was combined with analysis of authorship (pose) and intended audience (gaze).</p><p><strong>Results: </strong>Of 711 articles, 24 met inclusion criteria. Five interconnecting themes emerged: humility, reflection, local embeddedness, equitable partnerships, and student health and well-being. While these align with existing frameworks, guidance remains largely conceptual, with limited attention to implementation and accountability across ethical student conduct and program design, with responsibility predominantly located at the level of HIC students. Pose and gaze analysis revealed epistemic imbalances in authorship and intended audiences. Most articles reflected HIC-based perspectives, with North American authors overrepresented and no solely LMIC-authored articles.</p><p><strong>Discussion: </strong>Ethical guidance remains dominated by HIC perspectives and focused on student conduct rather than program structures. By distinguishing between individual and institutional ethics, this study highlights the need for actionable, co-created frameworks that address accountability, equity, and sustainability in LMIC electives, including attention to institutional responsibility and LMIC perspectives.</p>","PeriodicalId":48532,"journal":{"name":"Perspectives on Medical Education","volume":"15 1","pages":"600-620"},"PeriodicalIF":3.5,"publicationDate":"2026-07-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13378422/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580780","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":"Editorial: Perspectives on Theory and Methods.","authors":"Anél Wiese, Terese Stenfors, Erik Driessen, Meredith Vanstone","doi":"10.5334/pme.2812","DOIUrl":"10.5334/pme.2812","url":null,"abstract":"","PeriodicalId":48532,"journal":{"name":"Perspectives on Medical Education","volume":"15 1","pages":"583-585"},"PeriodicalIF":3.5,"publicationDate":"2026-07-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13378424/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148580818","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}