Teaching and Learning in Medicine最新文献

{"title":"A Master Adaptive Learner Approach to Cognitive Disability Support in a U.S. Urology Residency.","authors":"Rebecca J Stetzer, Joshua Schammel, Brian Inouye","doi":"10.1080/10401334.2025.2502670","DOIUrl":"https://doi.org/10.1080/10401334.2025.2502670","url":null,"abstract":"<p><p>Medical education is witnessing a growing need for disability support, particularly for cognitive and psychiatric disabilities, yet many medical learners do not receive the necessary accommodations. These barriers may arise from uncertainty in how to approach multifaceted challenges, lack of disability recognition by both learners and educators, fear of stigma, and unclear or inadequate institutional policies and support systems. This case study about a urology resident in a U.S. training program, presented from the viewpoint of his competency development coach and residency program leadership with case description and insights from the resident, explores how adopting a Master Adaptive Learner (MAL) approach to identifying multiple intertwined challenges enables targeted remediation and disability support efforts. While situated in a U.S. surgical graduate medical education program, this case offers insights that can be helpful to medical educators in a variety of settings about how to effectively support struggling learners, while emphasizing the importance of early identification, tailored accommodations, and the value of creating an inclusive learning environment for all medical learners. By modeling how the ability to be vulnerable is a strength in the learning environment, this case aims to reduce the stigma associated with having learning requirements that fall outside a program's standard curriculum. Ultimately, this paper advocates for shifting the remediation process from a stigma-laden experience to one that fosters growth, helping both learners and programs evolve.</p>","PeriodicalId":51183,"journal":{"name":"Teaching and Learning in Medicine","volume":" ","pages":"1-9"},"PeriodicalIF":2.1,"publicationDate":"2025-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144020257","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparisons of Validity of the New and Prior MCAT Exams in Predicting Performances on Steps 1, 2, and 3 of the United States Medical Licensing Examinations.","authors":"Aaron Douglas, Alisa Alfonsi LoSasso, Bernard L Lopez, Charles Pohl, Anita Wilson, Mohammadreza Hojat","doi":"10.1080/10401334.2025.2495353","DOIUrl":"https://doi.org/10.1080/10401334.2025.2495353","url":null,"abstract":"<p><p>This study examined the validity of the new MCAT exam (administered since 2015) for predicting medical students' performance on United States Medical Licensing Examinations (USMLE) and compared the findings with those of the prior MCAT version. Participants comprised two samples of students who entered Sidney Kimmel Medical College at Thomas Jefferson University between 2012 and 2020. One sample included 1,111 students (559 men, 552 women) with new MCAT scores who matriculated between 2016 and 2020, and the other comprised 1,312 students (668 men, 644 women) with prior MCAT scores who matriculated between 2012 and 2015. We used students' MCAT scores as predictors of performance on Steps 1, 2, and 3 of the USMLE. Bivariate correlations and path analysis were used for statistical analyses. Path analysis showed new MCAT total scores resulted in <i>R²</i> values of 0.14, 0.11, and 0.16 for predicting performance on Steps 1, 2, and 3 of the USMLE, respectively. The new MCAT total scores demonstrated levels of validity comparable to the prior MCAT for predicting students' performances on the criterion measures. Additional path analyses showed an impact of gender on the predictive validities for some section scores of the new (but not prior) MCAT exam. Replication of this study is recommended in other medical schools to examine generalizability of our findings regarding predictive validities of section scores of the new MCAT exam, particularly regarding gender and section.</p>","PeriodicalId":51183,"journal":{"name":"Teaching and Learning in Medicine","volume":" ","pages":"1-9"},"PeriodicalIF":2.1,"publicationDate":"2025-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144065049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparability of Preceptor Assessment of Medical Students in a General Practice and Multispecialty Longitudinal Integrated Clerkship in a US Medical School.","authors":"Hana Smith, Henry Colangelo, Kari Mader, Roberto Silva, Jennifer E Adams, Tai Lockspieser","doi":"10.1080/10401334.2025.2495351","DOIUrl":"https://doi.org/10.1080/10401334.2025.2495351","url":null,"abstract":"<p><strong>Background: </strong>Continuity is the organizing principle of the Longitudinal Integrated Clerkship (LIC) and drives its outcomes. In a multispecialty LIC, students are paired with specialty-specific preceptors in each of the core clerkships approximately one half-day per week and work with each of these preceptors longitudinally throughout their clinical training. The general practice (GP) LIC differs in that students are primarily paired with full-scope generalist preceptors who teach the content of several specialties in one setting. It is unknown if assessments from a single preceptor teaching multiple specialties will include sufficient data for summative grading. The aim of this study was to demonstrate non-inferior assessment narrative quality and comparable clerkship clinical grades for students in an urban GPLIC compared to multispecialty LIC students at a United States (U.S.) medical school.</p><p><strong>Methods: </strong>In 2022, 16 GPLIC preceptors assessed 6 students in pediatrics, obstetrics and gynecology, internal medicine, and family medicine, using forms that allowed assessment in multiple specialties concomitantly. Assessment forms included both comments and ratings of student performance of entrustable professional activities (EPAs) and other skills. Sixteen GPLIC assessment forms were matched to 16 multispecialty forms, deidentified, and evaluated for quality. Adequacy of assessment data was determined by the school's curricular and assessment deans who observed all clerkship grading committee meetings. Feedback on the assessment process was solicited from all 1164 LIC preceptors through an electronic survey at the end of the year.</p><p><strong>Results: </strong>Overall comment quality did not significantly differ between the groups. There was no significant difference in word count or presence of EPA-specific comments between GPLIC and multispecialty LIC assessment forms. We found no difference in the presence of adequate assessment data between the two groups as judged by final grading committees. The clinical grade distributions of Honors, High Pass, and Pass were not significantly different, and no differences in preceptor feedback about the assessment forms were found.</p><p><strong>Conclusion: </strong>This study demonstrates that in the inaugural year of an all-LIC curriculum at a US medical school, GPLICs, where preceptors concurrently assess students across multiple specialties, produce noninferior assessment data when compared to multispecialty LIC preceptors. These results suggest the feasibility for parallel GP and multispecialty LICs. This offers medical schools flexibility in expanding clinical training sites beyond traditional specialty-focused academic contexts, while maintaining comparability in assessment.</p>","PeriodicalId":51183,"journal":{"name":"Teaching and Learning in Medicine","volume":" ","pages":"1-10"},"PeriodicalIF":2.1,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Historical Roots of Tiered Grading in U.S. Medical Education.","authors":"James F Smith, Nicole M Piemonte","doi":"10.1080/10401334.2025.2495352","DOIUrl":"https://doi.org/10.1080/10401334.2025.2495352","url":null,"abstract":"<p><p>Evaluation of medical students remains one of the most complex and challenging issues in academic medicine. Evaluation occurs in an educational environment that must cultivate a diverse, collaborative, and resilient physician workforce imbued with skills, drive, and stamina for a lifelong commitment to patient care, self-care, and professional development. Additionally, evaluation must not only be valid and reliable but also relevant to the public who medical students will eventually serve. In U.S. medical education, evaluation, and the assessments on which evaluation is based, has evolved over several centuries. Understanding the history of how, when, and why U.S. medical students have been assessed and subsequently evaluated can inform contemporary dialogue on curricular reform. In exploring this history, several important considerations emerge. First, tiered grading arose through the historical assimilation of U.S. medical schools into universities rather than as a mechanism for assessing clinical competence or acumen. Second, even before influences of university academia suffused medical education, imprudent academic emphasis on the memorization of facts over deeper understanding of, and reflection on, medical sciences and practice was already entrenched. Evaluation systems like tiered grading served to validate-if not accelerate-overreliance on the memorization and recall of scientific facts. As a result, other professional attributes important for medical practice, including intrinsic motivation, group cohesiveness, and diversity of the physician workforce were, and remain, adversely affected. Finally, despite early observations that tiered grading is associated with medical student stress and anxiety, there has been insufficient attention to and mitigation of these effects on medical student wellbeing over the last century. Our collective response to controversies surrounding tiered grading should account for the historical rationality of the adoption of this form of evaluation and its enduring effects on contemporary medical education.</p>","PeriodicalId":51183,"journal":{"name":"Teaching and Learning in Medicine","volume":" ","pages":"1-12"},"PeriodicalIF":2.1,"publicationDate":"2025-04-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144031671","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining Differences in the Preparation and Performance of U.S. MCAT Examinees from Lower-SES Backgrounds: Awareness, Access, and Action Insights to Narrow Learning Opportunity and Performance Gaps and Promote Learning for All Aspiring Physicians.","authors":"Aubrie Swan Sein, Stephanie C McClure, Julie A Chanatry, Daniel M Clinchot, Edwin D Taylor, H Liesel Copeland, Francie Cuffney, Rhona Beaton, Kadian L McIntosh, Cynthia A Searcy","doi":"10.1080/10401334.2025.2492620","DOIUrl":"https://doi.org/10.1080/10401334.2025.2492620","url":null,"abstract":"<p><p><b><i>Phenomenon:</i></b> On the Medical College Admission Test (MCAT), required for entry into all medical schools in the U.S. and many in Canada, average scores are typically lower for individuals from lower socioeconomic status (SES) backgrounds compared to their more advantaged peers, although individuals from every background score in the lower, middle, and upper ranges of the score scale. This achievement gap is potentially due in part to disparities in resource utilization and effective study strategies. Viewing this challenge through a socioecological systems lens can help identify potential systems-level opportunities to support students from these backgrounds to succeed in medicine. <b><i>Approach:</i></b> This investigation was the first large-scale review of MCAT preparation strategies, resource utilization, and challenges for examinees from lower-SES backgrounds, focusing on those who obtained higher versus lower MCAT scores. It aimed to examine differences in students' use of evidence-supported learning/studying strategies and challenges experienced in preparing for the MCAT exam. Survey data from the Association of American Medical Colleges Post-MCAT Questionnaire on MCAT preparation strategies and resources used and challenges experienced by 2021-2023 examinees were analyzed, focusing on the 3,240 survey respondents from lower-SES backgrounds. T-tests and chi-square analyses compared continuous variables and proportions between lower- and higher-scoring examinees from lower-SES backgrounds, using Cohen's h to estimate effect size. <b><i>Findings:</i></b> Higher-scoring examinees reported greater use of many evidence-supported effective test preparation and learning strategies, including discussing preparation strategies with advisors/peers, establishing baseline capabilities, practicing applying knowledge to practice questions, and evaluating readiness by taking a practice test. Utilization rates of high-value, free/low-cost MCAT resources were significantly higher among top scorers. Conversely, lower-scoring examinees were more likely to report challenges in obtaining reliable internet access, determining how to begin studying, and accessing concrete information about the MCAT exam. <b><i>Insights:</i></b> This study highlights critical differences in preparation approaches and challenges among examinees from lower-SES backgrounds. Identifying these gaps may provide insights regarding interventions to improve access to resources and potential improvement to MCAT performance. We provide systems-level ideas for how to better support students from lower-SES backgrounds. For example, learning specialists and advisors could use the findings from this study to screen and educate examinees about evidence-based MCAT preparation strategies and resources. This study identifies opportunities to inform interventions to help students from lower-SES backgrounds advance toward a career in medicine.</p>","PeriodicalId":51183,"journal":{"name":"Teaching and Learning in Medicine","volume":" ","pages":"1-14"},"PeriodicalIF":2.1,"publicationDate":"2025-04-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143994440","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integration of Oral Health and Oral Surgery into Medical Training.","authors":"Kelly Mayol-Graciano, Gerald Chang, Maria Padilla, Jorge Cervantes","doi":"10.1080/10401334.2025.2487593","DOIUrl":"https://doi.org/10.1080/10401334.2025.2487593","url":null,"abstract":"<p><p>As the United States (U.S.) population continues to age, we need to promote a renewed perspective on oral health, helping policy makers understand the impact of poor oral health on older adults with chronic conditions. In this article we describe the issue of lack of oral health education in medical school curricula, the differences in dental school programs, and a brief history of Oral maxillofacial surgery DMD/MD programs in the U.S. In addition to an education focusing on technical skills, dental education should also address scientific, social, and health-related competencies. Not only should the lack of integration of oral health topics in medical curricula be addressed, we should also train future dental professionals on the systemic effects of oral conditions.</p>","PeriodicalId":51183,"journal":{"name":"Teaching and Learning in Medicine","volume":" ","pages":"1-7"},"PeriodicalIF":2.1,"publicationDate":"2025-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143812541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"U.S. Internal Medicine Residents' Inpatient Learning Experience Variation Revealed Through Electronic Health Record Data.","authors":"Sean Tackett, Bahareh Modanloo, Heather Sateia, Jiajun Wu, Laura Prichett, Todd Dorman, Alex Duran, Pamela Lipsett","doi":"10.1080/10401334.2025.2487598","DOIUrl":"https://doi.org/10.1080/10401334.2025.2487598","url":null,"abstract":"<p><p><b><i>Phenomenon</i></b>: Residents are assumed to be prepared for practice after completing required rotations, but there is little understanding of what clinical conditions they manage. Electronic health records (EHRs) capture resident clinical activities, but few studies have effectively used EHR data to characterize resident experiences. <b><i>Approach</i></b>: We extracted EHR data for all patients admitted July 1, 2018 to June 30, 2019 cared for by an internal medicine resident in the Johns Hopkins Hospital residency program. We examined individual residents' encounters with specific clinical conditions, identified using the principal International Classification of Diseases, 10th Revision, Clinical Modification (ICD-10 CM) discharge code and categorized according to the American Board of Internal Medicine (ABIM) Certification Exam Blueprint. We compared numbers and percentages of clinical conditions encountered across individuals and postgraduate years (PGYs). <b><i>Findings</i></b>: We included 19,129 admissions for 14,657 patients cared for by 135 residents. ABIM categories most commonly seen were cardiovascular (CV) (mean 20.4%, SD 4.7%), infectious diseases (ID) (mean 19.5%, SD 2.2%), and gastroenterology (GI) (mean 11.2%, SD 3.2%). The largest differences between clinical conditions encountered and ABIM Blueprint were excesses of 10.5% for ID and 6.4% for CV and deficits of 6.1% for rheumatology and orthopedics and 5.5% for endocrinology, diabetes, and metabolism. Total number of admissions per resident ranged 522-963 for PGY-1, 457-1268 for PGY-2, and 224-811 for PGY-3. Percentages of clinical conditions seen varied for individuals in the same postgraduate year: e.g., for CV, ranges were 16-23% for PGY-1, 15-40% for PGY-2, and 10-25% for PGY-3. <b><i>Insights</i></b>: Individual residents in the same program had varied inpatient experiences, suggesting a need to understand implications for variation. Linking residents to clinical conditions encountered using EHR data may generate insights that can be incorporated into precision medical education systems to improve learning and clinical outcomes.</p>","PeriodicalId":51183,"journal":{"name":"Teaching and Learning in Medicine","volume":" ","pages":"1-9"},"PeriodicalIF":2.1,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143796375","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Physician Shortages in Underserved Populations: Venezuelan Physician Perspectives on Emigration and Professional Development.","authors":"Katherine Otto Chebly, Alexandra Olavarrieta Herrera, Julio S Castro, Mario J Patiño Torres","doi":"10.1080/10401334.2025.2479146","DOIUrl":"https://doi.org/10.1080/10401334.2025.2479146","url":null,"abstract":"<p><p><b><i>Phenomenon:</i></b> Physician shortages are common in underserved populations globally, and strategic medical school programs have been associated with increased physician retention. Despite Venezuela's physician emigration crisis and its international impact, there is incomplete understanding of variables influencing emigration decisions and potential solutions to increase retention. <b><i>Approach:</i></b> Between January and June 2023, an anonymous, online questionnaire surveyed recent Venezuelan medical school graduates (2015-2021) living and practicing within and outside of Venezuela. Mixed-methods questions explored perspectives about medical training in Venezuela, desires for alternative medical school programming and professional development opportunities, and factors influencing emigration decisions. Quantitative responses were analyzed with descriptive statistics. Qualitative data were analyzed with a deductive content analysis approach to code for key themes. <b><i>Findings:</i></b> Among 312 respondents representing all eight national universities and 17 specialties, 40% had emigrated. Most respondents agreed that care for underserved communities was a positive aspect of training (83%), but nearly all agreed that insufficient hospital resources negatively affected training (97%) and limited the practice of evidence-based medicine (91%). Desires for new curriculum centered on topics of Medical Informatics & Technology, Research, and Public Health. Of all drivers of migration, 20% were related to medical training (versus individual- and societal-level drivers), including desires for improved professional development opportunities, higher quality of training, and modified work culture. <b><i>Insights:</i></b> This diverse sample of Venezuelan physicians expressed a core tension, common to physicians in low-resourced settings globally, between vocation to serve underserved populations and lack of economic and professional development opportunities. Medical education interventions to stimulate physician retention could include targeted curriculum to prepare students for systems-based practice, programs to address moral distress, and engagement with higher-resourced peer institutions to provide desired clinical and research collaborations.</p>","PeriodicalId":51183,"journal":{"name":"Teaching and Learning in Medicine","volume":" ","pages":"1-13"},"PeriodicalIF":2.1,"publicationDate":"2025-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143774574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Navigating Thematic Analysis: Practical Strategies Grounded in Abductive Reasoning.","authors":"Faraz Khurshid, Mario Veen, Jamie Thompson, Iman Hegazi","doi":"10.1080/10401334.2025.2475098","DOIUrl":"https://doi.org/10.1080/10401334.2025.2475098","url":null,"abstract":"<p><p>Abductive thematic analysis blends empirical observations with theoretical frameworks, fostering a continuous and dynamic exchange between research evidence and theory. It is distinct from other forms of analysis as it is underpinned by pragmatism and is flexible in its adoption of theory to best answer the research question. As a result of an interplay between theory and data, a surprising, puzzling, or anomalous finding may lead to new insights. This flexible approach to inquiry can draw from theories dependent upon what is best able to explain the data. This results in a theoretically informed explanation for empirical phenomena, which may in turn unveil unique insights about theories, making it a valuable tool across diverse research domains in medical science. The guidelines in this paper aim to illuminate abductive thematic analysis, steering the reader through each step toward maximizing novel theoretical contributions and fostering a comprehensive understanding for researchers and educators.</p>","PeriodicalId":51183,"journal":{"name":"Teaching and Learning in Medicine","volume":" ","pages":"1-10"},"PeriodicalIF":2.1,"publicationDate":"2025-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143765676","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Their Own Voices: A Critical Narrative Review of Black Women Faculty Members' First-Person Accounts of Racial Trauma Across Higher Education.","authors":"Sherese Johnson, Abigail Konopasky, Tasha Wyatt","doi":"10.1080/10401334.2024.2329680","DOIUrl":"10.1080/10401334.2024.2329680","url":null,"abstract":"<p><p><b><i>Phenomenon</i></b>: Black women often face more challenges in academic medicine than others and are leaving the profession due to unsupportive work environments, systematic neglect, and experiences of invisibility. Research offers insight into Black women faculty experiences, but studies have largely been conducted <i>on</i> their experiences rather than written <i>by</i> them. We analyzed first-person narratives exploring Black women faculty members' experiences with racial trauma across the academy considering the intersectionality of racism and sexism to lay the foundation for understanding Black women physicians' faculty experiences in similar spaces. <b><i>Approach</i></b>: We gathered first-person narratives of Black women faculty members in the U.S. from ERIC, Web of Science, and Ovid Medline. We used a variety of terms to draw out potential experiences with trauma (e.g., microaggressions, stigma, prejudice). Articles were screened by two researchers, with a third resolving conflicts. Drawing on constructs from Black feminist theory, two researchers extracted from each article authors' claims about: (a) their institutions, (b) their experiences in those spaces, and (c) suggestions for change. We then analyzed these data through the lens of racial trauma while also noting the effects of gendered racism. <b><i>Findings</i></b>: We identified four key themes from the 46 first-person accounts of racial trauma of Black faculty members in higher education: pressures arising from being \"the only\" or \"one of few\"; elimination of value through the \"cloak of invisibility\" and \"unconscious assumptions\"; the psychological burden of \"walking a tightrope\"; and communal responsibility, asking \"if not us, then who?\" <b><i>Insights</i></b>: Black women's narratives are necessary to unearth their specific truths as individuals who experience intersectional oppression because of their marginalized racial and gender identities. This may also assist with better understanding opportunities to dismantle the oppressive structures and practices hindering more diverse, equitable, and inclusive institutional environments where their representation, voice, and experience gives space for them to thrive and not simply survive within the academy, including and not limited to medicine.</p>","PeriodicalId":51183,"journal":{"name":"Teaching and Learning in Medicine","volume":" ","pages":"218-228"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140177586","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}