Teaching and Learning in Medicine最新文献

{"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":"Evaluation of Malnutrition Knowledge among Nursing Staff in the Czech Republic: A Cross-Sectional Psychometric Study.","authors":"Vit Blanar, Jan Pospichal, Doris Eglseer, Zuzana Kala Grofová, Silva Bauer","doi":"10.1080/10401334.2024.2331234","DOIUrl":"10.1080/10401334.2024.2331234","url":null,"abstract":"<p><p><b><i>Construct</i></b>: The Knowledge of Malnutrition - Geriatric 2.0' (KoM-G 2.0) instrument was designed to quantify nursing staff malnutrition knowledge in inpatient medical and rehabilitation care facilities, as well as home health care. It has been used to assess grasp of current clinical practice guidelines and proficiency in addressing issues related to malnutrition. It provides insight into familiarity with and capacity to tackle issues pertaining to malnutrition in clinical practice. Furthermore, it has been used assess the effectiveness of educational interventions aimed at improving nursing professionals knowledge and awareness of malnutrition. <b><i>Background</i></b>: The quality of nursing education affects malnutrition risk assessment, monitoring of food intake, and effectiveness of nutrition care. Improvements in malnutrition education require determining the current level of knowledge and benchmarking with other countries. In the Czech Republic, no nationwide assessment of nursing staff malnutrition knowledge has ever been conducted. <b><i>Approach</i></b>: The purpose of the study was to translate the KoM-G 2.0 instrument, gather initial validity evidence, and evaluate nursing staff knowledge of malnutrition in inpatient medical, rehabilitation care facilities, and home care in the Czech Republic. All inpatient healthcare facilities and home healthcare facilities in the Czech Republic were invited to participate. The Czech version of the internationally standardized KoM-G 2.0 (KoM-G 2.0 CZ) was used to assess nursing staff malnutrition knowledge between 3 February 2021 and 31 May 2021. A total of 728 nurses began the questionnaire, and 465 (63.9%) of respondents completed it and were included in the study. Data analyses examined instrument difficulty, discriminability, and reliability, as well as sources of variation in knowledge scores. <b><i>Findings</i></b>: The psychometric characteristics of the KoM-G 2.0 CZ instrument included the difficulty index Q (0.61), the discriminant index (ULI 0.29, RIT 0.38, upper-lower 30% 0.67), and Cronbach alpha (0.619). The overall mean of correct answers was 6.24 (SD 2.8). There was a significant impact of educational attainment and nutrition training on KoM-G 2.0 CZ scores. <b><i>Conclusions</i></b>: Our findings provide initial validity evidence that KoM-G 2.0 CZ is useful and appropriate for assessing malnutrition knowledge among Czech nursing staff. Our research identified gaps in knowledge and examples of good practice in understanding malnutrition that can be applied internationally. The knowledge of academic nurses was greater; therefore, we suggest they play a key role in nutritional care. We recommend continuous education to improve understanding of malnutrition in this setting.</p>","PeriodicalId":51183,"journal":{"name":"Teaching and Learning in Medicine","volume":" ","pages":"239-248"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140186282","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}

{"title":"\"What's Next in My Arc of Development?\": An Exploratory Study of What Medical Students Need to Care for Patients of Different Backgrounds.","authors":"Julie K Thomas, Jorie Colbert-Getz, Rachel Bonnett, Mariah Sakaeda, Jessica M Hurtado, Candace Chow","doi":"10.1080/10401334.2023.2298860","DOIUrl":"10.1080/10401334.2023.2298860","url":null,"abstract":"<p><strong>Phenomenon: </strong>Medical schools must equip future physicians to provide equitable patient care. The best approach, however, is mainly dependent on a medical school's context. Graduating students from our institution have reported feeling ill-equipped to care for patients from \"different backgrounds\" on the Association of American Medical Colleges' Graduation Questionnaire. We explored how medical students interpret \"different patient backgrounds\" and what they need to feel prepared to care for diverse patients.</p><p><strong>Approach: </strong>We conducted an exploratory qualitative case study using focus groups with 11, Year 2 (MS2) and Year 4 (MS4) medical students at our institution. Focus groups were recorded, transcribed, and coded using thematic analysis. We used Bobbie Harro's cycles of socialization and liberation to understand how the entire medical school experience, not solely the curriculum, informs how medical students learn to interact with all patients.</p><p><strong>Findings: </strong>We organized our findings into four major themes to characterize students' medical education experience when learning to care for patients of different backgrounds: (1) Understandings of different backgrounds (prior to medical school); (2) Admissions process; (3) Curricular socialization; and (4) Co-curricular (or environmental) socialization. We further divided themes 2, 3, and 4 into two subthemes when learning how to care for patients of different backgrounds: (a) the current state and (b) proposed changes. We anticipate that following the proposed changes will help students feel more prepared to care for patients of differing backgrounds.</p><p><strong>Insights: </strong>Our findings show that preparing medical students to care for diverse patient populations requires a multitude of intentional changes throughout medical students' education. Using Harro's cycles of socialization and liberation as an analytic lens, we identified multiple places throughout medical students' educational experience that are barriers to learning how to care for diverse populations. We propose changes within medical students' education that build upon each other to adequately prepare students to care for patients of diverse backgrounds. Each proposed change culminates into a systemic shift within an academic institution and requires an intentional commitment by administration, faculty, admissions, curriculum, and student affairs.</p>","PeriodicalId":51183,"journal":{"name":"Teaching and Learning in Medicine","volume":" ","pages":"149-159"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139522358","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":"\"I knew I was not going to get fired … I know what the line is\": How HPE Faculty Support Trainees' War Against Social Harm and Injustice.","authors":"T R Wyatt, C Chow, Q Nguyen, E Scarlett, T Ma","doi":"10.1080/10401334.2025.2486383","DOIUrl":"https://doi.org/10.1080/10401334.2025.2486383","url":null,"abstract":"&lt;p&gt;&lt;p&gt;&lt;b&gt;&lt;i&gt;Introduction:&lt;/i&gt;&lt;/b&gt; Trainees are adept at locating social harm and injustice in medical education. One of the ways in which they work for change is through ongoing acts of professional resistance. However, knowing how, when, and where to resist requires some institutional knowledge. Previous research shows that trainees garner clandestine support from faculty members who share similar values and interests. These faculty work in the shadows, assisting trainees to meet their goals of destabilizing harmful systems and structures in medical education, yet little is known about the role these faculty play. This study was designed to explore the kinds of support faculty provide, the role they play in supporting resistance efforts, and how faculty ensure their own safety. &lt;b&gt;&lt;i&gt;Methods:&lt;/i&gt;&lt;/b&gt; We used methodological bricolage to guide both data collection and analysis. We recruited 24 faculty from a variety of health professions and interviewed them on when they would/would not support trainees in their resistance efforts. Participants came from 12 different medical education institutions across four geographic regions of the U.S., along with one Canadian medical school. As the data came in, it was transcribed and analyzed using open coding, at which point we noticed that participants framed their roles using constructs found in the literature. Rather than continuing to open code, we refined our analysis using a deductive coding approach in which we drew on the concepts of &lt;i&gt;supporters and auxiliary staff, cultural brokers,&lt;/i&gt; and &lt;i&gt;tempered radicals.&lt;/i&gt; Through constant comparison, we identified patterns across participants in the roles they played and the kind of support they offered. &lt;b&gt;&lt;i&gt;Results:&lt;/i&gt;&lt;/b&gt; As trainees fight a metaphorical war against social harm and injustice in medical education, faculty play several key roles in supporting trainees. They protect the integrity of the institution and ensure trainees' efforts are not disruptive to the institution's function. They contextualize trainees' efforts within institutional goals. They also mediate relationships between students and institutional leadership. While helping to keep themselves, trainees, and institution safe, they reinforce the importance of being a life-long resistor against social harm and injustice to continue this work. &lt;b&gt;&lt;i&gt;Discussion:&lt;/i&gt;&lt;/b&gt; Efforts at changing health professions education is not new; each generation gives rise to trainees who cannot bear to experience or witness the harm and injustice present in the profession's educational and training programs and must work to change it. However, what appears to be new is that faculty are deeply engaged in this process of transformation, working alongside trainees. Given their role in the institution, they serve as the &lt;i&gt;strategist&lt;/i&gt; in fighting this war, providing big picture opportunities and risk assessments for trainees to consider. Whereas trainees serve as the &lt;i&gt;tacticians&lt;/i&gt; doing the wor","PeriodicalId":51183,"journal":{"name":"Teaching and Learning in Medicine","volume":" ","pages":"1-10"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143755808","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":"Changing Policy for Inclusion: Peer-to-Peer Physical Exam Practice in Medical School.","authors":"Allae Abdelrahman, Tegan Whitney, Natalie Mariam Salas, Eileen Barrett, Feranmi O Okanlami","doi":"10.1080/10401334.2023.2298865","DOIUrl":"10.1080/10401334.2023.2298865","url":null,"abstract":"<p><p><b><i>Evidence:</i></b> Across all U.S. medical schools, trainees spent a median of 59 hours teaching physical examination skills. Of this time, 30% is dedicated to PPE practice. Despite this prevalence, there are data that show some students find this uncomfortable, especially women. Literature on best practices around PPE highlights voluntary participation, informed consent, and an available alternative to learning physical xamination skills. These are not uniformly available in all learning environments. There are little data around the impact of PPE on students who have experienced or are experiencing sexual trauma. Authors have drawn conclusions about the potential for harm given the prevalence of sexual mistreatment in US higher education.</p><p><p><b><i>Implications:</i></b> Our medical school policy required students to participate in PPE practice, undressing for the exams wearing only shorts (and a sports bra for women) an and a hospital gown. Students who could not participate in this practice for reasons ranging from mobility to religious beliefs had to seek individual formal accommodations to be exempt, putting the onus of change on potentially vulnerable individuals. We evaluated the policy around PPE, and concluded that the school's requirements could be harmful and isolating, as they required students to disclose their personal vulnerabilities while seeking exemptions from being examined by peers. At our institution, a group of students instead advocated for the school to review the policy and create a PPE procedure that was safer and more inclusive while supporting student learning. Our experience emphasized the potential for students to advocate for change, while also highlighting the need for greater research in the field of trauma-informed curricular design for medical education.</p>","PeriodicalId":51183,"journal":{"name":"Teaching and Learning in Medicine","volume":" ","pages":"268-272"},"PeriodicalIF":2.1,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139514193","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}