Teaching and Learning in Medicine最新文献

{"title":"\"Those Darn Kids\": Having Meaningful Conversations about Learner Resistance in Medical Education.","authors":"Tasha R Wyatt, Lisa Graves, Rachel H Ellaway","doi":"10.1080/10401334.2024.2354454","DOIUrl":"https://doi.org/10.1080/10401334.2024.2354454","url":null,"abstract":"<p><p>The concept of <i>professional resistance</i> describes the principles professionals should follow when they seek to counter social harm and injustice. Applied to medical education, the principles of professional resistance can help learners and teachers balance the responsibilities to respond to harm and injustice with their roles and responsibilities as health professionals. However, there remains the problem of how educators and leaders can constructively respond to learner acts of resistance. It would seem that many leaders have dismissed learner resistance with variations on \"Those Darn Kids!\", a complaint that has long been levied at those in younger generations who challenge power and authority. How can productive change in medical education be achieved if learners' complaints are not taken seriously? Rather than dismissal, leaders and educators in these situations need the tools to engage learners in conversations that draw out their concerns.</p>","PeriodicalId":51183,"journal":{"name":"Teaching and Learning in Medicine","volume":" ","pages":"1-8"},"PeriodicalIF":2.5,"publicationDate":"2024-05-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141076680","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":"Identifying Physician Public Health Competencies to Address Healthcare Needs in Underserved, Border, and Outer Island Areas of Indonesia: A Rapid Assessment.","authors":"Perigrinus Hermin Sebong, Jerico Pardosi, Roberta Ellen Goldman, Anindyo Pradipta Suryo, Indra Adi Susianto, Andreasta Meliala","doi":"10.1080/10401334.2024.2353573","DOIUrl":"https://doi.org/10.1080/10401334.2024.2353573","url":null,"abstract":"<p><p><b><i>Phenomenon:</i></b> Most medical schools in Indonesia have developed innovations to integrate public health content into the curricula. However, ensuring that all schools meet appropriate standards regarding the quality of subjects, content relevancy, and course delivery takes time and effort. <b><i>Approach:</i></b> This study employed a rapid assessment procedure to identify the current knowledge and competencies required to practice medicine effectively in underserved, border, and outer island areas of Indonesia. Ninety-three participants from six remote districts were involved in 12 focus group discussions. Qualitative data were analyzed using content analysis using the social determinants of health as a guiding framework. <b><i>Findings:</i></b> Under decentralized health system governance, the local socio-geographical context is critical to understanding the current public health landscape. Medical education with respect to public health must emphasize physicians' ability to advocate and encourage the coordination of healthcare services in responding to disasters, as well as community-based surveillance and other relevant data for synergistic disease control. As part of a healthcare facility management team, prospective doctors should be able to apply systems thinking and provide critical input to improve service delivery at local health facilities. Also, recognizing underlying factors is essential to realizing effective interprofessional collaboration practices and aligning them with leadership skills. <b><i>Insights:</i></b> This study outlines recommendations for medical schools and relevant colleges in formulating compulsory block or integrated public health curricula. It also provides a public health learning topic that may aid medical schools in training their students to be competent for practice in underserved, border, and outer island areas. Medical schools should offer initiatives for students to acquire the necessary public health competencies merited by the population's health needs.</p>","PeriodicalId":51183,"journal":{"name":"Teaching and Learning in Medicine","volume":" ","pages":"1-12"},"PeriodicalIF":2.5,"publicationDate":"2024-05-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140923569","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":"Professionalism Policies and Practices as Experienced by First-Generation Medical Students, Residents, and Physicians.","authors":"Lynn Shaull, Paolo C Martin, Jessica Bunin, Tasha R Wyatt","doi":"10.1080/10401334.2024.2345394","DOIUrl":"https://doi.org/10.1080/10401334.2024.2345394","url":null,"abstract":"<p><p><b><i>Phenomenon</i></b>: While professionalism is largely understood to be complex and dynamic, it is oftentimes implemented as if it were static and concrete. As a result, policies and practices reflect dominant historical norms of the medical profession, which can cause tension for trainees from marginalized groups. One such group comprises those who identify as first-generation physicians - those whose parents have not earned an associate's degree or higher. This group is highly diverse in terms of gender, race, ethnicity, and socioeconomic status; however, their experiences with institutional professionalism policies and practices has not yet been fully explored. In this study, our aims were to understand the ways in which these participants experience professionalism, and to inform how professionalism can be more inclusively conceptualized. <b><i>Approach</i></b>: In November 2022-March 2023, we conducted semi-structured interviews with 11 first-generation medical students, residents, and physicians and analyzed select national and institutional professionalism policies in relation to key themes identified in the interviews. The interviews were designed to elicit participants' experiences with professionalism and where they experienced tension and challenges because of their first-gen identity. Data were analyzed using thematic analysis through a critical perspective, focused on identifying tensions because of systemic and historical factors. <b><i>Findings</i></b>: Participants described the ways in which they experienced tension between what was written, enacted, desirable, and possible around the following elements of professionalism: physical appearance; attendance and leaves of absence; and patient care. They described a deep connection to patient care but that this joy is often overshadowed by other elements of professionalism as well as healthcare system barriers. They also shared the ways in which they wish to contribute to changing how their institutions conceptualize professionalism. <b><i>Insights</i></b>: Given their unique paths to and through medicine and their marginalized status in medicine, first-generation interviewees provided a necessary lens for viewing the concept of professionalism that has been largely absent in medicine. These findings contribute to our understanding of professionalism conceptually, but also practically. As professionalism evolves, it is important for institutions to translate professionalism's complexity into educational practice as well as to involve diverse voices in refining professionalism definitions and policies.</p>","PeriodicalId":51183,"journal":{"name":"Teaching and Learning in Medicine","volume":" ","pages":"1-12"},"PeriodicalIF":2.5,"publicationDate":"2024-05-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140877863","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":"Culinary Medicine Experiences for Medical Students and Residents in the U.S. and Canada: A Scoping Review","authors":"Caitlin A. Hildebrand, Meghana B. Patel, Alyssa B. Tenney, Julia A. Logan, Khanh H. Luong, Miranda J. Crouch, Amanda E. Osta, Courtney DeRoo, Kurt O. Gilliland, Timothy S. Harlan, Alice S. Ammerman","doi":"10.1080/10401334.2024.2340977","DOIUrl":"https://doi.org/10.1080/10401334.2024.2340977","url":null,"abstract":"Despite the importance of diet in the prevention and management of many common chronic diseases, nutrition training in medicine is largely inadequate in medical school and residency. The emerging f...","PeriodicalId":51183,"journal":{"name":"Teaching and Learning in Medicine","volume":"18 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140835905","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":"Handle with Care: Transformative Learning as Pedagogy in an Under-Resourced Health Care Context","authors":"Jana Müller, Rhoda Meyer, Jason Bantjes, Elize Archer, Ian Couper","doi":"10.1080/10401334.2024.2332885","DOIUrl":"https://doi.org/10.1080/10401334.2024.2332885","url":null,"abstract":"Issue: A significant component of health professions education is focussed on students’ exposure to the social determinants of health and the challenges that patients within the health care system ...","PeriodicalId":51183,"journal":{"name":"Teaching and Learning in Medicine","volume":"3 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140608786","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":"Storylines of Trauma in Health Professions Education: A Critical Metanarrative Review","authors":"Amanda L. Roze des Ordons, Rachel H. Ellaway","doi":"10.1080/10401334.2024.2342443","DOIUrl":"https://doi.org/10.1080/10401334.2024.2342443","url":null,"abstract":"Learners in medical education are often exposed to content and situations that might be experienced as traumatic, which in turn has both professional and personal implications. The purpose of this ...","PeriodicalId":51183,"journal":{"name":"Teaching and Learning in Medicine","volume":"29 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-04-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140608700","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":"Early Bird or Night Owl: Insights into Dutch Students’ Study Patterns using the Medical Faculty’s E-learning Registrations","authors":"U. S. Ebeling, R. A. de Leeuw, J. R. Georgiadis, F. Scheele, J. K. G. Wietasch","doi":"10.1080/10401334.2024.2331649","DOIUrl":"https://doi.org/10.1080/10401334.2024.2331649","url":null,"abstract":"Phenomenon: Educational activities for students are typically arranged without consideration of their preferences or peak performance hours. Students might prefer to study at different times based ...","PeriodicalId":51183,"journal":{"name":"Teaching and Learning in Medicine","volume":"43 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-04-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140580378","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":"Medical Care as Flea Market Bargaining? An International Interdisciplinary Study of Varieties of Shared Decision Making in Physician–Patient Interactions","authors":"Ilka Sommer, Solmaz Assa, Cadja Bachmann, Wei Chen (陈未), Melih Elcin, Elisabeth Funk, Caner Kamisli, Tao Liu (刘涛), Alexander H. Maass, Stefanie Merse, Caroline Morbach, Anja Neumann, Till Neumann, Benjamin Quasinowski, Stefan Störk, Sarah Weingartz, Götz Wietasch, Anja Weiss (Weiß)","doi":"10.1080/10401334.2024.2322456","DOIUrl":"https://doi.org/10.1080/10401334.2024.2322456","url":null,"abstract":"Phenomenon: Shared decision making (SDM) is a core ideal in the interaction between healthcare providers and patients, but the implementation of the SDM ideal in clinical routines has been a relati...","PeriodicalId":51183,"journal":{"name":"Teaching and Learning in Medicine","volume":"319 1","pages":""},"PeriodicalIF":2.5,"publicationDate":"2024-04-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140580588","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 Inconspicuous Learner Handover: An Exploratory Study of U.S. Emergency Medicine Program Directors' Perceptions of Learner Handovers from Medical School to Residency.","authors":"Holly A Caretta-Weyer, Yoon Soo Park, Ara Tekian, Stefanie S Sebok-Syer","doi":"10.1080/10401334.2023.2178438","DOIUrl":"10.1080/10401334.2023.2178438","url":null,"abstract":"<p><p><b><i>Phenomenon</i>:</b> Central to competency-based medical education is the need for a seamless developmental continuum of training and practice. Trainees currently experience significant discontinuity in the transition from undergraduate (UME) to graduate medical education (GME). The learner handover is intended to smooth this transition, but little is known about how well this is working from the GME perspective. In an attempt to gather preliminary evidence, this study explores U.S. program directors (PDs) perspective of the learner handover from UME to GME. <b><i>Approach</i>:</b> Using exploratory qualitative methodology, we conducted semi-structured interviews with 12 Emergency Medicine PDs within the U.S. from October to November, 2020. We asked participants to describe their current perception of the learner handover from UME to GME. Then we performed thematic analysis using an inductive approach. <b><i>Findings</i>:</b> We identified two main themes: The inconspicuous learner handover and barrier to creating a successful UME to GME learner handover. PDs described the current state of the learner handover as \"nonexistent,\" yet acknowledged that information is transmitted from UME to GME. Participants also highlighted key challenges preventing a successful learner handover from UME to GME. These included: conflicting expectations, issues of trust and transparency, and a dearth of assessment data to actually hand over. <b><i>Insights</i>:</b> PDs highlight the inconspicuous nature of learner handovers, suggesting that assessment information is not shared in the way it should be in the transition from UME to GME. Challenges with the learner handover demonstrate a lack of trust, transparency, and explicit communication between UME and GME. Our findings can inform how national organizations establish a unified approach to transmitting growth-oriented assessment data and formalize transparent learner handovers from UME to GME.</p>","PeriodicalId":51183,"journal":{"name":"Teaching and Learning in Medicine","volume":" ","pages":"134-142"},"PeriodicalIF":2.5,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10731929","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":"Abortion and Contraception in Medical School Curricula: A Survey of North American Family Medicine Clinical Curriculum Directors.","authors":"Laurel B Witt, Sharon Wolff, Grace Shih, Valerie French","doi":"10.1080/10401334.2022.2163399","DOIUrl":"10.1080/10401334.2022.2163399","url":null,"abstract":"<p><p><b><i>Phenomenon:</i></b> Contraception and abortion care are commonly accessed health services, and physicians in training will encounter patients seeking this care. Curricula that teach contraception and abortion provision during medical school equip medical students with valuable skills and may influence their intention to provide these services during their careers. Family planning is nevertheless understood to be underrepresented in most medical curricula, including in North American medical schools where the laws on providing contraception and abortion have been consequentially changing. This study investigated the prevalence and predictors of contraception and abortion education in North American medical curricula in 2021.</p><p><p><b><i>Approach:</i></b> We asked family medicine clerkship directors from Canada and the United States (US) to report about contraception and abortion teaching in their clinical curricula and their school's whole curriculum and to report on associated factors. Survey questions were included in the 2021 Council of Academic Family Medicine's Educational Research Alliance (CERA) survey of Family Medicine Clerkship Directors at accredited North American medical schools. Surveys were distributed between April 29 and May 28, 2021, to the 160 clerkship directors listed in the CERA organization database.</p><p><p><b><i>Findings:</i></b> Seventy-eight directors responded to the survey (78/160, 48%). 47% of responding directors reported no contraception teaching in the family medicine clerkship. 81.7% of responding directors reported no abortion teaching in the clerkship, and 66% indicated abortion was not being taught in their school's whole curriculum. Medical school region correlated with the presence of abortion curricula, and schools with high graduation rates into the family medicine specialty reported abortion teaching more frequently. Fewer than 40% of responding directors had received training on both contraception and abortion care themselves.</p><p><p><b><i>Insights:</i></b> Contraception and abortion are both underrepresented in North American medical curricula. Formal abortion education may be absent from most family medicine clerkships and whole program curricula. To enhance family planning teaching in North American medical schools, we recommend that national curriculum resources be revised to include specific contraception and abortion learning objectives and for increased development and support for clinical curricula directors to universally include family planning teaching in whole program and family medicine clerkship curricula.</p>","PeriodicalId":51183,"journal":{"name":"Teaching and Learning in Medicine","volume":" ","pages":"174-182"},"PeriodicalIF":2.5,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9089197","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}