Medical education (Chicago, Ill.)最新文献

{"title":"Really Good Stuff reviewers 2019","authors":"","doi":"10.1111/medu.13997","DOIUrl":"https://doi.org/10.1111/medu.13997","url":null,"abstract":"","PeriodicalId":90259,"journal":{"name":"Medical education (Chicago, Ill.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/medu.13997","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47542783","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Experience‐based learning in undergraduate clinical placements: a step too soon?","authors":"R. Davidson, A. Davidson","doi":"10.1111/medu.13999","DOIUrl":"https://doi.org/10.1111/medu.13999","url":null,"abstract":"Editor We read with great interest the thoughts and opinions of Coakley et al1 in ‘ ‘Waiting in the wings’; Lived Experience at the Threshold of Clinical Practice’. We found their exploration of the transitional phase from medical student to doctor through the metaphor of an actor ‘Waiting in the wings’ highly compelling, and were particularly drawn to the solutions outlined by the authors to the problems encountered by the participants in the study, in particular the recommendation of a greater emphasis on experiencebased learning in undergraduate clinical training. As a recently appointed F1 doctor and a fourthyear medical student, we are uniquely placed to comment on this issue. Although we appreciate the problems caused by ‘transition shock’, as described, we do not agree with the proposed solution to this issue. As demonstrated in Atherley et al 2019,2 there already appears to be considerable apprehension amongst preclinical medical students regarding the transitional process to clinical training. Furthermore, we would argue that this lack of confidence in the clinical setting continues well into the penultimate and final years of medical school for many students. We believe the proposed solution to ‘transition shock’, by allowing senior medical students to ‘bear some of the burden’ of patient care in an incremental fashion, would only worsen the problems outlined by Atherley et al,2 and potentially lead to medical students feeling responsible in the event of poor patient outcome. Undergraduate clinical training commonly revolves around shadowing highly senior figures and individuals who perform highly specialist roles within the multidisciplinary team. We propose that the problem of ‘transition shock’ be eased by an increased emphasis on shadowing more junior figures within the team, allowing students to gain experience more directly applicable to the role they will be performing as newly appointed Foundation doctors.","PeriodicalId":90259,"journal":{"name":"Medical education (Chicago, Ill.)","volume":"54 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/medu.13999","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41476259","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"‘There shouldn't be anything wrong with not knowing’: epistemologies in simulation","authors":"Stella L. Ng, E. Kangasjarvi, G. Lorello, Lori Nemoy, R. Brydges","doi":"10.1111/medu.13928","DOIUrl":"https://doi.org/10.1111/medu.13928","url":null,"abstract":"Medical education embraces simulation‐based education (SBE). However, key SBE features purported to support learning, such as learner safety and learning through experience and error, may not align with the dominant culture of medicine, in which portraying confidence and certainty about one's knowledge prevails. Misaligned conceptions about knowledge and learning may produce unintended negative effects, including the suboptimal implementation of SBE, which could consequently compromise SBE and its outcomes.","PeriodicalId":90259,"journal":{"name":"Medical education (Chicago, Ill.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/medu.13928","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41849891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adipose Tissue Distribution and Cardiovascular Disease Risk Among Breast Cancer Survivors.","authors":"Elizabeth M Cespedes Feliciano, Wendy Y Chen, Patrick T Bradshaw, Carla M Prado, Stacey Alexeeff, Kathleen B Albers, Adrienne L Castillo, Bette J Caan","doi":"10.1200/JCO.19.00286","DOIUrl":"10.1200/JCO.19.00286","url":null,"abstract":"<p><strong>Purpose: </strong>Cardiovascular disease (CVD) is a major source of morbidity and mortality among breast cancer survivors. Although body mass index (BMI) is associated with CVD risk, adipose tissue distribution may better identify patients with a high risk of CVD after breast cancer.</p><p><strong>Methods: </strong>Among 2,943 patients with nonmetastatic breast cancer without prior CVD, we used International Classification of Diseases (9th and 10th revisions) codes to identify incidence of nonfatal stroke, myocardial infarction, heart failure, or CVD death. From clinically acquired computed tomography scans obtained near diagnosis, we measured visceral adiposity (centimeters squared), subcutaneous adiposity (centimeters squared), and intramuscular adiposity (fatty infiltration into muscle [Hounsfield Units, scored inversely]). We estimated hazard ratios (HRs) and 95% CIs per SD increase in adiposity accounting for competing risks and adjusting for demographics, smoking, cancer treatment, and pre-existing CVD risk factors.</p><p><strong>Results: </strong>Mean (SD) age was 56 (12) years. Over a median follow-up of 6 years, 328 CVD events occurred. Each SD increase in visceral or intramuscular adiposity was associated with an increase in CVD risk (HR, 1.15 [95% CI, 1.03 to 1.29] and HR, 1.21 [95% CI, 1.06 to 1.37]), respectively). Excess visceral and intramuscular adiposity occurred across all BMI categories. Among normal-weight patients, each SD greater visceral adiposity increased CVD risk by 70% (HR, 1.70 [95% CI, 1.10 to 2.62]).</p><p><strong>Conclusion: </strong>Visceral and intramuscular adiposity were associated with increased CVD incidence after breast cancer diagnosis, independent of pre-existing CVD risk factors and cancer treatments. The increased CVD incidence among normal-weight patients with greater visceral adiposity would go undetected with BMI alone. Measures of adipose tissue distribution may help identify high-risk patients and tailor CVD prevention strategies.</p>","PeriodicalId":90259,"journal":{"name":"Medical education (Chicago, Ill.)","volume":"27 1","pages":"2528-2536"},"PeriodicalIF":42.1,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7001794/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84839836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical student strategies for actively negotiating hierarchy in the clinical environment","authors":"M. Vanstone, L. Grierson","doi":"10.1111/medu.13945","DOIUrl":"https://doi.org/10.1111/medu.13945","url":null,"abstract":"Medical learning takes place in an extremely hierarchical environment. Medical students may struggle to understand how to succeed in such a rule‐bound environment that leaves them vulnerable to the influences of social power. This study explores how medical students experience the clinical learning environment from their low‐status positions in the social hierarchy.","PeriodicalId":90259,"journal":{"name":"Medical education (Chicago, Ill.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/medu.13945","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49534508","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emotional challenges of medical students generate feelings of uncertainty","authors":"Maria Weurlander, Annalena Lönn, A. Seeberger, H. Hult, Robert Thornberg, Annika Wernerson","doi":"10.1111/medu.13934","DOIUrl":"https://doi.org/10.1111/medu.13934","url":null,"abstract":"Health care students face many situations during their education that might be emotionally challenging. Students are confronted with illness, suffering, death, patient treatment dilemmas, and witnessing unprofessional behaviour on the part of health care professionals. Few studies have focused on what these experiences lead to in relation to the process of becoming a professional. The purpose of the study was to explore medical students’ main concerns relating to emotionally challenging situations during their medical education.","PeriodicalId":90259,"journal":{"name":"Medical education (Chicago, Ill.)","volume":"53 1","pages":"1037 - 1048"},"PeriodicalIF":0.0,"publicationDate":"2019-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/medu.13934","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46513477","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Medical student views of and responses to expectations of professionalism","authors":"Evangeline A Stubbing, E. Helmich, Jennifer Cleland","doi":"10.1111/medu.13933","DOIUrl":"https://doi.org/10.1111/medu.13933","url":null,"abstract":"To earn society's trust, medical students must develop professional values and behaviours via a transformative process, from lay person to doctor. Yet students are expected to epitomise the values and behaviours of a doctor from the outset of medical school, leading them to feel ‘judged all the time’ (in terms of their professionalism). Our aim, therefore, is to extend knowledge exploring the expectations communicated to and perceived by medical students and to provide a conceptually framed understanding of students’ associated emotional tensions.","PeriodicalId":90259,"journal":{"name":"Medical education (Chicago, Ill.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/medu.13933","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47207377","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Learning through the senses","authors":"M. F. van der Schaaf","doi":"10.1111/medu.13943","DOIUrl":"https://doi.org/10.1111/medu.13943","url":null,"abstract":"van der Schaaf comments on Kelly et al.'s study to further explain how the concept of embodied cognition can impact health professionals' learning and learning environments.","PeriodicalId":90259,"journal":{"name":"Medical education (Chicago, Ill.)","volume":"53 1","pages":"960 - 962"},"PeriodicalIF":0.0,"publicationDate":"2019-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/medu.13943","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41421513","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Towards a greater understanding of narrative data on trainee performance","authors":"C. E. Scarff","doi":"10.1111/medu.13940","DOIUrl":"https://doi.org/10.1111/medu.13940","url":null,"abstract":"In a research paper in this issue of Medical Education, Wilby et al (1) present a study on the interpretation of narrative data generated by assessors in a final year OSCE for pharmacy students in Qatar. The authors collated the written comments on the performance of a sample of nine students (of good, average and poor performance standard) across all 6 of the OSCE stations and enlisted expert-assessors to review them, using think-aloud procedures and verbal protocol analysis. The overall purpose was to explore how expert-assessors understand the narratives written by others in the setting of a standardized performance assessment. In other words, how we seek to reconstruct a learner’s unwitnessed performance based on descriptions provided by others.","PeriodicalId":90259,"journal":{"name":"Medical education (Chicago, Ill.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-08-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/medu.13940","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47958203","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Issue Information","authors":"","doi":"10.1111/medu.13661","DOIUrl":"https://doi.org/10.1111/medu.13661","url":null,"abstract":"","PeriodicalId":90259,"journal":{"name":"Medical education (Chicago, Ill.)","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1111/medu.13661","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46548150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}