April in this issue

This sociomaterial study on ‘fixing disconnects’ interviewed Canadian Competency-Based Medical Education implementation leads about their agency and constraints in the process of curriculum making. While curriculum design, education contexts and technologies were actors in disconnecting assessment from learning, some training programmes managed to adapt through creative workarounds for responsive teaching, tailored learning and meaningful entrustment. As such, this study offers insights and principles for making competency-based learning work for all learners and contexts.

Ott, MC, Dengler, L, Hibbert, K, Ott, M. Fixing disconnects: exploring the emergence of principled adaptations in a competency-based curriculum. Med Educ. 2025; 59(4): 428–438. doi:10.1111/medu.15475.

As medical students enter clinical practice, they often face emotionally charged end-of-life decisions that challenge their moral compass and professional identity. This study delves into the experiences of Brazilian medical students as they navigate these complex situations, revealing the profound impact of connecting with patients during end-of-life care. Key findings suggest that choosing to connect with patients rather than retreating to clinical detachment can transform students' professional identities and reinforce their commitment to compassionate care. This research underscores the need for medical educators to support students through these transformative experiences, promoting emotional resilience and patient-centred care.

Ribeiro, DL, Sacardo, D, Drzazga, G, Carvalho Filho, M. Connect or detach: a transformative experience for medical students in end-of-life care. Med Educ. 2025; 59(4): 395–408. doi:10.1111/medu.15545.

Using transformative theory as a framework, this research explores conceptual differences in the professionalism lapses of different health professional trainees and faculty to determine what helps or hinders transformation around these lapses. The context bound nature of professionalism lapses contributed to challenges in recognising or acknowledging lapses, especially when implicit, inconsistent or part of a hidden curriculum around expected social and/or communication norms. Also highlighted was the effect of power differentials on the response to professionalism lapses. To navigate these waters, clear communication of professional standards (including clinical context), space for dialogue and mindfulness of power dynamics are warranted.

Sibbald, M, Sheth, U, Last, N, Keuhl, A, McPherson, I, Wojkowski, S, Bakker, D, Rowland, P. Professionalism lapses in health professions training: navigating the ‘yellow card’ moments for transformative learning. Med Educ. 2025; 59(4): 418–427. doi:10.1111/medu.15540.

Qualitative interviews are both critically important and perennially challenging tools in health professions education research (HPER). Many researchers struggle to engage diverse participants and participants may find the questions researchers ask difficult to answer through oral questions alone. Alternative methods such as photos, videos or vignettes can work alongside oral interview questions to counter the challenges researchers face, but the HPER community has barely begun to engage with these diverse elicitation strategies. The framework provided in this article will guide researchers in identifying and selecting elicitation techniques that will improve the quality of their interview data.

Kahlke, R, Maggio, LA, Lee, M, Cristancho, S, LaDonna, K, Abdallah, Z, Khehra, A, Kshatri, K, Horsley, T, Varpio, L. When words fail us: an integrative review of innovative elicitation techniques for qualitative interviews. Med Educ. 2025; 59(4): 382–394. doi:10.1111/medu.15555.