September in this issue

This ethnographic exploration focusses on the emotionally charged processes in the interprofessional educational space of the clinical learning environment. Study findings reveal how nurses strived to maintain the sentimental order on the wards, through generously gifting emotional support to students and doctors. However, workplace stresses such as time pressures and staff shortages created interprofessional tensions, generating negative emotions. The authors illuminate this largely invisible dimension of the nursing role to project emotions as directly influencing student experience and interprofessional working.

Gupta, S, Howden, S, Moffat, M, Pope, L, Kennedy, C. Role of nurses in moderating the emotional dynamics in the clinical learning environments: Implications for medical students' experience. Med Educ. 2025;59(9):960-971. doi: 10.1111/medu.15728

Traditionally, guidance for workplace learning has been framed as an intraprofessional responsibility (e.g., physicians guide physicians-in-training); however, interprofessional guidance (e.g., nurses and advance practice clinicians guiding physicians-in-training) offers an insufficiently tapped resource. This constructivist interview study with medical trainees, nurses, advance practice clinicians and attending physicians suggests that guidance on interprofessional collaboration is provided, but is limited, informal, implicit and hampered by hierarchical professional boundaries. Empowering the full membership of the interprofessional healthcare team to support medical education—especially about interprofessional collaboration—is a promising opportunity strangled by socially and politically upheld professional silos.

Stalmeijer, R, de Grave, W, Smeenk, F, Varpio, L. Guiding Medical Trainees' Workplace Learning for Interprofessional Collaboration - Looking to Physicians or Seeing Nurses? Med Educ. 2025;59(9):950-959. doi: 10.1111/medu.15617

Learners have the potential to drive their own learning. However, knowledge gaps remain in how best to promote agentic learning (AL). In this paper, we shed new light on how AL manifests and can be promoted through the unique theoretical lens of Transformative Agency through Double Stimulation. By designing sufficiently challenging yet well-facilitated learning experiences, learners are encouraged to ‘hold the tension’ between creatively resolving challenges and maintaining professional credibility. This process is shaped by participation in a social group and influenced by the transformation of activities within that group. Embodying change provides a deep-seated message that learners can take to their future practice.

Carr, D, Kajamaa, A, Gormley, G, Spence, A. ‘Overcoming and owning challenges’: A qualitative study exploring the manifestation of agency in learners. Med Educ. 2025;59(9):972-982. doi: 10.1111/medu.15631

Successful integration of wisdom concepts into established U.S. medical competency frameworks has been hindered by variability in assumptions, values and practices. This study uses thematic analysis of physicians' understanding of medical wisdom (MW), comparative analysis with non-medical models of wisdom and complex problem-solving, and polarity mapping™ to create a practical model of MW. The study concludes that MW shares features with complex adaptive systems and successful integration into established frameworks will require explicit acknowledgement of differences between medicine's moral economy of science and wisdom's economy of morally directed and contextually responsive practice.

Woodruff, J, Millhollin, J, Lee, W, Weststrate, NM, Osterberg, L. Seeking Medical Wisdom: Development of a physician defined practical model of wise competence. Med Educ. 2025;59(9):938-949. doi: 10.1111/medu.15709