International Journal of Medical Education最新文献

Objectives: To examine stressors and coping skills as reflected in the student population at a southeastern United States medical school, including identifying key stressors over time and coping mechanisms used.

Methods: Repeated cross-sectional cohort, mixed-methods study conducted between 2016 and 2022 at a four-year medical school program. Participants were students from seven classes, with two classes providing data during each of their four years of medical school. A census sampling approach was used, with survey data collected annually from each class across four years.  Two surveys were used:  the Perceived Stress Scale (PSS) and a modified Coping Orientation to Problems Experienced (COPE) Inventory.  Open-text questions captured qualitative responses. Statistical analysis included Welch's t-tests, Pearson correlations, and Cronbach's alpha reliability testing. Qualitative data were examined through inductive thematic analysis.

Results: Students reported moderate levels of perceived stress across all four years with fluctuations identified by year of study. There were no statistically significant differences in perceived stress based on student gender; however, qualitative findings identified gender differences related to coping strategies. Thematic analysis of qualitative data revealed three recurring categories of stressors: academic workload, residency application and match pressures, and personal life challenges. Stressors shifted from academic in the pre-clinical years to career concerns during the clinical years.

Conclusions: This study highlights the presence of stress throughout medical school and underscores the importance of adaptive coping strategies and the need for phase-specific interventions to support student well-being. Future research should evaluate the effectiveness of interventions in reducing stress across training stages.

Objectives: This study aimed to identify and compare the perceptions of senior, middle, and frontline managers regarding the core competencies required for effective healthcare middle managers in Bahrain and Saudi Arabia. It also explored how these competencies can inform competency-based leadership development programs globally.

Methods: A qualitative descriptive design was adopted. Twenty-seven participants from healthcare and medical education institutions in Bahrain and Saudi Arabia were purposively selected across three hierarchical levels: senior (n = 6, 22%), middle (n = 10, 37%), and frontline (n = 11, 41%). Semi-structured interviews were conducted virtually, audio-recorded, transcribed verbatim, and analyzed thematically using Braun and Clarke's six-step framework. Credibility was strengthened through member checking, peer debriefing, and an audit trail.

Results: Five overarching competency domains emerged in the study. They include personality, managerial skills, work ethics, mental ability and interaction. Personality, integrity, and organizational ability were the most frequently cited traits (93%). Managerial and social competencies such as time management (90%), teamwork (83%), communication (70%), and decision-making (60%) were emphasized across all managerial levels. Senior managers prioritized strategic agility and ethics, whereas frontline managers stressed interaction and communication. These patterns reflect the dual operational and relational demands of middle management in healthcare.

Conclusions: Successful healthcare middle managers require a balanced integration of technical proficiency, ethical integrity, interpersonal competence, and adaptability. Embedding these domains into competency-based leadership training could enhance organizational performance and strengthen healthcare governance across the region.

Objectives: To explore the effectiveness of overall faculty development (FD) programs in terms of three indicators of successful careers of clinical teachers (CTs): positive feedback (on personality traits or teaching skills) from students, teaching awards, and scholarly publications.

Methods: Data on student feedback, number of teaching awards, number of scholarly publications, and sum of FD participation hours in a teaching hospital with 23 clinical departments and 623 clinical faculty members (2019-2021) were collected and analyzed using Spearman's rank-order correlation coefficient (r_s) and independent-samples t-tests (with Welch's correction where appropriate).

Results: The sum of FD hours was significantly associated with positive feedback from students (r_s = 0.15, p = .001) but not with teaching awards or publications. Furthermore, faculty members with more FD hours on research skills received better positive feedback from students regarding personal traits or teaching skills (Cohen's d = 0.60, 95% CI [0.34, 0.86], p < .001) and more teaching awards (Cohen's d = 0.34, 95 % CI [0.13, 0.55], p = .010) but did not have a greater number of publications (Cohen's d = 0.15, 95% CI [-0.07, 0.36], p = .780) than those with lower research FD hours. In addition, the number of teaching awards was significantly associated with positive feedback from students regarding personal traits (r_s = 0.92, p < .001) or teaching skills (r_s = 0.93, p < .001), and publication quantity (r_s = 0.13, p < .001) was markedly correlated with the number of teaching awards.

Conclusions: FD activities may provide positive impacts on CTs in terms of feedback from students and teaching awards but do not directly impact scholarly publications. However, faculty members who received teaching awards and positive feedback from students may have better scholarly publication performance.

Objectives: This study explores the application of the current curriculum, launched in 2016, for interprofessional learning (IPL) at the Faculty of Medicine and Health Sciences at Linköping University, Sweden.

Methods: Perceptions from students, teachers and key persons (n=19) were investigated with focus groups and individual interviews. The interviews explored perceptions of curriculum design, implementation, and interprofessional learning activities. A four-dimensional framework for curriculum development and evaluation constituted the theoretical lens for the analysis. Specifically, a qualitative directed content analysis was used.

Results: Four overarching categories were identified. 1) "Aiming towards high quality healthcare professionals working together naturally", included the arguments for IPL within healthcare and why the curriculum revision was conducted. 2) "Comprehending how to work in a group, a team, and an interprofessional team", related to the desired learning outcomes and competencies. 3) "All on board? - The search for meaningful learning activities for students and teachers that the programs embrace", reflected on how learning activities were designed and experienced. 4) "Enhancing legitimacy and the provision of organizational prerequisites for the curriculum", described the organisational structures for enhancing the legitimacy of the IPL curriculum, as well as the role of teachers.

Conclusions: This study emphasizes balancing pedagogical innovation with pragmatic considerations for successful curriculum application. The findings highlight the need for experienced teachers, organisational support, and meaningful learning activities that align with both program-specific and interprofessional outcomes. Despite challenges, the current curriculum at Linköping University shows potential as a model for integrating interprofessional learning into health professions education.

Objectives: This study aimed to elucidate, through qualitative analysis, the cognitive processes by which experienced oncology nurses regulate their emotions when facing anxiety and emotional conflict in communication with patients.

Methods: We employed a qualitative exploratory design using semi-structured individual interviews with six certified oncology nurses in Japan. Participants were recruited via snowball sampling and provided written informed consent. Interviews were conducted in Japanese using a pre-tested interview guide; audio data were transcribed verbatim. Data were analyzed with the Steps for Coding and Theorization (SCAT) method. Metacognitive theory-distinguishing metacognitive knowledge and metacognitive regulation-guided interpretation of the findings.

Results: Analysis of 38 theoretical descriptions yielded two overarching themes: (1) anxiety and conflict in communication with cancer patients, and (2) metacognitive emotion-regulation strategies. The latter comprised two subthemes: (a) patient-oriented cognitive strategies (e.g., linguistic adjustments, trust-building, facilitating patients' self-regulation), and (b) self-oriented cognitive restructuring (e.g., reframing dilemmas, monitoring and modulating one's own emotional responses). These processes reflected deliberate monitoring and regulation of thinking and feelings to sustain constructive engagement with patients.

Conclusions: Experienced oncology nurses use metacognition to recognize, interpret, and flexibly regulate emotions in challenging interpersonal situations. Educational implications include integrating structured metacognitive reflection alongside empathy and mindfulness training to cultivate durable, transferable coping skills. Future studies should examine this approach in diverse clinical contexts, include larger and cross-cultural samples, and evaluate longer-term outcomes in nurses' emotional resilience and clinical practice.

Objectives: This study aims to explore the preparedness of faculty in health professions education at three Malaysian universities by assessing their perceptions of basic concepts in microlearning as well as factors affecting effective content construction and digital format preferences.

Methods: An explanatory sequential mixed-method approach was used to systematically analyse faculty perceptions by integrating quantitative and qualitative findings. A total of 121 faculty members voluntarily completed the online survey. A qualitative exploratory study was conducted with 20 selected staff members, followed by a thematic analysis. Descriptive and analytical statistics, including Pearson's chi-square test, were used to analyse the data.

Results: The survey revealed that 95.9% (n=116) of faculty members agreed that microlearning is ideal for the acquisition of microcontent with single learning outcomes. The optimal duration should be between 3 and 5 minutes. Strong associations [χ²(16, N=121) =33.17, p=0.007] between time duration and content size and content size and form of knowledge [χ²(16, N=121) =28.79, p=0.025] were observed in chi-square goodness-of-fit test. Microcontent of a single learning outcome, chunking of content, cognitive load, and degree to which topic connects with the media used emerged as primary sub-themes. Challenges in adapting skills to construct engaging microlearning content were highlighted.

Conclusions: The study provides a microlearning framework for health professional educators to consider the complexity of content, its format, and integration with suitable digital tools. Future research should explore how combinations of microlearning and other instructional formats optimise learning outcomes.

Objectives: To address the problem of medical school applicants' lying about their reasons for becoming physicians in the admissions process, this study aims to explore the grounds for their reasons by distinguishing between their beliefs and statements.

Methods: The participants, recruited by convenience sampling, were 15 medical students and physicians who had entered graduate-entry programs of medical schools in Japan. We conducted individual semi-structured online interviews in 2020 and performed a reflexive thematic analysis.

Results: We generated five themes regarding the grounds for applicants' reasons in their beliefs: consistency with past interests, experience of being underprivileged, experience of family disease, parental influence, and no grounds; four themes regarding the grounds for applicants' true reasons in their statements: consistency with actual past interests, actual experience of being underprivileged, actual experience of family disease, and actual experience of being powerless for patients; and four themes regarding the grounds for applicants' untrue reasons in their statements: consistency with actual or fictional past interests, actual experience of family disease, fictional parental influence, and convenient origin.

Conclusions: This study is the first to distinguish between applicants' beliefs and statements and analyze the grounds for their reasons for becoming physicians. The findings propose a reconstruction of the concept of reasons for becoming physicians and suggest that admissions committees may be able to verify applicants' reasons in their statements by asking them to present the grounds for them.

Objectives: This study aimed to develop a reliable and valid scale to assess nurses' information ethics behavior, facilitating self-reflection and supporting the application of ethical principles in clinical settings involving digital information management.

Methods: A scale development study with exploratory factor analysis was conducted in 2023, targeting 1,464 hospital-based and home-visit nurses across Japan. Participants completed a preliminary version of the Information Ethics Behavior Evaluation Scale for Nurses along with demographic questions. Item analysis and exploratory factor analysis (EFA) using the alpha factor extraction method and promax rotation were performed. Criterion-related validity was assessed via Spearman's rank-order correlation with the Self-Evaluation Scale for Ethical Behavior as a Nurse.

Results: Valid responses were obtained from 427 participants. Item analysis led to the exclusion of 14 items due to low factor loadings or double loading. EFA identified a three-factor structure comprising 21 items: (1) conscious behavior in handling information, (2) appropriate information management, and (3) response to information leakage risk. The scale demonstrated strong internal consistency (Cronbach's α = .86). Criterion-related validity was supported by a significant correlation with the external measure (r_s = .74, p < .001).

Conclusions: The Information Ethics Behavior Evaluation Scale for Nurses is a brief, reliable, and valid tool for assessing ethical conduct related to information handling in nursing practice. It provides a framework for ethical self-assessment and may contribute to the prevention of information breaches and the promotion of ethical decision-making. Further research should investigate the integration of digital literacy and internet-specific ethical competencies.

Objectives: This study investigated the perspectives of residents on training in error managing. The research question was: how do residents perceive and experience their training in handling errors in clinical practice?

Methods: The study used a qualitative exploratory design to gain insight into the residents' experiences. The data consisted in seven virtual focus groups with 22 Danish residents from 11 specialties at various educational levels, i.e. from first to fourth year of their training. The data were transcribed and analyzed using reflexive thematic analysis.

Results: The analysis showed three themes: 1) formal education, 2) culture and clinical context, and 3) the need for more training. The residents reported learning primarily about the legal aspects of errors, complaints, and the adverse events reporting system. They emphasized the need for practical training in error disclosure and managing emotional reactions to errors. Training in error managing was described as sporadic in specialist training, often contingent on departmental culture and individual supervisors.

Conclusion: The study revealed that residents perceive their training in error handling as inadequate, particularly in terms of disclosure, emotional reactions, and victim support, and identified the need for greater emphasis on these aspects in both undergraduate education and postgraduate training. The Danish framework for physician roles and specialist training curricula should be revised and a more open culture regarding medical errors fostered. Furthermore, supervisor training is crucial as training in error management should be integrated into the clinical setting where errors occur.