International Journal of Medical Education最新文献

Objective: To explore benefits and challenges experienced by residents and faculty when teaching in virtual settings.

Methods: This was a qualitative descriptive study employing one-on-one semi-structured interviews with 10 residents and 12 faculty in the Department of Family Medicine at the University of Alberta, Canada, from May 2021 to May 2022. Participants were recruited via social media, resident and department events and email lists. Interview transcripts were analyzed descriptively and thematically employing the Self-Determination Theory (SDT) framework to map the identified benefits and challenges as facilitators and barriers to fulfilling teacher's basic psychological needs for autonomy, competence, and relatedness in virtual settings.

Results: Resident and faculty participants used virtual technology not only to deliver education, but also leveraged various platform features to support their needs in virtual settings. The emerging themes within benefits and challenges of virtual teaching were amenable to mapping onto three basic psychological needs of the SDT framework - autonomy (e.g., increased accessibility; lack of control over teaching environment), competence (e.g., increased self-confidence; technological limitations hindering skill development), and relatedness (e.g., timely exchange of information; difficulty with professional identity formation).

Conclusions: Despite the inherent challenges, teaching in virtual settings can support teachers' psychological needs. Recommendations for the future delivery and facilitation of virtual learning include: giving high priority to engagement and active participation; nurturing autonomy and greater individual responsibility for learning; and creating an environment of emotional support. The SDT-informed strategies shown to be effective in in-person teaching need to be examined for their applicability in virtual settings.

Objectives: To identify the main enablers and challenges for workplace learning during postgraduate medical education among residents and their supervisors involved in training hospital specialists across different medical specialties and clinical teaching departments.

Methods: A qualitative explorative study using semi-structured focus group interviews was employed. A purposeful sampling method was utilized to invite participants who were involved in postgraduate medical education for hospital specialist medicine at two universities. Hospital physicians in training, also called residents (n=876) and supervisors (n=66), were invited by email to participate. Three focus groups were organized: two with residents and one with supervisors. Due to the COVID-19 pandemic rules prohibiting real group meetings, these focus groups were online and asynchronous. The data was analyzed following an inductive thematic analysis.

Results: The following overarching themes were identified: 1) the dual learning path, which balances working in the hospital and formal courses, 2) feedback, where quality, quantity, and frequency are discussed, and 3) learning support, including residents' self-directed learning, supervisors' guidance, and ePortfolio support.

Conclusions: Different enablers and challenges for postgraduate medical education were identified. These results can guide all stakeholders involved with workplace learning to develop a better understanding of how workplace learning can be optimized to improve the postgraduate medical education experience. Future studies could focus on confirming the results of this study in a broader, perhaps international setting and exploring strategies for aligning residencies to improve quality.

Objectives: To identify how differences in cultural and professional values between New Zealand born and trained doctors and International Medical Graduates (IMGs) affect the practice and retention of IMGs in New Zealand.

Methods: A mixed-method approach was used. An anonymous 42-item online questionnaire was used to compare participants' cultural and professional values. Participants were 373 New Zealand doctors, 198 IMG, and 25 doctors born and raised elsewhere but who qualified in New Zealand, a group not identified prospectively. The qualitative component used interviews with 14 IMGs to identify cultural challenges faced and with nine New Zealand doctors to identify the challenges they faced working alongside IMGs. Qualitative data were transcribed and analysed thematically.

Results: There were differences in power distance, with the medically qualified in New Zealand doctors having the highest power distance, followed by the IMGs, suggesting a preference for a hierarchical environment at odds with the New Zealand culture. Interviews found cultural differences in communication styles and hierarchy contributed to professional challenges. The cultural transition was difficult for IMGs as they received minimal support. One-third of IMGs acknowledged their behaviours did not fit well in New Zealand. Complaints about IMGs increased when they reverted to default behaviours regarded negatively by New Zealand colleagues or patients.

Conclusions: IMGs are open to change but face a lack of orientation and cultural education opportunities, hindering integration. Residency programs must recognise this disconnect and incorporate cross-cultural programmes in the curriculum. Such programmes would assist the adaption and retention of IMG doctors.

Objectives: This study aimed to explore students' perspectives on the attributes of medical teachers as role models to students' professional behaviour in the educational process.

Methods: A phenomenological study was conducted to obtain participants' perceptions concerning the professional attributes of medical teachers. The participants were 21 final-year medical students in the School of Medicine, Universitas Gadjah Mada, who had completed and passed the national examination. The participants were recruited purposively to represent genders and performance (i.e., high-performing and average-performing students). The participants were divided into two focus groups based on their performance, each facilitated by non-teaching faculty members to avoid bias. Thematic analysis was conducted to analyze focus group transcripts by two independent coders. Codes were synthesized into themes related to the study aims.

Results: Seven themes were identified related to observed role model attributes, for instance, passionate lecturers, caring and empathetic, supportive and involving, objectivity, incompetence and compromising, poor communication and conflict, and time management. Subsequently, five themes were identified in participants' responses towards the observed role model, for instance, exemplary models, respect and motivating, confusion and inconvenience, avoiding and hate, and value collision and harmonization.

Conclusions: This study revealed a range of role model attributes and responded positively and negatively during learning encounters. As negative attributes are also prominent and observed by students, there is a need for medical schools to perform faculty development for the professional enhancement of medical teachers. Further study should be conducted to investigate the impact of role modelling on learning achievement and future medical practice.