Medical Education最新文献

{"title":"Applying self-determination theory to stem medical schools' clinical teacher sustainability crisis","authors":"David A. Hirsh,&nbsp;Paul E. S. Crampton,&nbsp;Nora Y. Osman","doi":"10.1111/medu.15181","DOIUrl":"10.1111/medu.15181","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> The problem</h3>\u0000 \u0000 <p>Medical schools require highly skilled and committed clinical faculty to teach, assess, supervise and mentor students' clinical care. Medical education is facing a crisis in recruiting and sustaining these clinical teachers. Faced with multiple demands and responsibilities in fast-paced clinical environments, teachers may not have the time, resources or stamina to sustain these critical roles. Medical school leaders must commit to and provide structures and processes to attract, sustain and retain clinical teachers.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conceptual framework</h3>\u0000 \u0000 <p>The authors use the lens of self-determination theory to frame approaches to support teacher sustainability. Self-determination theory describes sources of human motivation. The theory and its evidence base characterise three human psychological needs: autonomy, competence, and relatedness. This theory can bridge individual psychological and institutional leadership perspectives to help medical school leaders anticipate and respond to their clinical teachers' needs. The authors propose three practical steps: practices to advance employee-centredness, processes to align individual and institutional values, and restructuring education to support clinical teachers' needs alongside student and patient needs. The authors describe limitations to this relational approach that focuses on leadership actions and consider individual agency as another key factor for sustainability.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>Medical school leaders can develop and apply theory-driven approaches to advance sustainability. Sustainability now and in the future requires careful attention to the needs of clinical teachers and to their relationships with and within medical schools.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"58 1","pages":"118-128"},"PeriodicalIF":6.0,"publicationDate":"2023-08-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10021298","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Transitioning from professional to interprofessional identity","authors":"Fraide A. Ganotice Jr","doi":"10.1111/medu.15191","DOIUrl":"10.1111/medu.15191","url":null,"abstract":"&lt;p&gt;How to promote professional and interprofessional identity in medical students? What factors (internal and external) may help contribute to their development? Have we done enough to understand their nomological network and malleable nature? What benchmark curricular design is implemented to target their development? These are practical and theoretical questions medical educators ask in their quest to better prepare future healthcare professionals. While we know that fostering a strong sense of interprofessional identity is a means whereby healthcare professionals can work more effectively as a team, further investigations are needed to help us clearly understand the ‘black box’ of their formation in the medical curriculum. The purpose of this commentary is to understand what remains unknown in the light of our collective effort to advance important knowledge about interprofessional identity formation in medical education.&lt;/p&gt;&lt;p&gt;Interprofessional identity is ‘the development of a robust cognitive, psychological, and emotional sense of belonging to an interprofessional community(s), necessary to achieve shared context-dependent goals’.&lt;span&gt;&lt;sup&gt;1&lt;/sup&gt;&lt;/span&gt; The inclusion of interprofessional identity alongside professional identity resonates with the changing landscape of healthcare management as healthcare becomes more team-based. World health leaders advocate the dismantling of traditional silos and promote interprofessional education (IPE) as interprofessional collaborative practice yields better health outcomes: efficiency, safety, patient/carer satisfaction, and strengthened health systems.&lt;span&gt;&lt;sup&gt;2&lt;/sup&gt;&lt;/span&gt; Despite these developments, theory and empirical data remain scant, and factors that facilitate or thwart interprofessional identity formation remain undefined in medical education research and practice.&lt;/p&gt;&lt;p&gt;Reinders and Krijnen's&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; article established the nomological network of interprofessional identity by answering the neglected question of what outcomes it predicts. Their data indicated that interprofessional identity translates into interprofessional behaviours and identified the activating effect of interprofessional identity via interprofessional socialisation on various interprofessional collaboration outcomes in IPE as a contextual trigger. Their work was noteworthy as it uncovered the relationships of interprofessional identity with a network of interrelated variables.&lt;/p&gt;&lt;p&gt;Framed using the extended professional identity theory (EPIT), Reinders and Krijnen's&lt;span&gt;&lt;sup&gt;3&lt;/sup&gt;&lt;/span&gt; work underscored the external environmental factors (social agencies) in explaining interprofessional identity formation: socialisation, peer and mentor influences, education and training, experiences, organisational culture, societal normative expectation. What appears missing is the potent influence of internal processes that can lead to interprofessional identity formation. Social cognitive theory&lt;span&gt;&lt;sup&gt;4&lt;","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"57 11","pages":"999-1002"},"PeriodicalIF":6.0,"publicationDate":"2023-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/medu.15191","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10005518","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"When I say… transformative learning","authors":"Benjamin S. Vipler,&nbsp;Adam P. Sawatsky","doi":"10.1111/medu.15189","DOIUrl":"10.1111/medu.15189","url":null,"abstract":"<p>Transformation = change. Learning = change. So what do @VipsMDMEd &amp; @APSawatskyMD mean when they say #TransformativeLearning?</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"57 12","pages":"1184-1186"},"PeriodicalIF":6.0,"publicationDate":"2023-08-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10004069","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In response to from bones to bytes: Do manipulable 3D models have added value in osteology education compared with static images?","authors":"Dimitrios Chytas,&nbsp;Georgios Paraskevas,&nbsp;Irene Asouhidou,&nbsp;Marios Salmas","doi":"10.1111/medu.15193","DOIUrl":"10.1111/medu.15193","url":null,"abstract":"We","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"57 11","pages":"1167-1168"},"PeriodicalIF":6.0,"publicationDate":"2023-08-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9991504","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Embracing emotional disparities between simulation and real-life practice","authors":"Marie-Laurence Tremblay","doi":"10.1111/medu.15188","DOIUrl":"10.1111/medu.15188","url":null,"abstract":"<p>This commentary addresses key aspects of the impact of emotions in simulation-based training and disparities from real-life. By exploring cognitive load and its influence on emotions, it sheds light on the intricacies of simulation and their implications.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"57 12","pages":"1179-1181"},"PeriodicalIF":6.0,"publicationDate":"2023-08-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10003063","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"September in this issue","authors":"","doi":"10.1111/medu.15176","DOIUrl":"10.1111/medu.15176","url":null,"abstract":"&lt;p&gt;Conceptualised as a temporary form of assessment during COVID-19, virtual OSCEs (vOSCEs) could become a permanent part of health professions education. This meta-ethnography of candidates' and assessors' experiences of vOSCEs revealed both positive and negative consequences in this transition from in-person to virtual assessment. Students have felt less intimidated and more confident in vOSCEs, but vOSCEs may be limited when assessing examination skills. The authors of the study suggest that medical education policymakers should consider the various technical and operational challenges and develop a clear vision for the role of vOSCEs in the rapid rise of telehealth.&lt;/p&gt;&lt;p&gt;\u0000 &lt;span&gt;Chan, SCC&lt;/span&gt;, &lt;span&gt;Choa, G&lt;/span&gt;, &lt;span&gt;Kelly, J&lt;/span&gt;, &lt;span&gt;Maru, D&lt;/span&gt;, &lt;span&gt;Rashid, MA&lt;/span&gt;. &lt;span&gt;Implementation of virtual OSCE in health professions education: a systematic review&lt;/span&gt;. &lt;i&gt;Med Educ&lt;/i&gt;. &lt;span&gt;2023&lt;/span&gt;; &lt;span&gt;57&lt;/span&gt;(&lt;span&gt;9&lt;/span&gt;): &lt;span&gt;833&lt;/span&gt;-&lt;span&gt;843&lt;/span&gt;. doi:10.1111/medu.15089&lt;/p&gt;&lt;p&gt;Leading in academic health science centres can be difficult due to the need to maintain multiple roles and changing expectations. A group of leadership development practitioners and experts developed a new model, the LEADS+ Developmental Model, to help leaders navigate these complexities.&lt;/p&gt;&lt;p&gt;Through their work, conducted as an integrative conceptual review with knowledge user consultation, the authors developed a new model with four nested stages that leaders can move through as they evolve their practices. The received a high level of endorsement from knowledge users, suggesting that the model may be very useful in fostering the development of academic health centre leaders.&lt;/p&gt;&lt;p&gt;\u0000 &lt;span&gt;Ramelli, S&lt;/span&gt;, &lt;span&gt;Lal, S&lt;/span&gt;, &lt;span&gt;Sherbino, J&lt;/span&gt;, &lt;span&gt;Dickson, G&lt;/span&gt;, &lt;span&gt;Chan, TM&lt;/span&gt;. &lt;span&gt;LEADS+ Developmental Model: proposing a new model based on an integrative conceptual review&lt;/span&gt;. &lt;i&gt;Med Educ&lt;/i&gt;. &lt;span&gt;2023&lt;/span&gt;; &lt;span&gt;57&lt;/span&gt;(&lt;span&gt;9&lt;/span&gt;): &lt;span&gt;857&lt;/span&gt;-&lt;span&gt;869&lt;/span&gt;. doi:10.1111/medu.15062&lt;/p&gt;&lt;p&gt;As medical education application processes continue to become more holistic, determining skillsets and experiences that predict success in applicants is paramount. This systematic review demonstrates that prior participation in athletics may be a predictor of success in medical school and residency. This is demonstrated through objective scoring methods, such as exam scores, and subjective outcomes, such as faculty ratings and burnout. Specifically, multiple studies indicate that former athletes demonstrate increased surgical skill proficiency and decreased burnout as medical students and residents.&lt;/p&gt;&lt;p&gt;\u0000 &lt;span&gt;Anderson, KG&lt;/span&gt;, &lt;span&gt;Lemos, J&lt;/span&gt;, &lt;span&gt;Pickell, S&lt;/span&gt;, &lt;span&gt;Stave, C&lt;/span&gt;, &lt;span&gt;Sgroi, M&lt;/span&gt;. &lt;span&gt;Athletes in medicine: a systematic review of performance of athletes in medicine&lt;/span&gt;. &lt;i&gt;Med Educ&lt;/i&gt;. &lt;span&gt;202","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"57 9","pages":"781"},"PeriodicalIF":6.0,"publicationDate":"2023-08-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/medu.15176","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10019360","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The untapped potential of simulation for identity development and social integration","authors":"Victoria R. Tallentire,&nbsp;Samantha E. Smith","doi":"10.1111/medu.15187","DOIUrl":"10.1111/medu.15187","url":null,"abstract":"","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"58 2","pages":"271"},"PeriodicalIF":6.0,"publicationDate":"2023-08-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9982697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"‘Oh yes, that is also reflection’—Using discursive psychology to describe how GP registrars construct reflection","authors":"Sven P. C. Schaepkens,&nbsp;Anne de la Croix,&nbsp;Mario Veen","doi":"10.1111/medu.15183","DOIUrl":"10.1111/medu.15183","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Learners in medical education generally perceive that reflection is important, but they also find that reflection is not always valuable or practically applicable. We address the gap between the potential benefits of reflection and its practical implementation in medical education. We examined the perspective of Dutch GP registrars who (must) reflect for their GP specialty training to understand their participant perspective on reflection. Our aim is stimulating alignment between reflective activities that occur in a medical curriculum and the ideals of reflection as a valuable educational activity.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We conducted, video-recorded and transcribed seven focus group sessions with GP registrars in 2021 across two Dutch GP educational programmes. We used discursive psychology to analyse the focus group data by focusing on ‘assessments of reflection’. We analysed their discursive features (<i>how</i> something was said) and content features (<i>what</i> was said) and related these to each other to understand how GP registrars construct reflection.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Participants constructed reflection with nuance; they combined negative and positive assessments that displayed varied orientations to reflection. First, their combined assessments showed complex orientations to norms and experiences with reflecting in practice and that these are not simply negative or positive. Second, GP registrars constructed reflection as a negotiable topic and showed how reflection and its value can be variably understood. Third, through combined assessments, they displayed an orientation to the integration of reflection with other educational tasks, which impacts its value.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Generally, GP registrars speak positively about reflection, but the value of reflection partly depends on its proper integration with other educational tasks. When meaningful integration fails, activities to stimulate reflection can overshoot their own goal and hamper learner motivation to reflect. Developing a healthy ‘reflection culture’ could mitigate some challenges. Therein, reflection is treated as important while learners also have adequate autonomy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"58 3","pages":"318-326"},"PeriodicalIF":6.0,"publicationDate":"2023-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/medu.15183","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9962660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social Studies of Science and Technology: New ways to illuminate challenges in training for health information technologies utilisation","authors":"J. Cristian Rangel,&nbsp;Susan Humphrey-Murto","doi":"10.1111/medu.15179","DOIUrl":"10.1111/medu.15179","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Context</h3>\u0000 \u0000 <p>Electronic health records (EHRs) have transformed clinical practice. They are not simply replacements for paper records but integrated systems with the potential to improve patient safety and quality of care. Training physicians in the use of EHR is a highly complex intervention that occurs in a dynamic socio-technical health system. Training in this complex space is considered a wicked problem and would benefit from different analytic approaches to the traditional linear causal relationship analysis. Social Sciences theories see technological change in relation to complex social and institutional processes and provide a useful starting point.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Aim</h3>\u0000 \u0000 <p>Our aim, therefore, is to introduce the medical education scholar to a selection of theoretical approaches from the Social Studies of Science and Technology (SSST) literatures, to inform educational efforts in training for EHR use.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>We suggest a body of theories and frameworks that can expand the epistemological repertoire of medical education scholarship to respond to this wicked problem. Drawing from our work on EHR implementation, we discuss current limitations in framing training for EHRs use as a research problem in medical education. We then present a selection of alternative theories.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Unified Theory of Acceptance and Use of Technology (UTAUT) explains the individual adoption of new technologies in the workplace and has four key constructs: performance/effort expectancy, social influence and facilitating conditions. Social Practice Theory (SPT), rather than focusing on individuals or institutions, starts with the activity or practice. The socio-technical model (STM) is a comprehensive theory that offers a multidimensional framework for studying the innovation and application of EHRs. Practical examples are provided.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>We argue that education for effective utilisation of EHRs requires moving beyond the epistemological monism often present in the field. New theoretical lenses can illuminate the complexity of research to identify the best practices for educating and training physicians.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"58 1","pages":"27-35"},"PeriodicalIF":6.0,"publicationDate":"2023-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/medu.15179","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10020587","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Learning technology in health professions education: Realising an (un)imagined future","authors":"Rebecca Grainger,&nbsp;Qian Liu,&nbsp;Tehmina Gladman","doi":"10.1111/medu.15185","DOIUrl":"10.1111/medu.15185","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Context</h3>\u0000 \u0000 <p>Technology is being introduced, used and studied in almost all areas of health professions education (HPE), often with a claim of making HPE better in one way or another. However, it remains unclear if technology has driven real change in HPE. In this article, we seek to develop an understanding of the transformative capacity of learning technology in HPE.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods and Outcomes</h3>\u0000 \u0000 <p>We first consider the wider scholarship highlighting the intersection between technology and pedagogy, articulating what is meant by transformation and the role of learning technology in driving educational transformation. We then undertake a synthesis of the current high visibility HPE-focused research. We sampled the literature in two ways—for the five highest impact factor health professional education journals over the past decade and for all PubMed indexed journals for the last 3 years—and categorised the extant research against the Substitution, Augmentation, Modification, Redefinition model. We found that the majority of research we sampled focussed on substituting or augmenting learning through technology, with relatively few studies using technology to modify or redefine what HPE is through the use of technology. Of more concern was the lack of theoretical justification for pedagogical improvement, including transformation, underpinning the majority of studies.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>While all kinds of technology use in learning have their place, the next step for HPE is the robust use of technology aiming to lead transformation. This should be guided by transformational educational theory and aligned with pedagogical context. We challenge HPE practitioners and scholars to work thoughtfully and with intent to enable transformation in education for future health professionals.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"58 1","pages":"36-46"},"PeriodicalIF":6.0,"publicationDate":"2023-08-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/medu.15185","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9957465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"教育学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}