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Integrating design thinking for health promotion education 将设计思维融入健康促进教育。
IF 4.9 1区 教育学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES Pub Date : 2024-11-14 DOI: 10.1111/medu.15574
Therdpong Thongseiratch, Nutthaporn Chandeying, Tanan Bejrananda
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引用次数: 0
December In This Issue 本期十二月
IF 4.9 1区 教育学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES Pub Date : 2024-11-14 DOI: 10.1111/medu.15568
<p>Education on electronic health records remains highly variable despite their widespread use by medical trainees. This study interrogated the complex landscape of current EHR pedagogy by examining discourses of EHR use within the medical education literature. These discourses framed the EHR as a physical skill, a system of people and technologies, or a cognitive process influencing clinical reasoning and bias. Each discourse privileged certain stakeholders over others and rationalized educational interventions that could be beneficial in isolation yet were often disjointed in combination. Reforming EHR education will require engagement with these competing discourses.</p><p> <span>Huang, D</span>, <span>Whitehead, C</span>, <span>Kuper, A</span>. <span>Competing Discourses, Contested Roles: Electronic Health Records in Medical Education</span>. <i>Med Educ</i>. <span>2024</span>; <span>58</span>(<span>12</span>): <span>1490</span>-<span>1501</span>. 10.1111/medu.15428.</p><p>Institutional education leaders are often responsible for leading pre-determined major curricular changes in the complex adaptive systems of health professions education. This study explored how a group of institutional leaders navigated these systems during the change to competency-based residency education in Canada. Leaders set ensuring direction and maintaining momentum as change priorities and analyzed how their response to various threats and opportunities affected the priorities of direction and momentum. The article proposes a practical change framework for education leaders that addresses the non-hierarchal, complex, and uncertain nature of health professions education systems.</p><p> <span>Tam, H</span>, <span>Scott, I</span>. <span>Laying train tracks en route: How institutional education leaders navigate complexity during mandated curriculum change</span>. <i>Med Educ</i>. <span>2024</span>; <span>58</span>(<span>12</span>): <span>1528</span>-<span>1535</span>. 10.1111/medu.15464.</p><p>Learning and growth in postgraduate medical education (PGME) often require vulnerability, but being vulnerable can pose risks to residents’ credibility and professional identity. In this study, residents characterize vulnerability as a paradox, in which polarities exist between being a fallible, authentic learner and an infallible, competent professional. The authors explore factors influencing the experience and outcomes of vulnerability at the intrapersonal, interpersonal, and systems levels. This study begins to capture the complexity of vulnerability in PGME and offers insights into creating supportive learning environments that embrace the value of vulnerability while mitigating its risks.</p><p> <span>Nichol, H</span>, <span>Turnnidge, J</span>, <span>Dalgarno, N</span>, <span>Trier, J</span>. <span>Navigating the paradox: Exploring resident experiences of vulnerability</span>. <i>Med Educ</i>. <span>2024</span>; <span>58
尽管电子病历已被医学学员广泛使用,但其教育仍存在很大差异。本研究通过研究医学教育文献中有关电子病历使用的论述,对当前电子病历教学法的复杂情况进行了调查。这些论述将电子病历描述为一种物理技能、一个由人和技术组成的系统或一个影响临床推理和偏见的认知过程。每种论述都将某些利益相关者置于其他利益相关者之上,并使教育干预措施合理化,这些干预措施单独使用可能有益,但结合使用却往往脱节。改革电子病历教育需要与这些相互竞争的论述打交道。 Huang, D, Whitehead, C, Kuper, A. Competing Discourses, Contested Roles:医学教育中的电子健康记录》。2024; 58(12): 1490-1501.10.1111/medu.15428.Institutional education leaders are often responsible for leading pre-determined major curricular changes in the complex adaptive systems of health professions education.本研究探讨了在加拿大向以能力为基础的住院医师教育转变的过程中,一群院校领导是如何驾驭这些系统的。领导者将确保方向和保持动力作为变革的优先事项,并分析了他们对各种威胁和机遇的反应如何影响方向和动力的优先事项。文章针对卫生专业教育系统的非等级、复杂性和不确定性,为教育领导者提出了一个实用的变革框架。 Tam, H, Scott, I. Laying train tracks en route:机构教育领导者如何在强制性课程变革中驾驭复杂性。Med Educ. 2024; 58(12): 1528-1535.10.1111/medu.15464.医学研究生教育(PGME)中的学习和成长往往需要脆弱性,但脆弱性可能会给住院医师的信誉和专业身份带来风险。在本研究中,住院医师将脆弱性描述为一种悖论,在这种悖论中,存在着两极分化,即既要做一个容易犯错的、真实的学习者,又要做一个无懈可击的、称职的专业人员。作者从个人、人际和系统层面探讨了影响脆弱性体验和结果的因素。这项研究开始捕捉 PGME 中脆弱性的复杂性,并为创建支持性学习环境提供了见解,这种环境既能接受脆弱性的价值,又能降低其风险。 Nichol, H, Turnnidge, J, Dalgarno, N, Trier, J. Navigating the paradox: Exploring resident experiences of vulnerability.Med Educ. 2024; 58(12): 1469-1477.10.1111/medu.15426.尽管有关不良事件和失败的医疗保健研究日益增多且意义重大,但有关干扰如何发生的人种学研究仍很少见。本研究加深了我们对医疗流程中断的理解,并概述了在复杂的医疗环境中,中断的修复如何成为稳定、学习和变革的源泉。这项研究在芬兰一所大学医院的外科手术室进行,其独特的贴近实践的研究方法为我们提供了能够改进教育和加强病人护理的见解。 Kajamaa,A,Lahtinen,P,Mattick,K,Bethune,R.《芬兰医院中作为稳定、学习和变革之源的中断护理流程修复:一项活动理论研究》。2024; 58(12): 1502-1514.10.1111/medu.15407.
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引用次数: 0
Empowering dental students' collaborative learning using peer assessment 利用同伴评价增强牙科学生的协作学习能力。
IF 4.9 1区 教育学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES Pub Date : 2024-11-14 DOI: 10.1111/medu.15580
Marwa Madi, Shazia Sadaf, Amal Asiri, Jehan AlHumaid
<p>As dental educators, we face challenges evaluating students' case presentations, including providing balanced assessments, timely constructive feedback and fostering both technical and professional skills. Traditional evaluation methods often led to student anxiety and missed peer-learning opportunities. Our goal was to create a supportive learning environment mirroring professional dental practice's collaborative nature.</p><p>Adapted from social constructivism, peer assessment was used to enhance student learning. We envisioned a classroom where peer interaction could sharpen critical assessment skills and develop key capabilities in students, such as taking responsibility for their learning, understanding assessment criteria and developing critical reflection skills. This approach aimed to diversify learning experiences, enhance teamwork and better prepare students for clinical and professional settings.</p><p>The challenge was to design an assessment framework reflecting real-world clinical situations while promoting formative development and collegiality among students.<span><sup>1</sup></span></p><p>A comprehensive peer evaluation system was developed and implemented for dental students' case presentations across 4th to 6th year courses. The system was based on the collaborative learning model with formative assessment for students' oral case presentations. Training materials, grading rubrics and feedback mechanisms were developed to ensure consistent and reliable peer assessments that aligned with the objectives of collaborative learning and continuous improvement.</p><p>The peer assessment system was implemented as follows: 120 dental students began the programme in their 4th year practiced the assessment method throughout their 4th, 5th and 6th years of study. Students at each level were divided into small groups within their levels to collaborate on case presentations. Within each group, students alternated between roles of presenter and reviewer, ensuring a broad range of experiences and perspectives. Evaluators provided targeted training to students on conducting effective peer assessments, including how to give constructive feedback and use the assessment rubrics. The assessment system combined peer with conventional evaluator grading, allowing for comparison between the two methods. Data comparing student peer grading with faculty grades throughout the implementation period were collected. The analysis focused on how the discrepancy between student and faculty grades changed over time as students gained more experience with the assessment method. An annual survey was distributed after the 3-year implementation to gauge student satisfaction and comfort with the peer assessment method. And, finally, students were engaged in reflective exercises to ensure continuous learning from the peer assessment process. In doing so, this initiative emphasised building supportive environments for collaborative discussions and peer feedback, seek
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引用次数: 0
A holistic interprofessional student induction programme for dental education 针对牙科教育的跨专业学生综合入门课程。
IF 4.9 1区 教育学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES Pub Date : 2024-11-13 DOI: 10.1111/medu.15578
Venkitachalam Ramanarayanan, Balagopal Varma, Rakesh Suresh, Nanditha Sujir
<p>The transition from high school to dental school in India presents significant challenges due to the rigorous academic requirements, uncharted learning environments and local settings with unfamiliar language. Additionally, dental schools have students from diverse socio-cultural backgrounds, requiring cultural adaptation that is especially striking in a country like India. For most students, this is their first time away from home, often leading to homesickness and loneliness. Differences in learning, high expectations, fear of failure and adjusting to self-study can cause anxiety. This potentially overwhelming change demands guidance and support. While many institutions offer orientation programmes, they typically focus on the curriculum and last one half-day to a week. The profound adjustment needed warrants extended support systems that take a holistic and welfare-based approach.</p><p>To address these challenges, the Dental Education Unit of our institute initiated a month-long Bachelor of Dental Surgery Student Induction Programme titled ‘Deeksharambh’ (Sanskrit: initiation or commencement). This interprofessional programme aimed to facilitate a smooth transition into dental education without overwhelming students with an excess of curricular, policy and procedural content. The programme was delivered to a cohort of 30 newly inducted first year Bachelor of Dental Surgery (BDS) students and comprised 18 sessions grouped under themes such as course requirements, campus facilities, personality development, wellness and empowerment, research opportunities, and team bonding. The sessions were curated to holistically encompass a range of issues that students could be faced with like fear of interaction, improving self-efficacy, preparedness to face the dental curriculum, facilities within the campus, and awareness regarding potential issues like bullying, addiction to drugs, social media and so on. The sessions were delivered by relevant stakeholders (e.g., faculty, senior students and alumni) and interprofessional experts (law enforcement officers, language experts, auxiliary staff etc.) who were purposefully selected to address the transitional needs of the students. A booklet outlining the objectives and key learning outcomes for each session was provided: https://shorturl.at/mgiuR. A detailed description of the session can be found at https://www.amrita.edu/school/dentistry/dental-education-unit/.</p><p>Challenges in transitioning to dental school are more pronounced in high school entry students, necessitating the needs for an induction or pre-matriculation programme.<span><sup>1</sup></span> Following the creation of such, a dedicated feedback session was conducted for quality improvement. Online polls and reflective essays were used to obtain both quantitative and qualitative feedback. The feedback received was overwhelmingly positive, with most sessions rated as highly relevant. The programme helped reduce students' anxiety and confusi
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引用次数: 0
Three-I framework for health promotion of lifestyle disorders 促进生活方式失调健康的 "三个一 "框架。
IF 4.9 1区 教育学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES Pub Date : 2024-11-13 DOI: 10.1111/medu.15575
Prateek Bobhate, Swarupa Bhagwat, Saurabh Shrivastava
<p>Lifestyle disorders are health conditions that are linked with the way people live their life. These are non-communicable and pose a formidable challenge to healthcare systems despite being potentially preventable. The role of interns thus extends beyond therapeutic management to encompass health promotion, prevention, and community engagement.<span><sup>1</sup></span> Unfortunately, there is lack of comprehensive and structured training curricula tailored for interns focused on preventive aspects of lifestyle disorders in India.</p><p>A needs assessment was undertaken among interns using Google Forms. After analysing the responses, a structured health promotion training module using a 3-I framework was created for lifestyle disorders: Inquire (ask about health problems); Identify (risk factors for lifestyle disorders); and Intervene (Counsel the patient appropriately). Content validity was assessed using the Delphi method with five external subject-matter experts, and a training module was built with the intention of capacity building to improve interns' skill in health promotion, which focused on hypertension, type 2 diabetes mellitus and obesity, under the following domains: understanding lifestyle disorders; physical activity promotion; substance use; nutrition education; stress management, mental well-being; behaviour change communication; individual risk-assessment and counselling; and community engagement.</p><p>A three-day training programme was then conducted with interns during the first week of their posting in the Community Medicine Department. Two batches, totalling N = 62, were trained. A pre- and post-test six-station OSCE with standardised patients was used to assess trainees. Furthermore, during interns' 3-month posting in urban and rural health and training centres, weekly random prescription audits were done to assess interns' prescribing of lifestyle modification. Feedback from the interns and faculty was also gathered using a questionnaire.</p><p>Baseline OSCE scores confirmed students' inadequate communication skills (mean = 11.5/30 ± 3.25). After training there was significant increase (mean = 19.9/30 ± 5.72; p < 0.001). Random prescription audits showed that 83% of interns were prescribing lifestyle modifications for all adult patients attending health centres. Interns accepted the training using the 3-I framework well and felt that learning was useful for real-patient encounters. They also suggested conducting training program during the third phase of MBBS degree with refresher training offered at the start of internship. Faculty also expressed interest in incorporating training sessions into MBBS as the training and OSCEs were thought to fit well in the existing curriculum. In sum, the 3-I framework appears to have provided a useful tool to improve students' communication skills regarding health promotion.</p><p>The study emphasises the pivotal role of integrating such comprehensive training programs into medical
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引用次数: 0
Enhancing student engagement in anatomy by integrating technology to modify a practical exam 通过整合技术修改实践考试,提高学生对解剖学的参与度。
IF 4.9 1区 教育学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES Pub Date : 2024-11-12 DOI: 10.1111/medu.15577
Kanza Muzaffar, Rozmeen Akbar, Sadia Cassim, Zehra Jamil
<p>With the shift towards integrated organ and systems-based teaching in medical curricula, traditional anatomy courses have experienced fragmentation. This has led to declining student engagement with anatomy learning despite using technology for better visualisation.<span><sup>1</sup></span> As assessment drives learning, we hypothesised that transforming practical exams by integrating technology-assisted evaluations within an ‘Objective Structured Practical Examination setting’ would enhance students' engagement with learning gross anatomy, microscopy, embryology and anatomical skills.</p><p>A comprehensive station-based Anatomy Practical Exam (APEx) was developed, consisting of 15 knowledge-testing stations and two resting stations. These covered identifying gross and histological structures with their relationships and clinical relevance, X-ray interpretation and clinical examination skills via videos. A unique ‘living station’ tested understanding of surface landmarks critical for anatomical skills. Each station had a 3-minute limit and was set up in two parallel circuits with 34 students in each batch, catering for a class of 100 students. All stations underwent validation and reliability review by an educationist, emphasising concept integration and practical application. The formative APEx was piloted as compulsory to familiarise the students, and the summative APEx was set with a 55% passing cut-off, contributing 10% to the final assessment, reinforcing its importance with a must-pass requirement.</p><p>The first APEx examination in the Musculoskeletal module was well received, as students preferred APEx, calling it challenging due to its hands-on nature, an improvement over the previous ‘alternate to practical’ (ATP) exam that was picture-based slides. They rated it ‘more engaging and better aligned with our future expectations during clinical practice’. Another student said, ‘It has become necessary to visit the laboratory to work with the models and plastinates, which significantly enhanced our understanding while this hands-on preparation would not have been required for the ATP’. Based on this feedback, 6 to 10 hours of self-guided lab sessions have been scheduled across the modules to accommodate students' learning. Moreover, students reported that integration of simulated models and other media into the curriculum acted as an opportunity towards deeper learning. These sentiments were echoed by lab instructors who reported a notable shift in students' attitudes during anatomy laboratory sessions. External examiners further reiterated that during the year-end structured viva, students were better at identifying structures and responding to questions on their clinical significance than previous cohorts. To optimise logistics, modules were paired by regions: neurosciences with head and neck, gastrointestinal tract with the renal system, and cardiovascular with blood and inflammation, enabling cross-modular questions, for example, ‘id
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引用次数: 0
Balancing the voices of the Global South and North in shaping health professions education 在塑造卫生专业教育方面平衡全球南方和北方的声音。
IF 4.9 1区 教育学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES Pub Date : 2024-11-11 DOI: 10.1111/medu.15570
Champion N. Nyoni

Using cross-cultural dialogue pieces from this issue, Nyoni outlines factors to consider when trying to balance voices between south and north.

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引用次数: 0
‘Whispers of inclusion amidst the shouts of omission’—Breaking stereotypes and discrimination using queer arts in medical education 在遗漏的呐喊中低语包容"--利用医学教育中的同性恋艺术打破陈规和歧视。
IF 4.9 1区 教育学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES Pub Date : 2024-11-11 DOI: 10.1111/medu.15579
Krishna Mohan Surapaneni
<p>Using the ladder of inference, one can anticipate that inherent assumptions shape perceptions and drive decisions.<span><sup>1</sup></span> In medical education, therefore, embracing gender inclusivity requires training students to actively challenge their own biases to better understand the perspectives of gender-diverse patients. The problem with current educational practices is that they often take a passive approach when it comes to encouraging self-exploration of inherent biases. Therefore, students may miss opportunities to critically reflect on the stereotypes they bring into clinical encounters, perpetuating discrimination. To address this, art, with its profound capacity to evoke deep emotions, was utilised to encourage students to explore and reflect on their own biases.</p><p>A group of 24 final-year undergraduate medical students were selected through random sampling. A 9-item questionnaire with 5-point Likert scale measured students' baseline confidence in discussing gender diversity, recognising biases, providing inclusive care, addressing gender identity issues, applying inclusive language, and integrating gender diversity into clinical practice. In this 2-week flipped classroom programme, students were divided into six groups and then browsed the internet or visited museums to gather paintings and photographs that explicitly represented one or more gender identity from different cultural, social, or geographical contexts and portrayed an issue of challenge or confrontation. A session on ‘The Art of Seeing’ was conducted to orient learners to the Visual Thinking Strategies (VTS) essential for critical thinking through careful observation, interpretation and reflection of visual arts.</p><p>Students gauged each other's interpretations and synthesised a narrative report from queer communities' perspective, creatively describing the emotions, bias and discrimination faced and offering a reflective statement of how they aim to enhance inclusivity in their clinical practice. Each group presented their report followed by reflective discussions. The narratives were evaluated based on depth of interpretation, creativity, critical reflection, practical application, inclusive language and emotional insights.</p><p>Students perceived the programme to be highly impactful and there was a statistically significant increase in their confidence levels (2.1 ± 0.7 to 4.6 ± 0.5; p < 0.0001). In-depth small group interviews helped to explore the underlying reasons for this shift, revealing that exploring each other's perspectives to navigate solutions and creating a narrative helped students to consciously identify and understand physical, mental, social, & emotional challenges, while also facilitating respectful communication and a thoughtful commitment to promoting equality and empathy in future clinical practice.</p><p>One of the most striking realisations was how art could evoke an emotional engagement that typical medical curriculum oft
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引用次数: 0
Synergism of team-based learning and flipped classroom for comprehending posterior palatal seal 团队学习与翻转课堂在理解腭后印方面的协同作用。
IF 4.9 1区 教育学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES Pub Date : 2024-11-11 DOI: 10.1111/medu.15572
Abhishek Kumar Gupta, Bhawana Tiwari, Komal Maheshwari, Sakshi Verma
<p>Posterior palatal seal (PPS) is an area located posteriorly in the maxillary edentulous jaw that plays an important role in the retention of maxillary complete denture. Accurate visualization, demarcation and recording of PPS require pronunciation of specific sounds by patients and are quite challenging for dental students as it lies on soft tissue and varies from patient to patient. Errors in recording PPS abate denture retention, affecting the overall outcome of the prosthesis and negatively impacting student's and patient's confidence. The classical approach in teaching PPS in dental education encompasses didactic lectures and skill teaching through demonstration on real patients. Didactic lectures often lead to passive learning, limited interaction and difficulty in applying theoretical knowledge clinically, while clinical demonstrations restrict student participation and hands-on practice. Both methods may not address individual learning needs or provide sufficient personalized instruction and immediate feedback. Therefore, we felt a need to address this problem through an active learning approach and decided to synergize team-based learning (TBL) with student-led flipped classroom, aiming to make learning a student-driven process. These methods will provide an opportunity to apply conceptual knowledge, foster peer learning and facilitate development of communication, interpersonal and collaboration skills.</p><p>TBL along with flipped classroom was undertaken for undergraduate dental students (<i>n</i> = 10). Two teams comprising of five students each were formed for TBL through random assignment, based on the guidelines of Michaelson and Richards 2005.<span><sup>1</sup></span> Preparatory materials comprising of scholarly articles, PowerPoint presentation and a video demonstrating the marking of PPS were uploaded for individual pre-class preparation, 1 week prior to the in-class activity. The resources covered the anatomy, function and clinical importance of PPS. Individual Readiness Assurance Test (IRAT) that comprised of 10 MCQs was administered just before the start of the in-class activity. Conventionally in TBL, IRAT is followed by Team Readiness Assurance Test (TRAT) but to facilitate skill learning, clinical demonstration on marking of PPS was given by a faculty to the students as in-class activity. Subsequently, as a part of the clinical problem-solving activity, one student from each team was selected to mark the PPS area on a patient. While the student marked the area, other members of the team offered assistance and made a video recording. The same procedure was repeated by the second team. The video recordings were later projected on screen for group discussion and peer assessment. The faculty provided clarifications during the discussion. Lastly, IRAT was re-administered as TRAT followed by immediate feedback from the faculty.</p><p>Student-led flipped classroom worked as a useful tool for teaching PPS. Students might use t
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引用次数: 0
Another way to dance? An alternative way in which facilitators may recognise and respond to students' emotions during simulation. 另一种舞蹈方式?主持人在模拟过程中识别和应对学生情绪的另一种方式。
IF 4.9 1区 教育学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES Pub Date : 2024-11-03 DOI: 10.1111/medu.15571
Gopija Nanthagopan
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引用次数: 0
期刊
Medical Education
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