Medical Education最新文献

Introduction: Residency programmes are in transition to a framework for competency-based medical education (CBME). The intersection of CBME with transformational learning (TL) experiences and professional identity formation (PIF) - particularly within senior learners in transitional states - is unknown but important to understand in order to develop and implement strategies to support trainees' professional development.

Methods: Through inductive qualitative methods, we conducted semi-structured interviews (n = 22) of current trainees and recent graduates from adult cardiology residency training programmes within Canada to explore the impact of TL experiences on residents' professional growth and identity formation. Interviews were analysed using thematic analysis informed by TL theory.

Results: CBME did not appear to influence trainees' experiences of disorienting dilemmas and TL. Important clinical encounters and interpersonal relationships - in particular, those between mentor and mentee - shaped trainees' professional development as cardiologists ('enabling factors' for TL and PIF). 'Imposter phenomenon' was widely prevalent in our sample study population even among graduates who had already completed their training. Requisite elements for transformation (disorienting dilemmas, critical reflection, discourse and action) also contributed to PIF.

Discussion: TL experiences influenced PIF in senior learners but infrequently intersected with CBME; these experiences were more commonly prompted by disorienting dilemmas relating to clinical outcomes or interpersonal interactions independent of CBME-specific architecture.

Commenting on Wyatt and Vidal's dialogue about the relationship between time and culture, @hollykhach outlines opportunities and challenges of adopting competency-based education.

As medical and health professions education (HPE) fields shift towards frameworks of justice, equity, diversity and inclusion (JEDI), there has been an increased focus on addressing the environments of learning to understand hierarchies of power and create better learning experiences for students who have historically been marginalised in these fields. We propose the haunted curriculum as an evocative conceptual framing to engage with the aspects of medical and HPE that are toxic and troubling to learners and to understand how violent histories continue to loom large and permeate the present. The haunted curriculum examines how forms of oppression and injustice, such as racism and ableism, are always ever-present and often arise in unexpected ways during training. The haunted curriculum also helps to uncover how environments of training and professionalisation may themselves inflict these forms of oppression and injustice and may be ideal spaces to counter them.

Introduction: Interviews are central to many qualitative studies in health professions education (HPE). However, researchers often struggle to elicit rich data and engage diverse participants who may find this strategy exclusionary. Elicitation techniques are strategies tailored to address these challenges, enhancing oral conversations through other forms of interaction-for example, participant photography and neighbourhood walks. These strategies are tailored to elicit the rich data needed to address complex problems and meaningfully engage participants. Unfortunately, guidance on these techniques is scattered across literatures from diverse fields. In this synthesis, we offer an overview of the elicitation techniques available and advice about how to choose between them.

Methods: We conducted an integrative review, drawing on methodological literature from across the health and social sciences. Our interdisciplinary searches yielded 3056 citations. We included 293 citations that were methodologically focused and discussed elicitation techniques used in interviews with adults. We then extracted specific elicitation techniques, summarising each technique to capture key features, as well as strengths and weaknesses. From this, we developed a framework to help researchers identify challenges in their interview-based research and to select elicitation techniques that address their challenges.

Results: To enrich data, researchers might seek to shift conversations away from participants' entrenched narratives, to externalise conversations on sensitive topics, or to elicit affect, tacit knowledge or contextual details. When empowering participants, researchers might seek to increase equity between the researcher and participant or foster interview accessibility across diverse participant populations.

Discussion: When chosen with study goals in mind, elicitation techniques can enrich interview data. To harness this potential, we need to re-conceptualise interviews as co-production of knowledge by researcher(s) and participant(s). To make interviews more equitable and accessible, we need to consider flexibility so that each participant can engage in ways that best suit their needs and preferences.