Medical Education最新文献

英文中文

Desired features of feedback in a high-paced clinical setting: A Q-methodology study. 高节奏临床环境中反馈的期望特征：一项q方法学研究。

IF 5.2 1区教育学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES

Medical Education

Pub Date : 2025-12-01 DOI: 10.1111/medu.70105

Renee S Chuang, Nothando S Nkambule, Chih-Wei Yang, Yu-Che Chang, Madalitso Khwepeya

Introduction: The transformative learning potential of feedback, a key pillar of competency-based medical education, can only be fully realised when a learner's preferences are integrated into the feedback process. However, there is limited understanding of medical residents' preferences, which could better inform this process. This study investigates patterns in emergency residents' perspectives on preferences for feedback features and their potential implications on learning.

Methods: We used Q-methodology, which combines quantitative and qualitative data to systematically rank and compare shared and distinct perspectives on a specific topic. Thirty-two purposively sampled emergency medicine residents from 11 teaching hospitals were each invited to participate in a Q-sorting exercise and post-sorting interview. We analysed the Q-sorts to identify patterns in residents' preferences for feedback features. Qualitative insights from the interviews facilitated a structured interpretation and understanding of the differences and similarities between the generated viewpoints. Viewpoints represent subjective yet shared patterns of similarity in opinions about the most and least desirable feedback features, based on how residents ranked statements reflecting these features.

Results: Of the 32 Q-sorts, 27 (84.4%) successfully loaded onto four different viewpoints reflecting prevailing perspectives of feedback preferences during residency training: (i) specific and comprehensive feedback; (ii) safe and evidence-based feedback; (iii) timely and relationally grounded feedback; and (iv) growth-focused and motivational feedback. Despite differences, residents across all viewpoints stressed the importance of obtaining feedback during crucial moments in their learning process.

Discussion: Residents' preferences for feedback vary, suggesting that a universal approach to providing feedback may not be effective. Instead, various characteristics must be considered, reinforcing the necessity for innovative feedback practices to meet individual learners' unique needs in the clinical workplace.

导读：反馈的变革性学习潜力是基于能力的医学教育的关键支柱，只有当学习者的偏好被纳入反馈过程时，才能充分实现。然而，对住院医生的偏好了解有限，这可以更好地为这一过程提供信息。本研究探讨急诊住院医师对反馈特征的偏好模式及其对学习的潜在影响。方法：我们使用q方法，将定量和定性数据相结合，系统地对特定主题的共享和不同观点进行排名和比较。从11所教学医院随机抽取32名急诊科住院医师，分别进行q排序和排序后访谈。我们分析了q分类，以确定居民对反馈特征的偏好模式。从访谈中获得的定性见解有助于对所产生的观点之间的异同进行结构化的解释和理解。根据居民对反映这些特征的陈述的排名，观点代表了关于最理想和最不理想的反馈特征的主观但共有的相似模式。结果：在32个q分类中，27个（84.4%）成功加载了四种不同的观点，反映了住院医师培训期间反馈偏好的流行观点：(1)具体和全面的反馈；（ii）安全且基于证据的反馈；（iii）及时和相关的反馈；(4)以成长为中心的激励反馈。尽管存在差异，但所有观点的居民都强调在学习过程的关键时刻获得反馈的重要性。讨论：居民对反馈的偏好各不相同，这表明提供反馈的通用方法可能并不有效。相反，必须考虑各种特征，加强创新反馈实践的必要性，以满足临床工作场所中个体学习者的独特需求。

{"title":"Desired features of feedback in a high-paced clinical setting: A Q-methodology study.","authors":"Renee S Chuang, Nothando S Nkambule, Chih-Wei Yang, Yu-Che Chang, Madalitso Khwepeya","doi":"10.1111/medu.70105","DOIUrl":"https://doi.org/10.1111/medu.70105","url":null,"abstract":"Introduction: The transformative learning potential of feedback, a key pillar of competency-based medical education, can only be fully realised when a learner's preferences are integrated into the feedback process. However, there is limited understanding of medical residents' preferences, which could better inform this process. This study investigates patterns in emergency residents' perspectives on preferences for feedback features and their potential implications on learning.Methods: We used Q-methodology, which combines quantitative and qualitative data to systematically rank and compare shared and distinct perspectives on a specific topic. Thirty-two purposively sampled emergency medicine residents from 11 teaching hospitals were each invited to participate in a Q-sorting exercise and post-sorting interview. We analysed the Q-sorts to identify patterns in residents' preferences for feedback features. Qualitative insights from the interviews facilitated a structured interpretation and understanding of the differences and similarities between the generated viewpoints. Viewpoints represent subjective yet shared patterns of similarity in opinions about the most and least desirable feedback features, based on how residents ranked statements reflecting these features.Results: Of the 32 Q-sorts, 27 (84.4%) successfully loaded onto four different viewpoints reflecting prevailing perspectives of feedback preferences during residency training: (i) specific and comprehensive feedback; (ii) safe and evidence-based feedback; (iii) timely and relationally grounded feedback; and (iv) growth-focused and motivational feedback. Despite differences, residents across all viewpoints stressed the importance of obtaining feedback during crucial moments in their learning process.Discussion: Residents' preferences for feedback vary, suggesting that a universal approach to providing feedback may not be effective. Instead, various characteristics must be considered, reinforcing the necessity for innovative feedback practices to meet individual learners' unique needs in the clinical workplace.","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145648796","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}

引用次数: 0

From learners to healers: The essential link between student-centred education and patient-centred care. 从学习者到治疗师：以学生为中心的教育和以病人为中心的护理之间的重要联系。

IF 5.2 1区教育学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES

Medical Education

Pub Date : 2025-11-29 DOI: 10.1111/medu.70096

Ligia Maria Cayres Ribeiro, Marco A de Carvalho Filho

引用次数: 0

Transforming research in team-based learning. 以团队为基础的学习转变研究。

IF 5.2 1区教育学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES

Medical Education

Pub Date : 2025-11-28 DOI: 10.1111/medu.70128

Tracey Edelist, Stella Ng

引用次数: 0

Virtual escape rooms for electronic health record orientation. 电子健康记录导向的虚拟逃生室。

IF 5.2 1区教育学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES

Medical Education

Pub Date : 2025-11-28 DOI: 10.1111/medu.70114

Hali N Peterson, Elizabeth R Vogel, Jeffrey Huang

引用次数: 0

Wicked problems, collective solutions: Centring well-being via Nominal Group Technique. 邪恶的问题，集体的解决方案：通过名义团体技术集中幸福。

IF 5.2 1区教育学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES

Medical Education

Pub Date : 2025-11-27 DOI: 10.1111/medu.70119

Matthew Lipinski, Lyn K Sonnenberg, Kordan Harvey, Jerry Maniate, Victor Do

引用次数: 0

When I say … optimal distinctiveness. 我说的最优独特性。

IF 5.2 1区教育学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES

Medical Education

Pub Date : 2025-11-27 DOI: 10.1111/medu.70121

P Vivekananda-Schmidt, J Sandars

引用次数: 0

Conversing on Orthopaedic Complications and Unexpected Problems (COCUP) Club: A trainee-led safe space for reflection. 关于骨科并发症和意外问题的对话（COCUP）俱乐部：一个由学员领导的安全反思空间。

IF 5.2 1区教育学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES

Medical Education

Pub Date : 2025-11-27 DOI: 10.1111/medu.70111

Joseph Battle, Robyn Brown, Sophie Gatfield, Luke Duggleby, Andrew Tasker

引用次数: 0

The view from within: Professional identity formation when safety events involve trainees 内部视角：当安全事件涉及学员时，职业认同的形成。

IF 5.2 1区教育学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES

Medical Education

Pub Date : 2025-11-27 DOI: 10.1111/medu.70127

Allan McDougall

Every serious safety event involving a medical trainee triggers an organisational scramble. Who takes the lead on involving trainees in a QI review, the hospital or the university? Which policies guide the response? Who decides if the learner should be included in reviews? Rowland et al.'s analysis maps these institutional tensions.1 While their organisational lens highlights important systemic dynamics, there is a parallel medical education story that deserves attention. Safety events do not just expose system uncertainties. They can disrupt a developing physician's sense of professional self and career trajectory. We suggest that alongside and inside these organisational dynamics, safety events trigger individual and relational processes that fundamentally alter what clinical learning environments actually teach.Consider the spectrum of serious safety events that residents navigate, as captured by medico-legal data coding frameworks. As McCleery et al. demonstrate, patient safety incidents encompass events which could have resulted, or did result, in unnecessary harm to the patient.2 A near miss where no harm occurred might trigger internal self-doubt without external scrutiny. An adverse outcome with actual harm may activate institutional review processes, team debriefs for systems learning or even involvement by the medical regulatory authority. A complaint without harm might seem disproportionate to clinical reality. A complaint with harm can launch residents into months or years of hospital, regulatory or civil legal matters while they are still trying to learn medicine.3, 4 When these events involve trainees, the contributing factors extend beyond individual provider actions to encompass team dynamics, system resources and organisational culture.1 Each configuration creates distinct learning conditions, yet neither residents nor preceptors can predict which type of event they are experiencing until well into the process. What begins as a clinical moment becomes refracted through multiple lenses of analysis, each with its own language, timeline and consequences for professional development.Our research examining physicians who experienced patient complaints during residency reveals a consistent pattern.5 Routine clinical care can evolve into medico-legal complexity that challenges professional identity. Physicians who received complaints during residency told us they felt ‘blindsided’, questioned whether they ‘deserve to be a resident’ and wondered whether they had ‘conned everyone into believing [they're] capable’.5 These experiences create what we termed ‘professional identity disruption’. Rowland et al.'s findings help explain the organisational context: They describe how learners are shielded from ‘red tape bureaucracy’, excluded from QCIPA-protected

每一起涉及医疗实习生的严重安全事件都会引发组织内的混乱。医院还是大学，谁应该带头让实习生参与质量评估？哪些政策指导应对措施？谁决定学习者是否应该被包括在审查中？罗兰等人的分析描绘了这些制度张力虽然他们的组织视角突出了重要的系统动态，但有一个平行的医学教育故事值得关注。安全事件不仅仅暴露了系统的不确定性。它们会扰乱一个正在成长的医生的职业自我意识和职业轨迹。我们认为，除了这些组织动态之外，安全事件还会触发个人和关系过程，从根本上改变临床学习环境的实际教学内容。考虑一下医疗法律数据编码框架所捕获的居民所经历的一系列严重安全事件。正如McCleery等人所证明的那样，患者安全事件包括可能导致或确实导致对患者造成不必要伤害的事件没有造成伤害的侥幸脱险可能会在没有外部审查的情况下引发内心的自我怀疑。具有实际危害的不良结果可能会启动机构审查程序、团队汇报以进行系统学习，甚至可能会引起医疗监管机构的参与。没有伤害的抱怨似乎与临床现实不成比例。对伤害的投诉可能会使居民在仍在努力学习医学的时候陷入数月或数年的住院、监管或民事法律事务。3,4当这些事件涉及到受训者时，影响因素超出了个人提供者的行动，包括团队动态、系统资源和组织文化1每一种结构都创造了不同的学习条件，然而居住者和导师都不能预测他们正在经历的是哪种类型的事件，直到进入这个过程。最初的临床时刻通过多种分析镜头折射出来，每种分析镜头都有自己的语言、时间线和专业发展的后果。我们的研究考察了住院医师期间经历过病人投诉的医生，发现了一种一致的模式常规的临床护理可能演变成挑战职业身份的医学法律复杂性。在实习期间收到投诉的医生告诉我们，他们感到“措手不及”，怀疑自己是否“配得上住院医生”，并怀疑自己是否“欺骗了所有人，让他们相信自己有能力”这些经历造成了我们所说的“职业身份破坏”。Rowland等人的发现有助于解释组织背景：他们描述了学习者如何免受“繁文缛节”的影响，被排除在受qcipa保护的讨论之外，并陷入关于安全学习是否意味着发展临床专业知识或参与质量改进的争论中他们组织的模糊性——不确定适用哪些协议，谁应该参与其中，哪些问责结构优先——为我们观察到的身份破坏创造了条件。在安全事件期间，这种定位问题更加突出。居民们描述了一些情况，他们认为直言不讳和保持沉默都会给他们的职业地位带来风险。时间维度决定了结果。最初，遇到投诉的居民报告说，耻辱、孤立和羞耻，往往是通过沉默自我强加的。随着时间的推移，许多人将这些经历重新定义为交流和学院支持增长的催化剂。这种转变需要结构化的支持，透明的沟通和指导，帮助居民将这些经历融入他们的专业叙述中。住院医生的意图和病人的看法之间的不一致揭示了一种结构性的紧张。居民在有监督的环境中工作，他们的责任仍然模糊不清。罗兰等人研究中的一位医生声称，“从医学法律环境来看，学生和住院医生是不存在的。”他们实际上是我的一双手，被授予了权力这种说法虽然反映了一种普遍的看法，但在加拿大是不正确的。住院医师是独立的执业医师，与任何内科医生具有相同的法律、法规和专业义务。当安全事件发生时，这种认知和实际法律地位之间的矛盾加剧了身份挑战。住院医师同时是受监督的教育层次的学习者和法律上负责任的从业者。与此同时，患者体验到的是由个人而不是系统提供的护理。住院医师教育和患者隐私之间的紧张关系决定了安全学习的发生方式。而参与安全事件的住院医师可能作为提供护理的代理人参与医院审查，Rowland等。说明对隐私立法的解释如何对全面学习造成障碍。大学可能被排除在审查之外，因为在某些隐私框架下，它们不是医疗保健提供者。居民收到的信息经过过滤，教育背景被删除。没有医院电子邮件帐户的受训者可能无法获得安全建议。这些对隐私要求的行政解释，无论是法律上的必要还是制度上的谨慎，都截断了学习的机会。医学教育项目需要既能解决Rowland等人提出的组织复杂性，又能解决这些事件给受训者带来的职业身份挑战的框架。无论是作为事故的直接参与者，还是作为审查过程的旁观者，住院医生都必须应对各种相互矛盾的需求：从安全事件中学习，同时管理对他们新兴职业身份的威胁。其影响超出了居民个人。在安全事件期间的支持塑造了未来患者护理的方法，参与质量改进的意愿和支持同事的能力。在我们的研究中，一位医生说：“通过分享我自己的经验，我的目标是让我的住院医生掌握更好地处理类似情况的知识。”正如Rowland等人所证明的那样，将临床学习环境理解为协商命令仍然是必要的。这些空间也通过具有挑战性的体验来塑造职业身份。作者描绘的组织动态为形成时刻创造了条件。教育系统如何应对，决定了这些时刻是成为增长的机会，还是成为持久创伤的来源。患者和专业人士都需要循证方法来应对这些复杂性。

{"title":"The view from within: Professional identity formation when safety events involve trainees","authors":"Allan McDougall","doi":"10.1111/medu.70127","DOIUrl":"10.1111/medu.70127","url":null,"abstract":"Every serious safety event involving a medical trainee triggers an organisational scramble. Who takes the lead on involving trainees in a QI review, the hospital or the university? Which policies guide the response? Who decides if the learner should be included in reviews? Rowland et al.'s analysis maps these institutional tensions.1 While their organisational lens highlights important systemic dynamics, there is a parallel medical education story that deserves attention. Safety events do not just expose system uncertainties. They can disrupt a developing physician's sense of professional self and career trajectory. We suggest that alongside and inside these organisational dynamics, safety events trigger individual and relational processes that fundamentally alter what clinical learning environments actually teach.Consider the spectrum of serious safety events that residents navigate, as captured by medico-legal data coding frameworks. As McCleery et al. demonstrate, patient safety incidents encompass events which could have resulted, or did result, in unnecessary harm to the patient.2 A near miss where no harm occurred might trigger internal self-doubt without external scrutiny. An adverse outcome with actual harm may activate institutional review processes, team debriefs for systems learning or even involvement by the medical regulatory authority. A complaint without harm might seem disproportionate to clinical reality. A complaint with harm can launch residents into months or years of hospital, regulatory or civil legal matters while they are still trying to learn medicine.3, 4 When these events involve trainees, the contributing factors extend beyond individual provider actions to encompass team dynamics, system resources and organisational culture.1 Each configuration creates distinct learning conditions, yet neither residents nor preceptors can predict which type of event they are experiencing until well into the process. What begins as a clinical moment becomes refracted through multiple lenses of analysis, each with its own language, timeline and consequences for professional development.Our research examining physicians who experienced patient complaints during residency reveals a consistent pattern.5 Routine clinical care can evolve into medico-legal complexity that challenges professional identity. Physicians who received complaints during residency told us they felt ‘blindsided’, questioned whether they ‘deserve to be a resident’ and wondered whether they had ‘conned everyone into believing [they're] capable’.5 These experiences create what we termed ‘professional identity disruption’. Rowland et al.'s findings help explain the organisational context: They describe how learners are shielded from ‘red tape bureaucracy’, excluded from QCIPA-protected ","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"60 2","pages":"98-100"},"PeriodicalIF":5.2,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://asmepublications.onlinelibrary.wiley.com/doi/epdf/10.1111/medu.70127","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145635463","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}

引用次数: 0

When I say …'humility'. 当我说“谦卑”的时候。

IF 5.2 1区教育学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES

Medical Education

Pub Date : 2025-11-27 DOI: 10.1111/medu.70126

Barret Michalec

引用次数: 0

Reconfiguring tutor-peer roles to foster critical thinking in medical PBL assisted by tutor-managed chatGPT. 重新配置导师-同伴角色，在导师管理的chatGPT的帮助下，培养医学PBL中的批判性思维。

IF 5.2 1区教育学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES

Medical Education

Pub Date : 2025-11-27 DOI: 10.1111/medu.70100

Rong Wang, Chuanyong Liu, Fan Yi

Background: Critical thinking skills (CTS) are essential in medical education. Problem-based learning (PBL) effectively develops CTS, with generative AI (e.g., ChatGPT) offering enhancement potential.

Objectives: This study investigates how a tutor-managed ChatGPT-PBL model: (1) reconfigures tutor/peer roles and CTS compared to traditional PBL; (2) establishes predictive relationships between tutor/peer roles and CTS and (3) confirms optimal operational parameters for tutor-managed ChatGPT to enhance CTS.

Methods: A quasi-experimental study assigned 170 medical students to either a ChatGPT-PBL or a traditional PBL group. Data from a 31-item survey assessing tutor and peer roles and CTS, along with learning logs and tutor observations for 36 participants, recorded AI engagement metrics (e.g., query frequency, multi-source validation, comparative questioning). The intervention used a pre-defined "3-2-60 Rule" (≥3 queries/session, ≥2 authoritative sources/claim, >60% comparative framing), derived from existing literature, to guide ChatGPT engagement. Interrelationships were examined.

Results: ChatGPT-PBL improved CTS outcomes, enhancing tutor-guided constructive/self-directed/contextual/collaborative learning and peer-driven information processing/communication/critical analysis. Regression identified collaborative learning and information processing as CTS predictors in both approaches, but ChatGPT shifted their influence: collaborative learning's role decreased while information processing's increased. High adherence to the "3-2-60 Rule" correlated with CTS gains, with high-engagement groups (>3 queries, ≥2 sources, comparative framing) outperforming peers.

Conclusions: Tutor-managed ChatGPT reconfigures tutor/peer roles in PBL to enhance CTS development. Structured peer-ChatGPT-tutor interactions (following the 3-2-60 rule) contributed to enhancing CTS. Given ChatGPT's socioemotional limitations, future implementations should embed adversarial ChatGPT tasks and ethical transparency protocols.

背景：批判性思维技能（CTS）在医学教育中是必不可少的。基于问题的学习（PBL）有效地发展了CTS，生成式人工智能（例如，ChatGPT）提供了增强潜力。目的：本研究探讨了导师管理的ChatGPT-PBL模型如何：(1)与传统PBL相比，重新配置导师/同伴角色和CTS；(2)建立了导师/同伴角色与CTS之间的预测关系；(3)确定了导师管理的ChatGPT的最佳操作参数，以增强CTS。方法：一项准实验研究将170名医学生分配到ChatGPT-PBL组或传统PBL组。来自评估导师和同伴角色和CTS的31项调查的数据，以及36名参与者的学习日志和导师观察，记录了人工智能参与指标（例如，查询频率，多源验证，比较问题）。干预使用了一个预定义的“3-2-60规则”（≥3个查询/会话，≥2个权威来源/声明，bbb60 %比较框架），来自现有文献，来指导ChatGPT参与。研究了相互关系。结果：ChatGPT-PBL改善了CTS结果，增强了导师指导的建设性/自主/情境/协作学习和同伴驱动的信息处理/沟通/批判性分析。回归分析发现，协作学习和信息加工在两种方法中都是CTS的预测因子，但ChatGPT改变了它们的影响：协作学习的作用降低，信息加工的作用增加。高度遵守“3-2-60规则”与CTS收益相关，高参与度组（bb0 3个查询，≥2个来源，比较框架）表现优于同行。结论：导师管理的ChatGPT重新配置了PBL中的导师/同伴角色，以促进CTS的发展。结构化的peer-ChatGPT-tutor互动（遵循3-2-60规则）有助于增强CTS。考虑到ChatGPT的社会情感限制，未来的实现应该嵌入对抗性的ChatGPT任务和道德透明度协议。

{"title":"Reconfiguring tutor-peer roles to foster critical thinking in medical PBL assisted by tutor-managed chatGPT.","authors":"Rong Wang, Chuanyong Liu, Fan Yi","doi":"10.1111/medu.70100","DOIUrl":"https://doi.org/10.1111/medu.70100","url":null,"abstract":"Background: Critical thinking skills (CTS) are essential in medical education. Problem-based learning (PBL) effectively develops CTS, with generative AI (e.g., ChatGPT) offering enhancement potential.Objectives: This study investigates how a tutor-managed ChatGPT-PBL model: (1) reconfigures tutor/peer roles and CTS compared to traditional PBL; (2) establishes predictive relationships between tutor/peer roles and CTS and (3) confirms optimal operational parameters for tutor-managed ChatGPT to enhance CTS.Methods: A quasi-experimental study assigned 170 medical students to either a ChatGPT-PBL or a traditional PBL group. Data from a 31-item survey assessing tutor and peer roles and CTS, along with learning logs and tutor observations for 36 participants, recorded AI engagement metrics (e.g., query frequency, multi-source validation, comparative questioning). The intervention used a pre-defined \"3-2-60 Rule\" (≥3 queries/session, ≥2 authoritative sources/claim, >60% comparative framing), derived from existing literature, to guide ChatGPT engagement. Interrelationships were examined.Results: ChatGPT-PBL improved CTS outcomes, enhancing tutor-guided constructive/self-directed/contextual/collaborative learning and peer-driven information processing/communication/critical analysis. Regression identified collaborative learning and information processing as CTS predictors in both approaches, but ChatGPT shifted their influence: collaborative learning's role decreased while information processing's increased. High adherence to the \"3-2-60 Rule\" correlated with CTS gains, with high-engagement groups (>3 queries, ≥2 sources, comparative framing) outperforming peers.Conclusions: Tutor-managed ChatGPT reconfigures tutor/peer roles in PBL to enhance CTS development. Structured peer-ChatGPT-tutor interactions (following the 3-2-60 rule) contributed to enhancing CTS. Given ChatGPT's socioemotional limitations, future implementations should embed adversarial ChatGPT tasks and ethical transparency protocols.","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":5.2,"publicationDate":"2025-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145635465","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}

引用次数: 0

首页上一页

下一页尾页

类型

全部化学•材料生命科学医学物理工程技术环境•农林材料科学地球科学法学管理学化学环境科学与生态学计算机科学教育学经济学农林科学人文科学生物学数学物理与天体物理心理学综合性期刊其他工业工程理学历史学农学文学信息工程

数据库

全部 ACS Publications Elsevier ieeexplore Springer The Royal Society of Chemistry Wiley

期刊

Medical Education

全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.

﹀