Jessica Lees, Torsten Risǿr, Linda Sweet, Margaret Bearman
Background: There is a growing presence of digital technologies in clinical learning environments. However, there is little research into how such technologies shape embodied teaching and learning for health professional students. This study aims to explore current teaching practices in health disciplines to illuminate how digital technologies are used to facilitate the development of embodied knowledge during student learning of physical examination.
Methods: A qualitative interpretive approach was undertaken, sensitised by body pedagogics as a theoretical frame. In-depth interviews with 18 clinical educators across the disciplines of medicine, physiotherapy, midwifery and nursing were held. These interviews explored their current practices for teaching physical examination. The data was analysed using reflexive thematic analysis combined with a 'thinking with theory' approach, in which the theoretical framework of body pedagogics was central to guiding the reflexive and interpretative process.
Results: We interpreted a framework of five approaches where digital technologies are used to develop bodily knowledge: for sensate knowing; for modelling; for rehearsing; for guiding practice and for providing feedback information.
Conclusion: Findings suggest that in current teaching practices, digital technology may be used to facilitate multiple essential elements of physical examination instruction. We conceptualised a framework that extends body pedagogics, where we recognise the multiple roles of digital technology for developing bodily knowledge in the context of physical examination.
{"title":"Integrating digital technologies into teaching embodied knowledge in the context of physical examination.","authors":"Jessica Lees, Torsten Risǿr, Linda Sweet, Margaret Bearman","doi":"10.1111/medu.15599","DOIUrl":"https://doi.org/10.1111/medu.15599","url":null,"abstract":"<p><strong>Background: </strong>There is a growing presence of digital technologies in clinical learning environments. However, there is little research into how such technologies shape embodied teaching and learning for health professional students. This study aims to explore current teaching practices in health disciplines to illuminate how digital technologies are used to facilitate the development of embodied knowledge during student learning of physical examination.</p><p><strong>Methods: </strong>A qualitative interpretive approach was undertaken, sensitised by body pedagogics as a theoretical frame. In-depth interviews with 18 clinical educators across the disciplines of medicine, physiotherapy, midwifery and nursing were held. These interviews explored their current practices for teaching physical examination. The data was analysed using reflexive thematic analysis combined with a 'thinking with theory' approach, in which the theoretical framework of body pedagogics was central to guiding the reflexive and interpretative process.</p><p><strong>Results: </strong>We interpreted a framework of five approaches where digital technologies are used to develop bodily knowledge: for sensate knowing; for modelling; for rehearsing; for guiding practice and for providing feedback information.</p><p><strong>Conclusion: </strong>Findings suggest that in current teaching practices, digital technology may be used to facilitate multiple essential elements of physical examination instruction. We conceptualised a framework that extends body pedagogics, where we recognise the multiple roles of digital technology for developing bodily knowledge in the context of physical examination.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-12-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142854470","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}
<p>An essential component of competency-based frameworks within postgraduate medical training programmes is the Clinical Competency Committee (CCC). Enabling more structured, transparent and objective approaches to assessing learner performance, the primary purpose of a CCC is to ensure that programme graduates deliver high-quality and safe patient care.<span><sup>1</sup></span> This is accomplished through regular review and interpretation of each trainee's assessment data. Ideally this process leads to recommendations that support an individual trainee's development, outline a level of supervision the trainee requires and clarify the trainee's readiness for progression to the next stage of training or for practice.<span><sup>1</sup></span> CCCs are comprised of programme directors, faculty members and clinician educators who review and use assessment data to make prospective entrustment decisions.</p><p>Aiming to theorize how these prospective entrustment decisions unfold in real-world CCC settings, Schumacher et al conducted a realist literature synthesis.<span><sup>2</sup></span> The theoretical model that resulted was anchored by the finding that CCC decision making was rarely deliberative and most often occurred by default. Decisions about progression were found to frequently occur automatically, and when a deliberative process was utilized, it was in response to red flags having been identified.</p><p>To examine their theoretical model against empirical data, Schumacher et al. recently elaborated on the deliberative process undertaken by CCCs through a realist inquiry of committee structure and function among eight paediatric training programmes.<span><sup>3</sup></span> The authors found evidence of deliberation during CCC meetings however this was not for the purpose of guiding progression decisions. Rather, deliberation occurred when focus was on the developmental needs of trainees. When making progression decisions, the authors confirmed the predominant use of defaulting. This led to the recommendation that CCCs shift to more deliberate rather than passive processes when making progression decisions. Although the importance of optimizing strategies that improve the deliberative processes of a CCC (e.g., ensuring clarity on both committee terms of reference and shared mental models among a diverse membership) is inarguable, this recommended shift may not be as straightforward.</p><p>An important question to consider is why certain programmes may be less likely or less able to integrate deliberative processes into progression decisions. A rarely explored variable in the implementation of competency-based education in general is the underlying nature of a specialty, that is, procedure based, non-procedure based, or relational. The nature of a specialty may have direct implications for several implementation domains, one being the deliberative processes of CCC progression decisions.</p><p>Procedural specialties, including surgery, anaesthe
{"title":"The nature of a specialty","authors":"Jeff Myers","doi":"10.1111/medu.15593","DOIUrl":"10.1111/medu.15593","url":null,"abstract":"<p>An essential component of competency-based frameworks within postgraduate medical training programmes is the Clinical Competency Committee (CCC). Enabling more structured, transparent and objective approaches to assessing learner performance, the primary purpose of a CCC is to ensure that programme graduates deliver high-quality and safe patient care.<span><sup>1</sup></span> This is accomplished through regular review and interpretation of each trainee's assessment data. Ideally this process leads to recommendations that support an individual trainee's development, outline a level of supervision the trainee requires and clarify the trainee's readiness for progression to the next stage of training or for practice.<span><sup>1</sup></span> CCCs are comprised of programme directors, faculty members and clinician educators who review and use assessment data to make prospective entrustment decisions.</p><p>Aiming to theorize how these prospective entrustment decisions unfold in real-world CCC settings, Schumacher et al conducted a realist literature synthesis.<span><sup>2</sup></span> The theoretical model that resulted was anchored by the finding that CCC decision making was rarely deliberative and most often occurred by default. Decisions about progression were found to frequently occur automatically, and when a deliberative process was utilized, it was in response to red flags having been identified.</p><p>To examine their theoretical model against empirical data, Schumacher et al. recently elaborated on the deliberative process undertaken by CCCs through a realist inquiry of committee structure and function among eight paediatric training programmes.<span><sup>3</sup></span> The authors found evidence of deliberation during CCC meetings however this was not for the purpose of guiding progression decisions. Rather, deliberation occurred when focus was on the developmental needs of trainees. When making progression decisions, the authors confirmed the predominant use of defaulting. This led to the recommendation that CCCs shift to more deliberate rather than passive processes when making progression decisions. Although the importance of optimizing strategies that improve the deliberative processes of a CCC (e.g., ensuring clarity on both committee terms of reference and shared mental models among a diverse membership) is inarguable, this recommended shift may not be as straightforward.</p><p>An important question to consider is why certain programmes may be less likely or less able to integrate deliberative processes into progression decisions. A rarely explored variable in the implementation of competency-based education in general is the underlying nature of a specialty, that is, procedure based, non-procedure based, or relational. The nature of a specialty may have direct implications for several implementation domains, one being the deliberative processes of CCC progression decisions.</p><p>Procedural specialties, including surgery, anaesthe","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"59 3","pages":"264-266"},"PeriodicalIF":4.9,"publicationDate":"2024-12-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/medu.15593","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142818583","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}
Noting that clinician teachers are vital in medical education but face challenges in balancing teaching and clinical roles, Alexandraki reflects how support, recognition, and resources are key to navigating the tension.
{"title":"Exploring the boundaries between clinician and teacher","authors":"Irene Alexandraki","doi":"10.1111/medu.15586","DOIUrl":"10.1111/medu.15586","url":null,"abstract":"<p>Noting that clinician teachers are vital in medical education but face challenges in balancing teaching and clinical roles, Alexandraki reflects how support, recognition, and resources are key to navigating the tension.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"59 2","pages":"136-138"},"PeriodicalIF":4.9,"publicationDate":"2024-12-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142813694","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":"Navigating impostorism: The role of clinical learning environments and trainees' general causality orientation.","authors":"Cesar Orsini, Adam Neufeld","doi":"10.1111/medu.15592","DOIUrl":"https://doi.org/10.1111/medu.15592","url":null,"abstract":"","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142829070","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":"Retention beyond representation: A call for structural inclusion in health professions education.","authors":"Tal Jarus, Yael Mayer","doi":"10.1111/medu.15591","DOIUrl":"https://doi.org/10.1111/medu.15591","url":null,"abstract":"","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786305","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":"Creating Health Professions Trainee-Heroes Through Transformative Learning.","authors":"James H Wykowski, Benjamin S Vipler","doi":"10.1111/medu.15589","DOIUrl":"https://doi.org/10.1111/medu.15589","url":null,"abstract":"","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-12-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142786304","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":"Dances with doves, hawks and eagles: Realising the potential of emotion during simulation.","authors":"Russell Peek","doi":"10.1111/medu.15588","DOIUrl":"https://doi.org/10.1111/medu.15588","url":null,"abstract":"","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770446","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}
Yaros argues that advancing evidence on the costs and economic impacts of student-led clinics requires joining forces to build towards conceptual and methodological unity across all health professions education economic research.
{"title":"A call to unify cost and economic impact research of health professions education.","authors":"Jennifer Yaros","doi":"10.1111/medu.15590","DOIUrl":"https://doi.org/10.1111/medu.15590","url":null,"abstract":"<p><p>Yaros argues that advancing evidence on the costs and economic impacts of student-led clinics requires joining forces to build towards conceptual and methodological unity across all health professions education economic research.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-12-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770442","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}
Cavaleiro and de Carvalho Filho outline the evolving understanding of feedback in medical education, highlighting its significance while considering future research opportunities.
{"title":"‘Feedback: Now and then’","authors":"Inês Cavaleiro, Marco Antonio de Carvalho Filho","doi":"10.1111/medu.15584","DOIUrl":"10.1111/medu.15584","url":null,"abstract":"<p>Cavaleiro and de Carvalho Filho outline the evolving understanding of feedback in medical education, highlighting its significance while considering future research opportunities.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"59 2","pages":"142-144"},"PeriodicalIF":4.9,"publicationDate":"2024-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142770449","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}
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