Medical Education最新文献

英文中文

Influence of tutor interventions and group process on medical students' engagement in problem-based learning. 导师干预和小组进程对医学生参与问题式学习的影响。

IF 6 1区教育学 Q1 Social Sciences

Medical Education

Pub Date : 2024-04-02 DOI: 10.1111/medu.15387

Salah Eldin Kassab, Hossam Hamdy, Silvia Mamede, Henk Schmidt

Introduction: Student engagement is influenced by several variables, among which are the teaching styles employed by faculty. In problem-based learning (PBL), the role of faculty is to facilitate the learning of the tutorial group as they work through clinical problems. However, the influence of tutor intervention styles and group process on engagement of students in PBL tutorials is unclear.

Methods: The study was conducted with year 2 and 3 medical students (n = 176) in PBL tutorial groups at the end of an integrated PBL course. Students evaluated their behavioural, cognitive and emotional engagement in PBL tutorials using a pre-validated 11-item questionnaire. Students also filled in a modified version of a previously published tutor intervention profile (TIP) questionnaire. The modified TIP questionnaire represents three constructs (1) steering the learning process (6 items), (2) stimulating student autonomy (4 items) and (3) establishing relatedness with students (3 items). In addition, PBL group process was evaluated using a 5-item nominal scale: (1) tutorial atmosphere, (2) listening and information sharing, (3) group performance, (4) decision making and (5) reaction to leadership.

Results: Establishing sense of relatedness in the group by PBL tutors was the most important predictor of emotional engagement (F = 41.213, ΔR² = 0.191, β = 0.438, P = 0.000). On the other hand, steering the learning process was a significant predictor of behavioural engagement (F = 19.0, ΔR²=0.098, β = 0.314, P = 0.000). However, stimulating student autonomy was not a significant predictor of student engagement in PBL tutorials. On the other hand, enhancing the group process in PBL tutorials significantly predicts student engagement with strong impact on emotional and cognitive engagement of students.

Conclusions: Establishing the sense of relatedness in the group and steering the learning process by PBL tutors as well as improving PBL group process are significant predictors of student engagement in PBL tutorials with emotional and cognitive engagement being the most sensitive variables affected.

引言学生的参与度受多个变量的影响，其中包括教师采用的教学风格。在基于问题的学习（PBL）中，教师的作用是促进辅导小组在解决临床问题过程中的学习。然而，辅导员的干预方式和小组进程对学生参与 PBL 辅导的影响尚不清楚：研究对象为二年级和三年级医学生（n = 176），他们在综合 PBL 课程结束后参加了 PBL 辅导小组。学生们使用一份预先验证过的11项调查问卷，对自己在PBL教程中的行为、认知和情感参与度进行了评估。学生们还填写了之前发布的辅导员干预情况（TIP）问卷的修改版。修改后的 TIP 问卷包括三个方面：(1) 引导学习过程（6 个项目）；(2) 激发学生自主性（4 个项目）；(3) 与学生建立联系（3 个项目）。此外，还使用 5 个项目的名义量表对 PBL 小组过程进行了评估：(1) 辅导氛围；(2) 倾听和信息共享；(3) 小组表现；(4) 决策；(5) 对领导的反应：结果：PBL 辅导教师在小组中建立亲切感是预测情感投入的最重要因素（F = 41.213，ΔR2 = 0.191，β = 0.438，P = 0.000）。另一方面，引导学习过程对行为参与有显著的预测作用（F = 19.0，ΔR2 = 0.098，β = 0.314，P = 0.000）。然而，激发学生自主性对学生参与 PBL 辅导的预测作用并不明显。另一方面，增强 PBL 辅导中的小组过程对学生的参与度有明显的预测作用，对学生的情感和认知参与度有很大的影响：结论：PBL 辅导教师在小组中建立关联感和引导学习过程，以及改进 PBL 小组过程，对学生参与 PBL 辅导有重要的预测作用，而情感和认知参与是受影响最敏感的变量。

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引用次数: 0

Empowering rural educators: Strategies for overcoming barriers in clinical teaching 增强农村教育工作者的能力：克服临床教学障碍的策略。

IF 6 1区教育学 Q1 Social Sciences

Medical Education

Pub Date : 2024-03-29 DOI: 10.1111/medu.15386

Chia-Yu Hu, Yu-Che Chang

Equitable access to health services is fundamental to achieving universal health coverage, a principle underscored by both the Institute of Medicine in the United States¹ and the World Health Organization (WHO).² As a result, medical students in many parts of the world are mandated to undergo extended clinical training in rural or underserved areas to better prepare for practice and effectively serve community patients. Such requirements, however, create challenges given that the shortage (or unequal distribution) of community-based clinicians means there is necessarily a shortage (or unequal distribution) of community-based preceptors.³ With that in mind, we commend Alexandraki et al.'s⁴ efforts to investigate the motivators and barriers to teaching experienced by individuals serving as community preceptors. Their use of social cognitive career theory (SCCT) leads to conclusions that usefully draw attention to existing gaps and adversity supporting rural community preceptors' clinical teaching and career advancement. Their findings also underscore the importance, more generally, of enhancing clinical education in rural areas, emphasising that there is a necessity for stakeholders in underserved communities and medical schools to collaborate in establishing an inclusive educational environment and faculty development programme aimed at improving clinical teaching practices.

Alexandraki et al.⁴ highlight the disconnect between rural community preceptors and medical schools, attributing it to insufficient financial support, restricted access to resources, inadequate guidance and a sense of undervaluation. As a result, rural preceptors in their study reported needing to devise their own teaching strategies, tailored to their unique context, enabling them to overcome challenges and excel in their dual roles as both practising physicians and educators. As we reflect on these findings, we are struck by how many of the challenges rural preceptors can face that derive from social isolation. Graven et al.'s⁵ theory of social learning posits that professional development is inherently a social enterprise. O'Sullivan and Irby's⁶ model of faculty development goes further, emphasising that clinical preceptors are embedded in two communities of practice (CoP): the first comprises a community of educators involved in faculty development initiatives, while the second is the teaching practice community within preceptors' respective work settings (i.e., the workplace in which teaching occurs). O'Sullivan and Irby emphasise that inquiry into faculty development should focus on the interaction of elements within the two CoPs because one's engagement in each community so deeply impacts upon their activities within the other. Working in a community with fewer people, as rural preceptors do by d

公平获得医疗服务是实现全民医保的基础，美国医学研究所1 和世界卫生组织（WHO）2 都强调了这一原则。因此，世界上许多地区的医学生都必须在农村或医疗服务不足的地区接受长期临床培训，以便更好地为实践做好准备，并有效地为社区患者服务。3 有鉴于此，我们对亚历山德拉基等人4 为调查社区戒律指导者的教学动机和障碍所做的努力表示赞赏。他们运用社会认知职业理论（SCCT）得出结论，提醒人们注意支持农村社区实习医生临床教学和职业发展的现有差距和不利因素。亚历山德拉基等人4 强调了农村社区戒酒师与医学院之间的脱节，并将其归因于财政支持不足、资源获取受限、指导不足以及价值被低估的感觉。因此，在他们的研究中，农村实习医生需要根据自身的独特情况制定教学策略，从而克服困难，出色地履行执业医生和教育者的双重身份。当我们反思这些研究结果时，我们对农村实习医生可能面临的许多挑战感到震惊，这些挑战来自于社会隔离。Graven 等人5 的社会学习理论认为，专业发展本质上是一项社会事业。O'Sullivan 和 Irby6 的教师发展模式则更进一步，强调临床预任教师被嵌入两个实践社区（CoP）：第一个社区由参与教师发展计划的教育工作者组成，第二个社区则是预任教师各自工作环境（即开展教学的工作场所）中的教学实践社区。O'Sullivan 和 Irby 强调，对教师发展的探究应侧重于这两个 CoPs 中各要素之间的互动，因为一个人在每个社区中的参与都会对其在另一个社区中的活动产生深刻影响。亚历山德拉基等人4 强调了找到这种社会联系作为克服障碍的一种手段的重要性，他们强调，主治医生的教学以及榜样提供的替代学习对社区实习医生的教学准备及其随后的职业决定具有相当大的影响。有机会与其他志趣相投的人交流，有助于提高自我效能感，增强复原力和应对逆境的能力。当农村实习医生能够找到导师、积极参与医学教育社区和参与技能发展计划时，他们就能利用这些经验。温格-特雷纳（Wenger-Trayner）和温格-特雷纳（Wenger-Trayner）7 认为，通过在真实情境中进行辅导、搭建脚手架、互动、评估和反思，可以在社会学习空间中提高个人的专业知识和能力，同时也使参与者以外的其他主要利益相关者受益，从而实现变革。因此，如果医学院能与农村或服务不足的社区合作，共同创建社会学习环境，促进社区戒酒员的可持续学习，那么医学院受益的将不仅仅是获得一名新的戒酒员。尽管在工作与生活的平衡以及与医学院校的沟通方面存在挑战，但在农村和服务不足的社区开展临床教学显然仍然是一些农村临床实习医生的承诺。Alexandraki 等人4 强调，这些人报告说，感到被重视和被支持比金钱报酬更重要，这表明社会回报可能比外部回报更能激励他们。然而，他们的职业决定可能并不总是持久的，因为如果失去了强烈的目的感或以价值为基础的动机，即使是最有动力的人也可能会出现职业枯竭和倦怠。

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引用次数: 0

Profiling learning strategies of medical students: A person-centered approach. 剖析医学生的学习策略：以人为本的方法。

IF 6 1区教育学 Q1 Social Sciences

Medical Education

Pub Date : 2024-03-28 DOI: 10.1111/medu.15388

Nils Otto, Anja Böckers, Thomas Shiozawa, Irene Brunk, Sven Schumann, Daniela Kugelmann, Markus Missler, Dogus Darici

Background: Students within a cohort might employ unique subsets of learning strategies (LS) to study. However, little research has aimed to elucidate subgroup-specific LS usage among medical students. Recent methodological developments, particularly person-centred approaches such as latent profile analysis (LPA), offer ways to identify relevant subgroups with dissimilar patterns of LS use. In this paper, we apply LPA to explore subgroups of medical students during preclinical training in anatomy and examine how these patterns are linked with learning outcomes.

Methods: We analysed the LS used by 689 undergraduate, 1st and 2nd-year medical students across 6 German universities who completed the short version of the Learning Strategies of University Students (LIST-K) questionnaire, and answered questions towards external criteria such as learning resources and performance. We used the thirteen different LS facets of the LIST-K (four cognitive, three metacognitive, three management of internal and three management of external resources) as LPA indicators.

Results: Based on LPA, students can be grouped into four distinct learning profiles: Active learners (45% of the cohort), collaborative learners (17%), structured learners (29%) and passive learners (9%). Students in each of those latent profiles combine the 13 LS facets in a unique way to study anatomy. The profiles differ in both, the overall level of LS usage, and unique combinations of LS used for learning. Importantly, we find that the facets of LS show heterogeneous and subgroup-specific correlations with relevant outcome criteria, which partly overlap but mostly diverge from effects observed on the population level.

Conclusions: The effects observed by LPA expand results from variable-centered efforts and challenge the notion that LS operate on a linear continuum. These results highlight the heterogeneity between subgroups of learners and help generate a more nuanced interpretation of learning behaviour. Lastly, our analysis offers practical implications for educators seeking to tailor learning experiences to meet individual student needs.

背景：一个群体中的学生可能会采用独特的学习策略（LS）进行学习。然而，很少有研究旨在阐明医学生中特定亚群的学习策略使用情况。最近的方法论发展，特别是以人为中心的方法，如潜在特征分析（LPA），提供了识别具有不同学习策略使用模式的相关亚组的方法。在本文中，我们应用 LPA 来探索医学生在解剖学临床前培训期间的亚群，并研究这些模式如何与学习成果相关联：我们分析了德国 6 所大学的 689 名本科生、一年级和二年级医学生使用的 LS，他们填写了简短版的大学生学习策略（LIST-K）问卷，并回答了有关学习资源和成绩等外部标准的问题。我们将LIST-K的13个不同LS方面（4个认知方面、3个元认知方面、3个内部资源管理方面和3个外部资源管理方面）作为LPA指标：根据 LPA，学生可分为四种不同的学习类型：主动学习者（占学生总数的 45%）、协作学习者（17%）、结构化学习者（29%）和被动学习者（9%）。每种潜在特征中的学生都以独特的方式将通识教育的 13 个方面结合起来学习解剖学。这些特征在通识教育的总体使用水平和通识教育的独特学习组合方面都有所不同。重要的是，我们发现LS的各个侧面与相关结果标准呈现出异质性和亚组特定的相关性，这些相关性与在群体水平上观察到的效果部分重叠，但大部分不同：结论：LPA 观察到的效果扩展了以变量为中心的研究结果，并对 LS 在线性连续体上运行的观点提出了质疑。这些结果凸显了学习者亚群之间的异质性，有助于对学习行为做出更细致的解释。最后，我们的分析为教育者寻求定制学习体验以满足学生个人需求提供了实际意义。

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引用次数: 0

MEDU Annual Reviewer List 2023 2023 年 MEDU 年度审查员名单。

IF 6 1区教育学 Q1 Social Sciences

Medical Education

Pub Date : 2024-03-28 DOI: 10.1111/medu.15381

A. Emiko Blalock United States

Abigail Konipasky United States

Abigail Winkel United States

Abraham Cheloff United States

Adam Garber Canada

Adam Gavarkovs Canada

Adam Levine United States

Adam Sawatsky United States

Adam Szulewski Canada

Adelaide McClintock United States

Adin Nelson United States

Adina Kalet United States

Adnan Alseidi United States

Adrian Sutton United Kingdom

Agnes Dodds Australia

Agnes Elmberger Sweden

Aimee Charnell United Kingdom

Aisling Kerr United Kingdom

Aislinn Joy Ireland

Akshara Sharma United Kingdom

Alan Bleakley United Kingdom

Alexander Evins United States

Alexandra Hovaguimian United States

Alexandra Núñez Germany

Alexis Rossi United States

Alice Germa France

Alison Mostyn United Kingdom

Alison Sturrock United Kingdom

Allan McDougall Canada

Allison Seitchik United States

Allison Shorten United States

Alper Bayazit Turkey

Althea Blakey New Zealand

Amanda Provencio United States

Amanda L. Roze des Ordons Canada

Amelia Kehoe United Kingdom

Amin Feili The Islamic Republic of Iran

Amrit Kirpalani Canada

Amudha Poobalan United Kingdom

Amy Addams United States

Amy Blue United States

Ana Marusic Croatia

Ana Rancich Argentina

Ancil Abney United States

Andrea Gingerich Canada

Andrew Grant United Kingdom

Andrew Moeller Canada

Andrew Raikhel United States

Andrew Teodorczuk Australia

Andries Koster Netherlands

Andy Wearn New Zealand

Anél Wiese Ireland

Angelique Dueñas United States

Anique Atherley Netherlands

Anique de Bruin Netherlands

Anita Acai Canada

Anita Kusnoor United States

Anjum Jalal Pakistan

Anke Rohwer South Africa

Anna MacLeod Canada

Anna Melvin United Kingdom

Anna Richmond United Kingdom

Annahieta Kalantari United States

Anne Scerri Malta

Annie Noble United Kingdom

Anthony Donato United States

Antonia Rich United Kingdom

Antonio Peña Fernández Spain

Anurag Saxena Canada

April Edwell United States

April Richardson United States

Ar Aung Australia

Ardi Findyartini Indonesia

Arianne Teherani United States

Arvin Damodaran Australia

Ashley Dennis United Stat

Dyste 美国Todd Guth 美国Tracey Collett 联合王国Tracy Fulton 美国Tristan Price 联合王国Ubaid Tanzim 联合王国Ulemu Luhanga 加拿大Ulrike Nachtschatt 奥地利Van Nguyen 澳大利亚Vanessa Ryan 澳大利亚Veena Singaram 南非Victor Turcanu 联合王国Victoria Boyd 加拿大Victoria Hayes 美国Victoria Luong 加拿大Vivien Lee 新加坡Wael Haddara 加拿大Wagdy Talaat 埃及Wen- Hu黄文正台湾胡文迪澳大利亚威廉-劳格英国威廉-雷尼-约翰逊美国温-梅美国沃尔夫-豪茨瑞士温娜-敦缅甸徐小明荷兰陈彦新西兰铃木安日本张雅文台湾张彦元中国Ythan Goldberg 美国Yu-Chun Chiu 台湾Zahra Shahvari 伊朗伊斯兰共和国Zakia Arfeen 英国Zareen Zaidi 美国Zehra Jamil 巴基斯坦Zeinab El Maadawi 埃及Zeti Rahayu Abdul Karim 马来西亚Zhi Xiong Chen 新加坡

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引用次数: 0

April in this issue 本期四月。
IF 6 1区教育学 Q1 Social Sciences
Medical Education
Pub Date : 2024-03-28 DOI: 10.1111/medu.15376

While there has been a strong push for institutions and researchers to abandon the ‘student deficit model’ in examining differential attainment, the training experiences of Black, Asian, and Minority Ethnic (BAME) medical students remain largely underexplored. Using a sequential explanatory mixed-methods approach, this is the first national study to explore how multiple dimensions of the medical school environment affect the academic performance of BAME undergraduate students in the UK. This study's findings not only offer suggestions to develop more inclusive learning environments but also highlight the importance of fostering a true sense of belonging amongst these students.
Morrison, N, Machado, M, Blackburn, C. Bridging the gap: understanding the barriers and facilitators to performance for Black, Asian and Minority Ethnic medical students in the United Kingdom. Med Educ. 2024; 58(4): 443-456. doi:10.1111/medu.15246
In a regional area of Australia, this study explores medical students' prosocial behaviour following two major flooding incidents in 2022 and the mental health impacts of the events. Students displayed high levels of prosocial behaviour and a strong willingness to volunteer, driven by moral obligation. Yet, barriers like physical and psychological safety concerns and training disruptions limited continued volunteering. The students reported enduring stress, anxiety, and trauma during and after the flooding events. This study offers crucial insights into fostering prosocial behaviour among medical students during disasters, emphasizing the importance of addressing obstacles to support their involvement in such situations.
Bailie, J, Cockrell, K, Matthews, V, Scott, KM, Ahern, C, Bailie, R. Volunteering as prosocial behaviour by medical students following a flooding disaster and impacts on their mental health: a mixed methods study. Med Educ. 2024; 58(4): 430-442. doi:10.1111/medu.15199
Simulation-based education (SBE) is crucial to prepare healthcare professionals prior to their clinical practice. This study describes and analyzes how nursing students learn through simulation using a theory-based socio-material approach and explores the transfer of their knowledge and skills from simulation to clinical practice. 27 final-year nursing students participated in two simulated scenarios, followed by focus groups to capture their reflections and learning. Results highlight how SBE can be expanded using a socio-material approach to prepare students to learn beyond standardized methods by leaving room for emergent learning and increased awareness.
Hui, A,

尽管各院校和研究人员一直在大力推动放弃 "学生赤字模式 "来研究不同的成绩，但黑人、亚裔和少数民族（BAME）医学生的培训经历在很大程度上仍未得到充分探索。本研究采用顺序解释混合方法，是第一项探索医学院环境的多个方面如何影响英国黑人、亚裔和少数族裔本科生学习成绩的全国性研究。这项研究的结果不仅为发展更具包容性的学习环境提供了建议，还强调了在这些学生中培养真正归属感的重要性。 Morrison，N，Machado，M，Blackburn，C. 《缩小差距：了解英国黑人、亚裔和少数民族医科学生学习成绩的障碍和促进因素》。Med Educ. 2024; 58(4)： doi:10.1111/medu.15246在澳大利亚的一个地区，本研究探讨了医科学生在 2022 年两次重大洪水事件后的亲社会行为以及这些事件对心理健康的影响。在道德义务的驱使下，学生们表现出高水平的亲社会行为和强烈的志愿意愿。然而，身心安全问题和培训中断等障碍限制了志愿服务的继续。学生们表示，在洪灾期间和之后，他们承受着压力、焦虑和创伤。这项研究为在灾难中培养医学生的亲社会行为提供了重要启示，强调了消除障碍以支持他们参与此类情况的重要性。 Bailie，J，Cockrell，K，Matthews，V，Scott，KM，Ahern，C，Bailie，R. 水灾后医学生的志愿服务作为亲社会行为及其对心理健康的影响：一项混合方法研究。Med Educ. 2024; 58(4)： doi:10.1111/medu.15199模拟教育（SBE）对于医护人员在临床实践前的准备工作至关重要。本研究描述并分析了护理专业学生如何通过基于理论的社会物质方法进行模拟学习，并探讨了他们从模拟到临床实践的知识和技能转移。27 名护理专业毕业班学生参与了两个模拟场景，随后进行了焦点小组讨论，以了解他们的反思和学习情况。结果凸显了如何利用社会物质方法扩展 SBE，通过为新兴学习和提高意识留出空间，让学生做好准备，超越标准化方法进行学习。 Hui, A, Chan, EA, Chung, B, Chang, K, Rafferty, AM. 学生在基于理论的模拟中的学习：一项社会材料研究。2024; 58(4)： 405-414.doi:10.1111/medu.15201本文主张将土著研究范式纳入医疗专业以人为本的护理中，这种护理具有协作性和同情心，与更好的患者治疗效果相关。但是，我们如何选择能够始终如一地提供这种护理的人员？如何培养和保持医生所需的人际交往技能？在讨论 "非学术性素质 "时，经常会出现概念混淆的情况，本报告提出了一个新颖的循证模型。它描述了以人为本的医疗服务所需的情商（EI）"基本粒子"。该模型意味着，在选择医务人员时，应筛选出那些相关素质水平较低，不太适合接受培训的人。反之，教育则应侧重于情商中较容易训练的必要组成部分。 Tiffin, P, Roberts, RD. 交叉边缘：从情商的角度看医学选拔和教育。Med Educ. 2024; 58(4)： 382-391. doi:10.1111/medu.15244

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引用次数: 0

Medical education in Syria at a time of crisis: Analysis of the results of the knowledge-based National Medical Examination 危机时刻的叙利亚医学教育：基于知识的国家医学考试结果分析。
IF 6 1区教育学 Q1 Social Sciences
Medical Education
Pub Date : 2024-03-28 DOI: 10.1111/medu.15385

Jameel Soqia, Jamal Ataya, Rakan Saadoun, Lujain Nahas, Albaraa Yazbek, Mohammed Al-shafie, Hamdah Hanifa, Muhialdein Dakak, Ahmad Walid Izzat, Mohammad Bashar Izzat

Objective

This study explored how the Syrian crisis, training conditions, and relocation influenced the National Medical Examination (NME) scores of final-year medical students.

Methods

Results of the NME were used to denote the performance of final-year medical students between 2014 and 2021. The NME is a mandatory standardised test that measures the knowledge and competence of students in various clinical subjects. We categorised the data into two periods: period-I (2014–2018) and period-II (2019–2021). Period-I represents students who trained under hostile circumstances, which refer to the devastating effects of a decade-long Syrian crisis. Period-II represents post-hostilities phase, which is marked by a deepening economic crisis.

Results

Collected data included test scores for a total of 18 312 final-year medical students from nine medical schools (from six public and three private universities). NME scores improved significantly in period-II compared with period-I tests (p < 0.0001). Campus location or relocation during the crisis affected the results significantly, with higher scores from students of medical schools located in lower-risk regions compared with those from medical schools located in high-risk regions (p < 0.0001), both during and in the post-hostilities phases. Also, students of medical schools re-located to lesser-risk regions scored significantly less than those of medical schools located in high-risk regions (p < 0.0001), but their scores remained inferior to that of students of medical schools that were originally located in lower-risk regions (p < 0.0001).

Conclusion

Academic performance of final year medical students can be adversely affected by crises and conflicts, with a clear tendency to recovery upon crises resolution. The study underscores the importance of maintaining and safeguarding the infrastructure of educational institutions, especially during times of crisis. Governments and educational authorities should prioritise resource allocation to ensure that medical schools have access to essential services, learning resources, and teaching personnel.

目的：本研究探讨了叙利亚危机、培训条件和搬迁对医学专业毕业班学生国家医学考试（NME）成绩的影响：本研究探讨了叙利亚危机、培训条件和搬迁如何影响应届医学生的国家医学考试（NME）成绩：采用国家医学考试成绩来表示 2014 年至 2021 年期间应届医科学生的表现。国家医学考试是一项强制性标准化考试，用于衡量学生在各临床科目方面的知识和能力。我们将数据分为两个时期：第一时期（2014-2018 年）和第二时期（2019-2021 年）。第一阶段代表在敌对环境下接受培训的学生，敌对环境指的是长达十年之久的叙利亚危机的破坏性影响。第二阶段代表敌对行动后阶段，其特点是经济危机不断加深：收集的数据包括来自 9 所医学院（6 所公立大学和 3 所私立大学）的 18 312 名应届医学生的考试成绩。与第一阶段的测试相比，第二阶段的 NME 分数有了明显提高（P毕业班医学生的学业成绩可能会受到危机和冲突的不利影响，但危机解决后，学业成绩有明显的恢复趋势。这项研究强调了维护和保障教育机构基础设施的重要性，尤其是在危机时期。各国政府和教育当局应优先分配资源，确保医学院能够获得基本服务、学习资源和教学人员。

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引用次数: 0

RGS Annual Reviewer List 2023 2023 年 RGS 年度评审员名单。
IF 6 1区教育学 Q1 Social Sciences
Medical Education
Pub Date : 2024-03-28 DOI: 10.1111/medu.15382

Abdalazeem Ibrahem United Kingdom
Abdikarin Abdullahi United States
Abeba Zewdu United States
Abigail Luman United States
Abigail Swerdlow United Kingdom
Abigail Wright Hong Kong
Abraham Cheloff United States
Adam Garber Canada
Adam Levine United States
Adam Sawatsky United States
Adam Schaffer United States
Adam Stevenson United States
Adelaide McClintock United States
Adin Nelson United States
Adrian Sutton United Kingdom
Agathe Vrillon France
Ahmad Ramzi Yusof Malaysia
Aiden Shapiro United States
Aimee Charnell United Kingdom
Aisha Chachar Pakistan
Aisling Keane United Kingdom
Akshara Sharma United Kingdom
Alan Bleakley United Kingdom
Alan Chiem United States
Alanna Hare United Kingdom
Alev Atalay United States
Alexa Lindley United States
Alexis Peedin United States
Alia Chisty United States
Alicia Hurtado United States
Aliki Thomas Canada
Alisa Wray United States
Alison Mostyn United Kingdom
Alison Sturrock United Kingdom
Allie Bradley New Zealand
Allison Carroll United States
Allison Davidson United States
Allison Seitchik United States
Allison Thomas United States
Allison Tzeng United States
Allison Yan United States
Amanda Ivatorov United States
Amanda Provencio United States
Amaya Ellawala United Kingdom
Amber Pincavage United States
Amin Feili The Islamic Republic of Iran
Amir Sam United Kingdom
Amrit Kirpalani Canada
Amy Blue United States
Amy Caruso Brown United States
Amy Hayton United States
Amy Weinstein United States
Ana Da Silva United Kingdom
Ana Marusic Croatia
Ana Rancich Argentina
Anders Chen United States
Andrea Berry United States
Andrea Ens Canada
Andrea Lörwald Switzerland
Andrea Meisman United States
Andrea Praschinger Austria
Andrew Auerbach United States
Andrew Grant United Kingdom
Andrew Harris United States
Andrew Luks United States
Andrew Parsons United States
Andrew Raikhel United States
Andrew Yu United States
Andy Wearn New Zealand
Anél Wiese Ireland
Angela Chang United States
Animesh Jain India
Anique Atherley Netherlands
Anita Kusnoor United States
Anjum Jalal Pa

戈弗雷美国艾玛-巴特尔澳大利亚艾玛-韦伯斯特澳大利亚艾玛纽埃尔-陈新加坡恩吉-阿布泽德英国恩佐-德-保拉巴西埃里克-白美国埃林-朱迪斯美国埃文-佩罗美国埃夫-里滕伯格美国法布里齐奥-德-庞蒂意大利法伊亚兹-艾哈迈德沙特阿拉伯法扎尔-哈吉加拿大法尔汗-瓦卡尼巴基斯坦法鲁克英国Felicity Gibbons 英国Felix Schmitz 瑞士Fiona Carter 英国Fiona Kelly 澳大利亚Florence Graham 美国Florence Liaudet 瑞士Francis Real 美国Frédéric Laurent 法国Fun Gee Chen 新加坡Gabriella Tison 美国Gabrielle Berger 美国Gabrielle Piggin新西兰Gaby Lutgens 荷兰Gail March 美国Garrett Johnson 美国Garth Brand 美国Gaurav Bhalla 英国Gayathri Subramanian 英国Geneviève Digby 加拿大George Ibrahim 美国George Kim 加拿大George Slim 加拿大Georges Bordage 美国Georges Nakhoul 美国Georgina澳大利亚Gerald Stein 美国Gila Kriegel 美国Gilles Rode 法国Glenn Regehr 加拿大Gominda Ponnamperuma 英国Gordon Riha 美国Grace Hildenbrand 美国Graham Easton 英国Grainne Kearney 英国Gregory Ow 美国Grzegorz Tatoń 波兰Guangyuan Zhang 中国Guo台湾Gurpreet Dhaliwal 美国Hafez Sorouri Zanjani 新加坡Hafza Inshaar 美国Hakeem Yousef 美国Halah Ibrahim 阿拉伯联合酋长国Haley Bliss 美国Haley Kempf 美国Hanh Huynh 加拿大Hannah Calvelli 美国Hannah美国Hannah Calvelli 英国Hannah Oren 美国Hans Martin Bosse 德国Harsh Priya 印度Hassan Khan 英国Hazel Bending 英国Helen Cameron 英国Helen Church 英国Helen Kim 美国Helen Nolan 英国Helen Reid 美国英国Helen Wu 美国Helena Edwards 英国Henrietta Sabbagha 爱尔兰Henry Bair 美国Hima Veeramachaneni 美国Holly West 美国Holly Wobma 美国Honghe Li 中国Horace Hambrick 美国Hossam Hamdy 阿拉伯联合酋长国Huma美国Hussain Khawaja 美国Ian Couper 南非Ian Donmoyer 美国Ian Wilson 马来西亚Ido Zamberg 瑞士Idris Amin 美国Imogene Rothnie 澳大利亚Irene Alexandraki 美国Irina Kryzhanovskaya 美国Irma Elisa Eraña- Rojas 墨西哥Rojas 墨西哥Isabel Trapero 西班牙Isaura Macias 美国Isha Marina Di Bartolo 美国Isla Kuhn 英国Iya Whiteley 英国Izabel Rios 巴西J MacDougall 英国J.J. Pierce、美国 Jachin Velavan 印度 Jack Whiting 英国 Jacob Michie 加拿大 Jacob Pearce 澳大利亚 Jacqueline Driscoll 英国 Jacqueline Lee 加拿大 Jacqueline Ogilvie 加拿大 Jacqueline Roberge-Dao 加拿大 Jacqueline Wolvaardt 南非 Jade Lor- Chan 澳大利亚澳大利亚Jaeyun Yoo 加拿大Jaideep Talwalkar 美国James Brown 美国James Condren 爱尔兰James Hartley 英国James Naples 美国James Rathbone 英国James Townshend 澳大利亚James Wykowski 美国Jamiu Busari 荷兰Jamuna Vadivelu 马来西亚Jan Illing 爱尔兰Jan Kiesewetter 德国Jan Maurer 美国Jan Zottmann 德国Jan Anderson 美国Janet Lefroy 英国Janice Chung 美国Janice Shin- 金Kim 美国Janusz Janczukowicz 波兰Jared A.加拿大Jasmine Reese 美国Jasminka Criley 美国Jason Brown 美国Jay Bindman 美国Jay Bisen 美国Jean Setrakian 加拿大Jeanna Qiu 美国Jeannine Brant 美国Jeff Druck 美国Jeff Greenblatt 美国Jeffrey Jiang 新加坡Jeffrey La Rochelle 美国Jeffrey Wiseman 加拿大Jen Hartmark-希尔美国珍妮弗-罗杰斯美国珍妮弗-克鲁特美国珍妮弗-克劳利新西兰珍妮弗-希斯科特英国珍妮弗-霍尔茨美国珍妮弗-卡斯帕美国珍妮弗-凯瑟尔海姆美国珍妮弗-李美国珍妮弗-麦克布莱德美国珍妮弗-麦卡利斯特美国珍妮弗-佩雷斯美国珍妮弗-斯派塞美国珍妮弗-沃尔顿加拿大珍妮弗-韦勒新西兰珍妮弗-韦勒Newton 澳大利亚Jennifer Wilson 美国Jeremy Booth 英国Jeremy Richards 美国Jeremy Wang 新加坡Jessica Foulds 加拿大Jessica Hannick 美国Jessica Laird-加拿大Jessica Hannick 美国Jessica Laird- Gion 美国Jessica Strauss 美国Jia Liu 中国Jihyun Lee 大韩民国Jill Morrison 英国Jill Sangha 加拿大Joachim Kimmerle 德国Joanna Chan 美国Joanna Levene 英国Joanne Buckland 格林纳达Joanne Grimmer 加拿大Joaquim Vieira 巴西Jody Steinauer 美国Joe Blumer 美国Johan Francois Coetzee 南非Johanna Schönrock- Adema 荷兰John Dalrymerm Netherlands荷兰约翰-达尔林普尔美国约

{"title":"RGS Annual Reviewer List 2023","authors":"","doi":"10.1111/medu.15382","DOIUrl":"10.1111/medu.15382","url":null,"abstract":"Abdalazeem Ibrahem United KingdomAbdikarin Abdullahi United StatesAbeba Zewdu United StatesAbigail Luman United StatesAbigail Swerdlow United KingdomAbigail Wright Hong KongAbraham Cheloff United StatesAdam Garber CanadaAdam Levine United StatesAdam Sawatsky United StatesAdam Schaffer United StatesAdam Stevenson United StatesAdelaide McClintock United StatesAdin Nelson United StatesAdrian Sutton United KingdomAgathe Vrillon FranceAhmad Ramzi Yusof MalaysiaAiden Shapiro United StatesAimee Charnell United KingdomAisha Chachar PakistanAisling Keane United KingdomAkshara Sharma United KingdomAlan Bleakley United KingdomAlan Chiem United StatesAlanna Hare United KingdomAlev Atalay United StatesAlexa Lindley United StatesAlexis Peedin United StatesAlia Chisty United StatesAlicia Hurtado United StatesAliki Thomas CanadaAlisa Wray United StatesAlison Mostyn United KingdomAlison Sturrock United KingdomAllie Bradley New ZealandAllison Carroll United StatesAllison Davidson United StatesAllison Seitchik United StatesAllison Thomas United StatesAllison Tzeng United StatesAllison Yan United StatesAmanda Ivatorov United StatesAmanda Provencio United StatesAmaya Ellawala United KingdomAmber Pincavage United StatesAmin Feili The Islamic Republic of IranAmir Sam United KingdomAmrit Kirpalani CanadaAmy Blue United StatesAmy Caruso Brown United StatesAmy Hayton United StatesAmy Weinstein United StatesAna Da Silva United KingdomAna Marusic CroatiaAna Rancich ArgentinaAnders Chen United StatesAndrea Berry United StatesAndrea Ens CanadaAndrea Lörwald SwitzerlandAndrea Meisman United StatesAndrea Praschinger AustriaAndrew Auerbach United StatesAndrew Grant United KingdomAndrew Harris United StatesAndrew Luks United StatesAndrew Parsons United StatesAndrew Raikhel United StatesAndrew Yu United StatesAndy Wearn New ZealandAnél Wiese IrelandAngela Chang United StatesAnimesh Jain IndiaAnique Atherley NetherlandsAnita Kusnoor United StatesAnjum Jalal Pa","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":null,"pages":null},"PeriodicalIF":6.0,"publicationDate":"2024-03-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/medu.15382","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140306172","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

‘Walking together’: How relationships shape physicians' clinical reasoning 同行"：人际关系如何影响医生的临床推理。
IF 4.9 1区教育学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES
Medical Education
Pub Date : 2024-03-25 DOI: 10.1111/medu.15377

Jeffrey D. Krimmel-Morrison, Bjorn K. Watsjold, Gabrielle N. Berger, Judith L. Bowen, Jonathan S. Ilgen

Introduction

The clinical reasoning literature has increasingly considered context as an important influence on physicians' thinking. Physicians' relationships with patients, and their ongoing efforts to maintain these relationships, are important influences on how clinical reasoning is contextualised. The authors sought to understand how physicians' relationships with patients shaped their clinical reasoning.

Methods

Drawing from constructivist grounded theory, the authors conducted semi-structured interviews with primary care physicians. Participants were asked to reflect on recent challenging clinical experiences, and probing questions were used to explore how participants attended to or leveraged relationships in conjunction with their clinical reasoning. Using constant comparison, three investigators coded transcripts, organising the data into codes and conceptual categories. The research team drew from these codes and categories to develop theory about the phenomenon of interest.

Results

The authors interviewed 15 primary care physicians with a range of experience in practice and identified patient agency as a central influence on participants' clinical reasoning. Participants drew from and managed relationships with patients while attending to patients' agency in three ways. First, participants described how contextualised illness constructions enabled them to individualise their approaches to diagnosis and management. Second, participants managed tensions between enacting their typical approaches to clinical problems and adapting their approaches to foster ongoing relationships with patients. Finally, participants attended to relationships with patients' caregivers, seeing these individuals' contributions as important influences on how their clinical reasoning could be enacted within patients' unique social contexts.

Conclusion

Clinical reasoning is influenced in important ways by physicians' efforts to both draw from, and maintain, their relationships with patients and patients' caregivers. Such efforts create tensions between their professional standards of care and their orientations toward patient-centredness. These influences of relationships on physicians' clinical reasoning have important implications for training and clinical practice.

引言：临床推理文献越来越多地将情境视为影响医生思维的重要因素。医生与患者的关系以及他们为维持这种关系所做的不懈努力对临床推理的情境化具有重要影响。作者试图了解医生与患者的关系如何影响他们的临床推理：作者借鉴建构主义基础理论，对初级保健医生进行了半结构化访谈。访谈要求参与者对近期具有挑战性的临床经验进行反思，并使用探究性问题来探讨参与者如何在临床推理中关注或利用人际关系。三位研究人员采用不断比较的方法对记录誊本进行编码，将数据整理成代码和概念类别。研究小组从这些代码和类别中总结出有关现象的理论：作者采访了 15 名具有不同执业经验的初级保健医生，发现患者代理是影响参与者临床推理的核心因素。参与者以三种方式利用并处理与患者的关系，同时关注患者的代理权。首先，参与者描述了他们是如何根据疾病的具体情况构建个性化的诊断和管理方法的。其次，参与者处理了他们处理临床问题的典型方法与调整他们的方法以促进与患者的持续关系之间的紧张关系。最后，参与者关注与患者护理人员的关系，认为这些人的贡献对他们如何在患者独特的社会背景下进行临床推理具有重要影响：临床推理在很大程度上受到医生的影响，他们努力从与病人和病人护理者的关系中汲取养分并保持这种关系。这种努力在他们的专业护理标准和以患者为中心的取向之间造成了紧张关系。这些关系对医生临床推理的影响对培训和临床实践具有重要意义。

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引用次数: 0

‘Good’ evaluation: Methodological diversity may be empress, but sound methods remain queen 好 "评估：方法的多样性可能是女皇，但合理的方法仍然是女王
IF 6 1区教育学 Q1 Social Sciences
Medical Education
Pub Date : 2024-03-19 DOI: 10.1111/medu.15374

Betty Onyura

The appetite for evaluation of health professions education (HPE) programmes appears insatiable. Mandates to evaluate prevail and administrators persist in their quests for data to inform decision-making. Understandably, people want to know if their efforts ‘move the needle’ for today's learners and tomorrow's clinicians. Regulatory bodies want assurances that accreditation standards are met. And, communities deserve evidence-grounded accountability from those charged with training clinician workforces. Interestingly, however, the unabating appetite for evaluation exists in contrast to relatively modest scholarship or capacity-building on evaluation across HPE. Thus, it is encouraging to see contributions such as the one from Rees et al.¹ in this issue of Medical Education.
Rees et al.¹ present a comprehensive overview of the realist interview method. Following critical analysis of select realist evaluation studies, they outline best practice recommendations for applying realist interview techniques to realist evaluation. This work is timely, given the increasing popularity of realist evaluation across HPE, which may be a promising indicator of methodological expansion in the field's evaluation practices. Indeed, several scholars have critiqued the field's seeming preoccupation with simple outcome verification as the ‘go-to’ evaluation strategy.^2-6 Figuratively, the crux of this critique has been that when it comes to evaluation, HPE has focused on the trees—familiar, uniform trees—while neglecting the diversity of the forest. Indeed, I contend that embracing methodological diversity is the essence of ‘good’ evaluation. Not only does it enable the exploration of novel lines of inquiry, it also facilitates needed reflection on or redirection of how we are using evaluation to assign value (see Gates⁷). Conversely, asking similar questions of similar objects in routinised ways cannot satiate the appetite for new insights or innovative, evidence-informed, shifts away from a sub-optimal status quo across our academic healthcare systems.^8-10
As such, Rees et al.¹ present a strong value proposition for how realist evaluation expands possibilities for evaluative inquiry. Using examples, they illustrate the many avenues that emerge when a realist approach is used to explore how programme contexts may variably trigger change mechanisms and influence differences in outcomes. However, championing the merits of methodological diversity in evaluation is incidental to their aims. Rather, their core argument is best summarised as follows: The uptake of contemporary evaluation methodologies is of limited value if it is not accompanied by proper implementation of associated methods. Simply put, evaluators must adopt sound methods with fidelity to their espoused methodologies.
Additional points s

对卫生专业教育（HPE）课程进行评估的欲望似乎无法满足。评估任务盛行，管理者坚持不懈地寻求数据，为决策提供依据。可以理解的是，人们想知道他们的努力是否 "推动 "了今天的学习者和明天的临床医生。监管机构希望确保达到认证标准。同时，社会各界也希望负责培训临床医生队伍的人员能够承担有据可依的责任。然而，有趣的是，对评估的需求有增无减，与之形成鲜明对比的是，在整个高等教育中，有关评估的学术研究或能力建设却相对较少。因此，在本期《医学教育》杂志上看到 Rees 等人1 的文章令人鼓舞。Rees 等人1 全面概述了现实主义访谈法。在对部分现实主义评价研究进行批判性分析之后，他们概述了将现实主义访谈技术应用于现实主义评价的最佳实践建议。这项工作非常及时，因为现实主义评价在整个 HPE 中越来越受欢迎，这可能是该领域评价实践方法扩展的一个有希望的指标。事实上，一些学者已经批评了该领域似乎专注于将简单的结果验证作为 "常用的 "评价策略2-6。形象地说，这种批评的核心是，当涉及到评价时，HPE 只关注树木--熟悉的、千篇一律的树木--而忽视了森林的多样性。事实上，我认为方法的多样性是 "好 "评估的精髓。它不仅有助于探索新的研究方向，还有助于对我们如何利用评价来分配价值进行必要的反思或重新定位（见 Gates7）。反之，以常规的方式对类似的对象提出类似的问题，并不能满足我们对新见解的渴望，也不能满足我们对创新的渴望，更不能满足我们的学术医疗保健系统对次优现状的改变8-10。8-10 拥抱方法的多样性是 "好 "评价的精髓，它不仅能够探索新的研究方向，还能促进我们对如何使用评价来分配价值进行必要的反思或重新定向。因此，Rees 等人1 提出了一个强有力的价值主张，即现实主义评价如何扩展评价研究的可能性。他们举例说明了在使用现实主义方法探索计划背景如何以不同方式引发变革机制并影响结果差异时出现的许多途径。然而，倡导评估方法多样性的优点只是他们的附带目的。相反，他们的核心论点最好概括如下：如果不适当地实施相关的方法，采用当代评估方法的价值是有限的。简而言之，评估人员必须采用可靠的方法，忠实于他们所信奉的方法。尽管访谈是一种常见的数据收集方法，但在不同的研究传统和评估方法中，访谈技术都有其独特的特点。例如，Rees 等人1 解释了现实主义访谈与某些定性传统中的访谈有何不同，后者的重点是激发参与者对特定主题的体验。尽管访谈是一种常见的数据收集方法，但在不同的研究传统和评估方法中，访谈技术都有其独特之处。其二，现实主义访谈需要平衡教师与学习者之间的紧张关系，以服务于可信的理论建设。Rees 等人1 将 "教师-学习者循环 "描述为现实主义访谈的核心原则。现实主义访谈者必须同时掌握有关干预措施和理论联系的知识，这些知识可以解释干预措施的运作。访谈者必须与受访者分享其中的一些见解，同时保持必要的灵活性和谦逊，以便根据受访者的经验知识对其假设提出质疑并完善理论。Rees 等人1 认为，只要有迹象表明，一项计划对不同的利益相关者群体或在不同的环境下可能发挥不同的作用，那么现实主义访谈者就必须确保参与者的多样性，这一点尤为重要。乍一看，这一指导似乎很有道理。

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引用次数: 0

When I say … active learning 当我说......主动学习
IF 4.9 1区教育学 Q1 EDUCATION, SCIENTIFIC DISCIPLINES
Medical Education
Pub Date : 2024-03-19 DOI: 10.1111/medu.15383

Adam G. Gavarkovs, Emer Finan, Rune Dall Jensen, Ryan Brydges

Medical educators strive to offer their learners educational experiences that engage them effectively and efficiently. Educators commonly use the term ‘active learning’ to describe those experiences. One of the most cited articles on active learning in medical education defines it as ‘anything that involves students in doing things and thinking about the things they are doing’ by ensuring engagement, observation and reflection.¹ Debates about the best definition aside, we have noticed that the term has variably been used in the literature to describe a property of instruction (e.g. problem-based learning) or a process in which learners engage (e.g. selecting, organising and integrating presented information). Though this difference may appear subtle, we believe it has implications for how medical educators design effective instruction. In this When I Say … article, we offer some suggestions regarding how medical educators and researchers might use the term moving forward.
Designs that promote active learning (e.g. breakout groups) can certainly be built into instruction, but their presence does not guarantee that the desired learning processes will take place. Learners vary in their response to instructional stimuli, even those with well-designed supports for ‘active learning’. Some learners may engage in the motivational, behavioural, cognitive and/or social processes prompted by instruction while others may be unaffected, or affected in unexpected ways.
When researchers and educators define active learning as a property of instruction, they may conclude that active learning has been achieved when their instructional design appears to be successfully implemented. We worry that this instruction-centred conceptualization of active learning conceals the gap between the instruction that learners receive (which may prompt active learning strategies) and the motivational, behavioural, cognitive and/or social processes they actually engage in. Not all learners will traverse this gap.² An instruction-centred focus may render the specific needs of these learners invisible and, as a consequence, their achievement may suffer.
Conversely, when researchers and educators define active learning as learner-centred, they do not assume that it has been achieved through their instructional designs. Accordingly, researchers and educators may be more likely to consider the heterogeneous responses that learners have to the same instructional designs, and how to help learners who do not engage with supports as intended. This learner-centred perspective views active learning as a dynamic process within a given instructional situation, not as a fixed characteristic of instruction. For example, it may be that learners completing an e-learning module vary in their response to a prompt to connect their short-term goal-setting to their longer-term aspirations.³ It coul

医学教育工作者努力为学习者提供有效、高效的教育体验。教育者通常使用 "主动学习 "一词来描述这些体验。关于医学教育中的主动学习，一篇被引用最多的文章将其定义为 "通过确保参与、观察和反思，让学生参与做事并思考他们正在做的事情的任何事情"。1 除了关于最佳定义的争论之外，我们注意到该术语在文献中被不同地用于描述教学的一种特性（如基于问题的学习）或学习者参与的一个过程（如选择、组织和整合呈现的信息）。虽然这种区别看似微妙，但我们认为它对医学教育者如何设计有效的教学具有影响。在这篇 "当我说......时 "的文章中，我们将就医学教育者和研究人员今后如何使用这一术语提出一些建议。

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