Introduction: Recruiting and training a diverse pool of physicians from historically excluded groups is vital to solving complex scientific problems and increasing access to patient care. Disparate educational and health outcomes of COVID-19 amplified this need. In stratified higher education systems, underfunded institutions that serve greater numbers of underrepresented in medicine (URM) students face unique barriers to entering physician training. However, pathways from historically underfunded minority-serving institutions (MSIs) in the United States to medical school (MD) are not well understood.
Method: A hierarchical logistic regression analysis of 328 488 de-identified applicants to US MD-granting medical schools for academic years 2017-2018 through 2022-2023 was used to determine predictors of acceptance based on MSI attendance compared to predominantly White institutions (PWI) and other literature-informed predictors. An interrupted time series analysis determined the significance in changes in observed differences in application acceptance before and after the COVID-19 pandemic.
Results: In model 1, MSI attendance was associated with significantly lower odds of acceptance, with a 42% to 52% chance of acceptance compared to PWI applicants. Adding MCAT and GPA significantly increased odds of acceptance for most MSI applicants in model 2. MSI attendance, MCAT, GPA and socio-economic status indicators were useful predictors, improving the acceptance model by 39% better than the null model. Although some predictors showed a change in odds over time, none changed significantly when comparing before and after COVID-19.
Discussion: MSI attending students were less likely to be admitted to MD programmes, highlighting systemic stratification until other academic factors were introduced to the model that alleviated lower odds, and the COVID-19 pandemic did not substantially change these trends. Improved pathways and strengthened institutional relationships between institutions that have greater proportions of underrepresented students and medical schools may help improve MSI applicant odds furthering diversity within the physician-trained workforce.
{"title":"Exploring institutional stratification: Minority-serving institutional pathways to medical school acceptance in the United States.","authors":"Amanda K Burbage, Eushekia Y Hewitt","doi":"10.1111/medu.15539","DOIUrl":"https://doi.org/10.1111/medu.15539","url":null,"abstract":"<p><strong>Introduction: </strong>Recruiting and training a diverse pool of physicians from historically excluded groups is vital to solving complex scientific problems and increasing access to patient care. Disparate educational and health outcomes of COVID-19 amplified this need. In stratified higher education systems, underfunded institutions that serve greater numbers of underrepresented in medicine (URM) students face unique barriers to entering physician training. However, pathways from historically underfunded minority-serving institutions (MSIs) in the United States to medical school (MD) are not well understood.</p><p><strong>Method: </strong>A hierarchical logistic regression analysis of 328 488 de-identified applicants to US MD-granting medical schools for academic years 2017-2018 through 2022-2023 was used to determine predictors of acceptance based on MSI attendance compared to predominantly White institutions (PWI) and other literature-informed predictors. An interrupted time series analysis determined the significance in changes in observed differences in application acceptance before and after the COVID-19 pandemic.</p><p><strong>Results: </strong>In model 1, MSI attendance was associated with significantly lower odds of acceptance, with a 42% to 52% chance of acceptance compared to PWI applicants. Adding MCAT and GPA significantly increased odds of acceptance for most MSI applicants in model 2. MSI attendance, MCAT, GPA and socio-economic status indicators were useful predictors, improving the acceptance model by 39% better than the null model. Although some predictors showed a change in odds over time, none changed significantly when comparing before and after COVID-19.</p><p><strong>Discussion: </strong>MSI attending students were less likely to be admitted to MD programmes, highlighting systemic stratification until other academic factors were introduced to the model that alleviated lower odds, and the COVID-19 pandemic did not substantially change these trends. Improved pathways and strengthened institutional relationships between institutions that have greater proportions of underrepresented students and medical schools may help improve MSI applicant odds furthering diversity within the physician-trained workforce.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142290784","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>In an era where misinformation proliferates and public trust in science is crucial, medical professionals must possess the ability to communicate complex medical information accurately and empathetically to patients, colleagues and the broader community in an understandable manner. Therefore, it is essential for medical students to gain competencies in science communication.<span><sup>1</sup></span> However, how could we enable students to engage in comprehensive dialogue with society? A promising approach could be a student-moderated live podcast.</p><p>In the project ‘YOU ASK we explain’, monthly live podcasts were produced in public locations within the heart of communities, fostering citizen discussions on sensitive medical topics. The recordings took place at locations related to the topics. If we talked about euthanasia, the podcast took place in a cemetery, if we talked about alcohol abuse, we went to a beer garden and if we talked about eating disorders, we went to a farm store. The medical students played a critical role as moderators and link between experts and community. Students developed a moderation guide and got communication training (2 times 2 hours) before the recording. Afterwards the students got oral feedback to their performance from the organisers. For each podcast, we invited an interprofessional discussion panel, consisted of a medical student as moderator, and three experts from different fields (i.e. physicians, pastors, computer scientists and social workers). The audience had the opportunity to ask questions anonymously by cards at any time. The technical support recorded and edited the podcasts and offered them at common podcast platforms. After podcast release, an evaluation of the student moderators showed the skills acquired. Topics of professional, science and rhetorical competencies as well as feedback were assessed on a 5-point Likert scale.</p><p>Since January 2023, we produced 15 episodes, which overall had about 550 visitors and 3000 listeners. Interestingly, more female (68% versus 51%) and older (13% versus 4% over 60 years) visitors attended the life events in relation to podcast listeners.</p><p>The moderating students were very engaged in the medical school and felt comfortable to give lectures in front of other people. However, the evaluation showed that they improved their skills for future presentations and moderations through the podcast and would like to see the format repeated. The students took about 3 hours for content preparation, to be able to answer any questions at any time, although they were only moderators. They assessed their skills in scientific work as strong, but encountered challenges in introducing controversies into discussions and supporting statements with scientific sources.</p><p>The podcast addressed various learning objectives such as medical-scientific skills, communication skills and health counselling. Students improved their scientific skills and, in addition, gained
{"title":"Medical students experience science communication via moderating podcasts","authors":"Doreen Pretze, Stephan Wiegand","doi":"10.1111/medu.15505","DOIUrl":"10.1111/medu.15505","url":null,"abstract":"<p>In an era where misinformation proliferates and public trust in science is crucial, medical professionals must possess the ability to communicate complex medical information accurately and empathetically to patients, colleagues and the broader community in an understandable manner. Therefore, it is essential for medical students to gain competencies in science communication.<span><sup>1</sup></span> However, how could we enable students to engage in comprehensive dialogue with society? A promising approach could be a student-moderated live podcast.</p><p>In the project ‘YOU ASK we explain’, monthly live podcasts were produced in public locations within the heart of communities, fostering citizen discussions on sensitive medical topics. The recordings took place at locations related to the topics. If we talked about euthanasia, the podcast took place in a cemetery, if we talked about alcohol abuse, we went to a beer garden and if we talked about eating disorders, we went to a farm store. The medical students played a critical role as moderators and link between experts and community. Students developed a moderation guide and got communication training (2 times 2 hours) before the recording. Afterwards the students got oral feedback to their performance from the organisers. For each podcast, we invited an interprofessional discussion panel, consisted of a medical student as moderator, and three experts from different fields (i.e. physicians, pastors, computer scientists and social workers). The audience had the opportunity to ask questions anonymously by cards at any time. The technical support recorded and edited the podcasts and offered them at common podcast platforms. After podcast release, an evaluation of the student moderators showed the skills acquired. Topics of professional, science and rhetorical competencies as well as feedback were assessed on a 5-point Likert scale.</p><p>Since January 2023, we produced 15 episodes, which overall had about 550 visitors and 3000 listeners. Interestingly, more female (68% versus 51%) and older (13% versus 4% over 60 years) visitors attended the life events in relation to podcast listeners.</p><p>The moderating students were very engaged in the medical school and felt comfortable to give lectures in front of other people. However, the evaluation showed that they improved their skills for future presentations and moderations through the podcast and would like to see the format repeated. The students took about 3 hours for content preparation, to be able to answer any questions at any time, although they were only moderators. They assessed their skills in scientific work as strong, but encountered challenges in introducing controversies into discussions and supporting statements with scientific sources.</p><p>The podcast addressed various learning objectives such as medical-scientific skills, communication skills and health counselling. Students improved their scientific skills and, in addition, gained ","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"58 11","pages":"1406-1407"},"PeriodicalIF":4.9,"publicationDate":"2024-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/medu.15505","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142290786","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}
November brings the latest installment of invaluable lessons learned through innovative developments in health professional education in the form of the next installment of Really Good Stuff.
十一月的下一期 "真正的好东西"（Really Good Stuff）将为您带来最新一期健康专业教育创新发展的宝贵经验。
{"title":"Table of Contents November 2024 RGS","authors":"","doi":"10.1111/medu.15548","DOIUrl":"10.1111/medu.15548","url":null,"abstract":"<p>November brings the latest installment of invaluable lessons learned through innovative developments in health professional education in the form of the next installment of Really Good Stuff.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"58 11","pages":"1369"},"PeriodicalIF":4.9,"publicationDate":"2024-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142290787","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}
Casey N. McQuade, Thilan P. Wijesekera, David Chartash
{"title":"Dispelling the magic of artificial intelligence in medical education","authors":"Casey N. McQuade, Thilan P. Wijesekera, David Chartash","doi":"10.1111/medu.15536","DOIUrl":"10.1111/medu.15536","url":null,"abstract":"","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"59 3","pages":"350-351"},"PeriodicalIF":4.9,"publicationDate":"2024-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142290783","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>In 2022, we launched a ground-breaking Mini Medical School Program tailored for fourth and fifth graders in North Chicago, Illinois. This initiative aimed to tackle the issue of underrepresentation of historically marginalised groups in medicine, particularly among Black and Latinx students, and address health disparities. Data from the AAMC website reveal alarming statistics, with only 6.3% of active physicians being Latino/Latina and a mere 5.2% being Black or African American.<span><sup>1</sup></span></p><p>The primary objective of our programme was to ignite interest and provide exposure to the medical field at a young age to underrepresented populations. We achieved this through an engaging and age-appropriate curriculum designed to introduce students to medicine in a fun and interactive manner, thus fostering a supportive learning environment. By offering initiatives like ours, we aspire to contribute to an increase in the representation of underrepresented groups in medicine.</p><p>To fulfil its primary objective, Mini-Medical School (MMS) adopted a community-based approach by partnering with the programme's MMS Student Executive Board, North Chicago Community Partners (NCCP), and received funding from the Creating Pathways and Access for Student Success (CPASS) Foundation. Through this collaboration, an age-appropriate curriculum was delivered virtually to 25 fourth- and fifth-grade students from AJ Katzenmaier Academy. The MMS Student Executive Board is composed of first- and second-year Underrepresented Minorities in Medicine students from Chicago Medical School.</p><p>Throughout the programme, students participated in an opening White Coat Ceremony and received instruction on topics including the cardiovascular system, gastrointestinal system, and neurology/mental health, culminating in a graduation ceremony. Additionally, monthly Zoom calls were organised between the Student Executive Board and students' parents to provide guidance on facilitating continued learning at home.</p><p>The 2 hour classes followed a structured format: a pretest to assess student baselines, a lecture and smaller breakout sessions led by medical student volunteers serving as teaching assistants (TAs). These interactive sessions reinforced lecture concepts. At the conclusion of each lesson, a post-test was administered, and students shared their favourite part of the day and discussed topics they found interesting.</p><p>Numerous valuable insights were gleaned from the MMS experience, informing our approach for future programme iterations. Notably, among the participating 4th-grade students, there was a preference for the Neurology/Mental Health component of the curriculum, as well as a strong affinity for cardiopulmonary resuscitation (CPR) as their favourite activity during the course.</p><p>Furthermore, as part of the feedback collection process, an end-of-year focus group study was conducted, in which the MMS students were interviewed regarding their pr
{"title":"Community-based initiative: Engaging youth in medical education","authors":"Juan Medina-Echeverria, Daniel H. Sanchez","doi":"10.1111/medu.15507","DOIUrl":"10.1111/medu.15507","url":null,"abstract":"<p>In 2022, we launched a ground-breaking Mini Medical School Program tailored for fourth and fifth graders in North Chicago, Illinois. This initiative aimed to tackle the issue of underrepresentation of historically marginalised groups in medicine, particularly among Black and Latinx students, and address health disparities. Data from the AAMC website reveal alarming statistics, with only 6.3% of active physicians being Latino/Latina and a mere 5.2% being Black or African American.<span><sup>1</sup></span></p><p>The primary objective of our programme was to ignite interest and provide exposure to the medical field at a young age to underrepresented populations. We achieved this through an engaging and age-appropriate curriculum designed to introduce students to medicine in a fun and interactive manner, thus fostering a supportive learning environment. By offering initiatives like ours, we aspire to contribute to an increase in the representation of underrepresented groups in medicine.</p><p>To fulfil its primary objective, Mini-Medical School (MMS) adopted a community-based approach by partnering with the programme's MMS Student Executive Board, North Chicago Community Partners (NCCP), and received funding from the Creating Pathways and Access for Student Success (CPASS) Foundation. Through this collaboration, an age-appropriate curriculum was delivered virtually to 25 fourth- and fifth-grade students from AJ Katzenmaier Academy. The MMS Student Executive Board is composed of first- and second-year Underrepresented Minorities in Medicine students from Chicago Medical School.</p><p>Throughout the programme, students participated in an opening White Coat Ceremony and received instruction on topics including the cardiovascular system, gastrointestinal system, and neurology/mental health, culminating in a graduation ceremony. Additionally, monthly Zoom calls were organised between the Student Executive Board and students' parents to provide guidance on facilitating continued learning at home.</p><p>The 2 hour classes followed a structured format: a pretest to assess student baselines, a lecture and smaller breakout sessions led by medical student volunteers serving as teaching assistants (TAs). These interactive sessions reinforced lecture concepts. At the conclusion of each lesson, a post-test was administered, and students shared their favourite part of the day and discussed topics they found interesting.</p><p>Numerous valuable insights were gleaned from the MMS experience, informing our approach for future programme iterations. Notably, among the participating 4th-grade students, there was a preference for the Neurology/Mental Health component of the curriculum, as well as a strong affinity for cardiopulmonary resuscitation (CPR) as their favourite activity during the course.</p><p>Furthermore, as part of the feedback collection process, an end-of-year focus group study was conducted, in which the MMS students were interviewed regarding their pr","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"58 11","pages":"1399-1400"},"PeriodicalIF":4.9,"publicationDate":"2024-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/medu.15507","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142266683","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}
Medical training refers frequently to sex and gender, yet these terms are often used vaguely and interchangeably with little critical engagement. We aimed to better understand the key discourses around sex and gender in medical training.
Methods
All verbal and written instances of gendered/sexed language, occurring in lectures, slides and provided written materials, within 1 year of preclerkship medical education at a single institution in Canada were recorded autoethnographically by a medical student. We analysed these instances using critical discourse analysis informed by anticolonial, feminist and queer theoretical perspectives, particularly contrasting the concepts of governmentality and ungovernability to better understand how sex and gender are deployed in medical training.
Results
Despite the proliferation of ostensibly queer- and trans-positive content in medical curricula, sex and gender were frequently communicated inconsistently and imprecisely. In addition to, and perhaps as a result of, this inconsistent use, we uncovered three key discourses of (1) gender policing, (2) misogyny and (3) gender legibility. Collectively, these discourses can illustrate how medical education governs and reinforces gender norms.
Discussion
The repetitive and everyday use of ill-defined and uncritical gendered and sexed language can be seen to discursively uphold systems of cisheteropatriarchy and transphobia within medicine. Trans and intersex bodies cannot be considered addendums to be tacked on to a foundation of cisnormative and inaccurate teaching in medical education. Institutional attempts to improve curricula must go beyond the addition of new modules, which can be undermined by otherwise cisheteropatriarchal understandings of sex and gender.
{"title":"Beyond inclusion politics: A critical discourse analysis of sex and gender in medical education","authors":"Navin Kariyawasam, Nanky Rai, Malika Sharma","doi":"10.1111/medu.15532","DOIUrl":"10.1111/medu.15532","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Medical training refers frequently to sex and gender, yet these terms are often used vaguely and interchangeably with little critical engagement. We aimed to better understand the key discourses around sex and gender in medical training.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>All verbal and written instances of gendered/sexed language, occurring in lectures, slides and provided written materials, within 1 year of preclerkship medical education at a single institution in Canada were recorded autoethnographically by a medical student. We analysed these instances using critical discourse analysis informed by anticolonial, feminist and queer theoretical perspectives, particularly contrasting the concepts of governmentality and ungovernability to better understand how sex and gender are deployed in medical training.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Despite the proliferation of ostensibly queer- and trans-positive content in medical curricula, sex and gender were frequently communicated inconsistently and imprecisely. In addition to, and perhaps as a result of, this inconsistent use, we uncovered three key discourses of (1) gender policing, (2) misogyny and (3) gender legibility. Collectively, these discourses can illustrate how medical education governs and reinforces gender norms.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>The repetitive and everyday use of ill-defined and uncritical gendered and sexed language can be seen to discursively uphold systems of cisheteropatriarchy and transphobia within medicine. Trans and intersex bodies cannot be considered addendums to be tacked on to a foundation of cisnormative and inaccurate teaching in medical education. Institutional attempts to improve curricula must go beyond the addition of new modules, which can be undermined by otherwise cisheteropatriarchal understandings of sex and gender.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"59 3","pages":"302-308"},"PeriodicalIF":4.9,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/medu.15532","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142266423","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}
Hannah L Kakara Anderson, Marjan Govaerts, Layla Abdulla, Dorene F Balmer, Jamiu O Busari, Daniel C West
Context: Despite increasing discussion and scholarship, equity in assessment is rarely defined and distinguished in a way that allows for shared understanding in medical education. This paper seeks to clarify and expand the conversation about equity in assessment by critically reviewing three distinct and evolving orientations toward equity in assessment. Orientations refers to the positions, attitudes, interests or priorities individuals can hold toward equity in assessment. The three orientations include fairness-oriented assessment, assessment for inclusion and justice-oriented assessment. While fairness-oriented assessment is a prevailing orientation in medical education, assessment for inclusion and justice-oriented assessment, originally developed in other fields of education, deserve careful consideration.
Methods: In this paper, the authors explore unique underpinning assumptions of each orientation by critically examining the foundational literature of each orientation. They reflect on the unique perspectives each orientation provides, including the actions one might take and what advantages and disadvantages might result from looking at equity in assessment from any one orientation.
Conclusions: Informed by this reflection, the authors propose that to more effectively advance equity in assessment in medical education, those working in the field should clearly identify their respective orientations, intentionally choose methods, tools and measures aligned with their orientations and expand their work by exploring alternative orientations.
{"title":"Clarifying and expanding equity in assessment by considering three orientations: Fairness, inclusion and justice.","authors":"Hannah L Kakara Anderson, Marjan Govaerts, Layla Abdulla, Dorene F Balmer, Jamiu O Busari, Daniel C West","doi":"10.1111/medu.15534","DOIUrl":"https://doi.org/10.1111/medu.15534","url":null,"abstract":"<p><strong>Context: </strong>Despite increasing discussion and scholarship, equity in assessment is rarely defined and distinguished in a way that allows for shared understanding in medical education. This paper seeks to clarify and expand the conversation about equity in assessment by critically reviewing three distinct and evolving orientations toward equity in assessment. Orientations refers to the positions, attitudes, interests or priorities individuals can hold toward equity in assessment. The three orientations include fairness-oriented assessment, assessment for inclusion and justice-oriented assessment. While fairness-oriented assessment is a prevailing orientation in medical education, assessment for inclusion and justice-oriented assessment, originally developed in other fields of education, deserve careful consideration.</p><p><strong>Methods: </strong>In this paper, the authors explore unique underpinning assumptions of each orientation by critically examining the foundational literature of each orientation. They reflect on the unique perspectives each orientation provides, including the actions one might take and what advantages and disadvantages might result from looking at equity in assessment from any one orientation.</p><p><strong>Conclusions: </strong>Informed by this reflection, the authors propose that to more effectively advance equity in assessment in medical education, those working in the field should clearly identify their respective orientations, intentionally choose methods, tools and measures aligned with their orientations and expand their work by exploring alternative orientations.</p>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":" ","pages":""},"PeriodicalIF":4.9,"publicationDate":"2024-09-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142290782","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}
Megan E. Kruskie, Richard M. Frankel, J. Harry Isaacson, Neil Mehta, Jessica N. Byram
Introduction
Imposter phenomenon (IP), feeling as if a person does not belong, has been reported in medical students at various rates. In medical literature, this phenomenon has often been defined as a ‘syndrome’, but other studies have described it as a dynamic experience that can have various impacts on different people at different time points. Although studies have linked IP with other phenomena such as burnout in residents and physicians, no studies have examined its aetiology nor how these feelings are experienced by medical students.
Methods
With the use of social identity theory as a framework, the authors analysed 233 reflective essays for elements of IP across eight cohorts of medical students from two institutions. Students responded to a prompt that asked: ‘What was one part of your identity that you thought you would have to change in order to become a physician?’ Included reflections were analysed using the framework method.
Results
Elements of IP were identified in 121 reflections (52%) and were categorised into three major themes: (1) Comparing oneself to an idealised image of a medical student, (2) Comparing oneself to an idealised image of a physician and (3) Concerns about presentation of self to others. Each theme contained two or more sub-themes. Commonly, students discussed how their own personality traits, experiences, backgrounds and identities cast doubt on their sense of belonging in medicine.
Discussion
The results of this study were consistent across both institutions, suggesting that imposter feelings are common among all first-year medical students. However, the extent of the impact of these feelings on their identity formation depends on the individual lived experiences of students and the context in which these feelings arise. Encouraging reflective journaling and sharing of stories from all stages of education can normalise imposter feelings during the development of the professional identity as a physician.
简介冒名顶替现象（Imposter phenomenon，IP），即感觉自己不属于某个人，在医科学生中出现的比例不一。在医学文献中，这种现象通常被定义为一种 "综合征"，但也有研究将其描述为一种动态体验，在不同的时间点会对不同的人产生不同的影响。虽然有研究将 IP 与其他现象（如住院医师和内科医生的职业倦怠）联系起来，但还没有研究探讨过 IP 的病因，也没有研究探讨过医学生是如何体验到这些感受的：方法：作者以社会认同理论为框架，分析了两所院校八届医学生的 233 篇反思性论文，从中找出了 IP 的要素。学生们回答了这样一个问题："为了成为一名医生，你认为必须改变自己身份的哪一部分？在 121 份反思（52%）中发现了 IP 要素，并将其归类为三大主题：(1) 将自己与理想化的医科学生形象相比较；(2) 将自己与理想化的医生形象相比较；(3) 关注向他人展示自己。每个主题都包含两个或多个次主题。学生们普遍讨论了自己的个性特征、经历、背景和身份如何使他们对医学的归属感产生怀疑：本研究的结果在两所院校中都是一致的，表明冒名顶替的情绪在所有一年级医学生中都很普遍。然而，这些感觉对其身份形成的影响程度取决于学生的个人生活经历以及产生这些感觉的背景。鼓励学生写反思日记和分享各个教育阶段的故事，可以在培养医生职业认同感的过程中将 "冒名顶替 "情绪正常化。
{"title":"Investigating feelings of imposterism in first-year medical student narratives","authors":"Megan E. Kruskie, Richard M. Frankel, J. Harry Isaacson, Neil Mehta, Jessica N. Byram","doi":"10.1111/medu.15533","DOIUrl":"10.1111/medu.15533","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>Imposter phenomenon (IP), feeling as if a person does not belong, has been reported in medical students at various rates. In medical literature, this phenomenon has often been defined as a ‘syndrome’, but other studies have described it as a dynamic experience that can have various impacts on different people at different time points. Although studies have linked IP with other phenomena such as burnout in residents and physicians, no studies have examined its aetiology nor how these feelings are experienced by medical students.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>With the use of social identity theory as a framework, the authors analysed 233 reflective essays for elements of IP across eight cohorts of medical students from two institutions. Students responded to a prompt that asked: ‘What was one part of your identity that you thought you would have to change in order to become a physician?’ Included reflections were analysed using the framework method.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Elements of IP were identified in 121 reflections (52%) and were categorised into three major themes: (1) Comparing oneself to an idealised image of a medical student, (2) Comparing oneself to an idealised image of a physician and (3) Concerns about presentation of self to others. Each theme contained two or more sub-themes. Commonly, students discussed how their own personality traits, experiences, backgrounds and identities cast doubt on their sense of belonging in medicine.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>The results of this study were consistent across both institutions, suggesting that imposter feelings are common among all first-year medical students. However, the extent of the impact of these feelings on their identity formation depends on the individual lived experiences of students and the context in which these feelings arise. Encouraging reflective journaling and sharing of stories from all stages of education can normalise imposter feelings during the development of the professional identity as a physician.</p>\u0000 </section>\u0000 </div>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"59 3","pages":"318-327"},"PeriodicalIF":4.9,"publicationDate":"2024-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/medu.15533","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142290785","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}
Helen R. Church, Megan E. L. Brown, Lynelle Govender, Deborah Clark
<div> <section> <h3> Introduction</h3> <p>The shortage of educators within Health Professions Education (HPE) threatens the optimal training of the future health care workforce. Furthermore, without recruitment of diverse and skilled faculty, targets to expand the workforce will not be possible. Non-practising health care professionals offer extensive knowledge and qualifications within health care, without the competing clinical commitments of their clinical academic colleagues, and therefore are ideally positioned to support education and training initiatives. However, the limited available evidence suggests that these individuals face significant challenges transitioning from clinical to academic roles. The purpose of this scoping review is to address the research question ‘What is known about the career experiences of non-practicing healthcare professionals (defined as individuals with clinical backgrounds who no longer engage in direct patient care) across various professions and internationally, within the field of health professions education?’. To do so, we aim to map the global experiences of non-practising health care professionals from different specialties and disciplines transitioning to HPE, with a view to both current support strategies that aim to recruit and retain these individuals and fuel future research in this area.</p> </section> <section> <h3> Methods</h3> <p>Following Arksey and O'Malley's scoping review guidelines, a research question was formulated focussing on exploring the career experiences of non-practising health care professionals now working in HPE. Searching seven literature databases and grey literature identified 51 articles for analysis. Both quantitative and qualitative methods were utilised to chart and thematically analyse data to identify key themes.</p> </section> <section> <h3> Results</h3> <p>There has been a rise in publications on this topic, with most studies originating from the United States and focusing on nursing. Transition to academia is marked by significant challenges, including identity shifts, renumeration and professional progression tensions, licencing issues and financial concerns. Support systems are crucial to navigating new roles alongside personal/professional development but often lacking.</p> </section> <section> <h3> Discussion</h3> <p>This scoping review highlights challenges and opportunities for non-practising health care professionals in HPE. Additional support for making the transition to education, including structured onboarding processes and long-term mentoring relationship
{"title":"Beyond the bedside: A scoping review of the experiences of non-practising health care professionals in Health Professions Education","authors":"Helen R. Church, Megan E. L. Brown, Lynelle Govender, Deborah Clark","doi":"10.1111/medu.15529","DOIUrl":"10.1111/medu.15529","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Introduction</h3>\u0000 \u0000 <p>The shortage of educators within Health Professions Education (HPE) threatens the optimal training of the future health care workforce. Furthermore, without recruitment of diverse and skilled faculty, targets to expand the workforce will not be possible. Non-practising health care professionals offer extensive knowledge and qualifications within health care, without the competing clinical commitments of their clinical academic colleagues, and therefore are ideally positioned to support education and training initiatives. However, the limited available evidence suggests that these individuals face significant challenges transitioning from clinical to academic roles. The purpose of this scoping review is to address the research question ‘What is known about the career experiences of non-practicing healthcare professionals (defined as individuals with clinical backgrounds who no longer engage in direct patient care) across various professions and internationally, within the field of health professions education?’. To do so, we aim to map the global experiences of non-practising health care professionals from different specialties and disciplines transitioning to HPE, with a view to both current support strategies that aim to recruit and retain these individuals and fuel future research in this area.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>Following Arksey and O'Malley's scoping review guidelines, a research question was formulated focussing on exploring the career experiences of non-practising health care professionals now working in HPE. Searching seven literature databases and grey literature identified 51 articles for analysis. Both quantitative and qualitative methods were utilised to chart and thematically analyse data to identify key themes.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>There has been a rise in publications on this topic, with most studies originating from the United States and focusing on nursing. Transition to academia is marked by significant challenges, including identity shifts, renumeration and professional progression tensions, licencing issues and financial concerns. Support systems are crucial to navigating new roles alongside personal/professional development but often lacking.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Discussion</h3>\u0000 \u0000 <p>This scoping review highlights challenges and opportunities for non-practising health care professionals in HPE. Additional support for making the transition to education, including structured onboarding processes and long-term mentoring relationship","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"59 3","pages":"272-291"},"PeriodicalIF":4.9,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/medu.15529","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142266424","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}
<p>‘Where is it indexed?’ or ‘what's its impact factor?’ have been, for decades, typical questions researchers ask themselves when choosing a journal to disseminate their work. In the last few years, new questions have popped up: ‘is it open access?’, ‘is it compliant with my institution's mandates?’, ‘does it charge an APC (article processing charge)?’. Worryingly, a follow-up question is, all too often, ‘can I afford it?’.</p><p>We were reminded of these dilemmas by a recent <i>Medical Education</i> article, where Han and Kumwenda highlight, but also question, the claim that online education has been ‘touted for promoting equity and inclusivity’.<span><sup>1</sup></span> The authors acknowledge notable progress and efforts in providing open and equitable access to medical education globally, but they also highlight concerns about its potential to perpetuate—and even exacerbate—inequalities between well-resourced, or Global North, and under-resourced, or Global South regions. An analogous argument can be made when it comes to discussing access to scholarly articles.</p><p>The belief that removing—or better yet, not even building—the subscription paywalls that block access to scientific articles would make knowledge globally available was one of the starting points of the open access movement more than two decades ago.<span><sup>2</sup></span> While it certainly remains a necessary condition for the democratisation of knowledge, this seems like an overly optimistic simplification given the current state of the scholarly publishing landscape. The model known as ‘gold open access’, where articles are immediately made publicly available on a journal's website, has, for the most part, come to be equivalent with increasingly costly fees for authors, effectively reducing the spectrum of scholars who can afford them and therefore excluding a sizeable proportion of researchers from the most prestigious, internationally visible publication venues.</p><p>In a recent discussion about where to submit an article on physicians' use of social media,<span><sup>3</sup></span> LC, an Argentinian early career researcher, explained to LM, a full professor based in the United States, that this model, however, is not—and needs not be—the norm or the only possible implementation of open access. In regions such as Latin America, community-driven, non-commercial open access is the norm rather than the exception.<span><sup>4</sup></span> For example, a recent survey of Latin American scientific journal editors (<i>n</i> = 342) reported that 91% of the respondents' journals are open access, and 88% do not require authors to pay APCs.<span><sup>5</sup></span></p><p>So, for LC, targeting a diamond open-access journal (i.e. no fees for readers, no fees for authors) was the norm, whereas LM had been conditioned to accept the author pays model to ensure access, which can be prohibitively expensive; in 2023, the median APC for gold open access was $2000.<span><sup>6</sup></span>
{"title":"Looking beyond, around and within cultural differences and dialogues across the open access ecosystem","authors":"Lucía Céspedes, Lauren A. Maggio","doi":"10.1111/medu.15527","DOIUrl":"10.1111/medu.15527","url":null,"abstract":"<p>‘Where is it indexed?’ or ‘what's its impact factor?’ have been, for decades, typical questions researchers ask themselves when choosing a journal to disseminate their work. In the last few years, new questions have popped up: ‘is it open access?’, ‘is it compliant with my institution's mandates?’, ‘does it charge an APC (article processing charge)?’. Worryingly, a follow-up question is, all too often, ‘can I afford it?’.</p><p>We were reminded of these dilemmas by a recent <i>Medical Education</i> article, where Han and Kumwenda highlight, but also question, the claim that online education has been ‘touted for promoting equity and inclusivity’.<span><sup>1</sup></span> The authors acknowledge notable progress and efforts in providing open and equitable access to medical education globally, but they also highlight concerns about its potential to perpetuate—and even exacerbate—inequalities between well-resourced, or Global North, and under-resourced, or Global South regions. An analogous argument can be made when it comes to discussing access to scholarly articles.</p><p>The belief that removing—or better yet, not even building—the subscription paywalls that block access to scientific articles would make knowledge globally available was one of the starting points of the open access movement more than two decades ago.<span><sup>2</sup></span> While it certainly remains a necessary condition for the democratisation of knowledge, this seems like an overly optimistic simplification given the current state of the scholarly publishing landscape. The model known as ‘gold open access’, where articles are immediately made publicly available on a journal's website, has, for the most part, come to be equivalent with increasingly costly fees for authors, effectively reducing the spectrum of scholars who can afford them and therefore excluding a sizeable proportion of researchers from the most prestigious, internationally visible publication venues.</p><p>In a recent discussion about where to submit an article on physicians' use of social media,<span><sup>3</sup></span> LC, an Argentinian early career researcher, explained to LM, a full professor based in the United States, that this model, however, is not—and needs not be—the norm or the only possible implementation of open access. In regions such as Latin America, community-driven, non-commercial open access is the norm rather than the exception.<span><sup>4</sup></span> For example, a recent survey of Latin American scientific journal editors (<i>n</i> = 342) reported that 91% of the respondents' journals are open access, and 88% do not require authors to pay APCs.<span><sup>5</sup></span></p><p>So, for LC, targeting a diamond open-access journal (i.e. no fees for readers, no fees for authors) was the norm, whereas LM had been conditioned to accept the author pays model to ensure access, which can be prohibitively expensive; in 2023, the median APC for gold open access was $2000.<span><sup>6</sup></span>","PeriodicalId":18370,"journal":{"name":"Medical Education","volume":"59 1","pages":"17-19"},"PeriodicalIF":4.9,"publicationDate":"2024-09-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1111/medu.15527","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142216813","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}
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