Medical Teacher最新文献

Context: Situational judgment tests (SJTs) are increasingly considered in medical school admissions to assess non-academic competencies within holistic review. Questions remain regarding accessibility, variation in performance across applicant groups, and their relationship to admissions outcomes. This study examines the association between AAMC PREview SJT scores and admissions outcomes in a real-world applicant pool, where scores were not used in decision-making and were reviewed retrospectively.

Methods: We conducted a retrospective analysis of 5,993 applicants to the Icahn School of Medicine at Mount Sinai during the 2022-2023 application cycle. Of these, 4,046 (67.5%) completed the PREview SJT. Scores were not available to the admissions committee at any stage and did not influence interview or acceptance decisions. Applicants were categorized by socioeconomic status (SES) and first-generation college status. Logistic regression models evaluated associations between PREview scores, interview invitations, and post-interview committee evaluations, adjusting for demographic variables. Outcomes were compared between test takers and non-takers.

Results: Applicants from lower SES and first-generation backgrounds were more frequently represented among lower PREview score categories. PREview scores were not associated with post-interview committee evaluations. However, lower PREview scores were associated with a lower likelihood of interview invitation. Among interviewed applicants, neither PREview score nor demographic variables were associated with committee outcomes.

Conclusions: In a setting where PREview scores were not used in admissions decisions, lower scores were associated with interview invitation status but not with post-interview committee evaluations. These findings suggest limited alignment between PREview scores and the outcomes of holistic admissions review and underscore the importance of careful evaluation before incorporating SJTs into admissions processes.

Background and aims: Emotional intelligence (EI) is an essential competency for physicians. Medical educators seek educational interventions to cultivate EI in their learners. This scoping review aimed to conceptualize current knowledge about educational interventions for developing EI in medical education. Methods: This study adopted the first five stages of Levac et al.'s scoping review framework, which builds on Arksey and O'Malley's scoping review methodology. The authors accessed three databases-PubMed, CINAHL, and PsycINFO-to review the literature from 2014 to February 2025. Two authors (WI and TS) independently screened the literature for eligibility. A third author (BAAW) resolved any discrepancies. Two authors (WI and BAAW) charted the eligible articles. Results: Of the 638 studies, 64 were eligible. Approximately one-third of eligible studies focused on interventions for medical students. Stress management, leadership, communication, and professionalism were key topics integrated into EI development interventions. Various methods were employed, such as small-group discussions, case-based discussions, and simulations. Most studies used self-rating questionnaires as assessment tools. Half of the studies (56.25%) reported positive impacts from their interventions. Conclusions: The findings could serve as a guide for educators and researchers seeking to implement or study such interventions.

Accreditation systems create and enforce the rules for medical education. When accreditors expand their scope or change their standards or protocols, every medical school they regulate must change, with lasting impacts on large numbers of graduating physicians. Because the accreditation of undergraduate medical education (UME) has become globally accepted and widespread, one may assume it is supported by strong evidence. Such is not the case. This article recounts the origins of accreditation in the U.S. over 100 years ago as an effort to distinguish allopathic physicians from their competitors. It describes how the U.S. model for UME accreditation formed the basis for approaches endorsed by global organizations, and accreditation expanded without research demonstrating that a specific combination of standards, self-studies, and site visits was optimal or necessary. Allowing assumptions about accreditation to go unchecked can create problems, such as the misalignment of accreditation systems with needs, wasted resources, and lack of trust. Accreditation science-systematic inquiry that directly interrogates and informs accreditation policies and practices-offers a way to test assumptions and generate evidence that leads to higher quality accreditation practices. We describe resources that can be used for accreditation science and examples of accreditation science so that more of the global medical education community can participate in this emerging field. We also suggest priority areas of investigation, such as how accreditation judgments are made and the economics of accreditation and international accreditor marketplaces. The scientific method has for centuries proven to be the most efficient way to generate knowledge that improves the lives of people. It is past time for accreditation to move from its longstanding basis in tradition and assumption into an era defined by scientific inquiry.

Introduction: Addressing the social determinants of health (SDOH) can improve cancer-related outcomes and is widely recognized as integral to patient care. Despite this, little is known about how medical oncology residents perceive their role in addressing SDOH. Understanding their views is important not only because SDOH impact outcomes, but also because residency training should prepare oncologists to respond to evolving societal needs. In this study, we use Figured World (FW) theory to explore how residents negotiate their role within the sociocultural world of medical oncology training.

Methods: We conducted semi-structured interviews with 11 medical oncology residents from the four faculties of medicine in Québec, Canada. Participants were recruited through program directors, newsletters, and snowball sampling. Interviews were audio- and video-recorded, transcribed verbatim, and thematically analyzed. FW theory helped orient our analysis toward how residents make meaning of their roles and responsibilities, how they perceive societal expectations, and how they see themselves within the context of medical oncology training.

Results: We identified four key themes: (a) becoming an oncologist: what does it mean and entail?, (b) dealing with SDOH in medical oncology: a distressing role, (c) exploring the roots of powerlessness when confronted with SDOH, and (d) negotiating their roles and positioning themselves relative to others in addressing SDOH.

Conclusion: Residents expressed a desire to engage with SDOH but felt largely unprepared to do so, pointing to gaps in training and support. These findings call for a rethinking of how oncology residency training shapes professional identity, ensuring that future oncologists are prepared to take on roles that encompass both clinical care and social accountability.

A critical component of all programmes of instruction in Medical and Health Professions Education (MHPE) disciplines is the assessment of learning and assurance of clinical competency, spanning knowledge, clinical/technical performance skills, and professionalism. AMEE's ASPIRE-to-Excellence assessment framework draws together a series of key, evidence-based components of comprehensive assessment systems, providing a matrix to 'assess assessment' through the following stimulus questionsHow does an assessment programme serve and support the mission of the institution and the goal of MHPE globally in enhancing and improving the health of both populations and individuals?Does the assessment programme support, enhance, and create learning opportunities?How does the assessment programme ensure the competence of students as they progress?How is the assessment programme subject to a rigorous and continuous quality control process?How does the assessment programme demonstrate a commitment to scholarship and innovation, including the dissemination of good practice? In this paper, these elements are detailed together with descriptions of strategies that align with how each can be successfully demonstrated and evidenced. Drawing on details of assessment practices seen in a range of submissions to the ASPIRE award programme, from a range of jurisdictions and settings, the paper highlights strategies that align with success for excellence in assessment.

Background: Collaborative behaviours in acute care remain inconsistent despite substantial educational investment. Teamwork training often focuses on larger groups, overlooking dyads; the smallest collaborative unit. This study examines high-performing tennis doubles teams and expert medical dyads to identify collaborative behaviours that may inform medical education.

Methods: Using a limited realist perspective approach, we conducted 15 semi-structured interviews with 30 participants: 20 clinicians working in acute care dyads and 10 elite tennis doubles players. Participants were purposively sampled. Template analysis, guided by relational coordination and distributed cognition frameworks, was applied to explore how dyads coordinate and collaborate.

Results: Six collaborative dimensions were identified across both domains: trust, connectedness, shared goals, situation awareness, physical communication, and reflective practice with varying enactment strategies. Tennis dyads developed connectedness through repeated practice, psychological safety, co-regulation, error normalisation, and emotional trust. Medical dyads emphasised technical trust and task coordination, with limited opportunities for rehearsal, informal feedback, or relational engagement, often due to workload pressures and shifting schedules.

Conclusions: While collaborative dimensions are shared, tennis dyads draw on a broader behavioural repertoire. These findings highlight opportunities to enhance medical education by integrating dyad-focused training that explicitly develops relational competence in simulation, debriefing, and workplace learning.

In developing and administering OSCE-type assessments, institutions can spend significant resources training examiners and designing stations/scoring instruments in attempts to ensure that they are well-calibrated. This paper, situated in the context of a high-stakes OSCE for international medical graduates wanting to work in the national health service in the UK, employs a recently developed quantitative measure of examiner calibration to identify which stations show relatively high and low average degrees of calibration between examiners. Using documentary analysis of station materials, we then investigate these stations qualitatively to better understand what factors might drive better calibration as stations develop and design elements change over time. We find that those stations that are better calibrated are typically newer with more detailed and relevant scoring guidance and support materials, whilst there is little evidence that the nature of the task(s) or other contextual factors are important in determining calibration levels. In this work, we provide strong evidence of how key developments in station design, the quality of support materials and enhanced examiner training practices can succeed in improving degrees of calibration in OSCE stations - and suggest ways that all institutions might improve their practices in this regard.

Introduction: Problem-based learning (PBL) is central to many curricula, yet reports of 'PBL fatigue' and inconsistent gains in clinical reasoning suggest room for improvement. Grounded in Self-Determination Theory, we designed a Staged-Release Model (SRM) to enhance students' intrinsic motivation and refine clinical reasoning. This study evaluated the SRM's initial implementation by examining its association with medical students' intrinsic motivation and perceived clinical reasoning ability.

Methods: A mixed-methods study was conducted at the College of Medicine, Taibah University, Saudi Arabia. Third-year medical students (N = 151) participated in the new 7-step model (SRM). Quantitative data were collected using the 24-item Basic Psychological Needs Satisfaction and Frustration Scale (BPNSFS), which assessed, on a 5-point Likert scale, students' basic needs for intrinsic motivation. Qualitative data were collected through semi-structured focus group interviews.

Results: Median scores for satisfaction with autonomy, relatedness, and competence were positive, accompanied by very low frustration scores. Qualitative analysis suggested that using the model enhanced students' learning of clinical reasoning, provided effective group interaction and engagement in the clinical context, and offered suggestions for improving consolidation sessions and tutor facilitation.

Conclusions: This study suggests that SRM may enhance students' intrinsic motivation, potentially alleviating PBL fatigue, and may support the development of clinical reasoning by meeting students' basic psychological needs.