Medical Teacher最新文献

Purpose: Justice, equity, diversity, inclusion (JEDI), and anti-oppression (AO) concepts are necessary in healthcare settings to promote culturally safe and high-quality care; however, entry-level healthcare program curricula (EHPPC) may lack adequate integration and/or delivery of these concepts. The primary aim of this scoping review is to identify what guidelines, frameworks, and models (GFMs) are used, and how they are used, to develop and deliver JEDI, and AO concepts in mandatory EHPPC.

Methods: A search of Ovid MEDLINE, Ovid EMBASE, and CINAHL was conducted for studies published in English from 2015 onwards that discuss what GFMs are included in mandatory EHPPC and how they guide the development and/or delivery of JEDI and/or AO concepts. Data from the included studies was collated into themes which were presented in tables and figures and described in narrative summaries.

Results: Sixty-one studies from various healthcare programs including medicine, nursing, pharmacy, dentistry, and dietetics were included in this review. Data from the studies were organized into eight categories: GFMs, concepts, methods of evaluation, length and frequency of sessions, modes of delivery, learning activities, and training of curricular developers and facilitators.

Conclusions: GFMs are used in a variety of ways to integrate JEDI and/or AO concepts into health professional curriculum. Variability in the training of developers and facilitators of curricular concepts also exists. Future research is needed to determine if consistent or variable GFMs, as well as JEDI and/or AO developer and facilitator training, would be more effective for students' learning of these concepts.

In the same way as clinical medicine, health professions education should be evidence-based rather than based on tradition and convenience. Health professions education research (HPER), an academic area that first emerged in the 1950s, is essential for identifying new and better ways to educate health professionals. Again, just as with clinical research, setting up sustainable HPER units is critical to coordinate research efforts and facilitate the production of clear and strategic HPER. In this AMEE guide we draw upon the scholarly and grey literature and our own experiences as HPER unit leaders in several different global contexts to provide practical guidance on establishing and sustaining a HPER unit. We outline the multiple elements and considerations required to set up and operationalize a successful HPER unit, from engagement of key stakeholders and documentation of milestones to the production of programmatic research and its implementation. These are considered under the areas of   • Who do you need to partner with?  • Setting the agenda - or What will your unit be known for?  • Your most valuable resource - people!  • Operationalizing your HPER agenda  • Leading the way  We provide concrete tips on each of the above and illustrate these key steps with examples from our own experiences or the wider literature. Whether the reader is beginning, maintaining, or seeking to renew their HPER unit, we hope that the guidance we provide is as useful as it has been to us during our own research program building endeavours.

Despite recent calls to engage in scholarship with attention to anti-racism, equity, and social justice at a global level in Health Professions Education (HPE), the field has made few significant advances in incorporating the views of the so-called "Other" in understanding the nature, origin, and scope of knowledge as well as the epistemic justification of knowledge production. Editors, authors, and reviewers must take responsibility for questioning existing systems and structures, specifically about how they diffuse the knowledge of a few and silence the knowledge of many. This article presents 12 recommendations proposed by The Global South Counterspace Authors Collective (GSCAC), a group of HPE professionals, representing countries in the Global South, to help the Global North enact practical changes to become more inclusive and engage in authentic and representative work in HPE publishing. This list is not all-encompassing but a first step to begin rectifying non-inclusive structures in our field.

Data on American medical school enrollees show an increasing number of medical students with a form of physical disability. The lack of guidance for medical schools regarding student disability can serve as a significant barrier to success for these trainees. The physical examination is an essential competency for practicing physicians that requires visual, auditory, and hands-on skills. However, there are currently no published guidelines or educational tools on performing the physical examination for physicians with specific disabilities. The authors of this article developed two separate educational tools on guidance for performing the physical examination, one for practitioners with hearing deficits and the other for practitioners with the ability to use only one arm or hand. These educational tools are intended to provide medical schools with guidance for physical examination education for trainees with these disabilities. Such efforts can help alleviate some of the barriers faced by medical students and practitioners with disabilities.

A fit for purpose health workforce is essential for achieving universal health coverage and delivering on the 2030 Agenda for Sustainable Development. However, virtually all countries face challenges either in educating, employing or in retaining the health workforce they require to address population needs. The WHO estimates a global shortage of 11.1 million health workers by 2030. Some low- and middle-income countries have successfully expanded health workforce education and employment in recent years, leading to significant growth in workforce numbers. However, many graduates face job market absorption issues. Many high-income countries rely on international recruitment, with impacts on health systems in both sending and receiving countries. A comprehensive approach to health workforce strengthening must integrate education within health labour markets and health systems, to ensure effective returns on investment. The cost of health professions education remains poorly understood, with estimates ranging from USD $110 billion to $300 billion annually. Workforce retention strategies - such as decent employment, career development, and workplace safety - are critical. With five years remaining in the SDGs era, there is an opportunity - and an emerging consensus among countries at WHO's Executive Board in February 2025 - to accelerate action on the health and care workforce by 2030. Health workers must be prepared for the contexts in which they will practice, including a greater shift towards education and practice in primary and community care settings and contributions to public health functions, including emergency preparedness and response. Fundamental questions need to be asked, and gaps in the evidence must be addressed, to deepen understanding on what to teach, how to teach, whom to teach, how many to teach, and the underpinning science to guide cost, value and impact in health professions education.

Introduction: Genital examinations are challenging for medical students to learn in part due to practice opportunities. In an attempt to address this, we introduced clinical teaching associates (CTAs) who teach third year medical students and allow male intimate examinations to be practiced on themselves.

Materials and methods: A single-blinded parallel-group RCT was conducted, recruiting 96 students. The control group was only given access to the current curriculum (lectures, videos, models) whilst the other group was offered this and a teaching session with CTAs, who are professionally trained, allowing students to examine them. Assessment took the form of a bespoke Objective Structured Clinical Examination (OSCE) and a self-assessment confidence questionnaire before and after the teaching.

Results: Assessed by experienced surgeons, the group receiving the additional CTA teaching scored significantly higher than the control group in the OSCE in 55% (n = 11) of domains. This included, but was not limited to, competence at performing hernial orifice (effect size = 0.985), male genital (effect size = 0.943), penile (effect size = 1.347) and prostate examinations (effect size = 0.578). Assessment by the CTA, acting as the patient, also showed a significant difference in favour of the intervention group in all domains and included whether the patient felt safe (effect size = 0.797) and whether the patient would see the student again (effect size = 1.170).

Discussion: The use of CTAs for teaching male intimate examination results in significantly greater student competence and confidence and their use should be considered in medical schools.