Medical Teacher最新文献

Purpose: Physician educators are often expected to direct educational programs and assume roles that conform to field norms for career advancement but that may not afford meaningful work for educators. The purpose of this study was to describe and analyse the perspectives and actions taken by physician educators in response to tension between feeling compelled to direct an educational program and doing educationally meaningful work.

Methods and materials: We used data from a longitudinal study and focused on three participants who, over the course of the five-year study, offered significant insights into how physician educators act in ways that run counter to expectations for career advancement. Our narrative analysis entailed organizing data from interview transcripts into time-ordered displays, weaving data into counternarratives that were edited by participants, and using the theory of faculty agency (and its key constructs, strategic perspectives and strategic action) to thread the stories together.

Results: In each counternarrative, the participant deliberated their sense of being a physician educator (strategic perspectives) and when expectations became untenable, they did what they needed to do to engage in meaningful work (strategic action) rather than comply with expectations for career advancement in academic medicine. For one participant, faculty agency meant leaving academic medicine; for another, it meant reducing clinical time so that unpaid time could be devoted to education; and for another, it meant opting not do direct a reputable education program.

Conclusions: Faculty agency is a useful theoretical lens for conceptualizing how physician educators navigate their careers in academic medicine. Counternarratives that illuminate faculty agency offer stories that describe alternate career paths and portend a different future for physician educators.

Simulation-based mastery learning is a powerful educational paradigm that leads to high levels of performance through a combination of strict standards, deliberate practice, formative feedback, and rigorous assessment. Successful mastery learning curricula often require well-designed checklists that produce reliable data that contribute to valid decisions. The following twelve tips are intended to help educators create defensible and effective clinical skills checklists for use in mastery learning curricula. These tips focus on defining the scope of a checklist using established principles of curriculum development, crafting the checklist based on a literature review and expert input, revising and testing the checklist, and recruiting judges to set a minimum passing standard. While this article has a particular focus on mastery learning, with the exception of the tips related to standard setting, the general principles discussed apply to the development of any clinical skills checklist.

What was the educational challenge?: The objective structured clinical examination (OSCE) is used extensively in health and medical education to assess clinical competence. While OSCEs are not primarily designed for individual feedback, they provide an opportunity to generate meaningful and constructive feedback that students can use to reflect on areas of weakness (and strength). The most timely and effective way to incorporate individual feedback following a summative OSCE continues to be explored.

What was the solution?: This paper describes a novel OSCE feedback model which uses readily available summative assessment data to calculate 10% index scores. This provides information about relative station difficulty and relative individual student performance.

How was the solution implemented?: An individualised feedback report was provided to every student after the OSCEs. This enables identification of stronger and weaker performance areas and composite skills, which can be utilised by all students to direct future learning.

What lessons were learned that are relevant to a wider global audience?: Providing timely, individual actionable feedback to every student following a summative OSCE is possible without impacting the examination process or examiner burden.

What are the next steps?: A study is planned to determine the utilisation of this feedback by students and it's impact as a qualitative self-assessment exercise.

Healthcare educators are exploring ways to integrate Large Language Models (LLMs) into the curriculum. At the same time, they are concerned about the negative impact on students' cognitive development. There is concern that the students will not learn to think and problem-solve by themselves and instead become dependent on LLMs to find answers. In addition, the students could start accepting the LLM generated responses at face value. The Illusion of Explanatory Depth (IoED) is a cognitive bias where humans believe they understand complex phenomena in more depth than they do. This illusion is caused when people rely on external sources of information rather than deeper levels of internalized knowledge. This illusion can be exposed by asking follow-up in depth questions. Using the same approach, specifically iterative prompting, can help students interact with LLM's while learning actively, gaining deeper levels of knowledge, and exposing the LLM shortcomings. The article proposes that educators encourage use of LLMs to complete assignments using a template, that promotes students' reflections on their interactions with LLMs, using iterative prompting. This process based on IoED, and iterative prompting will help educators integrate LLMs in the curriculum while mitigating the risk of students becoming dependent on these tools. Students will practice active learning and experience firsthand the inaccuracies and inconsistencies in LLM responses.

Programmatic assessment is gaining traction in health professions education, emphasizing continuous, integrated appraisal to support holistic student development. Despite its adoption, effectively affording student agency within programmatic assessment remains challenging due to longstanding educational practices, entrenched power dynamics and cultural norms favoring educator and institutional control. This article aims to provide strategies to promote student agency in programmatic assessments, essential for modernizing educational practices and preparing self-regulated, lifelong learners. The tips include establishing student-educator partnerships, making power dynamics transparent, designing purposeful and inclusive assessments, and normalizing bidirectional feedback conversations. The strategies emphasize the importance of a growth mindset, effective communication, and the role of coaches. The article also explores leveraging artificial intelligence to empower students. Affording students agency requires a significant cultural shift but holds the potential to transform health professions education. By promoting student autonomy and engagement, educators can better prepare students as capable, self-regulated professionals, enhancing the quality and effectiveness of health education programs.

As artificial intelligence (AI) increasingly influences the healthcare landscape, integrating medical humanities into health professions education becomes essential for cultivating critical thinking and empathetic patient care. Visual Thinking Strategies (VTS), a framework for open discussions about visual art, emerges as a valuable pedagogical approach within this context. This guide presents a comprehensive overview of VTS, including its theoretical foundations and practical implementation. It offers insights into performing a needs assessment, facilitator training and session structure, essential for designing and running VTS sessions, as well as methods for evaluating VTS program effectiveness. By elucidating these elements, the guide aims to assist health professions educators in successfully incorporating VTS into their curricula, enhancing both the educational experience and the quality of healthcare delivery.