Medical Teacher最新文献

Purpose: Engagement in research and publication helps medical students develop the skills to improve healthcare through evidence-based medicine. The qualitative evidence-base for the medical student experience of publishing is limited. This study aims to explore medical students' publication practices and understand their experiences of research and publication.

Methods: The study is based on a mixed-methods convergent design. A survey questionnaire was distributed to medical students in UK medical schools by social media and email communication. We recruited volunteer participants through the survey and interviewed a sample whilst the survey was open. We purposively selected the sample to ensure representation from research-intensive and other universities.

Results: Survey results indicated that 21.3% (27/127) of respondents had a publication. The most common publication type was a conference abstract. The main motivation to publish was career progression and the main barriers were lack of opportunity or support to submit an article. There was no significant association between attending a research-intensive university and submitting an article. The interviews revealed that contributing to academic advancement was also a motivation to publish. Participants expressed receiving differing levels of support from supervisors and their institutions.

Conclusions: Data from the interviews suggested that the most commonly perceived barriers identified in the survey (lack of opportunity and support to conduct and publish research) may vary in prevalence between different medical schools. Further research is required to explore how different types of support offered by medical schools affect student engagement in publishing research.

While feedback is essential for learning in the health professions, clinical teachers rarely get feedback on their teaching, and the existing feedback is often non-specific and distant from teaching encounters. To enhance clinical teaching, we created a peer assessment program for clinical faculty. This program has been well-received and sustained for five years despite the challenges of faculty turnover and the pandemic. In this article, we identify twelve tips for creating and sustaining a peer assessment program for clinical faculty based on this experience. These tips focus on how to create a culture that supports peer assessment, on how best to implement a peer assessment program in practical terms, and on how to sustain a peer assessment program long-term. We hope these tips help educators receive better feedback about their clinical teaching and improve the future care delivered by our learners.

Purpose: Recruitment and retention of medical practitioners to rural practice is an ongoing global issue. Rural longitudinal integrated clerkships (LIC) are an innovative solution to this problem, which are known to increase rural workforce. Crucially this association increases with time on rural placement. This study examines factors that promote retention in a Rural LIC.

Methods: A two-phased, sequential design qualitative study in a cohort of students enrolled in a rural LIC at Griffith University, Queensland, Australia. Phase I consisted of an open-ended questionnaire and phase II follow-up focus groups from the same cohort. Data was transcribed and analysed using an iterative, six-step thematic analysis process to identify salient themes.

Results: Twenty-four students were invited to participate, of which eight respond in phase I and thirteen participated in phase II. Participants described retention being driven by connectivity within three broad themes: current practice, future practice (immediate internship and career intention), and social networks. Participant proposals to increase connectivity were also suggested including peer-led solutions and short rotations in metropolitan hospitals.

Conclusion: Connectivity is key to retention on rural longitudinal integrated clerkships. Programs which enhance connectivity with current practice, future practice, and social networks will increase retention on rural medical programs.

Purpose: In daily practice, junior doctors can contribute to quality improvement by providing innovative suggestions for change, referred to as voice behavior. Junior doctors are more likely to engage in voice behavior when they receive sufficient support from supervisors and peers. Such support has also been associated with less burnout and more work engagement. However, whether less burned-out and more work-engaged junior doctors demonstrate more voice behaviors in the face of sufficient supervisor and peer support is unclear. Therefore, we studied whether and how associations of supervisor and peer support with junior doctors' voice behaviors are mediated by burnout and work engagement.

Materials & methods: Participants were 301 junior doctors that completed a web-based survey including validated questionnaires on supervisor and peer support, burnout, work engagement, and voice behavior.

Results: Supervisor and peer support were associated with lower levels of burnout and higher levels of work engagement. Work engagement, but not burnout, mediated the associations of supervisor and peer support with voice behaviors.

Conclusions: Junior doctors who received more supervisor or peer support were more work-engaged and reported more voice behaviors. Thus, supervisor and peer support should be cultivated to facilitate junior doctors' roles as work-engaged professionals in quality improvement.

Purpose: To articulate proof of concept in relation to a complex pedagogical values intervention for a range of medical education's historically accumulated symptoms.

Methods: Using a discursive approach, symptoms that hinder development of medical education are set out. Such symptoms rest with the instrumentality of current pedagogical approaches, supressing potential. A 'cure' is articulated - that the dominant values complex of instrumentalism is raised in quality through embracing ethical, aesthetic, political, and transcendental (meaning) values. Key to this is the use of language in clinical encounters, where the productive metaphor count is repressed in instrumental-technical approaches but multiplied in embracing other values and qualities. This 'Values Prism' model shows instrumentalism passing through an expansive educational prism to create expansion in types and qualities.

Results and conclusions: Proof of concept is achieved. The Values Prism model can be adapted for any undergraduate medicine curriculum as a process model - a set of values that permeate the curriculum beyond the dominant instrumental. The enhanced and expanded curriculum acts in a translational capacity.

Post-assessments psychometric reports are a vital component of the assessment cycle to ensure that assessments are reliable, valid and fair to make appropriate pass-fail decisions. Students' scores can be summarised by examination of frequency distributions, central tendency measures and dispersion measures. Item discrimination indicies to assess the quality of items, and distractors that differentiate between students achieving or not achieving the learning outcomes are key. Estimating individual item reliability and item validity indices can maximise test-score reliability and validity. Test accuracy can be evaluated by assessing test reliability, consistency and validity and standard error of measurement can be used to measure the variation. Standard setting, even by experts, may be unreliable and reality checks such as the Hofstee method, P values and correlation analysis can improve validity. The Rasch model of student ability and item difficulty assists in modifying assessment questions, pinpointing areas for additional instruction. We propose 12 tips to support test developers in interpreting structured psychometric reports, including analysis and refinement of flawed items and ensuring fair assessments with accurate and defensible marks.

Purpose: This article reports on an evaluation which explored students' experiences with a Senior Citizen Partnership Program (SCPP). This was implemented in 2017 as part of Curtin Medical School's curriculum to support students' learning about healthy ageing.

Methods: This mixed methods study reports a cross-section of attitudes and content analyses of (i) open-ended responses from 258 students and (ii) transcriptions from seven focus group discussions which allowed 33 students from first, fourth and fifth years to articulate their experiences of the SCPP and its impact on their training.

Results: Three main themes were identified: (i) challenges to prior perceptions of older adults (with ten subthemes), (ii) positive impacts on their medical education (with eight subthemes) and (iii) on their personal development (with five subthemes). Overall, students viewed the SCPP as a valuable contribution to their learning. Its intentional creation of a designated space and time coincided with students' transition into adulthood and formation as a doctor. Clinical-year students attributed the SCPP to improved interpersonal communication and care of older patients.

Conclusion: A longitudinal program which partners students with residential-based older adults may support the emerging identity of a doctor who provides quality care for older persons.

Introduction: Domestic violence (DV) is common in the Australian community so it is likely that there will be medical students who are affected personally by DV. Some of these students may find DV training confronting or even re-traumatising. A trauma-informed medical education (TIME) framework utilising trauma-informed care principles may minimise this risk to students. We aimed to explore educators' perceptions of student well-being in Australian medical school DV training.

Method: This descriptive qualitative study interviewed 13 educators with experience teaching DV in Australian medical schools using an interpretivist methodology and a TIME framework. Interview data was thematically analysed to identify themes.

Results: Four key themes included (1) educators thrown in at the deep end; (2) keeping students emotionally safe; (3) a trauma-informed learning environment and; (4) challenges of student DV disclosures. Few of the participants had received training in DV. Educators used methods such as trigger warnings and ground rules to improve student's emotional safety. Experienced educators dealt with disclosures of DV by students which led to role confusion.

Discussion: There is a need for increased training of medical educators that includes awareness and implementation of TIME principles when training medical students in DV as well as increased supports and resources for educators.