Medical Teacher最新文献

Introduction: Effective online collaborative learning goes beyond completing a task. Regulating individual and group-shared learning processes is essential for success in online collaborative learning. This study had the aim of identifying how medical students use and sequence their regulation of learning during an online collaborative learning task.

Methods: This study employed lag sequential analysis to examine sequential patterns of regulated learning. 68 year 4 medical students were divided into 6 groups of 11 to 12 and worked on an online prescribing scenario. Group discussions were recorded, transcribed and coded using a specifically developed coding scheme. Lag sequential analysis was then applied to identify the sequences through which different types and processes of regulated learning unfolded during the collaborative task.

Results: Sequential analysis showed that medical students frequently used co-regulated learning and socially shared-regulated learning in a cyclical approach. Monitoring facilitated important metacognitive and cognitive processes and also there was an association between planning and orientation processes with positive emotions.

Conclusion: The findings have implications for the design of effective online collaborative learning, such as incorporating monitoring prompts, fostering positive atmosphere in groups and providing consecutive tasks to stimulate reflection.

Background: Learning skilled communication implies adapting and monitoring to the needs of the clinical encounter. Research suggests communication challenges can trigger learning; however, their nature remains unclear. This study explores what challenges act as triggers, improving understanding of developing skilled communication and guiding educators in targeted coaching.

Material and methods: This longitudinal qualitative study used a phenomenological approach to collect data from first- and third-year general practitioner trainees through clinical observations, interviews, and audio-diaries. Using a twofold approach, a thematic content analysis was performed, triangulating data sources and next, findings were used to craft stories illustrating the communication challenges learners encountered during training.

Results: Per year-group a story was crafted, illustrating communication challenges driving trainees' learning. First-year trainees focused on the effectiveness of patient-centred communication skills. Third-year trainees adopted a meta-perspective, using self-monitoring skills to develop a personalised style, adapt communication to patients' needs, and work collaboratively, driven by curiosity to understand each patient's context.

Conclusions: We identified communication challenges in workplace learning that trigger the development of skilled communication. To help learners recognise and share these challenges, a safe learning environment is crucial, along with scaffolded guidance from educators to support learners in identifying challenges and fostering self-monitoring skills throughout their learning journey.

Amidst the global increase of mis- and dis-information, students must learn how to address the public's distrust of universities, health professionals, health institutions and the work they do in communities. To support this trust building, we have developed a critical reflection workbook designed to support individuals and groups engaged in community-academic partnerships. The workbook offers a foundational framework and practical tools to guide reflective practice and action in servicelearning and community engagement across a variety of contexts.

Introduction: Outlier stringent/lenient and range-restricted assessors provide low utility assessment scores, reflecting assessor tendency more than learner performance. The quality of narrative comments generated by these assessors remains unknown.

Methods: End-of-shift assessments from an academic emergency department were scored using the Quality of Assessment of Learning (QuAL) score. The mean Qual score was calculated for each assessor. Stringency/leniency and range restriction were quantified using the mean-delta method and standard deviation of awarded scores respectively. Outlier vs. non-outlier assessor mean QuAL scores were compared using T-tests. Linear regression was conducted with mean QuAL score as the dependent variable, and assessor range-restriction as the independent variable.

Results: 2034 assessments were completed by 81 assessors. We identified 20 outlier assessors (10 stringent, 10 lenient). Assessor mean QuAL scores ranged from 1.2 to 5 (mean = 3.9, SD = 0.9). Mean QuAL score of non-outliers (4.0) was significantly higher than outlier lenient assessors (3.1, p = 0.02) but not different from outlier stringent assessors (3.8, p = 0.5). Range restriction was negatively correlated with mean QuAL scores (p = 0.003, R²=0.11).

Conclusions: Outlier lenient and range-restricted assessors provided lower-than-average quality narrative assessments. These assessors, where both numeric and narrative assessments are of limited utility, are ideal candidates for targeted interventions to improve assessment quality.

Purpose: Entrustable professional activities (EPAs) for entry into residency often remain broad and underspecified and lack alignment with the clinical contexts that medical graduates encounter. This study aims to identify chief complaints that can serve as context anchors for EPAs for entry into residency.

Methods: A structured, expert consensus survey was conducted in 2024 at Charité-Universitätsmedizin Berlin, Germany. In total, 192 participants from four groups (senior medical students, hospital residents, hospital specialists, and general practitioners) rated 134 chief complaints. An 80% threshold was set to define a consensus on the relevance of complaints for autonomous differential diagnostic work-up by new residents under supervision level 3b.

Results: Forty-four chief complaints (33%) reached the consensus threshold, with abdominal pain, dyspnoea, fever and cough receiving the highest agreement (>97%). Strong consistency was observed across expert groups, with all four groups agreeing on 35 complaints. For the remaining nine, only minor variations were observed, with generally only one expert group falling below the 80% threshold.

Conclusions: Defining core chief complaints offers a practical approach to contextualize undergraduate EPAs, thereby bridging the gap between educational expectations and real-world clinical practice. These findings support curriculum alignment and entrustment decisions while promoting trainees' readiness for early postgraduate training.

Introduction: Medical students are exposed to sensitive topics throughout their university education. Topics can be sensitive based on an individual's life experience, and common examples include domestic violence and mental health. Teaching sensitive topics risks re-traumatisation, and educators typically receive little training in balancing harm minimisation and maximising preparedness to handle distressing patient encounters. A trauma-informed medical education (TIME) approach has been proposed, aiming to optimise the learning environment, improve resilience and prepare students for practice. However, perceptions of TIME and which approaches students find effective remain incompletely understood.

Methods: We conducted a descriptive, qualitative study design using semi-structured interviews with sixteen medical students from Monash University, Australia. We recruited students in their final years who had completed their general practice rotation, and interviews were recorded and transcribed verbatim. We undertook reflexive thematic analysis of transcripts using NVivo software.

Results: The overarching theme was the generation of a 'Safe Space' to learn sensitive topics. Contributing elements included sub-themes of (1) Preparedness for Teaching, (2) Teaching Techniques, and (3) Debriefing.

Discussion: Students reported that many TIME strategies were already in place in their teaching. The findings highlighted that trauma-informed teaching strategies were effective in promoting medical student psychological safety and well-being.

Purpose of the article: Medical professionals may get to appreciate the experience of patients, without being patients themselves. This study explored whether VR technology can be useful for teaching medical professionals about patient experiences.

Materials and methods: A VR movie was made, showing a fictitious but realistic patient experience. Nineteen medical professionals, selected by a non-probability sampling method, saw this movie. Focus group discussions and interviews were held afterwards. Data were thematically analyzed with independent coding. Codes and (sub)themes were discussed within the research team.

Results: Immediately after viewing, medical professionals felt 'shaken awake' and after several weeks, they maintained a heightened awareness of patient experiences in their daily practice. The VR movie was seen as a valuable teaching tool, despite the passive viewer role. The VR movie made them aware of three aspects of the doctor-patient relationship: a) paying attention, b) a person-centered approach, and c) building confidence.

Conclusions: A VR movie helps medical professionals to 'see' and 'feel' what patients experience. The character in the VR movie is unable to respond to the fellow characters, underlining the passivity of patients. VR-glasses can be an easy way to encounter what others experience, although a blended learning approach, using passive patients' roles with VR-technology and active participation with role play methods, is recommended.

This article explores the evolving landscape of social accountability in medical education through the lens of the AMEE ASPIRE-to-Excellence initiative. Social accountability has become increasingly recognized as a fundamental principle in health professional education, requiring health professional education and training programs to align their teaching, research, and service activities with the priority health concerns, namely those of the communities they serve. Drawing on the ASPIRE Social Accountability criteria, this paper outlines how these elements function not only as assessment tools but as building blocks for embedding social accountability into curricula and institutional missions. Essential elements include mission-driven leadership and governance, community co-design, equitable student recruitment, socially responsive curricula, community-engaged research, contribution to health services, impact measurement, and continuous quality improvement. The paper illustrates this through examples of excellence in different contexts and identifies key challenges and strategies for expanding social accountability in health professional education and training programs. The discussion emphasizes that social accountability is a dynamic, context-sensitive endeavor grounded in authentic partnerships, continuous quality improvement, and an inclusive approach to health, equity and diversity. The conclusion highlights the call to action: to embrace these criteria as living elements that can guide institutions in fostering socially accountable, environmentally sustainable, and technologically responsive health professionals.