Clinical Teacher最新文献_第2页

Enhancing Dermatology Residents' Self-Assessment Accuracy Through Training: An Interventional Study Using the Mini-CEX 通过训练提高皮肤科住院医师自我评估的准确性：一项使用Mini-CEX的介入研究。

IF 1.2 Q4 MEDICINE, RESEARCH & EXPERIMENTAL

Clinical Teacher

Pub Date : 2026-02-05 DOI: 10.1111/tct.70340

Arghavan Azizpour, Mohammad Jalili, Sara Mortaz-Hejri, Maryam Nasimi, Vahideh Lajevardi, Maryam Ghiasi, Hanie Babaie

Background

Self-assessment is a key component of the formation and maintenance of clinical skills as well as a powerful type of formative assessment. The purpose of this study was to determine whether the mini–clinical evaluation exercise (mini-CEX) improved the accuracy of dermatology residents' self-assessments and their overall clinical performance.

Methods

Fifty-eight first- to fourth-year dermatology residents participated in this study in the outpatient clinic and during inpatient visits from 2021 to 2022. At the beginning of the study, each resident was assessed by two faculty members at the same time but independently and also filled out a self-evaluation test using the mini-CEX examination. After the intervention and feedback on the result of the assessment, the participants were reassessed.

Findings

After feedback and self-assessment training, the mean scores that the evaluators gave to the residents improved significantly in interview skills, examination and the mean score across all assessed domains (all p < 0.05). The score of self-assessment after the intervention had a significant increase in all seven categories of the mini-CEX test (all p < 0.05). Following the intervention, there was a greater correlation between the ratings of professors and residents, suggesting improved alignment in performance evaluation.

Conclusion

Training in self-assessment and providing feedback appear to significantly enhance dermatology residents' ability to assess their own performance. These improvements not only reflect skill acquisition but also show the importance of incorporating structured self-evaluation into residency programmes to promote clinical insight, lifelong learning and professional development across diverse medical specialties.

背景：自我评估是临床技能形成和维持的关键组成部分，也是一种强有力的形成性评估。本研究的目的是确定迷你临床评估练习（mini-CEX）是否提高了皮肤科住院医师自我评估的准确性及其整体临床表现。方法：在2021年至2022年期间，58名一至四年级皮肤科住院医师在门诊和住院期间参与了本研究。在研究开始时，每位住院医师同时接受两名教师的独立评估，并填写了一份使用mini-CEX考试的自我评估测试。在干预和反馈评估结果后，参与者被重新评估。结果：经过反馈和自我评估培训后，评估者给予住院医师的平均得分在面试技巧、考试成绩和各评估领域的平均得分均有显著提高（均p）。结论：自我评估培训和提供反馈可显著提高皮肤科住院医师对自身绩效的评估能力。这些改进不仅反映了技能的获得，而且表明了将结构化自我评估纳入住院医师计划的重要性，以促进临床洞察力，终身学习和不同医学专业的专业发展。

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引用次数: 0

Confidential Career Advising for Medical Students: A Qualitative Study 对医学生的保密职业建议：一项定性研究

IF 1.2 Q4 MEDICINE, RESEARCH & EXPERIMENTAL

Clinical Teacher

Pub Date : 2026-02-04 DOI: 10.1111/tct.70359

Hannah Archibald, Tianyu Chen, Heather Whelan, Patricia O'Sullivan, Erick Hung, Karen E. Hauer

Background

Medical students must navigate specialty career decisions and residency applications amid perceptions of conflicting faculty roles. Research is lacking concerning students' interaction with confidential advisors in these high-stakes contexts.

Approach

This study explored student and faculty perceptions of how students work with confidential career advisors for career exploration and decision-making within a comprehensive advising programme.

Evaluation

This qualitative study queried the perceptions held by medical students and faculty confidential career advisors at the University of California, San Francisco, gathered in interviews between October 2022 and 2023. Interview questions, guided by social cognitive career theory (SCCT), addressed career decision-making. Authors analysed data from interviews with 12 fourth-year students and nine faculty using thematic analysis with sensitizing concepts. Researchers achieved trustworthiness through credibility, reflexivity, triangulation and diverse team expertise, minimizing bias. Three themes characterized how confidential advisors facilitated students' decision-making around specialty career choice: One, trusting relationships enabled students to share openly with limited self-monitoring about their questions, goals and identities; two, supporting students' values strengthened advising within these trusting relationships; three, advising conversations promoted consideration of student-specialty fit as advisors helped students imagine themselves in careers. These themes support the self-efficacy component of SCCT.

Implications

Findings suggest confidential advising addresses unique student needs that traditional advising may not satisfy. Other medical schools may consider implementing similar confidential advising models to provide support to student decision-making. Future research should examine optimal advisor training, the impact of advisor approach on student outcomes and long-term career satisfaction among users of confidential advising services.

医学生必须在专业职业选择和住院医师申请中做出正确的选择，同时还要面对相互冲突的教师角色。在这些高风险的环境中，学生与保密顾问的互动缺乏研究。本研究探讨了学生和教师对学生如何在综合咨询计划中与保密的职业顾问一起进行职业探索和决策的看法。这项定性研究询问了加州大学旧金山分校医学院学生和教职员工的保密职业顾问在2022年10月至2023年10月期间的访谈中所持有的看法。在社会认知职业理论（SCCT）的指导下，面试问题涉及职业决策。作者分析了对12名四年级学生和9名教师的访谈数据，使用了带有敏感概念的主题分析。研究人员通过可信度、反身性、三角测量和多样化的团队专业知识来实现可信赖性，从而最大限度地减少偏见。三个主题描述了保密顾问如何促进学生在专业职业选择方面的决策：第一，信任关系使学生能够在有限的自我监控下公开分享他们的问题、目标和身份；第二，支持学生的价值观加强了在这些信任关系中的建议；第三，咨询对话促进了对学生专业契合度的考虑，因为顾问帮助学生想象自己的职业生涯。这些主题支持SCCT的自我效能成分。研究结果表明，保密咨询解决了传统咨询可能无法满足的学生独特需求。其他医学院可能会考虑实施类似的保密咨询模式，为学生的决策提供支持。未来的研究应该检查最佳顾问培训，顾问方法对学生成果的影响以及保密咨询服务用户的长期职业满意度。

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引用次数: 0

Personalised Pathways (PP) in the Medical Curriculum: How Does It Influence Students? 医学课程中的个性化路径（PP）：它如何影响学生？

IF 1.2 Q4 MEDICINE, RESEARCH & EXPERIMENTAL

Clinical Teacher

Pub Date : 2026-02-03 DOI: 10.1111/tct.70343

Annette Burgess, Naomi Staples, Matti Gild, Karen Scott, Tyler Clark, Stuart Lane, Jane Bleasel, Christian M Girgis

Background

In 2020, the Sydney Medical School introduced the ‘Personalised Pathways’ (PP) program in Year 2 of the medical curriculum. The PP aimed to provide students with access to specific specialty areas and an opportunity to individualise their educational experience at an early stage. The role this program plays in student career preference is not well understood. We sought to explore students' engagement and experience of the placement and gain an understanding of how it may influence their views of specialities, the role of the consultant and career intentions.

Approach

In 2023, 220 PP placements were offered to Year 2 students (n = 254) across six teaching hospitals as an optional activity. In total, 122/254 (48%) students applied for a PP; of these, 103/122 (84%) gained a placement. Students attended an individualised PP for 4 h each week across 12 weeks.

Evaluation

Qualitative data were collected by survey, reflecting on students' perception of the placement, the role of the consultant and potential influence on career choice. Data were coded and categorised into themes. In total, 24/103 (23%) students responded to the survey, reporting an increased awareness of specialty career pathways, lifelong learning requirements and work–life balance. The PP also provided insight into the breadth of the consultants' leadership role and teaching responsibilities.

Implications

Implementation of the personalised pathway provided valuable opportunities that students appreciated being afforded early on. Notably, it gave some students a reason to rethink their career choice, while others found the experience reinforced their initial plans regarding career pathway intentions.

背景：2020年，悉尼医学院在医学课程的第二年引入了“个性化途径”（PP）课程。该计划旨在为学生提供进入特定专业领域的机会，并在早期阶段个性化他们的教育经历。这个项目在学生职业偏好中所起的作用还不是很清楚。我们试图探索学生对实习的参与和体验，并了解它如何影响他们对专业的看法、顾问的角色和职业意向。方法：2023年，作为可选活动，六家教学医院为二年级学生提供了220个PP实习机会（n = 254）。总共有122/254（48%）的学生申请了PP；其中，103/122（84%）获得了安置。学生们在12周内每周参加4小时的个性化课程。评价：通过调查收集定性数据，反映学生对安置的看法、顾问的作用以及对职业选择的潜在影响。数据被编码并按主题分类。总共有24/103（23%）的学生回应了这项调查，他们表示对专业职业道路、终身学习要求和工作与生活平衡的认识有所提高。该计划亦有助深入了解顾问的领导角色和教学责任。启示：个性化课程的实施提供了宝贵的机会，学生们很早就意识到这一点。值得注意的是，它让一些学生有理由重新考虑自己的职业选择，而另一些学生则发现，这段经历强化了他们最初的职业发展规划。

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引用次数: 0

Emotions on Call: Making a Hidden Curriculum Visible 随叫随到的情绪：让隐藏的课程可见。

IF 1.2 Q4 MEDICINE, RESEARCH & EXPERIMENTAL

Clinical Teacher

Pub Date : 2026-02-03 DOI: 10.1111/tct.70363

Emma Claire Phillips, Joshua Hughes, Victoria Ruth Tallentire

引用次数: 0

Behind the Screen: Exploring Trainee Experiences With Consultant-Involved Conflicts Through Reddit Narratives 屏幕背后：通过Reddit的叙述探索实习生与顾问参与冲突的经历。

IF 1.2 Q4 MEDICINE, RESEARCH & EXPERIMENTAL

Clinical Teacher

Pub Date : 2026-02-03 DOI: 10.1111/tct.70349

B. T. B. Preti, B. Shih, M. Merrick, M. S. Sanatani, T. Moniz

Introduction

Reddit is an anonymous social media platform where users often share candid experiences, including in medical education. Conflict in medical education, particularly involving consultants, has been shown to have an impact on the learner experience and the learning environment.

Methods

In order to gain insight into the trainee experience with consultant-involved conflicts, we collected Reddit narratives written by trainees over a one-year period. The use of Reddit narratives allowed a candid view into this sensitive aspect of medical training unaffected by an interviewer's presence. We performed narrative and content analyses to understand the experience of conflict, including conflict types, drivers and management strategies.

Results

Analysis of 208 posts revealed five types of conflict: communication challenges; conflicts relating to medical culture; disagreements about medical practice; dissonance in mindset, perspective or perception; and moral conflicts. Four drivers of conflict were identified: the trainee's self-perception, interpretation of professionalism, desire to learn and moral values. Five strategies for conflict management were identified: anger, awareness, asking for help, communication and avoidance.

Conclusion

These findings illuminate the need for safe spaces to debrief about trainee experiences of consultant–involved conflict. In the increasingly diverse, high-stakes, high-stress clinical environments where training occurs, medical learners may not have access to the conflict management and dialogue skills needed to artfully and sustainably navigate hierarchy-laden disagreements. We encourage educators to build real-world examples into curricula and incorporate conflict resolution training.

简介：Reddit是一个匿名社交媒体平台，用户经常在这里分享坦诚的经历，包括医学教育方面的经历。医学教育中的冲突，特别是涉及顾问的冲突，已被证明对学习者的经验和学习环境有影响。方法：为了深入了解培训生与顾问冲突的经历，我们收集了一年多来培训生在Reddit上写的故事。使用Reddit的叙述可以让人们对医疗培训的这个敏感方面有一个坦诚的看法，而不受面试官在场的影响。我们进行了叙述和内容分析，以了解冲突的经历，包括冲突类型、驱动因素和管理策略。结果：对208篇帖子的分析揭示了5种冲突类型：沟通挑战；医疗文化冲突；对医疗实践的分歧；心态、观点或感知上的不和谐；道德冲突。冲突的四个驱动因素是：学员的自我认知、对专业的理解、学习欲望和道德价值观。他们确定了五种冲突管理策略：愤怒、意识、寻求帮助、沟通和回避。结论：这些发现说明了需要安全的空间来汇报实习生在咨询师参与的冲突中的经历。在日益多样化、高风险、高压力的临床环境中进行培训，医学学习者可能无法获得冲突管理和对话技巧，从而无法巧妙地、可持续地处理充满等级制度的分歧。我们鼓励教育工作者在课程中加入现实世界的例子，并纳入解决冲突的培训。

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引用次数: 0

Artificial Intelligence Augmented Competence Committees: A Collaborative Path Forward in Competency-Based Medical Education 人工智能增强能力委员会：以能力为基础的医学教育的合作之路。

IF 1.2 Q4 MEDICINE, RESEARCH & EXPERIMENTAL

Clinical Teacher

Pub Date : 2026-02-03 DOI: 10.1111/tct.70358

Nibra Yasin, Elif Bilgic, Mohammad S. Zubairi

引用次数: 0

Risk Governance in Clinical Education for Healthcare Students: A Scoping Review 医疗保健专业学生临床教育中的风险管理：范围综述。

IF 1.2 Q4 MEDICINE, RESEARCH & EXPERIMENTAL

Clinical Teacher

Pub Date : 2026-02-03 DOI: 10.1111/tct.70355

Raelynn R. Tong, Je Min Suh, Lisa Cheshire, Lucio Naccarella

Background

Clinical education is essential for the training and accreditation of healthcare students. It facilitates hands-on application and prepares students for their future roles in a dynamic and complex workforce. However, such clinical exposure comes with inherent risk, not least due to the delicate balance between patient safety and student learning. Understanding risk is particularly crucial now as we confront new technologies that will undoubtedly transform clinical education. This scoping review aims to map current practices of tertiary institutions in managing risks and incidents in healthcare students' clinical education.

Methods

This scoping review adhered to the Joanna Briggs Institute's methodology and was reported in accordance with PRISMA-ScR guidelines. The search strategy considered key terms of ‘risk’, ‘clinical’ and ‘students’ in MEDLINE, Embase, CINAHL and grey literature. An inductive-deductive approach was used for thematic data analysis.

Results

We included 21 studies, which addressed risks in patient safety, student safety and incident response. Twelve studies reported on existing local practices, whereas nine evaluated new interventions. Ten studies intervened at the student level with education programmes, and 11 intervened at the faculty level with protocols and policies. Included studies involved students from medicine, nursing, dentistry, physiotherapy and psychology, with one study involving multiple disciplines.

Conclusions

Risk governance in clinical education is an emerging field, with faculties at various stages of establishing a risk governance framework. Key requisites for risk governance are robust and streamlined processes for incident reporting, incident response and policy change. Further research is needed to understand the impact of centralised multidisciplinary governance.

背景：临床教育对卫生保健专业学生的培训和认证至关重要。它促进了实践应用，并为学生在动态和复杂的劳动力市场中的未来角色做好准备。然而，这种临床暴露伴随着固有的风险，尤其是由于患者安全和学生学习之间的微妙平衡。当我们面对毫无疑问会改变临床教育的新技术时，理解风险尤为重要。本研究旨在了解高等教育机构在管理医疗保健专业学生临床教育中的风险和事件方面的现状。方法：本综述遵循乔安娜布里格斯研究所的方法，并按照PRISMA-ScR指南进行报道。搜索策略考虑MEDLINE、Embase、CINAHL和灰色文献中的“风险”、“临床”和“学生”关键词。主题数据分析采用归纳演绎方法。结果：我们纳入了21项研究，涉及患者安全、学生安全和事件响应方面的风险。12项研究报告了现有的地方做法，而9项研究评估了新的干预措施。10项研究通过教育方案在学生一级进行干预，11项研究通过协议和政策在教师一级进行干预。纳入的研究涉及医学、护理、牙科、物理治疗和心理学的学生，其中一项研究涉及多个学科。结论：临床教育风险治理是一个新兴领域，各院系处于建立风险治理框架的不同阶段。风险治理的关键条件是事件报告、事件响应和策略更改的健壮和简化的流程。需要进一步的研究来了解集中式多学科治理的影响。

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引用次数: 0

Structured Team Training to Improve Resuscitation Performance and Communication in Nursing Students: A Nonrandomized Intervention Study 结构化团队训练提高护理学生复苏表现和沟通：一项非随机干预研究。

IF 1.2 Q4 MEDICINE, RESEARCH & EXPERIMENTAL

Clinical Teacher

Pub Date : 2026-02-02 DOI: 10.1111/tct.70352

Kyeongmin Jang, Sung Hwan Kim

Aim

This study aimed to evaluate the impact of structured team training on teamwork, communication and resuscitation performance among undergraduate nursing students in simulated cardiac arrest scenarios.

Design

A nonrandomized pretest–posttest intervention study with a control group.

Methods

Sixty-seven third-year nursing students from two accredited nursing programmes were assigned to either an intervention group (n = 34), which received advanced life support training integrated with five structured team training sessions based on the TeamSTEPPS framework, or a control group (n = 33), which received life support training alone. Teamwork and communication were measured before and after training using validated tools. Resuscitation performance was assessed posttraining through standardized simulation scenarios rated by trained evaluators.

Results

The intervention group demonstrated significant improvements in teamwork and communication scores compared to the control group. Posttraining resuscitation performance was also higher in the intervention group. These findings indicate that the integration of structured team training enhances both technical and nontechnical competencies in high-pressure clinical situations.

Conclusion

Structured team training is an effective educational strategy to improve communication, collaboration and resuscitation performance among nursing students.

目的：本研究旨在评估结构化团队训练对护理本科生在模拟心脏骤停情境下的团队合作、沟通和复苏表现的影响。设计：一项有对照组的非随机前测后干预研究。方法：67名来自两个认可护理专业的三年级护生被分配到干预组（n = 34）和对照组（n = 33），干预组接受高级生命支持培训，并结合基于TeamSTEPPS框架的五次结构化团队培训。团队合作和沟通在训练前后使用有效的工具进行测量。通过训练有素的评估人员评定的标准化模拟场景，对训练后的复苏表现进行评估。结果：干预组在团队合作和沟通得分上较对照组有显著提高。干预组的训练后复苏表现也更高。这些研究结果表明，结构化团队培训的整合提高了高压临床环境下的技术和非技术能力。结论：结构化团队训练是提高护生沟通、协作和复苏表现的有效教育策略。

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引用次数: 0

Medical Student Perceptions of Psychological Safety in the Clinical Learning Environment 医学生在临床学习环境中的心理安全感。

IF 1.2 Q4 MEDICINE, RESEARCH & EXPERIMENTAL

Clinical Teacher

Pub Date : 2026-01-29 DOI: 10.1111/tct.70342

Katie Lappé, Jennifer O'Donohoe, Rachel Bonnett, Jorie Colbert-Getz, Heather Campbell, Katherine Hastings, Kirstyn E. Brownson, Sara Lamb, Candace Chow

Introduction

Psychological safety in the learning environment allows students to take risks without fear of humiliation or negative consequences. The psychological safety of healthcare teams has been studied at three levels: organizational, team and individual. Prior work has shown how leadership behaviours contribute to student perceptions of psychological safety in the clinical learning environment, but less is known about the impact of organizational and individual factors. The present study explored student perceptions of facilitators and barriers of psychological safety in the clinical learning environment.

Methods

We conducted a qualitative case study in Academic Year 2022–2023. We held four focus groups with 23 third- and fourth-year medical students at Spencer Fox Eccles School of Medicine. Focus groups were recorded and transcribed verbatim; transcripts were analysed using thematic analysis.

Results

Thematic analysis revealed that there were organizational supports and barriers, inclusive and exclusive leadership behaviours and individual student characteristics that affected psychological safety in the learning environment. Psychological safety exists when high levels of organizational support and inclusive behaviour are present. However, it is also possible for an organizational support or an inclusive leader behaviour to overcome an exclusive leader behaviour or an organizational barrier, respectively.

Conclusions

Organizational support and inclusive leadership behaviours foster psychological safety. Furthermore, it appears that psychological safety factors do not exist in isolation, but rather in tandem with one another. This makes it possible for an individual medical educator or organizational support to foster psychological safety even when organizational barriers or exclusionary behaviours from other supervisors exist.

学习环境中的心理安全使学生敢于冒险，而不必担心受到羞辱或产生负面后果。从组织、团队和个人三个层面对医疗团队的心理安全进行了研究。先前的研究表明，领导行为如何影响学生在临床学习环境中的心理安全感，但对组织和个人因素的影响知之甚少。本研究探讨学生对临床学习环境中心理安全促进因素和障碍的认知。方法：在2022-2023学年进行定性案例研究。我们与斯宾塞·福克斯·埃克尔斯医学院的23名三年级和四年级医科学生举行了四个焦点小组讨论。对焦点小组进行逐字记录和转录；使用主题分析对转录本进行分析。结果：专题分析发现，组织支持与障碍、包容与排他的领导行为和学生个体特征对学习环境中的心理安全有影响。当高水平的组织支持和包容行为存在时，心理安全就存在。然而，组织支持或包容性领导者行为也可能分别克服排他性领导者行为或组织障碍。结论：组织支持和包容性领导行为促进心理安全。此外，心理安全因素似乎不是孤立存在的，而是相互联系的。这使得个体医学教育者或组织支持能够促进心理安全，即使存在组织障碍或来自其他主管的排斥行为。

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引用次数: 0

The Effectiveness of Spaced Repetition in Medical Education: A Systematic Review and Meta-Analysis 间隔重复在医学教育中的有效性：系统回顾与元分析。

IF 1.2 Q4 MEDICINE, RESEARCH & EXPERIMENTAL

Clinical Teacher

Pub Date : 2026-01-28 DOI: 10.1111/tct.70353

James Anthony Maye, Florence Hurley

Introduction

Spaced repetition studying techniques such as Anki are increasingly prevalent in undergraduate and postgraduate medical education. However, the evidence base for the effectiveness of these techniques in a medical education setting is unclear. This meta-analysis investigates the effect of spaced repetition use in medical education on learner performance in objective tests.

Methods

The systematic review and meta-analysis was performed in accordance with PRISMA guidelines. Electronic databases were searched in February 2025 for relevant articles, assessed using predefined eligibility criteria. Methodological quality was assessed using the Medical Education Research Study Quality Instrument (MERSQI). Effect sizes, heterogeneity and publication bias estimates were calculated using the R programming language.

Results

Of the 542 records identified, 14 studies were included in the systematic review, of which 13 were included in the meta-analysis. A meta-analysis including 21,415 learners showed an overall significant effect in favour of spaced repetition study compared to standard studying techniques (standardised mean difference = 0.78; 95% CI 0.56–0.99; p < 0.0001). Spaced repetition interventions included faculty-created or third-party flash cards, MCQs delivered via email or as part of a continuing medical education framework, and spaced classroom quizzes.

Conclusion

Spaced repetition is an effective study method in medical education. Further work is required to investigate the optimal design and delivery of spaced repetition interventions, as well as to assess the impact of spaced repetition on longer term performance and continuing medical education.

像Anki这样的间隔重复学习方法在本科和研究生医学教育中越来越流行。然而，这些技术在医学教育环境中的有效性的证据基础尚不清楚。本荟萃分析探讨了医学教育中使用间隔重复对学习者客观测试成绩的影响。方法：按照PRISMA指南进行系统评价和荟萃分析。在2025年2月检索了电子数据库中的相关文章，并使用预定义的资格标准进行了评估。采用医学教育研究质量工具（MERSQI）评估方法学质量。使用R编程语言计算效应量、异质性和发表偏倚估计。结果：在确定的542条记录中，有14项研究被纳入系统评价，其中13项被纳入meta分析。一项包含21,415名学习者的荟萃分析显示，与标准学习方法相比，间隔重复学习的总体效果显著（标准化平均差= 0.78;95% CI 0.56-0.99; p）。结论：间隔重复是医学教育中一种有效的学习方法。需要进一步的工作来调查间隔重复干预的最佳设计和提供，以及评估间隔重复对长期表现和继续医学教育的影响。

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引用次数: 0