Clinical Teacher最新文献

英文中文

Engaging Students in Large-Scale Interprofessional Learning Activities: Team-Based Learning (TBL) as a Pedagogical Solution 让学生参与大型跨专业学习活动：以团队为基础的学习作为一种教学解决方案。

IF 1.2 Q4 MEDICINE, RESEARCH & EXPERIMENTAL

Clinical Teacher

Pub Date : 2025-12-09 DOI: 10.1111/tct.70284

Christie van Diggele, Antonia J Clarke, Annette Burgess

Background

Interprofessional education (IPE) helps to prepare health professional students to deliver patient-centred care within collaborative team environments. However, large-scale delivery of IPE is challenging. Using team-based learning (TBL) as a teaching and learning strategy, we sought to develop, implement and evaluate a large-scale learning activity on ‘understanding, and learning from errors’.

Approach

In 2023, 769 senior students from pharmacy (n = 145), nursing (n = 158), dentistry (n = 109), oral health (n = 46) and medicine (n = 311) were timetabled to participate in one of nine 2 h interprofessional sessions structured in TBL format, as a mandatory component of their unit of study. At least five facilitators from multiple disciplines were present at each session.

Evaluation

In total, 752/769 (98%) students attended their assigned TBL session. Following the TBL session, students were invited to complete a questionnaire using closed and open-ended items. Quantitative data were analysed using descriptive statistics. Qualitative data were analysed using thematic analysis. Students reported that the TBL structure enabled interdisciplinary collaboration on a clinical scenario, immediate feedback, and the opportunity to better understand patient safety and the roles of different disciplines. However, some students felt the clinical scenario lacked relevance to their disciplines.

Implications

Our study provided a scalable and effective model for interprofessional learning using the TBL framework. In future iterations, consideration should be given to the number of disciplines per team, and the relevance of the clinical scenario.

背景：跨专业教育（IPE）有助于卫生专业学生在协作团队环境中提供以患者为中心的护理。然而，大规模交付IPE具有挑战性。使用基于团队的学习（TBL）作为一种教学策略，我们试图开发、实施和评估一个关于“理解和从错误中学习”的大规模学习活动。方法：2023年，769名来自药学（n = 145）、护理（n = 158）、牙科（n = 109）、口腔卫生（n = 46）和医学（n = 311）的高年级学生被安排参加以TBL格式组织的9个2小时的跨专业课程之一，作为其学习单元的强制性组成部分。每次会议至少有五位来自多个学科的主持人出席。评估：总共有752/769（98%）的学生参加了他们指定的TBL课程。在TBL课程之后，学生们被邀请完成一份使用封闭式和开放式项目的调查问卷。定量资料采用描述性统计进行分析。定性数据采用专题分析进行分析。学生们报告说，TBL结构促进了临床场景的跨学科合作，即时反馈，并有机会更好地了解患者安全和不同学科的作用。然而，一些学生认为临床场景与他们的学科缺乏相关性。启示：本研究为跨专业学习提供了一个可扩展且有效的模型。在未来的迭代中，应该考虑每个团队的规程数量，以及临床场景的相关性。

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引用次数: 0

‘Trial and Error’—How Do Interns Learn Their Role-Specific Workplace Skills? “试错”——实习生如何学习角色相关的职场技能？

IF 1.2 Q4 MEDICINE, RESEARCH & EXPERIMENTAL

Clinical Teacher

Pub Date : 2025-12-09 DOI: 10.1111/tct.70278

Karishma Patel, Gurpreet Dhaliwal

Introduction

Many of the essential workplace skills interns (graduates of US medical schools who are in their first year of supervised practice as physicians) need to function in their roles are taught briefly (e.g., a single didactic session) or are not formally taught at all. These role-specific skills—for example, managing a task list, constructing a patient handoff and calling a consultant—are not addressed like core medical knowledge subjects (e.g., diabetes) or clinical skills (e.g., procedures), which are reinforced through patient interactions, colleague discussions, supervisor feedback and didactics throughout residency. Understanding how interns learn their role-specific skills could empower them to manage their workplace learning opportunities.

Methods

We conducted a qualitative study to examine how interns acquire role-specific workplace skills. We conducted semistructured interviews of 16 interns in an internal medicine residency programme. Interview transcripts were analysed using template analysis. Codes were identified, refined and grouped into overarching themes.

Results

Interns described an iterative learning process (‘trial and error’) informed by peers and supervisors, reflection on the outcomes of completed tasks and technology. Participants identified time and workload pressures as positive influences on their learning. Planning, formal goal setting and direct feedback were not described; instead, interns recognised their progress retrospectively and subjectively, rather than using predefined benchmarks.

Conclusion

Interns learn many role-specific skills through an iterative and unstructured approach that aligns with workplace learning literature. Targeted reflection and teaching and feedback from supervisors may enhance skill acquisition.

导读：许多实习医生（美国医学院的毕业生，第一年作为医生在监督下实习）需要在他们的角色中发挥作用的基本工作技能被简短地教授（例如，一次教学会议），或者根本没有被正式教授。这些角色特定的技能——例如，管理任务列表，构建病人交接和呼叫顾问——不像核心医学知识科目（如糖尿病）或临床技能（如程序）那样被处理，这些技能通过患者互动，同事讨论，主管反馈和整个住院医师的教学来加强。了解实习生如何学习特定角色的技能可以帮助他们更好地管理工作场所的学习机会。方法：我们进行了一项定性研究，以考察实习生如何获得特定角色的职场技能。我们对内科住院医师项目的16名实习生进行了半结构化访谈。访谈记录采用模板分析法进行分析。代码被确定、精炼并分组为总体主题。结果：实习生描述了一个由同事和主管告知的迭代学习过程（“试错”），对完成任务的结果和技术的反思。参与者认为时间和工作量压力对他们的学习有积极影响。没有描述计划、正式目标设定和直接反馈；相反，实习生会回顾性地、主观地评估自己的进步，而不是使用预先设定的基准。结论：实习生通过迭代和非结构化的方法学习许多特定角色的技能，这些方法与职场学习文献相一致。主管有针对性的反思、教学和反馈可以促进技能习得。

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引用次数: 0

Policy Without Process: The Problem of the WFME 2025 Declaration 没有过程的政策：2025年世界粮食和农业大会宣言的问题。

IF 1.2 Q4 MEDICINE, RESEARCH & EXPERIMENTAL

Clinical Teacher

Pub Date : 2025-12-08 DOI: 10.1111/tct.70317

Mohammed Ahmed Rashid, Janet Grant

Medical education policy is increasingly tasked with addressing complex ethical, social, and institutional demands. The 2025 Declaration by the World Federation for Medical Education (WFME) calls on institutions to support the well-being of medical students, postgraduate trainees and practising physicians. While positioned as a progressive move toward systemic accountability, this paper argues that the Declaration raises significant concerns of legitimacy, authority, and coherence. Drawing on critical policy analysis, we interrogate the Declaration's authorship, scope, language and evidentiary base to examine how it constructs and performs authority. Our analysis reveals four key tensions: (1) the absence of transparent authorship and consultation, undermining representational legitimacy; (2) ambiguous definitions producing jurisdictional and operational uncertainty; (3) inconsistent normative language that performs obligation without enforcement; and (4) reliance on epistemically narrow frameworks without contextual adaptation. These ambiguities risk overstating WFME's remit and diminishing the Declaration's practical utility. We argue that for policy texts to advance global medical education meaningfully, they must be grounded in transparent authorship, plural epistemologies, contextual relevance and actionable mechanisms. Without these, declarations may reproduce symbolic authority rather than foster substantive institutional change.

医学教育政策的任务越来越多，以解决复杂的伦理，社会和制度的要求。《世界医学教育联合会2025年宣言》呼吁各机构支持医学生、研究生培训生和执业医生的福祉。虽然定位为向系统性问责制的进步，但本文认为，《宣言》提出了对合法性、权威性和一致性的重大关切。在批判性政策分析的基础上，我们对《宣言》的作者、范围、语言和证据基础进行了质疑，以检验它是如何构建和行使权威的。我们的分析揭示了四个关键的紧张关系：(1)缺乏透明的作者身份和咨询，破坏了代表性的合法性；(2)模棱两可的定义导致管辖权和操作的不确定性；（三）规范性语言不一致，不强制履行义务的；(4)依赖认识论上狭隘的框架，缺乏语境适应。这些含糊之处可能会夸大世界粮食基金的职权范围，削弱《宣言》的实际效用。我们认为，要使政策文本有意义地推进全球医学教育，它们必须建立在透明的作者身份、多元认识论、上下文相关性和可操作机制的基础上。没有这些，宣言可能会再现象征性的权威，而不是促进实质性的体制变革。

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引用次数: 0

Relational Supervision and Intellectual Candour: How to Create Trust? 关系监督与智力坦诚：如何创造信任？

IF 1.2 Q4 MEDICINE, RESEARCH & EXPERIMENTAL

Clinical Teacher

Pub Date : 2025-12-08 DOI: 10.1111/tct.70302

Daniel Anderson

引用次数: 0

Emotion Regulation in Procedural Medicine: From Suppression to Integration 程序医学中的情绪调节：从压抑到整合。

IF 1.2 Q4 MEDICINE, RESEARCH & EXPERIMENTAL

Clinical Teacher

Pub Date : 2025-12-08 DOI: 10.1111/tct.70305

Brian M. Moloney

引用次数: 0

Design and Implementation of an Internal Medicine Point-of-Care Ultrasound Curriculum for Undergraduate Medical Education 本科医学教育内科护理点超声课程的设计与实施。

IF 1.2 Q4 MEDICINE, RESEARCH & EXPERIMENTAL

Clinical Teacher

Pub Date : 2025-12-08 DOI: 10.1111/tct.70271

Béla H. Cseri, Benjamin M. Stieren, Kene A. Chukwuanu, Woo J. Moon

Background

Point-of-care ultrasound (POCUS) is increasingly used by internal medicine physicians to improve diagnostic accuracy and clinical outcomes. Despite its value, POCUS is not widely integrated into undergraduate medical education, particularly during the core internal medicine clerkship, due to barriers such as limited faculty expertise and institutional resources.

Approach

We evaluated a 2-week internal medicine POCUS elective for fourth-year medical students, offered from 2020 to 2023 at Saint Louis University School of Medicine, as a potential model for integration into the internal medicine clerkship. Designed and facilitated by a single faculty member, the elective included formal didactic sessions, faculty-led scanning using ultrasound simulators and standardised patients, as well as self-directed reading and online modules. Student outcomes were assessed through pre- and post-course knowledge assessments and self-reported confidence surveys.

Evaluation

Between 2020 and 2023, 23 students completed the elective. Average knowledge assessment scores increased from 58.8% pre-course to 91.8% post-course, representing a 33% improvement (p < 0.0001). All 12 students who completed the confidence survey reported that the elective increased their knowledge and understanding of POCUS.

Implications

Although initially designed for fourth-year medical students, this POCUS elective provided knowledge and hands-on skills relevant to internal medicine. Its flexible format and low faculty burden suggest it may serve as a scalable model for incorporation into core internal medicine clerkships, including at institutions with limited POCUS-trained faculty or resources.

背景：点护理超声（POCUS）越来越多地被内科医生用于提高诊断准确性和临床结果。尽管POCUS很有价值，但由于教师专业知识和机构资源有限等障碍，它并没有广泛融入本科医学教育，特别是在核心内科实习期间。方法：我们评估了圣路易斯大学医学院在2020年至2023年为四年级医学生提供的为期两周的内科POCUS选修课，作为整合内科实习的潜在模式。选修课由一名教师设计和指导，包括正式的教学课程，教师主导的使用超声模拟器和标准化患者的扫描，以及自主阅读和在线模块。通过课程前和课程后的知识评估和自我报告的信心调查来评估学生的成绩。评估：在2020年至2023年期间，有23名学生完成了选修课。平均知识评估分数从课程前的58.8%提高到课程后的91.8%，提高了33% (p含义：虽然最初是为四年级医学生设计的，但这门POCUS选修课提供了与内科相关的知识和实践技能。其灵活的形式和较低的教师负担表明，它可以作为一种可扩展的模式，纳入核心内科职员，包括在师资或资源有限的机构中。

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引用次数: 0

Beyond Stoicism: Cultivating Emotional Integration in Medical Training 超越禁欲主义：在医学训练中培养情感整合。

IF 1.2 Q4 MEDICINE, RESEARCH & EXPERIMENTAL

Clinical Teacher

Pub Date : 2025-12-08 DOI: 10.1111/tct.70303

Muskan Sharma, Jordan Byrne, Stephen Ho, Gabriela Bodero Jimenez

引用次数: 0

Reconsidering the Linearity of Cause and Effect Thinking in Teaching Clinical Reasoning 临床推理教学中因果思维线性的再思考。

IF 1.2 Q4 MEDICINE, RESEARCH & EXPERIMENTAL

Clinical Teacher

Pub Date : 2025-12-08 DOI: 10.1111/tct.70289

Zara Aayat Adil, Vinay Saini

引用次数: 0

Assessing the Quality of Narrative Feedback in Entrustable Professional Activities Using the EFeCT Feedback Scoring Tool 使用effect反馈评分工具评估可信赖的专业活动中叙述性反馈的质量。

IF 1.2 Q4 MEDICINE, RESEARCH & EXPERIMENTAL

Clinical Teacher

Pub Date : 2025-12-08 DOI: 10.1111/tct.70295

Rebecca Lee, Neil Dhami, William Gibson, Deena M. Hamza, Anna E. Oswald, Mandy Moffat

Background

Competency-based medical education (CBME) is the cornerstone of undergraduate training in Canada. Entrustable professional activities (EPAs) assess competency in professional tasks, with narrative feedback being a key component. There is currently a lack of published literature on the quality of narrative feedback in EPA observations in undergraduate medical education. This study explores the quality of narrative feedback in EPA observations provided to medical students.

Methods

The quality of narrative feedback in a random sample of anonymised EPA observations from Year 3 students was evaluated using the Evaluation of Feedback Captured Tool (EFeCT). The EFeCT tool explores five facets of quality feedback, with a score of five indicating high-quality feedback. Three evaluators independently assessed the quality of narrative feedback using the EFeCT tool. Any differences in score were resolved through discussion to reach consensus.

Results

In the 2022–2023 academic year, 15,240 EPA observations were completed for year 3 students. A subset of 748 observations was analysed. Of these, one scored 0, seven scored 1, 33 scored 2, 115 scored 3, 151 scored 4 and 441 scored 5 on the EFeCT tool. The mean EFeCT score was 4.3.

Conclusions

Overall, the majority of EPA narratives provided moderate to high-quality feedback to students. However, variability was evident, and many EPA narratives were missing one or more elements of high-quality feedback. This could result in significant implications for learner development. Addressing contextual factors such as clinical workload and creating faculty development opportunities may support faculty in providing high-quality narrative feedback.

背景：能力为基础的医学教育（CBME）是加拿大本科教育的基石。可信赖的专业活动（EPAs）评估专业任务的能力，叙述性反馈是一个关键组成部分。目前缺乏关于本科医学教育中EPA观察的叙事反馈质量的已发表文献。本研究探讨叙述反馈的质量在EPA观察提供给医学生。方法：采用反馈捕获评估工具（Evaluation of feedback capture Tool，简称effect），随机抽取三年级学生的匿名EPA观察样本，对叙事反馈的质量进行评估。effect工具探索了质量反馈的五个方面，得分为5表示高质量的反馈。三位评估者使用effect工具独立评估叙述反馈的质量。分数上的分歧通过讨论解决，达成共识。结果：在2022-2023学年，完成了15,240个三年级学生的EPA观察。分析了748个观察结果的子集。其中，1人得分为0,7人得分为1,33人得分为2,115人得分为3,151人得分为4,441人得分为5。平均效应评分为4.3分。结论：总体而言，大多数EPA叙事为学生提供了中等到高质量的反馈。然而，可变性是显而易见的，许多EPA叙述缺少一个或多个高质量反馈元素。这可能会对学习者的发展产生重大影响。解决诸如临床工作量和创造教师发展机会等环境因素可能有助于教师提供高质量的叙述性反馈。

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引用次数: 0

The Unknown Cost of Medical Education 医学教育的未知成本。

IF 1.2 Q4 MEDICINE, RESEARCH & EXPERIMENTAL

Clinical Teacher

Pub Date : 2025-12-08 DOI: 10.1111/tct.70290

Kennagh Marsh

引用次数: 0

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