Perspectives on Medical Education最新文献

Background: Childhood rheumatic diseases (cRDs) are more prevalent than commonly perceived, yet medical trainees often receive inconsistent exposure to pediatric rheumatology. Many medical schools and residency programs lack affiliated pediatric rheumatologists, contributing to knowledge gaps and delays in diagnosis. With a growing workforce shortage and care disparities, innovative educational approaches are essential.

Innovation: We developed an interactive, gamified bingo card to enhance pediatric rheumatology learning. This tool incentivizes engagement through structured clinical exposures, core knowledge tasks, and hands-on activities. Residents achieve "bingo" by completing five consecutive squares, each linked to key learning objectives based on American Board of Pediatrics content specifications and institutional clinical encounter data. Game mechanics-challenge, control, rules/goals, and assessment-promote self-directed learning and accountability.

Implementation & evaluation: Pediatric and medicine-pediatrics residents used the bingo card during a one-week rotation, with faculty validating completed tasks. In the 2023-2024 academic year, 50 interns received the tool, with 74% submitting completed cards. Residents checked off an average of 12 squares per week, with 31% achieving bingo. Post-rotation surveys (44% response rate) indicated the tool prioritized learning and facilitated faculty feedback. Faculty reported improved teaching efficiency by quickly identifying teaching points yet to be covered.

Conclusion: Gamification enhances pediatric rheumatology education within limited clinical experiences. This tool fosters engagement, supports knowledge acquisition, and offers a scalable model for specialized graduate medical education. Future adaptations may expand game elements to further increase motivation and peer collaboration.

Introduction: Many newly qualified doctors struggle to cope with the challenging transition to internship, raising a concern over whether they are adequately prepared with the competencies they need for legitimate practice. This study aimed to explore the reality of the internship role, the types of competencies that form the basis of achievement in this context, and the perceived readiness of newly qualified doctors to demonstrate these competencies.

Methods: A qualitative study, using focused ethnography, was undertaken in a regional public hospital in Johannesburg. 15 first year internship doctors volunteered to take part. Data was gathered over a seven-week period through participant observation and shadowing and informal conversations. Semi-structured interviews were recorded with 13 of the participants to further explore emerging themes. The data were analysed using a reflective thematic analysis with additional analysis using the Legitimation Code Theory (LCT) specialisation dimension coding framework.

Results: Interns are the 'engine room' of the hospital, facing long hours and the responsibility for a high workload. Some interns cope well, while others become overwhelmed, negatively impacting their wellbeing. Competency in teamwork, organization, efficiency, and communication provides the basis for legitimate practice, all attributes not highly valued by the undergraduate curriculum.

Discussion: To thrive, newly qualified doctors need to demonstrate both confidence in their clinical knowledge and skills as well as the attributes that form the basis of achievement in internship. To achieve this we need holistic competency based medical education that meaningfully values the personal and social competencies that are critical for legitimate practice.

Introduction: The characteristics of medical professionalism (MP) vary across cultural contexts. Professionalism constructs and MP tools currently rely on Western cultural perspectives. Chinese leaders are calling for MP tools that connect to historical traditions, current culture, and modern conceptualizations of MP inside and outside China.

Methods: The authors developed the China Medical Professionalism Inventory using standard processes in two steps. Phase I, "development of item pool," involved reviewing the literature to generate an item pool and conducting a first survey of Chinese clinical experts to develop content evidence. Phase II, "delineation of validity evidence," included three psychometric studies of practicing physicians and a second expert survey to create the final version of the tool; these processes aimed to determine validity evidence for content, internal structure, and relationships to other variables.

Results: Systematic review of the English- and Chinese-language literature identified 1537 professionalism-specific items from 63 sources to form the item pool. The authors conducted two rounds of expert review, including surveying nationally prominent Chinese clinician-leaders (n = 34, response rate 85%, and n = 76, response rate 63%). The authors conducted three psychometric studies of practicing Chinese physicians (n = 360, response rate 92%; n = 3653, response rate 90%; and n = 955, response rate 95%). The results generated the 20-item CMPI, with four factors: "Respect, Compassion, and Communication; Integrity; Excellence; and Responsibility."

Discussion: The CMPI presented validity evidence for content, internal structure, and relationship to other variables. This study may extend the conceptualization and reach of MP measurement.

Background & need for innovation: The importance of physician empathy for the quality of care is widely acknowledged, but comprehensive attention to the formation of empathy is often lacking in medical curricula.

Goal of innovation: In response to this incongruity, the aim was to develop education that contributes to the formation of empathy. In line with virtue-ethical theories, empathy is viewed as a character trait (virtue), developed by practicing. This includes acquiring knowledge of empathy as a virtue and understanding its demands in morally salient (clinical) situations (virtue literacy).

Steps taken for development and implementation of innovation: Four transdisciplinary teaching modules were developed for medical master's students during their four-week psychiatry rotation at Radboud University Medical Center in Nijmegen. Within each module, students (a) engage in discussions on empathy as a multidimensional virtue, (b) participate in exercises involving visual arts, literature, writing, drama, or clinical cases, followed by structured reflection, and (c) apply the insights gained during their rotations and subsequently reflect on these experiences.

Evaluation of innovation: Learning outcomes were exploratively assessed through qualitative, thematic analyses of: 1) pre- and post-module written students' accounts; 2) recordings of student discussions after modules; and 3) interviews on experiences and self-reported learning outcomes of the drama module.

Critical reflection on process: The modules promote understanding of empathy as a multidimensional virtue and student reflection on their empathic attitudes in clinical practice. Key factors include using art, connecting strongly to clinical experiences, and co-teaching by an ethicist or medical humanities teacher and a psychiatrist. More guidance (e.g. homework) may further support learning.

Introduction: Globally, alarming trends of psychological distress among physicians and medical students threaten patient care and professionalism. The resilience and well-being of medical educators have been recognised as key influences on learners. However, relevant research is limited, especially in Asian contexts. Using the National Academy of Medicine (NAM) model as a lens, this study explores what external and individual factors impact the resilience of Hong Kong (HK)-based medical educators.

Methods: HK-based medical educators, who taught medical students and physicians, were recruited using purposive sampling. They participated in semi-structured online interviews from 06/2021 to 04/2022. Anonymous sociodemographic information was collected through an online survey, and video recordings were transcribed anonymously. Guided by the NAM model, a hybrid deductive and inductive thematic analysis was conducted.

Results: Twenty medical educators participated. They identified factors capturing all seven NAM model domains as influencing their resilience. Of those, "organisational factors" (institutional expectations, recognition, and rewards) and "personal factors" (social support from family, friends, and colleagues, and a sense of purpose in their roles) were perceived as influencing their resilience to a similar extent, suggesting that both organisational support and individual connections can bolster medical educators' resilience.

Discussion: This study, the first of its kind in Asia, examined the applicability and contextual suitability of the NAM model for use among HK-based medical educators. They perceived organisational and individual factors as complementary in influencing their resilience. Our findings highlighted the importance of considering both system- and individual-level aspects when designing strategies for promoting resilience in this population.

Introduction: Small-group active learning methods can enhance student learning, but engaging students in these methods can be challenging for teachers. Therefore, Faculty Development Initiatives (FDIs) typically focus on medical teachers' proficiency in active learning strategies, yet transferring these strategies to actual teaching practices remains problematic. To address this, we designed, implemented, and evaluated an FDI aimed at stimulating this transfer to support medical teachers in facilitating active learning.

Methods: We conducted a Design-Based Research study with 34 new medical teachers in a small-group active learning course. The FDI combined Self-Directed Learning with on-the-job and off-the-job learning. Surveys and interviews were used in two separate iterations of the FDI to evaluate how transfer was stimulated. We adopted a pragmatic stance, applying inductive and deductive analysis methods.

Results: Participants reported that the FDI stimulated transfer in three ways: 1) Autonomy in creating personal learning objectives and learning processes increased motivation to transfer, 2) Support from peers, supervisors, and students encouraged the adoption of new teaching strategies, 3) Integration of on-the-job experiences and off-the-job meetings fostered a continuous learning cycle of experiencing, reflecting, understanding, and applying.

Discussion: Combining Self-Directed Learning with on-the-job and off-the-job learning within FDIs shows promise in stimulating the transfer of active learning strategies. This approach enables participants to progressively integrate such strategies into their teaching practices. While our findings provide valuable insights for FDI design, further research is needed to evaluate the relative effectiveness of this approach.

Background & need for innovation: Synthesizing academic literature is a foundational skill in health professions education (HPE), enabling evidence-informed decision-making and continuous improvement. However, privileging one review type as the "gold standard" reinforces a narrow hierarchy of evidence, marginalizing alternative worldviews and synthesis approaches.

Goal of innovation: This innovation aimed to broaden understanding and legitimate use of diverse literature synthesis methods by developing an accessible knowledge mobilization portal to support learners, educators, and scholars across the HPE community.

Steps taken for development and implementation of innovation: We developed LitR-Ex.com (Literature Reviews Explained) to showcase eight literature synthesis methods-the Literature Review Series (LRS). The Eco-Normalization Framework guided the design, implementation, and reflexive evaluation of the portal, aligning the innovation with contextual affordances and user needs. A collaborative, values-driven approach supported content co-creation, informed by lived experience, mutual trust, and a shared commitment to inclusivity.

Evaluation of innovation: The platform successfully launched and has been sustained through a network of contributors. Informal feedback and web analytics suggest positive engagement, and early adopters report its utility in teaching and research contexts. The innovation's resonance stems not only from its content but from the relationships and shared purpose underlying its development.

Critical reflection on your process: Key catalysts included: (1) friendship as an often-overlooked motivator in academic work; (2) trust and relationships that fostered momentum; and (3) a shared vision that anchored the innovation. These relational dimensions were as critical as the technical design in ensuring uptake and sustainability.

Introduction: The journey through submission, rejection, and eventual publication of scholarly work is challenging to academic researchers' resilience. Dealing with rejection without succumbing to burnout or impostor syndrome requires a growth mindset. This paper analyses one author's manuscript rejections over five years and makes recommendations for academic researchers regarding manuscript rejections.

Methods: This retrospective longitudinal mixed-methods study included one author's rejected submissions from 2019 to 2023. Quantitative data on manuscript rejection characteristics: number of rejections, subsequent publication, submission (field and research type), journal location and impact factor, and nature of rejection (desk rejection, rejection after review or revision) were analysed descriptively. Qualitative data (narrative text indicating reasons for desk rejection) were analysed thematically. Ethics approval was obtained.

Results: Eighty submissions of 47 manuscripts were rejected, including 65% desk rejections. Most manuscripts were rejected once (60%) or twice (26%), and 77% were subsequently published. Most submissions were to journals in Africa (56%), on postgraduate student research (63%), in the field of medicine (71%). Themes related to reasons for desk rejection included not meeting journal requirements (scope, focus, criteria or priority), manuscript inadequacy (novelty, relevance, methodology, or contribution), and ethical issues (similarity indices, or ethics documentation).

Discussion: This study on manuscript rejections received by one author over five years revealed that most rejected manuscripts were subsequently published. Desk rejection was most common. We support literature on normalizing and destigmatizing rejection and bolstering resilience to support academic researchers when dealing with technical, manuscript-related revisions and inevitable emotional responses to rejection to ensure healthy longevity in their scholarly careers.

Introduction: Virtual Reality (VR) has advanced in medical education, offering enhanced realism and immersion, allowing students to safely practice complex and rare scenarios like cancer truth-telling. This study aimed to develop and evaluate the effectiveness of a VR-based cancer truth-telling module.

Methods: This experimental study randomly assigned fifth-year medical students to the following groups: in-person communication skills training (iCST), VR, and a combined iCST+VR group. The intervention included a 30-minute video-based mini-lecture followed by practical application. The VR group received the VR truth-telling module, the iCST group received the small-class iCST module, and the iCST +VR group received both the iCST and VR modules. Primary outcomes assessed were cancer truth-telling perspectives, with communication confidence and learning satisfaction as a secondary outcome. Data were collected at baseline, immediately after, and at three and six months post-intervention.

Results: Seventy-nine medical students were enrolled and randomly assigned to the iCST (n = 28), VR (n = 29) and iCST +VR (n = 22) groups. The study findings showed that the iCST+VR group significantly improved in cancer truth-telling perspectives at six months post-intervention. No significant difference was found between iCST and VR groups for cancer truth-telling perspectives. Although communication confidence scores significantly improved across all groups, no differences were found between groups. The iCST group reported higher learning satisfaction compared to other groups, with no significant difference between VR and iCST+VR.

Discussion: This study demonstrated that VR is as effective as iCST in enhancing cancer truth-telling perspectives and communication confidence, highlighting VR's potential as an innovative tool in medical education.