Advances in Health Sciences Education最新文献

The perception held by clinical teachers of health professionals that their teaching efforts are under-valued by their education institutions persists despite intensive research and subsequent interventions to address this global problem. The purpose of this multi-site study is to examine how clinical teaching activities are organised, in order to reveal if there are underlying systemic factors that may contribute to this wicked problem. This study employed a cross-comparative case study design of one Singaporean and one Canadian medical school. Semi-structured interviews were conducted with organisational leaders (n = 23) who manage clinical teaching activities and/or have insights on their local assessment, support and recognition systems. Public records were also collected from each site (n = 24). A theory-driven content analysis using a complexity science interpretation of the concept of the Hidden Curriculum was conducted with both sets of data. The two sites were at different stages of maturation in respect of clinical teaching evaluation and feedback, support, and recognition and reward systems. Despite this, the interviews identified shared structure, process and culture-oriented challenges: low prioritisation of teaching, faculty demotivation and dissatisfaction across both research sites. Our findings suggest that a continued focus on structure and process-oriented reforms to elicit change is insufficient. Instead, further examination of site-specific, multiple intersecting academic and clinical cultures is needed. Future efforts to improve the value and drive the pursuit of teaching excellence will require multi-faceted structure, process and culture change approaches. We argue that Hafferty and Castellani’s (The hidden curriculum: A theory of medical education, Routledge, 2009) re-conceptualisation of hidden curriculum through a complexity science lens should be used as a heuristic device to address future research and reform in local medical education contexts.

There is a wide range of literature suggesting that implicit learning is more effective than explicit learning when acquiring motor skills. However, the acquisition of nursing skills in educational settings continues to rely heavily on detailed protocols and explicit instructions. This study aimed to examine the necessity for comprehensive protocols in the acquisition of nursing skills. In the context of bandaging techniques, three studies were conducted to investigate whether students who practiced with an instruction card containing minimal instructions (implicit group) performed comparably to the students who practiced with a protocol containing step-by-step instructions (explicit group). Study 1 was designed to determine whether both groups performed equally well in applying a bandage during training. Study 2 and 3 were designed to determine if both groups performed equally well during a retention and transfer (multitasking) test, administered after a series of three training sessions. In comparison with the explicit group, the implicit group demonstrated comparable performance with their practice attempts in Study 1 and performed equally well during the retention and transfer test in Study 2. Furthermore, several results from Study 3 indicated better performance of the implicit group. In conclusion, the use of protocols with explicit step-by-step instructions may not be essential for the acquisition of nursing skills. Instead, instructional methods that facilitate implicit learning may be preferable, as students in the implicit group demonstrated at least comparable performance in all studies and tended towards greater consistency when multitasking.

This column is intended to address the kinds of knotty problems and dilemmas with which many scholars grapple in studying health professions education. In this article, the authors set the stage for a series of articles exploring the research supervisory relationship (often also described as a mentor-mentee relationship) and how it influences the dissemination of scholarly work.

In this editorial the editor considers the nature and use of knowledge claims in the sciences of health professions education, and she explores ways in which these knowledge claims can be expressed and parsed that speak to their veracity, authority, and reliability.

The transition from being a medical student to working as a doctor is a pivotal phase, often marked by challenges in balancing learning with the demands of clinical practice. Despite extensive research on the struggles faced by junior doctors, there remains a gap in understanding how other key stakeholders perceive this transition and how it can be viewed as more than just a struggle. In this phenomenographic study, we used the Swedish medical internship as a proxy for the transition and explored internship programme directors’ (PDs) perceptions of the medical internship from a developmental point of view. A phenomenographic approach was chosen to capture the variation in how PDs conceptualise the meaning of the internship, offering a more nuanced understanding of the transition and its implications for educational practice. Interviews with twelve PDs gave rise to three perceptions: the internship as an education, as working as a doctor, and as a space for learning through work. These views highlighted the transition not merely as a preparatory phase but as a dynamic process in which learning and clinical work were intertwined. Our findings suggest that instead of focusing solely on better preparing students for work, empowering junior doctors to learn through work—supported by structured guidance—can turn this challenging period into an opportunity for professional and personal growth. This study offers a novel contribution by shedding light on the role of PDs in shaping the transition to clinical work and emphasising the need to view it as a learning-centred, reflective experience.

In this editorial the editors reflect on issues raised by the special edition of the Journal on data science by asking the question: is data science in health professions education a ‘science’ as the term is generally understood? A series of criteria for science as a whole are applied to data science and the implications explored in the context of our field.

In this commentary, the authors respond to Ellaway & Patocka’s “To define or not to define: A commentary on the Case for Metacognitive Reflection,” which raised several thoughtful and discerning questions concerning the implications of defining, or alternatively, refraining from defining constructs. The authors advocate for navigating the liminal space between precision and flexibility, acknowledging the dynamic and permeable nature of conceptual boundaries while striving for clarity. Moreover, they emphasize that only after a boundary is described can the tensions, gaps, exceptions, and contradictions around that boundary be explored. Finally, the authors highlight the significance of contextual definitions, fostering shared understanding, and embracing abductive reasoning (when is becomes as) to promote dialogue and advance knowledge in health professions education.

This study investigated whether career coaching can reduce medical students’ career decision-making stress through clarifying students’ self-concept, increasing career decision self-efficacy, and lowering perceived time pressure to make a career decision. We evaluated the effectiveness of a coaching intervention (including five individual coaching sessions over eight months) using a randomized-waitlist controlled trial design. Participating medical master’s students completed a first survey (T1). The intervention condition (n = 94) started the coaching program right away. The waitlist-control condition (n = 130) started after 8.5 months. Participants in the intervention condition completed a second (T2) survey three weeks after their last coaching session. Participants in the waitlist-control condition received the second survey 8.5 months after registration. Data were analyzed using multilevel path modelling. The total effect of coaching on career decision-making stress was significantly negative (-0.17; 95% CI [-0.31, -0.06]), reflecting a small to moderate effect size. This total effect was partially mediated (i.e., explained) by career decision self-efficacy (-0.02; 95% CI [-0.06, -0.00]). Exploratory analyses suggested that coaching only clarified the self-concept of students with a relatively negative coaching attitude at T1. Moreover, coaching resulted in more changes in career choices and an increase in students’ career choice certainty. This study demonstrates that coaching is effective in reducing medical students’ career decision-making stress and increasing their career decision self-efficacy and career choice certainty. High-quality career decision-making is important because it is associated with higher job satisfaction, well-being, and performance. Medical schools may consider providing coaching to students to support their career decision-making.

This commentary is a response to both Merkebu et al., (2024) and Ellaway and Patocka (2024) on the place and importance of definitions of key notions in health professions education (HPE). The author argues that definitions of key notions in HPE research, teaching, and assessment are both variably possible and variably useful. By differentiating across concepts, constructs, measures, and metrics, the author contextualizes the variable utility and necessity of definitions according to their intended use. While many conceptualizations of key notions peacefully co-exist in the current HPE literature, conflation across concepts, constructs, measures, and metrics lead to a fragmented literature base and problematic assumptions, operationalizations, and misattributions of some of our most closely held concepts.