Advances in Health Sciences Education最新文献

Feedback is an emotional business; evoking optimism, fear or disappointment, which in turn can lead to engagement, further feedback seeking or avoidance. Emotions therefore are not just background noise but are fundamental to the experience. Through conceptualising emotions as embodied, social and complex, we seek to better understand how feelings work within feedback in clinical education, beyond an individual 'managing' their emotions. In this post-qualitative study, we ask: How does the interplay between feelings and feedback unfold in specialty medical training? To this end, we conducted a focussed ethnography of feedback in intensive care medicine and surgical training in Australian tertiary-care hospitals. Thinking with theory, we traced how trainees' feelings move within and between feedback encounters through observation-based field notes and interview transcripts. We provide thick description of how feedback is saturated with feeling, integrating our findings with discussion. Supervisors expressed their judgements about trainee performance as feelings, through feelings and about feelings. And trainees responded with feelings of their own. Formal feedback particularly intensified feelings, which 'stuck with' trainees, leading to action, including avoidance. Feelings served to strengthen relationships and reinforce social hierarchies both within and beyond the supervisor-trainee dyad. We infer that the judgements made in and around feedback - such as appraisal of source credibility, assessment of performance quality, and deciding future actions - are themselves fundamentally entangled with feelings. A first step to remedy the desire to 'manage' emotions through 'putting them away' is to acknowledge their presence in clinical learning environments.

Effective patient education improves health outcomes, yet physical therapists and student physical therapists (SPTs) often report low self-efficacy and inadequate preparation for delivering education in clinical settings. While experiential learning enhances communication and confidence, most training occurs in classroom or simulated environments. Limited research has examined how SPTs develop patient education skills during real clinical interactions. This qualitative case study explored how SPTs describe their experiential learning cycle when providing patient education during an inpatient integrated clinical education (ICE) experience. Kolb's experiential learning theory guided the study design and data analysis within a constructivist research paradigm. Data sources included direct observation of inpatient care, semi-structured interviews, and qualitative surveys with nine second-year DPT students from a U.S.-based program. A deductive thematic analysis was conducted using the stages of Kolb's learning cycle as an organizing framework. Four themes were identified. First, students engaged in diverse patient education experiences shaped by clinical context and patient complexity. Second, opportunities for reflection were variable and often lacked structure. Third, students developed new ideas about effective education strategies, including communication adaptations, use of educational materials, and family involvement. Fourth, their ability to apply these ideas fluctuated based on environmental conditions and educator support. This study provides insight into how SPTs progress through experiential learning in real-time clinical settings. Findings underscore the importance of embedding structured reflection and purposeful practice into ICE curricula to better support student development. Improved curricular design may enhance student preparedness and promote effective, patient-centered communication in physical therapy practice.

Innovative qualitative approaches are essential for exploring how health professions education (HPE) can address complex, value-laden constructs such as social accountability. Visual elicitation techniques, including rich picture interviews (RPIs), offer distinctive opportunities to surface layered, affective, and contextually embedded understandings. This methodological study examines participant perspectives on the use of RPIs within a broader qualitative interpretive description on social accountability. 46 participants, including learners, community representatives, faculty, and institutional leaders, created rich pictures (20-30 min) followed by semi-structured interviews (60 min) conducted virtually in English or French. Importantly, a dedicated segment of each interview explicitly elicited participants' reflections on the RPI process itself, including its accessibility, relevance, and perceived value. Data were analyzed using Braun and Clarke's reflexive thematic analysis. Three overarching themes captured participants' experiences: (a) from hesitation to reflective engagement, (b) visual thinking as a catalyst for dialogue and adaptability, and (c) affordances and boundaries of RPIs. Many began with apprehension, often tied to artistic skill or ambiguity of the task, yet valued RPIs for structuring reflection, deepening emotional engagement, and anchoring abstract concepts in personalized, tangible representations. Participants noted the method's adaptability across cultural, linguistic, and professional contexts, while also identifying barriers such as discomfort with drawing or the abstract nature of social accountability. By documenting these experiences across diverse partner groups, this study offers practical guidance for employing RPIs in HPE and related fields. RPIs can serve not only as data collection tools but as reflective, generative spaces that bridge abstract ideals with concrete experiences.

Written examinations are commonly used to assess learning. Different resources made available during testing (closed-note, open-note, and cheat-sheet) may influence student learning. The effect of resource availability on long-term knowledge application is unknown. Understanding the effects of exam resource availability on long-term knowledge application is needed, as application is essential in applied fields such as Occupational Therapy. To explore differences in short-term knowledge retention (course one overall score, midterm exam, and final exam) and long-term knowledge application (course two summative assessment) among occupational therapy students who had different types of exam resource availability during course one (closed-note, open-note, cheat-sheet). Data were extracted from four consecutive cohorts (n = 73) as they completed two sequential occupational therapy courses. Exam resource availability was the independent variable (k = 3), with course one midterm and final exams and overall course grade, and course two summative assessment grade as dependent variables. Kruskal-Wallis tests compared differences across conditions. Concerning short-term retention, no significant differences were observed between groups for course one midterm exam grade or overall course one grade. Course one final exam grades were significantly higher in the cheat sheet condition compared to closed note (3.9%, p = .009). Concerning long-term application as measured by the course two summative assessment grade, the closed note condition scored significantly higher than open note (6.25%, p = .01). No other comparisons were significantly different. In this sample we observed a small difference in short-term knowledge retention in favor of a cheat sheet condition and moderate difference in long-term application in favor of a closed note condition. While results suggest possible differences in performance across exam conditions, findings should be interpreted cautiously due to the small, convenience-based sample. This exploratory analysis offers preliminary insights and identifies directions for future research on the pedagogical impact of exam design.