Advances in Health Sciences Education最新文献

Undergraduate interprofessional education aims to prepare health professions students for a future work field characterised by wicked problems demanding interprofessional collaboration (IPC). Interprofessional identity (IPI) has been suggested as key to IPC, but how to foster its formation remains underdeveloped. Therefore, we aimed to identify (1) the main characteristics of IPI and (2) guidelines for educational design fostering interprofessional identity formation (IPIF). Per critical review methodology, we analysed educational sciences, health professions education and management sciences literature. The results of two iterative, non-exhaustive literature searches were analysed through reflexive thematic analysis. The first search focused on conceptualisations of IPI to identify its main characteristics and theories explaining IPIF, the second on the mechanisms of these theories fostering IPIF to derive guidelines for educational design. Analysis of the first search yielded five themes characterising IPI: (1) sense of belonging to an interprofessional team; (2) commitment to working interprofessionally; (3) values, attitudes, beliefs, and ethics related to IPC; (4) knowledge and understanding of roles, responsibilities, and expertise; and (5) IPC skills. We identified five prevalent theories explaining IPIF. Analysis of the second search resulted in guidelines for educational design fostering IPIF targeting the student, interprofessional team, faculty, and curriculum. Fostering IPI alongside IPC competencies is crucial for preparing students for IPC. This critical review highlighted key characteristics of IPI and proposes ED-IPIF, a theory-based framework for fostering IPIF through integrated educational design. Future research should address existing gaps and empirically test the ED-IPIF through longitudinal studies and robust tools for measuring IPI.

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.