Advances in Health Sciences Education最新文献

Recent studies on handover communication highlight the role of the incoming physician in preventing misunderstandings that contribute to medical errors. However, existing research often only provides abstract recommendations for increasing their participation, without specifying where and how this should occur. This paper applies discourse theory and methods to identify where the incoming physician’s active involvement is interactionally appropriate and can be integrated naturally and effectively. Twelve handovers between six pairs of resident physicians were recorded in a simulated ICU setting at a teaching hospital and analyzed using a combination of genre theory and conversation analysis. By first identifying the "moves" that constitute the handover genre, we pinpointed places where active participation by the incoming physician is expected and facilitates effective communication. While the tasks and focus points and the questions and consultation moves clearly invite such participation, the clinical situation move requires more negotiation, as the outgoing physician maintains control over the conversational floor, making it less immediately accessible for the incoming physician to contribute. The four remaining moves exhibit a more monologic pattern, where both participants display interactional behavior signaling that active input from the incoming physician is not anticipated. Our findings suggest that medical professionals share an implicit understanding of when participation is appropriate, shaped by conventions of the handover genre itself. By reconstructing these tacit rules through genre theory and conversation analysis, we provide insights that can inform training methods, ensuring that recommendations for active participation by the incoming physician align with the structured expectations of clinical practice.

Online learning is integral to pre- and post-licensure training across health and allied health disciplines. This randomized controlled study examined the impact of incorporating self-reflection prompts into an online clinical skills training module. A total of 88 health and social science students were randomly assigned to either a control group (N = 44) or an experimental group (N = 44). Both groups completed a brief, asynchronous online training module adapted from the Triple P - Positive Parenting Program, featuring a recorded lecture on clinical consultation skills. The experimental group received additional self-reflection prompts and completed written reflections, while the control group completed the training without reflective exercises. Participants in both groups completed pre- and post-training self-assessment surveys measuring knowledge, self-efficacy, and confidence, alongside a simulated client interview assessed using a standardized competency checklist for interpersonal and procedural skills. Results showed that participants in the experimental group demonstrated significantly greater improvements in knowledge acquisition, interpersonal skills, and procedural performance compared to the control group. These findings suggest that incorporating structured self-reflection activities in online training can enhance learning outcomes, promote deeper engagement, and improve self-awareness and clinical competence.

Exploring students’ interprofessional education experiences highlights the occurrence of hierarchy as a barrier to collaborative practice. Individuals are however influenced by the multiple social identities of themselves and others and not just professional hierarchy. Intersectionality offers a useful lens through which to understand the complex influences of students’ learning experiences. Using poetic inquiry, this paper explores the influence of intersectionality on health professional students’ interprofessional learning experiences on two rural training platforms in South Africa. Sixteen individual interviews with final-year undergraduate students from five different healthcare professions were conducted in 2022. An inductive narrative analysis of the data was undertaken and represented using ‘found poems’. Reflexive analysis of the data presented in poems was conducted with student participants, co-authors, and an independent qualitative researcher. Themes related to the intersection of language and ethnicity, religion and profession, culture and profession as well as professional discipline and being a student were extracted from the data. Participants demonstrated disorienting learning experiences in both the clinical and social context. Using intersectionality as a lens, we have gained insight into the sometimes-disorienting influence of students’ intersecting social identities during interprofessional learning on two rural training platforms. A nuanced understanding of how multiple social identities intersect to influence experiences could help educators mitigate student and educator biases and understand structural power dynamics in training environments. Transformative learning may be a way to introduce intersectionality into both interprofessional education and health professions education in general.

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.