Advances in Health Sciences Education最新文献

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.

Learning analytics are increasingly used in medical education to analyze data and make decisions about learners’ abilities. While there are many potential benefits of using learning analytics to drive improvement in medical education, there are also ethical concerns surrounding how this may affect learners and their patients. We conducted a critical review of studies that use learning analytics and big data within medical education. Using guidelines established by Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA), relevant articles were identified in MEDLINE (PubMed) and SocINDEX databases from inception to April 2021. Detailed data abstraction was performed across studies to identify current uses of learning analytics and identify potential ethical concerns. Eighteen articles met the search criteria. Our analysis identified the use of learning analytics and big data in four aspects of medical education: (1) the learning process and pedagogy; (2) retrospective assessment; (3) prospective assessment; and (4) improvement of education. We identified some ethical concerns surrounding the use of learning analytics and big data, including the (1) trustworthiness of data; (2) reliability of methodology; (3) privacy, confidentiality, and management of data; and (4) labeling of learners as “problematic.” Using Beauchamp and Childress’s biomedical ethics as a framework, we identified potential consequences of using learning analytics for learners within the principles of beneficence, nonmaleficence, autonomy, and justice. As learning analytics becomes more widespread in medical education, examining and mitigating potential harm towards learners is imperative.

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 provide advice to junior researchers who wish to become– and to be seen as– members of the health professions education (HPER) community.

Medical students’ perceptions of their community learning experiences can provide valuable insights for evolving and improving healthcare professional education curricula to better respond to health needs. This study aims to explore the learning experiences of undergraduate medical students in a community health course at a Colombian University. Fifteen students who had completed the Family Medicine and Community Health course participated in this qualitative study, employing a phenomenographic approach and interview technique. The phenomenographic analysis, informed by the transformative service-learning theoretical framework, resulted in the construction of categories of description, organized hierarchically, based on levels of understanding. The findings revealed five main community health learning experiences: Fulfilling the requirements, Educating the community, Solving health problems, Joint construction, and Personal transformation. Students experienced learning in diverse hierarchical learning levels, with their understanding around community health evolving over time. Transformative learning experiences were identified among only some students, indicating the potential for everyone to reach such levels of complexity and depth. Educationally critical aspects for achieving more complex levels of learning include exposure to intense and major challenges in longer periods of community services, reflection guided by teacher in intentional pedagogical spaces, feedback, and meaningful relationships between key stakeholders. These findings hold significance for medical programs that offer community medicine or related courses, since they present pedagogical opportunities to create and improve similar learning contexts in other domains.

When students learn with–and from–other students, it is called peer-assisted learning (PAL). How undergraduate medical students use their peers for their clinical-reasoning learning process remains unclear, although literature suggests that it is a promising learning strategy at this stage. This research therefore explores the question: ‘How is PAL manifested in the clinical learning environment of undergraduate medical students with regard to developing clinical-reasoning skills?’. A constructivist paradigm with a sociocultural theoretical framework was adopted for this research, using PAL and workplace learning as theoretical background. Focused ethnography and a combination of template and open coding was used to gather and analyze qualitative data. Twenty semi-structured interviews were conducted with nine students, four residents, and seven clinical supervisors. A total number of 31.5 h were used for five clinical observations. Following categories were used to describe the data: (1) the role of PAL in the clinical-reasoning learning practice, in which PAL-theory was placed alongside clinical practice, (2) the role of different actors during PAL and (3) the PAL environment, in which contextual factors have been scrutinized. Students deploy various categories of PAL to advance their clinical-reasoning skills, although they were largely unaware of these processes, and facilitation of PAL is not consistently provided. Three topics of discussion are identified that need to be acknowledged: (1) the design of a PAL environment that is conducive to collaborative learning, (2) the shifting roles of peers when they enter clinical practice, and (3) the individualistic tendencies of students that can hamper PAL. Future research could focus on stimulating and facilitating PAL among the next generation of students and integrating PAL into the clinical practice workflow.

Self-management is important for people coping with chronic diseases. The self-determination theory (SDT) emphasizes the role of healthcare professionals’ (HCPs) (de)motivating interaction styles in either supporting or thwarting patients’ self-management behavior. Since developing (de)motivating interaction styles starts during education, this study aimed to identify profiles among HCPs in training based on their (de)motivating interaction styles and to assess how these profiles differ in sample characteristics, SDT-beliefs, and self-efficacy in self-management support. Cross-sectional data were collected using self-reported questionnaires among nurses (n = 125) and physiotherapists (n = 257) in training (total participants: n = 382). Cluster analyses were performed to identify the profiles followed by chi-square tests and MANCOVA-tests to assess profile differences. Five profiles were identified, labelled as: motivating (16%), active (22%), undifferentiated (29%), demotivating (17%) and inactive (17%). The motivating profile contained fewer men (10%), while the demotivating profile had a higher proportion of men (52%) compared to the whole sample distribution (28%). Fewer nursing students were categorized to the active profile (20%) compared to the overall sample distribution (33%). Higher SDT-beliefs and self-efficacy in self-management support were noted in the motivating and active profiles as opposed to the demotivating and inactive profiles. These results contribute to a better understanding of healthcare students’ interaction styles during patient self-management support. In education of HCPs, a focus on improving SDT-beliefs and self-efficacy in self-management support, may help HCPs to improve their interaction profile towards people with chronic diseases.