A strong sense of belonging is central to medical students’ academic success, well-being and career progression, yet students from underrepresented backgrounds often experience persistent threats to their sense of belonging. This scoping review synthesises what is known about the sense of belonging among underrepresented medical students and examines how it is shaped within medical education systems. Guided by Arksey and O’Malley’s five-stage framework, we searched six databases (MEDLINE, EMBASE, Scopus, Web of Science, PsycINFO and ERIC) and grey literature sources. Forty-one sources were included, descriptively analysed and organised into four thematic categories. The evidence base has grown steeply in recent years: only two articles were published before 2020, compared with 39 since. Most research originated from the United States and the United Kingdom, with limited representation from other regions. Four categories were mapped: (1) Barriers to sense of belonging, including discrimination, cultural exclusion, and lack of identity-concordant mentorship; (2) Consequences of diminished sense of belonging, such as disengagement, mental ill health, and altered career trajectories; (3) Efforts to protect sense of belonging, including masking and overperformance, alongside efforts to create peer networks and spaces of belonging; and (4) Institutional facilitators of sense of belonging, including inclusive curricula, supportive faculty, and visible role models. We interpret sense of belonging as an individual experience shaped through institutional cultures, power relations and everyday practices in medical education. We therefore argue that sense of belonging should be treated as a core educational outcome alongside competence and performance. Future research should examine how students’ sense of belonging evolves over time and evaluate interventions designed to foster more equitable and inclusive learning environments.
This editorial examines growing enthusiasm for historical inquiry alongside uneven standards of historical scholarship in health professions education research. It outlines key standards of the discipline of history and considers how they might enhance the rigour of historical scholarship in HPER.
In this editorial the editor reflects on this special issue on history-oriented research in health professions education, announces a new special issue, and notes a change in leadership at the Journal.
Medical error is commonly addressed in health professions education through patient safety, disclosure, remediation, reflection, learner well-being, coping, and error-based learning. Research also shows that clinicians and learners may experience guilt, self-doubt, disrupted confidence, and altered professional self-understanding after involvement in medical error. Yet existing approaches do not fully distinguish the clinical event from judgments made about it or specify the identity work required when harm, responsibility, and professional belonging are simultaneously at stake. Our aim is to clarify this problem by distinguishing medical error, failure, and fallibility and by proposing fallibility integration as a bounded developmental task within professional identity formation. Medical error names a clinical or system event. Failure names a judgment about performance, responsibility, or the event’s meaning. Fallibility names the enduring human condition that makes medical error possible even among competent, careful clinicians. Fallibility integration is the work of incorporating human limitation into an accountable professional self capable of honesty, learning, repair, and continued practice. It complements rather than replaces coping, support, remediation, or broader identity work. Judgments of failure also require scrutiny: who judges, by what standards, with what authority, and with what opportunity for contestation. Fallibility integration should be invoked selectively and must remain oriented to patients, accountability, and repair.
Changes in higher education and evolving pedagogical practices have increased the diversity of cognitive, emotional, and social demands experienced by students, highlighting the need to understand individual differences, including sensory processing sensitivity (SPS). To identify SPS profiles among social services and healthcare students and examine whether self-reported mental effort and concentration across selected pedagogical contexts differed between the profiles. A cross-sectional study. 1185 social and healthcare higher education students across Finland. The data were collected with the SPS Questionnaire (43 items) during 2024–2025. K-means clustering and One-way ANOVA were employed to analyse the profiles of SPS. The associated pedagogical factors were analysed using Chi-square tests. The STROBE guidelines were followed. Five distinct SPS profiles emerged, differing significantly in sensitivity, emotional reactivity, and pedagogical responses. Profiles characterised by higher emotional and physiological reactivity (Profiles 2, 4, and 5) generally reported greater mental effort and more concentration difficulties, particularly in socially demanding and performance-based situations such as group work, oral presentations, and simulations. In contrast, low-reactive profiles (Profiles 1 and 3) demonstrated stable concentration and lower cognitive load across learning contexts. Pedagogical methods do not influence all students equally. Instructional approaches that involve intense social interaction, performance exposure, or high cognitive demands may disproportionately increase stress and cognitive load for highly reactive learners. Designing inclusive, psychologically safe, and adaptive learning environments that consider SPS-related differences can support student well-being, learning effectiveness, and sustainable professional development in social and healthcare education.
