Abigail Konopasky United States Abigail Winkel United States Adam Gerace Australia Adam Gavarkovs Canada Adam Szulewski Canada Adam Sawatsky United States Adrian Sutton United Kingdom Ahsan Sethi Pakistan Aileen Barrett Ireland Aisling Kerr United Kingdom Aislinn Joy Ireland Alan Bleakley United Kingdom Alan Weber Qatar Alan Chiem United States Albertine Zanting Netherlands Alex Garrett United States Alexandria Garino United States Alexis Rossi United States Ali Bikmoradi Iran, Islamic Republic of Aliki Thomas Canada Althea Blakey New Zealand Amaya Ellawala United Kingdom Amelia Kehoe United Kingdom Amy Clithero United States Amy Addams United States Ana Gomez-Carrillo Canada Anderson Chun On Tsang Hong Kong Andrea Gingerich Canada Andrew O'Regan Ireland Andrew Teodorczuk Australia Andrew Moeller Canada AndrewWarren Canada Andrzej Kononowicz Poland Andy Wearn New Zealand Anél Wiese Ireland Angelique Dueñas United States Ani Orchanian-Cheff Canada Anique de Bruin Netherlands Anique Atherley Netherlands Anita Acai Canada Anita Laidlaw United Kingdom Anita Cheng Canada Ann George South Africa Ann Poncelet United States Anna Melvin United Kingdom Anna MacLeod Canada Anna Ryan Australia Annahieta Kalantari United States Anne Croker Australia Anne Franz Germany Anne-Marie Reid United Kingdom Annette Burgess Australia Annie Gula United States April Richardson United States Ardi Findyartini Indonesia Ariel Frajerman France Arno Kumagai Canada Arvin Damodaran Australia Ashlie Tseng United States Ayelet Kuper Canada Ayona Silva-Fletcher United Kingdom Barbara Blackie Qatar Barret Michalec United States Beata Dobrowolska Poland Bjorn Watsjold United States Boaz Shulruf Australia Breanna Chen Canada Brendan Prast United States Brian Mavis United States Bridget O'Brien United States Bruce Henschen United States Bruno Zumbo Canada Caragh Brosnan Australia Carlos Collares Netherlands Carlos Gomez-Garibello Canada Carlos El-Haddad Australia Carolin Sehlbach Netherlands Carrie Llewellyn United Kingdom DOI: 10.1111/medu.15010
This study investigates how surgical and intensive care trainees come to understand the quality of their performance and the role of feedback conversations. Trainees reported some commonalities between specialty, but they also indicated highly divergent experiences. They had to ‘patch together’ performance information into an evolving picture of overall progress; this was particularly challenging in intensive care, which was a more ambiguous and emotional clinical context. Attending to how, when and where trainee meaning making takes place may allow for effective conversations within specialty feedback cultures. Bearman, M, Ajjawi, R, Castanelli, D, et al Meaning making about performance: A comparison of two specialty feedback cultures. Med Educ. 2023;57(11):1010–1019. doi:10.1111/medu.15118
The potential for technology to transform healthcare education is boundless. Here, Kassutto, Tsao, and Bennett offer thoughts on how we must engage and embrace the possibility of change rather than ignore it.
Kumar et al. outline defining characteristics of Apprecative Inquiry, a framework based on positive psychology principles that yields great promise in medical education.
BackgroundMedical students from affluent and highly educated backgrounds remain overrepresented in Canadian medical schools despite widespread efforts to improve diversity. Little is known of the medical school experiences of students who are first in their family (FiF) to attend university. Drawing on Bourdieu and a critically reflexive lens, this study explored the experiences of FiF students in a Canadian medical school to better understand the ways in which the medical school environment can be exclusive and inequitable to underrepresented students. MethodsWe interviewed 17 medical students who self-identified as being FiF to attend university. Utilising theoretical sampling, we also interviewed five students who identified as being from medical families to test our emerging theoretical framework. Participants were asked to discuss what 'first in family' meant to them, their journey into medical school and their experiences at medical school. Bourdieu's theories and concepts were used as sensitising concepts to explore the data. ResultsFiF students discussed the implicit messages they received about who belongs in medical school, challenges in shifting from their pre-medical lives to a medical identity and competing with peers for residency programmes. They reflected on the advantages they perceived they had over their fellow students due to their less 'typical' social backgrounds. ConclusionWhile medical schools continue to make strides when it comes to increasing diversity, inclusivity and equity require increased attention. Our findings highlight the ongoing need for structural and cultural change at admissions and beyond-change that recognises the much-needed presence and perspectives that underrepresented medical students, including those who are FiF, bring to medical education and healthcare. Engaging in critical reflexivity represents a key way that medical schools can continue to address issues of equity, diversity and inclusion.
Medical EducationEarly View REALLY GOOD STUFF Experiential learning integrating humanities into preclinical medicine Chi-Chuan Yeh, Chi-Chuan YehSearch for more papers by this authorKuo-Shyan Lu, Kuo-Shyan LuSearch for more papers by this authorHuey-Ling Chen, Huey-Ling ChenSearch for more papers by this authorYu-Chun Chiu, Corresponding Author Yu-Chun Chiu [email protected] orcid.org/0000-0001-5714-6914 Correspondence Yu-Chun Chiu, Department of Medical Education, National Taiwan University Hospital; Department of Pediatrics, National Taiwan University Children's Hospital; Department and Graduate Institute of Medical Education and Bioethics, College of Medicine, National Taiwan University, Taipei, Taiwan. Email: [email protected]Search for more papers by this author Chi-Chuan Yeh, Chi-Chuan YehSearch for more papers by this authorKuo-Shyan Lu, Kuo-Shyan LuSearch for more papers by this authorHuey-Ling Chen, Huey-Ling ChenSearch for more papers by this authorYu-Chun Chiu, Corresponding Author Yu-Chun Chiu [email protected] orcid.org/0000-0001-5714-6914 Correspondence Yu-Chun Chiu, Department of Medical Education, National Taiwan University Hospital; Department of Pediatrics, National Taiwan University Children's Hospital; Department and Graduate Institute of Medical Education and Bioethics, College of Medicine, National Taiwan University, Taipei, Taiwan. Email: [email protected]Search for more papers by this author First published: 04 May 2023 https://doi.org/10.1111/medu.15110Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL No abstract is available for this article. REFERENCE 1Kolb DA. Experiential Learning: Experience as the Source of Learning and Development. Prentice-Hall; 1984. Early ViewOnline Version of Record before inclusion in an issue ReferencesRelatedInformation
INTRODUCTION:Physicians face uncertainties in complex clinical environments. Small group learning initiatives allow physicians to decipher new evidence and address challenges. This study aimed to understand how physicians in small learning groups discuss, interpret and assess new evidence-based information to make decisions for practice. METHODS:An ethnographic approach was used to collect data from observed discussions between practising family physicians (n = 15) that meet in small learning groups (n = 2). Physicians were members of a continuing professional development (CPD) programme that provides educational modules with clinical cases and evidence-based recommendations for best practice. Nine learning sessions were observed over 1 year. Field notes documenting the conversations were analysed using ethnographic observational dimensions and thematic content analysis. Observational data were supplemented with interviews (n = 9) and practice reflection documents (n = 7). A conceptual framework for 'change talk' was created. RESULTS:Observations elucidated the following: Facilitators played a significant role in leading the discussion by focusing on practice gaps. As group members shared approaches to clinical cases, baseline knowledge and practice experiences were revealed. Members made sense of new information by asking questions and sharing knowledge. They determined what information was useful and whether it applied to their practice. They reviewed evidence, tested algorithms, benchmarked themselves to best practice and consolidated knowledge before committing to practice change(s). Themes from interviews emphasised that sharing of practice experiences played an integral part in decisions to implement new knowledge, helped validate guideline recommendations and provided strategies for feasible practice changes. Documented practice reflections regarding decisions for practice change(s) overlapped with field notes. CONCLUSION:This study provides empirical data on how small groups of family physicians discuss evidence-based information and make decisions for clinical practice. A 'change talk' framework was created to illustrate the processes that occur when physicians interpret and assess new information to bridge gaps between current and best practices.
INTRODUCTION:This study explores narratives of physicians negotiating liminality while becoming and being mentors for medical students. Liminality is the unstable phase of a learning trajectory in which one leaves behind one understanding but has yet to reach a new insight or position. METHODS:In this study, we analysed semi-structural interviews of 22 physician mentors from group-based mentoring programmes at two Norwegian and one Canadian medical school. In a dialogical narrative analysis, we applied liminality as a sensitising lens, focusing on informants' stories of becoming a mentor. RESULTS:Liminality is an unavoidable aspect of developing as a mentor. Which strategies mentors resort to when facing liminality are influenced by their narrative coherence. Some mentors thrive in liminality, enjoying the possibility of learning and developing as mentors. Others deem mentoring and the medical humanities peripheral to medicine and thus struggle with integrating mentor and physician identities. They may contradict themselves as they shift between their multiple identities, resulting in rejection of the learning potentials that liminality affords. CONCLUSION:Mentors with integrated physician and mentor identities can embrace liminality and develop as mentors. Those mentors with contradicting dialogues between their identities may avoid liminality if it challenges their understanding of who they are and make them experience discomfort, confusion and insufficiency while becoming a mentor. Support of the mentoring role from the clinical culture may help these physicians develop internal dialogues that reconcile their clinician and mentor identities.
INTRODUCTION:The COVID-19 pandemic had significant impacts on many aspects of health care and education, including the accreditation of medical education programmes. As a community of international educators, it is important that we study changes that resulted from the pandemic to help us understand educational processes more broadly. As COVID-19 unfolded in Canada, a revised format of undergraduate medical accreditation was implemented, including a shift to virtual site visits, a two-stage visit schedule, a focused approach to reviewing standards and the addition of a field secretary to the visit team. Our case study research aimed to evaluate the sociomaterial implications of these changes in format on the process of accreditation at two schools.METHODS:We interviewed key informants to understand the impacts, strengths and limitations of changes made to the accreditation format. We used an abductive approach to analyse transcripts and applied a sociomaterial lens in looking for interconnections between the material and social changes that were experienced within the accreditation system.RESULTS:Stakeholders within the accreditation system did not anticipate that changes to the accreditation format would have significant impacts on how accreditation functioned or on its overall outcomes. However, key informants described how the revised format of accreditation reconstructed how power was distributed and how knowledge was produced. The revised format contributed to changes in who held power within each of the programmes, within each of the visiting teams and between site members and visiting team members. As power shifted across stakeholders in response to material changes to the accreditation format, key informants described changes in how knowledge was produced.CONCLUSIONS:Our findings suggest that the most powerful knowledge about any given programme might best be obtained through individualised tools, technologies and voices that are most meaningful to the unique context of each programme. Deliberate attention to how knowledge and power are influenced by the interactions between material and social processes within accreditation may help educators and leaders see the effects of change.
Workplace learning is central to healthcare students' and trainees' education, providing them with valuable opportunities and experiences and socialising them to become healthcare professionals.1 Yet, clinical workplaces are highly complex spaces, fraught with hierarchy and (very often) workplace pressures.2, 3 Within this environment, students and trainees exhibit and encounter wide-ranging professionalism behaviours and lapses.4-6 Alongside professionalism, discrimination and bullying (indeed, all forms of mistreatment) are pervasive, having serious adverse consequences for learners.7-10 So, the learning process can sometimes come at a cost, particularly when it involves mistreatment by those in authority. This mistreatment not only affects learners' well-being but also negatively impacts patient care and safety.6 We applaud Vanstone et al,11 therefore, for contributing to ongoing conversations around student and trainee workplace mistreatment, adding to voluminous prior research and keeping the spotlight on this continuing challenge. We have been researching this topic internationally since 2007 (using the terminology 'professionalism dilemmas' and 'workplace dignity').6 Sadly, workplace mistreatment remains an ongoing issue far from resolution. Nevertheless, Vanstone et al's11 articulation of this topic propels us forward, specifically with their examination of well-worn events from the perspective of the usually silent stakeholder—the educator (rather than typically privileging learner perspectives). Their analysis, guided by constructivist grounded theory, led the authors to conclude that, excepting extreme behaviours, participants' judgements about whether events comprised mistreatment varied because of differences in individuals' sense-making. As such, developing objective definitions of what comprises mistreatment is problematic. Workplace mistreatment remains an ongoing issue far from resolution. Whereas Vanstone et al11 highlight actors' active (versus passive) constructions of their social world through experiences, we think it valuable to add the important constructivist concept of socialisation to their data analysis. Socialisation is the active process through which objective events in the world are incorporated into existing understandings to become subjectively meaningful.12 Essentially, this individual sense-making shapes who we are (our identities) from birth (primary socialisation).1 Socialisation into a profession (secondary socialisation) is particularly prominent for students and trainees during workplace learning. Here, we come to understand our professional identity, the workplace culture, and internalise (to a greater or lesser degree) cultural values and norms. Socialisation reduces uncertainty, facilitating mastery of a new environment.13 Research suggests four main elements to socialisation: (i) learning job components (task mastery), (ii) understanding one's organisational role (role clarification), (iii) adjusting to the organisation's culture (acculturation) and (iv) developing co-worker relationships (social integration).13 The longer someone inhabits a profession (e.g. physician, nurse) or specific organisational environment (e.g. surgery, general practice), the more inculcated they become within that culture. And, if that profession or organisational culture could be described as abusive to a reasonable outsider, the more acclimatised they become to abuse. Given this background, we believe that differences in the data presented by Vanstone et al11 can (at least in part) be explained by the length of time participants had spent in specific workplace settings. The longer someone inhabits a profession (e.g. physician, nurse) or specific organisational environment (e.g. surgery, general practice), the more inculcated they become within that culture. It is impossible to contextualise Vanstone et al's11 data according to potential narrator levels of socialisation because they do not report the demographic features of their sample (to preserve confidentiality). It is also difficult to make sense of data privileging socialisation whenever investigators focus on the surface level of what participants said. This is commonplace amongst qualitative researchers in health professions education, and we also begin our analysis at this important foundational level.9 However, by digging deeper, and focusing attention on the process of talk (i.e. how participants speak, what they do with words), it is sometimes possible to reveal a different, richer story. This is because narratives are products of someone's social construction (the content of talk), as well as reflecting the construction process itself (how people talk). So, rather than analysing these narratives as if they are true representations of a real event (the so-called discourse as data perspective),14 there is value to analysing them as social constructions in a particular context (a data as discourse perspective).14 If one considers such narratives as social constructions in particular contexts (including degree of narrator socialisation), it can enable one to think deeply about the important impacts of socialisation on the people constructing the narratives and through the narratives themselves when they are narrated to others. By digging deeper, and focusing attention on the process of talk (i.e. how participants speak, what they do with words), it is sometimes possible to reveal a different, richer story. To provide an example of working with data as discourse, we discuss the educator's narrative in Vanstone et al's11 article. Here, the educator narrates a justification for why it may be appropriate to raise your voice in a surgical operating room: 'If somebody is in the middle of an [operating room] and is about to do something that he must stop doing immediately and you feel you need to raise your voice to make [the undesired behaviour] stop. Just like a child who is going to touch the stove, you may have to swipe their hand away because they're going to get hurt. To me, that's not mistreatment'. On reading this excerpt, we immediately wanted more context about the excerpt to better understand it. What went on beforehand? How did the conversation get to this point? Who is the narrator? Who is the story protagonist? But even without context, we can see how the narrator discursively constructs the information as truth. This is revealed though the use of the pronoun you in the excerpt (as bolded by us). You can be used referentially (i.e. person in front of me) or impersonally (i.e. everyone and anyone).15 When read carefully, we can see how the narrator uses you both referentially and impersonally as they justify an act of shouting (softened to voice raising) and slapping away a learner's hand (softened to swiping). Furthermore, both impersonal uses are followed by relatively softer, hedged verbs (feel, may) rather than harder and more directive verbs (will, should, must). Together, this suggests the narrator is using soft persuasion to convince the listener that their argument is rational. They then employ multiple analogies—likening the student to a vulnerable child needing protection from danger and likening surgical equipment to a hot stove. Ultimately, these analogies serve to justify the surgeon shouting at a learner and slapping their hand. The narrator ends their talk by owning their claim: This is not mistreatment. We cannot know from the paper how our interpretation reflects the data, but we offer it to ask, more generally, what it could mean for further research in this area. Admittedly, this is just one, acontextual narrative, from which we extrapolate to make points about the importance of socialisation of mistreatment in the healthcare workplace and of moving beyond the content of talk to analyse educator data as discourse. Our central argument is that to really understand what is happening in important data such as these, we encourage researchers to think deeply about what social constructionism means to optimise the richness of the data they collect. All too often qualitative researchers in health professions education jump to surface-level meanings, focusing on the content of talk. But language is more than this: We do things with language: 'Language is not simply a neutral medium for generating subject knowledge, but a form of social practice that acts to constitute as much as to reflect social realities' (p. 119).16 It is crucial, therefore, that researchers consider the constitutive power of their textual data, thinking about and analysing it for its content and linguistic messages.4, 15 As we have written previously, constructionism values language, dialogue and context.17 All too often qualitative researchers in health professions education jump to surface-level meanings, focusing on the content of talk. But language is more than this: We do things with language. If we ignore language, dialogue and context when exploring the persistent problem of learner mistreatment within the healthcare workplace, we risk being forever stuck in a cycle of reporting student mistreatment without understanding fully why it is legitimised by those socialised into this culture. More importantly, we risk not being able to break this cycle to advance towards cultural change in healthcare education. If we ignore language, dialogue and context when exploring the persistent problem of learner mistreatment within the healthcare workplace, we risk being forever stuck in a cycle of reporting student mistreatment without understanding fully why it is legitimised by those socialised into this culture. Lynn V. Monrouxe: Conceptualization; writing—original draft; writing—review and editing. Charlotte E. Rees: Conceptualization; writing—review and editing. Open access publishing facilitated by The University of Sydney, as part of the Wiley - The University of Sydney agreement via the Council of Australian University Librarians.
INTRODUCTION:To enter a profession is to take on a new identity. Professional identity formation can be difficult, with medical learners struggling to adopt professional norms. The role of ideology in medical socialisation may offer insight into these tensions experienced by medical learners. Ideology is the system of ideas and representations that dominates the minds of individuals or social groups and calls individuals into certain ways of being and acting in the world. In this study, we use the concept of ideology to explore residents' experiences with identity struggle during residency. METHODS:We conducted a qualitative exploration of residents in three specialties at three academic institutions in the United States. Participants engaged in a 1.5-hour session involving a rich picture drawing and one-on-one interview. Interview transcripts were coded and analysed iteratively, with developing themes compared concurrently to newly collected data. We met regularly to develop a theoretical framework to explain findings. RESULTS:We identified three ways that ideology contributed to residents' identity struggle. First was the intensity of work and perceived expectations of perfectionism. Second were tensions between the developing professional identity and pre-existing personal identities. Many residents perceived messages regarding the subjugation of personal identities, including the feeling that being more than physicians was impossible. Third were instances where the imagined professional identity clashed with the reality of medical practice. Many residents described how their ideals misaligned with normative professional ideals, constraining their ability to align their practice and ideals. CONCLUSION:This study uncovers an ideology that shapes residents' developing professional identity-an ideology that creates struggle as it calls them in impossible, competing or even contradictory ways. As we uncover the hidden ideology of medicine, learners, educators and institutions can play a meaningful role in supporting identity development in medical learners through dismantling and rebuilding its damaging elements.
BACKGROUND:The growing importance of sustainability has led to the current literature being saturated with studies on the necessity of, and suggested topics for, education for sustainable health care (ESH). Even so, ESH implementation has been hindered by educator unpreparedness and resource scarcity. A potential resolution lies in virtual education. However, research on the strategies needed for successfully implementing virtual education in the context of sustainable health care and medical education is sparse; this study aims to fill the gap.METHODS:Topic modelling, a computational text-mining method for analysing recurring patterns of co-occurring word clusters to reveal key topics prevalent across the texts, was used to examine how sustainability was addressed in research in medicine, medical education, and virtual education. A total of 17 631 studies, retrieved from Web of Science, Scopus and PubMed, were analysed.RESULTS:Sustainability-related topics within health care, medical education and virtual education provided systematic implications for Sustainable Virtual Medical Education (SVME)-ESH via virtual platforms in a sustainable way. Analyses of keywords, phrases, topics and their associated networks indicate that SVME should address the three pillars of environmental, social and economic sustainability and medical practices to uphold them; employ different technologies and methods including simulations, virtual reality (VR), artificial intelligence (AI), cloud computing, distance learning; and implement strategies for collaborative development, persuasive diffusion and quality assurance.CONCLUSIONS:This research suggests that sustainable strategies in virtual education for ESH require a systems approach, encompassing components such as learning content and objectives, evaluation, targeted learners, media, methods and strategies. The advancement of SVME necessitates that medical educators and researchers play a central and bridging role, guiding both the fields of sustainable health care and medical education in the development and implementation of SVME. In this way, they can prepare future physicians to address sustainability issues that impact patient care.
Medical EducationVolume 57, Issue 11 p. 1122-1122 REALLY GOOD STUFF Medical licensing examination-based reform of medical microbiology teaching Xiaodong Shen, Xiaodong ShenSearch for more papers by this authorYuhan Wang, Yuhan WangSearch for more papers by this authorDan Zhao, Dan ZhaoSearch for more papers by this authorMing Li, Corresponding Author Ming Li [email protected] Correspondence Ming Li, Department of Microbiology, College of Basic Medical Sciences, Army Medical University, No. 30 Gaotanyan Centre Street, Shapingba District, Chongqing 400038, China. Email: [email protected]Search for more papers by this author Xiaodong Shen, Xiaodong ShenSearch for more papers by this authorYuhan Wang, Yuhan WangSearch for more papers by this authorDan Zhao, Dan ZhaoSearch for more papers by this authorMing Li, Corresponding Author Ming Li [email protected] Correspondence Ming Li, Department of Microbiology, College of Basic Medical Sciences, Army Medical University, No. 30 Gaotanyan Centre Street, Shapingba District, Chongqing 400038, China. Email: [email protected]Search for more papers by this author First published: 13 September 2023 https://doi.org/10.1111/medu.15206 Funding information: This project is funded by the Educational Research Project of Army Medical University (NO. 2022A02). Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat No abstract is available for this article. REFERENCE 1Wang X. Experiences, challenges, and prospects of National Medical Licensing Examination in China. BMC Med Educ. 2022; 22(1): 349. doi:10.1186/s12909-022-03385-9 Volume57, Issue11November 2023Pages 1122-1122 ReferencesRelatedInformation
In the world of wellness, 'burnout' might as well be a God term. But what do we really mean when we say, "I'm burned out." And is this one little word enough?
Adams outlines the importance of routinely remembering medical education’s past and present colonial burden on Indigenous peoples.
As the field of health professions education (HPE) continues to evolve, it is necessary to occasionally pause and reflect on the potential effects and outcomes of our research practices. While future-casting does not guarantee that impending negative consequences will be evaded, the exercise can help us avoid pitfalls. In this paper, we reflect on two terms that have taken hold as powerful idols in HPE research that stand above questioning and apart from critique: patient outcomes and productivity. We argue that these terms, and the ways of thinking they uphold, threaten the sustainability of HPE research-one at the level of the community and one at the level of the scholar.First, we suggest that HPE research's history of endorsing a linear and causal association ethos has driven its quest to connect education to patient outcomes. To ensure the sustainability of HPE scholarship, we must deconstruct and disempower patient outcomes as one of HPE's god-terms, as the pinnacle goal of educational activities. To be sustained, HPE research needs to value all of its contributions equally.A second god-term is productivity; it impairs the sustainability of the careers of individual researchers. Problems of honorary authorship, research output expectations, and comparisons with other fields have constructed a space where only scholars with sufficient privilege can prevail. If productivity persists as a god-term, the field of HPE research could decay into a space where new scholars are silenced-not because they fail to make important contributions, but because access is restricted by existing research metrics.These are two of many god-terms threatening the sustainability of HPE research. By highlighting patient outcomes and productivity and by acknowledging our own participation in propagating them, we hope to encourage others to recognize how our collective choices threaten the sustainability of our field.
INTRODUCTION:Self-monitoring of clinical-decision-making is essential for health care professional practice. Using certainty in responses to assessment items could allow self-monitoring of clinical-decision-making by medical students to be tracked over time. This research introduces how aspects of insightfulness, safety and efficiency could be based on certainty in, and correctness of, multiple-choice question (MCQ) responses. We also show how these measures change over time. METHODS:With each answer on twice yearly MCQ progress tests, medical students provided their certainty of correctness. An insightful student would be more likely to be correct for those answers given with increasing certainty. A safe student would be expected to have a high probability of being correct for answers given with a high certainty. An efficient student would be expected to have a sufficiently low probability of being correct when they have no certainty. The system was developed using first principles and data from one cohort of students. A dataset from a second cohort was then used as an independent validation sample. RESULTS:The patterns of aspects of self-monitoring were similar for both cohorts. Almost all the students met the criteria for insightfulness on all tests. Most students had an undetermined outcome for the safety aspect. When a definitive result for safety was obtained, absence of safety was most prevalent in the middle of the course, while the presence of safety increased later. Most of the students met the criteria for efficiency, with the highest prevalence mid-course, but efficiency was more likely to be absent later. DISCUSSION:Throughout the course, students showed reassuring levels of insightfulness. The results suggest that students may balance safety with efficiency. This may be explained by students learning the positive implications of decisions before the negative implications, making them initially more efficient, but later being more cautious and safer.
Medical EducationVolume 57, Issue 11 p. 1159-1160 REALLY GOOD STUFF Med versus machine: Using ChatGPT in team-based learning Amrit Kirpalani, Corresponding Author Amrit Kirpalani [email protected] orcid.org/0000-0001-7567-9052 Correspondence Amrit Kirpalani, Division of Paediatric Nephrology, Children's Hospital, London Health Sciences Centre, 800 Commissioners Rd E, London, ON N6A 5W9, Canada. Email: [email protected]Search for more papers by this authorJoanne Grimmer, Joanne GrimmerSearch for more papers by this authorPeter Zhan Tao Wang, Peter Zhan Tao Wang orcid.org/0000-0002-9533-5748 Search for more papers by this author Amrit Kirpalani, Corresponding Author Amrit Kirpalani [email protected] orcid.org/0000-0001-7567-9052 Correspondence Amrit Kirpalani, Division of Paediatric Nephrology, Children's Hospital, London Health Sciences Centre, 800 Commissioners Rd E, London, ON N6A 5W9, Canada. Email: [email protected]Search for more papers by this authorJoanne Grimmer, Joanne GrimmerSearch for more papers by this authorPeter Zhan Tao Wang, Peter Zhan Tao Wang orcid.org/0000-0002-9533-5748 Search for more papers by this author First published: 14 September 2023 https://doi.org/10.1111/medu.15226Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat No abstract is available for this article. REFERENCE 1Young J, van Merrienboer JJG, Durning S, ten Cate O. Cognitive load theory: implications for medical education: AMEE Guide No. 86. Medical teacher; 2014. Google Scholar Volume57, Issue11November 2023Pages 1159-1160 ReferencesRelatedInformation
Medical EducationEarly View LETTER TO THE EDITOR The untapped potential of simulation for identity development and social integration Victoria R. Tallentire, Corresponding Author Victoria R. Tallentire [email protected] orcid.org/0000-0002-9178-1425 Medical Education Directorate, NHS Lothian, Edinburgh, UK Scottish Centre for Simulation and Clinical Human Factors, NHS Forth Valley, Larbert, UK Correspondence Victoria R. Tallentire, Medical Education Directorate, NHS Lothian, Edinburgh EH1 3EG, UK. Email: [email protected] Contribution: Conceptualization, Writing - original draft, Writing - review & editingSearch for more papers by this authorSamantha E. Smith, Samantha E. Smith orcid.org/0000-0003-1892-6365 Scottish Centre for Simulation and Clinical Human Factors, NHS Forth Valley, Larbert, UK Contribution: Conceptualization, Writing - review & editingSearch for more papers by this author Victoria R. Tallentire, Corresponding Author Victoria R. Tallentire [email protected] orcid.org/0000-0002-9178-1425 Medical Education Directorate, NHS Lothian, Edinburgh, UK Scottish Centre for Simulation and Clinical Human Factors, NHS Forth Valley, Larbert, UK Correspondence Victoria R. Tallentire, Medical Education Directorate, NHS Lothian, Edinburgh EH1 3EG, UK. Email: [email protected] Contribution: Conceptualization, Writing - original draft, Writing - review & editingSearch for more papers by this authorSamantha E. Smith, Samantha E. Smith orcid.org/0000-0003-1892-6365 Scottish Centre for Simulation and Clinical Human Factors, NHS Forth Valley, Larbert, UK Contribution: Conceptualization, Writing - review & editingSearch for more papers by this author First published: 12 August 2023 https://doi.org/10.1111/medu.15187Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onEmailFacebookTwitterLinkedInRedditWechat No abstract is available for this article. REFERENCES 1Gormley GJ, Murphy P. When I say … simulation. Med Educ. 2023; 1-2. doi:10.1111/medu.15165 2Islam G. Social identity theory. In: T Teo, ed. Encyclopedia of Critical Psychology. Springer; 2014: 1781-1783. doi:10.1007/978-1-4614-5583-7_289 3Tallentire VR, Kerins J, McColgan-Smith S, Power A, Stewart F, Mardon J. Exploring the impact of interprofessional simulation on the professional relationships of trainee pharmacists and medical students: a constructivist interview study. Int J Healthcare Simul. 2022; 2: 21-31. doi:10.54531/byiu8303 4Purdy E, Alexander C, Caughley M, Bassett S, Brazil V. Identifying and transmitting the culture of emergency medicine through simulation. AEM Educ Train. 2019; 3(2): 118-128. doi:10.1002/aet2.10325 5Smith SE, Tallentire VR. Simulation for social integration. Int J Healthcare Simul. 2023;null: 1-9. doi:10.54531/tdzn8875 6Roze des Ordons AL, Eppich W, Lockyer J, Wilkie RD, Grant V, Cheng A. Intermediating, facilitating, and teaching (GIFT): a conceptual framework for simulation educator roles in healthcare debriefing. Simul Healthc. 2022; 17(5): 283-292. doi:10.1097/SIH.0000000000000619 Early ViewOnline Version of Record before inclusion in an issue ReferencesRelatedInformation
