Background and aim:The aim of the study was to investigate patients' attitudes to and experiences of consultations in general practice where medical students acted as observers or conducted independent consultations. Participants were also asked about the advantages and disadvantages of student involvement. Material and method:We conducted a cross-sectional study in which patients completed an online questionnaire in general practitioners' (GPs') waiting rooms, having been invited to participate by medical students in a clinical placement. The results are presented descriptively. Results:A total of 2263 out of 5576 (41 %) invited patients participated. Of these, 1287/2263 (57 %) experienced consultations involving students. Of these, 890/1277 (70 %) reported that they valued the experience and 1009/1248 (81 %) agreed that it was a positive experience. Of the 847 patients who clearly recalled a consultation involving a student, 763/837 (91 %) reported feeling safe and 806/846 (95 %) felt they received adequate care. Interpretation:Although the vast majority of patients in the study felt well cared for in consultations involving medical students in clinical placement in general practice, special attention should be paid to vulnerable patient groups.

Psychiatry faces global recruitment challenges and is often viewed as low prestige among medical students. From their perspective, prior negative experiences including poor supervision and exclusion may reduce engagement during psychiatric placements. At the University of Oslo (UiO), students are typically supervised by residents, yet formal supervision training comes late and lacks practical components despite being required for specialist qualifications. This study will pilot a socially grounded supervision model emphasizing social safety as a driver of supervisory competence and learning outcomes.Phase 1 will test the feasibility of organizing residents and students into supervision families at Oslo University Hospital, deliver a supervision seminar for residents and offer targeted resources to enhance student engagement. Phase 2 will explore experiences with and without supervision families through interviews with students, residents, and training coordinators, assessing perceptions of intervention components and identifying barriers and facilitators. Phase 3 will implement a revised version of the intervention including updated seminars and improved learning resources, including a digital communication skills simulator, and re-examine new student and resident participant experiences to compare perceived impact. Data will be analyzed using a collective thematic approach. Findings will inform refinement and implementation of the model in psychiatric training for UiO students.•Pilot a socially grounded supervision model during psychiatric placements aiming at strengthening residents’ supervisory competence and enhance student learning.•Explore experiences and barriers through focus group interviews with students, residents, and training coordinators.•Use findings to refine and inform implementation of the model for medical students and residents in mental health and other clinical settings.

Objective To analyze the nature and etiology of shame, a common problem that diminishes the well-being of learners and clinicians in medical education and practice, and to explore the relationship between shame and medical uncertainty. Discussion We draw upon various theoretical insights on both shame and uncertainty, and argue that shame is ultimately a product of uncertainty and its transformation by medical learners. We argue that this transformation involves two key processes. The first is a personalization of uncertainty—i.e., a transformation of medical uncertainties focused on clinical care into personal uncertainties focused on one’s self-worth. The second is a resolution of personal uncertainty—i.e., a transformation of personal uncertainties about one’s self-worth into personal certainties about one’s lack of self-worth. These key processes linking medical uncertainty to shame suggest that shame might be prevented or mitigated by targeted interventions aimed at 1) depersonalizing medical uncertainties, 2) helping learners maintain their personal uncertainties, rather than resolving them in self-destructive ways, and 3) making uncertainty and its management a more central, explicit focus of medical training. Conclusions Medical uncertainty has a central, paradoxical relationship to shame among medical learners—representing both a source of the problem and a potential solution. Key processes that lead from uncertainty to shame represent potential targets for interventions to prevent and mitigate shame among medical learners, and fruitful directions for future research.

Background: Despite junior doctors' pivotal role as primary contacts for students in clinical placements, they are typically offered minimal or no mentor training, and their knowledge about how to facilitate student learning remains experience-based. We developed a co-mentoring program where junior doctors were offered training focused on student learning and agency, near-peer support and the promotion of psychological safety. Methods: To evaluate the intervention, we collected qualitative data using interviews, e-mail prompts and a focus group among 13 junior doctors across four cohorts of mentor training. No baseline data were included. Data were analyzed using thematic analysis. The research aimed to explore the junior doctors' experiences of transitioning from an unclear supervisory role to a defined mentor role with a relational focus. Results: Mentors felt that they were making a significant difference to the students' learning and that focusing on relationship building and belonging enabled entrustment. Furthermore, mentoring was demystified after the training regime. Finally, the concept of collective responsibility throughout the medical department emerged as a crucial element in the mentoring dynamic. Discussion: Respondents suggested that the intervention had shifted their attitudes: Participants realized that establishing contact and actively collaborating with the students, also beyond the mentor's primary team, were beneficial for both students and mentors without demanding additional sacrifices of time or energy. However, the initiative did not manage to change organizational structures or create motivation in mentors to pursue further pedagogic development, underscoring the need to address structural barriers and promote a growth-oriented mindset among mentors.

Medical students’ efforts to learn person-centered thinking and behavior can fall short due to the dissonance between person-centered clinical ideals and the prevailing epistemological stereotypes of medicine, where physicians’ life events, relations, and emotions seem irrelevant to their professional competence. This paper explores how reflecting on personal life experiences and considering the relevance for one’s future professional practice can inform first-year medical students’ initial explorations of professional identities. In this narrative inquiry, we undertook a dialogical narrative analysis of 68 essays in which first-year medical students reflected on how personal experiences from before medical school may influence them as future doctors. Students wrote the texts at the end of a 6-month course involving 20 patient encounters, introduction to person-centered theory, peer group discussions, and reflective writing. The analysis targeted medical students’ processes of interweaving and delineating personal and professional identities. The analysis yielded four categories. (1) How medical students told their stories of illness, suffering, and relational struggles in an interplay with context that provided them with new perspectives on their own experiences. Students formed identities with a person-centered orientation to medical work by: (2) recognizing and identifying with patients’ vulnerability , (3) experiencing the healing function of sharing stories , and (4) transforming personal experiences into professional strength . Innovative approaches to medical education that encourage and support medical students to revisit, reflect on, and reinterpret their emotionally charged life experiences have the potential to shape professional identities in ways that support person-centered orientations to medical work.

Introduction: Clinical workplaces offer unrivalled learning opportunities if students get pedagogic and affective support that enables them to confidently participate and learn from clinical activities. If physicians do not greet new students, the learners are deprived of signals of social respect and inclusion. This study explored how physicians’ non-greeting behaviour may impact medical students’ participation, learning, and professional identity formation in clinical placements. Methods: We analysed 16 senior Norwegian medical students’ accounts of non-greeting behaviours among their physician supervisors in a reflexive thematic analysis of focus group interview data. Results: The main themes were: A) Descriptions of non-greeting. Not being met with conduct signalling rapport, such as eye contact, saying hello, using names, or introducing students at the workplace, was perceived as non-greeting, and occurred across clinical learning contexts. B) Effects on workplace integration. Non-greeting was experienced as a rejection that hurt students’ social confidence, created distance from the physician group, and could cause avoidance of certain workplace activities or specific medical specialties. C) Impact on learning. Non-greeting triggered avoidance and passivity, reluctance to ask questions or seek help or feedback, and doubts about their suitability for a medical career. Conclusion: Medical students’ accounts of being ignored or treated with disdain by physician superiors upon entering the workplace suggest that unintended depersonalising behaviour is ingrained in medical culture. Interaction rituals like brief eye contact, a nod, a “hello”, or use of the student’s name, can provide essential affective support that helps medical students thrive and learn in the clinic.

BackgroundFor years, we have known that many medical students lose empathy and experience burn out during the last part of their undergraduate education, despite starting with high motivation and above average mental health. The most powerful learning environment is the clinic, where students in the final stages of their program interact with real patients and practice doctor’s skills in authentic environments. We wondered how students at this stage are cared for as learners and novice professionals. We tried to identify explicit and hidden professional norms and competence goals that students are measured by, and sanctioned for not conforming with, in daily practice. We asked: Is there a mismatch between what medical students need to manage in their professional lives and the affordances inherent to the workplace environment where learning takes place? Can we intervene to mitigate any gaps? MethodInspired by the Consolidated Framework for Implementation Research (CFIR), we engaged leaders, physicians, residents, and medical students at a small Norwegian hospital in a three-year project aiming to improve students’ motivation, participation, and clinical learning, by strengthening pedagogical and affective support during an 8-week practice period. ResultsMedical students and residents identified needs for preparation and orientation, continuity, and secure relationships where learners are acknowledged as unique individuals. A simple model of learning needs was developed, where educational goals can be arranged on three levels: 1) social survival, 2) medical knowledge and skills, and 3) clinical wisdom.

Abstract Background Mentoring medical students with varied backgrounds and individual needs can be challenging. Mentors’ satisfaction is likely to be important for the quality and sustainability of mentorships, especially in programs where the mentor has responsibility for facilitating a group of mentees. However, little is known about what influences mentors’ satisfaction. The aim of this study was to measure mentors’ self-reported satisfaction with the mentoring experience and to explore associations between satisfaction and its putative factors. Methods An online survey was sent out to all physician mentors in each of the three mentorship programs (UiT The Arctic University of Norway, the University of Bergen, and McGill University, graduation years 2013–2020, n = 461). Data were analyzed by descriptive statistics, dimension reduction, and linear regression. Results On a scale from 1 to 5, mean mentor satisfaction score at two Norwegian and one Canadian medical school was 4.55 (95% CI 4.47, 4.64). In a multilevel multivariate regression analysis, two predictors were significantly associated with mentors’ satisfaction: (1) the perception that students found the group meetings valuable (β = 0.186, 95% CI 0.021, 0.351, p = 0.027) and (2) mentors’ perceived rewards (β = 0.330, 95% CI 0.224, 0.437, p < 0.001). Perceived rewards included experiencing gratifying relationships with students, and mentors’ perception of self-development. Conclusions In this study, mentors appeared to be highly satisfied with their mentoring functions. Our findings suggest that mentors’ overall satisfaction is closely linked to their experiences of fulfilling mentor-student relationships and personal and professional development. Interestingly, and perhaps contrary to commonly held assumptions, we found no association between mentor satisfaction and financial compensation. Furthermore, satisfaction was not associated with the provision of pre-assigned topics for discussions for mentor group meetings. We propose that the mentors’ experienced psycho-social rewards, and their competence in establishing well-functioning group dynamics, should be areas of focus for faculty development.

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 literature on faculty development programs for mentors is scarce. This study examines mentors' experiences and challenges, with the aim of identifying threshold concepts in mentoring. It also discusses the implications for the faculty development of mentors.METHODS:Semi-structured interviews solicited personal narratives and reflections on mentors' lived experiences. Data analysis was guided by the threshold concepts framework allowing for the identification of significant and transformative shifts in perspectives.RESULTS:We interviewed 22 mentors from two Norwegian and one Canadian medical school with group-based mentoring programs. The mentoring experience involved four significant threshold concepts: focusing on students' needs; the importance of creating a trusting learning space; seeing oneself through the eyes of students; and aligning mentor and physician identities.CONCLUSION:Taking on a mentor role can provoke personal and professional dilemmas while also sparking growth. The trajectories of developing as a mentor and as a professional physician may be seen to mutually validate, mirror and reinforce each other. Faculty development programs designed specifically for mentors should aim to stimulate reflection on previous learning experiences and strive for a successful alignment of the distinct pedagogical and clinical content knowledge required to fulfill various professional roles.