INTRODUCTION:Advising is essential for student success in graduate health professions education (HPE). Advising does not happen in a vacuum, yet most research focuses narrowly on advisor-advisee relationships. To address this gap, this study examines how institutional structures, policies, and programmatic dynamics influence the effectiveness of advising in graduate HPE. METHODS:We conducted semi-structured interviews with 15 HPE program leaders across six WHO regions. Using framework analysis guided by Activity Theory and the concept of knotworking, we analyzed how institutional systems shape advising practices. RESULTS:Five institutional factors were identified: (1) strategic advisor recruitment, (2) supportive advising cultures, (3) bureaucratic and resource constraints, (4) advisor training and evaluation, and (5) recognition and support for advisors. Leaders described advising as an adaptive, cross-system process shaped by institutional complexity and evolving student needs. DISCUSSION:Advising in graduate HPE operates beyond dyadic relationships. It is embedded within institutional activity systems and requires ongoing negotiation across structural boundaries. Programs must adopt systemic strategies, such as faculty development, workload alignment, and policy reform, to support effective advising networks.

Background: As AI use becomes more common in research, disclosure policies have emerged to ensure transparency and appropriateness. However, database research in other fields suggests that disclosure may lag behind AI use. Medical education journal editors report that submitted manuscripts rarely include AI-use disclosures, and they perceive a lack of clarity regarding when and how AI use should be disclosed. However, we lack objective evidence regarding the incidence and nature of AI-use disclosure in medical education. Methods: Using bibliometric methods, we searched a database of 24 leading medical education journals for articles published between January and July 2025 (n = 2,762 articles). Screening with Covidence software excluded 716 non-empirical and/or non-English language articles. The remainder (n = 2,046) were examined for the presence of AI-use disclosures, which were content-analyzed. Results: 2.5% of empirical articles (n = 51) had an AI disclosure statement. BMC Medical Education contained the most disclosures (24), followed by Medical Teacher (7) and Journal of Surgical Education (4). Forty-two articles were authored in non-native Englishspeaking countries, and 69.4% of all first authors had begun publishing in the past decade. Disclosures averaged 43 words and described use superficially: most commonly "editing" and "translation". Of 18 named tools, ChatGPT was most common. Most disclosures explicitly attested to author responsibility for AI-produced material. Disclosures usually appeared in acknowledgements; those located in methods lacked responsibility attestation. Negative disclosures attesting that AI was not used were also present. Discussion: AI-use disclosures in medical education journals are rare and appear mostly in work from non-native English-speaking regions of the world. A shared disclosure practice is evident: name the tool and affirm author responsibility, but describe use superficially. This suggests a practice of "safe" disclosure that may be more performative than informative, therefore failing to satisfy the goal of ensuring transparent and ethical AI use in research.

In this State of the Methods, we describe the Mixed Critical Bibliometric Review as a novel knowledge synthesis approach that integrates qualitative research principles from critical reviews with bibliometric analyses to generate interpretive insights. Critical reviews are essential for mapping and advancing a field, yet researchers struggle to critically reassess what is already known. Developing a deep appreciation for a field’s literature and assumptions while simultaneously challenging those same assumptions creates an inherent paradox. Illuminating – and ultimately unlearning – disciplinary knowledge and assumptions is essential, yet doing so is often exceptionally difficult. Combining our expertise in qualitative critical reviews, bibliometric analysis, and mixed methods research, the Mixed Critical Bibliometric Review leverages qualitative research principles common in critical reviews, such as iterative and concurrent data generation and analysis, with bibliometric analyses that can help researchers “zoom out”, check their interpretations, question long-held assumptions, and generate novel insights to move their field forward. To elucidate this approach, we draw on examples from the field of health professions education to describe the defining characteristics of a Mixed Critical Bibliometric Review and describe three methods for enhancing qualitative critical reviews with bibliometric visualizations to clarify: (1) how a field’s perspectives evolve over time, (2) how researchers and their perspectives interconnect, and (3) the relative impact of different perspectives within the field. Finally, we discuss strategies for capturing and representing the unique potential of iteratively integrated qualitative and quantitative findings in a Mixed Critical Bibliometric Review. Through these strategies, we aim to empower researchers to adapt Mixed Critical Bibliometric Review approaches to meet their unique needs, generate novel insights, and build momentum for advancing their field through the complementary and iterative integration of bibliometric and qualitative analyses and findings.

PURPOSE:Becoming a physician requires navigating a deliberately rigorous pathway designed to ensure the development of competent physicians. Although most trainees complete training without difficulty, 2% to 30% require remediation. Remediation is a resource-intensive and emotionally charged process that often falls outside graduate medical education's (GME's) cultural norms, leading to negative personal and societal implications. This scoping review examines reviews on remediation in medical education with a focus on GME. METHOD:The authors searched Ovid MEDLINE, Embase, PsycINFO, and Web of Science for knowledge syntheses published from database inception to October 2025 discussing remediation in medical education, with a GME focus. The searches were initially run in December 2023 and updated in May and October 2025. Search terms included remediation, underperforming student, struggling learner, medical education, and review. Narrative and perspective reviews were excluded. A seven-stage remediation framework was used to organize the findings. RESULTS:Fourteen reviews were analyzed, with most being systematic (7 [50.0%]) or scoping (4 [28.6%]) reviews. Included reviews were published between 2009 and 2025, with most (78.5%) published between 2020 and 2025. Definitions of struggling learner and remediation varied across the literature or were undefined, illustrating an absence of shared clarity in their meanings. Reviews commonly reported on the identification and diagnosis of competency deficiencies and interventions to address them but did not discuss how to communicate and involve learners in remediation planning or on high-impact outcomes to evaluate remediation efficacy. CONCLUSIONS:Clear definitions of remediation in medical education have yet to be agreed on. Furthermore, gaps still exist in our collective knowledge surrounding learner involvement with remediation efforts and in determining impactful outcomes that measure the success of remediation, the struggling learner's reintegration into the health profession after remediation, and, ultimately, improvements in patient care.

SYNOPSIS: This viewpoint presents a turning point in clinical training and practice, where an attending physician faced difficulty performing an arthrocentesis in front of a trainee, highlighting challenges and vulnerabilities inherent in practice. The situation was resolved by enlisting the expertise of a colleague, who successfully completed the procedure. This experience prompted reflections on the concept of intellectual humility in health professional education-the ability to acknowledge limitations, seek help, and embrace collaborative learning and teaching. This article examines how intellectual humility can shape clinicians' responses to failure, particularly when role modeling for learners. It also raises critical questions about how educators and trainees navigate intellectual humility. By examining a moment of failure and related reflection, this article invites musculoskeletal rehabilitation clinicians to consider how intellectual humility can strengthen teaching, learning, and clinical practice. JOSPT Open 2026;4(2):128-132. Epub 19 February 2026. doi:10.2519/josptopen.2026.0206.

Introduction: This systematic review and meta-analysis evaluates the effectiveness of self-directed learning (SDL) in health professions education (HPE), examining its impact on knowledge, clinical performance, and behavioral outcomes. It investigates whether core SDL components influence educational outcomes, updating and extending the foundational work of Murad et al. (2010). Methods: We searched CINAHL, Embase, OVID Medline, PsycINFO, and Web of Science (2009–2023) for comparative studies evaluating SDL interventions in HPE. From 6,786 screened articles, 125 studies met inclusion criteria, with 48 eligible for meta-analysis. We conducted a three-level random-effects meta-analysis and moderator analyses on profession, outcome type, SDL modality, and facilitator role. Five independent reviewers conducted screening and extraction, resolving discrepancies via consensus. Results: The meta-analysis incorporated 74 effect sizes from 48 studies, revealing a small-to-moderate overall effect (Cohen’s d = 0.34, 95% CI 0.04, 0.64) with significant heterogeneity (I2 = 87%). SDL as intervention showed larger effects (d = 0.54 vs. d = –0.27, p = 0.004). Most studies involved Kirkpatrick Level 2 outcomes (knowledge/skills, 78%), with some Level 3 outcomes (skills/behaviors, 22%) and no Level 4 outcomes (patient/system) reported. Most teachers were absent or acted as facilitators, while learners were less likely to be involved in choosing resources (21%) or in assessments (25%). Conclusions: This updated meta-analysis reaffirms that SDL reliably enhances knowledge acquisition but suggests that it may yield only modest gains in clinical skills and behaviors. The wide variability in how SDL is defined and reported underscores the need for a consensus definition of SDL.

Introduction: Shared decision-making, in which a patient's values and preferences facilitate the co-construction of a clinical decision, is a key component of patient-centered care and is of pedagogical interest in medical training. Yet, barriers exist to implementation, with limited information about how patients understand and exert agency. To help educators and health professionals facilitate shared decision-making, we examined how patients narrate their agentic experiences and the roles of their physician and a decision aid mobile application (app) in contributing to agency when engaged in contraceptive clinical encounters. Methods: We conducted a qualitative study of 21 female patients, aged 17-45, who utilized a decision aid app before an encounter for contraceptive services. We conducted linguistic analysis of semi-structured interviews where patients narrated their decision-making experiences, by coding for linguistic markers of agency. Results: Patients narrated individual agency, identifying agentive tasks required for decision-making, including gaining knowledge, asking questions, voicing needs, and making choices. Patients narrated the app as a source of information, identifying questions, validating previous knowledge/opinions, and as surrogate provider. Patients narrated physicians as supportive agents, cueing patient agency and actions during the visit. Joint agency of patient and physician and agency distributed across the patient, physician, app, and other resources were contributory. Discussion: Linguistic analysis can offer important perspectives on patient experiences. The patient, physician, and decision aid app each played roles as agents during shared decision-making. Attending to various roles of agency in clinical encounters and in educational interventions may help health professionals more effectively conduct shared decision-making.

In academic medicine, extramural grant funding is widely regarded as a hallmark of scholarly success. Yet, in medical education (MedEd), the economics of grant funding are poorly matched to the scale and cost of most scholarly projects. Small-dollar MedEd grants, typically under $10,000, have low success rates that rival those of large clinical awards, but still require time-intensive applications. Using an illustrative economic model, the authors estimate that the faculty labor required to prepare a typical MedEd application, approximately 40 hours, often costs the institution more than the proposal's expected monetary value. These conservative estimates exclude indirect cost limitations, the added burden of reviewer time, and the applicant's opportunity cost: every hour invested in a low-probability application is an hour not spent designing studies, collecting data, analyzing results, or publishing scholarship. Thus, for most small MedEd projects, the math does not add up. Repeated applications can drain time, money, and energy, while constant grant chasing risks undermining the very scholarship that funding is intended to support. The authors encourage institutions to reconsider blanket expectations for extramural MedEd funding, shifting instead toward more sustainable support models. These include internal micro-funding to cover modest research costs, protected-time awards that address the major constraint on faculty productivity (ie, time), scholarship-first mindsets that reward contributions irrespective of external dollars, collaborative funding mechanisms that pool institutional resources, and scholarly communities of practice that offer ongoing mentorship and infrastructure. The authors further argue that institutions supported by student tuition and public funds have an ethical obligation to subsidize educational research and innovation, as the quality of educational practice is inseparable from the quality and safety of healthcare itself. Redirecting faculty efforts from low-probability, low-yield grant chasing toward scholarship can foster a more sustainable research culture that rewards quality, drives innovation, and delivers lasting educational impact.

The consultation stage of scoping reviews, originally proposed by Arksey and O'Malley and further developed by Levac et al and the Joanna Briggs Institute, remains a conceptually ambiguous and inconsistently applied component of knowledge synthesis. In this context, consultation refers to the planned, purposeful engagement with knowledge users to elicit input on priorities, interpretation and gaps and to inform dissemination strategies. Although consultation has been framed as a means to validate findings or inform dissemination, it is often treated as an optional or peripheral activity, if included at all. In this manuscript, we revisit the consultation stage as an integral, collaborative and methodologically embedded feature of scoping reviews, one that warrants the same reflexivity, rigour and transparency as other stages of the process. Drawing from recent critiques in the health professions education literature and our own experience conducting knowledge syntheses, we position consultation not as a standalone study or superfluous add-on but as a dialogical, contextually responsive strategy for engaging knowledge users meaningfully. We offer practical guidance on how to design and execute consultations with methodological intentionality, aligned with the scoping review's epistemological stance and research objectives. Through case examples from our work and additional strategies drawn from the literature, we highlight how consultation can enhance the credibility, usability and relevance of review findings. We also reflect on the ethical and epistemic considerations of consultation, including issues of authorship and the challenges that arise when feedback diverges from review findings. In doing so, we call for a shift in how the consultation stage is conceptualised, designed and reported in scoping reviews. Rather than viewing consultation as a symbolic or confirmatory gesture, we argue that it should be embraced as a dynamic, humanising process that deepens interpretation, challenges assumptions and expands the real-world applicability of scoping review findings.

Ideally, educators should use the best available evidence to make decisions about their practices as teachers, scholars, and policymakers. However, the rapid increase of scholarly literature in medical education poses a major challenge. Knowledge syntheses (aka reviews), which contextualize and integrate information into a single resource, have become essential tools for navigating this information overload. This article presents an overview of knowledge synthesis in medical education, starting by defining it and providing an overview of the general steps. It then examines four key types of syntheses: systematic reviews, scoping reviews, meta-reviews, and realist reviews, providing examples of each type and, when possible, pointing to reporting guidelines and resources for conducting the type. The article then addresses common methodological pitfalls, including inadequate time planning, limited collaboration with end-users, insufficiently actionable findings, and narrow search strategies. The article concludes by presenting emerging innovations, such as artificial intelligence-supported methodologies, living reviews, and alternative knowledge translation activities.

PROBLEM:Medical education scholars struggle to join ongoing conversations in their field due to the lack of a dedicated medical education corpus. Without such a corpus, scholars must search too widely across thousands of irrelevant journals or too narrowly by relying on PubMed's Medical Subject Headings (MeSH). In tests conducted for this study, MeSH missed 34% of medical education articles. APPROACH:From January to December 2024, the authors developed the Medical Education Corpus (MEC), the first dedicated collection of medical education articles, through a 3-step process. First, using the core-periphery model, they created the Medical Education Journals (MEJ), a collection of 2 groups of journals based on participation and influence in medical education discourse: the MEJ-Core (formerly the MEJ-24, 24 journals) and the MEJ-Adjacent (127 journals). Second, they developed and evaluated a machine learning model, the MEC Classifier, trained on 4,032 manually labeled articles to identify medical education content. Third, they applied the MEC Classifier to extract medical education articles from the MEJ-Core and MEJ-Adjacent journals. OUTCOMES:As of December 2024, the MEC contained 119,137 medical education articles from the MEJ-Core (54,927 articles) and MEJ-Adjacent journals (64,210 articles). In an evaluation using 1,358 test articles, the MEC Classifier demonstrated significantly improved sensitivity compared with MeSH (90% vs 66%, P = .001), while maintaining a similar positive predictive value (82% vs 81%). NEXT STEPS:The MEC provides a focused corpus that enables medical education scholars to more easily join conversations in the field. Scholars can rely on the MEC when reviewing literature to frame their work, and the MEC also creates opportunities for field-wide analyses and meta-research. The core methodology also underlies the MedEdMentor Paper Database (mededmentor.org), a separately maintained online tool that complements the versioned MEC snapshot with a web-based search interface.

This study sheds light on how journalists respond to evolving debates within academia around topics including research integrity, improper use of metrics to measure research quality and impact, and the risks and benefits of the open science movement. It does so through a codebook thematic analysis of semi-structured interviews with 19 health and science journalists from the Global North. We find that journalists’ perceptions of these academic controversies vary widely, with some displaying a highly critical and nuanced understanding and others presenting a more limited awareness. Those with a more in-depth understanding report closely scrutinizing the research they report, carefully vetting the study design, methodology, and analyses. Those with a more limited awareness are more trusting of the peer review system as a quality control system and more willing to rely on researchers when determining what research to report on and how to vet and frame it. While some of these perceptions and practices may support high-quality media coverage of science, others have the potential to compromise journalists’ ability to serve the public interest. Results provide some of the first insights into the nature and potential implications of journalists’ internalization of the logics of science.

PURPOSE:Clinical reasoning, an essential skill in medicine, is significantly influenced by emotions. Although the cognitive aspects of clinical reasoning have been extensively studied, the impact of emotions remains underexplored. This scoping review aimed to map the existing literature on the influence of emotions on clinical reasoning across medical education and practice. METHOD:The authors conducted a scoping review (March 11, 2022, and December 1, 2023) following Arksey and O'Malley's framework of MEDLINE (Ovid), Embase (Elsevier), Web of Science, and PsycInfo (Ebsco) to identify relevant literature. All empirical studies examining the interplay of emotions and clinical reasoning on the continuum of medical education training were eligible for inclusion. RESULTS:Sixty-one studies met the inclusion criteria. The findings indicate that negative and anxiety-provoking emotions, such as stress, fear, and uncertainty, are predominantly highlighted in the literature as influencing clinical reasoning. These emotions were associated with conservative clinical approaches, increased diagnostic errors, and suboptimal management decisions. Anxiogenic emotions showed mixed effects, sometimes leading to more thorough evaluations but also potentially prompting unnecessary interventions. Conversely, positive emotions and gut feelings, often cultivated through experience, were found to support effective clinical reasoning and potentially improve patient care by fostering adaptability and diagnostic accuracy. CONCLUSIONS:This review captures the integral role of emotions in clinical reasoning, impacting every facet of patient care. The nuanced interplay between emotions-both positive and negative-and clinical reasoning emphasizes that emotions not only arise as by products of clinical encounters but also actively shape clinical reasoning. These findings call for educational interventions that equip clinicians with emotional awareness and regulation strategies to enhance their clinical reasoning. Future research should explore the influence of positive emotions, investigate the effectiveness of emotional regulation interventions, and address gaps in understanding the contextual and cultural variability in emotional dimensions of clinical reasoning.

Physicians face two conflicting goals—demonstrating competence and showing awareness of their limits (intellectual humility [IH]). While competence has been studied extensively in health professions education (HPE), IH remains relatively unexamined, especially in relation to physician and trainee experiences. This gap is important because IH may improve quality of care by mitigating against premature closure in diagnosis and strengthening therapeutic relationships by demonstrating respect for patients’ perspectives. This study addresses this gap by exploring academic hospitalists’ experiences of IH, to facilitate trainees and clinicians engaging in IH in ways that avoid detrimental emotions (e.g., shame) and negative repercussions (e.g., remediation). To explore academic hospitalists’ experiences of IH, focusing on work with students and residents. Qualitative analysis of semi-structured interviews. Twelve hospitalists (6 women, 6 men) at an academic medical center who supervise medical students and residents on general medicine teams. We conducted virtual, semi-structured interviews, asking participants to share experiences in which IH was anticipated, experienced, or observed, including when they were aware of personal limitations and when their opinions differed from peers’ or learners.’ Transcripts were independently coded by two team members; regular meetings were held to discuss interpretations. Analysis was guided by Porter et al.’s work; the authors initially applied her six content categories derived through characterizations of IH surveys while remaining open to additional codes. Transcripts contained all six content categories Porter identified, but also additional themes including (1) mitigation of personal limitations, (2) anxiety, (3) arc of career, (4) modeling, and (5) psychological safety. Lived experiences of hospitalists contain themes substantially different from those of IH surveys. HPE has unique affordances and constraints affecting IH, even for attending physicians. Conceptualizations of competence that include IH provide direction for stronger relationships, shared decision-making, and responsible action in high-stakes situations.

Knowledge syntheses (literature reviews) are essential to health professions education (HPE), consolidating findings to advance theory and practice. However, they are labor-intensive, especially during data extraction. Artificial Intelligence (AI)-assisted extraction promises efficiency but raises concerns about accuracy, making it critical to distinguish AI 'hallucinations' (fabricated content) from legitimate interpretive differences. We developed an extraction platform using large language models (LLMs) to automate data extraction and compared AI to human responses across 187 publications and 17 extraction questions from a published scoping review. AI-human, human-human, and AI-AI consistencies were measured using interrater reliability (categorical) and thematic similarity ratings (open-ended). Errors were identified by comparing extracted responses to source publications. AI was highly consistent with humans for concrete, explicitly stated questions (e.g., title, aims) and lower for questions requiring subjective interpretation or absent in text (e.g., Kirkpatrick's outcomes, study rationale). Human-human consistency was not higher than AI-human and showed the same question-dependent variability. Discordant AI-human responses (769/3179 = 24.2

Peer coaching is a form of faculty development in which faculty improve their teaching skills through collaborative work or peer observation of teaching. As a tool grounded in experiential learning, peer coaching promotes targeted feedback, reflection on action, and collegial exchange to improve teacher self-efficacy and trainee learning outcomes. Nevertheless, faculty developers face challenges in creating sustainable, effective peer coaching programs as faculty fear scrutiny of their teaching practices. Additionally, to promote collegial exchange, faculty (the person observed and peer coach) must trust one another and accept vulnerability. Without attending to trust, faculty developers may find themselves on black ice, designing and implementing ineffective peer coaching programs. In this Black Ice article, we underscore the role of trust in peer coaching and present five ways to help faculty developers get a grip by incorporating trust into the design and implementation of peer coaching programs, optimizing its efficacy.

PURPOSE:Students with disabilities remain disproportionately underrepresented in undergraduate medical education (UME). This scoping review synthesizes the literature on undergraduate medical students with disabilities in the United States to identify the purpose of the literature and map how disability is portrayed. METHOD:The authors searched 8 databases for relevant publications published between January 2008 through August 2024. Publication inclusion was determined using a 2-phase title/abstract screening process and full-text review conducted by 2 independent authors. Data extraction focused on characterizing the publication, followed by an analysis of the publications' goals and how disability was portrayed. RESULTS:The authors identified 10,491 publications; 81 were included, most of which were journal articles ( n = 78). In 23 publications, at least one author disclosed their identity as disabled. Five main goals were identified in the publication purpose statements, including describing ( n = 50), calling for action ( n = 25), evaluating ( n = 24), arguing ( n = 14), and creating ( n = 14). Overall, disability was portrayed as (1) diversity, (2) deficiency, (3) inherently connected with accommodation and technical standards, and (4) a place of habitual omissions. Two studies discussed disability in relation to intersectional identities, and 2 used gender or race in multivariable models. No studies explicitly focused on UME and disabled students of color, disability and gender diversity, or disabled LGBQ+ students. CONCLUSIONS:This scoping review identified that disability is portrayed from an abled viewpoint as race- and gender-neutral, static, and as diversity, deficit, or a legal construct. Future researchers should consider how disability is conceptualized and the use of intersectional frameworks.