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Ecological interchangeability: supporting team adaptive expertise in moments of disruption
AbstractWhile undesirable, unexpected disruptions offer unique opportunities to enact adaptive expertise. For adaptive expertise to flourish, individuals and teams must embrace both efficiency and adaptation. While some industries do it readily, others continue to struggle with the tension between efficiency and adaptation, particularly when otherwise stable situations are unexpectedly disrupted. For instance, in healthcare settings, the efficiency mandate for strict compliance with scopes of practice can deter teams from using the adaptive strategy of making their members interchangeable. Yet, interchangeability has been ...
Source: Advances in Health Sciences Education - November 10, 2022 Category: Universities & Medical Training Source Type: research

Professional identity research in the health professions —a scoping review
AbstractProfessional identity impacts the workforce at personal, interpersonal and profession levels however there is a lack of reviews of professional identity research across practising health professionals. To summarise professional identity research in the health professions literature and explore how professional identity is described a scoping review was conducted by searching Medline, Psycinfo, Embase, Scopus, CINAHL, and Business Source Complete using “professional identity” and related terms for 32 health professions. Empirical studies of professional identity in post-registration health professionals were exa...
Source: Advances in Health Sciences Education - November 9, 2022 Category: Universities & Medical Training Source Type: research

Combining adaptive expertise and (critically) reflective practice to support the development of knowledge, skill, and society
AbstractAdaptive expertise (AE) and reflective practice (RP), two influential and resonant theories of professional expertise and practice in their own right, may further benefit health professions education if carefully combined. The current societal and systemic context is primed for both AE and RP. Both bodies of work position practitioners as agentive, learning continually and thoughtfully throughout their careers, particularly in order to manage unprecedented situations well. Similar on the surface, the roots and practices of AE and RP diverge at key junctures and we will focus on RP ’s movement towardcritically ref...
Source: Advances in Health Sciences Education - November 9, 2022 Category: Universities & Medical Training Source Type: research

Getting real in interprofessional clinical placements: patient-centeredness in student teams ’ collaborative learning
This study aimed to explore how interprofessional student teams and patients interact in interprofessional clinical placements. With a focused ethnographic approach, participant observation and qualitative interviews were conducted in two contexts; a physical and an online arrangement. Central ideas in Goffman’s dramaturgy constituted a theoretical lens. A reflexive thematic analysis generated three themes: (1) Preparing safe and comfortable encounters with patients, (2) Including and excluding the patient in the encounter, and (3) Adjusting to the patient's situation. We identified students ’ intentions of patient-cen...
Source: Advances in Health Sciences Education - November 7, 2022 Category: Universities & Medical Training Source Type: research

Productive struggle and failing safely: implications for developing adaptive expertise in communication
AbstractNavigating difficult conversations is a complex task that requires flexible and adaptive approaches. Residents developing this skill may initially struggle or fail, and require support. However, this experience may prepare residents for future learning which is essential to adaptive expertise. Limited understanding of how residents learn from failure in the workplace restricts the ability to maximize its potential benefits. The purpose of this study was to explore the role failure plays in learning to navigate difficult conversations during workplace learning. A constructivist grounded theory study was conducted us...
Source: Advances in Health Sciences Education - November 5, 2022 Category: Universities & Medical Training Source Type: research

Documentation as composing: how medical students and residents use writing to think and learn
AbstractSome educators have described clinical documentation as “scut”. Research in medicine has focused on documentation’s communicative value and not its function in learning. With time being an important commodity and electronic health records changing how we document, understanding the learning value of documentation is essential. The purpose of this s tudy was to explore how trainee composing practices shape learning. Qualitative methods employing Rhetorical Genre Theory were used to explore clinical documentation practices among medical trainees. Data collection and analysis occurred in iterative cycles. Data ...
Source: Advances in Health Sciences Education - November 1, 2022 Category: Universities & Medical Training Source Type: research

Social support experiences of students and clinicians with disabilities in health professions
AbstractSocial support is vital in promoting the health, well-being, and performance of students and clinicians in health professions. Health settings' demanding and competitive nature imposes unique challenges on students and clinicians with disabilities. This paper aims to explore the trajectories and experiences of social support interactions amongst students and clinicians with disabilities in health professions. In a qualitative longitudinal study, 124 in-depth semi-structured interviews were conducted with 27 health students and 29 health clinicians with disabilities. Data analysis was informed by grounded theory as ...
Source: Advances in Health Sciences Education - October 31, 2022 Category: Universities & Medical Training Source Type: research

Rethinking professional identity formation amidst protests and social upheaval: a journey in Africa
This study uses interviews with medical students to explore PIF within the context of social upheaval during the 2015 –2016 protests that rocked South Africa when students challenged asymmetries of power and privilege that persisted long after the country’s democratic transition. The combination of the primary author’s autoethnographic story, weaved into the South African sociohistorical context and ubuntu ph ilosophy, contributes to this study of PIF in the South African context. The use of an African metaphor allowed the reorientation of PIF to reflect the influence of an ubuntu-based value system. Using the calaba...
Source: Advances in Health Sciences Education - October 27, 2022 Category: Universities & Medical Training Source Type: research

Making sense of adaptive expertise for frontline clinical educators: a scoping review of definitions and strategies
AbstractAdaptive expertise has been promoted as an emerging model of expertise in health professions education in response to the inherent complexities of patient care; however, as the concept increasingly influences the structure of professional training and practice, it creates the potential for misunderstandings of the definition and implications of adaptive expertise. To foster a common understanding of the concept, we conducted a scoping review to explore how adaptive expertise has been discussed within health professions education literature. Five databases —MedLine, PubMed, ERIC, CINAHL, and PsycINFO—were search...
Source: Advances in Health Sciences Education - October 27, 2022 Category: Universities & Medical Training Source Type: research

“It’s making me think outside the box at times”: a qualitative study of dynamic capabilities in surgical training
AbstractCraft specialties such as surgery endured widespread disruption to postgraduate education and training during the pandemic. Despite the expansive literature on rapid adaptations and innovations, generalisability of these descriptions is limited by scarce use of theory-driven methods. In this research, we explored UK surgical trainees ’ (n = 46) and consultant surgeons’ (trainers,n = 25) perceptions of how learning in clinical environments changed during a time of extreme uncertainty (2020/2021). Our ultimate goal was to identify new ideas that could shape post-pandemic surgical training. We conducted se...
Source: Advances in Health Sciences Education - October 26, 2022 Category: Universities & Medical Training Source Type: research

Exploring US internal medicine resident career preferences: a Q-methodology study
The objective of this study was to explore and define the dominant viewpoints related to career choice selection in a cohort of U.S. IM residents. We administered an electronic Q-sort in which 218 IM residents sorted 50 statements reflecting the spectrum of opinions that influence postgraduate career choice decisions. Participants provided comments that explained the reasoning behind their individual responses. In the final year of residency training, we ascertained participating residents ’ chosen career. Factor analysis grouped similar sorts and revealed four distinct viewpoints. We characterized the viewpoints as “F...
Source: Advances in Health Sciences Education - October 20, 2022 Category: Universities & Medical Training Source Type: research

Expanding the advocacy lens: using photo-elicitation to capture patients ’ and physicians’ perspectives about health advocacy
AbstractHeath advocacy (HA) remains a difficult competency to train and assess, in part because practicing physicians and learners carry uncertainty about what HA means and we are missing patients ’ perspectives about the role HA plays in their care. Visual methods are useful tools for exploring nebulous topics in health professions education; using these participatory approaches with physicians and patients might counteract the identified training challenges around HA and more importantly, remedy the exclusion of patient perspectives. In this paper we share the verbal and visual reflections of patients and physicians re...
Source: Advances in Health Sciences Education - October 10, 2022 Category: Universities & Medical Training Source Type: research

This was the first …
AbstractIn this editorial, two of the Journal ’s editors reflect on why many authors emphasize in their study being the first one to focus on a given topic. They explore why authors may engage in this behavior and they offer guidance to authors as to how to strengthen the rationale for their work besides ‘being first.’ (Source: Advances in Health Sciences Education)
Source: Advances in Health Sciences Education - October 1, 2022 Category: Universities & Medical Training Source Type: research

Empathy across cultures – one size does not fit all: from the ego-logical to the eco-logical of relational empathy
AbstractEmpathy is extolled in Western healthcare and medical education as an exemplary quality to cultivate in trainees and providers. Yet it remains an elusive and inadequately understood attribute. It posits a “one size fits all” unidimensional attribute applicable across contexts with scant attention given to its multifaceted dimensions in intercultural contexts. In this article, we uncloak the shortcomings of this conventional empathy in intercultural settings, and instead propound an expanded “re lational empathy”. (Source: Advances in Health Sciences Education)
Source: Advances in Health Sciences Education - September 21, 2022 Category: Universities & Medical Training Source Type: research

How progress evaluations are used in postgraduate education with longitudinal supervisor-trainee relationships: a mixed method study
AbstractThe combination of measuring performance and giving feedback creates tension between formative and summative purposes of progress evaluations and can be challenging for supervisors. There are conflicting perspectives and evidence on the effects supervisor-trainee relationships have on assessing performance. The aim of this study was to learn how progress evaluations are used in postgraduate education with longitudinal supervisor-trainee relationships. Progress evaluations in a two-year community-pharmacy specialization program were studied with a mixed-method approach. An adapted version of the Canadian Medical Edu...
Source: Advances in Health Sciences Education - September 12, 2022 Category: Universities & Medical Training Source Type: research