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Equity, diversity, and …exclusion? A national mixed methods study of “belonging” in Canadian undergraduate medical education
AbstractEquity, diversity, and inclusion remain a prominent focus in medical schools, yet the phenomenon of “belonging” has arguably been overlooked. Little is known regarding how belonging is experienced by medical students from groups that face systemic oppression and exclusion. We employed a sequential explanatory mixed methods design to explore how students from equity-deserving groups (EDGs) expe rience belonging during medical school, including those who are women, racialized, Indigenous, disabled, and 2SLGBTQIA+. First, we conducted a national cross-sectional survey of medical students (N = 480) measuring fo...
Source: Advances in Health Sciences Education - August 10, 2023 Category: Universities & Medical Training Source Type: research

Expert consensus on the attributes and competencies required for rural and remote junior physicians to work effectively in isolated indonesian communities
This study sought to reach a consensus on the attributes and competencies that are viewed as essential and important for working effectively as an early career doctor in rural and remote practice in Indonesia. A two-round Delphi study was conducted by reference to 27 consenting physicians working in rural and remote Indonesia. Forty-three items covering 9 attributes and 34 competencies were sent to these physicians to be rated on a Likert scale ranging from 1 to 5 in terms of their importance for effective rural and remote practice. Nine attributes and 29 competencies progressed to Round 2. All nine attributes and 29 compe...
Source: Advances in Health Sciences Education - August 9, 2023 Category: Universities & Medical Training Source Type: research

Assessing clinical competence: a multitrait-multimethod matrix construct validity study
AbstractEducation in Doctor of Medicine programs has moved towards an emphasis on clinical competency, with entrustable professional activities providing a framework of learning objectives and outcomes to be assessed within the clinical environment. While the identification and structured definition of objectives and outcomes have evolved, many methods employed to assess clerkship students ’ clinical skills remain relatively unchanged. There is a paucity of medical education research applying advanced statistical design and analytic techniques to investigate the validity of clinical skills assessment. One robust statisti...
Source: Advances in Health Sciences Education - August 2, 2023 Category: Universities & Medical Training Source Type: research

The maintenance of classism in medical education: “time” as a form of social capital in first-generation and low-income medical students
This study argues that while all forms of capital are necessary for success,time as a specific form keeps classism in place. Using constructivist grounded theory techniques, we interviewed 48 FGLI students to understand where, why and how they allocated their time, and the perceived impact it had on them. Using open coding and constant comparison, we developed an understanding of FGLI students ’ relationship to time and then contextualized it within larger conversations on howtime is conceptualized in a capitalist system that demands time efficiency, and the activities where time is needed in medical school. When student...
Source: Advances in Health Sciences Education - August 1, 2023 Category: Universities & Medical Training Source Type: research

Seeking Utopia: a response to “Oncology residents’ experiences of decision-making in a clinical learning environment: a phenomenological study”
(Source: Advances in Health Sciences Education)
Source: Advances in Health Sciences Education - July 25, 2023 Category: Universities & Medical Training Source Type: research

The impact of prior performance information on subsequent assessment: is there evidence of retaliation in an anonymous multisource assessment system?
This study documents an association between receiving scores within an anonymous multi-source feedback (MSF) system and providing aberrant scores to team members. These findings suggest care must be given to designing MSF systems to protect against potential downstream consequences of providing and receiving anonymous feedback. (Source: Advances in Health Sciences Education)
Source: Advances in Health Sciences Education - July 24, 2023 Category: Universities & Medical Training Source Type: research

Legibility: knowing disability in medical education inclusion
AbstractHow medical students, their teachers, and school administrators understand disability appears connected to ongoing, unequal access to medical education for disabled people. The stigmatization of disability within medical education affects students ’ disability disclosures, yet few studies have explored how understandings of disability influence inclusion practices beyond individual student actions. This paper develops the concept oflegibility, derived from a constructivist grounded theory study that examined disability inclusion at four U.S. medical schools through interviews with 19 disabled students and 27 scho...
Source: Advances in Health Sciences Education - July 21, 2023 Category: Universities & Medical Training Source Type: research

“We’re back in control of the story and we’re not letting anyone take that away from us”: patient teacher programs as means for patient emancipation
AbstractWhile patient engagement in healthcare professions education (HPE) has significantly increased in the past decades, a theoretical gap remains. What are the varied reasons as towhy patients get involved with HPE programs? With a focus on understanding what drives patient involvement with HPE programs, this study examined how a patient as teacher (PAT) program was experienced by medical students, patient teachers, and faculty within a medical school. Through a phenomenographic approach, this study captures and describes the different ways our study participants experienced a PAT program (the ‘phenomenon’). 24 sem...
Source: Advances in Health Sciences Education - July 16, 2023 Category: Universities & Medical Training Source Type: research

Identity influences on medical students ’ orientation to feedback during third year clinical rotations
This study proposed that both how students view themselves personally (i.e., impostor syn drome) and how they view themselves in relation to the group (i.e., identification with the profession) are identity factors related to related to feedback orientation during clinical rotations. 177 third-year medical students enrolled in a four-phase longitudinal survey study beginning at the start of clinical rotations and continuing every twelve weeks of the academic year thereafter. Feedback orientation was conceptualized and measured as comprising aspects of utility (i.e., feedback is valuable and useful), sensitivity (i.e., feel...
Source: Advances in Health Sciences Education - July 12, 2023 Category: Universities & Medical Training Source Type: research

Comparing the stress response using heart rate variability during real and simulated crises: a pilot study
AbstractMedical personnel often experience stress when responding to a medical emergency. A known stress-response is a measurable reduction in heart rate variability. It is currently unknown if crisis simulation can elicit the same stress response as real clinical emergencies. We aim to compare heart rate variability changes amongst medical trainees during simulated and real medical emergencies. We performed a single center prospective observational study, enrolling 19 resident physicians. Heart rate variability was measured in real time, using a 2-lead heart rate monitor (Bodyguard 2, Firstbeat Technologies Ltd) worn duri...
Source: Advances in Health Sciences Education - July 11, 2023 Category: Universities & Medical Training Source Type: research

Past resources, future envisioning, and present positioning: how women who are medical students at one institution draw upon temporal agency for resistance
AbstractWhile women entering medical school are faced with a patriarchal system, they also enter into a community with other women and the potential forresistance. The purpose of this study is to use the theory of temporal agency to explore how first-year medical students who identify as women draw upon past, future, and present agency to resist the patriarchal system of medicine.The data for this study were drawn from the first year (October 2020-April 2021) of a longitudinal project using narrative inquiry to understand the socialization of women students in undergraduate medical education. Fifteen participants performed...
Source: Advances in Health Sciences Education - July 10, 2023 Category: Universities & Medical Training Source Type: research

Applying to medical school with undiagnosed dyslexia: a collaborative autoethnography
AbstractRecent statistics found the prevalence of dyslexia in UK medical schools to be 7%, sitting below the national prevalence of 10%. The factors contributing to this discrepancy are currently unknown, but may result from an interplay of individual and systemic barriers to entering medicine. This collaborative, analytic autoethnography aimed to use the experiences of ‘Meg’, a fourth-year medical student who was diagnosed as dyslexic whilst at medical school, to explore how the lack of a diagnosis during the admissions process may have impacted her journey into medicine. The data were collected using reflective writi...
Source: Advances in Health Sciences Education - July 10, 2023 Category: Universities & Medical Training Source Type: research

Opening the black box of school-wide student wellbeing programmes: a critical narrative review informed by activity theory
ConclusionsOur review shines a light into the black-box of holistic school-wide wellbeing programmes. We identified that tutors play a key role in wellbeing systems but confidentiality is a recurring tension which may jeopardise a wellbeing system. The time has come to investigate these systems in more detail, embracing and exploring the role of context at the same time as looking for common threads. (Source: Advances in Health Sciences Education)
Source: Advances in Health Sciences Education - July 2, 2023 Category: Universities & Medical Training Source Type: research

Exploring adaptive expertise in residency: the (missed) opportunity of uncertainty
AbstractPreparing novice physicians for an unknown clinical future in healthcare is challenging. This is especially true for emergency departments (EDs) where the framework of adaptive expertise has gained traction. When medical graduates start residency in the ED, they must be supported in becoming adaptive experts. However, little is known about how residents can be supported in developing this adaptive expertise. This was a cognitive ethnographic study conducted at two Danish EDs. The data comprised 80  h of observations of 27 residents treating 32 geriatric patients. The purpose of this cognitive ethnographic study wa...
Source: Advances in Health Sciences Education - July 1, 2023 Category: Universities & Medical Training Source Type: research

Moral injury and the hidden curriculum in medical school: comparing the experiences of students underrepresented in medicine (URMs) and non-URMs
AbstractUnderrepresented students in medicine (URM) have more negative perceptions of the medical school learning environment (LE), a phenomenon that can contribute to higher rates of burnout and attrition in these populations. The hidden curriculum (HC) —defined as a set of values informally conveyed to learners through clinical role-modeling—is a LE socialization construct that has been critically examined for its role in shaping students’ professional identities. Yet differences in how URMs and non-URMs experience the HC remain underexplore d. The study used a pragmatic approach that drew on elements of grounded t...
Source: Advances in Health Sciences Education - June 29, 2023 Category: Universities & Medical Training Source Type: research