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Objectives: The use of theory in research is reflected in its presence in research writing. Theory is often an ineffective presence in medical education research papers. To progress the effective use of theory in medical education, we need to understand how theory is presented in research papers. This study aims to elicit how theory is being written into general practice (GP) vocational education research papers in order to elucidate how theory might be more effectively used. This has relevance for the field of GP and for medical education more broadly. Methods: This is a scoping review of the presentation of theory in GP vocational education research published between 2013 and 2017. An interpretive approach is taken. We frame research papers as a form of narrative and draw on the theories of Aristotle's poetics and Campbell's monomyth. We seek parallels between the roles of theory in a research story and theories of characterisation. Results: A total of 23 papers were selected. Theories of 'reflective learning', 'communities of practice' and 'adult learning' were most used. Six tasks were assigned to theory: to align with a position; to identify a research problem; to serve as a vehicle for an idea; to provide a methodological tool; to interpret findings, and to represent an object of examination. The prominence of theory in the papers ranged from cameo to major roles. Depending on the way theory was used and the audience, theory had different impacts. There were parallels between the tasks assigned to theory and the roles of four of Campbell's archetypal characters. Campbell's typology offers guidance on how theory can be used in research paper 'stories'. Conclusions: Theory can be meaningfully present in the story of a research paper if it is assigned a role in a deliberate way and this is articulated. Attention to the character development of theory and its positioning in the research story is important. Treating theory as a character in a story, Brown et al. demonstrates how theory can be written into research papers in a way that contributes meaningfully to the research narrative. [ABSTRACT FROM AUTHOR]

ObjectiveTo investigate the content validity of Paper 1 of the MRCGP examination. MethodExploratory factor analysis was carried out on candidate responses to Paper 1 of the May and October MRCGP examination in 1998. Contribution of each test question across factors was assessed using a pattern matrix of the oblique rotation. Common dimensions and variations between factor sets were identified. Key testing areas were then matched against the ‘domains of competence’ intended to be assessed by Paper 1 (as defined within the examination blueprint matrix). ResultsWhilst critical appraisal, disease prevention/evidence-based medicine and clinical management emerged as areas tested consistently, content variation was observed between factor sets extracted from both sittings. In addition, some overlap, in terms of domains tested, was seen among other assessment instruments used within the examination. ConclusionPaper 1 conforms to the majority of its stated intentions. However, further development of techniques for investigating validity will be required in order to minimize content variation between both sittings of the examination as well as to help more closely define areas of competence to be tested by Paper 1 of the MRCGP examination. [ABSTRACT FROM AUTHOR]

A review of the article "Effectiveness of problem-based learning curricula: theory, practice and paper darts," by Geoffrey R. Norman and Henk G. Schmidt is presented.

Objective To determine the differential effects of a paper-based versus a web-based portfolio in terms of portfolio quality, user-friendliness and student motivation. Methods An experimental design was used to compare Year 1 medical students' reflective portfolios. The portfolios differed in presentation medium only (i.e. web-based versus paper-based). Content analysis, a student questionnaire and mentor interviews were used to evaluate portfolio quality, user-friendliness and student motivation. A total of 92 portfolios were scored independently by 2 raters using a portfolio quality-rating instrument. Results Portfolio structure, quality of reflection and quality of evidence showed no significant effects of presentation medium. Multi-level analysis showed a significant effect for student motivation: web-based portfolios scored 0.39 more than paper-based portfolios ( P < 0.05; effect size 0.76). The mentors reported no differences in portfolio quality, except that there were more visuals in web-based portfolios. Students spent significantly more time preparing the web-based than the paper-based portfolios (15.4 hours versus 12.2 hours; t = 2.1, P < 0.05; effect size 0.46). The 2 student groups did not differ significantly in terms of their satisfaction with the portfolio. The mentors perceived the web-based portfolios as more user-friendly. Conclusions The web-based portfolios were found to enhance students' motivation, were more user-friendly for mentors, and delivered the same content quality compared with paper-based portfolios. This suggests that web-based presentation may promote acceptance of portfolios by students and teachers alike. [ABSTRACT FROM AUTHOR]

There are few publications summarising the main issues concerning pathology teaching and learning within undergraduate medical degrees. This article examines the themes that have emerged from the literature over the last 2 decades. A literature search was performed using PubMed, which identified 86 relevant papers in the English language. The themes discussed in the literature included the timing and duration of pathology courses, the appropriate pathology teacher for medical students, the teaching strategies used for pathology, and the methods used to assess learning. With the gradual increase of integrated medical curricula, it is important for pathology teachers to engage in the change process and help to shape the new-style courses. One of the positive aspects of change is that it can provide an opportunity to rethink current practice. It is hoped that this paper might stimulate discussion about how pathology is taught and learnt, leading to further developments in this area. [ABSTRACT FROM AUTHOR]

Aim This study was conducted to investigate the value of a written knowledge test of communication skills for predicting scores on a performance test of communication skills. Method A paper-and-pencil test of knowledge about communication skills and a performance test of communication skills, consisting of four stations with standardised patients, were administered to students of two classes of the medical schools of Maastricht and Leiden, the Netherlands. The results on these tests were compared. Results From the results of both instruments, the classes of the participating students could be recognised equally well: 60% correct qualifications of the classes by the knowledge test and 64% by the multiple station examination. Between the two tests an overall, disattenuated correlation of 0·60 was found (N = 133, P < 0·01), suggesting moderate predictive value of the knowledge test for the performance test of communication skills. The correlation is stronger for students from Maastricht medical school than for their colleagues in Leiden. Correlation between the knowledge of communication skills test and other available test results of the participating Maastricht students is close to zero, suggesting that the test measures a distinct quality of students' competence. Discussion The paper-and-pencil test of knowledge of communication skills has predictive value for the performance of these skills, but this value seems to be less pronounced than similar findings for clinical procedural skills. The stronger relationship between 'knowing how' and 'showing' in the Maastricht student group might be indicative of an effect of the training format. [ABSTRACT FROM AUTHOR]

Context The White Paper, The New NHS: Modern, Dependable, once again heralds change and new expectations of primary care in the UK. Objectives This discussion paper aims to encourage reflection on the implications for primary care teams of current governmental strategy, and to address the pivotal role which education can play in equipping practitioners for their roles. Key areas The paper examines the opportunities and threats for primary care in the new NHS developments, the strengths and weaknesses of the role that education currently plays in primary care, and how recent innovations might be used to give a more holistic approach to the needs of practitioners. The challenges for clinical governance of lay engagement and ethical decision making are seen as two crucial outcomes for an educational strategy which must be practice-led, and must interface individual practitioner education with the needs of the team and the community as a whole. I draw on a range of policy documents and educational literature to alert the reader to the different choices which can be made when thinking about appropriate educational models and methods; and offer a detailed structure for a practical educational strategy that may effectively unite theory and practice. The key elements are a three-tier link between practices, primary care groups, and district-level resources for all educational and training activity, and the aim of continuing multiprofessional development which will underpin the new NHS. [ABSTRACT FROM AUTHOR]

An index of papers exhibited as posters for the October 2011 issue of the "Medical Education" journal is presented.

Objectives To explore the feasibility and value of using real patients as trigger material in problem-based learning (PBL). Design A questionnaire was given to all students participating in a PBL module including a question about ‘the added value of using real, as opposed to paper cases’, in problem-based learning. Resources used by students and assessment of feasibility were recorded by the course tutors. Setting A 7-week student-selected problem-based module in general practice in the fourth-year undergraduate medical curriculum, University of Newcastle upon Tyne. Subjects 69 students participating in the module over 2 years. Results All students valued the use of real patients. A total of 10 categories were identified, all congruent with accepted educational principles for effective adult learning. Real patients stimulated the use of a very wide range of resources and imaginative presentation of what had been learned. Conclusion Real patients are potent trigger stimuli in problem-based learning. The use of real patients in this general practice-based module presented no organizational or ethical difficulties. Their use should be considered more widely. [ABSTRACT FROM AUTHOR]

In a recent review article, Colliver concluded that there was no convincing evidence that problem-based learning was more effective than conventional methods. He then went on to lay part of the blame on cognitive psychology, claiming that ‘the theory is weak, its theoretical concepts are imprecise... the basic research is contrived and ad hoc’. This paper challenges these claims and presents evidence that (a) cognitive research is not contrived and irrelevant, (b) curriculum level interventions are doomed to fail and (c) education needs more theory-based research. [ABSTRACT FROM AUTHOR]

A subject index for the October 2011 issue of the "Medical Education" journal is presented.

It is important to establish the predictive validity of medical school grades. The strength of predictive validity and the ability to identify at-risk students in medical schools depends upon assessment systems such as number grades, pass/fail (P/F) or honours/pass/fail (H/P/F) systems. This study was designed to examine the predictive validity of number grades in medical school, and to determine whether any important information is lost in a shift from number to P/F and H/P/F grading systems. The participants in this prospective, longitudinal study were 6656 medical students who studied at Jefferson Medical College over 3 decades. They were grouped into 10 deciles based on their number grades in Year 1 of medical school. Participants were compared on academic accomplishments in Years 2 and 3 of medical school, medical school class rank, delayed graduation and attrition, performance on medical licensing examinations and clinical competence ratings in the first postgraduate year. Results supported the short- and longterm predictive validity of the number grades. Ratings of clinical competence beyond medical school were predicted by number grades in medical school. We demonstrated that small differences in number grades are statistically meaningful, and that important information for identifying students in need of remedial education is lost when students who narrowly meet faculty's expectations are included with the rest of the class in a broad ‘pass’ category. The findings refute the argument that knowledge of sciences basic to medicine is not critical to subsequent performance in medical school and beyond if an appropriate evaluation system is used. Furthermore, the results of this study raise questions about abandoning number grades in favour of a pass/fail system. Consideration of these findings in policy decisions regarding assessment systems of medical students is recommended. [ABSTRACT FROM AUTHOR]

Although health sciences programmes continue to value non-cognitive variables such as interpersonal skills and professionalism, it is not clear that current admissions tools like the personal interview are capable of assessing ability in these domains. Hypothesising that many of the problems with the personal interview might be explained, at least in part, by it being yet another measurement tool that is plagued by context specificity, we have attempted to develop a multiple sample approach to the personal interview. A group of 117 applicants to the undergraduate MD programme at McMaster University participated in a multiple mini-interview (MMI), consisting of 10 short objective structured clinical examination (OSCE)-style stations, in which they were presented with scenarios that required them to discuss a health-related issue (e.g. the use of placebos) with an interviewer, interact with a standardised confederate while an examiner observed the interpersonal skills displayed, or answer traditional interview questions. The reliability of the MMI was observed to be 0.65. Furthermore, the hypothesis that context specificity might reduce the validity of traditional interviews was supported by the finding that the variance component attributable to candidate–station interaction was greater than that attributable to candidate. Both applicants and examiners were positive about the experience and the potential for this protocol. The principles used in developing this new admissions instrument, the flexibility inherent in the multiple mini-interview, and its feasibility and cost-effectiveness are discussed. [ABSTRACT FROM AUTHOR]

Portfolios are increasingly advocated in medical education. Qualitative studies have suggested their value in stimulating experiential learning, promoting deep learning and encouraging reflection. This study explored the use of educational portfolios in reflective learning by general practice (GP) registrars in Yorkshire, England. A postal questionnaire was sent to the 92 registrars of a deanery in November 2001, after a pilot study with registrars in a single district had been carried out. The questionnaire explored the registrars' use of the portfolio to collect information and for reflection, as well as registrars' attitudes towards the portfolio. It was returned by 71 registrars, representing a 77% response rate. Structured in-depth interviews were used to support the results obtained. Of the registrars who responded, 65% recorded information on a regular basis and 42% used the portfolio in reflective learning. Experienced registrars used the portfolio least. Those with supportive trainers used the portfolio more in reflection. The study suggests that the role of the trainer/supervisor is vital in portfolio-based learning. It raises questions about the acceptability of portfolio learning. It adds weight to the suggestion that careful introduction of portfolios and training of supervisors is vital. Further work to establish the role of portfolios in reflective learning is recommended. [ABSTRACT FROM AUTHOR]

To explore the relationship between teaching scientific methodology in Year 2 of the medical curriculum and student attitudes towards and knowledge about science and scientific methodology. Anonymous questionnaire survey developed for this purpose. Zagreb University School of Medicine, Croatia. A total of 932 students (response rate 58%) from all 6 years were invited to participate. Score on attitude scale with 45 Likert-type statements and score on knowledge test consisting of 8 multiple choice questions. The average attitude score for all students was 166 ± 22 out of a maximum of 225, indicating a positive attitude towards science and scientific research. The students' average score on the knowledge test was 3.2 ± 1.7 on 8 questions. Students who had finished Year 2 had the highest mean attitude (173 ± 24) and knowledge (4.7 ± 1.7) scores compared with other year groups ( P < 0.001, anova and Tukey posthoc test). For students who had attended a mandatory Year 2 course on the principles of scientific research in medicine (Years 3 to 6), multiple linear regression analysis showed that knowledge test score (B = 3.4; SE = 0.4; 95% confidence interval 2.5–4.2; P < 0.001) and average grades (B = 7.6; SE = 1.5; 95% CI 4.6–10.6; P < 0.001) were significant predictors of attitude towards science, but not sex or failure to pass a year (B = − 0.6; SE = 1.7; 95% CI − 3.9–2.6; P = 0.707; and B = − 3.1; SE = 1.9; 95% CI − 6.8–5.7; P = 0.097, respectively). Medical students have generally positive attitudes towards science and scientific research in medicine. Attendance of a course on research methodology is related to a positive attitude towards science. [ABSTRACT FROM AUTHOR]

To evaluate potential learning outcomes for pre-registration house officer (PRHO) training and develop an evidence base for informed decision making. A 2-stage Delphi process was employed to establish the opinions of Scottish stakeholders with regard to learning outcomes for the PRHO year. Doctors involved in the provision of PRHO training, including deans, postgraduate tutors and general practitioners (GPs) with trainees, were invited to participate in the study. Respondents rated a range of outcomes according to which they believed should be included or excluded from the PRHO training year. Learning outcomes identified for PRHOs were grouped under the 12-domain framework of the 3-circle model: ‘What the doctor can do’, ‘How they approach their practice’ and ‘Their professionalism’. Based on the consensus opinions gained in the Delphi study, the ratings were classified into priority groupings. Priority 1 contained 45 of the original 81 learning outcomes, representing each area of the 3-circle model, with emphasis on the domains of clinical skills, patient investigation/management, communication, appropriate attitudes and personal development. Health promotion and disease prevention was the only domain not represented at priority 1. Priority 2 contained 24 outcomes with emphasis on the understanding of clinical skills, patient management and personal development. Priority 3 contained 12 outcomes indicating a lack of emphasis for some outcomes, particularly the role of the doctor and health promotion. Consensus on the learning outcomes for PRHO training has been achieved, providing an evidence base for curriculum planning. The relative priority assigned to these outcomes can facilitate the use of the evidence. This evidence base should be referred to when reviewing any PRHO training programme. [ABSTRACT FROM AUTHOR]

WFME has recently decided to extend its `International Collaborative Programme for the Reorientation of Medical Education', aiming at the implementation of its educational policy at the institutional level. The first objective is to stimulate educational institutions to formulate their own plans for change and for quality improvement to align with international standards. The second objective is to establish a system to assure minimum quality standards for medical school programmes. Both objectives can be accomplished by publishing a World Register of Medical Schools, which will constitute an instrument of quality assurance in medical education. The Register should specify designation of a World Register Accreditation of medical schools, which fulfil internationally accepted and approved standards of medical education programmes. The accreditation could be differentiated in various categories. [ABSTRACT FROM AUTHOR]

The article offers information on various medical workshops offered by different publication companies and universities which include the workshop on how to create a good research paper, workshop on understanding the methods in research, and a question and answer workshop on the development of Multiple Mini Interview (MMI) format.

Introduction: The threshold concept framework (TCF) was first described nearly 20 years ago, but its application in the field of medical education has recently seen a significant growth of interest with a diverse range of literature published on the subject. The transformative nature of threshold concepts (TCs) offers potential for the design of learning experiences and curricula across the medical education continuum. A scoping review was conducted to map the extent of the current literature regarding TCs in medical education—to describe the types of available evidence and its focus—and identify research gaps. Methods: The review followed the JBI Manual for Evidence Synthesis approach for scoping reviews. Four databases and two additional websites were searched for articles exploring TCs in medical education. Data were analysed using quantitative and qualitative thematic approaches. A framework of conceptual change was used to synthesise the TCs identified. Results: Thirty‐six papers, spanning undergraduate, postgraduate and continuing medical education, were included in the final analysis. The most frequent application of the TCF was in the identification of TCs, which related to basic scientific knowledge, ways of thinking and ways of practising in medicine. Uncertainty, patient care, clinical reasoning and professional identify formation were themes that emerged at multiple stages of training. Several papers evaluated the use of the TCF in teaching. Conclusion: The understanding and embodiment of TCs increases in complexity across the medical education continuum, with TCs recurring with changes in clinical environment and responsibilities. This lends support to a holistic approach to curriculum design spanning all stages of training. Further research is needed to develop a consistent approach for describing and applying the TCF in medical education and to address how the TCF can be used in teaching and how threshold crossing can be measured. Understanding and embodiment of threshold concepts across the medical education continuum is argued through this review to support a holistic approach to curriculum design. [ABSTRACT FROM AUTHOR]

Lists titles of articles related to medical education.

Context: The use of peer support as a faculty development technique to improve clinical teaching is uncommon in medical education, despite the benefits of situating learning in the workplace. The authors therefore conducted a broad search seeking theoretical and empirical literature describing peer support strategies for clinical teachers in health care workplaces. This included descriptive and non‐experimental studies that are often excluded from reviews. The review aimed to identify and assess existing initiatives and to synthesise key challenges and benefits. Methods: An integrative literature review was undertaken (2004–2017), based on searches of eight international electronic databases and targeted manual searches. Key concepts, elements and models were mapped using an iterative, constant comparative method. An evaluative framework, drawing on previous research, informed conclusions regarding the quality of evidence. Results: From a pool of 5735 papers, 34 met the inclusion criteria. The majority referred to studies conducted in the USA (59%) and in the medical profession (71%). Analysis revealed a trend towards using a collaborative model (56%), voluntary participation (59%), and direct workplace observation by a peer clinician (68%). Design features of the peer support strategy were commonly reported (65%), with half providing outcome measures (56%). Few papers reported on process evaluation (15%) or evidence of programme sustainability (15%). Despite logistical and time‐associated challenges, benefits accrued to individuals and the workplace, and included improved teaching practices. Embedding the peer support strategy into routine organisational practice proved effective. Conclusions: The results indicated that a workplace‐based peer support model is an acceptable and effective faculty development strategy for health care clinical teachers. Conceptualising workplace‐based peer support via a sociocultural model that acknowledges the significance of educational design, peers as collaborators and the importance of workplace context and culture is emphasised. Future research should focus on clarification studies informed by contemporary models of faculty development, in which factors impacting the health care workplace are considered. By reviewing the literature, Campbell et al. highlight how collaborative relationships and workplace connections with peers offer an under‐utilized resource for effectively improving teaching expertise. [ABSTRACT FROM AUTHOR]

Introduction: The growing interest in knowledge translation and implementation science, both in clinical practice and in health professions education (HPE), is reflected in the number of studies that have sought to address what are believed to be evidence‐practice gaps. Though this effort may be intended to ensure practice improvements are better aligned with research evidence, there is a common assumption that the problems researchers explore and the answers they generate are meaningful and applicable to practitioner needs. Methods: This Mythology paper considers the nature of problems from HPE as the focus of HPE research and the ways in which they may or may not be aligned. The authors argue that, in an applied field such as HPE, it is vital that researchers better understand how their research problems relate to practitioner needs and what the limitations on evidence uptake might be. Not only can this establish clearer paths between evidence and action, but it also requires a rethink of much of knowledge translation and implementation science thinking and practice. Results: The authors explore five myths: whether everything in HPE is a problem; whether practitioner needs involve problem solving; whether practitioner problems are resolvable with sufficient evidence; whether researchers effectively target practitioner problems; and whether studies that focus on solving practitioner problems make significant contributions to the literature. Conclusions: To advance the conversation on the connections between problems and HPE research, the authors propose ways in which knowledge translation and implementation science might be approached differently. In the latest instalment of Medical Education Mythology, Thomas and Ellaway explore five myths surrounding "problems" in health professional education research and their impact on using research to guide practice. [ABSTRACT FROM AUTHOR]

Context Methods Conclusions Despite increasing discussion and scholarship, equity in assessment is rarely defined and distinguished in a way that allows for shared understanding in medical education. This paper seeks to clarify and expand the conversation about equity in assessment by critically reviewing three distinct and evolving orientations toward equity in assessment. Orientations refers to the positions, attitudes, interests or priorities individuals can hold toward equity in assessment. The three orientations include fairness‐oriented assessment, assessment for inclusion and justice‐oriented assessment. While fairness‐oriented assessment is a prevailing orientation in medical education, assessment for inclusion and justice‐oriented assessment, originally developed in other fields of education, deserve careful consideration.In this paper, the authors explore unique underpinning assumptions of each orientation by critically examining the foundational literature of each orientation. They reflect on the unique perspectives each orientation provides, including the actions one might take and what advantages and disadvantages might result from looking at equity in assessment from any one orientation.Informed by this reflection, the authors propose that to more effectively advance equity in assessment in medical education, those working in the field should clearly identify their respective orientations, intentionally choose methods, tools and measures aligned with their orientations and expand their work by exploring alternative orientations. [ABSTRACT FROM AUTHOR]

Context Discussion Context In this article, we draw upon diverse and contextually different experiences of working on inclusive assessment, with the aim of bridging and enhancing practices of inclusive assessments for health professions education (HPE) within universities. Instead of juxtaposing our views from three countries, we combine our perspectives to advocate for inclusive assessment.Creating an inclusive assessment culture is important for equitable education, even if priorities for inclusion might differ between contexts. We recognise challenges in the enactment of inclusive assessment, namely, the notion of lowering standards, harming reliability and robustness of assessment design and inclusion as a poorly defined and catchall term. Importantly, the lack of awareness that inclusion means recognising intersectionality is a barrier for well‐designed inclusive assessments. This is why we offer considerations for HPE practitioners that can guide towards a unified direction of travel for inclusive assessments. This article highlights the importance of contextual prioritisation and initiatives to be considered at the global level to national, institutional, programme and the individual level. Utilising experience and literature from undergraduate, higher education contexts, we offer considerations with applicability across the assessment continuum.In this state of science paper, we were set the challenge of providing cross‐cultural viewpoints on inclusive assessment. In this discursive article, we focus on inclusive assessment within undergraduate health professions education whilst looking to the wider higher education literature, since institutional policies and procedures frequently drive assessment decisions and influence the environment in which they occur. We explore our experiences of working in inclusive assessment, with the aim of bridging and enhancing practices of inclusive assessments for HPE. Unlike other articles that juxtapose views, we all come from the perspective of supporting inclusive assessment.We begin with a discussion on what inclusive assessment is and then describe our contexts as a basis for understanding differences and broadening conversations. We work in the United Kingdom, Australia and Malaysia, having undertaken research, facilitated workshops and seminars on inclusive assessment nationally and internationally. We recognise our perspectives will differ as a consequence of our global context, institutional culture, individual characteristics and educational experiences. (Note that individual characteristics are also known as protected characteristics in some countries).Then, we outline challenges and opportunities associated with inclusive assessment, drawing on evidence within our contexts, acknowledging that our understanding of inclusive assessment research is limited to publications in English and currently tilted to publications from the Global North. In the final section, we then offer recommendations for championing inclusion, focussing firstly on assessment designs, and then broader considerations to organise collective action.Our article is unapologetically practical; the deliberate divergence from a theoretical piece is with the intent that anyone who reads this paper might enact even one small change progressing towards more inclusive assessment practices within their context. [ABSTRACT FROM AUTHOR]

Introduction: Qualitative approaches have flourished in medical education research. Many research articles use the term 'lived experience' to describe the purpose of their study, yet we have noticed contradictory uses and misrepresentations of this term. In this conceptual paper, we consider three sources of these contradictions and misrepresentations: (1) the conflation of perspectives with experiences; (2) the conflation of experience with lived experience; and (3) the conflation of researching lived experience with phenomenology. We offer suggestions to facilitate more precise use of terminology. Argument: Our starting point is to free researchers from unnecessary shackles: Not every problem in medical education should be studied through experience, nor should every study of experience be phenomenological. Data based on participants' perceptions, beliefs, opinions and thoughts, while based on reflections of experiences, are not in and of themselves accounts of experience. Lived experiences are situated, primal and pre‐reflective; perspectives are more abstract. Lived experience—as opposed to experiences as such—deeply attune to bodies, relationality, space and time. There is also a difference between experiences as lived, how a person makes sense of these and what the researcher interprets and represents. Phenomenology is a meaningful approach to the study of lived experience, but other approaches, such as narrative inquiry and self‐study, can also offer useful avenues for undertaking this type of research. Discussion We aim to broaden researchers' scope with this paper and equip researchers with the information they need to be clear about the meaning and use of the terms experience and lived experience. We also hope to open new methodological possibilities for researching experiences as lived and, through highlighting tensions, to prompt researchers of lived experience to strive for ontological closeness and resonance. Interested in researching lived experiences? What are they anyway? Find out in this paper where the authors dive into complexity and offer explanation to enable more precise use of terminology. #meded [ABSTRACT FROM AUTHOR]

Introduction: The real‐world mechanisms underlying prospective entrustment decision making (PEDM) by entrustment or clinical competency committees (E/CCCs) are poorly understood. To advance understanding in this area, the authors conducted a realist synthesis of the published literature to address the following research question: In E/CCC efforts to make defensible prospective entrustment decisions (PEDs), what works, for whom, under what circumstances and why? Methods: Realist work seeks to understand the contexts (C), mechanisms (M) and outcomes (O) that explain how and why things work (or do not). In the authors' study, contexts included individual E/CCC members, E/CCC structures and processes, and training programmes. The outcome (i.e. desired outcome) was a PED. Mechanisms were a substantial focus of the analysis and informed the core findings. To define a final corpus of 52 included papers, the authors searched four databases, screened all results from those searches and performed a full‐text review of a subset of screened papers. Data extraction focused on developing context–mechanism–outcome configurations from the papers, which were used to create a theory for how PEDM leads to PEDs. Results: PEDM is often driven by default (non‐deliberate) decision making rather than a deliberate process of deciding whether a trainee should be entrusted or not. When defaulting, some E/CCCs find red flags that sometimes lead to being more deliberate with decision making. E/CCCs that seek to be deliberate describe PEDM that can be effortful (when data are insufficient or incongruent) or effortless (when data are robust and tell a congruent story about a trainee). Both information about trainee trustworthiness and the sufficiency of data about trainee performance influence PEDM. Several moderators influence what is considered to be sufficient data, how trustworthiness data are viewed and how PEDM is carried out. These include perceived consequences and associated risks, E/CCC member trust propensity, E/CCC member personal knowledge of and experience with trainees and E/CCC structures and processes. Discussion: PEDM is rarely deliberate but should be. Data about trainee trustworthiness are foundational to making PEDs. Bias, equity and fairness are nearly absent from the papers in this synthesis, and future efforts must seek to advance understanding and practice regarding the roles of bias, equity and fairness in PEDM. Entrustment decisions made by committees are rarely deliberate, but should be. These authors provide practical advice, based in the literature, for improvement. [ABSTRACT FROM AUTHOR]

Introduction: In order to be prepared for professional practice in a globalised world, health professions students need to be equipped with a new set of knowledge, skills and attitudes. Experiential learning gained during an international placement has been considered as a powerful strategy for facilitating the acquisition of global health competencies. The aim of this review was to synthesise the diverse body of empirical research examining the process and outcomes of international short‐term placements in health professions education. Methods: A systematic review was conducted using a meta‐narrative methodology. Six electronic databases were searched between September 2016 and June 2022: Medline, Embase, CINAHL, PsycINFO, Education Research Complete and Web of Knowledge. Studies were included if they reported on international placements undertaken by undergraduate health professions students in socio‐economically contrasting settings. Included studies were first considered within their research tradition before comparing and contrasting findings between different research traditions. Results: This review included 243 papers from 12 research traditions, which were distinguished by health profession and paradigmatic approach. Empirical findings were considered in four broad themes: learner, educational intervention, institutional context and wider context. Most studies provided evidence on the learner, with findings indicating a positive impact of international placements on personal and professional development. The development of cultural competency has been more focus in research in nursing and allied health than in medicine. Whereas earlier research has focussed on the experience and outcomes for the learner, more recent studies have become more concerned with relationships between various stakeholder groups. Only few studies have looked at strategies to enhance the educational process. Conclusion: The consideration of empirical work from different perspectives provides novel understandings of what research has achieved and what needs further investigation. Future studies should pay more attention to the complex nature of the educational process in international placements. This review of 243 papers highlights positive impacts of international placements on personal & professional development, suggesting more focus is needed on educational processes surrounding cultural competence [ABSTRACT FROM AUTHOR]

To consider Medical Education' s claim to international status in terms of the extent of international authorship within published articles, the degree to which authors draw on the international literature to support their work, and its self-citation rates and publication decisions. We examined 6 journals' citation rates for the period 1997–2001 to see if there was evidence of national publication bias; we calculated their self-citation rates to see if this had any influence on impact factor, and we examined Medical Education's management files for trends which might indicate publication bias due to country of origin of authors. All 6 journals exhibited a bias in favour of citing journals from their own countries. The US journals were more likely to cite journals from their own country. Medical Education was most likely to cite journals from non-UK countries. Self-citation rates did not appear to affect impact factors. The ratio of UK to non-UK papers published in Medical Education has not changed significantly over the period studied although non-UK submissions increased sharply in 2002 and the number of North American submissions has doubled since 1998. Medical Education is justified in calling itself an international journal to the extent that the majority of papers it publishes are from countries other than the UK, and it is more likely than other journals in the field to publish papers which cite work in journals published outside the UK. Nevertheless, there is some evidence of publication bias in the journal and more work is needed to discover why this is the case. Various strategies to address the issue of national bias in Medical Education are discussed. [ABSTRACT FROM AUTHOR]

Presents the results of a survey of British doctors to find out the prevalence of 'bottom drawer papers,' defined as articles intended for publication in a peer reviewed journal that has been written but are no longer moving towards publication. Reasons for botton drawer papers; Publication bias.

Introduction: Documents, from policies and procedures to curriculum maps and examination papers, structure the everyday experiences of health professions education (HPE), and as such can provide a wealth of empirical information. Document analysis (DA) is an umbrella term for a range of systematic research procedures that use documents as data. Methods: A meta‐study review was conducted with the aims of describing the current state of DA in HPE, guiding researchers engaging in DA and improving methodological, analytical and reporting rigour. Structured searches were conducted, returns were filtered for inclusion and the 115 remaining articles were critically analysed for their use of DA methods and methodologies. Results: There was a significant increase in the number of articles reporting the use of DA over time. Sixty‐three articles were single method (DA only), while the others were mixed methods research (MMR). Overall, there were major lacunae in terms of why documents were used, how documents were identified, what the authors did and what they found from the documents. This was particularly apparent in MMR where DA reporting was typically poorer than the reporting of other methods in the same paper. Discussion: Given these many lacunae, a framework for reporting on DA research was developed to facilitate rigorous DA research and transparent, complete and accurate reporting of the same, to help readers assess the trustworthiness of the findings from document use and analysis in HPE and, potentially, other domains. It was also noted that there are gaps in HPE knowledge that could be addressed through DA, particularly where documents are conceptualised as more than passive holders of information. Scholars are encouraged to reflect more deeply on the applications and practices of DA, with the ultimate aim of ensuring more substantive and more rigorous use of documents for understanding and constructing meaning in our field. Cleland et al. report on a meta‐review of document analysis in health professional education, offering guidance for improving methodological, analytical, and reporting rigour. [ABSTRACT FROM AUTHOR]

Introduction: Competency‐based medical education (CBME) led to the widespread adoption of workplace‐based assessment (WBA) with the promise of achieving assessment for learning. Despite this, studies have illustrated tensions between the summative and formative role of WBA which undermine learning goals. Models of workplace‐based learning (WBL) provide insight, however, these models excluded WBA. This scoping review synthesizes the primary literature addressing the role of WBA to guide learning in postgraduate medical education, with the goal of identifying gaps to address in future studies. Methods: The search was applied to OVID Medline, Web of Science, ERIC and CINAHL databases, articles up to September 2020 were included. Titles and abstracts were screened by two reviewers, followed by a full text review. Two members independently extracted and analysed quantitative and qualitative data using a descriptive‐analytic technique rooted in Billett's four premises of WBL. Themes were synthesized and discussed until consensus. Results: All 33 papers focused on the perception of learning through WBA. The majority applied qualitative methodology (70%), and 12 studies (36%) made explicit reference to theory. Aligning with Billett's first premise, results reinforce that learning always occurs in the workplace. WBA helped guide learning goals and enhanced feedback frequency and specificity. Billett's remaining premises provided an important lens to understand how tensions that existed in WBL have been exacerbated with frequent WBA. As individuals engage in both work and WBA, they are slowly transforming the workplace. Culture and context frame individual experiences and the perceived authenticity of WBA. Finally, individuals will have different goals, and learn different things, from the same experience. Conclusion: Analysing WBA literature through the lens of WBL theory allows us to reframe previously described tensions. We propose that future studies attend to learning theory, and demonstrate alignment with philosophical position, to advance our understanding of assessment‐for‐learning in the workplace. The authors' synthesis of literature that focuses on the overlap between workplace learning and workplace assessment highlights gaps and identifies key strategies for enabling "assessment for learning" in the workplace. [ABSTRACT FROM AUTHOR]

Introduction: 'Culture' is a word frequently invoked within medical education literature to explain challenges faced by learners in practice. While social settings and practices are widely acknowledged as critical influences on medical education, there is vast variability in how the term 'culture' is employed. This may lead to confusion, resulting in assumptions and oversights. Objective: This critical literature review aims to characterise how the term 'culture' is explicitly and implicitly conceptualised in medical education research. Methods: Four leading English language journals in the medical education field were searched in a twelve‐month period for research papers or reviews that mentioned culture in title or abstract in a substantive way. A content analysis was undertaken of extracted definitions. In addition, metaphor analysis was used to identify conceptual metaphors, which were subsequently clustered thematically. Results: Our search yielded 26 papers, 8 of which contained definitions, mostly from the organisational literature. We interpreted nine conceptual metaphors related to how the term culture was employed (terroir, divider, dominant force, toxic force, obstacle, microclimate, object, brand and holdall) in four categories (unchanging, powerful, can adapt around, can be used). Discussion: This critical review reveals that medical education as a field: 1) draws most explicitly from the organisational literature; 2) invokes culture in multiple means but in ways that privilege either acontextual human agency or all‐powerful social forces; and 3) regards culture as a negative or neutral force but rarely a positive one. There is a notable absence around conceptualisations of 'culture' that allow educator, student and administrator agency but at the same time acknowledge the deep forces that various social settings and practices exert. Other literatures investigating learning cultures and cultural reflexivity focus on this nexus and may provide possible means to advance considerations of culture within medical education research. This critical review of the term "culture" within medical education research literature calls for cultural reflexivity to help acknowledge both individual agency and the strong forces exerted by the social. [ABSTRACT FROM AUTHOR]

Introduction: While authorship plays a powerful role in the academy, research indicates many authors engage in questionable practices like honorary authorship. This suggests that authorship may be a contested space where individuals must exercise agency—a dynamic and emergent process, embedded in context—to negotiate potentially conflicting norms among published criteria, disciplines and informal practices. This study explores how authors narrate their own and others' agency in making authorship decisions. Method: We conducted a mixed‐methods analysis of 24 first authors' accounts of authorship decisions on a recent multi‐author paper. Authors included 14 females and 10 males in health professions education (HPE) from U.S. and Canadian institutions (10 assistant, 6 associate and 8 full professors). Analysis took place in three phases: (1) linguistic analysis of grammatical structures shown to be associated with agency (coding for main clause subjects and verb types); (2) narrative analysis to create a 'moral' and 'title' for each account; and (3) dialectic integration of (1) and (2). Results: Descriptive statistics suggested that female participants used we subjects and material verbs (of doing) more than men and that full professors used relational verbs (of being and having) more than assistant and associate. Three broad types of agency were narrated: distributed (n = 15 participants), focusing on how resources and work were spread across team members; individual (n = 6), focusing on the first author's action; and collaborative (n = 3), focusing on group actions. These three types of agency contained four subtypes, e.g. supported, contested, task‐based and negotiated. Discussion: This study highlights the complex and emergent nature of agency narrated by authors when making authorship decisions. Published criteria offer us starting point—the stated rules of the authorship game; this paper offers us a next step—the enacted and narrated approach to the game. Konopasky et al highlight the complex nature of agency in author teams. Interviews with first authors suggest three broad agency types: distributed (across team and resources), individual (first author) and collaborative (joint action). [ABSTRACT FROM AUTHOR]

Presents the list of the forthcoming papers related to medicine. Titles; Authors; Countries.

To evaluate the effect of a compulsory evidence-based medicine (EBM) seminar in critical appraisal skills and the overall acceptance of compulsory EBM seminars for Year 3 medical undergraduate students. Small group seminars by peer teaching were conducted for up to 23 undergraduates. Knowledge and skills in EBM before and after the compulsory seminars were evaluated by 2 different sets of 20 questions. To apply knowledge, each undergraduate had to analyse an individual paper case using the principles of EBM. Undergraduates gave anonymous feedback using separate evaluation sheets at the end of the seminar. Main outcome variables were changes in knowledge and skills. A total of 132 Year 3 undergraduates at the University of Frankfurt participated in a compulsory EBM seminar during the academic half-year 2003/04 as part of their regular curriculum. Complete datasets were available for evaluation from 124 undergraduates (94%). The seminars led to an overall increase in knowledge (question paper score increase from 2.37 to 7.48, 99% CI 6.61–8.36, or 216%). Transfer of knowledge into a paper case scenario was generally good, with a mean score of 49.5 (SD 5.24) out of 55 points. Feedback indicated good overall acceptance of the seminars, with a median of 2 (score range from 1 = excellent to 6 = failed). Trained medical students are effective and well accepted EBM trainers in compulsory undergraduate seminars. [ABSTRACT FROM AUTHOR]

Researchers everywhere are under increasing pressure to publish in high quality journals. The amount of space available in a journal such asMedical Educationhas not kept pace with the rise in submissions. Against a background of fierce competition, authors sometimes cut corners. This may lead to misconduct.This paper aims to explore the most common types of publication misconduct seen in theMedical Educationeditorial office, and to consider the reasons for this and the implications for researchers in the field.This paper looks at the work of the Committee on Publication Ethics and describes the type of routine, low level misconduct which is increasingly reported by its member journals, includingMedical Education. We offer a list of authors' responsibilities as a way of drawing attention to the wide range of individuals affected by author misconduct. The paper outlines 7 representative cases of actual or potential misconduct which have been dealt with in theMedical Educationeditorial office during the 18-month period to May 2004, putting them in context and using them to illustrate some of the ways in which apparently minor deviations from standard practice can have far reaching implications.This paper argues that misconduct affects a wider group than editors, although it is editors who are currently taking the lead in the promotion of standards. The authors suggest that responsibility for maintaining and improving standards in research publication should not be left to editors but should be seen as something in which all researchers have a stake. They support moves to make editors themselves more accountable to their readers and authors. [ABSTRACT FROM AUTHOR]

Context The impact of academic scholarship has traditionally been measured using citation-based metrics. However, citations may not be the only measure of impact. In recent years, other platforms (e.g. Twitter) have provided new tools for promoting scholarship to both academic and non-academic audiences. Alternative metrics (altmetrics) can capture non-traditional dissemination data such as attention generated on social media platforms. Objectives The aims of this exploratory study were to characterise the relationships among altmetrics, access counts and citations in an international and pre-eminent medical education journal, and to clarify the roles of these metrics in assessing the impact of medical education academic scholarship. Methods A database study was performed (September 2015) for all papers published in Medical Education in 2012 ( n = 236) and 2013 ( n = 246). Citation, altmetric and access ( HTML views and PDF downloads) data were obtained from Scopus, the Altmetric Bookmarklet tool and the journal Medical Education, respectively. Pearson coefficients ( r-values) between metrics of interest were then determined. Results Twitter and Mendeley (an academic bibliography tool) were the only altmetric-tracked platforms frequently (> 50%) utilised in the dissemination of articles. Altmetric scores (composite measures of all online attention) were driven by Twitter mentions. For short and full-length articles in 2012 and 2013, both access counts and citation counts were most strongly correlated with one another, as well as with Mendeley downloads. By comparison, Twitter metrics and altmetric scores demonstrated weak to moderate correlations with both access and citation counts. Conclusions Whereas most altmetrics showed limited correlations with readership (access counts) and impact (citations), Mendeley downloads correlated strongly with both readership and impact indices for articles published in the journal Medical Education and may therefore have potential use that is complementary to that of citations in assessment of the impact of medical education scholarship. [ABSTRACT FROM AUTHOR]

Context: Health professions trainees must acquire a vast amount of clinical knowledge and skills, and a deliberate instructional design approach is needed to provide trainees with effective learning strategies. One powerful yet counterintuitive strategy that facilitates long‐term learning is incorporating intentional difficulties during the learning process. Difficulties that require more effort from learners may impede short‐term learning but are ultimately beneficial for long‐term learning and are therefore termed Desirable Difficulties. Objectives: In this cross‐cutting edge paper, we describe the Desirable Difficulty effect from three theoretical perspectives originating in different fields, discuss common evidence‐based Desirable Difficulty strategies used in Health Professions Education and explore emerging research that could further optimise Desirable Difficulty‐enhanced learning for health professions trainees. Methods: We synthesise theory and research from psychology, cognitive science and Health Professions Education literatures to further the understanding and application of Desirable Difficulties. We introduce three theoretical perspectives that provide a comprehensive overview of the theoretical underpinnings of the Desirable Difficulty effect: the New Theory of Disuse, the Challenge Point Framework and Cognitive Load Theory. We then illustrate how three common Desirable Difficulty strategies in medical education research—retrieval practice, spaced practice and interleaved practice—can be understood through these theoretical lenses. Finally, we provide relevant examples from the literature and explore emerging research in this area. Conclusions: This paper summarises the theory and empirical research on Desirable Difficulties during the learning process, from explaining what they are and why they may be effective to how they have been applied in different contexts. We argue that providing educators and trainees with a comprehensive theoretical and applied understanding of Desirable Difficulty will promote deliberate instructional design decisions and lead to more effective learning. Synthesizing theories and frameworks from psychology and education, Nelson and Eliasz propose a unified understanding of the powerful "desirable difficulty" effect. [ABSTRACT FROM AUTHOR]