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Promoting reflection on experience and developing students' reflective skills is an important element of curricula across the health professions. Students often do not find reflection easy and educators use a range of approaches to facilitate this. This qualitative study analysed final year medical students' written reflections about important and difficult concepts they had encountered at medical school and personal change. As part of this, students were expected to look back on their written reflections from earlier years of the undergraduate programme. An initial analysis identified 'learning from past reflections' as an important theme. Here we report an in-depth analysis of this theme. Thirty-six final year volunteer students' reflections were analysed and 6 themes identified where students explicitly referred to earlier written reflections. These were: managing emotions; holistic, patient-centred care; uncertainty and ambiguity; self-regulation; growth in identity and sense of self efficacy; and reflective practice changes. Asking students to reflect on past reflections appeared to help students identify personal change, and how their understanding of 'important concepts' and their views and approach to reflective practice have developed. Experienced by students as a motivating, profound, sometimes cathartic process, this activity could be a useful addition to reflective writing training in health professions. [ABSTRACT FROM AUTHOR]

Professionalism is a core element of curricula in many disciplines but can be difficult to teach and learn. This study used audio-diary methodology to identify professionalism threshold concepts in a small group learning setting in undergraduate medicine and to understand factors that might facilitate students to "get" such concepts. Fifteen students and seven tutors kept audio-diaries over two terms. Data were analysed qualitatively for content. The key themes were then cross referenced to threshold concept criteria (e.g. where language indicated that learning was troublesome, integrative or transformative). Seven potential threshold concepts were identified which centred on students' developing professional identities including working with uncertainty, considering the bigger picture, not needing to know everything and professional culture. Reflection on workplace experiences within a small group helped students "get" these concepts. The study concludes that threshold concepts and audio-diaries are useful tools for understanding lived experiences of professionalism learning.

Background: Medical academia is in crisis, with fewer people entering and growing concern at numbers leaving. While faculty development is often seen as part of the solution, there are significant issues with faculty not engaging with and resisting development opportunities. Lack of motivation may be linked to what might be called a 'weak' educator identity. We studied medical educators' experiences of career development to gain further insights into: how professional identity may develop; individuals' accompanying emotional responses to perceived identity change; and consideration of the accompanying temporal dimensions. Drawing on new materialist sociology, we explore medical educator identity formation in terms of an affective flow that places the individual within a constantly shifting assemblage of psychological, emotional and social relations. Method: We interviewed 20 medical educators at various career stages, with differing strengths of medical educator self‐identity. Using an adapted transition model as a basis for understanding the emotions experienced by those undergoing identity transitions, we explore the process that, for some medical educators, appears to lead to decreased motivation, ambiguous identity and disengagement, but for others results in renewed energy, a stronger and more stable professional identity and increased interest and engagement. Results: By more effectively illustrating the emotional impact of the transition process leading to a more stable educator identity, we show that some individuals, especially where the change was not sought or welcomed, express their uncertainty and distress through low mood, resistance and an attempt to minimise the significance of undertaking or increasing teaching duties. Discussion: Understanding the emotional and developmental phases of the transition to medical educator identity has several key implications for faculty development. Faculty development approaches should be alert to the individual educator's stage of transition since this will affect that individual's readiness to accept and respond to guidance, information and support. A renewed emphasis on early educational approaches that will support the transformational and reflective learning of the individual is needed, while traditional approaches emphasising skills and knowledge may be more useful in the later stages. Further testing of the transition model and its applicability to identity development in medical education is indicated. In a study of medical educators' career trajectories, Browne and Collett reveal how attitudes and emotions change, leading to a strong professional identity for some and disengagement for others. [ABSTRACT FROM AUTHOR]

The centrality of teamwork in ensuring the effective functioning of institutions across all sectors is undeniable. However, embedding teamwork into higher education has been hampered due to a range of deeply entrenched practices associated broadly with the foregrounding of knowledge, beliefs about the place of skill training and routines of assessment. As a result, despite an urgent need to address teamwork, little progress has been made with respect to progressing teamwork education. We have designed and evaluated a novel teamwork module delivered to fourth-year undergraduate medical students involving placements, a cocreated piece of work, reflection and summative peer assessment. This paper aimed to investigate whether the module increased students’ insight into teamwork, including their own skill development, and whether their perceptions of teamwork changed. Throughout the evaluation, students played a key role, with four final-year medical students working alongside others in the multidisciplinary project team. Five distinct themes emerged from our in-depth, semistructured interviews: (a) importance and meaning; (b) insight into skill development; (c) transferability; (d) peer assessment; and (e) resistance to teamwork education. Themes had positive and negative components, and student perceptions changed in multiple ways after experiencing a longitudinal educational opportunity to develop their teamwork skills. Before practice, students focused on superficial explanations and on where they might improve. In contrast, after practice, students conveyed deeper insights, contextualisation, focus on how they might improve, and shared structured reflection. [ABSTRACT FROM AUTHOR]

Driven by demand for high standards in university education, efforts have been made in the UK to address the perceived imbalance between teaching and research. However, teaching is still perceived by many as having less credibility and is attributed less importance. The purpose of our research was to explore how distinct types of academic job profiles ('research' or 'education' focused, or 'balanced') impact on biomedical scientists' perceptions of the lecturer role. Specifically, we investigated the experiences of biomedical scientists in 'post‐1990' medical schools, which are known for their commitment to excellence in both research and education. We conducted 22 face‐to‐face, semi‐structured interviews with biomedical scientists in five schools. Focusing on experiences of work, the interviews covered: 'motivations', 'role expectations', 'teaching', 'research' and 'career'. The recorded qualitative data were transcribed and then analysed thematically. Our results, offering an insight into the working lives of biomedical scientists in medical education, suggest that in settings with a dual emphasis on education and research, individuals on 'balanced' contracts can experience a strong pull between research and teaching. In addition to posing significant challenges with respect to workload management, this can impact profoundly on professional identity. In contrast to the balanced role, 'research' or 'education' focused roles appear to have clearer requirements, leading to higher employee satisfaction. We conclude that to assist the educational mission of Higher Education, attention should be paid to balanced contracts, to (a) ensure employee support, (b) mitigate against negative perceptions of teaching, and ultimately, (c) guard against staff attrition. [ABSTRACT FROM AUTHOR]

Summary: Background: The hidden curriculum (HC) refers to unscripted, ad hoc learning that occurs outside the formal, taught curriculum and can have a powerful influence on the professional development of students. While this learning may be positive, it may conflict with that taught in the formal curriculum. Medical schools take a range of steps to address these negative effects; however, the existence and nature of the concept tends to be hidden from students. Methods: Since 2007, our medical school has incorporated into its small group programme an educational activity exploring the concept of the hidden curriculum. We undertook a qualitative evaluation of our intervention, conducting a thematic analysis of students' wiki reflections about the HC. We also analysed students' responses to a short questionnaire about the educational approach used. Findings: The majority of students felt that the HC session was important and relevant. Most appeared able to identify positive and negative HC experiences and consider how these might influence their learning and development, although a few students found the concept of the HC hard to grasp. Discussion: Revealing and naming the hidden curriculum can make students aware of its existence and understand its potential impact. The hidden curriculum may also be a useful tool for triggering debate about issues such as power, patient centredness, personal resilience and career stereotypes in medicine. Supporting students to think critically about HC experiences may empower them to make active choices about which messages to take on board. The hidden curriculum can have a powerful influence on the professional development of students [ABSTRACT FROM AUTHOR]

Understanding the social basis of health and medicine and the contexts of clinical care are essential components of good medical practice. This includes the ways in which social factors such as class, ethnicity, and gender influence health outcomes and how people experience health, illness, and health care. In our Guide we describe what sociology is and what it brings to medicine, beginning with the nature of the "sociological imagination." Sociological theory and methods are reviewed to explain and illustrate the role of sociology in the context of undergraduate medical education. Reference is made to the 2016 report, A Core Curriculum for Sociology in UK Undergraduate Medical Education by Collett et al. Teaching and student learning are discussed in terms of organization and delivery, with an emphasis on practice. Sections are also included on assessment, evaluation, opportunities, and challenges and the value of a "community of practice" for sociology teachers in medical education. [ABSTRACT FROM AUTHOR]

The notion of “threshold concepts” is being widely applied and researched in many disciplines but is rarely discussed within medical education. This article is written by three medical educators who regularly draw on threshold concept theory in their work. They explore here the nature of threshold concepts and describe how the theory can offer medical educators new perspectives in terms of how they design curricula, approach teaching and support learners. [ABSTRACT FROM PUBLISHER]

Background: Despite recommendations stemming from the 1930s espousing the value of a living anatomy component in undergraduate medical education, living anatomy remains relatively under described. Aim: In this article, we explore the role of the living anatomy model in living anatomy teaching. Method: Our report is based on a larger ethnographic study of living anatomy classes, undertaken at Peninsula Medical School between 2002 and 2004. A Research Fellow participated as an observer in 24 Year One and Year Two anatomy classes in which living anatomy models were employed. The findings are based on field notes and conversations with models, students and tutors. Results and conclusions: Within the supervised context of the anatomy class the living models assisted students in the learning of structure, function, surface anatomy and body variation. Far from being 'passive sites' for the students to practice their anatomical knowledge, the living models were active participants in class, assisting students with their communication skills, sharing anatomical knowledge, offering guidance to staff and sharing their past medical history and experiences. Living anatomy models can foster an additional dimension of humanitarian thinking within the anatomy class; however, further research needs to focus on the power messages implicit in the organization of sessions. [ABSTRACT FROM AUTHOR]

Longitudinal data are used to explore the reliability of long‐term illness measures using information on ‘long‐term/permanent sickness or disability’ as recorded via the question on economic activity in the Census of England and Wales. Specifically it is asked ‘what evidence is there that individuals answer the item on long‐term sickness or disability in the same way at different time points?’. The research is based on data from the Office for National Statistics Longitudinal Study (LS) and the responses of persons who reported long‐term sickness or disability in 1971 are tracked to see if they also reported long‐term sickness or disability in 1981 and 1991. That a large number of people reported long‐term sickness or disability at three Census points suggests that the measure was reliable. In addition, it is suggested that a degree of content validity has been achieved with respect to the understanding of the concept of ‘long‐termness’. It is concluded that longitudinal data provide a valuable way of investigating the reliability and validity of frequently used categorical measures and can help to distinguish between the extent to which a phenomenon such as long‐term sickness is ‘new’ or ‘ongoing’. [ABSTRACT FROM AUTHOR]

This study aims to explore quantitatively and qualitatively students' attitudes towards peer physical examination (PPE) and the influence of demographics on students' willingness to participate in PPE. A total of 296 first-year medical students from two consecutive cohorts at the Peninsula Medical School, UK completed the EFS questionnaire. Quantitative data from the questionnaire were analysed using univariate (i.e. Mann–Whitney and chi-squared tests) and multivariate statistics (i.e. stepwise multiple regression) and qualitative data were analysed using theme analysis. At least 92% of Peninsula Medical School students were willing to examine all 11 body parts (except breast and inguinal regions) of peers of same and opposite gender. Qualitative data support this by highlighting students' positive attitudes towards PPE. PPE was more acceptable within rather than across gender and students generally felt more comfortable examining their peers than being examined by peers. Qualitative data outline the range of student concerns with PPE. Significant relationships existed between students' attitudes towards PPE and various variables: gender, age and religious faith. The findings demonstrate that students may show a greater willingness to participate in PPE than previously thought. Further research is required to explore more fully the barriers to PPE. [ABSTRACT FROM AUTHOR]

Background: Modern medical education teaching and learning approaches now lay emphasis on students acquiring knowledge, skills and attitudes relevant to medical practice. Aims: To explore students' perceived impacts of using hands-on approaches involving peer/life model physical examination and palpation in teaching and learning living human anatomy on their practice of physical examination of real patients. Methods: This study used exploratory focus groups and a questionnaire survey of years 3-5 medical students. Results: The focus group discussions revealed new insights into the positive impacts of the hands-on approaches on students' clinical skills and professional attitudes when dealing with patients. Students' exposure to the hands-on approaches helped them to feel comfortable with therapeutically touching unclothed patients' bodies and physically examining them in the clinical environment. At least 60% of the questionnaire survey respondents agreed with the focus group participants on this view. Over 75% also agreed that the hands-on experiences helped them develop good professional attitudes in their encounter with patients. Conclusions: This study highlights the perceived educational value of the hands-on approaches as a pedagogic tool with a positive impact on students' clinical skills and professional attitudes that helps in easing their transition into clinical practice. [ABSTRACT FROM AUTHOR]

The article discusses solo living in England and Wales. The rise of solo living is frequently seen as an indicator of "individualization". In recent decades there has been a significant rise in the numbers of people who live alone and it was predicted that by 2002 that a third of all households will be single-person households. Although living alone remains common among older age groups, the largest growth has been within younger populations. Single men who live alone have different characteristics to women living alone. They are more likely to be younger and to have never married. Also, for men, living alone it is common at either end of the social class scale whereas for women it is closely associated with professional status. The fact that solo living is common for women across the life course is indicative of the greater financial independence of women today compared with earlier generations. Solo living has a different social significance depending where it is located in the life course. Solo living among twenty-year-olds is likely to be associated with a different life style and set of meanings than solo living for those in their forties or those in their sixties.