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Purpose: The stakes of medical trainee selection are high, making it ironic and somewhat paradoxical that patients and the public often get little say in selection practices. The authors sought to undertake a knowledge synthesis to uncover what is known about patient engagement across the medical trainee selection continuum., Method: The authors conducted a scoping review aimed at exploring the current state of practice and research on patient engagement in medical trainee selection in 2017-2021. MeSH headings and keywords were used to capture patient, community, and standardized patient engagement in selection processes across multiple health professions. The authors employed broad inclusion criteria and iteratively refined the corpus, ultimately, limiting study selection to those reporting engagement of actual patients in selection within medicine, but maintaining a broad focus on any patient contributions across the entire selection continuum. The Cambridge Framework was adapted and used to organize the included studies., Results: In total, 2,858 abstracts were reviewed, and ultimately, 28 papers were included in the final corpus. The included studies were global but nascent. Most of the literature on this topic appears in the form of individual projects advocating for patient engagement in selection rather than cohesive programs with empirical exploration of patient engagement in selection. Job analysis methodology was particularly prominent for incorporating the patient voice into identifying competencies of relevance to selection. Direct patient engagement in early selection activities allowed the patient voice to assist candidates in determining their fit for medicine., Conclusions: Patient engagement has not been made a specific focus of study in its own right, leading the authors to encourage researchers to turn their lens more directly on patient engagement to explore how it complements the professional voice in medical trainee selection., (Copyright © 2023 the Association of American Medical Colleges.)

Objectives: To explore how virtual, asynchronous modules can be used in interprofessional health education curricula and to identify any advantages and shortcomings of asynchronous interprofessional education., Methods: A sample of 27 health professional students who attended in-person interprofessional education workshops at the McMaster Centre for Simulation-Based Learning from 2019-2020 were recruited through email discourse. Participants were asked to complete an asynchronous interprofessional education module and take part in a semi-structured interview that was recorded and transcribed verbatim. Techniques of direct content analysis were used to analyze the qualitative data from recorded transcripts., Results: The following emergent themes from participants' responses were identified: 1) the modules, as well as the features interspersed throughout, taught strategies for conflict resolution and interprofessional communication, 2) the modules have utility in preparing students for future interprofessional learning, 3) the convenience of virtual asynchronous modules introduces a sense of learner safety, and 4) a sense of isolation and fatigue was identified as a consequence of the lack of face-to-face interaction in these modules., Conclusion: Asynchronous interprofessional education modules may be best suited to prepare students for future interprofessional learning in a synchronous setting. Asynchronous modules effectively provide an introduction to interprofessional objectives such as conflict resolution and role clarification, yet the competency of team functioning is more difficult to achieve in an asynchronous environment. Future studies may focus on establishing a sequence of completing asynchronous modules for ideal development of interprofessional competencies in health professions learners.

Background: High-stakes assessments are often used as a 'gate-keeper' activity for entry into the health professions by ensuring that the minimum core competency thresholds of the profession are met. The aim of the study was to explore if common areas of underperformance existed in international candidates assessed with a high-stakes clinical-based simulation assessment for entry into the physiotherapy profession in Australia., Methods: A retrospective mixed methods analysis of the clinical assessments completed by international candidates over a one-month period in 2021 that were deemed as not meeting competency. The clinical assessments were completed in one of the three practice areas: cardiorespiratory, musculoskeletal, or neurological rehabilitation. Each assessment was scored by two independent assessors, who discussed the performance and then completed a moderated assessment form. The assessment form used to score competency included seven domains such as initial assessment, effective treatment, communication skills, and risk management., Results: Fifty-one clinical assessments graded as not competent were analysed. Across the practice areas, a high failure rate was found in domains related to interpreting assessment findings and developing a treatment plan. This trend was also observed in the qualitative data, suggesting candidates struggled to meet competency in areas of planning and prioritisation, interpretation and implementation of the information gathered, and selection and evaluation of effective treatment., Conclusion: These findings align with published data on the underperformance of Australian physiotherapy students in clinical placement settings, suggesting these issues are not specific to high stakes assessment of overseas physiotherapists, and that education needs to focus on improving these skills within the profession at all levels. With the identified areas of underperformance aligning with the ability to use higher order thinking and skills integral to clinical reasoning, improvements in the education and implementation of clinical reasoning may be a place to start., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Background: Advancing healthcare access and quality for underserved populations requires a diverse, culturally competent interprofessional workforce. However, high educational debt may influence career choice of healthcare professionals. In the United States, health professions lack insight into the maximum educational debt that can be supported by current entry-level salaries. The purpose of this interprofessional economic analysis was to examine whether average educational debt for US healthcare graduates is supportable by entry-level salaries. Additionally, the study explored whether trainees from minoritized backgrounds graduate with more educational debt than their peers in physical therapy., Methods: The study modeled maximum educational debt service ratios for 12 healthcare professions and 6 physician specialties, incorporating profession-specific estimates of entry-level salary, salary growth, national average debt, and 4 loan repayment scenarios offered by the US Department of Education Office of Student Financial Aid. Net present value (NPV) provided an estimate for lifetime "economic power" for the modeled careers. The study used a unique data source available from a single profession (physical therapy, N = 4,954) to examine whether educational debt thresholds based on the repayment model varied between minoritized groups and non-minoritized peers., Results: High salary physician specialties (e.g. obstetrics/gynecology, surgery) and professions without graduate debt (e.g. registered nurse) met debt ratio targets under any repayment plan. Professions with strong salary growth and moderate debt (e.g. physician assistant) required extended repayment plans but had high career NPV. Careers with low salary growth and high debt relative to salary (e.g. physical therapy) had career NPV at the lowest range of modeled professions. 29% of physical therapy students graduated with more debt than could be supported by entry-level salaries. Physical therapy students from minoritized groups graduated with 10-30% more debt than their non-minoritized peers., Conclusions: Graduates from most healthcare professions required extended repayment plans (higher interest) to meet debt ratio benchmarks. For several healthcare professions, low debt relative to salary protected career NPV. Students from minoritized groups incurred higher debt than their peers in physical therapy., (© 2023. BioMed Central Ltd., part of Springer Nature.)

This article offers the first critical review of focused ethnography, an increasingly popular research method across health disciplines. Focused ethnographers, we argue, exemplify the practice of methodological boundary work, defining their method in contrast to the 'traditional' ethnographic approach of anthropology and sociology. To examine this boundary work, we collected two samples of health research articles published over the last decade and compared how focused ethnographers and medical anthropologists described, justified, and practised ethnography. We found that the core characteristics most often asserted to differentiate focused ethnography from conventional ethnography were: a more limited study timeframe and scope; a limited subpopulation sample; more concentrated research questions; the inclusion of insider researchers; and more orientation towards applied results. We show, however, that these are imagined binaries that fail to map onto actual differences of practice in the two samples and which obscure many similarities between them. By contrast, we identified four alternative differences between the two methods of ethnography. These centre on understandings of 'research time'; the very meaning of ethnography; the relationship of researchers to 'data'; and the presumed best method of social intervention. We therefore define focused ethnography as a versatile method of ethnography that attends to specific epistemological expectations within the health sciences regarding valid proof and empirical description, the boundaries of research, the nature of research relationships, and the duty to improve biomedicine. Ultimately, our study highlights that methodological boundary-work matters, because assumed differences and unexpressed misunderstandings can prevent productive dialogue and fruitful collaboration between disciplines to address pressing health problems., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

In many low- and middle-income countries, there seems to be a mismatch between graduate skills and healthcare industry requirements due to variability in curricula. With the current increased global demand for competent health profession graduates, harmonizing competency-based curricula (CBC) is necessary to address this mismatch. This paper describes how three health professions training universities in Tanzania and their two long-standing United States partners embarked on developing harmonized CBC for undergraduate medicine and nursing degrees. The main goal of the activity was to develop templates to harmonize curricula that would support graduates to acquire mandatory national Graduate Minimum Essential Competencies (GMEC) irrespective of the institution of their training. The paper describes the processes of engaging multiple institutions, the professions of medicine and nursing and various stakeholders to develop mandatory curricula generic competencies, creating milestones for assessing competencies, training faculty at each of the three partnering institutions in curriculum delivery and assessments, resulting in the adoption of the curricula by the University leadership at each institution. Ultimately the Tanzania Commission for Universities (TCU) a regulatory body required all schools of medicine and nursing in the country to adopt the curricula, thus creating a harmonized national standard for teaching medicine and nursing beginning October 2022.

Objectives: The objectives of this scoping review are to (1) describe the available literature regarding the utility of the debate-style journal club for health professional learners on literature evaluation skills and (2) report the themes found within debate-style journal club research and assessments in the context of professional education., Findings: A total of 27 articles written in the English language were included in this scoping review. Published evaluations of debate-style journal clubs have been predominantly based in the pharmacy profession (48%, n = 13), but are reported in other health professions, such as medicine (22%, n = 6), dentistry (15%, n = 4), nursing (7%, n = 2), occupational therapy (4%, n = 1), and physical therapy (4%, n = 1), as well. The skills assessed in these studies often included critical literature evaluation, application of literature to patient care, critical thinking, knowledge retention, use of supporting literature, and debate-specific skills. Learners typically reported better understanding and application of the literature, and enjoying the experience more than traditional journal clubs, but note the increased assessor and learner time requirement for debating. Pharmacy learner-specific articles more often utilized a traditional, team-based debate format, incorporated grading rubrics for skill assessment and debate performance, and included a grading component for the debate in the course., Summary: Debate-style journal clubs are well-received by learners but require an additional time commitment. Debate platforms, format, rubric use and validation, and outcome assessment vary across published reports., (Copyright © 2023 American Association of Colleges of Pharmacy. Published by Elsevier Inc. All rights reserved.)

The importance of preparing students and practitioners in the health professions to understand and be equipped to address the social determinants of health (SDOH) has become increasingly urgent. To help support this goal, faculty and staff from the National Collaborative for Education to Address the Social Determinants of Health built a digital platform for health professions educators to access and share curricular work related to SDOH. As of 2022, this online resource included more than 200 curricula focused on SDOH and additional content related to both SDOH and health equity. Educators in undergraduate and graduate medicine, nursing, pharmacy, continuing education, and other fields may find these resources relevant to their teaching practice and consider this platform as a way to disseminate their work in this field to others., Competing Interests: Conflicts of interest: Dr Persell receives unrelated research support from Omron Healthcare Co Ltd. The other authors report no competing interests., (© 2023 Annals of Family Medicine, Inc.)

Introduction: To achieve a healthier future for all, improving diversity through efforts such as diversifying faculty and leadership in academic medicine is imperative. Therefore, medical trainees (medical students, residents, fellows) from groups underrepresented in medicine (UiM) are encouraged to pursue academic careers and have opportunities to gain faculty leadership skills during their training. Trainees also need exposure to the leadership positions within various offices of an academic institution such as the Office of Diversity, Equity, and Inclusion (DEI). The goal of this module is to expose UiM trainees to the Office of DEI and leadership competencies that can be obtained via service and leadership opportunities with it., Methods: The Kern model was used in the development, implementation, and evaluation of this 75-minute workshop. The workshop consisted of a PowerPoint presentation, reflection exercises, and case discussion to raise trainees' awareness of the Office of DEI and opportunities to become engaged with and develop faculty leadership competencies through the office., Results: Sixty-six diverse learners across three sites completed pre- and postworkshop surveys. Ninety-five percent of participants agreed or strongly agreed that the learning objectives of the workshop had been met., Discussion: Overall, this interactive workshop facilitated learners' awareness of the responsibilities of the Office of DEI and opportunities for learners to develop faculty leadership competencies through engagement. Although primarily evaluated among medical students, the module can be of use to learners and faculty of other health professions programs with an Office of DEI., (© 2022 Castillo et al.)

Background: A public health student service was set up by the French government in 2018 with the aim of increasing awareness of primary health promotion among the 47,000 students of medicine and other health professions. It is an annual program involving community-based actions on nutrition, physical activity, addiction or sexuality. Our objective was to evaluate its implementation at local level and the different experiences of the stakeholders., Methods: A quasi-experimental study using process evaluation was performed in a Faculty of Medicine in Paris. Quantitative and qualitative data were collected from medical students who carried out preventive health actions, in the institutions in which the actions took place and from a subsample of beneficiaries., Results: One hundred and eight actions were carried out by 341 students in 23 educational or social institutions, mostly high schools (n = 12, 52%). Two thirds of the students did not feel sufficiently prepared to deliver preventive health interventions (65.7%, 224/341); however the beneficiaries found that the interventions were good (278/280, 99,2%). Nineteen (83%) of the host institutions agreed to welcome health service students again, of which 9 required some modifications. For students, the reporting of a satisfactory health service experience was associated with the reporting of skills or knowledge acquisition (p < 0.01). Delivering actions in high schools and to a medium-sized number of beneficiaries per week was associated with students' satisfaction. No effect of gender or theme of prevention was observed. For 248/341 (72.7%) students, the public health service program prompts them to address prevention issues in the future., Conclusion: The public health service undertaken by medical students through the program is a feasible and acceptable means of delivering preventive actions. Reinforcement of training and closer interaction with the host institutions would improve results.

While the medical field in the United States is renowned for research and innovation, with large numbers of world-class healthcare facilities and cutting-edge technologies, inequities in overall health outcomes demonstrate pronounced disparities in accessing care. This article addresses increasing provider diversity and cultural humility as critical steps in ensuring advancements are made to equitable care under the current confines of the American healthcare system. Increasing diversity amongst medical providers starts before students begin applying to medical school. Critical strategies are needed at the K-12 level to ensure early exposure to Science, Technology, Engineering, and Mathematics (STEM). Research demonstrates that early exposure to STEM can positively impact children's interest, confidence, and pursuit of STEM careers, including medicine. Early exposure to STEM can increase engagement and motivation in STEM subjects particularly for girls and racially marginalized groups.

Motivated by lack of diversity in Science Technology Engineering Mathematics and Medicine (STEMM) professions, this case-study explores a group of 25 high achieving, low SES, mostly female, majority-minority high school students' perception of race, ethnicity, and gender as factors for success in their future as STEMM professionals. Additionally, the study elucidates the benefits of participating in a pipeline programme designed to promote high skill and high wage jobs in the medical and health fields. Emergent themes of race and merit prominently surfaced. Responses to the effect of race and gender varied by subgroup, with the themes of the 'power of personal merit' over sociocultural factors emerging as the most striking theme. Participants' perceived benefits aligned with the programme goals: broadening of STEM knowledge, access to role-models, and hands-on experience. Teachings on social inequality and more access to female, minority role-models are suggested to prepare participants for their entrance into the STEMM field.

Reflection in healthcare education is an emerging topic with many recently published studies and reviews. This current systematic review of reviews (umbrella review) of this field explores the following aspects: which definitions and models are currently in use; how reflection impacts design, evaluation, and assessment; and what future challenges must be addressed. Nineteen reviews satisfying the inclusion criteria were identified. Emerging themes include the following: reflection is currently regarded as self-reflection and critical reflection, and the epistemology-of-practice notion is less in tandem with the evidence-based medicine paradigm of modern science than expected. Reflective techniques that are recognised in multiple settings (e.g., summative, formative, group vs. individual) have been associated with learning, but assessment as a research topic, is associated with issues of validity, reliability, and reproducibility. Future challenges include the epistemology of reflection in healthcare education and the development of approaches for practising and assessing reflection without loss of theoretical background.

While University students increasingly participate in work-integrated learning (WIL), their dignity is often violated during WIL. The current literature is limited in so far as it typically focuses on student perspectives within healthcare contexts and does not use the concept of 'dignity'. Instead, this study explored student and supervisor perspectives on student dignity during WIL across healthcare and non-healthcare disciplines. Research questions included: What are: (1) types of student dignity experiences and patterns by groups; (2) factors contributing to experiences; (3) consequences of experiences? Sixty-five semi-structured interviews were conducted using narrative interviewing techniques with 30 supervisors and 46 students from healthcare (medicine, nursing and counselling) and non-healthcare (business, law and education) disciplines. Data were analyzed using framework analysis. Nine common narrative types were identified within 344 stories: verbal abuse, right for learning opportunities, care, inclusion, reasonable expectations, right for appropriate feedback, equality, trust, and right to be informed. Factors contributing to dignity experiences and consequences were often at the individual level (e.g. student/supervisor characteristics). We found some salient differences in perceptions of experiences between students and supervisors, but few differences between healthcare and non-healthcare disciplines. This study extends WIL research based on student perspectives in healthcare, and provides practice and further research guidance to enhance student dignity during WIL.

The Asian race represents one of the fastest growing racial groups in the United States that have unique health-care issues and barriers to services. Despite being the second largest racial group among medical students, Asians represent a markedly smaller proportion of leadership. Greater inclusion may facilitate Asian-related curriculum content development, community-engaged research, and increased services for Asian communities. This article explores Southeast and East Asian American (AA) medical students' perceptions of and challenges toward pursuing academic medicine careers. We collected quantitative and qualitative data among 138 participants. Factors that increased trainees' interests include collaboration with others, teaching and research opportunities, and influential role models/mentors. Interventions identified to overcome perceived challenges include exposure to senior-level race-concordant role models and mentors, enhancement of communication skills, and informed career discussions between parents and trainees. Such interventions may engage more AA trainees into academia and facilitate their growth as leaders.

A sound knowledge of pathological disease processes is required for professional practice within health professions. The project described in this paper reviewed the resources currently available for the delivery of systematic pathology tutorials. Additional complementary resources were developed and the inclusion of these additional learning resources in practical tutorial sessions was evaluated for their impact on student learning. Student evaluation of the learning resources was undertaken across one semester with two different cohorts of health profession students using questionnaires and focus group discussion. Both cohorts reported an enhancement to their understanding of pathological disease processes through the use of the additional resources. Results indicate student perception of the value of the resources correlates with staff perception and is independent of prior experiences. (Contains 2 figures.)

Purpose: This paper aims to examine how employee perceptions of organizational context relate to willingness to mentor. This research will help organizations to understand the relationship between organizational context and willingness to mentor to encourage mentoring. Design/methodology/approach: This study used a survey approach. Employees who worked in the development, production and marketing of pharmaceuticals were administered a survey questionnaire. Data were analyzed through structural equation modeling. Findings: The findings showed that the downsizing experience was negatively related to willingness to mentor, and the threat of being downsized was negatively related to perceived organizational support. In contrast, perceived organizational support was positively related to organization-based self-esteem, which, in turn, was positively related to willingness to mentor. Research limitations/implications: The relationship between perceived organizational support and organization-based self-esteem, with its subsequent positive effect on willingness to mentor, indicates the importance of organizations' providing their employees with needed organizational support. Conversely, the negative relationship between the downsizing experience and willingness to mentor, and the threat of being downsized and perceived organizational support, indicates the need to separate mentoring programs from downsizing events even if it means delaying the initiation of a mentoring programs. Originality/value: Research on the impact of organizational context on willingness to mentor is limited, and this study helps to address that gap.

Interest in human behavior has always been present in schools of medicine. Particularly since World War II, this interest has been amplified, as shown by a number of trends. These include increasing time in the medical school curriculum for the teaching of the behavioral sciences, increasing numbers of people on medical school faculties who are studying problems of human behavior, and more emphasis on integrated teaching of human behavior by a number of disciplines. The behavioral sciences have also had impact on a number of the methods in medical schools. These various trends have changed the literature needs of the community that the library serves in that there has been an increase in the amount of material available and in the people interested in this material. The library has also profited as an institution from the increasing body of knowledge available in the behavioral sciences. From the level of learning to the level of social interaction in the library it is becoming increasingly possible to organize this important institution in the medical center in a conscious goal-directed way.