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The article discusses the use of triptychs as a new publication format in the field of health professions education (HPE) to enhance understanding and application of qualitative research methods. Triptychs consist of three separate papers that address a specific element of qualitative research: an explanation, an empirical research paper, and a commentary on research choices and implications. The How To Triptych Series in The Clinical Teacher will cover various aspects of qualitative research, such as using theory, justice and equity, transferability of findings, and longitudinal research. The article provides an example of a triptych on using theory to inform a qualitative study, demonstrating how this format can offer deeper insights and practical illustrations for readers. [Extracted from the article]

Introduction: Patient ownership is an important element of physicians' professional responsibility, but important gaps remain in our understanding of this concept. We sought to develop a theory of patient ownership by studying it in continuity clinics from the perspective of residents, attending physicians, and patients. Methods: Using constructivist grounded theory, we conducted 27 semi-structured interviews of attending physicians, residents, and patient families within two pediatric continuity clinics to examine definitions, expectations, and experiences of patient ownership from March–August 2019. We constructed themes using constant comparative analysis and developed a theory describing patient ownership that takes into account a diversity of perspectives. Results: Patient ownership was described as a bi-directional, relational commitment between patient/family and physician that includes affective and behavioral components. The experience of patient ownership was promoted by continuity of care and constrained by logistical and other systems-based factors. The physician was seen as part of a medical care team that included clinic staff and patient families. Physicians adjusted expectations surrounding patient ownership for residents based on scheduling limitations. Discussion: Our theory of patient ownership portrays the patient/family as an active participant in the patient–physician relationship, rather than a passive recipient of care. While specific expectations and tasks will vary based on the practice setting, our findings reframe the way in which patient ownership can be viewed and studied in the future by attending to a diversity of perspectives. [ABSTRACT FROM AUTHOR]

This paper introduces a new column in the Journal for the exploration of and reflection on the roles and articulations of theory in the health professions education sciences. This introduction provides initial orientation to concepts such as theory as worldview, theory linked to empiricism and paradigm, and theory and reflexivity. The authors invite scholars to submit papers that explore the role of theory in HPE scholarship, that propose new and adapted theoretical positions, and that critique the many theories that might be brought to bear to address questions in the field. [ABSTRACT FROM AUTHOR]

There is a special category of mentor: the person who supports you as much as they support your career. They offer a unique relationship that is rich and powerful. Researchers have tried to better understand this relationship and the other varieties of mentoring relationships. But there is a significant gap in that research: we don't talk about the experience of the sudden loss of a mentor. Sometimes mentoring relationships end-especially if the mentoring was in support of specific goals, learning objectives, or when the relationship simply no longer fits the needs of the mentor or the mentee. But sometimes disease, tragic accidents, or other powers beyond our control intervene; suddenly, relationships with important mentors are simply gone. How do we navigate these losses? In this piece, I reflect on the most powerful mentorship relationships, on the loss thereof, and on the challenges of mourning lost mentors. It celebrates mentors who invest in others, who put we ahead of me. This elegy is for Dr. Joanna Bates and Dr. Meridith Marks-two women who embodied the highest qualities of mentorship. [ABSTRACT FROM AUTHOR]

Context: Research in health professions education (HPE) spans an array of topics and draws from a diversity of research domains , which brings richness to our understanding of complex phenomena and challenges us to appreciate different approaches to studying them. To fully appreciate and benefit from this diversity, scholars in HPE must be savvy to the hallmarks of rigour that differ across research approaches. In the absence of such recognition, the valuable contributions of many high‐quality studies risk being undermined. Methods: In this article, we delve into two constructs‐‐‐generalisability and bias‐‐that are commonly invoked in discussions of rigour in health professions education research. We inspect the meaning and applicability of these constructs to research conducted from different paradigms (i.e., positivist and constructivist) and orientations (i.e., objectivist and subjectivist) and then describe how scholars can demonstrate rigour when these constructs do not align with the assumptions underpinning their research. Conclusions: A one‐size‐fits‐all approach to evaluating the rigour of HPE research disadvantages some approaches and threatens to reduce the diversity of research in our field. Generalisability and bias are two examples of problematic constructs within paradigms that embrace subjectivity; others are equally problematic. As a way forward, we encourage HPE scholars to inspect their assumptions about the nature and purpose of research—both to defend research rigour in their own studies and to ensure they apply standards of rigour that align with research they read and review. Through analysis of the concepts of generalizabilty and bias, the authors encourage the field to avoid one‐size‐fits‐all approaches to the evaluation of rigour. [ABSTRACT FROM AUTHOR]

Healthcare professionals need to be able to collaborate in interprofessional healthcare teams (IHTs). This paper discusses how healthcare professionals (can) contribute to IHT effectiveness. Using cultural historical activity theory and its affiliated concept of knotworking, it argues that healthcare professionals would benefit from developing not just leadership but also followership skills. Moreover, IHT collaborators need the ability to switch fluently between leader and follower roles as appropriate to advance patient care. This fluency is essential for collaborative knotworking. Knotworking refers to the process of tying and retying together individual threads of activity and expertise from across the IHT, over time, to achieve specific objects. Knotworking highlights the dynamic dimensions of IHT collaboration that require professionals to be both effective leaders and followers. The perspectives presented in this paper lead to a different view of IHTs, one that recognizes how leaders and followers co-produce the leadership teams need. [ABSTRACT FROM AUTHOR]

Research into military interprofessional healthcare teams (MIHTs) is rarely reported in the interprofessional literature. MIHTs must effectively collaborate in the low resource and chaotic contexts of humanitarian and combat deployments; however, we have yet to study how MIHTs learn to work in these contexts. To address this gap, we investigated military interprofessional education (MIPE). Using an ethnographic approach, we conducted non-participant observations (n = 30.5 hours) of a specific platoon (n = 32 participants) during an MIPE simulation called Operation Bushmaster – a large-scale immersive simulation of battlefield deployment. Findings indicated three aspects of MIPE: (1) a culture where flailing isn't failing; (2) the importance of followership; and (3) an interprofessional respect fostered by role adoption. Considering these findings through Dweck's fixed vs growth mind-set conceptualization, we suggest that – although unusual when compared with traditional IPE – MIPE's teaching and learning methods provide developmental opportunities for team members. We also suggest why Dweck's mind-set conceptualizations could be usefully extended from an individual-focus to also include a collaborative-team-focus. We contend that the findings developed from this research could be transferred to civilian contexts so that the lessons learned by those who serve on the war front could inform those who serve at home. [ABSTRACT FROM AUTHOR]

Context: A wellness crisis exists among physicians and medical trainees. High rates of burnout, depression, stress and other states of impaired wellness have driven a sense of urgency to create solutions, and the medical education community has mobilised impressively. However, we argue—and data suggest—that this rush to find solutions has outpaced our efforts to more fully understand the nature of impaired wellness in medicine. This, we believe, has led to the implementation of solutions informed by limited understanding of the problems we intend to solve. Methods: In this paper, we explore three contributors to this situation: (i) shaky definitions and conceptualisations of wellness, (ii) the predominance of deductive, quantitative research informing our understanding and current solutions, and (iii) the reliance on a 'disease‐focused' approach to addressing impaired wellness in physicians and trainees. We discuss how these contributors have led to the current state of the science of wellness in medicine: one characterised by an expanding array of solutions built upon narrow conceptualisations of wellness and how it can be impaired. Discussion: Moving beyond the current state of the science on wellness in medicine will require three critical developments: (i) consistent use of clear definitions of wellness; (ii) expanding our methodologies to include those utilising direct interaction with participants; and (iii) moving beyond solutions informed by a disease‐model approach. We propose a different way of thinking about wellness: one based on what we view as an inherent—and potentially unavoidable—risk of experiencing impairment during a career in medicine. We argue that efforts to extinguish and eliminate all states of impaired wellness may also eliminate opportunities to develop constructive coping mechanisms and future resilience, and that wellness may best be conceptualised as healthy and authentic engagement with the inevitable adversity of a career in medicine. Shaky conceptual foundations, over‐reliance on objectivism, and use of a "disease model" have led to excess focus on solutions & loss of opportunities for resilience development in our struggle with impaired wellness. [ABSTRACT FROM AUTHOR]

Disclaimer The views expressed herein are those of the authors and do not necessarily reflect those of the United States Department of Defense or other federal agencies. So, these casual conference conversations are a key mechanism to stay current with the cutting-edge ideas in the field. Thus, having informal conversations with colleagues at conferences is a great way to quickly and effectively share your ideas and get immediate insight into others' reactions to your latest thinking and work. Thus, the approaches for "conferencing well" that we share here are derived from in-person conference experiences, recognizing that as conference formats change, practices will also have to evolve. [Extracted from the article]

Introduction: There has been a marked increase in institutional structures developed to support health professions education scholarship recently. These health professions education scholarship units (HPESUs) engage in a diverse range of activities. Previous work provided insight into factors that influence the functioning of such units, but data from European, Asian, Latin American, and African contexts was absent, potentially leading to a single world-view informing international standards for HPESUs. This aim of this study was to explore perspectives from sub-Saharan Africa (SSA) in response to this omission. Methods: Situated within an interpretivist paradigm, the research team conducted semi-structured interviews with nine HPESU leaders in SSA, exploring how participants experienced and understood the functioning of their units. Despite efforts to have representation from across the region, most participants were from South Africa. The researchers analysed data thematically using the theory of institutional logics as an analytical frame. Results: Several aspects of the HPESUs aligned with the previously identified logics of academic research, service and teaching; and of a cohesive education continuum. By contrast, leaders described financial sustainability as a more prominent logic than financial accountability. Discussion: The similarities identified in this study may reflect isomorphism—a process which sees institutions within a similar field becoming more alike, particularly as newer institutions seek to acquire legitimacy within that field. An important caveat, however, is that isomorphism tends to occur across similar institutional contexts, which was not the case in this study. Understanding these differences is key as these HPESUs move to foster scholarship that can respond to the region's unique context. [ABSTRACT FROM AUTHOR]

The contexts and methods for communicating in healthcare and health professions education (HPE) profoundly affect how we understand information, relate to others, and construct our identities. Multimodal analysis provides a method for exploring how we communicate using multiple modes—e.g., language, gestures, images—in concert with each other and within specific contexts. In this paper, we demonstrate how multimodal analysis helps us investigate the ways our communication practices shape healthcare and HPE. We provide an overview of the theoretical underpinnings, traditions, and methodologies of multimodal analysis. Then, we illustrate how to design and conduct a study using one particular approach to multimodal analysis, multimodal (inter)action analysis, using examples from a study focused on clinical reasoning and patient documentation. Finally, we suggest how multimodal analysis can be used to address a variety of HPE topics and contexts, highlighting the unique contributions multimodal analysis can offer to our field. [ABSTRACT FROM AUTHOR]

Scoping reviews are increasingly used in health professions education to synthesize research and scholarship, and to report on the depth and breadth of the literature on a given topic. In this Perspective, we argue that the philosophical stance scholars adopt during the execution of a scoping review, including the meaning they attribute to fundamental concepts such as knowledge and evidence, influences how they gather, analyze, and interpret information obtained from a heterogeneous body of literature. We highlight the principles informing scoping reviews and outline how epistemology-the aspect of philosophy that "deals with questions involving the nature of knowledge, the justification of beliefs, and rationality"-should guide methodological considerations, toward the aim of ensuring the production of a high-quality review with defensible and appropriate conclusions. To contextualize our claims, we illustrate some of the methodological challenges we have personally encountered while executing a scoping review on clinical reasoning and reflect on how these challenges could have been reconciled through a broader understanding of the methodology's philosophical foundation. We conclude with a description of lessons we have learned that might usefully inform other scholars who are considering undertaking a scoping review in their own domains of inquiry. [ABSTRACT FROM AUTHOR]

Introduction: To date, research studying health professions education scholarship units has overlooked the perspectives of research scientists in the field, despite their important role in these units. This research explores how health professions education scientists uphold and/or upend the institutional logics of the units they work within. Methods: Recruited via snowball sampling, 29 Canadian health professions education scientists participated in semi-structured interviews that lasted between 32–55 min. Data analysis was informed by the theories of organizational institutionalism—specifically, the microfoundation element of sensemaking. Results: Respondents' narrations of career success were overtly linked to their research-oriented pursuits above other expectations (i.e., teaching, service). Discussion: Respondents' narrative revealed a mismatch between the value they associated with teaching- and service-related pursuits, and the value the institution associated with those pursuits. Participants indicated a need to reconceptualize the institutional value associated with these endeavors. [ABSTRACT FROM AUTHOR]