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Student-staff partnership advocates the active involvement of students' voices in the design of education. Although the concept of student-staff partnership is rapidly gaining momentum in health professions education, the current practices are more outcome-focused and pay less attention to the partnership process itself. Students' involvement in most of the claimed partnerships has been viewed as input information to the educational design process rather than inviting them to the more pronounced role as partners. In this commentary, we elaborate on different levels of students' involvement in educational design, before highlighting the possible dynamics between students and staff in partnership. We propose five key features of dynamics involved in the process of real student-staff partnerships and a Process-Outcome Model for Student-staff Partnership. We advocate that moving beyond outcomes and diving deeper into the partnership processes is the way forward to establishing true student-staff partnerships.

PURPOSE: Medical students' transition to postgraduate training, given the complexity of new roles and responsibilities, requires the engagement of all involved stakeholders. This study aims to co-create a transition curriculum and determine the value of involving the key stakeholders throughout such transition in its design process.METHODS: We conducted a mixed-methods study involving faculty/leaders (undergraduate/postgraduate), final-year medical students, and chief residents. It commenced with eight co-creation sessions (CCS), qualitative results of which were used to draft a quantitative survey sent to non-participants, followed by two consensus-building CCS with the original participants. We applied thematic analysis for transcripts of all CCS, and mean scores with standard deviations for survey analysis.RESULTS: We identified five themes: adaptation, authenticity, autonomy, connectedness, and continuity, embedded in the foundation of a supportive environment, to constitute a Model of Learning during Transition (MOLT). Inclusion of various stakeholders and optimizing their representation brought rich perspectives to the design process. This was reinforced through active students' participation enabling a final consensus.CONCLUSIONS: Bringing perspectives of key stakeholders in the transition spectrum enriches transition curricula. The proposed MOLT can provide a guide for curriculum designers to optimize the final year of undergraduate medical training in preparing students for postgraduate training with essential competencies to be trained.

Applying professional-vision skills to classroom situations depends on knowledge about what matters in these situations. In an experiment with 85 biology pre-service teachers, we investigated a 90-min intervention combining both acquisition and application of knowledge about tutoring. The interven-tion started with an introductory text, followed by classroom video examples. Students who read a text on concrete tutoring strategies made more references to pedagogical concepts in their analyses than students who read about generic video observational guidelines. We conclude that combining a short, focused theoretical introduction and video analysis is a promising method to broadly anchor professional-vision training within teacher education.(c) 2023 Elsevier Ltd. All rights reserved.

INTRODUCTION: Verbal feedback from trainees to supervisors is rare in medical education, although valuable for improvement in teaching skills. Research has mostly examined narrative comments on resident evaluations of their supervisors. This study aimed to explore supervisors' and residents' beliefs and experiences with upward feedback, along with recommendations to initiate and facilitate effective conversations.METHODS: Using 60-minute focus group discussions, a previous study explored opinions of internal medicine residents and clinical supervisors at the Brigham and Women's Hospital regarding the impact of institutional culture on feedback conversations. For this study, we conducted a thematic analysis of the transcribed, anonymous data to identify key concepts pertaining only to verbal upward feedback, through the theoretical lens of Positioning theory.RESULTS: Twenty-two supervisors and 29 residents participated in three and five focus groups, respectively. Identified themes were mapped to three research questions regarding (1) existing beliefs (lack of impact, risks to giving supervisors feedback, need for preparation and reflection), (2) experiences (nonspecific language, avoidance of upward feedback, bypassing the supervisor), and (3) recommended approaches (setting clear expectations, seeking specific feedback, emphasizing interest in growth).DISCUSSION: Study participants appeared to assume learner-teacher positions during feedback conversations, resulting in residents' concerns of adverse consequences, beliefs that supervisors will neither accept feedback nor change their behaviors, and avoidance of constructive upward feedback. Residents suggested that emphasis on mutual professional growth and regular feedback seeking by supervisors could encourage them to take on the role of feedback providers. Their recommendations could be a valuable starting point for faculty development initiatives on upward feedback.

Background Training residents in delivering high-value, cost-conscious care (HVCCC) is crucial for a sustainable healthcare. A supportive learning environment is key. Yet, stakeholders’ attitudes toward HVCCC in residents’ learning environment are unknown. Objective We aimed to measure stakeholders’ HVCCC attitudes in residents’ learning environment, compare these with resident perceptions of their attitudes, and identify factors associated with attitudinal differences among each stakeholder group. Design We conducted a cross-sectional survey across the Netherlands between June 2017 and December 2018. Participants Participants were 312 residents, 305 faculty members, 53 administrators, and 1049 patients from 66 (non)academic hospitals. Main Measures Respondents completed the Maastricht HVCCC Attitude Questionnaire (MHAQ), containing three subscales: (1) high-value care, (2) cost incorporation, (3) perceived drawbacks. Additionally, resident respondents estimated the HVCCC attitudes of other stakeholders, and answered questions on job demands and resources. Univariate and multivariate analyses were used to analyze data. Key Results Attitudes differed on all subscales: faculty and administrators reported more positive HVCCC attitudes than residents (p ≤ 0.05), while the attitudes of patients were less positive (p ≤ 0.05). Residents underestimated faculty’s (p < 0.001) and overestimated patients’ HVCCC attitudes (p < 0.001). Increasing age was, among residents and faculty, associated with more positive attitudes toward HVCCC (p ≤ 0.05). Lower perceived health quality was associated with less positive attitudes among patients (p < 0.001). The more autonomy residents perceived, the more positive their HVCCC attitude (p ≤ 0.05). Conclusions Attitudes toward HVCCC vary among stakeholders in the residency learning environment, and residents misjudge the attitudes of both faculty and patients. Faculty and administrators might improve their support to residents by more explicitly sharing their thoughts and knowledge on HVCCC and granting residents autonomy in clinical practice.

Student performance in general subjects such as language and mathematical skills is poor in secondary vocational education. A professional culture of teaching-including recruitment of well qualified teachers, effective teacher collaboration and effective teaching practice-could be the key to success. To what extent is there a professional culture of teaching in vocational education? Do differences in the professional culture of teaching affect student achievement? National achievement tests on functional language skills, mathematical skills and information processing were administered to third grade students (N = 3,381) in 116 secondary schools offering vocational education across Flanders. Their teachers (N = 184) completed an online questionnaire about their collaboration and teaching practice. We found evidence that teacher collaboration and effective teaching practices are strongly correlated. Positive correlations were found between combinations of characteristics of a professional culture of teaching and student achievement. However, in many schools a professional culture of teaching is not yet a reality. Our findings demonstrate a need for continually providing support within a professional culture of teaching to prevent teachers from leaving. Improving professional growth for teachers and their teaching teams is also needed, as well as a shift in education policies to support these needs.

Background The R2C2, a 4-phase feedback and coaching model, builds relationships, explores reactions, determines content and coaches for change, and facilitates formal feedback conversations between clinical supervisors/preceptors and residents. Formal discussions about performance are typically based on collated information from daily encounter sheets, objective structured clinical examinations, multisource feedback, and other data. This model has not been studied in settings where brief feedback and coaching conversations occur immediately after a specific clinical experience. Objective We explored how supervisors adapt the R2C2 model for in-the-moment feedback and coaching and developed a guide for its use in this context. Methods Eleven purposefully selected supervisors were interviewed in 2018 to explore where they used the R2C2 model, how they adapted it for in-the-moment conversations, and phrases used corresponding to each phase that could guide design of a new R2C2 in-the-moment model. Results Participants readily adapted the model to varied feedback situations; each of the 4 phases were relevant for conversations. Phase-specific phrases that could enable effective coaching conversations in a limited amount of time were identified. Data facilitated a revision of the original R2C2 model for in-the-moment feedback and coaching conversations and design of an accompanying trifold brochure to enable its effective use. Conclusions The R2C2 in-the-moment model offers a systematic approach to feedback and coaching that builds on the original model, yet addresses time constraints and the need for an iterative conversation between the reaction and content phases. The model enables supervisors to coach and co-create an action plan with residents to improve performance.

Construct:Entrustable professional activities (EPAs) provide a novel approach to support teachers' structured professionalization and to assess improvement in teaching competence thereafter. Despite their novelty, it is important to assess EPAs as a construct to ensure that they accurately reflect the work of the targeted profession.Background:The co-creation of an EPA framework for training and entrustment of small-group facilitators has been discussed in the literature. Although a rigorous design process was used to develop the framework, its content validity has not been established yet.Approach: A modified Delphi technique was used. Three survey rounds were conducted from December 2019 to April 2020. Expert health professions educationalists were recruited using purposive sampling and snowball techniques. In Round 1, a rubric consisting of seven items was used to assess the quality of nine pre-designed EPAs. In Round 2, competencies required to perform the agreed-upon EPAs were selected from 12 competencies provided. In Round 3, consensus was sought on sub-activities recommended for agreed-upon EPAs. Quantitative data were analyzed using multiple statistical analyses, including item-wise and rubric-wise content validity indices, asymmetric confidence interval, mean, standard deviation, and response frequencies. Qualitative data were thematically analyzed using content analysis.Findings:Three of the nine proposed EPAs achieved statistical consensus for retention. These EPAs were: (1) preparing an activity, (2) facilitating a small-group session, and (3) reflecting upon self and the session. Nine of the 12 pre-determined competencies achieved consensus and were then mapped against each agreed-upon EPA based on their relevance. Finally, results indicated consensus on five, six, and four sub-activities for EPA 1, EPA 2, and EPA 3, respectively.Conclusions:The final framework delineates three EPAs for small-group facilitation and their associated sub-activities. The full description of each EPA provided in this article includes the title, context, task specification, required competencies, and entrustment resources. Program developers, administrative bodies, and teaching staff may find this EPA framework useful to structure faculty development, to entrust teachers, and to support personal development.

Stakeholders in vocational education have difficulties communicating and collaborating on the design of education because they often lack a shared understanding of what constitutes effective student learning. The aim of this study is to investigate whether the perspectives of teacher educators, teachers and students on good education in vocational education are aligned with what literature says about Powerful Learning Environments (PLEs) and to what extent the perspectives of different groups of stakeholders are mutually aligned. Results of nine focus group interviews showed that perspectives are mostly similar in the three groups. They strongly favoured authentic and challenging pathways, endorsed the importance of supporting opportunities for developing key competences and, although not univocal by students, adaptive teaching and learning support, within a positive and safe learning community. Differences between preferences of different stakeholders on some of the design characteristics of PLEs underline the importance of developing a shared understanding about learning and teaching among stakeholders.

Objectives Coaching in medical education has recently gained prominence, but minimal attention has been given to key skills and determining how they work to effectively ensure residents are progressing and developing self-assessment skills. This study examined process-oriented and content-oriented coaching skills used in coaching sessions, with particular attention to how supervisors use them to enhance resident acceptance of feedback to enhance learning. Methods This qualitative study analysed secondary audiotaped data from 15 supervisors: resident dyads during two feedback sessions, 4 months apart. The R2C2 model was used to engage the resident, build a relationship, explore reactions to feedback, explore resident perceptions of content, and coach for change. Framework analysis was used, including familiarisation with the data, identifying the thematic framework, indexing and charting the data and mapping and interpretation. Results Process skills included preparation, relationship development, using micro communication skills and techniques to promote reflection and self-assessment by the resident and supervisor flexibility. Content skills related to the specific feedback content included engaging the resident in discussion, ensuring the discussion was collaborative and focused on goal setting, co-developing a Learning Change Plan, ensuring resident commitment and following up on the plan. Together, these skills foster agency in the resident learner. Three overarching themes emerged from the analysis: the interconnectedness of process and content; tensions between encouraging self-direction and ensuring progress and competence; and balancing a coaching dialogue and a teaching monologue. Conclusions Effective coaching by supervisors requires a combination of specific process and content skills that are chosen depending on the needs of the individual resident. Mastering these skills helps residents engage and develop agency in their own professional development. These outcomes depend on faculty maintaining a balance between coaching and teaching, encouraging resident self-direction and ensuring progression to competence.

Background Less attractive specialties in medicine are struggling to recruit and retain physicians. When properly organized and delivered, continuing medical education (CME) activities that include short courses, coaching in the workplace, and communities of practice might offer a solution to this problem. This position paper discusses how educationalists can create CME activities based on the self-determination theory that increase physicians’ intrinsic motivation to work in these specialties. Main content The authors propose a set of guidelines for the design of CME activities that offer physicians meaningful training experiences within the limits of the available resources and support. First, to increase physicians’ sense of professional relatedness, educationalists must conduct a learner needs assessment, evaluate CME’s long-term outcomes in work-based settings, create social learning networks, and involve stakeholders in every step of the CME design and implementation process. Moreover, providing accessible, practical training formats and giving informative performance feedback that authentically connects to learners' working life situation increases physicians’ competence and autonomy, so that they can confidently and independently manage the situations in their practice contexts. For each guideline, application methods and instruments are proposed, making use of relevant literature and connecting to the self-determination theory. Conclusions By reducing feelings of professional isolation and reinforcing feelings of competence and autonomy in physicians, CME activities show promise as a strategy to recruit and retain physicians in less attractive specialties.

In this mixed-methods study, we hypothesized that social cognitive theory (SCT)-based educational interventions for healthcare participation can improve the self-efficacy of older rural citizens in participating in their health management without any difficulties. Quasi-experimental study before and after SCT-based educational interventions and semi-structured interviews were conducted. Participants were Japanese elderly (&gt, 65 years) from rural communities. Propensity score matching was performed to estimate the effectiveness of educational interventions on participants’ perception (intervention: n = 156, control: n = 121). Interview contents were transcribed verbatim and analyzed based on thematic analysis. The intervention group scored significantly higher than the control group for participation in planning and managing self-care. Interviews revealed three themes: ability to manage health conditions, relationship with medical professionals, and relationship among citizens. Participants reported difficulties in judging symptoms and communicating with medical professionals. Hierarchy and low motivation to participate in healthcare hindered collaboration. The findings suggest that SCT-based educational interventions can positively impact rural citizens’ self-efficacy in healthcare participation.

This AMEE guide aims to emphasize the value of active learner involvement in the design and development of education, referred to as co-creation, and provides practical tips for medical educators interested in implementing co-created educational initiatives at their own institutions. Starting with definitions of co-creation and related terms, we then describe its benefits and summarize the literature in medical and higher education to provide an appropriate context and a shared mental model for health professions educators across the world. Potential challenges and barriers to implementation of co-creation in practice are described in detail from the perspective of learners, teachers, and institutions. Challenges are linked to relevant principles of Self-Determination Theory, Positioning Theory and theory on Psychological Safety, to provide direction and fundamental reasons for implementation of co-creation. Finally, solutions to listed challenges and practical approaches to education design and implementation using co-creation are described in detail. These tips include strategies for supporting learners and teachers in the process, enhancing the collaboration between them, and ensuring appropriate support at the organizational level.

Background Primary health care (PHC), of which preventive medicine (PM) is a subspecialty, will have to cope with a deficiency of staff in the future, which makes the retention of graduates urgent. This study was conducted in Vietnam, where PM is an undergraduate degree in parallel to medical training. It aims to identify facilitating and hindering factors that impact recruitment and retention of PM graduates in the specialty. Methods A cross-sectional study enrolled 167 graduates who qualified as PM doctors from a Vietnamese medical school, between 2012 and 2018. Data were collected via an online questionnaire that asked participants about their motivation and continuation in PM, the major life roles that they were playing, and their satisfaction with their job. Multiple regression analyses were used to identify which life roles and motivational factors were related to the decision to take a PM position and to stay in the specialty, as well as how these factors held for subgroups of graduates (men, women, graduates who studied PM as their first or second study choice). Results Half of the PM graduates actually worked in PM, and only one fourth of them expressed the intention to stay in the field. Three years after qualification, many graduates had not yet decided whether to pursue a career in PM. Satisfaction with opportunities for continuous education was rated as highly motivating for graduates to choose and to stay in PM. Responsibility for taking care of parents motivated male graduates to choose PM, while good citizenship and serving the community was associated with the retention of graduates for whom PM was their first choice. Conclusions The findings demonstrate the importance of social context and personal factors in developing primary care workforce policy. Providing opportunities for continued education and enhancing the attractiveness of PM as an appropriate specialty to doctors who are more attached to family and the community could be solutions to maintaining the workforce in PM. The implications could be useful for other less popular specialties that also struggle with recruiting and retaining staff.

Background To receive high-quality healthcare, citizens should actively participate in public healthcare programs and share decision-making with medical professionals, especially in rural areas; this requires support for citizens in the form of education. Few studies examine educational interventions’ effects on rural citizens’ motivation to participate in public healthcare efforts or interprofessional collaboration (IPC) perceptions. Thus, the current study investigates rural citizens’ participation and difficulties faced in healthcare efforts and educational intervention effects.Methods As a quasi-experimental, mixed-methods study, 277 (156=intervention group; 121=control group) rural Japanese participants were surveyed before and after a healthcare workshop, and scores were compared. Semi-structured interviews were also conducted with 17 participants post-workshop. The contents of the interviewed were analyzed based on the framework of thematic analysis.Results Regarding pretest–posttest difference, intervention-group participants scored significantly higher regarding participating in planning and managing self-care than control-group participants (p=0.001 and p=0.014, respectively); there was no difference regarding having a dialogue with healthcare staff and sharing knowledge. Interviews revealed three themes: ability to manage health conditions, relationship with medical professionals, and relationship among citizens. Participants reported difficulties in judging symptoms and communicating with medical professionals. Hierarchy and citizens’ low motivation to participate in IPC hindered collaboration. Furthermore, community conditions, including weakening relationships, privacy issues, and social norms, affected healthcare behaviors. Conclusions Educational interventions emphasizing healthcare and IPC may positively impact rural citizens’ healthcare perceptions. However, citizens may experience difficulties changing their community conditions, enhancing limited healthcare knowledge/skills, and maintaining good relationships with medical professionals and other citizens. Both continuous educational information and interventions and dialogue among medical professionals and rural citizens should be promoted.

Background Residents have to learn to provide high value, cost-conscious care (HVCCC) to counter the trend of excessive healthcare costs. Their learning is impacted by individuals from different stakeholder groups within the workplace environment. These individuals’ attitudes toward HVCCC may influence how and what residents learn. This study was carried out to develop an instrument to reliably measure HVCCC attitudes among residents, staff physicians, administrators, and patients. The instrument can be used to assess the residency-training environment. Method The Maastricht HVCCC Attitude Questionnaire (MHAQ) was developed in four phases. First, we conducted exploratory factor analyses using original data from a previously published survey. Next, we added nine items to strengthen subscales and tested the new questionnaire among the four stakeholder groups. We used exploratory factor analysis and Cronbach’s alphas to define subscales, after which the final version of the MHAQ was constructed. Finally, we used generalizability theory to determine the number of respondents (residents or staff physicians) needed to reliably measure a specialty attitude score. Results Initial factor analysis identified three subscales. Thereafter, 301 residents, 297 staff physicians, 53 administrators and 792 patients completed the new questionnaire between June 2017 and July 2018. The best fitting subscale composition was a three-factor model. Subscales were defined as high-value care, cost incorporation, and perceived drawbacks. Cronbach’s alphas were between 0.61 and 0.82 for all stakeholders on all subscales. Sufficient reliability for assessing national specialty attitude (G-coefficient > 0.6) could be achieved from 14 respondents. Conclusions The MHAQ reliably measures individual attitudes toward HVCCC in different stakeholders in health care contexts. It addresses key dimensions of HVCCC, providing content validity evidence. The MHAQ can be used to identify frontrunners of HVCCC, pinpoint aspects of residency training that need improvement, and benchmark and compare across specialties, hospitals and regions.

PurposeThe authors previously developed and tested a reflective model for facilitating performance feedback for practice improvement, the R2C2 model. It consists of four phases: relationship building, exploring reactions, exploring content, and coaching. This research studied the use and effectiveness of the model across different residency programs and the factors that influenced its effectiveness and use.MethodFrom July 2014-October 2016, case study methodology was used to study R2C2 model use and the influence of context on use within and across five cases. Five residency programs (family medicine, psychiatry, internal medicine, surgery, and anesthesia) from three countries (Canada, the United States, and the Netherlands) were recruited. Data collection included audiotaped site assessment interviews, feedback sessions, and debriefing interviews with residents and supervisors, and completed learning change plans (LCPs). Content, thematic, template, and cross-case analysis were conducted.ResultsAn average of nine resident-supervisor dyads per site were recruited. The R2C2 feedback model, used with an LCP, was reported to be effective in engaging residents in a reflective, goal-oriented discussion about performance data, supporting coaching, and enabling collaborative development of a change plan. Use varied across cases, influenced by six general factors: supervisor characteristics, resident characteristics, qualities of the resident-supervisor relationship, assessment approaches, program culture and context, and supports provided by the authors.ConclusionsThe R2C2 model was reported to be effective in fostering a productive, reflective feedback conversation focused on resident development and in facilitating collaborative development of a change plan. Factors contributing to successful use were identified.

Background. Students are ever more involved in the design of educational practices, which is reflected in the growing body of literature about approaches to student participation. Similarities and differences between these approaches often remain vague since the terms are used interchangeably. This confusing and fragmented body of literature hampers our understanding the process and outcomes of student participation and choosing the most suitable approach for it.Method. We identified the three most frequently used terms related to the design of learning and teaching – design-based research (DBR), participatory design (PD), and co-creation – and disentangled the terminology by focusing on relevant definitions, aims, involvement of students, outcomes, and related terminology.Results. Differences between the approaches to student participation can be found in the degree to which students are the central actors and the degree to which the design is informed by educational theory.Conclusion. It is important to align the level of student participation with the purpose of the approach.

It is recognised that educational environments influence learning experiences, so it is important to ensure that educational buildings are designed to be fit for purpose. In order to ensure that educational buildings meet the needs of those who use them, all relevant stakeholders should be involved in the design process. However, this is not straightforward and much remains unclear about how involvement in such complex design processes should proceed. This article presents the findings of four small heterogeneous groups of architects, educational designers, teachers and students from the UK and The Netherlands, discussing how they would envision optimal collaboration and involvement of stakeholders in the process of (re)designing educational buildings and instructional methods. Presentations from the four groups were transcribed and analysed. Informed by a review of existing models and frameworks, our findings were synthesised into a new interdisciplinary model of participatory building design in education. This new model focuses on an iterative design process with different stakeholders involved in different ways at different times. We propose that this model can inform policy and practice in educational building design, as well as within co-creation of curricula, learning, teaching and assessment.

User participation is a key element in decision processes concerning the accommodation of dynamic organisations such as schools. This article addresses the discrepancy between the perspectives of the architects and engineers, as the makers of school buildings, and school management, teachers and students, as the users of the buildings, and proposes that productive and efficient participatory design of school buildings requires appropriate information tools. Visual information technology tools, such as Building Information Modelling (BIM), already used in interaction between architects, engineers, consultants, etc., are proposed to support school managers, teachers and students in participating in all stages of the life cycle of their school building. The proposed use of BIM is compared to a retrospective analysis of a Dutch school which realised a completely new secondary education building. The article concludes with recommendations to increase the impact of visual information technology tools such as BIM in the design of school buildings in Europe and beyond.

Many educational change proposals, designed to improve student learning, fail to be implemented in classrooms, which is a threat to the impact of educational policy on educational practice. This has led to a call for participatory educational design in which different stakeholders are involved in the generation and consideration of alternative learning environments, including physical spaces that better support learning. The development of tools to effectively engage non-professional designers in design activities is still in its early stages. In this article, we present two tools that can improve mutual learning of those involved in the design process and the quality and usability of both learning environments and supportive physical spaces: the laddering tool and the building block tool. Both are based on a new conception of teaching as bounded rational design in which a teaching practice is seen as a design to attain multiple goals simultaneously in a complex classroom context with limited available resources. By presenting a case from biology teaching, we illustrate how educational design processes between teachers unfold when they use these two tools. We argue and demonstrate that these tools are important for facilitating effective use of diverse contributions from different stakeholders, and also when involving students and architects in a participatory design process.

The aim of this study is to compare the role of the tutor in an online and a face‐to‐face problem‐based learning (PBL) session to shed light on potential differences of the tutor role in both settings. In this practice‐based study we compared the two groups with the same tutor undertaking the same module. Students completed questionnaires about tutor performance, student characteristics and the module. Marks on the end‐of‐module test were analysed. The tutor was interviewed about his expectations and experiences. One session of each group was recorded and analysed qualitatively. Results show tutor tasks appeared to be comparable in both settings with regard to “content and pedagogical content knowledge,” “group dynamics,” “process instruction” and “intermediary between faculty and students.” The face‐to‐face group rated tutor performance lower than the online students. Students and tutor identified the absence of nonverbal cues as a limitation of online PBL. In online sessions the tutor additionally provided technical support and moderated the chat box. It is recommended to involve an extra person in online sessions who is responsible for technical issues. This person could also check the chat box for messages of students. Future research should focus on the necessity of an extra tutor training for online sessions. [ABSTRACT FROM AUTHOR]

Background Mentoring plays a pivotal role in workplace-based learning, especially in the medical realm. Organising a formal mentoring programme can be labor and time intensive and generally impractical in resource constrained medical schools with limited numbers of mentors. Hence, informal mentoring offers a valuable alternative, but will be more likely to be effective when mentors and protégés share similar views. It is therefore important to gain more insight into factors influencing perceptions of informal mentoring. This study aims to explore mentors and protégés’ perceptions of informal mentoring and how these vary (or not) with gender, age and the duration of the relationship. Method We administered an Informal Mentor Role Instrument (IMRI) to medical practitioners and academics from Egypt, Pakistan and Saudi Arabia. The questionnaire was developed for the study from other validated instruments. It contained 39 items grouped into 7 domains: acceptance, counselling, friendship, parenting, psychological support, role modelling and sociability. Results A total of 103 mentors and 91 protégés completed the IMRI. Mentors had a better appreciation for the interpersonal aspects of informal mentoring than protégés, especially regarding acceptance, counselling and friendship. Moreover, being older and engaged in a longer mentoring relationship contributed to more positive perceptions of interpersonal aspects of mentoring, regardless of one’s role (mentor or protégé). Conclusion It can be concluded that the expectations of mentors and protégés differed regarding the content and aim of the interpersonal characteristics of their mentoring relationship. We recommend mentors and protégés to more explicitly exchange their expectations of the informal mentoring relationship, as typically practiced in formal mentoring. Additionally, in our study, seniority and lasting relationships seem crucial for good informal mentoring. It appears beneficial to foster lasting informal mentoring relationships and to give more guidance to younger mentors.

PurposeNewer definitions of feedback emphasize learner engagement throughout the conversation, yet teacher and learner perceptions of each other's behaviors during feedback exchanges have been less well studied. This study explored perceptions of residents and faculty regarding effective behaviors and strategies during feedback conversations and factors that affected provision and acceptance of constructive feedback.MethodSix outpatient internal medicine preceptors and 12 residents at Brigham and Women's Hospital participated (2 dyads per preceptor) between September 2017 and May 2018. Their scheduled feedback conversations were observed by the lead investigator, and one-onone interviews were conducted with each member of the dyad to explore their perceptions of the conversation. Interviews were transcribed and analyzed for key themes. Because participants repeatedly emphasized teacher-learner relationships as key to meaningful feedback, a framework method of analysis was performed using the 3-step relationship-centered communication model REDE (relationship establishment, development, and engagement).ResultsAfter participant narratives were mapped onto the REDE model, key themes were identified and categorized under the major steps of the model. First, establishment: revisit and renew established relationships, preparation allows deeper reflection on goals, set a collaborative agenda. Second, development: provide a safe space to invite self-reflection, make it about a skill or action. Third, engagement: enhance self-efficacy at the close, establish action plans for growth.ConclusionsFeedback conversations between longitudinal teacher-learner dyads could be mapped onto a relationship-centered communication framework. Our study suggests that behaviors that enable trusting and supportive teacher-learner relationships can form the foundation of meaningful feedback.