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While program-level learning objectives are required for medical school accreditation, session-level learning objectives are not, although many institutions use them. Most pre-clerkship basic science medical educators (PCBSMEs) do not have formal pedagogy training, so it is unknown when PCBSMEs learn about learning objectives or how they communicate them to students. A questionnaire was designed to phenomenologically explore these aspects during PCBSMEs' time as a student and as an educator. Qualitative data underwent inductive thematic analysis and generated two descriptive themes. Theme Educator Experiences describes how respondents learned about and used learning objectives as a student and as an educator. Theme Educator Communications describes how PCBMSEs communicate with students about using learning objectives. The relationship between themes suggest learning occurs following Bandura's Social Cognitive Theory. Findings indicate potential obstacles preventing implementation or communication about learning objectives, regardless of training. Strategies to proactively expose PCBSMEs to pedagogical concepts regarding learning objectives are recommended.

This article is dedicated to the late Michael D. Fetters--a giant in the world of mixed methods research, an exceptional researcher and scholar, a professor of family medicine, a caring and beloved family physician, a lifelong learner, a colleague, a mentor, a steadfast advocate, a son, a sibling, a husband, a father, and, above all, a dear friend to everyone who knew him. Inspired by Professor Fetters's innovation, we offer an expanded definition of autoethnography through the formal introduction of the 10 dimensions of autoethnography, as well as the debut of mixed methods autoethnography and of integrated mixed methods autoethnography. An autoethnographic narrative writing style honors both the research genre and the mixed methods researchers' voices.

Recently, a new digital clinical reasoning test (DCRT) was developed to evaluate students' clinical-reasoning skills. Although an assessment tool may be soundly constructed, it may still prove inadequate in practice by failing to function as intended. Therefore, more insight is needed into the effects of the DCRT in practice. Individual semi-structured interviews and template analysis were used to collect and process qualitative data. The template, based on the interview guide, contained six themes: (1) DCRT itself, (2) test debriefing, (3) reflection, (4) practice/workplace, (5) DCRT versus practice and (6) 'other'. Thirteen students were interviewed. The DCRT encourages students to engage more in formal education, self-study and workplace learning during their clerkships, particularly for those who received insufficient results. Although the faculty emphasizes the different purposes of the DCRT (assessment of/as/for learning), most students perceive the DCRT as an assessment of learning. This affects their motivation and the role they assign to it in their learning process. Although students appreciate the debriefing and reflection report for improvement, they struggle to fill the identified knowledge gaps due to the timing of receiving their results. Some students are supported by the DCRT in exhibiting lifelong learning behavior. This study has identified several ways in which the DCRT influences students' learning practices in a way that can benefit their clinical-reasoning skills. Additionally, it stresses the importance of ensuring the alignment of theoretical principles with real-world practice, both in the development and utilization of assessment tools and their content. Further research is needed to investigate the long-term impact of the DCRT on young physicians' working practice.

It can be difficult for some students to learn three-dimensional anatomical structure concepts. While virtual reality (VR) systems have been reported as helpful for learning, there has been scarce research on either VR teaching strategies or the influence of visually induced motion sickness (VIMS) in the context of large anatomy classes (i.e., over 100 students). The study thus aimed to (1) establish a VR anatomy instruction video for a large class; (2) determine how many students experience VIMS when watching a VR anatomy instruction video; (3) evaluate the influence of VIMS on VR anatomy video-based learning; and (4) examine whether a small screen size alleviates VIMS. Laboratory course students viewing a VR anatomy instruction video about the vascular system were invited to participate in the questionnaire survey. Anatomy faculty and staff participated in an experimental trial to determine whether small screen size could alleviate VIMS. The Likert scale survey revealed that students reported the VR strategy as advantageous and appropriate for large classes, but that it cannot replace practical dissection. Of the total participants, 32% reported experiencing VIMS, and 40% of those experiencing VIMS agreed that this could negatively impact their learning through a VR anatomy instruction video. Adjusting the screen size from large to small significantly delayed the onset of VIMS. In conclusion, the VR anatomy instruction video strategy is feasible and helpful for large classes, but educators should consider VIMS when planning their use of this teaching approach.

This non-experimental quantitative study investigated medical school faculty members' behavioral intention to use and actual usage behavior of technology in inquiry-based learning activities in medical schools in the United States by applying the unified theory of acceptance and use of technology (UTAUT). In medical education, situational problems for students to solve typically incorporate instructive clinical cases to guide problem-solving and prepare them for their professional lives as clinicians. Technology-infused inquiry-based learning pedagogy can require significant paradigm shifts for both students and instructors. It can impact the level of responsibility students take upon themselves for their own learning, and use of a pedagogy instructors may find unfamiliar, to deliver content. Major findings demonstrated performance expectancy, effort expectancy, and social influence had a significant relationship with behavioral intention to use technology for teaching medical education inquiry-based activities. Gender and voluntariness of use were both found to have significant effects on the relationship between performance expectancy and behavioral intention to use technology. The results of this study can aid stakeholders in providing support mechanisms for faculty to adopt technology for teaching and learning. This is possibly the first of its kind on the application of this theoretical model to address medical educators' behavioral intention to use and actual usage behavior of educational technologies for the delivery of inquiry-based learning activities.

Education in Doctor of Medicine programs has moved towards an emphasis on clinical competency, with entrustable professional activities providing a framework of learning objectives and outcomes to be assessed within the clinical environment. While the identification and structured definition of objectives and outcomes have evolved, many methods employed to assess clerkship students' clinical skills remain relatively unchanged. There is a paucity of medical education research applying advanced statistical design and analytic techniques to investigate the validity of clinical skills assessment. One robust statistical method, multitrait-multimethod matrix analysis, can be applied to investigate construct validity across multiple assessment instruments and settings. Four traits were operationalized to represent the construct of critical clinical skills (professionalism, data gathering, data synthesis, and data delivery). The traits were assessed using three methods (direct observations by faculty coaches, clinical workplace-based evaluations, and objective structured clinical examination type clinical practice examinations). The four traits and three methods were intercorrelated for the multitrait-multimethod matrix analysis. The results indicated reliability values in the adequate to good range across the three methods with the majority of the validity coefficients demonstrating statistical significance. The clearest evidence for convergent and divergent validity was with the professionalism trait. The correlations on the same method/different traits analyses indicated substantial method effect; particularly on clinical workplace-based assessments. The multitrait-multimethod matrix approach, currently underutilized in medical education, could be employed to explore validity evidence of complex constructs such as clinical skills. These results can inform faculty development programs to improve the reliability and validity of assessments within the clinical environment.

In peer observation of teaching, an experienced colleague in the educational environment of a faculty member observes the educational performance of that faculty member and provides appropriate feedback. The use of peer review as an alternative source of evidence of teaching effectiveness is increasing. However, no research has been done in the field of tool design and development to peer review in classrooms that use a learning management system (LMS). This study used mixed methods. In the qualitative stage, after studying sources and interviewing professors active in virtual education, a question bank was prepared and a 26-item initial questionnaire created. In the quantitative stage, the psychometric properties of the developed instruments, such as the face, content, and structural validity, were examined, and reliability tests were performed. IBM SPSS Statistics (Version 20) was used for analysis. Five categories, including content preparation, content presentation, effective interactions, motivation management, and support services, and 26 subcategories were determined to be effective indicators in peer observation in LMS-based classes in medical sciences. During content analysis, 9 items were removed due to lack of necessary criteria. Then, using principal component analysis and varimax rotation in the present mode (Watkins, 2018), 5 components with eigenvalues higher than 1 were extracted, which explained a total of 70.55% of the total variance. The inter-cluster correlation coefficient (ICC) was 0.88. Thus, the peer observation measurement tool, designed with 17 expressions using the answer method "yes/no", showed good validity and reliability. The research results demonstrate that the evaluation of virtual classes of professors by their peers is effective and that the results can be used in e-learning promotion plans.

Simulated learning programs are an important component of allied health education. Although the role of simulation clinical educators has been highlighted as critical for student learning within simulation, their perceptions of their role have not yet been investigated. This study aimed to explore the experiences of simulation clinical educators. Participants were ten simulation clinical educators who had supported speech-language pathology students' learning during a 5-day simulation program focussed on speech-language pathology practice with adult clients in acute hospital and rehabilitation settings. Educators participated in individual semi-structured interviews exploring their role and their perceptions of the simulation-based learning program. Data were analysed using inductive thematic analysis. Three inter-related themes emerged from participants' views. The major theme of Unique teaching and learning environment incorporated five subthemes: focus on teaching; safe learning environment; authenticity and engagement; structure and intensity of learning, and; feedback opportunities. Two additional themes were identified: Clinical educator role same but different, and Simulation bridges the gap between theory and practice. This study offers new insights into simulation clinical educators' perceptions of their role when supporting students within simulation and highlight the importance of harnessing the unique benefits of simulation as a teaching pedagogy to maximize its impacts on student learning and justify its costs.

This brief communication proposes a possible model for training clinically practicing Physician Assistants/Associates (PA) for a transition into academic medicine. Demand for full-time PA educators is rising. Most new full-time PA educators come from clinical practice and find the transition challenging, resulting in attrition. There is no uniform, expected pathway for PAs wanting to transition into academia, however several institutions have developed fellowships in recent years. Traditionally, residencies have given medical providers, mainly physicians, training for specialty areas of medicine, though only some of those have been wholly devoted to full-time academic medicine. The reasons for their absence are beyond the scope of this paper. It is not uncommon for universities and educational hospitals to experience budget constraints when considering establishing a residency training program. The authors describe the part-time residency at their institution for PAs desiring to be educators, succinctly describe their process and outcomes, and propose it as a model for emulation.

The laboratory practice "Primary culture and directional differentiation of rat bone marrow mesenchymal stem cells (BMSCs)" is part of a required course for sophomore medical students at Tongji university, which has been conducted since 2012. Blended learning has been widely applied in medical courses. Based on a student-centered teaching philosophy, we reconstructed a comprehensive stem cell laboratory module with blended learning in 2021, aiming to facilitate students in enhancing their understanding of the multi-lineage differentiation potential of stem cells and improve their experimental skills, self-directed learning ability, and innovative thinking. First, we constructed in-depth online study resources, including videos demonstrating laboratory procedures, a PowerPoint slide deck, and published literature on student self-learning before class. In class, students performed a primary culture of BMSCs, freely chose among adipogenic, osteogenic, or chondrogenic differentiation, and used cytochemical or immunofluorescence staining for identification. After class, the extracurricular part involved performing quantitative polymerase chain reaction to examine the expression of multi-lineage differentiation marker genes, which was designed as an elective. After 2 years of practice, positive feedback was obtained from both students and faculty members who achieved, the learning goal as expected. The reconstructed stem cell laboratory module provides comprehensive practice opportunities for students. Students have a better understanding of BMSC at the molecular, cellular, and functional levels and have improved their experimental skills, which forms a basis for scientific research for medical students. Introducing blended learning into other medical laboratory practices thus seems valuable.

This study summarizes employment benefits from across 155 U.S. allopathic medical schools, investigates differences in employment benefits according to institutional characteristics, and explores possible connections between employment benefits and institutional wealth. Employment benefits data were extracted from institutions' websites across four categories: time-off, time-away, retirement contributions, and Employee Assistance Programs (EAPs)/family benefits. This dataset was mixed with other publicly available datasets sourced through the Association of American Medical Colleges (AAMC), the American Council on Education (ACE), and the American Association of University Professors (AAUP) to conduct additional analyses. Nationally, medical schools offered an average of 31 vacation/sick days and 12 paid holidays. Schools typically offered 4 out of 8 time-away benefits. Employers' retirement contributions ranged from 3.0% to 15.5%, with a mean contribution of 8.5%. A total of 43.2% (67 of 155) of medical schools offered a pension. Collectively, private medical schools offered fewer time-away benefits and more EAP/family benefits compared to public schools. Universities with larger endowments per student were associated with a higher number of EAP/family benefits offerings (r = 0.543, p < 0.001). Institutional wealth did not influence other benefits offerings. The quantity/quality of most employment benefits offered at allopathic medical schools were wide-ranging, tended not to vary by region or school control, and were not a function of institutional wealth.

(1) Background: Programmatic assessment optimizes the coaching, learning, and decision-making functions of assessment. It utilizes multiple data points, fit for purpose, which on their own guide learning, but taken together form the basis of holistic decision making. While they are agreed on principles, implementation varies according to context. (2) Context: The University of Toronto MD program implemented programmatic assessment as part of a major curriculum renewal. (3) Design and implementation: This paper, structured around best practices in programmatic assessment, describes the implementation of the University of Toronto MD program, one of Canada's largest. The case study illustrates the components of the programmatic assessment framework, tracking and making sense of data, how academic decisions are made, and how data guide coaching and tailored support and learning plans for learners. (4) Lessons learned: Key implementation lessons are discussed, including the role of context, resources, alignment with curriculum renewal, and the role of faculty development and program evaluation. (5) Conclusions: Large-scale programmatic assessment implementation is resource intensive and requires commitment both initially and on a sustained basis, requiring ongoing improvement and steadfast championing of the cause of optimally leveraging the learning function of assessment.

Traditional forms of clinical pedagogy include post-observation feedback and side-by-side coaching. The purpose of this pilot study was to evaluate a newer strategy, bug-in-ear technology (BIET), in which clinical supervisors provide live feedback through a discrete earpiece. BIET has the potential to overcome limitations associated with traditional clinical pedagogy. This pilot study compared side-by-side coaching to BIET coaching, using standardized patients in an on-campus audiology clinic. In this study, first-year Au.D. students conducted a case history assessment for two standardized patients. Likert-response ratings and qualitative data from open-set questions indicated BIET coaching was well received by supervisors because it provided a discrete way to deliver quick, live feedback to students. Although supervisor ratings of BIET were slightly more positive than student ratings, comments from both students and supervisors indicated they could see BIET coaching working well in the future, with modifications. Likert-response items indicated student preference for BIET was associated with feelings of confidence and desire to use BIET. More research is needed to examine ways in which BIET coaching can be operationalized to support audiology clinical education.

In the last two decades, India has seen a massive rise in the number of medical schools. As a result, numerous issues, including the availability of qualified teachers, have made medical education in India challenging. Faculty development (FD) has gained significant attention because of its importance in educational capacity building. FD programs help faculty become more aware of their professional responsibilities. Medical education units can play a vital role in FD and thus improve the quality of medical training by training the teachers. The National Teacher Training Centre (NTTC), Jawaharlal Institute of Postgraduate Medical Education and Research (JIPMER), Puducherry, was the first center established by the Ministry of Health and Family Welfare, Government of India in 1975, with the assistance of the World Health Organization, to promote the training of health professionals in educational science and technology, including educational planning and research. This article describes the profile of activities of NTTC, which is functioning under the aegis of the Department of Medical Education (DME), JIPMER, and lists the outcomes that contributed to the success of DME with particular reference to the last decade. The establishment of DME is seen to affect the medical school positively.

The nursing workforce constitutes the largest professional health workforce in Australia. Nursing is traditionally a female dominated profession. This study reviewed Australian universities that provide entry to practice nursing education. The study identified the distribution of females and males in leadership in nursing education, the positioning of the discipline in the university, and where nurses occupy leadership roles above the nursing discipline (faculty/college). Of the 37 universities that offered entry to practice nursing, more females were evident. However, more men were evident in academia than the proportion of men in nursing outside of the academic setting. Leadership nomenclature varied within each nursing discipline group reviewed. This study demonstrated that the number of nursing academics has decreased since the late 1990's. The nursing workforce is still a significant contributor to the academic workforce and yet numbers of nurse academics working in roles senior to their discipline were few. This paper discusses how the nursing workforce as predominantly female, has implications to both females and males, and may impact opportunities for leadership and promotion to senior roles. [Note: The page range (107-121) shown on the PDF is incorrect. The correct page range is 107-119.]

Objective: To examine experiences of anti-Indigenous racism in a Canadian medical school and inform the development of critical and action-oriented Indigenous health education necessary to pave the way for reconciliation within health systems. Design: A qualitative study conducted within a constructivist paradigm which involved: (1) semi-structured interviews with students, faculty and staff at a Canadian medical school; and (2) consensus-building/collaborative analytical sessions with an Indigenous advisory group and a non-Indigenous working group. Setting: Twenty-three semi-structured interviews were completed with students, staff and faculty working across a Canadian medical school. Results: Inductive coding generated 211 codes that were grouped into seven overarching thematic domains. By engaging in an iterative dialogue with the advisory and working groups, we deductively aligned the thematic analysis with faculty-level and institution-level Indigenous education strategies to ensure local relevance. Self-reflective statements were developed with the advisory group to guide areas for action and resulted in 18 statements with five-point Likert-type-style response options. Conclusion: The results of this study suggest that promoting self-reflexivity in health professional education can prompts educators to engage with Indigenous health curriculum and pedagogy; mentorship and role modelling; and accountability. Critically evaluating systemic injustices at an individual level enables educators to resist systemic oppression and create change in the spaces where they work.

Medical graduates are expected to apply scientific principles and explain the processes underlying common and important diseases. Evidence shows that integrated medical curricula, which deliver biomedical science within the context of clinical cases, facilitate student learning in preparation for practice. However, research has also shown that the student's perception of their knowledge can be lower in integrated compared to traditional courses. Thus the development of teaching methods to support both integrated learning and build student confidence in clinical reasoning is a priority. In this study, we describe the use of an audience response system to support active learning in large classes. Sessions, delivered by medical faculty from both academic and clinical backgrounds, were designed to build on the knowledge of the respiratory system in both health and disease through the interpretation of clinical cases. Results showed that student engagement was high throughout the session and students strongly agreed that the application of knowledge to real-life cases was a better way to understand clinical reasoning. Qualitative free text comments revealed that students liked the link between theory and practice and the active, integrated method of learning. In summary, this study describes a relatively simple but highly effective way of delivering integrated medical science teaching, in this case respiratory medicine, to improve student confidence in clinical reasoning. This educational approach was applied within the early years of the curriculum in preparation for teaching within a hospital setting, but the format could be applied across many different settings.

A new teaching format, the LecturePlus, was formulated as a lecture followed by small-group learning activities. This study assessed the effectiveness of LecturePlus in medical education. An interventional study was conducted among final-year medical students, with 74 students in the experimental group and 96 students in the control group. Each LecturePlus lasted [tilde]1 h and was conducted with 12-18 students. A LecturePlus session comprised of a lecture followed by small-group problem-solving exercises. The exercises were clinical cases with open-ended short-answer questions. Students were divided into groups of three (triads) for these exercises. A faculty tutor assisted the small groups as needed. Closure was achieved through a discussion moderated by the tutor. Learning outcomes were assessed via the National Board of Medical Examiners (NBME) subject scores and compared with those of the preceding academic year. An additional multiple-choice question (MCQ) test was administered before and after the clerkship. The MCQ test showed improvement in knowledge application (P < 0.001, partial eta squared = 0.42). There was a statistically significant improvement in adjusted NBME scores among female students (74.8 vs. 71.8; P = 0.017) but not among male students. An anonymous written questionnaire survey showed high ratings for LecturePlus (95% selecting yes or partly yes to overall satisfaction). LecturePlus is an instructional strategy that integrates a lecture with learning activities. It can be scaled to large class sizes facilitated by one teacher. By combining didactic teaching with problem-solving, this new instructional strategy may foster application of knowledge.

The competency-based undergraduate medical curriculum in the preclinical years requires clinical topics to be taught using a linker clinical case for students to appreciate the clinical application of basic sciences. The objective of this study was to evaluate student and faculty satisfaction regarding the construct and delivery of an aligned and integrated curriculum that involved the use of linker clinical cases. We aimed at evaluating the perceptions and performance of students when paper cases were supplemented with a simulated patient (SP) video. This interventional study was conducted by inviting 250 medical students from the first professional phase from the 2020-2021 batch. Integrated modules were prepared for two clinical conditions: myocardial infarction (MI) and nephrotic syndrome (NS). The topic NS was taught with a paper-based case while the topic MI was supplemented with an SP video. Feedback from students and faculty was collected using a newly developed and validated questionnaire and focused group discussions. The students performed significantly better in the assessment conducted after the topic MI compared to NS. The majority of the students (80%) expressed a preference for the video to understand the clinical relevance when compared to the paper case. Overall, the students (83-87%) expressed satisfaction with integrated teaching sessions using clinical cases. Using linker clinical cases in an aligned and integrated preclinical curriculum allowed students to interrelate the subjects and apply them to clinical contexts. The SP videos prepared from an authentic setting facilitated learner engagement with a better understanding of the clinical relevance of the basic sciences.

The centrality of entrustable professional activities (EPAs) in competency-based medical education (CBME) is predicated on the assumption that low-stakes, high-frequency workplace-based assessments used in a programmatic approach will result in accurate and defensible judgments of competence. While there have been conversations in the literature regarding the potential of this approach, only recently has the conversation begun to explore the actual experiences of clinical faculty in this process. The purpose of this qualitative study was to explore the process of EPA assessment for faculty in everyday practice. We conducted 18 semi-structured interviews with Anesthesia faculty at a Canadian academic center. Participants were asked to describe how they engage in EPA assessment in daily practice and the factors they considered. Interviews were audio-recorded, transcribed, and analysed using the constant comparative method of grounded theory. Participants in this study perceived two sources of tension in the EPA assessment process that influenced their scoring on official forms: the potential constraints of the assessment forms and the potential consequences of their assessment outcome. This was particularly salient in circumstances of uncertainty regarding the learner's level of competence. Ultimately, EPA assessment in CBME may be experienced as higher-stakes by faculty than officially recognized due to these tensions, suggesting a layer of discomfort and burden in the process that may potentially interfere with the goal of assessment for learning. Acknowledging and understanding the nature of this burden and identifying strategies to mitigate it are critical to achieving the assessment goals of CBME.

The Decolonising the Curriculum movement in higher education has been steadily gaining momentum, accelerated by recent global events calling for an appraisal of the intersecting barriers of discrimination that ethnic minorities can encounter. While the arts and humanities have been at the forefront of these efforts, medical education has been a 'late starter' to the initiative. In this article, we describe the pioneering efforts to decolonise the undergraduate medical curriculum at UCL Medical School (UCLMS), London, by a group of clinician educators and students, with the aim of training emerging doctors to treat diverse patient populations equitably and effectively. Throughout this process, students, faculty and members of the public acted as collaborative 'agents of change' in co-producing curricula, prompting the implementation of several changes in the UCLMS curriculum and rubric. Reflecting a shift from a diversity-oriented to a decolonial framework, we outline three scaffolding concepts to frame the process of decolonising the medical curriculum: epistemic pluralism, cultural safety and critical consciousness. While each of these reflect a critical area of power imbalance within medical education, the utility of this framework extends beyond this, and it may be applied to interrogate curricula in other health-related disciplines and the natural sciences. We suggest how the medical curriculum can privilege perspectives from different disciplines to challenge the hegemony of the biomedical outlook in contemporary medicine -- and offer space to perspectives traditionally marginalised within a colonial framework. We anticipate that through this process of re-centring, medical students will begin to think more holistically, critically and reflexively about the intersectional inequalities within clinical settings, health systems and society at large, and contribute to humanising the practice of medicine for all parties involved.

The study assessed the service quality and satisfaction among Pharmacy students at one of the private medical colleges in Saudi Arabia using ServQual model. Specifically, it sought to determine the respondents' profile in terms of gender, year level, and grade point average; service quality using SERVQUAL Model; over-all students' satisfaction of students on the provided college services; and which profile and service quality dimensions best predict the over-all satisfaction of the students. Using a descriptive statistics and Multiple Regression Analysis for data analysis, this paper had 189 respondents. Based on the results, majority of the respondents were female from levels 2, 3, and 4 with above average GPA. Responsiveness, empathy and tangibility dimensions of service quality had a negative gap, which means that the expected services did not meet the perceived services on the cited service quality dimensions. Meanwhile, when overall satisfaction was measured, students expressed satisfaction to the college services. Year level was a predictor for all measures of student satisfaction; while GPA was identified as a negative predictor to student satisfaction in terms of faculty. Students' satisfaction in terms of faculty was best predicted by responsiveness, assurance, tangibility. Meanwhile, assurance was a predictor of students' satisfaction in terms of curriculum. Responsibility, responsiveness and assurance, on the other hand were predictors of students' satisfaction in terms of students services and facilities. Finally, the overall student satisfaction was predicted by responsiveness, assurance and tangibility.

The rapid growth of the U.S. Latinx population has led to an increased need for community organizations and academic institutions to develop partnerships focused on addressing gaps in health maintenance and education of Latinx individuals. Medical schools also have a responsibility to educate future physicians in delivering culturally sensitive care through community-oriented learning experiences. This case study approach outlines the logistics of establishing a youth mentoring program between a medical school and a Latinx community and demonstrates the benefits to the institution, medical students, and the population served. We also discuss the challenges arising from this partnership and present early program evaluation data showing consistent mentor satisfaction reported over time. This description of the program development provides a framework for creating similar initiatives in medical education to address known disparities in health and well-being of Latinx individuals and other minority populations.

The purpose of this study was to 1) help novice students scaffold problem-solving and engage safely in the deliberate practice of diagnostic reasoning and medical decision-making in real time; 2) assess how accurately students gather and apply data in medical reasoning and treatment during high-fidelity patient simulations (HFPSs); 3) identify students' scientific misconceptions related to the case; 4) promote student metacognitive processing, self-assessment, and self-efficacy; and 5) facilitate the explicit calibration of student confidence in deliberate reasoning with patient outcomes. In a mixed-method design, a metacognitive calibration self-assessing (MCC) survey tool was applied to HFPS (n = 80, 20 teams of 6 medical students) and semistructured interviews were conducted with faculty (n = 5). When scored by faculty with a rubric, the mean student accuracy ranged from 23% to 74%, whereas their self-assessment of confidence ranged from 71% to 86%. This result revealed overconfidence bias in novice students regarding the correctness of their wrong responses. The most common misconception identified was inverting cause and effect: metabolic acidosis was pointed to as the cause of the patient's problems rather than a consequence of untreated diabetes mellitus. The most common treatment error was overtreatment, with unnecessary added medication. Interviews with faculty suggested that the MCC tool improved the team process by slowing students down, requiring them to think through their answers, and that overall the tool improved their critical thinking. This study demonstrated the feasibility of using a metacognitive confidence calibration tool to assist novice students in learning safely to make deliberate diagnostic reasoning and decisions on patient care in real time during complex simulations while observing objectively their levels of psychological confidence against patient outcomes. New & Noteworthy: This study demonstrates the feasibility of a metacognitive confidence calibration tool (MCC) to assess and promote novices in the learning of diagnostic reasoning and treatment decisions on patient care in real time during high-fidelity patient simulations while comparing confidence and accuracy data and identifying students' scientific misconceptions. Results revealed the presence of overconfidence bias, overtreatment, and the misconception of metabolic acidosis as the cause of the patient's problems rather than a consequence of untreated diabetes mellitus.

Human body donation (HBD) serves an essential function in many medical schools, particularly in institutions where people engage in cadaver-based simulation (CBS) as a pedagogical approach. The people who facilitate HBD and CBS have a highly specialized skill set, yet their expertise remains largely unacknowledged, and takes place out of sight from the broader medical school community. This manuscript, based on a two-year practice-based ethnography (Structured Observations n = 68 h, Unstructured Observations n = 150 + hours; Interviews n = 24; and Document/Policy Analysis n = 14) illuminates the complex work of HBD. We identify three primary functions of HBD and CBS (1. Cadaver Intake & Administration, 2. Cadaver Preparation, and 3. Cadaver-Based Pedagogy). We describe how medical educators involved in CBS have developed a skillset specific to their role: negotiating humanity.

In pursuing assessment excellence, clinician-educators who design and implement assessment are pivotal. The influence of their assessment practice in university-run licensure exams on student learning has direct implications for future patient care. While teaching practice has been shown to parallel conceptions of teaching, we know too little about conceptions of assessment in medical education to know if this is the case for assessment practice and conceptions of assessment. To explore clinician-educators' conceptions of assessment, a phenomenographic study was undertaken. Phenomenography explores conceptions, the qualitatively different ways of understanding a phenomenon. Data analysis identifies a range of hierarchically inclusive categories of understanding, from simple to more complex, and the dimensions that distinguish each category or conception. Thirty-one clerkship convenors in three diverse Southern settings were interviewed in three cycles of iterative data collection and analysis. Four conceptions of assessment were identified: passive operator, awakening enquirer, active owner and scholarly assessor. Six dimensions were elucidated to describe and distinguish each conception: purpose of assessment; temporal perspective; role and responsibility; accountability; reflexivity and emotional valence. Additionally, three characteristics that appeared to track the progressive nature of the conceptions were identified: professional identity, assessment literacy and self-efficacy. These conceptions encompass and extend previously described conceptions across different educational levels, disciplines and contexts, suggesting applicability to other settings. There is some evidence of a relationship between conceptions and practice, suggesting, together with the hierarchical nature of these conceptions, that targeting conceptions during faculty development may be an effective approach to enhance assessment practice.

Perceptions of teachers and students about curriculum viability inhibitors are equally important yet may differ. Divergence can lead to destructive friction and adversely affect curriculum viability. Our team aimed to find the perceptions of teachers and students on inhibitors affecting the viability of an implemented medical curriculum, report their convergence or divergence, and explore approaches to reduce divergence. Through a mixed-method approach, using valid and reliable questionnaires, we found the curriculum under review had no clear inhibitors. Whereas teachers exhibited complete agreement that no educational programme inhibitors existed, students did not fully agree. Upon qualitative inquiry, using focus group discussion with students and teachers, we found that 'improving the communication gap', 'enhancing the role of faculty and students in curriculum', and 'improving the assessment process' can reduce the friction between teachers and students. This study provides an approach that identifies the curriculum viability inhibitors and solutions to address them.

The teaching and learning that takes place in clinical settings has a significant influence on the practice of future health professionals. This article describes the use of a logic model and case study methodology to evaluate an online and face-to-face video-club, a novel professional development activity designed with the aim of improving clinical educators' teaching practice. A video-club brings together a small group of clinical educators who have a shared interest in exploring their educator role through collective inquiry, using video-recordings of their authentic teaching practices as stimuli for learning discussions. The article focuses on the extent to which the learning design was both implemented and working as intended and offers an examination of proximal outcomes and an initial examination of distal outcomes. The authors claim that the video-club's core activity -- watching and discussing the video-excerpts -- was successful in generating the requisite 'teacher talk' necessary to influence clinical educators' teaching practices. The examination of the video-clubs' impact on clinical educators' practice was promising and justifies a larger study to fully investigate the intervention's effectiveness. In order for the video-club to grow and thrive, systemic changes, particularly at the level of policy and 'culture', are likely to be required.

Anatomy-related departments have access to comparative research productivity data (e.g., Blue Ridge Institute for Medical Research), yet no datasets exist for comparing departments' general practices pertinent to education-focused faculty. Practice trends in anatomy-related departments across U.S. medical schools were explored by surveying departmental leaders. The survey inquired about: (i) faculty time allocations, (ii) anatomy teaching services, (iii) faculty labor distribution models, and (iv) faculty compensation practices. A nationally representative sample of 35 departments (of 194) responded to the survey. On average, anatomy educators are allotted 24% (median = 15%) protected time for research, irrespective of funding, 62% for teaching and course administration (median = 68%), 12% for service, and 2% for administration. Forty-four percent (15 of 34) of departments taught at least five different student populations, often across multiple colleges. Many departments (65%; 11 of 17) applied formulaic methods for determining faculty workloads, often as a function of course credits or contact hours. Average base salaries for assistant and associate professors reported by this survey were consistent (p = 0.056) with national means (i.e., Association of American Medical Colleges Annual Faculty Salary Report). Merit-based increases and bonuses averaged 5% and 10% of faculty's salaries, respectively, when awarded. Cost-of-living increases averaged 3%. Overall, departments' workload and compensation practices vary widely, likely a consequence of different institutional cultures, locations, needs, and financial priorities. This sample dataset allows anatomy-related departments to compare and reflect upon their practices and competitiveness in recruiting and retaining faculty.

Clerkships are defining experiences for medical students in which students integrate basic science knowledge with clinical information as they gain experience in diagnosing and treating patients in a variety of clinical settings. Among the basic sciences, there is broad agreement that anatomy is foundational for medical practice. Unfortunately, there are longstanding concerns that student knowledge of anatomy is below the expectations of clerkship directors and clinical faculty. Most allopathic medical schools require eight "core" clerkships: internal medicine (IM), pediatrics (PD), general surgery (GS), obstetrics and gynecology (OB), psychiatry (PS), family medicine (FM), neurology (NU), and emergency medicine (EM). A targeted needs assessment was conducted to determine the anatomy considered important for each core clerkship based on the perspective of clinicians teaching in those clerkships. A total of 525 clinical faculty were surveyed at 24 United States allopathic medical schools. Participants rated 97 anatomical structure groups across all body regions on a 1-4 Likert-type scale (1 = not important, 4 = essential). Non-parametric ANOVAs determined if differences existed between clerkships. Combining all responses, 91% of anatomical structure groups were classified as "essential" or "more important." Clinicians in FM, EM, and GS rated anatomical structures in most body regions significantly higher than at least one other clerkship (p = 0.006). This study provides an evidence-base of anatomy content that should be considered important for each core clerkship and may assist in the development and/or revision of preclinical curricula to support the clinical training of medical students.

Communication skills are fundamental in healthcare, but assessing them among medical students presents challenges. In the Indian context, the lack of a specific assessment tool further compounds the issue. Thus this study aimed to develop and validate an observation-based communication skills checklist tailored to Phase I Bachelor of Medicine and Bachelor of Surgery (MBBS) students. The checklist was developed using both inductive and deductive approaches and underwent rigorous testing to ensure its reliability and validity. After piloting, the finalized version was administered to 84 Phase I MBBS students. Results indicated a critical content validity ratio of 0.78, face validity of 0.80, and an impressive Cronbach's alpha of 0.91, indicating good internal consistency and reliability of the checklist. The students scored over 80% in all checklist domains, except for empathy (73%) and support (74%), highlighting areas for potential improvement. Nonetheless, about 75% of students expressed satisfaction with the checklist's communication skills assessment. The feedback from faculty members was positive, as they found the checklist was easy to use, quick, and effective for evaluating communication skills. Consequently, the checklist's introduction has been well received by both students and faculty. In conclusion, the developed checklist proves to be an effective and valid instrument for assessing communication skills in Phase I MBBS students. By integrating this tool into observed station clinical examinations, medical educators can comprehensively evaluate students' communication behaviors. Moreover, the checklist serves as a valuable resource for bridging the gap between theoretical knowledge and practical application, enabling future physicians to excel in doctor-patient interactions, a crucial aspect of patient-centered care.

Physiology is a critical subject that bridges basic and clinical medicine. The reform of physiology education is crucial to improving the quality of teaching and supporting student learning; however, there is a lack of comprehensive data documenting the current state of physiology education in medical programs in China. This study conducted an online survey among experienced teachers from the top 100 medical schools in the Chinese mainland in 2022. A total of 89 valid questionnaires were included in this study. In 57.3% of the surveyed medical schools, 70% of the physiology teachers have a Ph.D. degree, while the number of faculty members with a medical background has tended to decrease in 53.9% of the surveyed medical schools. Of the 89 medical schools, 62 have implemented physiology course integration, with 69.4% of the respondents believing that curriculum integration could enhance students' knowledge acquisition and application. The lecture hours per term are 50-70 and 71-90 in 49.4% and 42.7% of the 89 medical schools, respectively. The ratio of course duration of lecture to laboratory was 2:1 in 47.2% of the surveyed medical schools, while the ratio was between 1:1 and 2:1 in 47.2% of the surveyed medical schools, and only 5.6% of medical schools opted for a 1:1 course arrangement. For teaching methods, about 60% of medical schools used problem-based learning, case-based learning, and task-based learning (PBL/CBL/TBL) for clinical medicine students only, and 25.4% of medical schools applied PBL/CBL/TBL to all students. This study is conducive to promoting dialogue and communication among physiology teachers, administrators, and researchers.

The disadvantaged position in which underrepresented faculty in medicine often find themselves is characteristic of not only our current society but also tradition and elitism in academic medicine. This study analyzed the experiences of Latino/a/x faculty in academic medicine and examined the messages that perpetuate racist nativist attitudes in academia. The analysis employed qualitative content textual analysis to examine interview transcripts with Latino/a/x faculty. The approach is grounded on racist nativism as the foundation for analysis, expanding its theoretical reach to academic medicine. Findings revealed experiences of racism, discrimination and microaggressions, as well as the role of perceived accents as exclusionary identifiers, and provided insights into its effect on academic credibility. The exodus of Latino/a/x faculty and administrators from traditionally White institutions is thought to be multifactorial, including poor institutional climates and instances of racism. This article demonstrates how racism challenges the credibility of Latino/a/x faculty.

Introduction: During the SARS-CoV-2 pandemic, the training of medical students was severely disrupted. Government authorities imposed a second national lockdown, which lasted from December 2020 to May 2021, forcing medical schools to adapt their teaching strategies. Several surveys have assessed students' perspectives, but there is limited data available to objectively assess and compare different strategies between medical faculties. The aim of this study was to evaluate the lecturer-based perspective to assess the impact on the theoretical and practical education of medical students before and during the second lockdown. Methods: We developed a questionnaire focusing on theoretical and practical training during pandemic before and during the second lockdown. The questionnaire was sent by personal invitation in January 2021 to all responsible lecturers of gastroenterology and hepatology departments at university hospitals in Germany. Results: The complete response rate was obtained from 52.5% (21/40) teaching centres representative of all regions in Germany. While the majority of respondents (62%) reported a limited impact of the lockdown on theoretical training, 90.5% reported a significant impact on practical training during the SARS-CoV-2 pandemic response. Several centres adapted virtual or hybrid education early during the pandemic, bedside teaching was down to 38.1% (8/21), particularly for students in the early phase of education, suggesting a substantial long-term impact on students' skills. Conclusion: Our questionnaire-based data provide one of the first systematic evaluation of faculty-based assessments of the potential impact of the pandemic during lockdown on medical education. We observed considerable heterogeneity in strategies for maintaining teaching activities during the SARS-CoV-2 pandemic in Germany.

In the literature, research education is insufficiently addressed. Existing studies often document pre-/post-educational interventions. Accounts of individual scholars colored by their views and experience are rarely considered. This study describes the research experience of a faculty member in academic medicine and examines the values and practices that make up the subculture of research. Drawing on Hafler's conceptual framework and autoethnography as a method, professional experiences related to research education are described and analyzed. Data were collected through the author's journaled self-reflections. The findings were organized according to Hafler's three suggested areas of faculty development. The first was the experience of formal professional development activities. There was a dearth of research education activities provided to faculty. The second was the experience of informal mentorship. Despite the tapestry of mentors, the types of relationships involved were unclear. The third theme is the experience of the culture surrounding promotion and funding. The quality of the research was challenged by the lack of funding. Current research education for faculty members are, in the author's experience, modest. The research subculture encourages tacit strategies that orient faculty toward producing research on their own and influence scholarship decisions that produce works that do not necessarily have value and may not be considered impactful. A clearer purpose and more structured professional development that takes into consideration the three levels of faculty development--formal, informal, and cultural--are needed to help faculty fully realize their roles as researchers.

How is academic work accomplished within a curriculum that has been established through a digital education infrastructure, and what, exactly, does an academic member of staff do within this digital context? Reflecting on the empirical findings of a three-year ethnography of a distributed medical education curriculum delivered across two university campuses in Canada, this paper demonstrates that the ways in which work that has typically been characterized as academic is enacted within this curriculum, positioned as a socio-technological network, through a heterogeneous network of people and materials. Drawing on the philosophical anthropology of Bruno Latour, An Inquiry into Modes of Existence, this paper positions the individual academic member of staff as one amongst many network elements within the digital platform across which academic work is generated and circulated. The paper argues that studies of digitally-mediated higher education can equally rest on small and localized instances of practice as well as on cross-boundary or institutional explorations, and offers ways of thinking that are informed by Latour's philosophical anthropology.

This report presents the compilation of interaction analysis of a month long online discussion that supplemented regular FAIMER fellowship programme for health professional teachers. Online discussion forums are considered as an effective means and if conducted using appropriate protocols and activities will help learners to share and gain knowledge from each other. Research on interaction analysis stresses the need for proper protocols to evaluate online discussion for meaningful learning. For preparing this report Henri's (1992) model for interaction analysis of computer-mediated communication was used for the qualitative analysis of electronic discourse that held as part of FAIMER programme among the 2015 and 2016 FAIMER fellows. The key domains examined for reporting are electronic interaction, social cues, cognitive skills and depth of information processing and metacognitive skills and knowledge. Transcript of interaction analysis of 454 mails posted for the entire month revealed most of the interactions were linear and some are of branching type. The social cues used during this computer mediated communication gave recognition to the moderators. Around 60% of participants' information were at the surface level, 25% were at an in-depth level of information processing, and nearly 15% were of both surface and deep information processing. The metacognitive activities identified by Henri, such as planning, self-awareness, and evaluation were also witnessed in this online discussion making the discussion forum learner-centered. The outcomes of this maiden attempt on the interaction analysis supports the assumption of online discussion forums as an important component of online courses, and the need for usable protocols for analyzing the effectiveness of online discussions as a form of computer-mediated communication. Thus, the FAIMER online discussion forum that was created for collaborative learning on the topic "Giving Feedback" fulfils the criteria proposed in Henri's protocol for evaluating meaningful collaborative learning through online discussions. Online discussions if conducted following appropriate protocols will have greatest potential on the impact of learning and can serve as easy and effective means of capacity building of health professional educators.

Little is known about the process of tracking the activity and days-to-productivity of new research faculty in pediatric academic medical centers in the United States. The purpose of this study was to design a quantitative technique for measuring the startup journey and academic productivity of new research faculty at an established research academic medical center. Three measures, (1) engagement, (2) efficiency, and (3) publication, were used to identify the total number of days that it takes for a new research faculty member to move from the discovery phase (value-consumed) into the engagement phase (value-created) after accepting a new position. General findings were that the typical research faculty member hired from 2014 to 2018 at Children's Mercy was male, submitted his first research project within the first three months of employment and averaged one new research submission per year. He would collaborate on a publication as a co-author within the first six months of employment, his first primary author publication would be published near his first employment anniversary, and he would average 2.9 publications per year in the first few years. The current study hopes to fill a gap in existing literature regarding the best practices for tracking, reporting and comparing the startup journey and academic productivity of new research faculty in pediatric academic medical centers.

Emphasis on teaching religious education in the university and raising the level of religious awareness of students in parallel with specialized education, raises attention to the important point that the set of Islamic education courses was in line with the demands and desires of students? The aim of this study is to an increase of the analytic mood among the students and faculty members of the department of Islamic education by the teaching method of Problem-based learning. The present study was performed cross-sectionally on students of Shiraz University of Medical Sciences in Islamic education courses that they had taken as a general course. One of the strengths of this method is the student-centered and process-oriented instead of text-centric and moving from central memorization to research-oriented.

Health disparities faced by transgender people are partly explained by barriers to trans-inclusive healthcare, which in turn are linked to a lack of transgender health education in medical school curricula. We carried out a theory-driven systematic review with the aim to (1) provide an overview of key characteristics of training initiatives and pedagogical features, and (2) analyze barriers and facilitators to implementing this training in medical education. We used queer theory to contextualize our findings. We searched the PubMed/Ovid MEDLINE database (October 2009 to December 2021) for original studies that reported on transgender content within medical schools and residency programs (N = 46). We performed a thematic analysis to identify training characteristics, pedagogical features, barriers and facilitators. Most training consisted of single-session interventions, with varying modes of delivery. Most interventions were facilitated by instructors with a range of professional experience and half covered general LGBT+-content. Thematic analysis highlighted barriers including lack of educational materials, lack of faculty expertise, time/costs constraints, and challenges in recruiting and compensating transgender guest speakers. Facilitators included scaffolding learning throughout the curriculum, drawing on expertise of transgender people and engaging learners in skills-based training. Sustainable implementation of transgender-health objectives in medical education faces persistent institutional barriers. These barriers are rooted in normative biases inherent to biomedical knowledge production, and an understanding of categories of sex and gender as uncomplicated. Medical schools should facilitate trans-inclusive educational strategies to combat transgender-health inequities, which should include a critical stance toward binary conceptualizations of sex and gender throughout the curriculum.

This study aimed at investigating the perceptions of using first language (Arabic) in the ESP classroom from the viewpoints of both students and teachers of the Preparatory Year Department at an applied medical college in Saudi Arabia. It also intended to find out if there were significant differences in perceptions according to variables like gender and college level. Surveying 92 students and 10 teachers through a questionnaire and interviews, the results revealed that instructors' and students' viewpoints of L1 use in their medical- English classes were considerably negative. No statistical differences in the students' perceptions were noted according to college level; however, there were slight differences due to gender variable; females were more to disagree with more L1 use in the classroom. Despite their negative views, instructors stated differences between students due to both gender and college level, believing that males and Level 1 students need more L1 while teaching medical English than females and Level 2 students.

The urgent need for English instruction at the faculty of medicine, Mostaganem University, motivated us to investigate the teachers' needs for medical English. In this prospect, an in-depth needs analysis was conducted to know the "teachers' of medicine" needs for English in order to make an appropriate course design for them. Accordingly, a set of procedures were taken in which a questionnaire was elaborated to investigate the learners' profiles, their target needs, and their learning styles. Furthermore, an interview with the responsible for medical English was held to determine the way the learning process should be conducted. Moreover, a placement test consolidated by a classroom observation was used to reveal the learners' strengths and weaknesses regarding the language. The results of the needs analysis were exploited and interpreted to elaborate a suitable course design for the teachers of medicine at Abdelhamid Ibn Badis University to equip them with the linguistic tool to be able to use English as a medium in their researches and to attend international conferences. Finally, an official implementation of the suggested course design for medical professionals in the academic setting was proposed as a first attempt to introduce English to the faculty of medicine.

The present study is conducted to implement the newly developed questionnaire to assess the readiness of academics for Implementation of e-learning programs. The questionnaire was developed and its validity and reliability were evaluated. Then a cross-sectional study was conducted including 907 academics in three categories (faculties, students, and employees) of Shiraz University of Medical Sciences. Data were analyzed in SPSS-16 using descriptive and inferential statistics. The results of the implementation of the questionnaire showed a significant relationship between e-learning knowledge and participants' position in the university, as the professors and students had higher levels of this knowledge compared to the university employees (P<0.001). There was a significant relationship between e-learning knowledge and an academic degree in the study subjects (P=0.004). Skills and attitude were also significantly related to the variables of position, academic degree, and place of residence and hours of internet use. Skills, knowledge and attitude were all related to computer and internet access and language used on the internet.

Educational perspectives from Hawaiian points of view in all areas of Native Hawaiian health are timely and critical to share today, as remarkable and unprecedented collaborations within the Hawaiian community are addressing not only the overall health and wellness of Hawaiians, but a range of additional culturally grounded issues, such as healing from intergenerational/historical trauma, visioning for an alternative system of healthcare, and social justice. Examples of such collaborative efforts include Na Limahana O Lonopuha, a consortium of health professionals from a wide range of disciplines; the diverse range of community, cultural and health related groups involved in the E Ola Mau a Mau project with Papa Ola Lokahi; as well as Kukulukumuhana, another gathering of organizations and members from the community, all of whom are working tirelessly to confront persistent health disparities and improve the health and wellness of Native Hawaiians. The deep and ambitious work of reimagining how Hawaiian institutions and providers could begin the work of making substantive change in systems thinking laterally, which would more closely align with cultural healing practices, is the direction Hawaiians are moving toward together. This coalescing of organizations and individuals is also happening in educational circles as many have worked for years to bring parity and cultural awareness to learning within the school environment and beyond. This article describes the invitation for visual artists to join this conversation and the role of the visual arts to offer ways for Hawaiian communities to see and experience concepts such as historical trauma, health, and healing in novel, dynamic, and lively ways. This article tells the story of how the visual arts can contribute to healing and also be viewed as part of a comprehensive cross sector prespective for achieving health and wellness.

In order to make the existing MBBS curriculum more effective as per the health care needs of the nation, Medical Council of India (MCI) has taken a bold step by proposing new teaching-learning approaches including a structured longitudinal programme on attitude, ethics and communication, which is named as the Attitude, Ethics and Communication Module (AETCOM). AETCOM which is a case-based module offers a framework of competency-based learning in the AETCOM domains that a medical professional must possess at the time of graduation to effectively fulfill the functions of an Indian Medical Graduate. Before implementing the AETCOM, the MCI introduced a mandatory training for the faculty of medical colleges through its nodal and regional centres. The authors of this paper analysed the open-ended feedback received from the participants participated in the nine AETCOM sensitisation workshops conducted in a tertiary care teaching hospital which is also an MCI Regional Centre for conducting faculty development programmes. The feedback from the faculty participants of AETCOM were compiled and analysed for better understanding of their concerns regarding AETCOM. Based on these compilations, the authors have discussed about the organisation of AETCOM module and the anticipated challenges as perceived by the faculty participants with suggested measures for encountering the challenges in transacting the module at undergraduate level under selected headings.