Pub Date : 2025-12-01Epub Date: 2025-03-12DOI: 10.1080/10872981.2025.2477666
Cate Goldwater Breheny, Angela Cebolla Sousa, Ana Vitoria Baptista
Resitting, being offered a 'second chance' at an exam following failure to achieve a passing grade, is both common and stressful in medical school. There is a significant gap in the medical education literature around evidence-based support for resitting medical students. The study explores medical student experiences of resits through a peer-assisted learning programme (PAL) delivered to early years resitting medical students at Imperial College School of Medicine (ICSM) in 2021 and 2022. To the authors' knowledge, this is the first qualitative study analysing early years medical students' experiences of resitting exams. The authors performed an inductive thematic analysis of 22 semi-structured interviews with early years medical students who resat exams at ICSM in 2022. The authors identified three key themes and a cross-cutting theme: Theme 1. Self: students' individual and internal characteristics and experiences that influenced their journey of resitting exams. Subthemes included self-sufficiency and students' emotional approach to resitting; Theme 2. Others: resitting students' social networks. Subthemes explored students' relationships as part of the ICSM academic community, with near-peer role models and with their emotional support networks; Theme 3. Structures: organisational and structural factors that influence student experiences of resit exams. Subthemes included academic information, welfare, and socio-economic factors. Cross-cutting theme. Stigma: experienced a lack of open communication around resitting. The data emphasises the holistic nature of resitting, with students' self-image, their relationships with others, and the structural and institutional context all impacting on their experience, cross-cut with their experience of stigma through silence. The authors suggest that resitting is about more than academic ability: the broader context of resit stigma plays a key role in students' experiences of resits. PAL may be a useful tool to address resit stigma alongside institutional commitments to rethink medical school culture around academic failure.
{"title":"Unpacking medical students' resit experiences: a qualitative study of early years medical students´ experiences of a peer-assisted learning programme during summer resit exams.","authors":"Cate Goldwater Breheny, Angela Cebolla Sousa, Ana Vitoria Baptista","doi":"10.1080/10872981.2025.2477666","DOIUrl":"10.1080/10872981.2025.2477666","url":null,"abstract":"<p><p>Resitting, being offered a 'second chance' at an exam following failure to achieve a passing grade, is both common and stressful in medical school. There is a significant gap in the medical education literature around evidence-based support for resitting medical students. The study explores medical student experiences of resits through a peer-assisted learning programme (PAL) delivered to early years resitting medical students at Imperial College School of Medicine (ICSM) in 2021 and 2022. To the authors' knowledge, this is the first qualitative study analysing early years medical students' experiences of resitting exams. The authors performed an inductive thematic analysis of 22 semi-structured interviews with early years medical students who resat exams at ICSM in 2022. The authors identified three key themes and a cross-cutting theme: Theme 1. Self: students' individual and internal characteristics and experiences that influenced their journey of resitting exams. Subthemes included self-sufficiency and students' emotional approach to resitting; Theme 2. Others: resitting students' social networks. Subthemes explored students' relationships as part of the ICSM academic community, with near-peer role models and with their emotional support networks; Theme 3. Structures: organisational and structural factors that influence student experiences of resit exams. Subthemes included academic information, welfare, and socio-economic factors. Cross-cutting theme. Stigma: experienced a lack of open communication around resitting. The data emphasises the holistic nature of resitting, with students' self-image, their relationships with others, and the structural and institutional context all impacting on their experience, cross-cut with their experience of stigma through silence. The authors suggest that resitting is about more than academic ability: the broader context of resit stigma plays a key role in students' experiences of resits. PAL may be a useful tool to address resit stigma alongside institutional commitments to rethink medical school culture around academic failure.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"30 1","pages":"2477666"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11905298/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143617349","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-03-07DOI: 10.1080/10872981.2025.2471433
Akila V Muthukumar, Zhi Ven Fong, Radek Buss, Santiago Rolon, Anai Kothari, Jashodeep Datta, Jed Calata, Gopika SenthilKumar
International medical students (IMS; non-U.S. citizens/permanent residents) greatly enhance the diversity of U.S. medical schools and serve in areas of greatest healthcare needs. Despite 15% of the US population being foreign born, international students represent < 2% of US-MD matriculants. Factors that contribute to this underrepresentation of IMS remain unknown. In this study, we analyzed the accessibility, quality, and inclusivity of publicly available admissions and financial aid policies at all US-MD schools, with the goal of evaluating potential institutional and informational barriers faced by IMS. Institutional webpages and American Association of Medical College (AAMC) databases were searched from May-July 2023 to gather IMS-specific admissions and financial aid information from 153 accredited US-MD schools. Two-tailed t-test or chi-square analysis was used to examine differences. An inductive thematic approach was used to qualitatively categorize institutional webpage friendliness. While 45% (69/153) of U.S.-MD schools reported accepting IMS, only 18% (27/153) admitted students without restrictions (e.g., Canadians only, state/religious preference). Further, 38% (26/69) of the schools that accept IMS did not provide financial aid information, while nearly two-thirds of the remaining schools required proof of personal financial ability with no institutional/federal support. International students also entered schools with a higher average Medical College Admission Test (MCAT) score and Grade Point Average (GPA). In the national AAMC databases, 19 additional programs were listed as accepting IMS although the institutional webpages stated otherwise; the databases also lacked details on specific restrictions posed by the majority of institutions. Of all 153 webpages, only 14% were deemed 'international friendly.' Restrictive admissions and financial aid policies as well as the poor quality and access to information are major barriers that affect IMS. Strategies that aim to overcome these challenges can greatly help advance diversity, equity, and inclusion in medical education.
{"title":"International students in United States allopathic medical education: a mixed-methods analysis of institutional policies.","authors":"Akila V Muthukumar, Zhi Ven Fong, Radek Buss, Santiago Rolon, Anai Kothari, Jashodeep Datta, Jed Calata, Gopika SenthilKumar","doi":"10.1080/10872981.2025.2471433","DOIUrl":"10.1080/10872981.2025.2471433","url":null,"abstract":"<p><p>International medical students (IMS; non-U.S. citizens/permanent residents) greatly enhance the diversity of U.S. medical schools and serve in areas of greatest healthcare needs. Despite 15% of the US population being foreign born, international students represent < 2% of US-MD matriculants. Factors that contribute to this underrepresentation of IMS remain unknown. In this study, we analyzed the accessibility, quality, and inclusivity of publicly available admissions and financial aid policies at all US-MD schools, with the goal of evaluating potential institutional and informational barriers faced by IMS. Institutional webpages and American Association of Medical College (AAMC) databases were searched from May-July 2023 to gather IMS-specific admissions and financial aid information from 153 accredited US-MD schools. Two-tailed t-test or chi-square analysis was used to examine differences. An inductive thematic approach was used to qualitatively categorize institutional webpage friendliness. While 45% (69/153) of U.S.-MD schools reported accepting IMS, only 18% (27/153) admitted students without restrictions (e.g., Canadians only, state/religious preference). Further, 38% (26/69) of the schools that accept IMS did not provide financial aid information, while nearly two-thirds of the remaining schools required proof of personal financial ability with no institutional/federal support. International students also entered schools with a higher average Medical College Admission Test (MCAT) score and Grade Point Average (GPA). In the national AAMC databases, 19 additional programs were listed as accepting IMS although the institutional webpages stated otherwise; the databases also lacked details on specific restrictions posed by the majority of institutions. Of all 153 webpages, only 14% were deemed 'international friendly.' Restrictive admissions and financial aid policies as well as the poor quality and access to information are major barriers that affect IMS. Strategies that aim to overcome these challenges can greatly help advance diversity, equity, and inclusion in medical education.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"30 1","pages":"2471433"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892059/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574276","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-01Epub Date: 2025-03-06DOI: 10.1080/10872981.2025.2474134
Jessica Martin, Rebecca Johnson, Lahia Yemane, Ndidi Unaka, Chineze Ebo, Jessica Hippolyte, Margaret Jones, Monique Quinn, Aisha Barber, Baraka Floyd, Rebecca Blankenburg, Sarah L Hilgenberg
Background: Anti-racism curricula are increasingly being recognized as an integral component of medical education. To our knowledge, there has not yet been a publication exploring resident perspectives from multiple institutions and explicitly representing both underrepresented in medicine (UIM) and non-UIM perspectives.
Objective: To explore and compare UIM and non-UIM pediatric residents' perspectives on the content and qualities of meaningful anti-racism curricula.
Methods: We performed an IRB-approved multi-institutional, qualitative study that incorporated Sotto-Santiago et al's conceptual framework for anti-racism education. Between February and May 2021, we conducted focus groups of UIM and non-UIM pediatric residents at three large residency programs in the United States. We developed focus group guides using literature review, expert consensus, feedback from study team racial equity experts, and piloting. Focus groups were conducted virtually, audio-recorded, and transcribed verbatim. We employed thematic analysis to code transcripts, create categories, and develop themes until we reached thematic sufficiency. We completed member checking to ensure trustworthiness of themes.
Results: Forty residents participated (19 UIM and 21 non-UIM) in a total of six focus groups. We identified 7 themes, summarized as: 1) racism in medicine is pervasive, therefore (2) anti-racism education is critical to the development of competent physicians, and 3) education should extend to all healthcare providers. 4) Residents desired education focused on action-oriented strategies to advance anti-racism, 5) taught by those with both learned and lived experiences with racism, 6) in a psychologically safe space for UIM residents, and 7) with adequate time and financial resources for successful implementation and engagement.
Conclusion: Our multi-institutional study affirms the need for pediatric resident anti-racism education, promotes co-creation as a method to affect culture change, and provides practical strategies for curricular design and implementation.
{"title":"Multi-institutional exploration of pediatric residents' perspectives on anti-racism curricula: a qualitative study.","authors":"Jessica Martin, Rebecca Johnson, Lahia Yemane, Ndidi Unaka, Chineze Ebo, Jessica Hippolyte, Margaret Jones, Monique Quinn, Aisha Barber, Baraka Floyd, Rebecca Blankenburg, Sarah L Hilgenberg","doi":"10.1080/10872981.2025.2474134","DOIUrl":"10.1080/10872981.2025.2474134","url":null,"abstract":"<p><strong>Background: </strong>Anti-racism curricula are increasingly being recognized as an integral component of medical education. To our knowledge, there has not yet been a publication exploring resident perspectives from multiple institutions and explicitly representing both underrepresented in medicine (UIM) and non-UIM perspectives.</p><p><strong>Objective: </strong>To explore and compare UIM and non-UIM pediatric residents' perspectives on the content and qualities of meaningful anti-racism curricula.</p><p><strong>Methods: </strong>We performed an IRB-approved multi-institutional, qualitative study that incorporated Sotto-Santiago et al's conceptual framework for anti-racism education. Between February and May 2021, we conducted focus groups of UIM and non-UIM pediatric residents at three large residency programs in the United States. We developed focus group guides using literature review, expert consensus, feedback from study team racial equity experts, and piloting. Focus groups were conducted virtually, audio-recorded, and transcribed verbatim. We employed thematic analysis to code transcripts, create categories, and develop themes until we reached thematic sufficiency. We completed member checking to ensure trustworthiness of themes.</p><p><strong>Results: </strong>Forty residents participated (19 UIM and 21 non-UIM) in a total of six focus groups. We identified 7 themes, summarized as: 1) racism in medicine is pervasive, therefore (2) anti-racism education is critical to the development of competent physicians, and 3) education should extend to all healthcare providers. 4) Residents desired education focused on action-oriented strategies to advance anti-racism, 5) taught by those with both learned and lived experiences with racism, 6) in a psychologically safe space for UIM residents, and 7) with adequate time and financial resources for successful implementation and engagement.</p><p><strong>Conclusion: </strong>Our multi-institutional study affirms the need for pediatric resident anti-racism education, promotes co-creation as a method to affect culture change, and provides practical strategies for curricular design and implementation.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"30 1","pages":"2474134"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11892060/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143574281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Aspiring to become a physician is a natural expectation for applicants to medical school. However, choosing a career in medicine is a critical decision, especially in countries where high school students can apply to medical school without an undergraduate degree. Students may select a medical career for various reasons, including parental pressure and academic performance. The question of whether there are students who enroll in medical school without clear intentions of becoming doctors has not been extensively investigated in the literature. We conducted a retrospective study at a national university in Japan. Given the scarcity of research examining medical students who did not have a clear intention to become doctors at the time of admission, we created a survey. The questionnaire asked students whether they had clear intentions to become doctors upon enrollment, and those who responded affirmatively were defined as students with clear intentions to become doctors at admission and assigned to the first group. The second group was composed of students who entered medical school without clear intentions to become doctors. We then compared the differences in sociodemographic characteristics and career determinants between these groups using statistical methods, including Chi-square tests and logistic regression. The collection rate of the questionnaire was 76.2%. We found that 28.8% of students at a national medical school in Japan entered medical school without clear intentions of becoming doctors. For these students, 'parental expectations' and 'peer influence' were identified as significant career determinants. No sociodemographic characteristics showed significant associations with the ambiguity of students' intentions to pursue a medical career at admission. This study confirmed that some students enroll in medical school without clear intentions of becoming doctors. The background factors related to this type of student were parental expectations and the influence of peers on career choice.
{"title":"Ambiguous motivations in medical school applicants: a retrospective study from Japan.","authors":"Asuka Kikuchi, Ryuichi Kawamoto, Masanori Abe, Daisuke Ninomiya, Yoshio Tokumoto, Teru Kumagi","doi":"10.1080/10872981.2025.2467487","DOIUrl":"10.1080/10872981.2025.2467487","url":null,"abstract":"<p><p>Aspiring to become a physician is a natural expectation for applicants to medical school. However, choosing a career in medicine is a critical decision, especially in countries where high school students can apply to medical school without an undergraduate degree. Students may select a medical career for various reasons, including parental pressure and academic performance. The question of whether there are students who enroll in medical school without clear intentions of becoming doctors has not been extensively investigated in the literature. We conducted a retrospective study at a national university in Japan. Given the scarcity of research examining medical students who did not have a clear intention to become doctors at the time of admission, we created a survey. The questionnaire asked students whether they had clear intentions to become doctors upon enrollment, and those who responded affirmatively were defined as students with clear intentions to become doctors at admission and assigned to the first group. The second group was composed of students who entered medical school without clear intentions to become doctors. We then compared the differences in sociodemographic characteristics and career determinants between these groups using statistical methods, including Chi-square tests and logistic regression. The collection rate of the questionnaire was 76.2%. We found that 28.8% of students at a national medical school in Japan entered medical school without clear intentions of becoming doctors. For these students, 'parental expectations' and 'peer influence' were identified as significant career determinants. No sociodemographic characteristics showed significant associations with the ambiguity of students' intentions to pursue a medical career at admission. This study confirmed that some students enroll in medical school without clear intentions of becoming doctors. The background factors related to this type of student were parental expectations and the influence of peers on career choice.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"30 1","pages":"2467487"},"PeriodicalIF":3.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11841105/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143450517","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-31Epub Date: 2024-01-07DOI: 10.1080/10872981.2024.2302233
Kaylee Eady, Katherine A Moreau
When clinician-educators and medical education researchers use and discuss medical education research, they can advance innovation in medical education as well as improve its quality. To facilitate the use and discussions of medical education research, we created a prefatory visual representation of key medical education research topics and associated experts. We conducted one-on-one virtual interviews with medical education journal editorial board members to identify what they perceived as key medical education research topics as well as who they associated, as experts, with each of the identified topics. We used content analysis to create categories representing key topics and noted occurrences of named experts. Twenty-one editorial board members, representing nine of the top medical education journals, participated. From the data we created a figure entitled, Medical Education Research Library. The library includes 13 research topics, with assessment as the most prevalent. It also notes recognized experts, including van der Vleuten, ten Cate, and Norman. The key medical education research topics identified and included in the library align with what others have identified as trends in the literature. Selected topics, including workplace-based learning, equity, diversity, and inclusion, physician wellbeing and burnout, and social accountability, are emerging. Once transformed into an open educational resource, clinician-educators and medical education researchers can use and contribute to the functional library. Such continuous expansion will generate better awareness and recognition of diverse perspectives. The functional library will help to innovate and improve the quality of medical education through evidence-informed practices and scholarship.
当临床教育工作者和医学教育研究人员使用和讨论医学教育研究时,他们可以推动医学教育的创新并提高其质量。为了促进医学教育研究的使用和讨论,我们创建了一个关键医学教育研究课题和相关专家的前言式可视化表述。我们对医学教育期刊编委会成员进行了一对一的虚拟访谈,以确定他们认为哪些是关键的医学教育研究课题,以及他们将哪些人作为专家与每个确定的课题联系在一起。我们使用内容分析法创建了代表关键主题的类别,并记录了指定专家的出现情况。代表九种顶级医学教育期刊的 21 位编委会成员参与了调查。根据这些数据,我们创建了一个名为 "医学教育研究资料库 "的图表。该库包括 13 个研究课题,其中以评估最为普遍。它还注明了公认的专家,包括 van der Vleuten、ten Cate 和 Norman。图书馆中确定和收录的主要医学教育研究课题与其他文献中确定的趋势一致。包括基于工作场所的学习、公平、多样性和包容性、医生福利和职业倦怠以及社会责任在内的部分主题正在出现。一旦转化为开放式教育资源,临床教育工作者和医学教育研究人员就可以使用该功能图书馆并为其做出贡献。这种持续扩展将使人们更好地认识和认可不同的观点。功能图书馆将有助于通过循证实践和学术研究创新和提高医学教育质量。
{"title":"A Medical Education Research Library: key research topics and associated experts.","authors":"Kaylee Eady, Katherine A Moreau","doi":"10.1080/10872981.2024.2302233","DOIUrl":"10.1080/10872981.2024.2302233","url":null,"abstract":"<p><p>When clinician-educators and medical education researchers use and discuss medical education research, they can advance innovation in medical education as well as improve its quality. To facilitate the use and discussions of medical education research, we created a prefatory visual representation of key medical education research topics and associated experts. We conducted one-on-one virtual interviews with medical education journal editorial board members to identify what they perceived as key medical education research topics as well as who they associated, as experts, with each of the identified topics. We used content analysis to create categories representing key topics and noted occurrences of named experts. Twenty-one editorial board members, representing nine of the top medical education journals, participated. From the data we created a figure entitled, Medical Education Research Library. The library includes 13 research topics, with assessment as the most prevalent. It also notes recognized experts, including van der Vleuten, ten Cate, and Norman. The key medical education research topics identified and included in the library align with what others have identified as trends in the literature. Selected topics, including workplace-based learning, equity, diversity, and inclusion, physician wellbeing and burnout, and social accountability, are emerging. Once transformed into an open educational resource, clinician-educators and medical education researchers can use and contribute to the functional library. Such continuous expansion will generate better awareness and recognition of diverse perspectives. The functional library will help to innovate and improve the quality of medical education through evidence-informed practices and scholarship.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"29 1","pages":"2302233"},"PeriodicalIF":3.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10773632/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139111285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-31Epub Date: 2024-01-09DOI: 10.1080/10872981.2024.2302232
Faique Rahman, Vivek Bhat, Ahmad Ozair, Donald K E Detchou, Manmeet S Ahluwalia
India has been historically challenged by an insufficient and heterogeneously clustered distribution of healthcare infrastructure. While resource-limited healthcare settings, such as major parts of India, require multidisciplinary approaches for improvement, one key approach is the recruitment and training of a healthcare workforce representative of its population. This requires overcoming barriers to equity and representation in Indian medical education that are multi-faceted, historical, and rooted in inequality. However, literature is lacking regarding the financial or economic barriers, and their implications on equity and representation in the Indian allopathic physician workforce, which this review sought to describe. Keyword-based searches were carried out in PubMed, Google Scholar, and Scopus in order to identify relevant literature published till November 2023. This state-of-the-art narrative review describes the existing multi-pronged economic barriers, recent and forthcoming changes deepening these barriers, and how these may limit opportunities for having a diverse workforce. Three sets of major economic barriers exist to becoming a specialized medical practitioner in India - resources required to get selected into an Indian medical school, resources required to pursue medical school, and resources required to get a residency position. The resources in this endeavor have historically included substantial efforts, finances, and privilege, but rising barriers in the medical education system have worsened the state of inequity. Preparation costs for medical school and residency entrance tests have risen steadily, which may be further exacerbated by recent major policy changes regarding licensing and residency selection. Additionally, considerable increases in direct and indirect costs of medical education have recently occurred. Urgent action in these areas may help the Indian population get access to a diverse and representative healthcare workforce and also help alleviate the shortage of primary care physicians in the country. Discussed are the reasons for rural healthcare disparities in India and potential solutions related to medical education.
{"title":"Financial barriers and inequity in medical education in India: challenges to training a diverse and representative healthcare workforce.","authors":"Faique Rahman, Vivek Bhat, Ahmad Ozair, Donald K E Detchou, Manmeet S Ahluwalia","doi":"10.1080/10872981.2024.2302232","DOIUrl":"10.1080/10872981.2024.2302232","url":null,"abstract":"<p><p>India has been historically challenged by an insufficient and heterogeneously clustered distribution of healthcare infrastructure. While resource-limited healthcare settings, such as major parts of India, require multidisciplinary approaches for improvement, one key approach is the recruitment and training of a healthcare workforce representative of its population. This requires overcoming barriers to equity and representation in Indian medical education that are multi-faceted, historical, and rooted in inequality. However, literature is lacking regarding the financial or economic barriers, and their implications on equity and representation in the Indian allopathic physician workforce, which this review sought to describe. Keyword-based searches were carried out in PubMed, Google Scholar, and Scopus in order to identify relevant literature published till November 2023. This state-of-the-art narrative review describes the existing multi-pronged economic barriers, recent and forthcoming changes deepening these barriers, and how these may limit opportunities for having a diverse workforce. Three sets of major economic barriers exist to becoming a specialized medical practitioner in India - resources required to get selected into an Indian medical school, resources required to pursue medical school, and resources required to get a residency position. The resources in this endeavor have historically included substantial efforts, finances, and privilege, but rising barriers in the medical education system have worsened the state of inequity. Preparation costs for medical school and residency entrance tests have risen steadily, which may be further exacerbated by recent major policy changes regarding licensing and residency selection. Additionally, considerable increases in direct and indirect costs of medical education have recently occurred. Urgent action in these areas may help the Indian population get access to a diverse and representative healthcare workforce and also help alleviate the shortage of primary care physicians in the country. Discussed are the reasons for rural healthcare disparities in India and potential solutions related to medical education.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"29 1","pages":"2302232"},"PeriodicalIF":4.6,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10778416/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139404820","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-31Epub Date: 2024-02-16DOI: 10.1080/10872981.2024.2316986
Maya S Iyer, David Way, Barbara Overholser, Nancy Spector
Academics in medicine are frequently asked to serve on panels to discuss their clinical, research, education, administrative or personal expertise. While panel discussions are often the highlight of a conference or event, in the medical literature, there is very little published on how an individual can effectively prepare and present as an expert panelist. This paper offers guidelines that will enable academics to prepare, deliver, and engage in active dialogue during a panel discussion. Specific tactics include how to accept invitations to serve on a panel, conducting pre-panel conference meetings and background research, preparing concise opening statements and new insights, connecting with the audience, answering questions in a collaborative spirit, and debriefing after the panel. These guidelines will be valuable to any individual invited to serve on a panel discussion and will promote future panelists in engaging in constructive and fulfilling dialogue, with the ultimate goal of leaving the audience with a greater understanding of the topic of discourse.
{"title":"\"How to article:\" guidelines for serving on an expert panel.","authors":"Maya S Iyer, David Way, Barbara Overholser, Nancy Spector","doi":"10.1080/10872981.2024.2316986","DOIUrl":"10.1080/10872981.2024.2316986","url":null,"abstract":"<p><p>Academics in medicine are frequently asked to serve on panels to discuss their clinical, research, education, administrative or personal expertise. While panel discussions are often the highlight of a conference or event, in the medical literature, there is very little published on how an individual can effectively prepare and present as an expert panelist. This paper offers guidelines that will enable academics to prepare, deliver, and engage in active dialogue during a panel discussion. Specific tactics include how to accept invitations to serve on a panel, conducting pre-panel conference meetings and background research, preparing concise opening statements and new insights, connecting with the audience, answering questions in a collaborative spirit, and debriefing after the panel. These guidelines will be valuable to any individual invited to serve on a panel discussion and will promote future panelists in engaging in constructive and fulfilling dialogue, with the ultimate goal of leaving the audience with a greater understanding of the topic of discourse.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"29 1","pages":"2316986"},"PeriodicalIF":4.6,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10878348/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139742312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-31Epub Date: 2024-02-15DOI: 10.1080/10872981.2024.2312716
Tess I Jewell, Elizabeth M Petty
Introduction: People who identify as lesbian, gay, bisexual, transgender, queer/questioning, intersex, and other sexual/gender minorities (LGBTQ+) may experience discrimination when seeking healthcare. Medical students should be trained in inclusive and affirming care for LGBTQ+ patients. This narrative literature review explores the landscape of interventions and evaluations related to LGBTQ+ health content taught in medical schools in the USA and suggests strategies for further curriculum development.
Methods: PubMed, ERIC, and Education Research Complete databases were systematically searched for peer-reviewed articles on LGBTQ+ health in medical student education in the USA published between 1 January 2011-6 February 2023. Articles were screened for eligibility and data was abstracted from all eligible articles. Data abstraction included the type of intervention or evaluation, sample population and size, and key outcomes.
Results: One hundred thirty-four articles met inclusion criteria and were reviewed. This includes 6 (4.5%) that evaluate existing curriculum, 77 (57.5%) study the impact of curriculum components and interventions, 36 (26.9%) evaluate student knowledge and learning experiences, and 15 (11.2%) describe the development of broad learning objectives and curriculum. Eight studies identified student knowledge gaps related to gender identity and affirming care and these topics were covered in 34 curriculum interventions.
Conclusion: Medical student education is important to address health disparities faced by the LGBTQ+ community, and has been an increasingly studied topic in the USA. A variety of curriculum interventions at single institutions show promise in enhancing student knowledge and training in LGBTQ+ health. Despite this, multiple studies indicate that students report inadequate education on certain topics with limitations in their knowledge and preparedness to care for LGBTQ+ patients, particularly transgender and gender diverse patients. Additional integration of LGBTQ+ curriculum content in areas of perceived deficits could help better prepare future physicians to care for LGBTQ+ patients and populations.
{"title":"LGBTQ+ health education for medical students in the United States: a narrative literature review.","authors":"Tess I Jewell, Elizabeth M Petty","doi":"10.1080/10872981.2024.2312716","DOIUrl":"10.1080/10872981.2024.2312716","url":null,"abstract":"<p><strong>Introduction: </strong>People who identify as lesbian, gay, bisexual, transgender, queer/questioning, intersex, and other sexual/gender minorities (LGBTQ+) may experience discrimination when seeking healthcare. Medical students should be trained in inclusive and affirming care for LGBTQ+ patients. This narrative literature review explores the landscape of interventions and evaluations related to LGBTQ+ health content taught in medical schools in the USA and suggests strategies for further curriculum development.</p><p><strong>Methods: </strong>PubMed, ERIC, and Education Research Complete databases were systematically searched for peer-reviewed articles on LGBTQ+ health in medical student education in the USA published between 1 January 2011-6 February 2023. Articles were screened for eligibility and data was abstracted from all eligible articles. Data abstraction included the type of intervention or evaluation, sample population and size, and key outcomes.</p><p><strong>Results: </strong>One hundred thirty-four articles met inclusion criteria and were reviewed. This includes 6 (4.5%) that evaluate existing curriculum, 77 (57.5%) study the impact of curriculum components and interventions, 36 (26.9%) evaluate student knowledge and learning experiences, and 15 (11.2%) describe the development of broad learning objectives and curriculum. Eight studies identified student knowledge gaps related to gender identity and affirming care and these topics were covered in 34 curriculum interventions.</p><p><strong>Conclusion: </strong>Medical student education is important to address health disparities faced by the LGBTQ+ community, and has been an increasingly studied topic in the USA. A variety of curriculum interventions at single institutions show promise in enhancing student knowledge and training in LGBTQ+ health. Despite this, multiple studies indicate that students report inadequate education on certain topics with limitations in their knowledge and preparedness to care for LGBTQ+ patients, particularly transgender and gender diverse patients. Additional integration of LGBTQ+ curriculum content in areas of perceived deficits could help better prepare future physicians to care for LGBTQ+ patients and populations.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"29 1","pages":"2312716"},"PeriodicalIF":3.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10877666/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139742343","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-31Epub Date: 2024-09-05DOI: 10.1080/10872981.2024.2397864
Stefan Heber, Michaela Wagner-Menghin, Ivo Volf, Marjan Slak Rupnik, Diethart Schmid, Richard Marz, Michael J M Fischer
Assigning students to work in permanent teams is a design principle in Team-based learning (TBL). It has been assumed that a stable team composition supports the emergence of collaborative problem-solving and learning: when students became more familiar with each other, they shared more information and resolved discrepancies together, which in turn stimulated knowledge acquisition and comprehension. However, this assumption had not been probed by a randomized controlled trial with performance assessment as an outcome. In an online course for second term medical students, 50% of the students were reassigned to new teams for each of the 24 problems to be solved during four classes, thus precluding familiarity. The learning outcome was assessed shortly after the third of four classes by a domain knowledge test. Whether TBL teams were permanent or temporary did not affect the score of a domain knowledge test. As expected, participation in online TBL improved the domain knowledge test results. Overall, the permanent team seems to be less important for cognitive learning outcomes than previously assumed, but this may depend on the specific educational setting. However, team familiarity may still be important for team decision-making. As clinical reasoning in the medical workplace often involves collaborating in changing teams, future research on TBL should focus on how to utilize this format to prepare medical students for decision-making and optimal learning outcomes under these conditions.
{"title":"Short-term cognitive learning outcomes in team-based learning: is the permanent team important?","authors":"Stefan Heber, Michaela Wagner-Menghin, Ivo Volf, Marjan Slak Rupnik, Diethart Schmid, Richard Marz, Michael J M Fischer","doi":"10.1080/10872981.2024.2397864","DOIUrl":"10.1080/10872981.2024.2397864","url":null,"abstract":"<p><p>Assigning students to work in permanent teams is a design principle in Team-based learning (TBL). It has been assumed that a stable team composition supports the emergence of collaborative problem-solving and learning: when students became more familiar with each other, they shared more information and resolved discrepancies together, which in turn stimulated knowledge acquisition and comprehension. However, this assumption had not been probed by a randomized controlled trial with performance assessment as an outcome. In an online course for second term medical students, 50% of the students were reassigned to new teams for each of the 24 problems to be solved during four classes, thus precluding familiarity. The learning outcome was assessed shortly after the third of four classes by a domain knowledge test. Whether TBL teams were permanent or temporary did not affect the score of a domain knowledge test. As expected, participation in online TBL improved the domain knowledge test results. Overall, the permanent team seems to be less important for cognitive learning outcomes than previously assumed, but this may depend on the specific educational setting. However, team familiarity may still be important for team decision-making. As clinical reasoning in the medical workplace often involves collaborating in changing teams, future research on TBL should focus on how to utilize this format to prepare medical students for decision-making and optimal learning outcomes under these conditions.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"29 1","pages":"2397864"},"PeriodicalIF":3.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11382708/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142141417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-31Epub Date: 2024-10-08DOI: 10.1080/10872981.2024.2412394
Marijke Avonts, Nele R Michels, Olivier M Vanderveken, Benedicte Y De Winter, Katrien Bombeke
Teaching is an essential skill for future doctors. Peer-assisted learning (PAL)-where students take up a teaching role at an early stage of their training-is widely used in medical curricula. No studies have explored the long-term perceived impact of peer teaching. Therefore, we aimed to determine how former peer teachers reflected on PAL and its perceived long-term impact. In this longitudinal descriptive study, we conducted 42 semi-structured interviews with 11 former peer teachers at the University of Antwerp. Five of them were interviewed 6 months after PAL; 6 of them 9 years after PAL. This latter group was also interviewed during PAL in a previous study. We conducted secondary analyses of previously collected interviews, consistently comparing the findings with new data gathered from the current interviews. Using realist thematic analysis, topic summary themes were generated. Former peer teachers reflected on their PAL experience with a lot of satisfaction. Those meanwhile working as residents are still passionate about teaching. Peer teachers experienced a gain in clinical examination- and professional skills in the long-term, facilitating a smoother transition to their internship. Our findings suggest that PAL selects diverse but committed students. The longitudinal data demonstrate how PAL initiates or stimulates different skills in diverse students, including public speaking, teaching, time management, and self-efficacy in specific clinical skills. Regarding the chicken-and-egg question, our study encompasses both longitudinal cases illustrating the pre-existing skill theory and cases demonstrating how achieved competences were induced by PAL. Former peer teachers experienced long-term benefits of PAL, which eased their transition into the internship. PAL has the potential to ignite a lasting passion for teaching, providing diverse and unique learning opportunities not only for the most talented and 'pre-selected' medical students but also for a range of dedicated future clinicians.
教学是未来医生的一项基本技能。同伴辅助学习(PAL)--即学生在培训的早期阶段承担教学角色--被广泛应用于医学课程中。目前还没有研究探讨同伴教学的长期影响。因此,我们旨在了解前任同伴教师对 PAL 及其长期影响的看法。在这项纵向描述性研究中,我们对安特卫普大学的 11 名前同伴教师进行了 42 次半结构式访谈。其中 5 人在 PAL 结束 6 个月后接受了访谈,6 人在 PAL 结束 9 年后接受了访谈。在之前的一项研究中,后一组教师也在 PAL 期间接受了访谈。我们对以前收集的访谈进行了二次分析,并将分析结果与本次访谈收集的新数据进行了比较。采用现实主义主题分析法,得出了主题摘要。以前的同伴教师在回顾自己的 PAL 体验时感到非常满意。目前担任住院医师的同行教师仍然对教学充满热情。从长远来看,同伴教师在临床检查和专业技能方面都有所收获,从而更顺利地过渡到实习阶段。我们的研究结果表明,PAL 挑选的学生各不相同,但都很投入。纵向数据显示了 PAL 如何启动或激发不同学生的不同技能,包括公开演讲、教学、时间管理和特定临床技能的自我效能感。关于 "先有鸡还是先有蛋 "的问题,我们的研究既包括说明已有技能理论的纵向案例,也包括说明 PAL 如何诱导学生获得能力的案例。前同行教师体验到了 PAL 的长期益处,这缓解了他们向实习生的过渡。PAL 有可能点燃人们对教学的持久热情,不仅为最有天赋和 "预选 "的医学生,也为一系列兢兢业业的未来临床医生提供多样化和独特的学习机会。
{"title":"The perceived long-term impact of peer teaching in the skills lab. A descriptive interview study.","authors":"Marijke Avonts, Nele R Michels, Olivier M Vanderveken, Benedicte Y De Winter, Katrien Bombeke","doi":"10.1080/10872981.2024.2412394","DOIUrl":"10.1080/10872981.2024.2412394","url":null,"abstract":"<p><p>Teaching is an essential skill for future doctors. Peer-assisted learning (PAL)-where students take up a teaching role at an early stage of their training-is widely used in medical curricula. No studies have explored the long-term perceived impact of peer teaching. Therefore, we aimed to determine how former peer teachers reflected on PAL and its perceived long-term impact. In this longitudinal descriptive study, we conducted 42 semi-structured interviews with 11 former peer teachers at the University of Antwerp. Five of them were interviewed 6 months after PAL; 6 of them 9 years after PAL. This latter group was also interviewed during PAL in a previous study. We conducted secondary analyses of previously collected interviews, consistently comparing the findings with new data gathered from the current interviews. Using realist thematic analysis, topic summary themes were generated. Former peer teachers reflected on their PAL experience with a lot of satisfaction. Those meanwhile working as residents are still passionate about teaching. Peer teachers experienced a gain in clinical examination- and professional skills in the long-term, facilitating a smoother transition to their internship. Our findings suggest that PAL selects diverse but committed students. The longitudinal data demonstrate how PAL initiates or stimulates different skills in diverse students, including public speaking, teaching, time management, and self-efficacy in specific clinical skills. Regarding the chicken-and-egg question, our study encompasses both longitudinal cases illustrating the pre-existing skill theory and cases demonstrating how achieved competences were induced by PAL. Former peer teachers experienced long-term benefits of PAL, which eased their transition into the internship. PAL has the potential to ignite a lasting passion for teaching, providing diverse and unique learning opportunities not only for the most talented and 'pre-selected' medical students but also for a range of dedicated future clinicians.</p>","PeriodicalId":47656,"journal":{"name":"Medical Education Online","volume":"29 1","pages":"2412394"},"PeriodicalIF":3.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11463006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142394279","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}