BACKGROUND: Faculty development programs often focus on high-achieving academics, overlooking those with less ambitious academic goals. To address this gap, we launched a comprehensive faculty development initiative in J...BACKGROUND: Faculty development programs often focus on high-achieving academics, overlooking those with less ambitious academic goals. To address this gap, we launched a comprehensive faculty development initiative in January 2022, aiming to support all faculty through structured mentoring and individualized professional development. APPROACH: The program includes three main components: (1) new faculty orientation; (2) biannual, individualized mentoring sessions; and (3) department-wide initiatives such as webinars. Faculty participation and program impact were evaluated through surveys and tracking academic and clinical achievements. EVALUATION: In 3 years, participation grew from 13 to 26 mentees and 6 to 15 mentors, with 67% of faculty engaging in formal mentoring sessions. A survey conducted 2 years post-launch had a 70% response rate (41/59), including 11 mentees and 8 mentors. All new faculty reported that the orientation met their needs. Among mentees, 90% agreed or strongly agreed that mentoring enhanced promotion readiness and engagement in teaching and research. Outcomes included three internal grant recipients who launched new clinical programs, and 10 departmental award recipients. IMPLICATION: This faculty development model supports diverse academic goals, strengthens mentoring culture and enhances institutional success. Its flexible design can be tailored to meet the unique infrastructure and needs of other academic programs.
BACKGROUND: Final-year assistantships are a common feature of undergraduate curriculae, both in the United Kingdom and internationally. However, they often fail to adequately prepare students for practice, with task comp...BACKGROUND: Final-year assistantships are a common feature of undergraduate curriculae, both in the United Kingdom and internationally. However, they often fail to adequately prepare students for practice, with task complexity and low confidence as common barriers to engagement. In the face of increasing burnout amongst newly qualified doctors, and recent studies showing lack of preparedness upon qualification, interventions to improve the efficacy and utilisation of assistantships are urgently required. APPROACH: A 3-week longitudinal narrative simulation, framed within a virtual inpatient ward, was used to prepare final-year medical students for assistantship. The simulation used persistent patient narratives that could be affected by student actions across a range of learning activities. Students had the opportunity to practice autonomously taking greater responsibility for meaningful decisions in handovers, patient admissions and discharges, on-call and routine clinical tasks, emergencies and patient/family discussions. EVALUATION: The module was evaluated with semi-structured interviews and focus groups. Three main themes were identified: acting like a doctor, feelings of safety and feelings of legitimacy. Participants described the virtual ward as a stepping stone to participating on real wards during their assistantships by providing a safe but realistic environment to practice as an FY1, increasing self-efficacy and self-perceived professional identity. IMPLICATIONS: A longitudinal simulation using continuous patient narratives offered students realistic, consequence-driven engagement with doctor-level tasks, bridging the gap between classroom and clinical practice. Despite resource demands, this model may be a valuable tool to enhance assistantships, particularly in preparing students for roles typically inaccessible during training.
BACKGROUND: Interprofessional education (IPE) helps to prepare health professional students to deliver patient-centred care within collaborative team environments. However, large-scale delivery of IPE is challenging. Usi...BACKGROUND: Interprofessional education (IPE) helps to prepare health professional students to deliver patient-centred care within collaborative team environments. However, large-scale delivery of IPE is challenging. Using team-based learning (TBL) as a teaching and learning strategy, we sought to develop, implement and evaluate a large-scale learning activity on 'understanding, and learning from errors'. APPROACH: In 2023, 769 senior students from pharmacy (n = 145), nursing (n = 158), dentistry (n = 109), oral health (n = 46) and medicine (n = 311) were timetabled to participate in one of nine 2 h interprofessional sessions structured in TBL format, as a mandatory component of their unit of study. At least five facilitators from multiple disciplines were present at each session. EVALUATION: In total, 752/769 (98%) students attended their assigned TBL session. Following the TBL session, students were invited to complete a questionnaire using closed and open-ended items. Quantitative data were analysed using descriptive statistics. Qualitative data were analysed using thematic analysis. Students reported that the TBL structure enabled interdisciplinary collaboration on a clinical scenario, immediate feedback, and the opportunity to better understand patient safety and the roles of different disciplines. However, some students felt the clinical scenario lacked relevance to their disciplines. IMPLICATIONS: Our study provided a scalable and effective model for interprofessional learning using the TBL framework. In future iterations, consideration should be given to the number of disciplines per team, and the relevance of the clinical scenario.
INTRODUCTION: Many of the essential workplace skills interns (graduates of US medical schools who are in their first year of supervised practice as physicians) need to function in their roles are taught briefly (e.g., a...INTRODUCTION: Many of the essential workplace skills interns (graduates of US medical schools who are in their first year of supervised practice as physicians) need to function in their roles are taught briefly (e.g., a single didactic session) or are not formally taught at all. These role-specific skills-for example, managing a task list, constructing a patient handoff and calling a consultant-are not addressed like core medical knowledge subjects (e.g., diabetes) or clinical skills (e.g., procedures), which are reinforced through patient interactions, colleague discussions, supervisor feedback and didactics throughout residency. Understanding how interns learn their role-specific skills could empower them to manage their workplace learning opportunities. METHODS: We conducted a qualitative study to examine how interns acquire role-specific workplace skills. We conducted semistructured interviews of 16 interns in an internal medicine residency programme. Interview transcripts were analysed using template analysis. Codes were identified, refined and grouped into overarching themes. RESULTS: Interns described an iterative learning process ('trial and error') informed by peers and supervisors, reflection on the outcomes of completed tasks and technology. Participants identified time and workload pressures as positive influences on their learning. Planning, formal goal setting and direct feedback were not described; instead, interns recognised their progress retrospectively and subjectively, rather than using predefined benchmarks. CONCLUSION: Interns learn many role-specific skills through an iterative and unstructured approach that aligns with workplace learning literature. Targeted reflection and teaching and feedback from supervisors may enhance skill acquisition.
INTRODUCTION: Despite research on how Longitudinal Integrated Clerkships (LICs) influence career choice, few studies have examined how graduates' career paths shaped their LIC experiences, a key gap in guiding LIC develo...INTRODUCTION: Despite research on how Longitudinal Integrated Clerkships (LICs) influence career choice, few studies have examined how graduates' career paths shaped their LIC experiences, a key gap in guiding LIC development that meets diverse learner needs. This study examined perspectives on the LIC among graduates pursuing primary care (PC) versus non-PC, with career stage as a secondary aim. METHODS: This sequential mixed-methods quality improvement study examined the LIC at the Warren Alpert Medical School of Brown University, which trains students in PC and population medicine. A survey evaluating the LIC was sent to all its graduates. Interested survey respondents participated in interviews exploring LIC factors that supported success, required improvement and shaped career direction. Survey data were analysed using descriptive statistics and nonparametric tests and interview data with theoretical thematic analysis. RESULTS: Among 87 survey respondents, 51% (n = 44/87) were pursuing PC and 46% were not (n = 40/87). PC respondents rated the LIC more positively than non-PC respondents. Differences by career stage were minimal. Interviews with both PC (n = 12) and non-PC (n = 14) LIC graduates identified similar themes. Continuity and autonomy supported success, whereas preceptorship variability, lack of programme standardisation and limited inpatient exposure required improvement. Many described the LIC as instrumental in clarifying career direction and broadening their physician identity. CONCLUSIONS: PC graduates reported more positive LIC perspectives in surveys, though interviews identified shared experiences across PC and non-PC paths. Perceptions varied little by career stage. Findings suggest practical strategies, including strengthening faculty development and operational infrastructure for developing and enhancing LICs.
INTRODUCTION: Realistic simulation, including standardized patients, virtual reality and hybrid modalities, offers immersive and risk-free environments for psychiatric training, yet its impact on learner outcomes remains...INTRODUCTION: Realistic simulation, including standardized patients, virtual reality and hybrid modalities, offers immersive and risk-free environments for psychiatric training, yet its impact on learner outcomes remains unclear. This systematic review assesses how realistic simulation influences knowledge, skills and confidence in psychiatric education for healthcare students and professionals in medicine and nursing. METHODS: We followed PRISMA 2020 guidelines to search, screen and analyse articles in BVS, Embase, PUBMED and Scopus databases through 15 April 2025. We included quantitative studies with control groups that evaluated active, realistic simulation interventions in psychiatry. Four reviewers independently screened, extracted data and applied the JBI's critical appraisal tools, according to each study design to assess the trustworthiness, relevance and results of the published papers. RESULTS: Of 7690 records, eight studies met the inclusion criteria. Interventions spanned standardized patient encounters, video-based mental status exams, 360° lived-experience immersions, virtual-reality self-harm scenarios and cross-professional OSCEs. Most studies reported significant improvements versus traditional methods in diagnostic reasoning, clinical assessment, communication, empathy and self-reported confidence; one pilot found no between-group differences despite positive learner feedback. All studies clearly described instruments and objectives, 50% employed randomized or matched controls, 100% targeted student learning, 88% discussed limitations and 75% detailed applicability to medical curricula. CONCLUSION: Realistic simulation enhances multiple competencies in psychiatric education but is hampered by methodological heterogeneity and limited controlled designs. Standardized outcome measures, longitudinal follow-up and exploration of emerging modalities are needed to optimize and validate their role in mental health training.
INTRODUCTION: Understanding why faculty engage in medical education is critical because it illuminates how to sustain faculty motivation and engagement. This study uses self-determination theory (SDT) and practice theory...INTRODUCTION: Understanding why faculty engage in medical education is critical because it illuminates how to sustain faculty motivation and engagement. This study uses self-determination theory (SDT) and practice theory to examine how faculty perceptions of their own competence, autonomy and relatedness evolve as external perceptions of skills, meaning and practice also change. METHODS: We used longitudinal qualitative research to conduct a case study of nine faculty at one institution in the United States from AY2019-2020 through AY2023-24. Each faculty member was interviewed annually. Eight completed all interviews; one faculty left the study after the second year. After using reflexive thematic analysis to inductively code transcripts, we used theory to deductively code data. RESULTS: As societal and institutional perceptions of competence, autonomy and relatedness changed over the 4 years of the study, faculty perspectives of these factors changed. As expertise in social determinants of health gained importance, faculty with this experience grew more confident about their teaching skills, while those with less lost confidence. All faculty experienced greater autonomy over drawing boundaries around personal lives with the advent of the COVID-19 pandemic, but only the women faculty reflected on this during interviews. All experienced a loss of relatedness but found ways to connect virtually with each other and with students. CONCLUSION: Examining faculty engagement and motivation through SDT and practice theory with a longitudinal approach allowed us to understand how faculty perspectives about their roles as educators change over time and in relation to evolving contexts.
BACKGROUND: The underrepresentation of skin of colour in medical educational textbooks has been demonstrated in a variety of specialties. The representation of skin colour in UK ophthalmology textbooks remains unquantifi...BACKGROUND: The underrepresentation of skin of colour in medical educational textbooks has been demonstrated in a variety of specialties. The representation of skin colour in UK ophthalmology textbooks remains unquantified. Without adequate racially diverse educational resources for medical trainees, there is a risk to patient outcomes and diagnostic delays. In this paper, we aim to analyse the representation of skin colour to inform the development of future textbooks on the importance of racial inclusivity and diversity. METHODS: Four bestselling UK ophthalmology textbooks were reviewed using the Fitzpatrick's skin phototype scale to categorise images into Caucasian (Fitz I-III), medium (Fitz IV) and richly pigmented (Fitz V and VI). To assess reliability, a second observer reclassified a 10% sample. Images where skin colour was not representable were excluded. A total of 1644 images were reviewed, of which 460 were included for analysis. FINDINGS: Across the 460 images, 86.5% demonstrated Fitz I-III skin, and only 7.60% and 5.87% demonstrated Fitz IV and Fitz V and VI skin, respectively. CONCLUSION: The proportion of richly pigmented images was statistically significantly lower than the national demographic data suggesting an inadequacy in the representation of those from non-Caucasian backgrounds. Addressing this gap is essential to ensure equitable care for patients of all backgrounds.
BACKGROUND: Technology-enhanced learning (TEL) can promote knowledge consolidation and retention, feedback and active learning. There are scant data on how broad TEL usage affects assessment in clinical rotations. Throug...BACKGROUND: Technology-enhanced learning (TEL) can promote knowledge consolidation and retention, feedback and active learning. There are scant data on how broad TEL usage affects assessment in clinical rotations. Through learning analytics, we investigated TEL usage patterns in a paediatric medicine term, examining associations with student characteristics and assessment results. METHODS: TEL usage measures were extracted from virtual learning environment access logs for an in situ sample of 266 students who completed all assessments. The dataset included 38 measures that summarised 116,518 website accesses and 10,033 hours, reduced by principal components analysis to 12 independent TEL summary measures, input to K-means cluster analysis to identify usage patterns. Chi-square and analysis of variance were used to analyse differences in TEL usage clusters according to student characteristics and assessment results. RESULTS: A three-cluster K-means solution was the best fit for identifying TEL usage patterns with associated assessment results: 'Conscientious' (25.9% students; high TEL usage, high duration, high assessment results); 'Savvy' (54.55% students; selective TEL usage, moderate duration, good assessment results); 'Borderline'(19.6% students; low TEL usage, low duration, low assessment results). Although demographic differences were nonsignificant (p > 0.05), the 'Conscientious' cluster included more females and international students and the 'Borderline' cluster included more males and domestic students. CONCLUSIONS: We identified three TEL usage patterns that corresponded with assessment results in paediatrics. TEL usage review could enable early identification of at-risk students. While research in other disciplines would strengthen the results, embedding learning analytics into education programmes through dashboards, synchronous feedback and resource evaluation is recommended.
The challenge persists of engaging students in anatomy education, especially neuroanatomy. Conventional lectures often fail to accommodate the diverse learning preferences of students, leading to disinterest and stress....The challenge persists of engaging students in anatomy education, especially neuroanatomy. Conventional lectures often fail to accommodate the diverse learning preferences of students, leading to disinterest and stress. Innovative teaching methods, such as gamification and interactive learning, have shown promise. Recent advances, like 3D printing, card games and basic materials, have created more tactile models that enhance student engagement. Leipzig's anatomy department has developed a method called 'Acting-out' to teach and understand the spinal tracts, autonomic nervous and limbic systems. The 'Acting-out' method involves the collaborative creation of an enlarged neurological complex symbolising a particular aspect of structure, within which participants immerse themselves through role-playing scenarios, embodying and personifying a specific part or nerve structure. This method employs immersive 3D models, enhancing spatial understanding, encouraging collaboration and critical thinking. Students physically embody anatomical structures. Our 'Acting-out' method aligns with modern pedagogical principles. Physical activity enhances learning, while role play fosters deeper comprehension. Assigning roles and becoming structures provides unique perspectives, aiding memory retention. Peer teaching encourages reinforcement and cultivates a supportive environment. The 'Acting-out' method's unconventional approach has succeeded in engaging students. By stepping outside of traditional bounds, educators can offer students enriching, transformative educational experiences that prepare them for the dynamic demands of their career.
BACKGROUND: Competency-based medical education (CBME) is the cornerstone of undergraduate training in Canada. Entrustable professional activities (EPAs) assess competency in professional tasks, with narrative feedback be...BACKGROUND: Competency-based medical education (CBME) is the cornerstone of undergraduate training in Canada. Entrustable professional activities (EPAs) assess competency in professional tasks, with narrative feedback being a key component. There is currently a lack of published literature on the quality of narrative feedback in EPA observations in undergraduate medical education. This study explores the quality of narrative feedback in EPA observations provided to medical students. METHODS: The quality of narrative feedback in a random sample of anonymised EPA observations from Year 3 students was evaluated using the Evaluation of Feedback Captured Tool (EFeCT). The EFeCT tool explores five facets of quality feedback, with a score of five indicating high-quality feedback. Three evaluators independently assessed the quality of narrative feedback using the EFeCT tool. Any differences in score were resolved through discussion to reach consensus. RESULTS: In the 2022-2023 academic year, 15,240 EPA observations were completed for year 3 students. A subset of 748 observations was analysed. Of these, one scored 0, seven scored 1, 33 scored 2, 115 scored 3, 151 scored 4 and 441 scored 5 on the EFeCT tool. The mean EFeCT score was 4.3. CONCLUSIONS: Overall, the majority of EPA narratives provided moderate to high-quality feedback to students. However, variability was evident, and many EPA narratives were missing one or more elements of high-quality feedback. This could result in significant implications for learner development. Addressing contextual factors such as clinical workload and creating faculty development opportunities may support faculty in providing high-quality narrative feedback.
BACKGROUND: In medicine and medical education, women are disproportionately affected by gender bias. Artificial intelligence (AI) is increasingly being employed in medical education. As gender bias exists within AI, ther...BACKGROUND: In medicine and medical education, women are disproportionately affected by gender bias. Artificial intelligence (AI) is increasingly being employed in medical education. As gender bias exists within AI, there is a risk of reinforcing gender stereotypes if AI is used to generate images of medical professionals. We examined whether the gender distribution of doctors seen in AI-generated images was representative of UK specialty trainee doctors. METHODS: Free-to-use AI text-to-image generators were used to create 1200 images across 30 specialties. NHS England recruitment data provided figures on gender. Specialties accounting for < 0.25% of overall recruitment were excluded as small numbers precluded meaningful analysis. Each image was independently reviewed by both authors and classified (male/female/not-classifiable). Any disagreement was resolved by discussion. 'Not-classifiable' images were removed from analysis. Gender distribution between the AI images and recruitment data was compared (chi-squared test, significance p < 0.05). FINDINGS: There was a significantly higher proportion of males in the AI-generated images compared to NHS specialty data (82% vs. 47%; p < 0.0001). Notably, both AI tools created no images of female general practitioners, orthopaedic surgeons or urologists. Conversely females were overrepresented as dermatologists, obstetricians and gynaecologists and plastic surgeons. CONCLUSION: The finding of representational and presentational gender bias in AI-generated images of doctors is consequential because 'visual culture' within medical school, and beyond, matters. We contend that healthcare educators ought to employ caution when using AI and consider developing guidance on responsible use of AI imagery; otherwise, they risk perpetuating, rather than challenging, harmful gender stereotypes about medical career pathways.
Medical education policy is increasingly tasked with addressing complex ethical, social, and institutional demands. The 2025 Declaration by the World Federation for Medical Education (WFME) calls on institutions to suppo...Medical education policy is increasingly tasked with addressing complex ethical, social, and institutional demands. The 2025 Declaration by the World Federation for Medical Education (WFME) calls on institutions to support the well-being of medical students, postgraduate trainees and practising physicians. While positioned as a progressive move toward systemic accountability, this paper argues that the Declaration raises significant concerns of legitimacy, authority, and coherence. Drawing on critical policy analysis, we interrogate the Declaration's authorship, scope, language and evidentiary base to examine how it constructs and performs authority. Our analysis reveals four key tensions: (1) the absence of transparent authorship and consultation, undermining representational legitimacy; (2) ambiguous definitions producing jurisdictional and operational uncertainty; (3) inconsistent normative language that performs obligation without enforcement; and (4) reliance on epistemically narrow frameworks without contextual adaptation. These ambiguities risk overstating WFME's remit and diminishing the Declaration's practical utility. We argue that for policy texts to advance global medical education meaningfully, they must be grounded in transparent authorship, plural epistemologies, contextual relevance and actionable mechanisms. Without these, declarations may reproduce symbolic authority rather than foster substantive institutional change.
BACKGROUND: Engagement in training is a key predictor of identifying as a health professional, satisfaction with the learning process, academic persistence and success and social commitment. Student interest groups are a...BACKGROUND: Engagement in training is a key predictor of identifying as a health professional, satisfaction with the learning process, academic persistence and success and social commitment. Student interest groups are a promising approach to engaging learners and teaching core values and skills associated with quality care. APPROACH: An interprofessional program to train health professions students to deliver primary care to high-need communities developed a virtual student-centred, student-led curriculum delivered through interprofessional student interest groups, formed on the basis of shared interest in current priority healthcare topics. The authors surveyed trainees to assess their engagement, perceptions and recommendations for program development. EVALUATION: Quantitative analysis indicated that, overall, students were satisfied with the interest group program. Several factors were correlated with student satisfaction, including support from leadership and experiencing influence in the group through engagement and input. Students agreed that interest groups effectively explored the subject matter and taught interprofessional care skills. Group organization, roles and responsibilities, communication about objectives, leadership support and the virtual platform are key areas for improvement in the future. IMPLICATIONS: Student interest groups show potential as an effective, low-cost approach for engaging students, teaching the value of serving populations with greatest need and teaching Interprofessional Education Collaborative (IPEC) competency. Implementation may be enhanced by combining virtual and in-person interest group training with community-based training in team-based care to vulnerable communities.
BACKGROUND: Point-of-care ultrasound (POCUS) is increasingly used by internal medicine physicians to improve diagnostic accuracy and clinical outcomes. Despite its value, POCUS is not widely integrated into undergraduate...BACKGROUND: Point-of-care ultrasound (POCUS) is increasingly used by internal medicine physicians to improve diagnostic accuracy and clinical outcomes. Despite its value, POCUS is not widely integrated into undergraduate medical education, particularly during the core internal medicine clerkship, due to barriers such as limited faculty expertise and institutional resources. APPROACH: We evaluated a 2-week internal medicine POCUS elective for fourth-year medical students, offered from 2020 to 2023 at Saint Louis University School of Medicine, as a potential model for integration into the internal medicine clerkship. Designed and facilitated by a single faculty member, the elective included formal didactic sessions, faculty-led scanning using ultrasound simulators and standardised patients, as well as self-directed reading and online modules. Student outcomes were assessed through pre- and post-course knowledge assessments and self-reported confidence surveys. EVALUATION: Between 2020 and 2023, 23 students completed the elective. Average knowledge assessment scores increased from 58.8% pre-course to 91.8% post-course, representing a 33% improvement (p < 0.0001). All 12 students who completed the confidence survey reported that the elective increased their knowledge and understanding of POCUS. IMPLICATIONS: Although initially designed for fourth-year medical students, this POCUS elective provided knowledge and hands-on skills relevant to internal medicine. Its flexible format and low faculty burden suggest it may serve as a scalable model for incorporation into core internal medicine clerkships, including at institutions with limited POCUS-trained faculty or resources.