INTRODUCTION: Disabled healthcare professionals offer valuable expertise yet face systemic barriers in education and practice. This study explores perspectives of professional organizations on the inclusion of students (...INTRODUCTION: Disabled healthcare professionals offer valuable expertise yet face systemic barriers in education and practice. This study explores perspectives of professional organizations on the inclusion of students (SRA) and practitioners (PRA) requiring accommodations in health and human service (HHS) professions. METHOD: Using an exploratory qualitative design framed within a critical disability studies lens, 28 representatives from professional organizations across 10 HHS professions in Canada participated in semistructured interviews. Data were analysed to identify key themes related to their perceived roles and perspectives on challenges faced by SRA/PRA, and how organizational policies impact inclusion. RESULTS: Three key themes highlighted the multilayered challenges of acknowledging and supporting SRA/PRA: (1) We do not know what we do not know; (2) not our responsibility; and (3) between a rock and a hard place. Many participants reported that this study marked the first time they had explicitly considered SRA/PRA within their organizational mandate, a foundational finding underpinning all three themes. Findings revealed limited awareness of SRA/PRA needs and experiences within organizational structure, uncertainty about their responsibility for addressing accessibility, often in favour of public protection or professional standards, and systemic obstacles constraining their ability to implement inclusive policies. DISCUSSION: Inclusion of SRA/PRA represents a 'wicked problem': While equity and inclusion are already embedded in many professional mandates, tacit ableist discourses constrain the agency of professional organization representatives and perpetuate the systemic marginalization of SRA/PRA in HHS professions. Results provide insights and recommendations for dismantling these barriers and promoting equitable and accessible pathways into and through HHS education and practice.
BACKGROUND: There is limited published evidence supporting integrated team-based learning (TBL) as an effective method for teaching undergraduate medical students. This study describes student and staff perceptions, asse...BACKGROUND: There is limited published evidence supporting integrated team-based learning (TBL) as an effective method for teaching undergraduate medical students. This study describes student and staff perceptions, assessment outcomes and financial factors after integrated TBL was implemented into Year 1 of a large UK undergraduate medical programme. METHODS: Five methods of data collection were used. An online survey was distributed to students, focus groups held with academic and technical staff, observation of teaching sessions, analysis of student assessment data and calculation of expenses for TBL delivery. Quantitative data were summarised narratively; qualitative survey data were analysed using conceptual content analysis; focus group data were analysed using inductive thematic analysis; and expenses data were summarised narratively and compared with problem-based learning (PBL). RESULTS: A total of 449 participants were involved in this study. Students and staff had overall positive perceptions of TBL, highlighting the engaging and consistent teaching and learning approach, effective teamworking and real-world applicability of the weekly themes. Limitations raised were focused on logistical issues such as using new technology and session timing. Compared with previous cohorts taught through PBL, assessment analysis found mixed results by assessment type. Finally, TBL was found to be more financially viable than PBL through reduced staff time requirements despite initial cost outlays. CONCLUSION: TBL represents a potentially effective and efficient method for teaching undergraduate medical students on a large scale and should be considered by other medical programmes where increasing student numbers may affect the quality of PBL teaching.
BACKGROUND: Medical student electives play an important role in both personal and professional development. The need for medical students to have early exposure to teacher training skills has also been recognised. The Sy...BACKGROUND: Medical student electives play an important role in both personal and professional development. The need for medical students to have early exposure to teacher training skills has also been recognised. The Sydney Medical School elective in medical education was designed and implemented in 2021 in response to growing student interest in acquiring professional skills in teaching, as well as the global mobility restrictions at the time. We sought to explore students' perception of their experience. APPROACH: The 4-week elective was designed based on the successful 'Peer Teacher Training' programme for health professional students. Delivered online to 49/250 (20%) final year medical students, the programme consisted of 13 e-learning modules with required asynchronous and synchronous activities and formative assessment. EVALUATION: We collected qualitative data from 34 participants (69%) using a postcourse questionnaire. Students valued learning about educational theory with opportunities to practice teaching and feedback with their peers. The elective was found to enhance participants' confidence in teaching. Although students valued the flexibility afforded by online delivery, some expressed a preference for the inclusion of in-person learning activities. IMPLICATIONS: The medical education elective provided students with dedicated time to develop knowledge and skills in clinical teaching and fostered engagement and interest in teaching activities. Such electives present a valuable alternative for students and may offer an initial entry point into the clinician educator pipeline.
BACKGROUND: Management reasoning (MR), the component of clinical reasoning concerned with treatment planning, patient preferences and resource considerations, develops later than diagnostic reasoning and remains underemp...BACKGROUND: Management reasoning (MR), the component of clinical reasoning concerned with treatment planning, patient preferences and resource considerations, develops later than diagnostic reasoning and remains underemphasised in medical education. Despite calls to explicitly teach MR, instructional strategies remain scarce. APPROACH: We developed a mnemonic, the "Six R's of Management Reasoning," and implemented a 90-min workshop grounded in social constructivism. Between July 2023 and December 2024, we taught 22 sessions to 119 subinterns. Students used the mnemonic to collaboratively construct management plans and admission orders through case-based activities and facilitated discussions. EVALUATION: Using three levels of Kirkpatrick's model-reaction, learning and behaviour-we assessed the workshop through IRB-approved surveys, tests and workplace assessments. Postworkshop and postrotation surveys showed significant increases in students' confidence and ability to apply MR (all p < 0.001). Knowledge test scores improved from 81.7% to 93.3% (p < 0.001, Hedges's g = 1.20). Faculty assessments confirmed students' strengths in risk calculation and shared decision-making, though some students struggled with applying high-value care and citing evidence. IMPLICATIONS: The "Six R's of Management Reasoning" provided a practical tool for MR development, and activities selected based on social constructivism were effective and well received. Mixed performance in clinical settings suggests that MR requires longitudinal reinforcement, repeated patient encounters and continued mentorship beyond a single workshop. This approach is feasible for broader implementation and may serve as a foundation for intentionally integrating MR across the medical education continuum.
BACKGROUND: Pelvic examination is a core, yet anxiety-provoking, clinical skill in undergraduate medical education. Traditional teaching approaches-often opportunistic or reliant on simulation-have been criticised for di...BACKGROUND: Pelvic examination is a core, yet anxiety-provoking, clinical skill in undergraduate medical education. Traditional teaching approaches-often opportunistic or reliant on simulation-have been criticised for disembodying technical skill from relational and ethical practice. Gynaecology Teaching Associates (GTAs), trained educators who use their own bodies to teach and provide embodied feedback, have emerged as an alternative model. This scoping review aimed to map what is known about GTAs, whose perspectives are represented, and what factors influence implementation. METHODS: A scoping review was conducted in accordance with Arksey and O'Malley's framework and prospectively registered. Searches of MEDLINE, Embase, PsycINFO, ERIC and Scopus (June 2025) were supplemented by citation tracking and grey literature searches. English-language sources focused on GTAs were included, with no date restriction. Screening and data extraction were undertaken by two reviewers, with thematic synthesis conducted inductively. FINDINGS: Eighty-three sources were included. Four interrelated domains were identified: educational outcomes, finance, ethics and representation/standardisation. GTA programmes are consistently associated with reduced student anxiety, improved confidence and enhanced communication skills, though evidence is frequently short-term and self-reported. Financial constraints and logistical complexity present ongoing barriers. Ethically, GTAs are positioned as an advance on historical practices, yet concerns regarding GTA well-being and labour persist. Standardisation improves programme quality but may inadvertently narrow representations of bodily diversity. IMPLICATIONS: GTAs represent a pedagogically and ethically significant approach to pelvic examination teaching. Future research should prioritise longitudinal, multi-institutional evaluation, clearer definitions of effectiveness, patient-centred outcomes and co-produced standards to support sustainable, equitable implementation.
BACKGROUND: UK Foundation Year 1 doctors (FY1s) undergo 30 h of core teaching annually to supplement clinical experiential learning. Previous weekly hour-long teaching at our institution was unpopular due to curriculum i...BACKGROUND: UK Foundation Year 1 doctors (FY1s) undergo 30 h of core teaching annually to supplement clinical experiential learning. Previous weekly hour-long teaching at our institution was unpopular due to curriculum issues, difficulty in attending and focusing on teaching, and an overuse of lectures. This prompted the development of STR1DE-Simulation, Teaching and Reflection for FY1 Development and Education-which aimed to improve FY1s' satisfaction with a new teaching programme. APPROACH: STR1DE comprises six full-day sessions per year, each repeated six times (~12 participants per day). Competitively appointed and specifically trained near-peer teaching fellows design and deliver content. The curriculum is adapted in response to FY1s' feedback. Interactive educational techniques, including simulation, are used. Clinically relevant topics are prioritised while integrating core requirements from the Foundation Programme Curriculum. EVALUATION: STR1DE was attended by 168 FY1s over 3 years. Anonymised feedback forms were completed after each session. Quantitative data consistently showed high satisfaction (mean rating > 4.8/5 per session). The full-day format was preferred by 99.3% (N = 149). Qualitative feedback was collected via open-ended questions on the days' strengths and weaknesses. Thematic analysis showed that (1) the full-day approach, (2) the near-peer faculty and (3) the relevant and co-designed curriculum were key drivers of the positive quantitative feedback. IMPLICATIONS: STR1DE demonstrates that a full-day teaching programme, designed and delivered by near-peer teaching fellows, can be highly valued. Stakeholder engagement, learner involvement in curriculum development and creating a positive, collaborative learning culture are vital.
BACKGROUND: Health professions education (HPE) programmes prepare clinicians for roles as educators, leaders and scholars. Although prior evaluations report academic and identity outcomes, little is known about effects o...BACKGROUND: Health professions education (HPE) programmes prepare clinicians for roles as educators, leaders and scholars. Although prior evaluations report academic and identity outcomes, little is known about effects on clinical practice and patient care. This study explored how graduates of a HPE programme described changes in their clinical practice, patient interactions and professional roles. METHODS: We conducted a qualitative descriptive study using semi-structured interviews with graduates of certificate and degree programmes in HPE at a military affiliated institution. Interviews explored perceived influences on clinical practice, teaching, leadership and professional identity. Transcripts were analysed using reflexive thematic analysis. Reporting followed established qualitative research criteria. RESULTS: Twenty-six graduates participated, representing multiple disciplines and degree programmes. Three themes were identified. Teaching within clinical encounters described how graduates reframed patient encounters as opportunities for explanation, questioning and shared understanding. Partnership in practice reflected shifts toward collaborative communication, shared decision making and attention to patient perspectives. Reconsidering the clinician role captured how participants adopted an educator mindset, influencing interactions with colleagues and clinical teams. Graduates reported greater patience, curiosity and deliberate communication and described strengthened patient engagement and team relationships. CONCLUSIONS: Graduates perceived that HPE training influenced their clinical practice by shaping how they approached patient care and interprofessional collaboration. These findings suggest that HPE programmes may influence not only academic development but also everyday clinical work. Future research should examine links between these perceived changes and measurable patient and system outcomes.
BACKGROUND: The trainee requiring extra support (TRES) is a doctor who requires support from their supervisor beyond usual training provision. Supervision of a TRES has been consistently described as challenging, particu...BACKGROUND: The trainee requiring extra support (TRES) is a doctor who requires support from their supervisor beyond usual training provision. Supervision of a TRES has been consistently described as challenging, particularly for new consultants. However, this topic has not been explored in depth and existing literature has limited transferability to the UK hospital setting. This study aimed to explore supervision of a TRES from the supervisor's perspective by asking: What is the experience of new consultants when supervising a TRES in a UK hospital? METHODS: The study was conducted at a district general hospital in north-west England in 2024. Nine new consultants (within 5 years of completion of training) representing a range of specialties participated in face-to-face semi-structured interviews. Interviews were analysed using thematic analysis. RESULTS: Three themes were identified from thematic analysis: unprepared for the role of supervisor; needing a support network for supervision; and negative impact on self from supervision. Supervision of a TRES compounded challenges that new consultants faced when transitioning into their new role. Support provided to supervisors was inconsistent and was a determinant of supervisor experience. There were substantial time and emotional burdens on supervisors from supervision of a TRES. CONCLUSION: Supervision of a TRES was challenging for new consultants due to multiple interrelated factors. Consideration should be given to developing supervisor support networks and improving handover of trainee information. Further research should consider the pedagogy of supervision from the supervisor's perspective and investigate how to effectively prepare and support new consultants to supervise a TRES.
Simulation-based medical education (SBME) has emerged as a dominant pedagogical tool globally, yet its diffusion into low- and middle-income countries (LMICs) frequently occurs through uncritical transfer from high-incom...Simulation-based medical education (SBME) has emerged as a dominant pedagogical tool globally, yet its diffusion into low- and middle-income countries (LMICs) frequently occurs through uncritical transfer from high-income country (HIC) contexts. This viewpoint examines how coloniality, the enduring structures of power, knowledge and cultural hierarchy inherited from colonialism continue to shape SBME in LMICs. Drawing on the author's experiences as a simulationist in Sri Lanka and the United Kingdom, the paper explores how colonial assumptions manifest across three phases of simulation practice: design and planning, execution and facilitation and evaluation. In the planning stage, imported educational theories and faculty-development models often neglect local learning cultures and social hierarchies, resulting in pedagogical dissonance. In execution, simulation activities are frequently delivered in colonial languages and rely on equipment designed for Western physiologies, producing artificial learning encounters and limiting psychological safety. Evaluation processes, meanwhile, depend on HIC-derived metrics and standards that marginalise Indigenous perspectives and reinforce epistemic dependency. These practices collectively reproduce inequities that privilege Western frameworks while silencing local innovation and contextual adaptation. Decolonising SBME therefore requires deliberate awareness, reflection and re-design-through multilingual instruction, co-creation of contextually relevant scenarios and development of locally led faculty and research ecosystems. By reframing simulation not as a technology to be imported but as a relational, culturally situated educational practice, educators can create more authentic and equitable learning environments. This article calls on simulationists, educators and policymakers in both HICs and LMICs to recognise colonial legacies in SBME and to pursue inclusive, locally grounded approaches that enhance patient safety and learning outcomes without perpetuating dependency. Confronting coloniality within simulation is thus a necessary step towards the broader decolonisation of global medical education.