[Show abstract][Hide abstract] ABSTRACT: Today's medical students (tomorrow's doctors) will be entering a world of conflict, war and regular outbreaks of infectious diseases. Despite numerous international declarations and treaties protecting human rights, the last few decades has been fraught with reports of "lapses" in medical professionalism involving torture and force-feeding of detainees (e.g. captured during the War on Terror) and health care professionals refusing to treat infected patients (e.g. HIV and Ebola). This paper provides some historical background to the changing status of a physician's duty to treat and how medical practitioners came to be involved in the inhumane treatment of detainees during the War on Terror, culminating in reports of "lapses" in professionalism. The Theory of Planned Behavior, which takes into account the individual, the environment and the social context, is used to explain the factors that might influence an individual's behavior in challenging situations. The paper concludes with some recommendations for medical and health professions education. The recommendations include selecting students who, as a minimum, can provide evidence of "basic" professionalism, engaging them in exploring the history of the medical profession, exposing them to contexts of uncertainty and moral dilemmas and challenging them to reflect on their responses.
[Show abstract][Hide abstract] ABSTRACT: ContextStudents who engage in self-regulated learning (SRL) are more likely to achieve academic success compared with students who have deficits in SRL and tend to struggle with academic performance. Understanding how poor SRL affects the response to failure at assessment will inform the development of better remediation.Methods
Semi-structured interviews were conducted with 55 students who had failed the final re-sit assessment at two medical schools in the UK to explore their use of SRL processes. A thematic analysis approach was used to identify the factors, from an SRL perspective, that prevented students from appropriately and adaptively overcoming failure, and confined them to a cycle of recurrent failure.ResultsStruggling students did not utilise key SRL processes, which caused them to make inappropriate choices of learning strategies for written and clinical formats of assessment, and to use maladaptive strategies for coping with failure. Their normalisation of the experience and external attribution of failure represented barriers to their taking up of formal support and seeking informal help from peers.Conclusions
This study identified that struggling students had problems with SRL, which caused them to enter a cycle of failure as a result of their limited attempts to access formal and informal support. Implications for how medical schools can create a culture that supports the seeking of help and the development of SRL, and improves remediation for struggling students, are discussed.
No preview · Article · Apr 2015 · Medical Education
[Show abstract][Hide abstract] ABSTRACT: There is an increasing use of technology for teaching and learning in medical education but often the use of educational theory to inform the design is not made explicit. The educational theories, both normative and descriptive, used by medical educators determine how the technology is intended to facilitate learning and may explain why some interventions with technology may be less effective compared with others.
The aim of this study is to highlight the importance of medical educators making explicit the educational theories that inform their design of interventions using technology.
The use of illustrative examples of the main educational theories to demonstrate the importance of theories informing the design of interventions using technology.
Highlights the use of educational theories for theory-based and realistic evaluations of the use of technology in medical education.
An explicit description of the educational theories used to inform the design of an intervention with technology can provide potentially useful insights into why some interventions with technology are more effective than others. An explicit description is also an important aspect of the scholarship of using technology in medical education.
[Show abstract][Hide abstract] ABSTRACT: Abstract The capability approach, with its origins in economic and human development work, has a focus on the freedom of persons to make choices about how they wish to lead a valued life. There has been increasing recognition within general education that the capability approach offers a theoretical and practical framework to both implement and evaluate educational interventions that are designed to increase social justice, such as widening participation. There is great potential for the capability approach to also offer medical education a creative way for changing and evaluating curricula, with an emphasis on the teacher facilitating students to achieve their potential by recognising their aspirations and challenging the constraining factors to achieve their aspirations.
[Show abstract][Hide abstract] ABSTRACT: Abstract Responding to the healthcare needs of the twenty-first century is a challenge for medical education, requiring a holistic curriculum that stimulates intellectual growth and facilitates personal development of all learners. Self-authorship theory has a focus on the essential development of cognitive maturity, an integrated identity and mature relationships. The educational application of self-authorship situates learning in the experiences of learners and challenges learners' current worldview enabling them to take responsibility for their own decisions and actions. Implications for curriculum development and implementation are discussed, including the need to provide a challenging, yet supportive, learning environment. The use of self-authorship theory to inform educational research is also discussed.
[Show abstract][Hide abstract] ABSTRACT: Background: Posters are an integral part of academic conferences, but have limitations. e-Posters offer a new way to overcome these limitations, but their potential is largely under-utilised because of misconceptions regarding their design, creation and use at conferences.
Aim and Method: By drawing on literature and our own experience of creating and judging e-posters, we aim to present some ideas for e-poster designers so that they can fully utilise the potential of this new medium.
Results: We present ideas that begin with conceptual considerations and then move to practical applications (including technical suggestions)for designing, creating, and presenting effective e-posters.
Conclusions: In the not-too-distant future, we believe that e-posters will evolve to become the standard poster format, and these ideas will assist in the presentation of research at conferences through this format.
[Show abstract][Hide abstract] ABSTRACT: Ethnic minority (EM) medical students in the United Kingdom underperform academically compared to their Caucasian counterparts, but the reasons are unclear and further understanding is required.
To explore self-reported factors that might influence academic underperformance of EM medical students.
An online semi-structured questionnaire was used to identify associations between several dimensions that had been identified in previous research and obtain free-text comments.
Three-hundred and fifty-one medical students (73.3% Caucasian and 26.5% EM) from the Universities of Sheffield, Keele and London responded. EM medical students were less satisfied with their academic performance and less likely to feel they belonged to the medical school community due to their cultural background, including socio-economic factors.
Differences exist between EM and Caucasian medical students in their learning experiences in medical school. There is a need to increase awareness, for both medical students and teaching staff, of the impact of cultural diversity on academic performance at medical school.
No preview · Article · Jan 2015 · Education for Primary Care
[Show abstract][Hide abstract] ABSTRACT: Workplace learning happens in work processes in the context of work, is multi episodic, often informal, problem based and takes place on a just in time basis. While this is a very effective means of delivery, it also does not scale very well beyond the immediate context. We review three types of technologies that have been suggested to scale learning and three connected theoretical discourses around learning and its support. Based on an in-depth analysis of the challenges of two workplace learning domains, Healthcare and Building and Construction, four design-based research projects were conducted that have given rise to designs for scaling informal learning with technology. These projects also contributed to a model that provides an integrative view on three informal learning processes at work and how they can be supported with technology.
Full-text · Article · Dec 2014 · British Journal of Educational Technology
[Show abstract][Hide abstract] ABSTRACT: Abstract Making an accurate clinical diagnosis is an essential skill for all medical students and doctors, with important implications for patient safety. Current approaches for teaching how to make a clinical diagnosis tend to lack the complexity that faces clinicians in real-life contexts. In this Guide, we propose a new trans-theoretical model for teaching how to make an appropriate clinical diagnosis that can be used by teachers as an additional technique to their current approach. This educational model integrates situativity theory, dual-information processing theory and socio-cognitive theory. Mapping and microanalysis help the teacher to identify the main processes involved in making an accurate clinical diagnosis, so that feedback can be provided that is focused on improving key aspects of the skill. An essential aspect of using the new educational model is the role of the experienced clinical teacher in making judgments about the appropriateness of the learner's attempts to make a clinical diagnosis.
[Show abstract][Hide abstract] ABSTRACT: Objectives: The aim of the study was to develop and consider the usefulness of a new mixed-methods approach to evaluate the student-centredness of teaching and learning on undergraduate medical courses. An essential paradigm for the evaluation was the coherence between how teachers conceptualise their practice (espoused theories) and their actual practice (theories-in-use).
Methods: The context was a module within an integrated basic sciences course in an undergraduate medical degree programme. The programme had an explicit intention of providing a student-centred curriculum. A content analysis framework based on Weimer’s dimensions of student-centred teaching was used to analyze data collected from individual interviews with seven teachers to identify espoused theories and 34h of classroom observations and one student focus group to identify theories-in-use. The interviewees were identified by purposeful sampling. The findings from the three methods were triangulated to evaluate the student-centredness of teaching and learning on the course.
Results: Different, but complementary, perspectives of the student-centredness of teaching and learning were identified by each method. The triangulation of the findings revealed coherence between the teachers’ espoused theories and theories-in-use.
Conclusions: A mixed-methods approach that combined classroom observations with interviews from a purposeful sample of teachers and students offered a useful evaluation of the extent of student-centredness of teaching and learning of this basic science course. Our case study suggests that this new approach is applicable to other courses in medical education.
[Show abstract][Hide abstract] ABSTRACT: Background:
The recognition of medical professionalism as a complex social construct makes context, geographical location and culture important considerations in any discussion of professional behaviour. Medical students, medical educators and practitioners are now much more on the move globally, exposing them to cultural and social attitudes, values and beliefs that may differ from their own traditional perceptions of professionalism.
Aims and methods:
This paper uses the model of the intercultural development continuum and the concept of "cultural fit" to discuss what might transpire when a student, teacher or doctor is faced with a new cultural environment. Using our own experiences as medical educators working abroad and supported by evidence in the literature, we have developed four anecdotal scenarios to highlight some of the challenges that different cultural contexts bring to our current (Western) understanding of professionalism.
Results and conclusions:
The scenarios highlight some of the potentially different regional and/or cultural perspectives and nuances of professional behaviours, attitudes or values that many of us either take for granted or find difficult, depending on our training and socio-cultural upbringing. With this paper, we hope to start a long overdue conversation about global professionalism amongst medical educators, identify potential areas for research and highlight a need for medical schools to embrace a "global" approach to how professionalism is embedded in their curricula.
[Show abstract][Hide abstract] ABSTRACT: Developmental student support has a focus on developing the whole person, not only academic and clinical competence. The positive and proactive developmental approach is in marked contrast to the deficit and reactive approach to student support which only targets identified students who are considered to be “at risk”. The medical school is a nexus for personal development, combining the personal identity formation journey of early adulthood with the variety of new experiences in medical school. Important aspects of developmental student support are the development of resilience and ensuring reasonable adjustments for students with learning difficulties and disabilities. Careers guidance is an essential aspect of developmental student support, including students with doubts about a career in medicine and who are leaving because of poor performance. Developmental student support requires an organizational culture in which student support is considered as the responsibility of everyone, with further support from named personal tutors.
[Show abstract][Hide abstract] ABSTRACT: While several technological advances have been suggested to scale learning at the workplace, none has been successful to scale informal learning. We review three theoretical discourses and suggest an integrated systems model of scaffolding informal workplace learning that has been created to tackle this challenge. We derive research questions that emerge from this model and illus-trate these with an in-depth analysis of two workplace learning domains.
[Show abstract][Hide abstract] ABSTRACT: Reflection has become established as a key principle underpinning maintenance of standards within professional education and practice. A requirement to evidence reflection within performance review is intended to develop a transformative approach to practice, identify developmental goals, and ultimately, improve healthcare. However, some applications have taken an excessively instrumental approach to the evidencing of reflection, and while they have provided useful templates or framing devices for recording individualistic reflective practice, they potentially have distorted the original intentions. This article revisits the educational theory underpinning the importance of reflection for enhancing performance and considers how to enhance its value within current paediatric practice.
No preview · Article · Aug 2013 · Archives of Disease in Childhood