Kevin W Eva’s research while affiliated with University of British Columbia and other places

Medical Education's Editors announce that Really Good Stuff will now be published monthly, with rolling peer review. Read this to discover how to join our RGS Reviewer Panel.

Objectives: This study was aimed at improving clarity regarding the goals underlying motivation for attendance at international meetings to accommodate evolving needs. Methods: We performed a case study of a large international medical conference by undertaking (a) semi-structured interviews with 13 multi-disciplinary stakeholders, which underwent thematic analysis, and (b) surveys of 1229 conference attendees, which underwent descriptive statistical analysis and directed content analysis. Results: Interviews suggested scientific updates and networking are priorities for in-person formats whereas flexibility and reduced travel are priorities for virtual formats. Surveys suggested motivations for attending both in-person and virtual conferences included: scientific updates (81.3% and 85.4%, respectively) and advancements in patient care (76.6%, 78.2%). Social interaction (e.g., to meet experts 80.6% and make/deepen professional connections 69.3%) was highly rated for in-person meetings, but not virtual meetings (51.0% and 30.8%, respectively). 58.9% of attendees prefer future meetings to be hybrid, including both in-person and virtual formats. Conclusions: We found a disconnect between attendees' preferences and recommendations currently put forward as socially responsible in terms of climate, equity and diversity. Meeting organisers may need to educate others about the value and costs involved in hybrid formats. When hybrid formats are possible, our data provide guidance on what to prioritize during in-person components and how to combine those with the benefits of global accessibility and flexibility enabled by virtual technology.

Purpose To identify risk and protective factors associated with physician performance in practice; to use this information to create a risk assessment scale; and, to test use of the risk assessment scale with a new population of assessed physicians. Design Physician assessments that were completed by community-based physicians between March 2016 and February 2022 (n =2708) were gathered to determine what professional characteristics and practice context factors were associated with poor peer practice assessment (PPA). The predictive capacity of the resulting model was then tested against a new sample of physician assessments completed between March 2022 and February 2023 (n =320). Results N=2401 physicians were eligible for inclusion in a logistic regression analysis, which resulted in an empirical model containing 11 variables that was able to account for 21.6% of the variance in the likelihood of receiving a poor PPA generated by the College of Physicians and Surgeons of British Columbia. The resulting model, when tested against 320 new cases, was able to predict good versus poor PPA performance with a sensitivity of 0.79 and specificity of 0.75. Not having undertaken peer review (OR=1.47) created a risk like that arising from a full decade passing since completion of medical school (OR=1.50). Conclusion In addition to being the largest known study of its type, this work builds on similar studies by demonstrating the capacity to use regulator-mandated peer review to empirically identify physicians who are at risk of substandard performance using factors that are safe from claims of violating Human Rights Codes; that emphasize modifiable aspects of practice; and that can be readily updated to account for change over time.

What equity, diversity and inclusion issues are commented upon by Med Educ's reviewers? This commentary offers an analysis and recommendations for authors, reviewers and editors alike.

Introduction Research on feedback has shifted emphasis away from its ‘delivery’ to consideration of the interaction between individual learners and their ‘feedback provider’. The complexity inherent in determining whether feedback is perceived as valuable by learners, however, can quickly overwhelm educators if every interaction must be considered completely idiosyncratic. We, therefore, require a better understanding of variability in the ways in which feedback is perceived. To that end, we ran a discrete choice experiment aimed at determining residents' preferences and whether discernible patterns exist across learners regarding factors that influence perceptions of feedback's learning value. Methods We performed a discrete choice experiment in which respondents were asked to read a clinical case and select repetitively between two feedback scenarios that differed according to six attributes identified from the literature as influencing feedback credibility: Dialogue, Focus, Relationship, Situation, Source and Valence. By systematically varying the levels of each attribute contained in the scenarios and asking residents to choose which from each pair they deemed more valuable for learning, a mixed logit model and latent class analysis could be applied to determine learners' feedback preferences and whether clusters of preference exist. Results Ninety‐five elderly care medicine residents in the Netherlands completed the questionnaire. Their responses indicated that Valence, Dialogue, Relationship and Focus each accounted for about 20% of their preferences regarding the type of feedback perceived to offer the most learning value. Source and Situation were less influential, each accounting for 11% of the choices made. A latent class model with three clusters of respondents best accounted for the heterogeneity in feedback preferences. A total of 62% of respondents could be assigned to one of the three profiles with at least 80% probability. None of the respondents' characteristics (seniority, residency programme nor sex) were related to the feedback preference profile. Discussion Our findings suggest that ‘how’ feedback is provided has a greater influence on perceived learning value than who provides it. That said, variability exists in resident perceptions with no evidence (as yet) of factors that predict individual preferences. As such, tailoring to the needs and reactions of individual learners is likely to require open and ongoing conversations, and we recommend using the learner profiles generated through this study as a starting point because they provide classifications that could facilitate effective connections for the majority of residents.

Feedback from learners is important to support faculty development, but negative feedback can harm teachers’ motivation, engagement, and retention. Leaders of educational programs, therefore, need to balance enabling students’ voices to be heard with maintaining teachers’ enthusiasm and commitment to teaching. Given the paucity of research to explain or guide this struggle, we explored why and how education leaders grapple with negative learner feedback received about their teachers. Using an Interpretive Description methodology, 11 education leaders participated in semi-structured interviews. Discussion was stimulated by showing participants learner narratives they had previously asked to be deleted because they perceived the narrative to be overly critical. Transcripts were iteratively analyzed as codes were developed, refined, and combined into themes. Education leaders interpreted the scope, framing, and focus of the feedback to decide whether it was overly critical. Such determinations were combined with contextual considerations such as the teacher’s personal circumstances, the learning environment and how the teacher might react to think through what potential damage the feedback might do to the teacher. Throughout the process, leaders struggled with whether protecting teachers risked not protecting learners and remained unsure about the ethics of censoring student voices. Our study offers direction regarding how to optimize feedback to teachers while minimizing risks inherent in sharing negative feedback with them. Implications include that there is value in: (1) extending feedback interpretation support to teachers, education leaders and learners; (2) situating upward feedback in a coaching dialogue; and, (3) applying the same principles recommended for the provision of feedback to learners, to teachers.

The editors detail how Medical Education's 2025 State of the Science issue aimed to stimulate cross‐cultural dialogue for the betterment of our field.

Purpose Physicians often experience moral distress from being prevented from taking what they believe to be the right course of action. Although causes and consequences of moral distress have been studied, little research offers insight into the significance of feeling morally challenged, especially in medicine. This study was undertaken to advance understanding of what physicians experience when encountering morally challenging situations and to examine how those experiences influence their interactions with the world of health care. Method Guided by hermeneutic phenomenology, the authors conducted semistructured interviews with purposefully sampled Canadian physicians from September 2022 to January 2023. Analysis used Van Manen’s 6 activities of hermeneutic research and included “story crafting” to sharpen insights. Late in that process, Van Manen’s “lived existentials” was determined to provide a strong framework for physicians’ experiences of moral distress. Results Of the 12 physicians interviewed, all experienced varied and long-lasting emotional reactions to morally challenging experiences. The emotions associated with moral distress, reported as inevitable, were experienced in ways that aligned with the lived existentials of body, space, time, and relations. Conclusions A richer understanding of physicians’ lived experiences with moral distress can help mentors and educators more thoughtfully engage in conversations about it with colleagues and learners. This study highlights the core dimensions of moral distress through body, space, time, and relations, thereby providing a means to enrich discussion about emotions and their transformational power. Through such nuanced consideration, calls for emotional candor may be strengthened to enhance practice by acknowledging the scope of impact that efforts to deliver care are likely to provoke.

The Editor‐in‐chief shares the tremendous news of this year's award winners (and a final warning about the looming Medical Education Unleashed deadline).