Wiley: Medical Education: Table of Contents

There is no way back home: A phenomenological study of the fears and future uncertainty of Afghan female medical students in Iran

Nadia Rehman, Xiao Huang, Chaocheng Zhou, Amir Mahmood — Wed, 10 Jun 2026 21:25:56 -0700

Abstract

Purpose

The Taliban's 2022 ban on women's higher education represented one of the most extensive gender-based restrictions in recent history. Little was known about how this ban shaped the educational experiences, professional identities and future expectations of Afghan female medical students studying abroad. This study examined how Afghan women enrolled in medical programmes in Iran understood their training, fears and imagined futures under the shadow of the ban.

Methods

This qualitative study employed Interpretative Phenomenological Analysis. In-depth online interviews were conducted with 25 Afghan female medical students enrolled in MBBS programmes across Iranian universities. Snowball sampling was used due to the sensitivity of the topic and the dispersed nature of the student population. Interviews were transcribed and analysed through iterative phenomenological coding to understand how participants interpreted their educational journeys and future possibilities.

Findings

Participants reported that the Taliban's restrictions created persistent feelings of fear, guilt and emotional burden. Many believed their medical degrees might lose value and described returning to Afghanistan as unsafe or impossible due to gendered limitations and escalating risks for women professionals. Despite these constraints, students actively reconstructed hope by exploring migration pathways, international licensing options and transnational strategies to support Afghan women. Becoming a doctor emerged as a symbol of purpose and resistance.

Discussion

The findings demonstrated that Afghanistan's education ban functioned as an enduring emotional, professional and identity-based disruption for Afghan women abroad. However, students also showed resilience by re-imagining attainable futures beyond Afghanistan. These findings highlight the need for trauma-informed support, structured academic advising and international mechanisms to protect educational and professional continuity for Afghan female medical students. In addition, this study contributes to international health professions education highlighting how educational disruption is experienced not only as interrupted access but also as a destabilisation of identity, belonging and professional futurity.

Validity of constructed‐response situational judgement tests in health professions education: A systematic review and meta‐analysis

Thu, 04 Jun 2026 17:25:54 -0700

Abstract

Introduction

Constructed-response situational judgement tests (CR-SJTs) are used internationally to assess personal and professional attributes in health professions admissions, with over one million applicants to more than 500 programs having used them in the last decade. Despite this, a synthesis of their validity is lacking. This study aimed to quantify the association between CR-SJT scores and measures of personal, interpersonal and professional performance in health professions education and to determine how moderating factors influence this relationship.

Methods

MEDLINE, EMBASE, CINAHL, ERIC, SCOPUS, Web of Science and grey literature sources (ProQuest Dissertations & Theses, EThOS and OpenGrey) were searched from inception to 7 April 2025. Search was supplemented by contacting experts and admissions directors to include unpublished quality assurance studies. Eligible studies evaluated a CR-SJT for applicants or trainees in health professions programmes and reported a quantitative relationship with a non-academic outcome (e.g., professionalism and communication). Of 463 full-texts reviewed, 27 met inclusion criteria. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, two reviewers independently extracted data and assessed risk of bias using the Quality In Prognosis Studies (QUIPS) tool. A multilevel random-effects meta-analysis was used to pool Fisher z-transformed correlation coefficients. Meta-regressions tested moderator effects, and sensitivity analyses examined bias impact. The primary outcome was the correlation between CR-SJT scores and measures of interpersonal or professional skills. Moderators included the construct congruence between the CR-SJT and the outcome measure, outcome type, publication type, and outcome assessment stage.

Results

The 27 studies yielded 100 unique effect sizes and were judged, in total, to be at moderate risk of bias. The pooled correlation between CR-SJT scores and outcomes was z = 0.22 (95% CI, 0.16–0.28; p < 0.001). Construct congruence was the only significant moderator; more congruent outcomes showed z = 0.32 (95% CI, 0.25–0.37), compared to that of less congruent outcomes (z = 0.17; 95% CI, 0.12–0.18). Publication bias was insignificant (Egger's test, p = 0.73).

Discussion

The use of CR-SJTs in health professions selection is supported by the evidence. Validity depends substantially on construct congruence between the CR-SJT and the outcome measure. Programs should consider CR-SJTs within their operational context and with deliberate attention to downstream evaluation alignment.

“We're Kind of in This Weird Space”: How Asian Americans physicians navigate perspectives towards race‐conscious admissions

Wed, 03 Jun 2026 19:58:52 -0700

Abstract

Introduction

(In)equity in admissions is a global conversation. Approaches to addressing these inequities include affirmative action, holistic admissions and race-conscious admissions. Different countries vary in their usage of these approaches: while some have nationwide policies to implement affirmative action through quota systems, others utilise more holistic approaches, which are determined by individual institutions. This study explored the perspectives of Asian American physicians regarding race-conscious admissions in medical education, using Poon and colleagues' multidimensional model of race class frames to understand how individuals navigate tensions between private and public interests.

Methods

Using an interpretive qualitative approach, we employed an inductive-deductive qualitative research methodology using purposeful, snowball sampling to identify participants. One-hour interviews were conducted with 25 Asian American physicians across the Northeastern, Southern, Midwestern and Western regions of the United States. Interview transcriptions were analysed using inductive and deductive thematic analysis.

Results

The majority of participants supported race-conscious admissions, but both groups (supporters and non-supporters) had fundamentally different interpretations of educational equity. We constructed five themes. (1) Understandings of Race-conscious Admissions examines whether participants held accurate understandings of race-conscious admissions policies; (2) Intersectional Realities versus Individual Merit explores how supportive participants viewed race and socioeconomic status as inextricably intertwined whereas unsupportive participants treated them as separate variables; (3) Public versus Private Interests demonstrates how supportive participants wanted to expand educational opportunities whereas unsupportive participants emphasised individual interests; (4) Evolution of Consciousness documents transformative experiences that facilitated movement from individualistic merit-based frameworks toward systemic understanding; and (5) Coalition versus Competition illustrates divergent visions for Asian American physicians. Critically, widespread misunderstanding of race-conscious admissions practices was identified, particularly among unsupportive participants.

Discussion

This study challenges monolithic representations of Asian American perspectives on race-conscious admissions, demonstrating significant heterogeneity that aligns with Poon's multidimensional framework. These results have significant implications for medical education policy, suggesting that efforts to build support for equitable admissions practices must address both factual misunderstandings and deeper philosophical differences about individual versus structural explanations for educational disparities. Future research should explore intervention effectiveness and examine how physicians' admissions policy attitudes relate to their clinical practice patterns with diverse patient populations.

Navigating early career intentions: A qualitative study of influences on specialty choices for medical students

Tim Dubé, Yanouchka Labrousse, Mariem Fourati, Éric Lachance — Tue, 02 Jun 2026 05:27:02 -0700

Abstract

Background

Medical students' career intentions and choices are shaped early in their education, at a time when their interaction with various specialties and professional influences is both formative and essential. Despite this being a pivotal period, the literature offers limited insights into what drives students' specialty choices during these early stages. Our study seeks to address this gap by exploring how medical trainees engage in sensemaking around specialty choice, navigating the interplay between individual aspirations, institutional contexts and perceived professional expectations.

Methods

We conducted an interpretive descriptive study with two consecutive student cohorts at a francophone university in Canada during the implementation of a new medical campus site. Using purposive convenience and snowball sampling, we held 10 focus groups (in-person and virtual): six with first- and second-year medical students and four with clinical teachers. Inductive thematic analysis was employed to interpret the data, enabling us to identify key patterns and relationships between participant perspectives.

Results

The participants' perspectives organised around five key themes including (a) navigating career indecision and decision-making processes, (b) role of lifestyle, work–life balance, and career sustainability, (c) role of early educational experiences in career selection, (d) influence of mentorship and role models on career orientation, and (e) hidden curriculum and perceptions of specialty prestige.

Conclusion

This study offers insights into the factors influencing medical students' specialty choices early in their training. By identifying actionable elements within the undergraduate medical curriculum and the broader learning environment, training programmes can better support students in making well-informed career decisions.

Virtual teaching and power dynamics: Implications for decolonial practices in LIC‐HIC educational partnerships

Tue, 02 Jun 2026 05:27:02 -0700

Abstract

Introduction

Global collaborations, particularly those between low-income (LIC) and high-income countries (HIC), may inadvertently reproduce the very power differentials they aspire to overcome. The Toronto Addis Ababa Academic Collaboration (TAAAC) is a partnership model deliberately built to follow a relational and invited guest model of collaboration with in-person teaching visits by University of Toronto (UofT) faculty to teach within Addis Ababa University (AAU) programmes. The COVID-19 pandemic required that teaching be conducted virtually, which provided an opportunity to explore our assumptions that an in-person component ensured contextual and relational accountability.

Methods

This study used a qualitative case study approach that was both descriptive and intrinsic in nature. We sought to examine and describe the adaptations that emerged in response to a shift towards virtual teaching and to understand the experiences of key stakeholders from both AAU and UofT within the specific context of the TAAAC collaboration.

Results

Two foundational principles of the TAAAC model were disrupted during the COVID-19 pandemic: its emphasis on local context and its relational component. As virtual teaching replaced the historical on-site teaching of TAAAC programme curricula, these historical structures were unable to mitigate power differentials between AAU and UofT faculty, teachers and leaders.

Discussion

The relational and context-specific aspects of the TAAAC model were undermined with the use of a virtual platform. Virtual teaching reinforced one-sided knowledge exchange and decontextualized teaching, thereby perpetuating epistemic injustice within TAAAC programmes. This injustice was experienced as a loss of accountability to the relationships that had built and sustained a longstanding LIC-HIC partnership. While virtual teaching has an allure of being efficient and accessible, our experience suggests that it may be poorly suited within partnerships where context and relationality are cornerstones of efforts to reshape dimensions of power.

Final‐year students' perspectives on socially responsive curricula in medical education: A qualitative case study

Anthea Hansen, Susan Van Schalkwyk, Cecilia Jacobs — Tue, 02 Jun 2026 05:27:02 -0700

Abstract

Introduction

There is urgency for health professionals to be better prepared to tackle health inequities. Transitioning to responsive and contextually relevant curricula is an important strategy to equip students to be both clinically competent and critically conscious of the contexts in which they provide health care. Although the literature suggests reframing medical education to be responsive, student engagement in this process remains limited. Little is known about how students understand and experience social responsiveness, or their involvement in reframing medical curricula to be more responsive. This paper, therefore, aims to explore how a medical curriculum has influenced undergraduate final-year medical students to become socially responsive.

Method

This was a qualitative exploratory case study positioned within a constructivist paradigm. Data were generated through focus group discussions and individual interviews. Rich picture drawings served as reflective prompts. Initially, 27 students participated. Three withdrew across the course of the study. Data were coded inductively and analysed using reflexive thematic analysis. All relevant ethical and institutional approvals were granted.

Results

The findings revealed that becoming socially responsive is a complex endeavour. Four intersecting themes were identified: (i) applying a socially responsive approach to health care; (ii) the culture and traditions of medicine; (iii) shattering of mindsets and (iv) the value of the student voice in the curriculum. The students expressed that the curriculum provided opportunities to engage with concepts related to social responsiveness. However, these opportunities were less frequent and were considered less valuable when compared to biomedical knowledge. Furthermore, the cultures and traditions of medicine were seen to create conditions that position students as consumers of the curriculum.

Conclusion

This paper argues that although the curriculum is an important aspect in developing social responsiveness in students, other aspects, such as the health system and what the student brings should also be considered. Additionally, the students should be considered co-constructors of their learning and key role players in transforming curricula to be socially responsive and contextually relevant.

‘You can't have an ego in this game’: A simulation primed qualitative inquiry of team reflection in paediatrics

Rustin Meister, Mary E. McBride, Jan B. Schmutz, Mark Adler, Walter Eppich — Tue, 02 Jun 2026 05:27:02 -0700

Abstract

Introduction

Acute care paediatric teams face ambiguous, dynamic patient care situations that demand adaptability to avoid patient harm. Team huddles and adaptation processes have shown promise in mitigating risk and reducing harm. One team process that may occur in huddles is team reflection (TR), defined as a team's capacity to consciously reflect on the group objectives or strategies to adapt to dynamic circumstances. Prior research on in-action TR during patient care episodes demonstrated improved team performance and learning. This study explored how interprofessional teams experience pre-action TR through a simulated huddle before patient arrival. A better understanding of pre-action TR behaviours may reveal an underutilized strategy for improving team function and patient outcomes.

Methods

The authors used simulation-primed qualitative inquiry to examine pre-action TR. Eleven multidisciplinary, interprofessional paediatric critical care teams (four to six members) participated in a simulation in which they were handed off a critically ill patient with imminent arrival time and instructed to plan care, immediately followed by focus groups to explore their experience of pre-action TR. A deductive then inductive approach to thematic analysis was applied using the TuRBO framework: (a) seeking information, (b) evaluating information, and (c) planning.

Results

Teams reported that pre-action TR behaviours fostered psychological safety, reduced barriers for sharing input, supported inclusive leadership, and enhanced shared mental model generation. These behaviours also enabled more effective and efficient planning. Importantly, participants described how pre-action TR behaviours both relied on and reinforced team dynamics such as team familiarity, trust, and psychological safety—highlighting their self-amplifying nature.

Conclusion

Pre-action TR behaviours promote team engagement and coordination, serving as a powerful tool in both training and practice. Integrating TR behaviours into huddles is a feasible strategy to strengthen team training, team dynamics and readiness. Future research should quantify its impact on team performance and patient outcomes.

Myths of contestation in the medical education curriculum: A dialogical exploration

Rachel H. Ellaway, Martina Kelly, Kent G. Hecker, Tasha R. Wyatt — Tue, 02 Jun 2026 05:27:02 -0700

Abstract

Purpose

In this paper, the authors use their collective experience as medical education scholars and change agents to engage in a dialogical approach examining five myths regarding the role of contestation in curricular change. In doing so, they argue that what is taught, how it is taught and what knowledge is valued in curricula is not a neutral decision; rather, it is the result of contestation, negotiation and compromise.

Approach

Five myths are contested: that curriculum planning is uncontested; that contestation is between two individuals; that curriculum is and should be the primary focus of contestation; that change is both necessary and desirable; and that consensus (or compromise) is valued over contestation. To challenge the myths, the author team engaged in a dialogic analysis prompted by a literature review on curriculum change and drawing on the authors' experiences as medical educators, which resulted in a suite of heuristics regarding how curriculum change can be both supported and opposed.

Findings

Curriculum, whether it changes or not, is a site of ideological struggle. Participants should anticipate and strategically navigate disagreement. Compromise, rather than victory, is often the outcome. There is a need to go beyond the basics of what is taught, how much it is taught and when. Change should not always be the goal, not least because it can lead to superficial reforms, unintended consequences and a neglect of rigorous pedagogical evaluation. The pursuit of consensus and buy-in from all members can inadvertently (and sometimes deliberately) stifle diverse perspectives, leading to long-term resentment and disengagement.

Implications

Educators need to identify, understand and constructively engage with different forms of contestation in curriculum planning and management. By attending to processes for engaging in contestation, it is hoped that more educators will feel empowered to raise their concerns and negotiate with others in a professional manner.

When I say … optimal distinctiveness

P. Vivekananda‐Schmidt, J. Sandars — Tue, 02 Jun 2026 05:27:02 -0700

Medical Education, Volume 60, Issue 7, Page 727-728, July 2026.

When I say … responsibility

Michael Sanatani — Tue, 02 Jun 2026 05:27:02 -0700

Medical Education, Volume 60, Issue 7, Page 729-731, July 2026.

Who gets to choose? Inequality and the illusion of choice in medical careers

Eliot L. Rees, Guilherme Movio — Tue, 02 Jun 2026 05:27:02 -0700

Medical Education, Volume 60, Issue 7, Page 724-726, July 2026.

Beyond the myths: Epistemic justice in curriculum contestation

Lindsey Pope, Lynsay Crawford — Tue, 02 Jun 2026 05:27:02 -0700

Medical Education, Volume 60, Issue 7, Page 721-723, July 2026.

Social accountability and the social determinants of rural medical career choice: Is a smorgasbord approach ethical?

Paul Worley, Lambert Schuwirth — Tue, 02 Jun 2026 05:27:02 -0700

Medical Education, Volume 60, Issue 7, Page 718-720, July 2026.

A field in motion: The parallel evolution of coaching in modern health professions education and elite sports

Rune D. Jensen, Kristoffer Henriksen, Sarah Williams — Tue, 02 Jun 2026 05:27:02 -0700

Medical Education, Volume 60, Issue 7, Page 716-717, July 2026.

Creating a versatile digital handbook to streamline medical student induction to brief clinical placements in specialist areas

Connor Williams, Helen Clarke — Tue, 02 Jun 2026 05:27:02 -0700

Medical Education, Volume 60, Issue 7, Page 820-821, July 2026.

BrainMed: A mobile platform for neurosurgical CPD in China

Qiao Zuo, Guoyang Zhang, Pengfei Yang, Jianmin Liu — Tue, 02 Jun 2026 05:27:02 -0700

Medical Education, Volume 60, Issue 7, Page 818-819, July 2026.

Hunting for identity: Scavenger hunts for student orientation

Jenny Blythe, Leila Saeed, Safiya Virji — Tue, 02 Jun 2026 05:27:02 -0700

Medical Education, Volume 60, Issue 7, Page 809-810, July 2026.

Sustaining leadership growth through alumni‐led Learning Circles

Sookyung Suh, Boyung Suh, Andrew Sanghyun Lee — Tue, 02 Jun 2026 05:27:02 -0700

Medical Education, Volume 60, Issue 7, Page 814-815, July 2026.

The Rural Generalist Pathway for medical students: An antidote to despair

Frances Kilbertus, Sarah Newbery, Cheri Bethune, Erin Cameron — Tue, 02 Jun 2026 05:27:02 -0700

Medical Education, Volume 60, Issue 7, Page 816-817, July 2026.

Empowering students to tackle social needs

Sriram Palepu, Sarita Damaraju, Esther Pak, Lauren Eberly — Tue, 02 Jun 2026 05:27:02 -0700

Medical Education, Volume 60, Issue 7, Page 813-813, July 2026.

Dear donor—Humanising cadaveric dissection

Tamra Nathan — Tue, 02 Jun 2026 05:27:02 -0700

Medical Education, Volume 60, Issue 7, Page 811-812, July 2026.

Reflections on the 2026 award‐winning papers

Rola Ajjawi — Tue, 02 Jun 2026 05:27:02 -0700

Medical Education, Volume 60, Issue 7, Page 714-715, July 2026.

Issue Information

Tue, 02 Jun 2026 05:27:02 -0700

No abstract is available for this article.

The impact of coaching on professional identity development in postgraduate medical trainees: A scoping review

Roshanee Seth, Gerri Mortimore, Jill Gould, Vittoria Sorice — Tue, 02 Jun 2026 05:27:02 -0700

Abstract

Background

This scoping review explores the impact of coaching on the professional identity formation (PIF) of postgraduate medical trainees. Although coaching is well-documented in undergraduate medical education, its role in postgraduate medical education (PME) remains underexplored. This review aims to identify enablers and barriers to coaching in PIF, examine modalities employed and assess coaching's contribution to developing well-rounded, resilient physicians.

Methods

Following Arksey and O'Malley's scoping review framework and reported in accordance with the PRISMA-ScR guidelines, the research question was formulated using the Joanna Briggs Institute's Population–Concept–Context (PCC) framework. A comprehensive, peer-reviewed search strategy was executed across PubMed, Embase, Web of Science and Google Scholar (first 20 pages). Grey literature was included, and no date limits were applied. Studies of any design focusing on coaching in PME were eligible. Titles and abstracts were screened using Rayyan, and full-text reviews were conducted independently by three reviewers using a negotiated consensual validation approach. An additional study was identified through snowballing. Data were extracted using a structured charting framework and analysed thematically.

Results

Of the 336 records identified through database searches, 20 studies met the inclusion criteria, including one added through snowballing. The literature highlighted diverse coaching modalities and their positive impact on PIF. Coaching supported trainees in professional development, identity evolution, career planning, resilience and well-being. It fostered psychologically safe environments for self-reflection, self-assessment and development of both technical and non-technical skills. However, qualitative and longitudinal research on coaching's effectiveness in PME remains limited.

Conclusions

This review emphasises coaching as a valuable tool in shaping postgraduate medical trainees' professional identity. A conceptual framework of coaching has been identified, and its integration into medical curricula may enhance reflective capacity, communication skills, resilience and overall well-being. Future research should prioritise the validation of this evidence-based coaching framework and its impact on fostering communities of practice to support identity formation, holistic physician development and care.

Policy to practice: Social accountability in medical school admissions—A scoping review

Tue, 02 Jun 2026 05:27:02 -0700

Abstract

Background

Medical schools worldwide are integrating social accountability into admissions to address health inequities, improve workforce distribution and enhance population health outcomes. While foundational frameworks exist, implementation outcomes of specific admissions policies remain underexplored. This scoping review maps how social mission mandates are operationalized within medical school admissions and examines reported impacts on applicant diversity, geographic representation and workforce alignment.

Methods

We conducted a scoping review using the Joanna Briggs Institute and Arksey & O'Malley frameworks. MEDLINE, Embase, Web of Science, ERIC and Education Source were searched from inception to 8 August 2024. Studies were included if they examined MD admissions incorporating defined social mission objectives and reported selection or enrolment outcomes. Screening and data extraction were performed in duplicate, and findings were synthesized descriptively and categorized inductively, and we reported findings following PRISMA-ScR guidelines.

Results

Seventeen studies (1994–2022) met inclusion criteria, spanning North America, Australia, Oceania, Europe, Africa and the Caribbean. Although searches ran to 8 August 2024, the newest eligible studies meeting our inclusion criteria were published in 2022. Three main categories of social accountability emerged: (1) Geographic and Practice Location, with admissions strategies targeting rural and underserved regions and reporting improved local retention; (2) Sociodemographic Equity, emphasizing admissions pathways for applicants from Indigenous, low-income, racialized and marginalized groups; and (3) Workforce Composition, focusing on recruiting future primary care and generalist physicians for underserved areas. Despite promising outcomes, including increased diversity, rural representation and generalist intent, several studies reported implementation challenges, inconsistent alignment with institutional missions, and limited long-term outcome tracking.

Conclusion

Social mission-driven admissions frameworks can advance physician workforce equity and alignment with community needs. However, their success depends on sustained investment, supportive institutional structures and integration across the education continuum.

Correspondence: Widening access must continue beyond admission

Zara Aayat Adil, Vinay Saini — Tue, 02 Jun 2026 05:27:02 -0700

Medical Education, Volume 60, Issue 7, Page 824-824, July 2026.

The double‐edged sword of AI in medical education

Zekai Yu, Weihao Cheng, Shangxuan Li — Tue, 02 Jun 2026 05:27:02 -0700

Medical Education, Volume 60, Issue 7, Page 822-823, July 2026.

When I say … lore

Kelsey A. Miller, Sayra Cristancho, Jonathan S. Ilgen, Renee E. Stalmeijer — Mon, 01 Jun 2026 19:05:05 -0700

Medical Education, EarlyView.

Caring for older adults: Students' experiences beyond the cure–care divide

Kenechi Herler, Louis John Koizia, Benjamin Howell Lole Harris — Fri, 29 May 2026 06:33:35 -0700

Medical Education, EarlyView.

Ready for interdependent or independent or unsupervised or autonomous practice? What's in a name?

Olle ten Cate — Tue, 19 May 2026 02:19:03 -0700

Medical Education, EarlyView.

Have researchers in health professions education pathologised medical training?

Dorene F. Balmer, May Shum, A. Emiko Blalock — Fri, 15 May 2026 07:10:10 -0700

Medical Education, EarlyView.

Conceptualising and assessing interdependent clinical performances: Early insights from emergency medicine and paediatric faculty

Fri, 15 May 2026 06:30:24 -0700

Abstract

Purpose

Patient care is inherently collaborative, yet traditional assessment methods often emphasise individual performance. This study explores how the concept of interdependence can be used for assessment within clinical settings by examining how faculty in Emergency Medicine (EM) and Paediatrics identify interdependence and distinguish between the different types when assessing residents.

Methods

We employed a mixed-methods survey design, recruiting board-certified faculty from EM and Paediatrics across Canada and the United States. Participants watched three different videos, each ranging from 3 to 7 minutes that depicted interdependent performances. After watching the videos, participants completed relevant Entrustable Professional Activity (EPA) assessments. Then, each video was broken down into smaller clips for participants to watch again. After watching each of the individual video clips, participants answered questions regarding their observations of interdependence, which included the type and appropriateness. After watching all the videos and their associated clips, participants provided Milestone ratings.

Results

A total of 126 faculty members participated, evenly split between EM and Paediatrics. Descriptive statistics revealed that participants were able to precisely identify interdependence, but notable differences in distinguishing between supportive and collaborative interdependence existed based on specialty. Open-ended responses support the notion that faculty conceptually understand the interdependence they observed in clinical scenarios. Correlation analyses indicated various relationships between interdependence assessments, EPAs and Milestone ratings.

Conclusion

This study highlights the complexities of assessing interdependence. Although faculty demonstrated an understanding of interdependence and were able to identify it, challenges remain with classification during real-time assessments. These findings underscore the need for faculty development and reflection on how to best use assessments of interdependence to measure residents' performance and contributions to collaborative patient care.

Where Does Yarigai Come From? Meaning and Fulfilment in Medicine When Cure Is Limited

Hiroshi Nishigori — Wed, 13 May 2026 06:19:49 -0700

Medical Education, EarlyView.

Accurate contextual reporting amidst dynamic AI curricula development: A response to Zainal and colleagues

Wed, 13 May 2026 04:43:55 -0700

Medical Education, EarlyView.

Disclosing mental health in medical education: A global qualitative meta‐synthesis

Sameera Aljuwaiser, Gwyndaf Roberts — Fri, 08 May 2026 05:21:39 -0700

Abstract

Introduction

Mental health disorders among medical students represent a persistent global challenge. Disclosure, defined as the act of revealing a mental health disorder to peers, educators or institutions, is shaped by cultural norms, institutional structures and professional expectations. Despite growing awareness of well-being, disclosure remains complex and fraught with stigma, confidentiality concerns and fears of professional repercussions. This international qualitative meta-synthesis explores how medical students experience and navigate mental health disclosure, aiming to clarify the social, cultural and institutional forces that shape disclosure decisions. It further seeks to inform policies that create psychologically safe learning environments.

Methods

A systematic search of nine databases (updated December 2025) identified peer-reviewed qualitative and mixed-methods studies published between 2013 and 2025. Data were synthesised using Thomas and Harden's thematic synthesis method within an interpretivist paradigm. Reporting followed the enhancing transparency in reporting the synthesis of qualitative research (ENTREQ) and preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines, and methodological quality was assessed using the critical appraisal skills programme (CASP) checklist. Confidence in the review findings was evaluated using confidence in the evidence from reviews of qualitative research (GRADE-CERQual). The review protocol was registered with the international prospective register of systematic reviews (PROSPERO; CRD42024521037).

Results

Eighteen studies from seven countries (n = 379 participants) met the inclusion criteria. Six overarching themes and 16 subthemes were identified. Key barriers to disclosure included stigma, professional anxiety, confidentiality concerns, institutional rigidity and uncertainty about support services. Peer influence emerged as the only consistent facilitator of disclosure. The findings illustrate how medical culture, systemic structures and social expectations intersect to sustain nondisclosure and limit access to support.

Conclusion

Disclosure of mental health disorders in medical education is a negotiated, relational process embedded within socio-cultural and institutional power dynamics. This synthesis advances understanding by situating disclosure within disability and critical theory frameworks, highlighting how ableism and professional identity norms perpetuate silence. Addressing these structural forces through inclusive policies and psychologically safe learning cultures is essential to normalising openness and supporting the well-being of future doctors.

A playlist approach to teaching osteoporosis risk factors

Jadah Keith, Kimberly Manning — Tue, 05 May 2026 04:29:10 -0700

Medical Education, EarlyView.

Professional identity struggles in healthcare professions education: A theoretical review

Sat, 02 May 2026 00:01:05 -0700

Abstract

Introduction

Professional identity formation in healthcare professions education (HPE) is a complex and often fraught process. Physicians and trainees experience identity struggles as they navigate their personal and professional development, along with the conflicting expectations, cultural norms and systemic pressures within the healthcare environment. Despite growing attention to these challenges, conceptual clarity around identity struggle remains limited.

Method

To advance theoretical understanding of identity struggle, we conducted a critical narrative review of identity theories from developmental psychology, social psychology and sociology. We selected three major theoretical traditions—Neo-Eriksonian, symbolic interactionist and social identity theories—and analysed their conceptualizations of identity, identity development and identity struggle. We examined these diverse perspectives to inform research and educational practice on professional identity formation in HPE.

Results

Each theoretical tradition offers distinct insights into identity struggle. Neo-Eriksonian theories emphasize exploration and commitment as central processes, framing struggle as developmental and potentially productive. Symbolic Interactionist theories highlight the role of socialization and identity dissonance, viewing struggle as emerging from tensions between personal agency and societal norms. Social Identity theories focus on group belonging and intergroup dynamics, conceptualizing struggle at both individual and socio-contextual levels. We provide common critiques and limitations of each theoretical tradition. These perspectives illuminate varied mechanisms through which identity struggle manifests and evolves.

Discussion

This review underscores the multifaceted nature of identity struggle and the value of theoretical pluralism in understanding professional identity formation. Struggle is not inherently negative; rather, it can be a catalyst for growth when appropriately framed and supported. We propose how educators and researchers might use these theoretical lenses to design interventions that foster productive identity development and address systemic contributors to identity struggles. We invite scholars drawing on critical perspectives of power and structure to challenge and deepen the conversation on identity struggle in HPE.

Audit to Action: Planetary health within medical curriculum

Thu, 30 Apr 2026 06:23:58 -0700

Medical Education, EarlyView.

‘Just a checkbox’: Growth mindset and feedback in resident experiences with EPA assessments

Amanda Hempel, Justin Boyle, Anique de Bruin, Shiphra Ginsburg — Thu, 30 Apr 2026 06:19:21 -0700

Abstract

Introduction

There have been consistent reports of tension between the dual goals of assessment of learning and assessment for learning in competency-based medical education. This is exemplified by assessments of Entrustable Professional Activities where trainees report a focus on assessment of learning and engaging in performance-oriented behaviours that undermine meaningful assessment. It has been proposed that fostering a growth mindset amongst trainees may encourage use of EPA assessments for learning. This study aimed to explore how trainee mindset interacts with their perception of the role of EPAs in assessment of and for learning.

Methods

We conducted 19 semi-structured interviews of residents enrolled in 12 Canadian specialty post-graduate programmes. Interviews explored residents' experiences with EPAs and their views on how tasks are learned. Transcripts were analysed using reflexive thematic analysis to generate themes.

Results

Though most participants described attitudes of a growth mindset and a desire to learn from failure, a minority described attitudes associated with a fixed mindset contributing to avoidance of unsuccessful EPA assessments, suggesting mindset may impact the use of EPA assessments for learning. However, even amongst residents expressing views consistent with a growth mindset, the lack of meaningful feedback on EPA assessments prevented them from being a tool for learning. Participants described a variety of system factors that undermined provision of meaningful feedback and a view that programmes utilised EPA assessments only as a checkbox.

Discussion

Even if a growth mindset may promote assessment for learning, a system that results in poor-quality feedback turns EPA-based assessments into an assessment of learning. An assessment system that supports both a culture of growth mindset and high quality of feedback is needed if EPA assessments are to be utilised for assessment for learning.

What could we learn from team sports? Cohesion as a lens to understand research teams in health professions education

Tim Dubé, Meredith Young — Thu, 30 Apr 2026 06:09:15 -0700

Abstract

Context

Research in health professions education (HPE) is increasingly produced by collaborative teams that transcend disciplinary, institutional and professional boundaries. Yet, despite the centrality of these teams to the field's scholarly output, we know little about the social and structural dynamics that enable research teams to function well. In this Cross-Cutting Edge paper, we argue that the concept of cohesion—well established in sport psychology as a determinant of team performance—offers a productive and underexplored lens for understanding HPE research teams. Cohesion captures both the task-related alignment that enables members to pursue shared scholarly goals and the social bonds that support communication, conflict navigation and sustained collaboration.

Discussion

Drawing on Carron's multidimensional model of team cohesion, we adapt four determinants of cohesion to the context of HPE research, including environmental, personal, leadership and team-level factors. We propose that these factors provide a conceptual scaffold for examining how research teams develop, function and sustain collaborative work over time. To support this argument, we integrate insights from sport psychology, team science and recent scholarship describing the nature of HPE research teams. Positioning cohesion as a conceptual lens opens new avenues for empirical inquiry into the life cycle of research teams, the conditions under which they thrive and the practices that support their development.

Conclusion

Greater attention to cohesion may strengthen research capacity, enhance team functioning and support high-quality collaborative inquiry in HPE.

Towards justice: Applying Rawlsian fairness to health professions education

Wed, 29 Apr 2026 22:50:27 -0700

Abstract

Context

Health professions education (HPE) continues to confront persistent inequities in access, opportunity and outcomes, even as diversity, equity and inclusion (DEI) initiatives have become increasingly contested within institutional and public discourse. Although DEI efforts draw upon a long intellectual tradition in the social sciences, DEI research within HPE remains undertheorized, in part because the field is often siloed from broader philosophical debates about justice and fairness. While these concepts are widely valued, they are interpreted and applied differently across cultural, political and institutional contexts, contributing to misunderstanding and resistance when DEI-oriented reforms lack explicit normative grounding. Revisiting the theories that underlie DEI work is therefore important for clarifying why inequities matter in HPE and how institutions justify efforts to address them.

Proposal

We highlight prioritarian moral reasoning as a foundational, though often implicit, commitment underlying DEI work in HPE. Prioritarianism holds that improving the position of those who are worse off carries special moral importance, particularly when disadvantage arises from structural conditions rather than individual choice. Within this framework, John Rawls's theory of ‘justice as fairness’ offers a lens for examining DEI in HPE institutions. Rather than presenting Rawls as a comprehensive or universally accepted theory, this paper situates his work alongside broader intellectual traditions that inform DEI and emphasizes its relevance for examining how educational opportunities are organized and justified.

Conclusion

Drawing on Rawls's emphasis on fair opportunity and attention to those least advantaged, the paper highlights how justice as fairness can be used pragmatically in admissions, curriculum, assessment and resource allocation. In particular, it invites HPE to ask whether the changes being implemented are acceptable under conditions of fair opportunity and whether they would improve the position of the least advantaged. Used this way, Rawls's ideas support efforts to identify structural barriers and design policies that expand meaningful opportunity.

The roots of resistance: An institutional ethnography of faculty opposition to social justice curricula in undergraduate medical education

Wed, 29 Apr 2026 20:36:35 -0700

Abstract

Introduction

Augmenting training on the social and structural determinants of health in medical education is essential for addressing health disparities and fulfilling medical schools' accreditation-mandated social accountability obligations. Despite these mandates, significant implementation challenges impede curricular efforts, including faculty capacity and resistance to teaching equity-focused content. To navigate this resistance, we must first understand it.

Methods

An institutional ethnography was conducted over 18 months at a Canadian medical school to trace how faculty resistance is socially and institutionally organised. Data included field observations, interviews with 14 faculty and curriculum leaders and analysis of 124 institutional and regulatory texts. Analysis traced how ruling relations and text-mediated practices shape faculty engagement with social justice education.

Results

Faculty resistance—manifesting as scepticism, discomfort and disengagement—was shaped by professional identities rooted in biomedicine and authoritative expertise, hierarchical structures and sociopolitical discourses that framed equity as ideological. Licensing examination objectives operated as boss texts that perpetuated these dynamics, producing tensions that sidelined health equity and social justice content in favour of biomedical priorities. A recursive ideological circle and institutional circuit reinforced the marginalisation of social justice in medical education.

Discussion

Faculty resistance to teaching health equity and social justice-oriented content is not simply individual or attitudinal, but an institutional product shaped by professional, structural and sociopolitical relations. Addressing this requires structural re-alignment across governance, regulatory frameworks and professional norms to position social justice as integral, rather than peripheral, to contemporary medical education and practice.

Using structured video review guidance to surface interprofessional participation patterns during ward rounds

Sze‐Yuen Yau, Ching‐Yi Lee, Szu‐Han Wang — Wed, 29 Apr 2026 17:19:04 -0700

Medical Education, EarlyView.

Premature closure underlies bias in medical diagnosis in students: A randomised controlled experiment

Tue, 28 Apr 2026 23:32:06 -0700

Abstract

Objective

The purpose of the study reported in this article was to shed light on the cognitive mechanism mediating between biasing information and diagnostic error. The literature suggests at least two different hypotheses: premature closure leading biased participants to spend less time on diagnosis or increased competition between diagnostic hypotheses. The latter hypothesis predicts that biased participants would spend more time reaching a diagnosis.

Method

Using the salient distracting findings (SDF) experimental paradigm, we biased 58 fourth-year medical students while diagnosing 12 clinical vignettes in a within-group incomplete block design under three conditions: cases presented without SDF, with SDF at the beginning and with SDF at the end. For each of these conditions, diagnostic accuracy, the number of SDF-related mistakes and time per word needed to process the case were recorded. The data were analysed using linear mixed modelling. Estimated marginal mean scores were reported.

Results

Participants confronted with salient distracting features (SDFs) at the beginning of a clinical case demonstrated significantly lower diagnostic accuracy (mean 0.11) compared with the No-SDF condition (0.27), representing a 61% reduction (F_2,693 = 11.995, p < 0.001), and made more SDF-related mistakes (F_{2, 693} = 16.395, p < 0.001). When SDFs were presented at the end of the case, diagnostic accuracy was also reduced (mean 0.17; 36% reduction), but processing time did not differ from the No-SDF condition. Only early presentation of SDFs was associated with reduced processing time per word (F_2,636 = 4.799, p < 0.01), consistent with premature closure.

Conclusion

These findings demonstrate that biasing information increases diagnostic error in medical students and that only early bias is associated with reduced information processing. The data do not support the competition hypothesis for early bias, as processing time did not increase under biasing conditions. Premature closure can therefore be directly observed rather than inferred, inviting further research.

Exploring the use of gender‐inclusive language amongst health care students and staff in obstetrics and gynaecology

Mon, 27 Apr 2026 19:00:47 -0700

Abstract

Introduction

Gender-inclusive language is increasingly recognised as essential in health care to ensure respectful and equitable care for transgender and gender-diverse individuals. However, the adoption of gender-inclusive language in Obstetrics and Gynaecology (O&G) may vary across generations and hierarchical levels, and the perspectives of students and staff on its use remain underexamined. This study aimed to explore how O&G learners and clinicians understand and use gender-inclusive language.

Methods

An exploratory qualitative study was conducted in a UK teaching hospital's O&G department. Data were gathered via an online survey (27 respondents) and follow-up semi-structured interviews (12 participants: 7 students and 5 clinical staff). The study design was guided by queer and generational theory, applied via a constructivist lens. Reflexive thematic analysis was used to identify key themes.

Results

Four themes were generated, reflecting generational, educational and power dynamics in gender-inclusive language usage. Students generally reported greater familiarity and commitment to gender-inclusive language, whereas some senior staff, but also a minority of students, voiced reservations or confusion. Hierarchical barriers were noted, with students hesitant to challenge non-inclusive language used by superiors. Participants highlighted perceived curricular gaps and limited explicit teaching on caring for sexual and gender minority patients, recommending longitudinal, practical training, supportive correction of mistakes and visible role-modelling. Structural obstacles, such as electronic record systems lacking non-binary options, further constrained inclusive practice. Despite varied enthusiasm, participants universally emphasised respectful communication as a common professional value, converging on the importance of inclusive language for patient dignity.

Conclusions

Gender-inclusive language uptake in O&G is shaped by generational, hierarchical, educational and structural factors; however, a shared commitment to respectful care provides common ground. Fostering supportive intergenerational dialogue and addressing structural barriers can enable consistent, respectful practice. Senior role-modelling and structured opportunities for juniors to teach upwards may further shift clinical culture without overburdening minority staff, ultimately improving care for gender-diverse patients.

Uncertainty management as multiple goal regulation

Adam G. Gavarkovs — Tue, 21 Apr 2026 22:55:00 -0700

Medical Education, EarlyView.

Normalising vulnerability, humanising learning: A qualitative exploration of dissonance and growth in clinical learning environments

Javeed Sukhera, Tess M. Atkinson, Mario Fahed — Tue, 21 Apr 2026 20:45:11 -0700

Abstract

Introduction

Dissonance is common in clinical learning, especially when experiencing conflict with prior beliefs, expectations, or developing identities. Yet, an understanding of how teachers and learners move from dissonance to growth in emotionally charged, hierarchical clinical environments remains underexplored. In this study, the authors sought to explore how teachers and learners experience and navigate dissonance in the context of equity-related pedagogy.

Methods

This qualitative study employed Constructivist Grounded Theory (CGT). Fifteen participants including medical students, residents, and faculty were recruited through purposive, theoretical, and snowball sampling. Data were collected through semi-structured interviews, which were analysed using constant comparative analysis to develop a theoretical framework.

Results

Participants described dissonance as a dynamic experience ranging from manageable discomfort to panic. Dissonant moments were especially intense when they involved hierarchy, surveillance, identity threat, ethical conflict, or perceived harm. In these conditions, learners often shifted toward self-protection and cognitive shutdown. Growth was more likely when educators normalised struggle, modelled vulnerability, and created structured opportunities for reflection. Participants also described trust and safety as reciprocally co-created: when teachers signalled curiosity and care, learners were more willing to disclose uncertainty and remain engaged, which in turn prompted further teacher investment.

Discussion

Findings reinforce that learners need supportive conditions to grow through dissonance. Such conditions include spaces where they can face challenges without fear of judgement or punishment. Findings suggest that creating such conditions remains difficult in medical education, where rigid hierarchies and institutional norms often erode psychological safety. This work extends prior research by showing how trust and safety are co-created in real time, with both learners and educators influencing and reinforcing each other's openness and vulnerability.

When I say … listening

Brian Tuohy — Sun, 12 Apr 2026 21:24:26 -0700

Medical Education, EarlyView.

‘Like an infant … trying to run a marathon’: A longitudinal audio‐diary study exploring the transition from medical school to internship

Stuart Redvers Pattinson, Hans Savelberg, Anique Atherley — Thu, 09 Apr 2026 04:08:01 -0700

Abstract

Introduction

The transition from student to doctor represents a challenging shift in identity and responsibility that many graduates find difficult to manage. To understand better how to support the transition to practice we need an exploration of graduates' experiences that does not see the transition as a single moment, but a continuous learning process. This study aimed to explore how medical students negotiate legitimate participation and professional identity formation (PIF) through time as they transitioned to internship in South Africa.

Methods

We conducted longitudinal qualitative research using audio-diaries and semi-structured interviews to collect data from students over 7 months as they transitioned from medical school to several different health care institutions for internship. Twenty-two students took part in entrance interviews, 20 collected audio-diaries and 17 took part in exit interviews. Data were analysed using a narrative analysis approach, using communities of practice (CoP) theory as a sensitising–analytic framework.

Results

We identified four dominant narrative plotlines in our data, revealing how legitimacy and PIF are constantly renegotiated through time. PIF faltered in medical school when students were excluded from hierarchical clinical teams, on graduation when they began to doubt their preparedness and in internship when participants were unable to demonstrate the competencies valued by CoPs within the demanding South African health care system. Professional identity was built when participants perceived themselves as being valued through their meaningful contributions to the shared enterprise of the CoP.

Discussion

We call for a change in our framing of preparedness from ‘preparedness for practice’ to ‘preparedness for transition’, shifting our conceptualisation of preparedness towards equipping students with the resources they need for a complex, contextual, ongoing process rather than a moment in time. This requires clinical learning environments that legitimise trainees as peripheral participants, where learning is orientated towards gaining experience, cultivating professional identity and supporting individuals in developing the confidence, adaptability and resilience that will allow them to thrive as they negotiate the ongoing transition from student to doctor.

From fragmentation to integration: Introducing the COMPEL module in competency‐based physiotherapy curriculum

Mariya Jiandani, Y. Praveen Kumar, Vrushali Panhale — Sun, 05 Apr 2026 18:34:19 -0700

Medical Education, EarlyView.

When I say … liberation pedagogy

Ugo Caramori, Marco Antonio de Carvalho‐Filho — Sun, 05 Apr 2026 18:23:48 -0700

Medical Education, EarlyView.

From mechanisms to systems: Reconceptualising supervised workplace learning in postgraduate medical education

Anél Wiese, Deirdre Bennett — Sat, 04 Apr 2026 02:09:26 -0700

Abstract

Background

Why do the same supervisory mechanisms (feedback, observation, entrustment) produce different learning experiences across clinical settings? Current research treats them as discrete behaviours rather than examining how they interact within local contexts. This study uses realist theory to reframe supervised workplace learning as contextually configured systems, examining how key mechanisms (the processes through which attending physicians and residents interact) couple differently across postgraduate clinical settings.

Methods

We conducted a realist-informed multiple case study across four clinical departments in Ireland (Geriatric Medicine, Surgery, Paediatrics and Infectious Diseases). Semi-structured interviews with residents and attending physicians explored everyday clinical work, learning and supervisory dynamics. Analysis proceeded in two phases: (1) within-case, theory-informed inductive analysis using a realist theory on supervised workplace learning as a sensitising concept; (2) cross-case configurational analysis tracing how six mechanisms (entrustment, support seeking, monitoring, modelling, meaning making and feedback) patterned differently by context.

Results

Fifty participants (38 residents, 12 attending physicians) were interviewed. All six mechanisms appeared in every setting but were organised into distinct patterns shaped by local conditions. Geriatric medicine: continuous monitoring and narrow entrustment produced high oversight with limited autonomy progression (shaped by patient frailty, strong continuity, containment culture). Surgery: tightly coupled entrustment-monitoring-feedback drove staged procedural progression (shaped by observable performance, resource scarcity, competitive selection). Paediatrics: fluid, overlapping mechanisms enabled relational negotiation (shaped by family-facing work, small teams and psychological safety). Infectious diseases: fragmented, reactive mechanisms produced discontinuous supervision (shaped by severe discontinuity, high workload, frequent roster changes). What distinguished settings was not mechanism presence but mechanism coupling (how mechanisms reinforced or constrained one another), producing systematically different outcomes.

Discussion

Supervision operates as a contextually adapted configuration of interdependent mechanisms, not a set of discrete behaviours. The same mechanisms organise into different patterns depending on local conditions (continuity, patient complexity, resources, culture), producing different learning experiences. These context-dependent patterns (not specialty templates) challenge policies that audit mechanism presence rather than mechanism function, positioning supervision as an emergent practice that requires both enabling structural conditions and skilful pedagogical enactment within those conditions.

Is AI replacing faculty? Rethinking faculty roles in medical education

Rebekah Cole — Sat, 04 Apr 2026 00:00:00 -0700

Medical Education, EarlyView.

Pragmatism: The ‘easy choice’ for early career medical education researchers?

Emma Claire Phillips — Wed, 01 Apr 2026 02:15:24 -0700

Medical Education, EarlyView.

The myth that slow test‐takers are worse students: Implications for time‐limited testing

Saul J. Weiner, Yoon Soo Park, Morton Ann Gernsbacher, Kristina H. Petersen — Mon, 30 Mar 2026 04:22:57 -0700

Abstract

Problem

Time-limited testing, a form of assessment in which participants have a fixed amount of time to complete an exam, remains a global standard across the medical education continuum from admissions through licensure and board certification. A wide-ranging literature, however, documents how speededness, the extent to which a test's time limit alters individual performance, poses a threat to both validity and equity. Specifically, some students require more time than allotted to complete an exam. When afforded more time, they perform as well as or better than those who complete it within the time constraints. While some students who need more time seek and obtain accommodations, many others—because of stigma or a lack of awareness that they have a disability—fall outside this group. Among those who seek accommodation, some are denied despite a diagnosed disability because they lack childhood documentation.

Myth

There is a lack of sufficient research evidence that people who complete academic tests rapidly are better at making appropriate clinical decisions or acting under time pressure, such as when a patient is bleeding into a surgical field. Rather, studies show experts know when to slow down to better manage a complex situation.

Implications

Eliminating speededness on exams could be accomplished through power tests that functionally eliminate time pressure for virtually all test takers. At a practical level, this could be achieved by giving all examinees maximum accommodation, which is typically double time. Leveraging new technology and optimizing test design, including utilizing computerized adaptive testing, shortening stems, providing fewer response items and allowing remote proctoring, could partially off-set the added time and associated testing centre costs. Given the critical need to accurately and equitably assess performance on these gatekeeping exams, we recommend eliminating time limits expeditiously.

When I say … absenteeism

Lorenzo Madrazo, Samantha Halman, Susan Humphrey‐Murto, Kori A. LaDonna — Tue, 24 Mar 2026 05:20:23 -0700

Medical Education, EarlyView.

Reprioritising consultation in scoping reviews: Clarifying purposes and practices

Marco Zaccagnini, Lauren A. Maggio, Christina St‐Onge, Tim V. Dubé — Sun, 22 Mar 2026 21:44:13 -0700

Abstract

The consultation stage of scoping reviews, originally proposed by Arksey and O'Malley and further developed by Levac et al and the Joanna Briggs Institute, remains a conceptually ambiguous and inconsistently applied component of knowledge synthesis. In this context, consultation refers to the planned, purposeful engagement with knowledge users to elicit input on priorities, interpretation and gaps and to inform dissemination strategies. Although consultation has been framed as a means to validate findings or inform dissemination, it is often treated as an optional or peripheral activity, if included at all. In this manuscript, we revisit the consultation stage as an integral, collaborative and methodologically embedded feature of scoping reviews, one that warrants the same reflexivity, rigour and transparency as other stages of the process. Drawing from recent critiques in the health professions education literature and our own experience conducting knowledge syntheses, we position consultation not as a standalone study or superfluous add-on but as a dialogical, contextually responsive strategy for engaging knowledge users meaningfully. We offer practical guidance on how to design and execute consultations with methodological intentionality, aligned with the scoping review's epistemological stance and research objectives. Through case examples from our work and additional strategies drawn from the literature, we highlight how consultation can enhance the credibility, usability and relevance of review findings. We also reflect on the ethical and epistemic considerations of consultation, including issues of authorship and the challenges that arise when feedback diverges from review findings. In doing so, we call for a shift in how the consultation stage is conceptualised, designed and reported in scoping reviews. Rather than viewing consultation as a symbolic or confirmatory gesture, we argue that it should be embraced as a dynamic, humanising process that deepens interpretation, challenges assumptions and expands the real-world applicability of scoping review findings.

Enhancing the success of undergraduate medical student research through a dual mentorship model

Long Bao Hoang, Siaw Cheok Liew — Thu, 19 Mar 2026 00:00:00 -0700

Medical Education, EarlyView.

Geopolitics, international collaborations and publication ethics

Sat, 14 Mar 2026 01:09:15 -0700

Medical Education, EarlyView.

Making case‐based learning work and why context matters

Skye Nandi Adams — Wed, 11 Mar 2026 05:20:18 -0700

Medical Education, EarlyView.

When I say … pragmatism

Ghaith Alfakhry, Danica Sims, Ariel Lindorff — Wed, 11 Mar 2026 05:12:56 -0700

Medical Education, EarlyView.

Multi‐speciality simulation to support holistic clinical reasoning across the patient journey

Ashita Leena Ramtohul, Sandiso Moyo, Neeraj Kumar Malhan — Tue, 10 Mar 2026 04:06:06 -0700

Medical Education, EarlyView.

Beyond imposter syndrome: Deconstructing the hidden architecture of belonging in medical schools

Xiaoshuai Li, Rui Wang — Mon, 09 Mar 2026 21:00:15 -0700

Medical Education, EarlyView.

Beyond warnings: Leveraging AI disagreement as a catalyst for reflective clinical reasoning

Yu Xiao, Yuan‐Xin Guo, Liang Liu, Zhong‐Rui Ma — Mon, 09 Mar 2026 20:56:17 -0700

Medical Education, EarlyView.

School‐based health centres: Interprofessional training for healthcare students

Isaac Bouhdana, Kathleen Morgan, David D'Arienzo — Thu, 05 Mar 2026 19:57:16 -0800

Medical Education, EarlyView.

From principle to practice: Developing a digital‐age clinical artificial intelligence ethics competence framework through early‐career doctors' experiences

Humairah Zainal, Voo Teck Chuan, Xin Xiaohui, Julian Thumboo, Fong Kok Yong — Thu, 05 Mar 2026 03:11:01 -0800

Abstract

Introduction

As artificial intelligence (AI) becomes increasingly embedded in clinical workflows, clinicians encounter ethical challenges that traditional, principle-based medical ethics education may not adequately address. Empirical evidence on clinicians' experiences with AI-related ethics is limited, constraining curricular improvement. This qualitative study explores how early-career doctors in Singapore perceive and negotiate ethical dilemmas arising from clinical AI use and translates findings into an operationalised competence framework for medical education.

Methods

Between April and June 2025, we conducted semi-structured interviews with 30 early-career doctors (1–5 years post-graduation) from nine public healthcare institutions in Singapore. Purposive sampling ensured diversity across specialties, institutions, gender and ethnicity. Interviews explored participants' AI-related ethical challenges in day-to-day practice and their perceptions of ethics training in medical school. Data were analysed using Braun and Clarke's (2022) reflexive thematic analysis, with codes developed iteratively and informed by the four classical bioethical principles as sensitising concepts—autonomy, beneficence, non-maleficence and justice. Interdisciplinary reflexive discussions guided the construction and interpretation of themes.

Results

Participants reported limited formal AI education. Seven recurring practical ethical challenges were identified: (1) system opacity, (2) dataset bias and generalisability, (3) data privacy and consent in networked environments, (4) insufficient patient-specific contextualisation of outputs, (5) risks of hallucinations, (6) ambiguous accountability and (7) cognitive offloading. These themes reframed classical bioethical principles through epistemic, relational and institutional lenses.

Discussion

Ethical competence for AI-mediated care requires integrated epistemic and relational capacities beyond technical literacy or traditional medical ethics. We propose the Digital-Age Clinical AI Ethics Competence (DCEC) framework, comprising four domains of epistemic awareness, relational integrity, reflexive accountability and adaptive professionalism, anchored by ethical digital literacy (EDL). Each domain is operationalised with specific learning activities and assessment strategies such as Objective Structured Clinical Examination (OSCE) stations, reflective portfolios and ethics viva. We discuss implications for curriculum design, faculty development and competency-based assessment.

When structure mattered more than authorship: Lessons from developing a generative AI Tool for high‐stakes multiple‐choice question generation

Fri, 27 Feb 2026 06:03:58 -0800

Medical Education, EarlyView.

When I say … Simulated ‘patients’

Gerard J. Gormley, Jacqueline Driscoll, Linda Ní Chianáin — Thu, 26 Feb 2026 19:48:53 -0800

Medical Education, EarlyView.

Playmobil for stepping up, pressure and prioritisation skills

Simon J. Mercer — Fri, 20 Feb 2026 03:11:59 -0800

Medical Education, EarlyView.

The origin of Student Interest Groups (SIGs)—Evolution of student‐led innovations

Nevin Yi Meng Chua, Jennifer Cleland, Siew Ping Han — Sun, 15 Feb 2026 22:40:48 -0800

Medical Education, EarlyView.

ToC Tick: A time‐efficient way to connect clinician‐educators with the medical education literature

Trevor Thompson, Lizzie Grove — Sun, 15 Feb 2026 00:00:00 -0800

Medical Education, EarlyView.

‘See me for me’: An intersectional approach exploring sexual and gender minority medical students' experiences of role models

Antony P. Zacharias, Robert Douglas, Debbie Aitken — Tue, 10 Feb 2026 23:14:41 -0800

Abstract

Phenomenon

Sexual and/or gender minority-identifying (SGM) medical students report lower levels of belonging and heightened discrimination in medical schools, especially among those who hold intersecting identities that are underrepresented in medicine (URM). Role modelling has been identified as a tool to combat this phenomenon. We used an intersectional approach to explore how interacting URM identities in relation to SGM identity mediate the experience of role models to influence feelings of belonging.

Approach

We employed interpretative phenomenological analysis to explore nuanced and heterogeneous role modelling experiences. We conducted semi-structured interviews with 10 medical students from six medical schools in the United Kingdom.

Findings

Participants described how cisheteronormativity often led to loss of identity control, fragmentation and accompanying self-inauthenticity to protect their sense of belonging. Intersecting URM identities heightened feelings of otherness, and mediating multiple URM identities was cognitively taxing to many participants, even within traditionally inclusive spaces. Role models empowered participants to reclaim control over their narratives, engage in activism and enact disruptive visibility that challenged hierarchical norms. Participants valued role models who shared their intersecting identities, although many also emphasised that anyone who visibly respected SGM and URM identities could equally effectively foster belonging. Hierarchy and power imbalances prioritised by medicine limited the positive effects of role modelling and perpetuated identity fragmentation and inauthenticity. Accordingly, role models were consistently most visible and positive when in positions of influence. Overall, when positive and available, role modelling relationships provided practical pathways for students to integrate fractured identity threads into a more coherent, authentic self.

What this paper adds

This study is the first to apply an intersectional lens to role modelling experiences of SGM medical students with multiple URM identities in the UK. We offer some practical steps for medical schools to cultivate inclusive role modelling.

Trainees pursuing parenthood: Infertility and assisted reproduction workshop

Fri, 06 Feb 2026 06:00:47 -0800

Medical Education, EarlyView.

Case‐based learning (CBL) in undergraduate health professions education: A realist review

Wed, 04 Feb 2026 16:25:23 -0800

Abstract

Introduction

Case-based learning (CBL) has been adopted internationally, although there is significant heterogeneity in implementation and delivery. It is unclear how this pedagogical approach is experienced across contexts, among different groups of students, and the important aspects of implementation. The aim of this study was to understand the mechanisms that enable CBL to facilitate learning in undergraduate health professions education, for whom and in what contexts.

Methods

A realist review was adopted to explore the literature on CBL. Initial programme theories were derived from the CBL literature and based on adult learning theory and inquiry-based learning. 5731 abstracts investigating CBL in undergraduate HPE courses were screened in duplicate. 436 full-text papers were screened and assessed for rigour and relevance, resulting in 25 papers suitable for inclusion in the final analysis.

Results

Seven programme theories were developed from our review. Institutional, implementation and student-level factors were found to impact outcomes such as exam performance, participation and clinical reasoning. A lack of institutional support and recognition of faculty contribution to CBL results in poorer learning outcomes. Clinical facilitators promote student engagement, and authentic multimodal cases afford students the opportunity to step into their future roles. When assessment focuses solely on behaviours and teamwork is not fostered, negative group dynamics may result.

Discussion

Our realist review provides insight for healthcare educators on how best to implement CBL to optimise academic, skill and behavioural outcomes for undergraduate students. Fostering student trust in learning through access to clinician facilitators and authentic cases leads to improved learning outcomes. Recognition of faculty and student efforts to contribute to CBL is essential for successful implementation. The facilitation of a safe and secure group learning environment is required for students to meaningfully engage with CBL.

Participatory learning in home health care for complex care

Elaine Lin, Florence Gagne, Karen Fitton, Kathleen Huth — Wed, 04 Feb 2026 16:04:57 -0800

Medical Education, EarlyView.

Early interprofessional training: Nurses teaching medical students

Robert A. Edelstein, Dawn Chandonnet, Barbara Viens, Jody Schindelheim — Tue, 03 Feb 2026 17:43:47 -0800

Medical Education, EarlyView.

A qualitative exploration of first‐in‐family medical students' decisions to partake in noncurricular activities

Fri, 30 Jan 2026 03:05:31 -0800

Abstract

Objectives

Medical students who are first in family (FiF) to attend college navigate an education system with limited social capital compared to their non-FiF peers. This situation leads to difficult decisions regarding the use of their time. How these students balance their goals inside and outside of medical school is an under-explored area within medical education research. By illuminating how FiF students decide what noncurricular activities to perform, this study aimed to better understand how they relate to and manage their time.

Method

Drawing on aspects of constructivist grounded theory, we interviewed 15 US FiF students between September 2023 and May 2024 regarding the noncurricular activities they participated in and how they made decisions with their time. We collected and analysed data iteratively, adjusting the interview protocol as needed to probe deeper into ideas and themes. Formal data analysis included open and focused coding to identify patterns and relationships within and across the data to understand what drives FiF students in their decision-making processes and how this affects their activities.

Results

FiF students are constantly trying to secure their future, prioritizing their survival and that of their communities. They described how persisting through a lifetime of inequity instilled a skill for resourcefulness, and they draw on this experience when choosing activities. Their choices reflected a sense of what they must do, based on alignment with their personal values and a deep sense of responsibility to others.

Conclusions

FiF students must choose activities that contribute to their survival and that of their communities. By illuminating that survival is at the centre of their decision-making, their narratives challenge the ways that medical training emphasizes extracurricular activities. By not necessarily choosing those activities that are expected of medical students, FiF students exert agency to reclaim aspects of their identity deemphasized by school expectations.

Addressing educational gaps in NHS diagnostic imaging

Tina Mistry, Danni Palmer — Thu, 29 Jan 2026 02:35:15 -0800

Medical Education, EarlyView.

Mixed‐methods research in medical education: Lessons from a meta‐study of methodological practice

Jennifer Cleland, Anna MacLeod, Susan van Schalkwyk, Rachel H. Ellaway — Sat, 24 Jan 2026 00:00:00 -0800

Abstract

Introduction

Mixed-methods research (MMR) intentionally combines (variously) theories, study designs, data collection, analyses and/or syntheses associated with more than one approach to research. Despite a rich literature on the theory and practice of MMR, the authors were concerned that much MMR in medical education fell short of the state of the art. To substantiate the problem, the authors conducted a meta-study to explore the strengths and weaknesses of MMR in medical education and to propose a framework to improve the conduct and reporting of this research design.

Methods

Structured searches were conducted, and returns were filtered based on inclusion and exclusion criteria, establishing a corpus of 1070 articles. A series of purposive samples was taken from this corpus and put through full data extraction. The findings from these extractions were synthesized using descriptive statistics and a dialogical identification of core issues of concern.

Results

Descriptive statistics were produced for the full corpus, after which a series of samples led to 547 (51%) articles undergoing full data extraction. There was a significant increase in the number of articles reporting the use of MMR in the last 20 years. Several recurring issues were identified including a lack of theoretical and conceptual grounding in MMR, a lack of diversity in what constitutes MMR, questionable component rigour, a lack of integration (mixing), a tension between MMR as more than one thing and MMR as a methodology in its own right, and very little adaptation and innovation in MMR approaches. These issues had not improved over time.

Discussion

Major gaps in how MMR was justified and used were found. Integration, central to MMR, was notably lacking. Thus, the authors propose a checklist to help researchers and reviewers ensure that future use of MMR in medical education is more rigorous, transparent, complete and accurate.

Medical students' experiences in providing medical care to older patients: A rich picture study

Fri, 23 Jan 2026 23:59:39 -0800

Abstract

Introduction

With an ageing population, future doctors must be prepared to care for older patients facing complex and often chronic needs. Despite curricular efforts, medical students often report less positive attitudes towards providing this care—shaped not only by knowledge gaps but also by cultural norms and the hidden curriculum. Little is known about how students themselves reflect on their clinical encounters with older patients. This study explores medical students' experiences providing care to older patients, and which aspects they find rewarding or frustrating.

Methods

We conducted a qualitative study based on a constructivist paradigm, using semi-structured interviews supported by a visual narrative method (rich pictures). Sixteen final-year medical students who had completed their senior internship were purposively sampled. Participants drew two ‘rich pictures’ representing one positive and one negative clinical experience involving the care of older persons. These drawings were used as prompts for in-depth interviews. Data were analysed using reflexive thematic analysis.

Results

We identified three themes that captured students' experiences: (1) feeling connected, (2) witnessing humane and compassionate care, and (3) making a difference. Rewarding experiences involved human connection, dignity and presence—particularly in end-of-life care or when guided by compassionate role models—leading to a sense of fulfilment. Frustrating experiences arose from poor communication, systemic barriers and unclear goals of care, leaving students feeling powerless, isolated and emotionally burdened.

Conclusion

Students experienced care for older patients as emotionally rich and qualitatively distinct from other clinical work. This practice demands patience, presence, and the ability to navigate complexity beyond mere clinical competence. Medical education should support students in valuing care beyond cure—through fostering reflective practice, peer support, and engaged supervision—helping them reframe what it means to make a difference for older patients and their families in complex, chronic and end-of-life care.

Mirrors and prisms: How interprofessional interactions influence medical students' professional identity formation

Fri, 23 Jan 2026 21:54:14 -0800

Abstract

Purpose

Professional identities impact professional boundaries and hierarchies, influencing how physicians approach collaboration. Despite the growing emphasis on developing students to become effective collaborators, little is known about how other health professionals (OHPs) shape students' professional identity formation (PIF). This study explored how interacting with OHPs during clinical care contributed to medical students' construction of what it means to be a physician.

Methods

For this constructivist grounded theory study, researchers conducted 20 semi-structured interviews with medical students during clinical clerkships. Students drew rich pictures representing their interactions with OHPs and described these pictures during their interviews. Interviews were iteratively conducted and analysed, enabling the research team to theorize how interacting with OHPs contributed to medical students' PIF.

Results

Participants expressed a strong desire to contribute to patient care and described how interprofessional interactions provided opportunities to do so in ways aligned with their current capabilities. These opportunities were often more accessible than the roles and responsibilities of physicians, and participating alongside OHPs fostered participants' sense of their own developing capabilities and belonging on healthcare teams. Interactions with OHPs helped participants to see the expertise of OHPs and the value of collaborating with them in ways that shifted their focus away from becoming independent. Conceptually, participants' interactions with OHPs became both a mirror reflecting their present readiness to meaningfully contribute and a prism through which they could envision their future identities as physicians in new ways.

Conclusions

Interprofessional interactions influenced medical students' current and future professional identities, enabling students to see themselves as contributors on health care teams and highlighting collaboration and interdependence as core attributes of the physician profession. These findings highlight opportunities to amplify the impact of interprofessional interactions on the PIF of medical students and the need for research into how OHPs view their roles in these processes.

Simulating interprofessional collaboration: An asynchronous online activity

Thu, 22 Jan 2026 01:53:56 -0800

Medical Education, EarlyView.

‘I was a bit hasty … I was a young resident!’ Medical residents' responses to clinical uncertainty

Wed, 21 Jan 2026 04:07:32 -0800

Abstract

Introduction

Uncertainty is intrinsic to medical practice. Improving trainees' uncertainty tolerance requires exploring their responses to clinical uncertainty in clinical contexts. Although previous research works have highlighted the role of self-assessment, contextual cues and responsibility, existing models—developed for experienced physicians—often fail to capture residents' intuitive, situated responses. This study explores residents' behavioural responses to clinical uncertainty, focusing on how contextual features shape their actions and decision making. Following Hillen et al., we define behavioural responses as the actions individuals take to cope with uncertain situations.

Methods

Using an interpretative paradigm, we conducted a thematic analysis of semi-structured interviews with residents from several medical specialties. Considering that age, gender and clinical experience shape responses to uncertainty, we used a maximum variation sampling strategy to ensure diversity in year of residency and gender among participants. Audio-recorded interviews were conducted following a pretested interview guide focusing on residents' lived experiences of uncertainty and transcribed into verbatims. Analysis combined deductive coding, informed by Hillen's framework and Han's taxonomy, with inductive theme generation to capture novel insights.

Results

Fourteen participants described three main behavioural responses to clinical uncertainty, aligned with Han's taxonomy: reducing uncertainty, protection and adaptation. Their responses were determined by situational determinants, including the patient, the problem at hand, the environment and their individual characteristics. Over time, participants progressed from avoiding uncertainty or relying on supervisors to taking a more systemic and situated approach, integrating a combination of complementary strategies to balance the objectives of patients and physicians. This approach fostered the development of competence in navigating complex clinical situations.

Discussion

Our study shows that uncertainty is a situated experience shaped by dynamic interactions between practitioners and context. Recognising this helps move beyond a purely cognitive view, framing uncertainty as a core competency developed through experiential learning and supported by adaptive strategies.

Not all reflection is equal: Reflective practice, not self‐reflection, correlates with Indonesian medical students' professional identity formation

Wed, 21 Jan 2026 03:07:26 -0800

Abstract

Background

Professional identity formation (PIF) plays a significant role in the development of medical students, with reflection expected to help learners align their personal values with the expectations of the profession. While theoretical models propose that reflection and PIF advance hand in hand, empirical studies suggest that the various types of reflection may evolve independently. In this study, we aimed to (a) investigate the levels of PIF, reflective practice and self-reflection and insight across academic years, and (b) assess whether reflective practice and self-reflection and insight are significant predictors of medical students' PIF.

Methods

We conducted a cross-sectional quantitative study that included 1401 medical students from four universities in Indonesia. Participants completed a demographic questionnaire along with the Professional Identity Formation (PIF) questionnaire, Reflective Practice Questionnaire (RPQ) and Self-reflection and Insight Scale (SRIS). We used one-way ANOVA to examine the differences of PIF, RPQ and SRIS across the academic years; Pearson correlations to examine the association between PIF, RPQ and SRIS; and regression analysis to assess the predictive value of RPQ and SRIS on PIF.

Results

Both PIF (F = 32.221, p < 0.001) and reflective practice (F = 6.796, p < 0.001) increased across academic years, while self-reflection and insight remained stable (F = 1.683, p = 0.136). Reflective practice correlated with PIF (r = 0.420; p < 0.001), while self-reflection and insight did not (r = −0.017; p = 0.528). Reflective practice was a significant predictor of PIF in the regression analysis (B = 0.674, p < 0.001).

Conclusion

Reflection on practice associates with professional identity formation in medical students, but self-reflection and insight do not.