Medical Teacher's equity diversity inclusion policy.

Medical Teacher is a leading international journal in health professions education. The Journal recognizes its responsibility to publish papers that reflect the breadth of topics that meet the needs of its readers around the globe including contributions from countries underrepresented in the health professions education arena. This paper sets out the Journal's policy with regard to Equity Diversity Inclusion (EDI) and the steps to be taken to implement the policy in practice.

Exploring Perceptions and Practices of Interprofessional Shared Decision-Making Education in Palliative Care Settings.

Background: Palliative care teams provide support to patients and their caregivers during terminal illness, which requires interprofessional collaboration. One of the foundational skills is to assist patients with decision-making. This can be facilitated through interprofessional shared decision-making (IP-SDM). So far, IP-SDM education frameworks have only been used to a limited extent in the area of palliative care. Aim: This study aims to explore perceptions and practices of faculty members, health professionals, and students toward IP-SDM education in palliative care and to indicate associated factors to implement an IP-SDM in undergraduate health professions education in palliative care settings. Methods: We used a cross-sectional study design in which the data was obtained via an online self-administered questionnaire adapted from existing validated tools. The questionnaire was distributed to faculty members and health professionals (n = 125) and students (n = 334) at King Abdulaziz Medical City in Jeddah, Saudi Arabia. The sampling technique was a non-probability convenience sampling. Bivariate statistics, such as independent sample t-tests, one-way ANOVA, correlation coefficient, and linear multiple regression were conducted. Findings: The response rate was 54% (85 faculty members and health professionals and 164 students). Perceptions on IP-SDM did not differ between participants. From those who had previous experience with IP-SDM, the mean practices score was slightly higher for faculty members and health professionals (M = 83.1, SD = 15.9) than for students (M = 74.1, SD = 11.5), which was significant (p < 0.05). Factors such as gender, age, discipline, nationality, level of education, years of study, and previous experience that were associated with perceptions and practices were varied among participants. Conclusion: The findings show high levels of perception with low levels of practice of IP-SDM in palliative care. Other factors that could be associated with the topic should be addressed in further studies.

Transitioning to sustainable, climate-resilient healthcare: insights from a health service staff survey in Australia.

BACKGROUND: More than 80 countries, including Australia, have made commitments to deliver climate-resilient and low carbon healthcare. Understanding how healthcare workers view their own and their organization's efforts to achieve sustainable and climate-resilient healthcare practice is vital to inform strategies to accelerate that transition. METHODS: We conducted an online staff survey in a large state government hospital-and-health-service organisation in Queensland, Australia, to ascertain attitudes and practices towards environmentally sustainable, climate-resilient healthcare, and views about the organizational support necessary to achieve these goals in their workplace. RESULTS: From 301 participants showed staff strongly support implementing sustainable and climate-resilient healthcare but require significantly more organizational support. Participants identified three categories of organizational support as necessary for the transition to environmentally sustainable and climate-resilient health services and systems: (1) practical support to make sustainability easier in the workplace (e.g. waste, energy, water, procurement, food, transport etc.); (2) training and education to equip them for 21st century planetary health challenges; and (3) embedding sustainability as 'business as usual' in healthcare culture and systems. CONCLUSIONS: The research provides new insight into health workforce views on how organizations should support them to realize climate and sustainability goals. This research has implications for those planning, managing, implementing, and educating for, the transition to environmentally sustainable and climate-resilient health services and systems in Queensland, Australia, and in similar health systems internationally.

Group concept mapping for health professions education scholarship.

While explicit conceptual models help to inform research, they are left out of much of the health professions education (HPE) literature. One reason may be the limited understanding about how to develop conceptual models with intention and rigor. Group concept mapping (GCM) is a mixed methods conceptualization approach that has been used to develop frameworks for planning and evaluation, but GCM has not been common in HPE. The purpose of this article is to describe GCM in order to make it more accessible for HPE scholars. We recount the origins and evolution of GCM and summarize its core features: GCM can combine multiple stakeholder perspectives in a systematic and inclusive manner to generate explicit conceptual models. Based on the literature and prior experience using GCM, we detail seven steps in GCM: (1) brainstorming ideas to a specific "focus prompt," (2) preparing ideas by removing duplicates and editing for consistency, (3) sorting ideas according to conceptual similarity, (4) generating the point map through quantitative analysis, (5) interpreting cluster map options, (6) summarizing the final concept map, and (7) reporting and using the map. We provide illustrative examples from HPE studies and compare GCM to other conceptualization methods. GCM has great potential to add to the myriad of methodologies open to HPE researchers. Its alignment with principles of diversity and inclusivity, as well as the need to be systematic in applying theoretical and conceptual frameworks to practice, make it a method well suited for the complexities of contemporary HPE scholarship.

Co-designing formal health professions curriculum in partnership with students: A scoping review.

There is growing evidence of the value of co-design and partnering with students in the design, development, and delivery of health professions education (HPE). However, the way in which students participate in co-designing HPE remains largely unexplored and there is little guidance on how to embed and strengthen partnerships with students. Using scoping review methodology, we identified and aggregated research reporting studies in which students were active partners in co-designing formal curricula in HPE. After searching five databases and screening 12,656 articles against inclusion criteria, 21 studies were identified. We found that most of the research was based in medical programs (n = 15) across Western contexts. Studies were mostly descriptive case reports (n = 10), with only three studies utilising participatory/action research designs. The co-designed outputs were mostly classroom-based learning on challenging HPE topics, for example, ethics, health inequities, racial and sexual bias, global health, and Indigenous health. Detailed descriptions of student-faculty partnerships and underpinning approaches were lacking overall. To optimise co-design methods, HPE and research require deeper engagement with critical research and pedagogical approaches and more robust evaluations of the processes, outputs and outcomes of co-design. In pedagogical practices, this necessitates challenging institutional structures, teaching and learning cultures and relational elements, such as through creating formal roles and opportunities for students as active co-design partners and fostering more equitable student-faculty positioning in HPE.

Perceptions of lecturers and students regarding discriminatory experiences and sexual harassment in academic medicine - results from a faculty-wide quantitative study.

BACKGROUND: Discrimination and sexual harassment are prevalent in higher education institutions and can affect students, faculty members and employees. Herein the aim was to assess the extent of discriminatory experiences and sexual harassment of students and lecturers at one of the largest teaching hospitals in Europe. We analyze whether there are differences between lecturers and students, different study programs as well as sex/gender differences. METHODS: In an interdisciplinary, iterative process, a semi-standardized questionnaire was developed and sent to N = 7095 students (S) of all study programs and N = 2528 lecturers (L) at Charité-Universitätsmedizin Berlin, Germany. The study was conducted from November 2018 to February 2019. Besides a broad range of questions on sociodemographic background allowing for diversity sensitive data analysis, they were asked if they had witnessed and/or experienced any form of discrimination or sexual harassment at the medical faculty, if yes, how often, the perceived reasons, situational factors and perpetrators. RESULTS: The response rate was 14% (n = 964) for students and 11% (n = 275) for lecturers. A proportion of 49.6% of students (L: 31%) reported that they have witnessed and/or experienced discriminatory behavior. Sexual harassment was witnessed and/or experienced by 23.6% of students (L: 19.2%). Lecturers (85.9%) were identified as the main source of discriminatory behavior by students. Directors/supervisors (47.4%) were stated as the main source of discriminatory behavior by lecturers. As the most frequent perceived reason for discriminatory experiences sex/gender (S: 71%; L: 60.3%) was reported. Women and dental students experienced more discriminatory behavior and sexual harassment. CONCLUSIONS: Discriminatory behavior is experienced by a significant number of students and lecturers, with power structures having a relevant impact. Dental students and women appear to be particularly exposed. Specific institutional measures, such as training programs for lecturers and students are necessary to raise awareness and provide resources. Furthermore, national preventive strategies should be thoroughly implemented to fight discrimination and harassment at the workplace.

Handle with Care: Transformative Learning as Pedagogy in an Under-Resourced Health Care Context.

Issue: A significant component of health professions education is focussed on students' exposure to the social determinants of health and the challenges that patients within the health care system face. An appropriate way to provide such exposure is through distributed clinical training. This usually entails students training in smaller groups along the continuum of care, away from tertiary academic hospitals. This also means students are away from their existing academic and social support systems. It is evident that knowledge and clinical skills alone are not sufficient to prepare students, they also need to be taught to critically reflect on how their own values and attitudes traverse their knowledge and skills to influence their practice as healthcare professionals. This process of critical reflection should aim to provide a transformative learning experience for students and requires active facilitation. In under-resourced health care contexts where clinicians responsible for student training are facing high patient load, lack of resources, inequitable health care services and high levels of burn-out, the facilitation of student learning may be compromised. Evidence: Clinical learning opportunities that are considered transformative, frequently challenge students' sense of self and sense of belonging. This experience can have detrimental effects if the processes of transformative learning pedagogy are not adequately facilitated. The provision of support staff, lecturers and clinical facilitators on the distributed training platform is challenged by the remote nature of some of the sites and the cost of recruiting and capacitating additional on-site staff. The potential for what has been termed "transformative trauma" and the subsequent halted transformative learning experience, has ethical implications in terms of student wellness and the educational responsibility institutions carry. Implications: The authors suggest considerations in facilitating an ethical transformative learning process. These include making the transformative learning pedagogy explicit to students and clinical facilitators and using the 'brave spaces' framework to help students with individuation and provide them with the tools to understand how emotion influences behavior. Strategies to improve relationship development and communities of support, as well as ideas for faculty development are offered.

Assessment approaches in undergraduate health professions education: towards the development of feasible assessment approaches for low-resource settings.

BACKGROUND: Feasible and effective assessment approaches to measuring competency in health sciences are vital in competency-based education. Educational programmes for health professions in low- and middle-income countries are increasingly adopting competency-based education as a strategy for training health professionals. Importantly, the organisation of assessments and assessment approaches must align with the available resources and still result in the fidelity of implementation. A review of existing assessment approaches, frameworks, models, and methods is essential for the development of feasible and effective assessment approaches in low-resource settings. METHODS: Published literature was sourced from 13 electronic databases. The inclusion criteria were literature published in English between 2000 and 2022 about assessment approaches to measuring competency in health science professions. Specific data relating to the aims of each study, its location, population, research design, assessment approaches (including the outcome of implementing such approaches), frameworks, models, and methods were extracted from the included literature. The data were analysed through a multi-step process that integrated quantitative and qualitative approaches. RESULTS: Many articles were from the United States and Australia and reported on the development of assessment models. Most of the articles included undergraduate medical or nursing students. A variety of models, theories, and frameworks were reported and included the Ideal model, Predictive Learning Assessment model, Amalgamated Student Assessment in Practice (ASAP) model, Leadership Outcome Assessment (LOA) model, Reporter-Interpreter-Manager-Educator (RIME) framework, the Quarter model, and the model which incorporates four assessment methods which are Triple Jump Test, Essay incorporating critical thinking questions, Multistation Integrated Practical Examination, and Multiple Choice Questions (TEMM) model. Additional models and frameworks that were used include the Entrustable Professional Activities framework, the System of Assessment framework, the Reporter-Interpreter-Manager-Educator (RIME) framework, the Clinical Reasoning framework (which is embedded in the Amalgamated Student Assessment in Practice (ASAP) model), Earl's Model of Learning, an assessment framework based on the Bayer-Fetzer Kalamazoo Consensus Statement, Bloom's taxonomy, the Canadian Medical Education Directions for Specialists (CanMEDS) Framework, the Accreditation Council for Graduate Medical Education (ACGME) framework, the Dreyfus Developmental Framework, and Miller's Pyramid. CONCLUSION: An analysis of the assessment approaches, frameworks, models, and methods applied in health professions education lays the foundation for the development of feasible and effective assessment approaches in low-resource settings that integrate competency-based education. TRIAL REGISTRATION: This study did not involve any clinical intervention. Therefore, trial registration was not required.

Improving Health Professional Recognition and Response to Child Maltreatment and Intimate Partner Violence: Protocol for Two Mixed Methods Pilot Randomized Controlled Trials.

BACKGROUND: The optimal educational approach for preparing health professionals with the knowledge and skills to effectively recognize and respond to family violence, including child maltreatment and intimate partner violence, remains unclear. The Violence, Evidence, Guidance, and Action (VEGA) Family Violence Education Resources is a novel intervention that can be completed via self-directed learning or in a workshop format; both approaches focus on improving health professional preparedness to address family violence. OBJECTIVE: Our studies aim to determine the acceptability and feasibility of conducting a randomized controlled trial to evaluate the effectiveness of the self-directed (experimental intervention) and workshop (active control) modalities of VEGA, as an adjunct to standard education, to improve learner (Researching the Impact of Service provider Education [RISE] with Residents) and independent practice (RISE with Veterans) health professional preparedness, knowledge, and skills related to recognizing family violence in their health care encounters. METHODS: The RISE with Residents and RISE with Veterans research studies use embedded experimental mixed methods research designs. The quantitative strand for each study follows the principles of a pilot randomized controlled trial. For RISE with Residents, we aimed to recruit 80 postgraduate medical trainees; for RISE with Veterans, we intended to recruit 80 health professionals who work or have worked with Veterans (or their family members) of the Canadian military or the Royal Canadian Mounted Police in a direct service capacity. Participants complete quantitative assessments at baseline, after intervention, and at 3-month follow-up. A subset of participants from each arm also undergoes a qualitative semistructured interview with the aim of describing participants' perceptions of the value and impact of each VEGA modality, as well as research burden. Scores on potential outcome measures will be mapped to excerpts of qualitative data via a mixed methods joint display to aid in the interpretation of findings. RESULTS: We consented 71 individuals to participate in the RISE with Residents study. Data collection was completed on August 31, 2023, and data are currently being cleaned and prepared for analysis. As of January 15, 2024, we consented 34 individuals in the RISE with Veterans study; data collection will be completed in March 2024. For both studies, no data analysis had taken place at the time of manuscript submission. Results will be disseminated through peer-reviewed publications; academic conferences; and posting and sharing of study summaries and infographics on social media, the project website, and via professional network listserves. CONCLUSIONS: Reducing the impacts of family violence remains a pressing public health challenge. Both research studies will provide a valuable methodological contribution about the feasibility of trial methods in health professions education focused on family violence. They will also contribute to education science about the differences in the effectiveness of self-directed versus facilitator-led learning strategies. TRIAL REGISTRATION: ClinicalTrials.gov NCT05490121, https://clinicaltrials.gov/study/NCT05490121; ClinicalTrials.gov NCT05490004, https://clinicaltrials.gov/study/NCT05490004. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/50864.

Mapping student engagement in health professions education policy and decision-making: a scoping review.

BACKGROUND: "Student engagement" (SE) is gaining momentum as an approach to improve the performance of health professions education (HPE). Nevertheless, despite the broad studies about the role of students in various areas, little is known about the role of SE in policy and decision-making activities. This study aimed to map SE in policy and decision-making regarding terms and definitions, engagement models, influencing factors, outcomes and achievements, and the interconnection between the influencing factors. METHOD: Five databases (PubMed, Scopus, ProQuest, Web of Science, and ERIC) were systematically searched from Jan 1, 1990, to Nov 12, 2022. The review was followed according to the Arksey and O'Malley framework for scoping reviews and reported according to the PRISMA-ScR guidelines. We included articles published in English focusing on HPE policy and decision-making. The authors summarized and synthesized the findings into themes, subthemes, tables, and models. RESULTS: Of the 22 articles included in the full-text review, terms and definitions were tabled, and three themes were extracted: 1. models of SE, in which 10 studies (45.5%) presented the highly structured formal models as Organizations, 5 studies (22.7%) reported less-structured community and group as Programs, and 7 studies (31.8%) engaged students only in surveys or interviews as Perspective; 2. Factors influencing SE, that were categorized into 7 subthemes: structural, environmental, and motivational factors, member characteristics, training and mentoring, member relationships, valuing and recognizing. 3. Outcomes and achievements of SE related to systems and members. The interconnection between influencing factors is also demonstrated as a conceptual model. DISCUSSION: There are various SE models in HPE policy and decision-making, which are mapped and categorized depending on the degree of formality, structuredness, and level of engagement. In our study, three more common SE models in HPE policy and decision-making were investigated. Additionally, these collaborative methods emphasized curriculum development and quality assurance and employed students in these activities. It is worth mentioning that to make SE models more efficient and sustainable, several influencing factors and their interconnections should be considered.

Teamwork baseline assessment tool: Sparking teamwork dialogues in health professions training.

WHAT WAS THE EDUCATIONAL CHALLENGE?: A major challenge in health professions education is to equip graduates with essential teamwork skills, addressing cognitive, motivational, and emotional barriers that hinder effective collaboration among students from diverse backgrounds. WHAT WAS THE SOLUTION AND HOW WAS THIS IMPLEMENTED?: The Teamwork Baseline Assessment Tool (TBAT) was developed as an innovative solution to teach collaboration and teamwork, focusing on growth mindsets, reactions to challenging scenarios, and ideal team player attributes. Implemented during the orientation for new first-year students, TBAT facilitated early engagement in teamwork discussions, with students receiving personalised reports to aid in self-reflection and development. WHAT LESSONS WERE LEARNED?: Key lessons included the importance of initiating teamwork conversations early, the value of personalised feedback in promoting self-awareness and peer understanding, and the effectiveness of TBAT in providing instructors with insights into students' teamwork aptitudes. WHAT ARE THE NEXT STEPS?: Expanding TBAT across various student populations and integrating it into the curriculum aims to provide continuous opportunities for applying and reinforcing teamwork and collaboration skills. This strategy will support the development of targeted instructional approaches, fostering a collaborative learning environment and preparing students for the teamwork challenges in healthcare settings.

Gender differences in autonomy and performance assessments in a national cohort of vascular surgery trainees.

OBJECTIVE: Gender disparities in surgical training and assessment are described in the general surgery literature. Assessment disparities have not been explored in vascular surgery. We sought to investigate gender disparities in operative assessment in a national cohort of vascular surgery integrated residents (VIRs) and fellows (VSFs). METHODS: Operative performance and autonomy ratings from the Society for Improving Medical Professional Learning (SIMPL) application database were collected for all vascular surgery participating institutions from 2018 to 2023. Logistic generalized linear mixed models were conducted to examine the association of faculty and trainee gender on faculty and self-assessment of autonomy and performance. Data were adjusted for post-graduate year and case complexity. Random effects were included to account for clustering effects due to participant, program, and procedure. RESULTS: One hundred three trainees (n = 63 VIRs; n = 40 VSFs; 63.1% men) and 99 faculty (73.7% men) from 17 institutions (n = 12 VIR and n = 13 VSF programs) contributed 4951 total assessments (44.4% by faculty, 55.6% by trainees) across 235 unique procedures. Faculty and trainee gender were not associated with faculty ratings of performance (faculty gender: odds ratio [OR], 0.78; 95% confidence interval [CI], 0.27-2.29; trainee gender: OR, 1.80; 95% CI, 0.76-0.43) or autonomy (faculty gender: OR, 0.99; 95% CI, 0.41-2.39; trainee gender: OR, 1.23; 95% CI, 0.62-2.45) of trainees. All trainees self-assessed at lower performance and autonomy ratings as compared with faculty assessments. However, women trainees rated themselves significantly lower than men for both autonomy (OR, 0.57; 95% CI, 0.43-0.74) and performance (OR, 0.40; 95% CI, 0.30-0.54). CONCLUSIONS: Although gender was not associated with differences in faculty assessment of performance or autonomy among vascular surgery trainees, women trainees perceive themselves as performing with lower competency and less autonomy than their male colleagues. These findings suggest utility for exploring gender differences in real-time feedback delivered to and received by trainees and targeted interventions to align trainee self-perception with actual operative performance and autonomy to optimize surgical skill acquisition.

Exploring experiential learning within interprofessional practice education initiatives for pre-licensure healthcare students: a scoping review.

BACKGROUND: Interprofessional collaborative team-based approaches to care in health service delivery has been identified as important to health care reform around the world. Many academic institutions have integrated interprofessional education (IPE) into curricula for pre-licensure students in healthcare disciplines, but few provide formal initiatives for interprofessional practice (IPP). It is recognized that experiential learning (EL) can play a significant role supporting IPP education initiatives; however, little is known of how EL is used within education for IPP in healthcare settings. METHODS: We conducted a scoping review to map peer-reviewed literature describing IPP education initiatives involving EL for pre-licensure students in healthcare disciplines. A literature search was executed in MEDLINE, CINAHL, EMBASE, ERIC, PsycINFO, Scopus, and Social Services Abstracts. After deduplication, two independent reviewers screened titles and abstracts of 5664 records and then 252 full-text articles that yielded 100 articles for data extraction. Data was extracted using an Excel template, and results synthesized for presentation in narrative and tabular formats. RESULTS: The 100 included articles represented 12 countries and IPP education initiatives were described in three main typologies of literature - primary research, program descriptions, and program evaluations. Forty-three articles used a theory, framework, or model for design of their initiatives with only eight specific to EL. A variety of teaching and learning strategies were employed, such as small interprofessional groups of students, team huddles, direct provision of care, and reflective activities, but few initiatives utilized a full EL cycle. A range of perspectives and outcomes were evaluated such as student learning outcomes, including competencies associated with IPP, impacts and perceptions of the IPP initiatives, and others such as client satisfaction. CONCLUSION: Few educational frameworks specific to EL have been used to inform EL teaching and learning strategies to consolidate IPE learning and prepare students for IPP in healthcare settings. Further development and evaluation of existing EL frameworks and models would be beneficial in supporting robust IPP educational initiatives for students in healthcare disciplines. Intentional, thoughtful, and comprehensive use of EL informed by theory can contribute important advances in IPP educational approaches and the preparation of a future health care workforce.

Measuring the added value of virtual communities of practice for developing the educator role of critical care professionals.

In healthcare settings, workplace learning is often supported by clinicians who strive to combine service provision and educator roles. We evaluated an international 12-month programme that supports widely distributed critical care health professional educators (HPEs) through a virtual community of practice (vCoP). Specifically, we evaluate if and how the vCoP approach affects learning experiences using an innovative evaluation framework in medical education-the value-creation framework (VCF). We used a mixed-methods approach to evaluation, including an anonymous survey and semistructured interviews. Themes from data sources were identified using the VCF as the common thread. Themes discussed by at least two-thirds of interview participants were analysed using narrative inquiry. 27 of 66 participants responded to the survey, and 15 participated in interviews. Positive and negative indicators of value creation were extracted and organised according to the framework's eight value cycles. Framework analysis made value-creation and potential flow-on effects in one value-creation cycle to another visible, offering insight into relationships. Themes from narrative inquiry elaborated on the results of the framework analysis. Using the VCF to evaluate the Incubator programme brings to bear the complexity of boundary-crossing HPE faculty development for critical care educators. The framework can be a valuable tool for evaluating a vCoP associated with faculty development programmes.

The impact of moulage on learners' experience in simulation-based education and training: systematic review.

BACKGROUND: Moulage is a technique used to simulate injury, disease, aging and other physical characteristics specific to a scenario, often used in health and emergency worker training, predominantly for simulation-based learning activities. Its use in allied health fields is unclear. Previous work has explored moulage as an adjunct for authentic simulations, however there is opportunity for broadening its scope. AIM: To explore the effects of moulage interventions in simulation-based education and training, for learner experience. A secondary aim was to understand which pedagogical frameworks were embedded in moulage interventions. METHOD: Four electronic databases (PubMed, CINAHL, EmBase, Proquest Central) were systematically searched to December 2022 for studies utilising moulage in simulation-based education experiences. Outcomes were focused on learner satisfaction, confidence, immersion, engagement, performance, or knowledge. Study quality was assessed using the Mixed Methods Appraisal Tool. RESULTS: Twenty studies (n = 11,470) were included. Studies were primarily conducted in medicine (n = 9 studies) and nursing (n = 5 studies) and less frequently across other health disciplines. The findings demonstrated greater learner satisfaction, confidence, and immersion when moulage was used against a comparator group. Minimal improvements in knowledge and performance were identified. One study underpinned the intervention with a pedagogical theory. CONCLUSION: Moulage improves learner experience in simulation-based education or training, but not knowledge or clinical performance. Further research utilising moulage across a broader range of professions is needed. Interventions using moulage should be underpinned by pedagogical theories.

Implementing Reflective Writing at a Newly Established Health Science Academy of Nepal: Exploring a Novel Practice, Overcoming Obstacles and Recommendations.

Establishing new institutions for health professions provides the opportunity to implement innovative approaches catering to the current health needs and also allows to address the inadequacies of well-established institutions. Grabbing this opportunity, we initiated the implementation of reflective practices at Madan Bhandari Academy of Health Sciences, a new provincial university in Nepal. Though literature shows that reflection is a helpful tool to reflect on choices, experiences, and failures and obtain knowledge for the students, the adoption of reflective writing in health professions education in Nepal is limited. Therefore, we looked into the practices from other countries to adopt them in our settings and integrated them into our curriculum. But, we came across many impediments during the process-particularly those related to limited resources. We found innovative solutions like using technology and peer mentoring to overcome these challenges and integrated these practices to initiate reflective writing at the institution. The introspective "talking to oneself" has been a valuable strategy for implementing the reflective practices at our institution. Based on our experiences, we highly recommend educators in Nepal or similar settings embrace team-based writing practices that are contextually appropriate. But, we also recognize the benefits of team-based reflective writing that considers the cultural context. We hope this review will inspire educators, particularly those who lack the resources to initiate such practices at their institution. Our firsthand experience is detailed in this perspective article.

Gamification in medical education: identifying and prioritizing key elements through Delphi method.

BACKGROUND: Gamification has gained popularity in medical education, but key elements have not been formally identified. This study aimed to generate and prioritize a list of key elements of gamification in medical education. METHODS: This study utilized a two-stage approach, including the Delphi method and qualitative interview. Nineteen medical educators with expertise in gamification participated in the Delphi method stage. Experts who had more than three years of experience with gamification in medical education constituted the expert panel. The experts were then asked to rate the gamification elements using the Likert five-point scale through at least two consensus-seeking rounds. Consensus for key elements was predefined as ≥ 51% of respondents rating an element as 'important' or"very important." In the qualitative interview stage, 10 experts provided feedback on the application of these key gamification elements. RESULTS: Eighteen participants (11 males and 7 females) completed the entire Delphi process for this study. After two rounds of surveys, the consensus was reached on all elements. Thirteen elements scored more than 4 points (37%) and reached the criteria of key elements of gamification in medical education. The top five key elements were integration with instruction objectives, game rules, rapid feedback, fairness, and points/scoring. The thirteen key elements for successful gamification in medical education were further organized into two main categories: (1) gamification design principles and (2) game mechanisms. CONCLUSIONS: Integration with educational objectives, gamification in curriculum design and teaching methods, and balancing between the mechanisms and principles were the three key components for successful gamification. This study explored the gamification key elements, providing practical tips for medical educators in their efforts to gamify medical education. Future studies involving learners could be performed to examine the efficacy of these key elements in gamification.

Radiology image interpretation services in a low-resource setting: Medical doctors' experiences and the potential role of radiographers.

INTRODUCTION: Medical doctors can encounter significant challenges in both the radiology image interpretation service and their ability to interpret images to promote effective patient management. This study aimed to explore the experiences of medical doctors in a low-resource setting regarding the image interpretation service received in state-funded hospitals and the potential role of radiographers. METHODS: A qualitative approach with a descriptive phenomenology design was employed. Thirteen medical officers and medical interns, with a maximum of three years of experience, were purposively selected from three state-funded hospitals. Semi-structured interviews were conducted in English, and data analysis followed the conventional content analysis method using Atlas.ti for Windows (version 9). RESULTS: Three main themes emerged from the data. The first theme was a poor image interpretation service which highlighted issues such as long turnaround times for image reporting and compromised patient management. The second theme was training and support deficiency which revealed the inadequacy of image interpretation training and the need for additional on-the-job support. The third theme was the inconspicuous radiographer role which showcased the potential opportunities for radiographers to aid in filling the gaps in the image interpretation system. CONCLUSION: Medical doctors in this low-resource setting experience significant delays in radiology image interpretation, leading to compromised patient management. Their training in image interpretation is inadequate, and they often lack on-the-job support. Radiographers potentially play a role in image interpretation which may provide solutions to these contextual challenges. IMPLICATIONS FOR PRACTICE: There is a need to review and develop a comprehensive image interpretation system that effectively supports medical doctors in image interpretation, possibly involving the collaboration of radiographers.

Twelve tips for designing and implementing an academic coaching program.

Coaching has become increasingly popular as a mechanism to support learning across the health professions education (HPE) continuum. While there is a growing body of literature in this area, there is minimal guidance related to the design and implementation of academic coaching in health professional courses. This paper seeks to contribute to this literature by presenting guidance for academic developers who are considering introducing academic coaching into a health professional course. The 12 tips are based on the authors' collective experiences of designing and implementing academic coaching in university medical courses in Australia and the UK. Although focused on medical education, this paper is intended to have applicability across the health professions, and potentially across university and postgraduate training contexts. Together, the tips offer a strategic and operational framework to guide the design and implementation of academic coaching initiatives in health professions education.