RESUMO
In many contexts, responsibility for exit-level assessment design and implementation in undergraduate medical programmes lies with individuals who convene clinical clerkships. Their assessment practice has significant consequences for students' learning and the patients and communities that graduates will serve. Interventions to enhance assessment must involve these assessors, yet little is known about factors influencing their assessment practice. The purpose of this study was to explore factors that influence assessment practice of clerkship convenors in three varied low-and-middle income contexts in the global South. Taking assessment practice as a behaviour, Health Behaviour Theory (HBT) was deployed as a theoretical framework to explore, describe and explain assessor behaviour. Thirty-one clinician-educators responsible for designing and implementing high-stakes clerkship assessment were interviewed in South Africa and Mexico. Interacting personal and contextual factors influencing clinician-educator assessment intention and action were identified. These included attitude, influenced by impact and response appraisal, and perceived self-efficacy; along with interpersonal, physical and organisational, and distal contextual factors. Personal competencies and conducive environments supported intention to action transition. While previous research has typically explored factors in isolation, the HBT framing enabled a systematic and coherent account of assessor behaviour. These findings add a particular contextual perspective to understanding assessment practice, yet also resonate with and extend existing work that predominantly emanates from high-income contexts in the global North. These findings provide a foundation for the planning of assessment change initiatives, such as targeted, multi-factorial faculty development.
RESUMO
This article introduces the lesser known qualitative research design of phenomenography to medical science and health professions education researchers. Phenomenography, as distinct from phenomenology, seeks to describe and organise the different ways people experience and understand a phenomenon. Here, the origins and philosophical underpinnings of phenomenography are briefly shared, and an outline of how a phenomenographic research study may be undertaken is presented. This includes data collection tools, analytic method, and examples from the field. Overall, phenomenography is valuable for better understanding the varied experiences of students, educators, practitioners, and patients, with implications for pedagogy, practice, and related outcomes.
RESUMO
The imperative for decolonial research in health professions education (HPE) is rooted in a resistance to coloniality, which characterises modern medicine and HPE. Coloniality is a residual effect of colonialism, which upholds White, Western, Eurocentric knowledge systems while simultaneously marginalising diverse epistemologies. We outline the problematic nature of coloniality in HPE typified in unequal research partnerships, skewed student exchanges and poor representation of diverse authors. Decoloniality advocates for the active disruption and dismantling of colonial hierarchies to promote epistemic justice. We suggest a practical framework for applying decolonial principles in research, emphasising awareness (critical consciousness), deliberation (reflexivity) and action (transformative praxis). Practical steps for decolonial practice include interrogating research conceptualisation, sharing power and diversifying research teams, adopting participatory and reciprocal (mutually beneficial) methodologies, (re)centring marginalised voices and amplifying 'Other' knowledges, and disrupting hegemonic dissemination practices. By employing decolonial strategies, researchers can produce equitable, socially accountable and epistemically just scholarship, ultimately enhancing the relevance and impact of HPE research for all people globally.