The dermatologist identity crisis: a phenomenological analysis of dermatology trainee professional identity during generalist redeployment.

BACKGROUND: Dermatology faces a workforce crisis against a backdrop of wider medical education shifts towards generalism. A pivot towards generalism may have an impact on dermatology trainee professional identity, which, to our knowledge, has not been investigated and is known to have an impact on competence and conceptualization of ethics among physicians. Disruption because of the COVID-19 pandemic led to dermatology trainee redeployment and therefore presents a unique opportunity to examine dermatology trainee professional identity during times of pressure. AIM: To identify the impact of COVID-19 redeployment on dermatology trainee professional identity, the factors influencing identity and whether such factors affect trainees' perceptions about their future careers. METHODS: Ten trainees were purposively recruited to the study. Data were collected through semistructured interviews and were analysed phenomenologically using the template analysis method. Central and integrative themes were identified. RESULTS: Three central themes were identified: trainee identity and values; redeployment transitions; and future clarity. Three integrative themes were found: tribes; sense of purpose; and uncertainty. Trainees see competence and community as central to the dermatologist identity. Most trainees experienced a reaffirmation of their prior values, psychologically retreating to close-knit communities. However, some underwent disorienting dilemmas, later reflecting on their futures as dermatologists. CONCLUSION: Healthcare crises may have a significant impact on dermatology trainee professional identity and may lead to reaffirmation of prior tribal values or disorienting reflection upon future career trajectories. Improved support among diverse communities, minimization of uncertainty and fostering a sense of purpose among trainees may aid identity enrichment and safeguard the future dermatology consultant workforce.

Gaining ethics approval for health professions education research.

Within health professions education (HPE), there is a well-established and expanding literature offering empirical evidence to inform pedagogic practice. Research ethics refers to the set of professional standards and principles that should be followed to ensure that work is conducted in a responsible and legitimate manner. Conducting scholarly inquiry within educational practice can be categorized as either research or evaluation, but boundaries between the two approaches may be blurred. Ethical risks in HPE research include coercion, psychological stress and infringement upon data privacy. This review considers ethical considerations at each stage of the research process and makes practical recommendations for the HPE researcher.

Technology-enhanced learning interventions on skin of colour dermatology for dermatology trainees and fellows: are they effective or sustainable?

Recent shifts towards synchronous online learning and raised awareness of ethnic inequalities in health have resulted in the establishment of frequent 'one-off' technology-enhanced learning (TEL) initiatives on diversity issues. There is little established evidence regarding the efficacy or sustainability of such interventions. We designed a prospective cohort pilot study including 14 dermatology registrars and fellows and delivered a TEL programme focusing on central centrifugal cicatricial alopecia and keloid scarring. Information was collected on the existing competence and confidence of our cohort about managing these conditions, as well as the short-term and long-term impact of our intervention. Following our programme, participant knowledge improved transiently, but was not sustainable 6 weeks later. Over half of participants were not confident in adopting newly acquired knowledge on skin of colour into practice. Results demonstrate a disparity between how effective one-off education initiatives are perceived vs. actual benefit. More systemic solutions may be warranted.

Social media in undergraduate medical education: A systematic review.

INTRODUCTION: There are over 3.81 billion worldwide active social media (SoMe) users. SoMe are ubiquitous in medical education, with roles across undergraduate programmes, including professionalism, blended learning, well being and mentoring. Previous systematic reviews took place before recent explosions in SoMe popularity and revealed a paucity of high-quality empirical studies assessing its effectiveness in medical education. This review aimed to synthesise evidence regarding SoMe interventions in undergraduate medical education, to identify features associated with positive and negative outcomes. METHODS: Authors searched 31 key terms through seven databases, in addition to references, citation and hand searching, between 16 June and 16 July 2020. Studies describing SoMe interventions and research on exposure to existing SoMe were included. Title, abstract and full paper screening were undertaken independently by two reviewers. Included papers were assessed for methodological quality using the Medical Education Research Study Quality Instrument (MERSQI) and/or the Standards for Reporting Qualitative Research (SRQR) instrument. Extracted data were synthesised using narrative synthesis. RESULTS: 112 studies from 26 countries met inclusion criteria. Methodological quality of included studies had not significantly improved since 2013. Engagement and satisfaction with SoMe platforms in medical education are described. Students felt SoMe flattened hierarchies and improved communication with educators. SoMe use was associated with improvement in objective knowledge assessment scores and self-reported clinical and professional performance, however evidence for long term knowledge retention was limited. SoMe use was occasionally linked to adverse impacts upon mental and physical health. Professionalism was heavily investigated and considered important, though generally negative correlations between SoMe use and medical professionalism may exist. CONCLUSIONS: Social media is enjoyable for students who may improve short term knowledge retention and can aid communication between learners and educators. However, higher-quality study is required to identify longer-term impact upon knowledge and skills, provide clarification on professionalism standards and protect against harms.

Fostering excellence in medical education career pathways.

High quality medical education requires committed and skilled educators, researchers, and leaders. Capacity building for future educationalists is fundamental in the pursuit of excellence in medical education. Medical education as a discipline is undervalued, underfunded, and often badmouthed. In order to pave the way to excellence, we must lay down the correct career pathways and foster a supportive climate in our speciality. In order to attract and support tomorrow's educationalists we argue that we need to champion the field, develop integrated clinical and educational training programmes, and promote role modelling and mentorship.

Less than full-time training, barriers and future needs. A UK-wide online survey of doctors in training.

OBJECTIVES: To assess the current views of less-than full-time (LTFT) training by both LTFT and full-time (FT) doctors in training, with regards to health and well-being, clinical and non-clinical opportunities, in addition to associated future workforce implications and challenges. DESIGN: A cross-sectional study of UK-based doctors in training via an online questionnaire, designed and piloted by the Royal College of Physicians Edinburgh (RCPE) Trainees and Members Committee. Design was informed by prior investigation into LTFT training undertaken amongst similar populations by RCPE in 2019. SETTING/PARTICIPANTS: The survey was distributed from May to September 2023 via email to trainees across the United Kingdom and was open to all specialties and training grades. The survey focused on lived experience of both LTFT and FT training, as well as perceived challenges for the future workforce. RESULTS: There were 648 responses from doctors in training across the United Kingdom, with an even spread of LTFT and FT trainees. Most responses (52.5%) were from trainees in medical specialties. Most LTFT trainees plan to train at this pace for more than 5 years. LTFT was commonly linked to improved work-life balance and well-being, with FT training perceived to feature high stress and burnout. Concerns around LTFT relate to administrative errors, reduced training opportunities and colleague prejudice. Trainees are concerned about LTFT leading to rota gaps and incoherent workforce planning around training numbers. CONCLUSION: With ever-increasing popularity in LTFT training, flexible and robust long-term workforce planning is necessary for the system to adapt to a new normal and improve retention of doctors in training.

Patient and Public Involvement in Dermatology Research: A Review.

Patient and public involvement (PPI) in research is defined as research being carried out 'with' or 'by' members of the public, patients, and carers, on both an individual and a group level, rather than simply 'about', or 'for' them. Within dermatology, PPI is increasingly recognised as a vital component of research as it helps to ensure that research remains relevant to the populations we intend to serve. Dermatology scholarship, with its rich psychosocial implications due to the stigma, physical disability, and mental health burdens these conditions may incur, is in a unique position to benefit from PPI to unlock previously inaccessible patient lived experiences or therapeutic consequences. Throughout the rapid growth of PPI, it has been infused throughout the research lifecycle, from design to dissemination and beyond. After first explaining the principles of PPI, we examine the existing evidence base at each research stage to explore whether our specialty has effectively harnessed this approach and to identify any subsequent impact of PPI. Finally, we scrutinise the challenges faced by those implementing PPI in dermatology research.

Social media: medical education's double-edged sword.

Social media (SoMe) are platforms that enable users to create and share content, or participate in social networking. Medical education is rapidly moving into a post-COVID world, with the use of SoMe becoming ever more prominent. We explore the risks and benefits of using this technology to assist learning and examine these in light of relevant educational theory. Benefits include accessibility to experts, opportunities for mentorship, access to support networks, resource sharing and global participation. Following the 'Black Lives Matter' movement, SoMe has provided the impetus to adapt medical curricula to address health inequities in minority ethnic individuals. Key criticisms focus on superficial learning, psychological safety, correctly identifying level of expertise, professionalism and ownership protections for content creators. Users have limited ways to manage risk. The medical education community must adapt and rapidly critique SoMe innovations so that they can be better developed and learned from, all the while remaining vigilant.

The great escape? The rise of the escape room in medical education.

Medical education has changed focus to a more learner-centred model, placing learners at the centre of innovations in training. The escape room is one such innovative learner-focused activity, in which a team of players cooperatively discover clues, solve puzzles and complete tasks in order to progress through the challenge to achieve a specific goal. Escape rooms can be used in medical education as a tool for team building, an entertaining way of delivering technical and non-technical skills, to read and acquire or refresh knowledge, as well as for educational research. Despite appearing to be a superficial form of entertainment, escape rooms can be grounded in sound educational theory and, when used effectively, act as a low-cost, high-impact resource for a variety of learners. While escape rooms may well be an example of yet another educational 'fad' demonstrating the rising influence of 'Millennial MedEd', it signals a promising shift to more learner-centred, team-based methods which are essential to the practice of safe modern healthcare during the current COVID-19 pandemic and beyond.

The Next Generation: How medical students use new Social Media to support their learning.

This article was migrated. The article was marked as recommended. Background The rise of social media [SoMe] has changed medical education practice, possibly facilitating learning through conversational interaction, social feedback and relationships. Usage of newer SoMe tools like Instagram and Snapchat has not been scrutinised.This study aimed to understand how medical students may use newer SoMe tools, specifically Twitter, Instagram & Snapchat, in their learning, in the context of a parallel SoMe course. Methods An optional, parallel SoMe course was established at Newcastle University Medical School. 301 fourth-year medical students were invited to engage using Twitter, Snapchat and Instagram. Evaluation adopted a mixed methods approach, gathering SoMe analytics and survey data as well as qualitative, free-text responses from a questionnaire and focus-group discussion. Results Live-tweeting lectures featured 95 facilitator tweets, with five replies by students. 22 Instagram posts received no student responses, and three Snapchat stories were viewed 15,312 times, with 212 screenshots taken. Of questionnaire respondents, 75% [n=66] stated they engaged with content. Framework analysis of free-text responses and focus group discussion identified peer influence, fear of exposure, cognitive load and curiosity as drivers in new SoMe use. Discussion Medical students may engage with new SoMe for learning. This may manifest as yet another unilateral learning resource, rather than a tool for discussion or debate. Educators should be aware of external influences, such as peer influence, before assuming student interaction. Further research into medical student use of newer SoMe platforms is warranted, given their popularity, rapidly evolving nature and short lifespan.

How to ask for and act on feedback: practical tips for medical students.

This article was migrated. The article was marked as recommended. Receiving feedback is an essential component of learning and can be invaluable to help you improve your knowledge and skills as you progress towards qualification as a doctor. Whilst formal feedback from assessments is commonplace, it can be daunting to approach others to provide you with feedback. Furthermore, it can be difficult to know how to act on the feedback once you have received it. In this article we look at how best for medical students to ask for feedback and act on the advice which is given to them with a unique point-of-view provided from a current clinical teaching fellow.