Navigating the paradox: Exploring resident experiences of vulnerability.

INTRODUCTION: Learning and growth in postgraduate medical education (PGME) often require vulnerability, defined as a state of openness to uncertainty, risk, and emotional exposure. However, vulnerability can threaten a resident's credibility and professional identity. Despite this tension, studies examining vulnerability in PGME are limited. As such, this study aims to explore residents' experiences of vulnerability, including the factors that influence vulnerability in PGME. METHODS: Using a constructivist grounded theory approach, individual semi-structured interviews were conducted with 15 residents from 10 different specialities. Interview transcripts were coded and analysed iteratively. Themes were identified and relationships among themes were examined to develop a theory describing vulnerability in PGME. RESULTS: Residents characterised vulnerability as a paradox represented by two overarching themes. 'Experiencing the tensions of vulnerability' explores the polarities between being a fallible, authentic learner and an infallible, competent professional. 'Navigating the vulnerability paradox' outlines the factors influencing the experience of vulnerability and its associated outcomes at the intrapersonal, interpersonal, and systems levels. Residents described needing to have the bandwidth to face the risks and emotional labour of vulnerability. Opportunities to build connections with social agents, including clinical teachers and peers, facilitated vulnerability. The sociocultural context shaped both the experience and outcomes of vulnerability as residents faced the symbolic mask of professionalism. CONCLUSION: Residents experience vulnerability as a paradox shaped by intrapersonal, interpersonal, and systems level factors. These findings capture the nuance and complexity of vulnerability in PGME and offer insight into creating supportive learning environments that leverage the benefits of vulnerability while acknowledging its risks. There is a need to translate this understanding into systems-based change to create supportive PGME environments, which value and celebrate vulnerability.

Exploring perspectives of personal learning plans in a residency programme.

BACKGROUND: Personal learning plans (PLPs) have gained traction in postgraduate medical education as an avenue for enhancing resident learning. However, implementing PLPs in real-world education settings presents unique challenges. To realise the potential of PLPs, we must understand the factors that influence the quality of PLP implementation. The purpose of this study was to explore the use and implementation of PLPs during residency training from the residents' and academic advisors' perspectives within a competency-based residency programme. METHODS: We conducted semi-structured interviews with residents (n = 18) and academic advisors (n = 9) in an Internal Medicine residency programme at a Canadian academic centre. Interviews were audio recorded, transcribed verbatim and analysed using open coding. FINDINGS: Three higher order themes were developed to represent the participants' perceptions of implementing PLPs in a competency-based residency programme: (a) setting the stage for learning, (b) fostering meaningful engagement and (c) learning through reflection. Results indicated that implementing PLPs requires collaboration between residents and academic advisors and supports from the broader programme and institution. PLP implementation is an iterative process that can provide a salient avenue for reflection and the development of self-regulation skills. DISCUSSION AND CONCLUSION: PLPs can be a useful tool to foster self-regulated learning skills in residency education. It is imperative to consider how social and environmental supports can be enacted to facilitate engagement with, and implementation of, PLPs.

Talent identification and development in an English Premiership rugby union club: the perspectives of players and coaches.

The pathway towards senior professional status in sport is affected by a multitude of factors. An abductive examination of the talent identification and development processes at an English Premiership rugby union (RU) club was undertaken for the present study. Part one examined the perspectives on the selection and development processes of senior academy male players (n = 8), whereas part two explored the perceptions of male coaches (n = 7). A total of three focus groups were used. Three main themes were confirmed by players and coaches: (a) task constraints, (b) performer constraints, and (c) environmental constraints. Specifically, although athletes and coaches believed that performer constraints were highly impactful on players' career in RU, there were inconsistencies surrounding the task and environmental constraints. Despite an indication that three common themes impacted an players path, this preliminary study shows an imbalance in the understanding of some of the key factors perceived to be important for talent progression in the present rugby academy. More research using similar qualitative methods is recommended to better understand the differences in opinions between players and coaches. Meanwhile, practitioners should consider implementing objective and holistic strategies to improve the talent pathway in English RU academies.

Characteristics of transformational leadership development programs: A scoping review.

The effectiveness of transformational leadership (TFL) on various outcomes is well known. Accordingly, researchers have developed training programs to enhance TFL behaviours of leaders. Yet, no reviews summarizing the characteristics of TFL training programs exist. The purpose of this review was to examine the characteristics, reporting, and application of TFL-informed programs. A search of six databases yielded 4032 articles, 31 of which met the inclusion criteria. Program characteristics were analyzed using the Template for Intervention Description and Replication (TIDieR) checklist tool, while outcomes were analyzed according to the Kirkpatrick model of evaluation. The most common context for TFL program implementation was healthcare (n = 9). Programs were tailored and often delivered using group workshops and individual feedback. Studies reported variation in the dose of programs, rarely evaluated outcomes multiple times post-baseline, and typically employed Level 3a (subjective ratings of behaviour) evaluation measures. Reporting on program location, modifications, and fidelity was poor. Varying conceptualizations of TFL in different contexts lead to disparities in programs and protocols. Evaluation specialists should consider using tools like the TIDiER checklist to ensure that program characteristics are reported appropriately. Program planners should develop common approaches for planning and evaluating TFL programs to improve transparency and replicability of programs.

Exploring the role of socioeconomic status and psychological characteristics on talent development in an English soccer academy.

Social factors and psychological characteristics can influence participation and development in talent pathways. However, the interaction between these two factors is relatively unknown. The aim of this study was to investigate the implications of socioeconomic status and psychological characteristics in English academy soccer players (n=58; aged 11 to 16 years). To assess socioeconomic status, participants' home postcodes were coded according to each individual's social classification and credit rating, applying the UK General Registrar Classification system and CameoTM geodemographic database, respectively. Participants also completed the six factor Psychological Characteristics for Developing Excellence Questionnaire (PCDEQ). A classification of 'higher-potentials' (n=19) and 'lower-potentials' (n=19) were applied through coach potential rankings. Data were standardised using z-scores to eliminate age bias and data were analysed using independent sample t-tests. Results showed that higher-potentials derived from families with significantly lower social classifications (p=0.014) and reported higher levels for PCDEQ Factor 3 (coping with performance and developmental pressures) (p=0.007) compared to lower-potentials. This study can be used to support the impetus for researchers and practitioners to consider the role of social factors and psychological characteristics when developing sporting talent. For example, facilitating player-centred development within an academy and, where necessary, providing individuals with additional support.

It's a 'two-way street': resident perspectives of effective coaching relationships in the clinical learning environment.

Background: Coaching has gained traction in postgraduate medical education to enhance interactions between residents and clinical teachers, but these relationships present unique challenges and tensions. In order to realize the promises of coaching in medical education, we must understand how coaching relationships can be enacted to optimize resident development. The purpose of this study was to explore residents' perceptions of key characteristics for effective clinical teacher-resident (CT-R) coaching relationships. Methods: We conducted four focus groups and eight interviews with residents at a Canadian academic center. Using a social constructionist approach, focus groups and interviews were audio recorded, transcribed verbatim, and thematically analyzed. Results: Residents described three main characteristics that contributed to effective CT-R coaching relationships: safe, meaningful, and collaborative. Residents emphasized that these characteristics needed to be bidirectional in nature to be most effective, in that both the resident and clinical teacher embodied these characteristics. Conclusions: Residents identified that effective coaching relationships were shaped not only by clinical teacher behaviours, but importantly, the quality of the interpersonal relationship that was fostered. Thus, it is imperative to consider the bidirectional nature of the CT-R coaching relationship when striving to enhance resident development.

Contexte: Bien que le coaching ait gagné du terrain en éducation médicale postgraduée, notamment comme moyen de renforcer les interactions entre les résidents et les cliniciens enseignants, les rapports entre eux présentent néanmoins des défis et des tensions uniques. Pour atteindre les résultats souhaités en lien avec le coaching en éducation médicale, il faut comprendre comment ces interactions peuvent être mises à profit de façon à optimiser le perfectionnement des résidents. L'objectif de cette étude était d'explorer les perceptions des résidents quant aux caractéristiques clés d'une relation de coaching efficace entre le clinicien enseignant et le résident. Méthodes: Nous avons organisé quatre groupes de discussion et huit entretiens avec des résidents d'un centre universitaire canadien. Suivant une approche socioconstructiviste, les groupes de discussion et les entrevues ont été enregistrés, les verbatims ont été transcrits et ensuite analysés de façon thématique. Résultats: Les résidents ont décrit trois caractéristiques principales de la relation de coaching pouvant contribuer à son efficacité : elle doit être sécuritaire, significative et collaborative. Ils ont insisté sur le fait que pour atteindre une efficacité optimale des interactions de coaching, ces caractéristiques devaient être bidirectionnelles, à savoir présentes tant chez le résident que le clinicien enseignant. Conclusions: D'après les résidents, si l'efficacité de la relation de coaching est déterminée par les comportements des cliniciens enseignants, elle dépend surtout de la qualité des rapports interpersonnels cultivés. Il est donc impératif de tenir compte de la nature bidirectionnelle de la relation de coaching entre cliniciens enseignants et résidents lorsqu'on vise à améliorer le développement de ces derniers.

Developing a Curriculum for Addressing the Opioid Crisis: A National Collaborative Process.

BACKGROUND: The burgeoning use of opioids and the lack of attention to the safe prescribing, storage, and disposal of these drugs remains a societal concern. Education plays a critical role in providing a comprehensive response to this crisis by closing the training gaps and empowering the next generation of physicians with the knowledge, skills, and resources needed to diagnose, treat and manage pain and substance use. Curricular Development: The Association of Faculties of Medicine of Canada (AFMC) developed a competency-based, bilingual curriculum for undergraduate medical students to be implemented in all Canadian medical schools. The authors describe the principles and framework for developing a national curriculum. The curriculum design process was situated in the Knowledge to Action theoretical framework. Throughout the development of this curriculum, different stakeholder groups were engaged, and their needs and contexts were considered. CONCLUSION: The curriculum ensures that consistent information is taught across all medical schools to educate future physicians on pain management, opioid stewardship and substance use disorder.

Relative Age Effects in Male Cricket: A Personal Assets Approach to Explain Immediate, Short-Term, and Long-Term Developmental Outcomes.

The purpose of this study was to adopt the Personal Assets Framework (PAF) to examine the immediate, short-term, and long-term developmental outcomes associated with relative age effects (RAEs) in male cricket. As such, this study was comprised of three aims: (a) examine the birth quarter (BQ) distribution of players throughout the England and Wales Cricket Board (ECB) national talent pathway (i.e., Regional U15, Regional U17, England U19, England Lions, England T20, England ODI, and England Test; n = 1800; immediate timescale), (b) explore the youth-to-senior transitions based on BQ and skill-set (i.e., batters and bowlers; short-term timescale), and (c) analyse the average number of games played at senior levels based on BQ and skill-set (i.e., long-term timescale). A chi-square goodness of fit test, Cramer's V, odds ratios, and 95% confidence intervals were used to compare the BQ distributions of each cohort against the expected BQ distributions. In the immediate timescale, results showed that relatively older players were overrepresented throughout all the youth levels (p < 0.05, V = 0.16−0.30), whereas there were no differences at senior levels (p > 0.05, V = 0.05−0.15). In the short-term timescale, when the senior cohorts were compared to the expected BQ distributions based on the Regional U15 cohort, relatively younger players were more likely to transition from youth to senior levels (p < 0.05, V = 0.22−0.37). In the long-term timescale, relatively older batters were selected for more games (p < 0.05, V = 0.18−0.51), whereas relatively younger bowlers were selected for more games (p < 0.05, V = 0.17−0.39). Moving forward, it is important for researchers and practitioners to better understand how (bi)annual-age grouping shapes developmental outcomes in across different timescales (i.e., immediate, short-term, and long-term), as well as consider alternative grouping strategies and RAE solutions.

An Examination of the Relationship Between Coaches' Transformational Leadership and Athletes' Personal and Group Characteristics in Elite Youth Soccer.

There is a growing body of the literature highlighting the positive impact of transformational leadership behaviours across contexts, including sport. However, there is a lack of knowledge of this relationship within elite sport settings. Thus, the purpose of the present study was to examine the relationship between elite youth athletes' perceptions of coaches' transformational coaching-behaviours and variables that have been linked to transformational leadership in other settings (i.e., group cohesion, motivational climate, self-regulation of learning and athlete satisfaction). Norwegian elite youth soccer players (n = 753) selected into the national talent development program completed questionnaires to measure the variables of interest. Using structural equation modelling, results revealed a positive path from transformational leadership to both task and social cohesion, task-oriented motivational climates, self-regulation of learning and athlete satisfaction. Finally, a negative path from transformational leadership to ego-oriented climates was identified. The findings are in line with previous research in associating transformational leadership behaviours with adaptive outcomes, and further indicating that such relationships may also be valid in elite sport contexts.

Talent Identification and Relative Age Effects in English Male Rugby Union Pathways: From Entry to Expertise.

A common practice in youth rugby union is to group players based on (bi)annual age with fixed cut-off dates. The overrepresentation of players born at the start of the cut-off date and the underrepresentation of players born toward the end of the cut-off date are termed relative age effects (RAEs). The aim of this study was to examine RAEs during entry into professional and international rugby union pathways in England, as well as comparing them to their respective senior cohort: U15 Regional Academy Player (n = 1,114) vs. Senior Professional Player (n = 281) and U16-23 England Academy Player (n = 849) vs. Senior International Player (n = 48). Chi-square (χ2) analysis compared birth quarter (BQ) distributions against expected distributions. Odds ratios and 95% confidence intervals compared the likelihood of a BQ being selected. Findings revealed a significant overrepresentation of relatively older players compared with their relatively younger peers within both youth cohorts (P < 0.001; BQ1 = 42.5% vs. BQ4 = 9.6%; BQ1 = 36.5% vs. BQ4 = 15.2%). In comparison, there was no significant difference in the BQ distributions within both senior cohorts. Further, BQ4s were 3.86 and 3.9 times more likely to achieve senior professional and international levels than BQ1s and BQ2s, respectively. It is suggested that relatively younger players may have a greater likelihood of achieving expertise following entry into a rugby union talent pathway due to benefitting from more competitive play against relatively older counterparts during their development (e.g., reversal effects; the underdog hypothesis). Moreover, possible solutions (e.g., age and anthropometric banding; playing-up and playing-down) are discussed to encourage practitioners and policy makers to create the most appropriate learning environment for every player.

A multidisciplinary investigation into "playing-up" in academy football according to age phase.

In an attempt to facilitate more appropriate levels of challenge, a common practice in academy football is to play-up talented youth players with chronologically older peers. However, the context of playing-up in academy football is yet to be empirically explored. Thus, the purpose of this study was to examine the multidimensional factors that differentiated players who play-up from those who do not. Ninety-eight participants from a single football academy were examined within their age phase: Foundation Development Phase (FDP; under-9 to under-11; n = 40) and Youth Development Phase (YDP; under-12 to under-16; n = 58). Drawing upon the FA Four Corner Model, 27 factors relating to Technical/Tactical, Physical, Psychological, and Social development were assessed. Following MANOVA analysis within both the FDP and YDP, significant differences were observed for Technical/Tactical and Social sub-components (P < 0.05). Further differences were observed for Physical and Psychological sub-components (P < 0.05) within the YDP. In sum, Technical/Tactical and Social characteristics appeared to differentiate those who play-up compared to those who do not within the FDP. In the YDP however, there were measures representing all sub-components from the FA Four Corner Model. Subsequently, it is suggested coaches and practitioners consider these holistic factors when playing-up youth football players within relevant age-phases.

"Birthday-Banding" as a Strategy to Moderate the Relative Age Effect: A Case Study Into the England Squash Talent Pathway.

The relative age effect (RAE) is almost pervasive throughout youth sports, whereby relatively older athletes are consistently overrepresented compared to their relatively younger peers. Although researchers regularly cite the need for sports programs to incorporate strategies to moderate the RAE, organizational structures often continue to adopt a one-dimensional (bi)annual-age group approach. In an effort to combat this issue, England Squash implemented a "birthday-banding" strategy in its talent pathway, whereby young athletes move up to their next age group on their birthday, with the aim to remove particular selection time points and fixed chronological bandings. Thus, the purpose of this study was to examine the potential effects of the birthday-banding strategy on birth quarter (BQ) distributions throughout the England Squash talent pathway. Three mixed-gender groups were populated and analyzed: (a) ASPIRE athletes (n = 250), (b) Development and Potential athletes (n = 52), and (c) Senior team and Academy athletes (n = 26). Chi-square analysis and odds ratios were used to test BQ distributions against national norms and between quartiles, respectively. Results reveal no significant difference between BQ distributions within all three groups (P > 0.05). In contrast to most studies examining the RAE within athlete development settings, there appears to be no RAE throughout the England Squash talent pathway. These findings suggest that the birthday-banding strategy may be a useful tool to moderate RAE in youth sports.

Disentangling the Relations between Social Identity and Prosocial and Antisocial Behavior in Competitive Youth Sport.

The social identities formed through membership on extracurricular activity groups may contribute to the frequency with which youth engage in prosocial and antisocial behavior. However, researchers have yet to disentangle the individual- and group-level processes social identification effects operate through; sex and perceived norms may also moderate such effects. Thus, we investigated the hierarchical and conditional relations between three dimensions of social identity (i.e., ingroup ties, cognitive centrality, ingroup affect) and prosocial and antisocial behavior in youth ice hockey players (N = 376; 33% female). Multilevel analyses demonstrated antisocial teammate and opponent behavior were predicted by cognitive centrality at the team level. Further, prosocial teammate behavior was predicted by cognitive centrality and ingroup ties at the individual-level. Also, perceived norms for prosocial teammate behavior moderated the relations between ingroup ties, cognitive centrality, and ingroup affect and prosocial teammate behaviour. Finally, sex moderated the relations between cognitive centrality/ingroup affect and antisocial opponent behavior. This work demonstrates the multilevel and conditional nature of how social identity dimensions relate to youth prosocial and antisocial behavior.