The transdisciplinary health research apparatus: A Baradian account of knowledge boundaries and beyond.

This paper engages with new materialist theory to reimagine transdisciplinary health research. In particular, we draw upon Karen Barad's theory of agential realism and concept of apparatus to rethink the processes of doing transdisciplinary research. A Baradian inspired approach to transdisciplinarity encourages us to not only explore ways of knowing health phenomena differently by working across disciplines, but also to pay close attention to the politics and practices in such research. We offer a case study based on a two-year transdisciplinary research project focused on the health condition known as Low Energy Availability (LEA) in sportswomen. Through this case we highlight three key ways that Barad's concept of apparatus helped us know transdisciplinarity differently: (1) Reading disciplines through each other, (2) Intra-actions and the everyday performativity of disciplinary boundaries, and (3) Troubling the boundaries of the apparatus. Ultimately this paper illustrates the value in feminist new materialist conceptual tools for encouraging different questions of transdisciplinary research as ethico-onto-epistemological practices, processes, and politics of knowledge production.

Toward More-Than-Human Understandings of Sport and the Environment: A New Materialist Analysis of Everyday Fitness Practices.

Sport and fitness have long been linked with healthy lifestyles, yet most sporting events and consumption practices are highly detrimental to the environment. While academics have examined the harmful effects of sporting mega-events and the production and consumption of sport equipment and clothing, there has been less engagement with the "mundane," everyday activities of consuming, laundering, and recycling of fitness objects. In this paper, we explore the potential in feminist new materialisms for rethinking the complex relationships between sport, fitness, and the environment. In particular, we explain how our engagement with Karen Barad's theory of agential realism led us to rethink women's habitual fitness practices as connected to environmental degradation. Working with Barad's concept of entanglement, we came to notice new human-clothing-environment relationships, focusing on how athleisure clothing itself is an active, vital force that intra-acts with other non-human (and human) matter within the environment. Adopting a diffractive methodology that included reading interviews with women about their activewear practices, our own experiences, new materialist theory, and environmental literature through each other, we focus on two examples that emerged through this process: laundering and disposal practices. Through these examples, we demonstrate the ways in which new materialisms encouraged us to move toward non-anthropocentric understandings of the sport-environment relationship and toward new ethical practices in our everyday fitness lifestyles.

Are multiple choice tests fair to medical students with specific learning disabilities?

The purpose of multiple choice tests of medical knowledge is to estimate as accurately as possible a candidate's level of knowledge. However, concern is sometimes expressed that multiple choice tests may also discriminate in undesirable and irrelevant ways, such as between minority ethnic groups or by sex of candidates. There is little literature to establish whether multiple choice tests may also discriminate against students with specific learning disabilities (SLDs), in particular those with a diagnosis of dyslexia, and whether the commonly-used accommodations allow such students to perform up to their capability. We looked for evidence to help us determine whether multiple choice tests could be relied upon to test all medical students fairly, regardless of disability. We analyzed the mean scores of over 900 undergraduate medical students on eight multiple-choice progress tests containing 1,000 items using a repeated-measures analysis of variance. We included disability, gender and ethnicity as possible explanatory factors, as well as year group. There was no significant difference between mean scores of students with an SLD who had test accommodations and students with no SLD and no test accommodation. Virtually all students were able to complete the tests within the allowed time. There were no significant differences between the mean scores of known minority ethnic groups or between the genders. We conclude that properly-designed multiple-choice tests of medical knowledge do not systematically discriminate against medical students with specific learning disabilities.

The changing landscape of medical education in the UK.

The UK shares many characteristics with other western developed countries, including a current adherence to the view that defining educational outcomes enables improvements in learning and teaching and a more effective management of the learning and assessment process. There are, however, some features that make UK medical education unique or that give it a distinctive flavour. This article looks at the various forces that shape medical education in the UK and the structures that underpin its delivery, and discusses the distinctive climate that is produced, in which doctors, students and medical teachers are expected to work. We examine and assess these special features of UK medical education and report on the ways in which medical education and medical educators are adapting to the complex and constantly changing environment. We conclude that the healthcare and higher education systems in the UK face unprecedented economic and political challenges over the coming years. Medical educators working within these systems have an important role in ensuring that these challenges are met and that standards are maintained and improved. A stronger professional architecture to support careers in medical education is needed to ensure that those involved in teaching medical students and doctors have the necessary training, time, resources and incentives to do it effectively.

Thinking the post-colonial in medical education.

CONTEXT: Western medicine and medical techniques are being exported to all corners of the world at an increasing rate. In a parallel wave of globalisation, Western medical education is also making inroads into medical schools, hospitals and clinics across the world. Despite this rapidly expanding field of activity, there is no body of literature discussing the relationship between post-colonial theory and medical education. DISCUSSION: Although the potential benefits of international partnerships and collaborations in education are incontrovertible, many medical educators are sometimes too unreflecting about what they are doing when they advocate the export of Western curricula, educational approaches and teaching technologies. The Western medical curriculum is steeped in a particular set of cultural attitudes that are rarely questioned. We argue that, from a critical theoretical perspective, the unconsidered enterprise of globalising the medical curriculum risks coming to represent a 'new wave' of imperialism. Using examples from Japan, India and Southeast Asia, we show how medical schools in non-Western countries struggle with the ingrained cultural assumptions of some curricular innovations such as the objective structured clinical examination, problem-based learning and the teaching of clinical skills. CONCLUSIONS: We need to develop greater understanding of the relationship between post-colonial studies and medical education if we are to prevent a new wave of imperialism through the unreflecting dissemination of conceptual frameworks and practices which assume that 'metropolitan West is best'.

Further insights into the roles of the medical educator: the importance of scholarly management.

Medical educators need to be able to define excellence within the various roles they occupy so that they can demonstrate internationally recognized, high-quality scholarship. Previous definitions of scholarship have focused on research and teaching but have been unable to integrate other roles such as leadership, management, and administration. Clearer definition of the various roles of the medical educator, coupled with a broader understanding of medical education scholarship that is able to encompass management, as well as teaching and research, will help institutions to evaluate and reward faculty members appropriately. We propose that management should now be introduced as a third "priority of the professoriate." We outline the concept of the scholarly manager, particularly as it applies to management in medical education. We offer a new conceptual model which situates the role of the academic manager within the scholarship of medical education and shows it to be an essential part of the skills and competences of the excellent medical educator. We emphasize that at the heart of all scholarly activity in medical education lie the core skills, values, and behaviors shared by all involved in the education of doctors and medical students. Future research is needed to explore and, where possible, achieve consensus on the core skills, values, and behaviors of an excellent medical educator. In addition, work should commence to define and categorize the various stages in the development of a significant management portfolio in medical education teaching and research.

Author misconduct: not just the editors' responsibility.

BACKGROUND: Researchers everywhere are under increasing pressure to publish in high quality journals. The amount of space available in a journal such as Medical Education has not kept pace with the rise in submissions. Against a background of fierce competition, authors sometimes cut corners. This may lead to misconduct. AIMS: This paper aims to explore the most common types of publication misconduct seen in the Medical Education editorial office, and to consider the reasons for this and the implications for researchers in the field. DISCUSSION: This paper looks at the work of the Committee on Publication Ethics and describes the type of routine, low level misconduct which is increasingly reported by its member journals, including Medical Education. We offer a list of authors' responsibilities as a way of drawing attention to the wide range of individuals affected by author misconduct. The paper outlines 7 representative cases of actual or potential misconduct which have been dealt with in the Medical Education editorial office during the 18-month period to May 2004, putting them in context and using them to illustrate some of the ways in which apparently minor deviations from standard practice can have far reaching implications. FUTURE DIRECTIONS: This paper argues that misconduct affects a wider group than editors, although it is editors who are currently taking the lead in the promotion of standards. The authors suggest that responsibility for maintaining and improving standards in research publication should not be left to editors but should be seen as something in which all researchers have a stake. They support moves to make editors themselves more accountable to their readers and authors.