Int. Med. Educ., Volume 3, Issue 4 (December 2024) – 8 articles

For feedback to be productive, it relies on the interactions of participants, design elements, and resources. Yet, complexities in clinical education pose challenges for feedback practices in students and teachers, and efforts to improve feedback often ignore the influence of culture and context. A recent sociocultural approach to feedback practices recognized three layers to understand the complexity of productive feedback: the encounter layer, the design layer, and the knowledge layer. This study explores the sociocultural factors that influence productive feedback practices in clinical settings from the clinical teacher–student dyad perspective. A cross-sectional qualitative study in a physiotherapy clerkship involved semi-structured interviews with ten students and eight clinical educators. Convenience sampling was used, and participation was voluntary. Employing thematic analysis from a sociocultural perspective, this study examined feedback practices across the three layers of feedback practices. The analysis yielded different elements along the three layers that enable productive feedback practices in the clinical workplace: (1) the feedback encounter layer: dyadic relationships, mutual trust, continuity of supervision, and dialogue; (2) the feedback design layer: enabled learning opportunities and feedback scaffolding; (3) the knowledge domain layer in the clinical culture: Growing clinical experience and accountability. In the context of undergraduate clinical education, productive feedback practices are shaped by social–cultural factors. Designing feedback practices should consciously integrate these components, such as cultivating relationships, fostering guidance, enhancing feedback agency, and enabling supervised autonomy to promote productive feedback. Full article

Small-group learning is a mainstay of medical education, and group functioning can have a major influence on these learning experiences. Our objective was to explore verbal exchange patterns within small-group learning sessions and examine how different patterns related to tutor involvement, tutor expertise, and participants’ perceptions. A non-participant observer collected group interactivity data using a real-time mobile device-based system. Verbal interaction patterns were visualized and analyzed using social network analysis and correlated with participant survey data and aggregate course grades. There were 46 observations across 30 separate groups. Group interactions clustered into four patterns defined by (1) tutor involvement (high vs. low) and (2) interactivity (high vs. low). Interaction patterns were largely stable for a given group and groups with content expert facilitators were generally less interactive. Students reported objectively fewer interactive groups as more interactive and enjoyable. There were no significant intergroup differences in aggregate course grades. Paradoxically, student perceptions were not aligned with observed interactivity data, and tutor content expertise influenced group interactivity. These findings suggest the need to better manage learner expectations of small-group learning, and to explicitly reflect on and develop skills for effective collaborative learning with both faculty and students. Full article

Plastic surgery is a diverse speciality relevant to non-plastic doctors, as plastic surgeons frequently collaborate with other specialities and its basic principles are transferable across multiple specialities. Foundation-year (FY) doctors are the most junior doctors in the workforce and may need to apply plastic surgery knowledge and principles during their clinical duties. Despite this, formal plastic surgery education for junior doctors is limited, resulting in an educational gap. This study gains insight into the perceived confidence, knowledge gaps, skills, educational activities and needs related to plastic surgery. This qualitative study uses phenomenology through semi-structured individual interviews with eight FY doctors. Data was analysed using reflexive thematic analysis. This study revealed that plastic surgery features diversely in the work life of FYs, who often manage patients with a lack of knowledge and confidence, influencing patient care and FY wellbeing. FYs primarily acquire knowledge and confidence through experiential learning and individual initiative. A need for curriculum improvements was expressed. FYs are an essential part of the workforce who exhibited educational gaps and a lack of confidence in plastic surgery knowledge. We suggest improved integration of plastic surgery into the FY curriculum for improved FY knowledge and patient care. Full article

(1) Background: There is a need to scale and transform health professional education (HPE) globally to not only improve the quantity but also the quality of health workers. This paper describes the approach undertaken by a Health University in Lao PDR. (2) Approach: The HPE curriculum was designed in an iterative process with key stakeholders from both the institution and government, with external expert advice. (3) Outcomes: The curriculum was successfully developed consisting of nine core modules and one elective module, reflecting both elements seen globally in HPE curricula as well as reflecting local needs. The content and teaching methods were validated and reviewed through piloting with local education leaders. (4) Conclusions: Despite the need to scale HPE globally, there are few examples of how this can be achieved in countries in which large gaps exist in HPE capacity. This paper provides one such example, through recognizing that sustained external partnerships will still be needed for successful future implementation. Full article

Despite the potential benefits of generative artificial intelligence (genAI), concerns about its psychological impact on medical students, especially about job displacement, are apparent. This pilot study, conducted in Jordan during July–August 2024, aimed to examine the specific fears, anxieties, mistrust, and ethical concerns medical students harbor towards genAI. Using a cross-sectional survey design, data were collected from 164 medical students studying in Jordan across various academic years, employing a structured self-administered questionnaire with an internally consistent FAME scale—representing Fear, Anxiety, Mistrust, and Ethics—comprising 12 items, with 3 items for each construct. Exploratory and confirmatory factors analyses were conducted to assess the construct validity of the FAME scale. The results indicated variable levels of anxiety towards genAI among the participating medical students: 34.1% reported no anxiety about genAI‘s role in their future careers (n = 56), while 41.5% were slightly anxious (n = 61), 22.0% were somewhat anxious (n = 36), and 2.4% were extremely anxious (n = 4). Among the FAME constructs, Mistrust was the most agreed upon (mean: 12.35 ± 2.78), followed by the Ethics construct (mean: 10.86 ± 2.90), Fear (mean: 9.49 ± 3.53), and Anxiety (mean: 8.91 ± 3.68). Their sex, academic level, and Grade Point Average (GPA) did not significantly affect the students’ perceptions of genAI. However, there was a notable direct association between the students’ general anxiety about genAI and elevated scores on the Fear, Anxiety, and Ethics constructs of the FAME scale. Prior exposure to genAI and its previous use did not significantly modify the scores on the FAME scale. These findings highlight the critical need for refined educational strategies to address the integration of genAI into medical training. The results demonstrate notable anxiety, fear, mistrust, and ethical concerns among medical students regarding the deployment of genAI in healthcare, indicating the necessity of curriculum modifications that focus specifically on these areas. Interventions should be tailored to increase familiarity and competency with genAI, which would alleviate apprehensions and equip future physicians to engage with this inevitable technology effectively. This study also highlights the importance of incorporating ethical discussions into medical courses to address mistrust and concerns about the human-centered aspects of genAI. In conclusion, this study calls for the proactive evolution of medical education to prepare students for new AI-driven healthcare practices to ensure that physicians are well prepared, confident, and ethically informed in their professional interactions with genAI technologies. Full article

The integration of sociology into medical education is essential for cultivating a nuanced understanding of the complex interplay between social determinants and health outcomes. This national cross-sectional survey utilized a qualitative, descriptive research approach to examine the inclusion of sociology as a course in the undergraduate curricula of medical schools in Greek higher education. Data collection and analysis were conducted through a comprehensive review of the syllabi from all seven medical schools in Greece. The analysis revealed that none of the seven undergraduate medical curricula include sociology as a discrete course. Social medicine is offered as a discrete course in three out of the seven programs, whereas sociological concepts are present in the majority of the medical curricula (six out of seven). A significant gap in the integration of sociology as a discrete course within Greek medical graduate education is revealed. To better equip future medical doctors with sociological lenses towards medical practice, a more comprehensive integration of sociology into medical training is recommended. Full article

Advances in artificial intelligence (AI) in the medical sector necessitate the development of AI literacy among future physicians. This article explores the pioneering efforts of the AI in Medicine Association (AIM) at Brigham Young University, which offers a framework for undergraduate pre-medical students to gain hands-on experience, receive principled education, explore ethical considerations, and learn appraisal of AI models. By supplementing formal, university-organized pre-medical education with a student-led, faculty-supported introduction to AI through an extracurricular academic association, AIM alleviates apprehensions regarding AI in medicine early and empowers students preparing for medical school to navigate the evolving landscape of AI in healthcare responsibly. Full article

Through the pivot to emergency remote teaching during the pandemic, most universities have managed to become ‘digital’, at least in the delivery of educational programmes and business operations. And yet, the purposeful design and use of technology for education is far from the reality of such a pivot and remains difficult to achieve. While most universities outline some level of digital transformation as part of their innovation narrative and strategies, there is only a limited number of universities that adopt the culture of co-creation. This paper illustrates a bottom-up approach to the co-creation of a new digital and medical education strategy in a London-based Russell Group university to bring on change that is fit for purpose. The findings include the key insights, specifically, the five key values of what the community believed to be crucial—(i) broadening access to education, (ii) flexibility, efficiency and convenience, (iii) authentic learning, (iv) business proposition, and (v) pastoral care; and the eight areas of opportunities and challenges—(i) human relationships, (ii) co-creation, (iii) digital engagement, (iv) digital pedagogy, (v) digital literacy, (vi) edtech and IT infrastructure, (vii) support, and (viii) digital assessment and feedback. This paper also outlines the strategic project plans that were generated and since implemented as a result of the co-creation process. The limitations and future directions of this study are also noted. Full article