Can Case-Based Training Improve the Confidence of Final Year Student Doctors in Drug Prescribing?

An interactive prescribing course for final year medical students to improve their confidence in prescribing as junior doctors

Classifying Simulation-based Studies using the Description, Justification and Clarification Framework: A Review of Simulation Conference Abstracts

Introduction Simulation-based medical education (SBME) is an accepted learning methodology with an ever-expanding evidence base. Concerns have been expressed that research output in SBME lacks explicit links to educational theory. Using the ‘Description, Justification and Clarification’ framework we have investigated the extent to which SBME conference abstracts declare the educational theory underpinning their studies. Methods Abstracts from four major international SBME conferences (for 2014 and 2015) were reviewed. Abstracts were classified using the framework offered by Cook et al who classified studies published in major educational journals. Clarification studies are those which specifically declare and test their underpinning educational approach. Results We reviewed 1398 conference abstracts which we classified as Description 54.4%, Justification 36.3% and Clarification 9.3%. The two most frequently declared educational theories were Cognitive Theories and Experiential Learning. Conclusion The low proportion of Clarification studies found in the SBME conference abstracts reflects previous findings highlighting the lack of medical education studies that establish how and why SBME works. Researchers should be encouraged to declare their underpinning educational theories when presenting their work. Conference organisers play an important role in facilitating this through allowing sufficient word count in their submission criteria

Twelve tips for choosing and surviving a PhD in medical education – a student perspective

The decision to undertake a PhD in medical education could mark a critical point in defining your future career. Attaining the highest level of degree in such a diverse and rewarding area as medical education may not only provide you with an opportunity to undertake important new research, but could also unlock different job opportunities. As is often the case, such rewards are not gained lightly. There can be real challenges in making the decision to undertake and then to successfully navigate a PhD. The specific subject and process of each doctorate is unique, leaving many prospective and current students uncertain as to what to expect. We offer our twelve tips from the perspective of two current PhD students to help guide those who share our interest in medical education and are considering doctoral study

Beyond the bedside: a scoping review of the experiences of non‐practising health care professionals in Health Professions Education

Introduction The shortage of educators within Health Professions Education (HPE) threatens the optimal training of the future health care workforce. Furthermore, without recruitment of diverse and skilled faculty, targets to expand the workforce will not be possible. Non-practising health care professionals offer extensive knowledge and qualifications within health care, without the competing clinical commitments of their clinical academic colleagues, and therefore are ideally positioned to support education and training initiatives. However, the limited available evidence suggests that these individuals face significant challenges transitioning from clinical to academic roles. The purpose of this scoping review is to address the research question ‘What is known about the career experiences of non-practicing healthcare professionals (defined as individuals with clinical backgrounds who no longer engage in direct patient care) across various professions and internationally, within the field of health professions education?’. To do so, we aim to map the global experiences of non-practising health care professionals from different specialties and disciplines transitioning to HPE, with a view to both current support strategies that aim to recruit and retain these individuals and fuel future research in this area. Methods Following Arksey and O'Malley's scoping review guidelines, a research question was formulated focussing on exploring the career experiences of non-practising health care professionals now working in HPE. Searching seven literature databases and grey literature identified 51 articles for analysis. Both quantitative and qualitative methods were utilised to chart and thematically analyse data to identify key themes. Results There has been a rise in publications on this topic, with most studies originating from the United States and focusing on nursing. Transition to academia is marked by significant challenges, including identity shifts, renumeration and professional progression tensions, licencing issues and financial concerns. Support systems are crucial to navigating new roles alongside personal/professional development but often lacking. Discussion This scoping review highlights challenges and opportunities for non-practising health care professionals in HPE. Additional support for making the transition to education, including structured onboarding processes and long-term mentoring relationships, would be beneficial. Recognising the liminal space these professionals occupy might also facilitate more effective integration into academic roles, contributing to a more dynamic and inclusive HPE environment. Future research should explore these experiences from broader professional and geographical perspectives and employ an intersectional approach to fully understand and support this growing demographic in our field

Beyond the bedside: protocol for a scoping review exploring the experiences of non-practicing healthcare professionals within health professions education

Background The number of healthcare professionals leaving clinical practice and transitioning to alternative careers in health professions education is increasing. Among these non-practicing healthcare professionals, concerns have been reported regarding tensions in relation to identity, role, and credibility in their new field. There are suggestions that this is a particularly pressing issue for minoritised professionals who make this transition. Support is critical to attract and retain diverse talent within health professions education teaching and research. The purpose of this scoping review is to explore the career experiences of non-practicing healthcare professionals who work in health professions education internationally. Methods Arksey and O’Malley’s framework has been utilised to guide the design of this scoping review process and will be used throughout the course of the review. A comprehensive search of seven electronic databases and limited search of Google Scholar will be conducted, as well as a hand search of eligible article reference lists. Two reviewers will independently screen all articles based on inclusion criteria, with conflicts resolved by a third reviewer. Data from included articles will be charted, collated, and analysed thematically. Meta-data will be summarised quantitatively. Discussion This scoping review aims to explore the role and experiences of non-practicing healthcare professionals working within health professions education. The review will follow established scoping review guidelines and will include studies from various regions and languages, provided an English translation is available. The study remit will be broad, including both quantitative and qualitative studies, as well as reviews and opinion papers. Limitations may include the exclusion of non-English articles and potential difficulty of identifying papers which discuss the experiences of non-practicing clinicians. However, the review will provide insight into the current knowledge on what it is like to be a non-practicing clinician working within health professions education and identify gaps for both future research, and future support for those making this career transition

What can medical educators learn from the Rio 2016 Olympic Games?

Medical Educators face an ongoing challenge in optimising preparedness for practice for newly qualified doctors. Junior doctors have highlighted specific areas in which they do not feel adequately equipped to undertake their duties, including managing the acutely unwell patient. In these highly stressful, time-critical scenarios it might be assumed that a lack of knowledge underpins these feelings of apprehension from junior medics; however, having studied, trained and passed examinations to demonstrate such knowledge, perhaps other factors should be considered. The recent Olympic Games in Rio demonstrated the impact of sport psychology techniques in allowing athletes to achieve their optimum performance in the face of adversity. The use of mental and behavioural strategies to control feelings of anxiety and low self-efficacy are pivotal for athletes to deliver their best performance under extreme pressure. We consider whether such techniques could improve the preparedness of the newest recruits to the healthcare system, and the impact this could have on patient care. Finally, suggestions for potential research directions within this area are offered to stimulate interest amongst the research community

Educational interventions for imposter phenomenon in healthcare: a scoping review

Background Imposter Phenomenon (IP) is a subjective feeling of intellectual fraudulence and self-doubt experienced by individuals in goal-orientated high-achieving professions. The impact of IP within healthcare has been associated with individual physical and mental health and concerns around training, career progression and DEI at an institutional level. To effectively address IP in healthcare, this scoping review aims to explore educational interventions designed to empower high-achieving individuals with the tools needed to confront and overcome IP. Methods The scoping review adhered to a predetermined protocol informed by the JBI methodology and PRISMA-ScR guidelines in order to identify educational interventions addressing IP in high-achieving industries. Articles were searched across multiple databases, including MEDLINE (Ovid), PsychINFO, SCOPUS, and Web of Science, alongside grey literature, without imposing any time constraints. A systematic approach including a thematic analysis allowed for a nuanced exploration and interpretation of the identified educational interventions and their impact on addressing IP. Results Seventeen articles were incorporated into the review, with the majority originating from the USA and majority being published since 2020. Ten studies targeted healthcare professionals, undergraduate and postgraduate healthcare students. Majority of studies aimed at addressing IP, featured a larger number of female participants than males. Workshops with self-reflection and group-guided exercises to overcome IP were the most popular educational interventions. Coaching and structured supervision were also suggested. Across all papers, three themes emerged for coping strategies: individual, peer-to-peer, and institutional. Conclusions This scoping review suggests how group and individual interventions such as workshops, small group discussions and coaching can be used to overcome IP in healthcare. Institutional changes like diversity promotion, supervisor education, and support networks are crucial in addressing IP. Further long term and speciality specific assessments are needed to measure impact. Overall, the review highlights how educational awareness and a variety of strategies can be implemented to create a supportive environment for professionals dealing with IP, promoting their well-being and success

The Mathematical Universe

I explore physics implications of the External Reality Hypothesis (ERH) that there exists an external physical reality completely independent of us humans. I argue that with a sufficiently broad definition of mathematics, it implies the Mathematical Universe Hypothesis (MUH) that our physical world is an abstract mathematical structure. I discuss various implications of the ERH and MUH, ranging from standard physics topics like symmetries, irreducible representations, units, free parameters, randomness and initial conditions to broader issues like consciousness, parallel universes and Godel incompleteness. I hypothesize that only computable and decidable (in Godel's sense) structures exist, which alleviates the cosmological measure problem and help explain why our physical laws appear so simple. I also comment on the intimate relation between mathematical structures, computations, simulations and physical systems.Comment: Replaced to match accepted Found. Phys. version, 31 pages, 5 figs; more details at http://space.mit.edu/home/tegmark/toe.htm

Measurement of the Charged Multiplicities in b, c and Light Quark Events from Z0 Decays

Average charged multiplicities have been measured separately in $b$, $c$ and light quark ($u,d,s$) events from $Z^0$ decays measured in the SLD experiment. Impact parameters of charged tracks were used to select enriched samples of $b$ and light quark events, and reconstructed charmed mesons were used to select $c$ quark events. We measured the charged multiplicities: $\bar{n}_{uds} = 20.21 \pm 0.10 (\rm{stat.})\pm 0.22(\rm{syst.})$, $\bar{n}_{c} = 21.28 \pm 0.46(\rm{stat.}) ^{+0.41}_{-0.36}(\rm{syst.})$ $\bar{n}_{b} = 23.14 \pm 0.10(\rm{stat.}) ^{+0.38}_{-0.37}(\rm{syst.})$, from which we derived the differences between the total average charged multiplicities of $c$ or $b$ quark events and light quark events: $\Delta \bar{n}_c = 1.07 \pm 0.47(\rm{stat.})^{+0.36}_{-0.30}(\rm{syst.})$ and $\Delta \bar{n}_b = 2.93 \pm 0.14(\rm{stat.})^{+0.30}_{-0.29}(\rm{syst.})$. We compared these measurements with those at lower center-of-mass energies and with perturbative QCD predictions. These combined results are in agreement with the QCD expectations and disfavor the hypothesis of flavor-independent fragmentation.Comment: 19 pages LaTex, 4 EPS figures, to appear in Physics Letters

Single-fly genome assemblies fill major phylogenomic gaps across the Drosophilidae Tree of Life

Long-read sequencing is driving rapid progress in genome assembly : across all major groups of life, including species of the family Drosophilidae, a longtime model system for genetics, genomics, and evolution. We previously developed a cost-effective hybrid Oxford Nanopore (ONT) long-read and Illumina short-read sequencing approach and used it to assemble 101 drosophilid genomes from laboratory cultures, greatly increasing the number of genome assemblies for this taxonomic group. The next major challenge is to address the laboratory culture bias in taxon sampling by sequencing genomes of species that cannot easily be reared in the lab. Here, we build upon our previous methods to perform amplification-free ONT sequencing of single wild flies obtained either directly from the field or from ethanol-preserved specimens in museum collections, greatly improving the representation of lesser studied drosophilid taxa in whole-genome data. Using Illumina Novaseq X Plus and ONT P2 sequencers with R10.4.1 chemistry, we set a new benchmark for inexpensive hybrid genome assembly at US $150 per genome while assembling genomes from as little as 35 ng of genomic DNA from a single fly. We present 183 new genome assemblies for 179 species as a resource for drosophilid systematics, phylogenetics, and comparative genomics. Of these genomes, 62 are from pooled lab strains and 121 from single adult flies. Despite the sample limitations of working with small insects, most single-fly diploid assemblies are comparable in contiguity (>1 Mb contig N50), completeness (>98% complete dipteran BUSCOs), and accuracy (>QV40 genome-wide with ONT R10.4.1) to assemblies from inbred lines. We present a well-resolved multi-locus phylogeny for 360 drosophilid and 4 outgroup species encompassing all publicly available (as of August 2023) genomes for this group. Finally, we present a Progressive Cactus whole-genome, reference-free alignment built from a subset of 298 suitably high-quality drosophilid genomes. The new assemblies and alignment, along with updated laboratory protocols and computational pipelines, are released as an open resource and as a tool for studying evolution at the scale of an entire insect family