Exploring social media and admissions decision-making – friends or foes?

Background: Despite the ever-increasing use of social media (e.g., Facebook, Twitter) little is known about its use in medical school admissions. This qualitative study explores whether and how social media (SM) is used in undergraduate admissions in Canada, and the attitudes of admissions personnel towards such use.Methods: Phone interviews were conducted with admissions deans and nominated admissions personnel. A qualitative descriptive analysis was performed using iterative coding and comparing, and grouping data into themes.Results: Personnel from 15 of 17 Canadian medical schools participated. A sizeable proportion had, at some point, examined social media (SM) profiles to acquire information on applicants. Participants did not report using it explicitly to screen all applicants (primary use); however, several did admit to looking at SM to follow up on preliminary indications of misbehaviour (secondary use). Participants articulated concerns, such as validity and equity, about using SM in admissions. Despite no schools having existing policy, participants expressed openness to future use.   Conclusions: While some of the 15 schools had used SM to acquire information on applicants, criteria for formulating judgments were obscure, and participants expressed significant apprehension, based on concerns for fairness and validity. Findings suggest participant ambivalence and ongoing risks associated with “hidden” selection practices

Stretching the Comfort Zone: Using Early Clinical Contact to Influence Professional Identity Formation in Medical Students

Purpose: To explore first-year medical students’ affective reactions to intimate encounters with severely sick patients in their homes, within a curricular innovation targeting the development of a patient-centered professional identity. Background: Early patient encounters create complex emotional challenges and constitute fertile ground for professional identity formation. The literature indicates that students often learn, largely through the hidden curriculum, to avoid and suppress emotion. This can culminate in mental health problems and loss of empathy. Method: A qualitative descriptive analysis of 28 randomly selected, mandatory, reflective essays focused on a home visit to a previously unknown patient, in an unsupervised group of 4 students, within the context of a structured course called Patient Contact—PASKON. Results: Students described a wide range of affect-laden responses, positive and negative, elicited by the home visits. The observations were typically related to loss of control, struggles to behave “professionally,” and the unmasking of stereotypes and prejudices. Conclusions: Medical students’ initial clinical encounters elicit emotional responses that have the potential to serve as triggers for the development of emotional maturity, relational skills, and patient-centered attitudes. Conversely, they can foreground uncertainty and lead to defensive distancing from patients’ existential concerns. The findings point to a role for structured educational strategies and supervision to assist students in the emotion work necessary in the transition from a “lay” to a “medical” identity.publishedVersio

Éclipsé par l'observation : comment les étudiants en médecine canadiens vivent-ils l’observation?

Background: Preclinical medical students commonly perceive shadowing as beneficial for career exploration. However, research is sparse on the broader impact of shadowing as a learning strategy. We explored students’ perceptions and lived experiences of shadowing to understand its role and impact on their personal and professional lives. Methods: Between 2020-2021, individual semi-structured video interviews were conducted with 15 Canadian medical students in this qualitative descriptive study. Inductive analysis proceeded concurrently with data collection until no new dominant concepts were identified. Data were iteratively coded and grouped into themes. Results: Participants described internal and external factors that moulded shadowing experiences, arising tensions between intended and perceived experiences, and how these lived experiences impacted their wellness. Internal factors associated with shadowing behaviour included: 1) aspiring to be the best and shadowing to demonstrate excellence, 2) shadowing for career exploration, 3) shadowing as learning opportunities for early clinical exposure and career preparedness, and 4) reaffirming and redefining professional identity through shadowing. External factors were: 1) unclear residency match processes which position shadowing as competitive leverage, 2) faculty messaging that perpetuates student confusion around the intended value of shadowing, and 3) social comparison in peer discourse, fuelling a competitive shadowing culture. Conclusions: The tension between balancing wellness with career ambitions and the unintended consequences of unclear messaging regarding shadowing in a competitive medical culture highlights issues inherent in shadowing culture.Contexte : De manière générale, les étudiants en médecine préclinique considèrent que l’observation présente une occasion intéressante d’explorer les possibilités de carrière. Cependant, peu de recherches ont été menées sur l’impact plus large de l’observation comme stratégie d’apprentissage. Nous avons exploré les perceptions et les expériences vécues des étudiants en matière d’observation afin de comprendre son rôle et ses répercussions sur leur vie personnelle et professionnelle. Méthodes : Dans le cadre de cette étude qualitative descriptive, entre 2020 et 2021, des entretiens vidéo individuels semi-structurés ont été menés avec 15 étudiants en médecine canadiens. L’analyse inductive s’est déroulée simultanément à la collecte des données jusqu’à ce qu’aucun concept dominant nouveau n’apparaisse. Les données ont été codées de manière itérative et regroupées en thèmes. Résultats : Les participants ont décrit les facteurs internes et externes qui ont façonné leur expérience de l’observation et les tensions qui en ont découlé, ainsi que l’impact de ces expériences sur leur bien-être. Les facteurs internes associés au comportement d’observation sont les suivants : 1) vouloir être le meilleur et faire de l’observation pour montrer son excellence, 2) faire de l’observation dans le but d’explorer les débouchés de carrière, 3) faire de l’observation pour apprendre par l’exposition clinique précoce et pour se préparer à la carrière, et 4) réaffirmer et redéfinir l’identité professionnelle par l’observation. Les facteurs externes sont 1) le manque de clarté dans les processus de jumelage des résidents pouvant donner l’impression que l’observation est un atout, 2) le discours enseignant qui entretient la confusion des étudiants quant à la valeur de l’observation, et 3) la comparaison sociale dans le discours des pairs, alimentant une culture de l’observation compétitive. Conclusions : La difficulté de trouver un équilibre entre le bien-être et les ambitions professionnelles, et les conséquences involontaires d’un discours peu clair concernant l’observation dans le contexte d’un climat compétitif mettent en évidence les problèmes inhérents à la culture de l’observation

Conceptual models for knowledge management, an empirical study using Knowledge Forum

grantor: University of TorontoAdvances in telecommunications and computer software and hardware have led to an ever-increasing amount of information, and a corresponding need for knowledge management tools. Knowledge Forum is software designed to support creative work with ideas, and a goal of its workplace applications is to maximize affordances for knowledge management while supporting knowledge building and innovation. Recently, conceptual models have been proposed as supports for knowledge management. Specifically, models can be used as tools for organizing, representing and communicating information. The present study sought to empirically evaluate the potential benefits of using conceptual models as tools for knowledge building in a work environment supported by Knowledge Forum. A qualitative case study was conducted using six participants. Conceptual modeling was used first as a tool for each individual to express his/her understanding of the project and second as a collaborative representation of the groups understanding.M.A

How supervision and educational supports impact medical students’ preparation for future learning of endotracheal intubation skills: a non-inferiority experimental trial

Abstract Background Professional education cannot keep pace with the rapid advancements of knowledge in today’s society. But it can develop professionals who can. ‘Preparation for future learning’ (PFL) has been conceptualized as a form of transfer whereby learners use their previous knowledge to learn about and adaptively solve new problems. Improved PFL outcomes have been linked to instructional approaches targeting learning mechanisms similar to those associated with successful self-regulated learning (SRL). We expected training that includes evidence-based SRL-supports would be non-inferior to training with direct supervision using the outcomes of a ‘near transfer’ test, and a PFL assessment of simulated endotracheal intubation skills. Method This study took place at the University of Toronto from October 2014 to August 2015. We randomized medical students and residents (n = 54) into three groups: Unsupervised, Supported; Supervised, Supported; and Unsupervised, Unsupported. Two raters scored participants’ test performances using a Global Rating Scale with strong validity evidence. We analyzed participants’ near transfer and PFL outcomes using two separate mixed effects ANCOVAs. Results For the Unsupervised, Supported group versus the Supervised, Supported group, we found that the difference in mean scores was 0.20, with a 95% Confidence Interval (CI) of − 0.17 to 0.57, on the near transfer test, and was 0.09, with a 95% CI of − 0.28 to 0.46, on the PFL assessment. Neither mean score nor their 95% CIs exceeded the non-inferiority margin of 0.60 units. Compared to the two Supported groups, the Unsupervised, Unsupported group was non-inferior on the near transfer test (differences in mean scores were 0.02 and − 0.22). On the PFL assessment, however, the differences in mean scores were 0.38 and 0.29, and both 95% CIs crossed the non-inferiority margin. Conclusions Training with SRL-supports was non-inferior to training with a supervisor. Both interventions appeared to impact PFL assessment outcomes positively, yet inconclusively when compared to the Unsupervised and Unsupported group, By contrast, the Unsupervised, Supported group did not score well on the near transfer test. Based on the observed sensitivity of the PFL assessment, we recommend researchers continue to study how such assessments may measure learners’ SRL outcomes  during structured learning experiences

Exploring lesbian, gay, bisexual, and queer (LGBQ) people’s experiences with disclosure of sexual identity to primary care physicians: a qualitative study

Abstract Background It has been demonstrated that health disparities between lesbian, gay, bisexual and queer (LGBQ) populations and the general population can be improved by disclosure of sexual identity to a health care provider (HCP). However, heteronormative assumptions (that is, assumptions based on a heterosexual identity and experience) may negatively affect communication between patients and HCPs more than has been recognized. The aim of this study was to understand LGBQ patients’ perceptions of their experiences related to disclosure of sexual identity to their primary care provider (PCP). Methods One-on-one semi-structured telephone interviews were conducted, audio-recorded, and transcribed. Participants were self-identified LGBQ adults with experiences of health care by PCPs within the previous five years recruited in Toronto, Canada. A qualitative descriptive analysis was performed using iterative coding and comparing and grouping data into themes. Results Findings revealed that disclosure of sexual identity to PCPs was related to three main themes: 1) disclosure of sexual identity by LGBQ patients to a PCP was seen to be as challenging as coming out to others; 2) a solid therapeutic relationship can mitigate the difficulty in disclosure of sexual identity; and, 3) purposeful recognition by PCPs of their personal heteronormative value system is key to establishing a strong therapeutic relationship. Conclusion Improving physicians’ recognition of their own heteronormative value system and addressing structural heterosexual hegemony will help to make health care settings more inclusive. This will allow LGBQ patients to feel better understood, willing to disclose, subsequently improving their care and health outcomes

The imperative for (and opportunities of) research on adaptive expertise in health professions education

In this editorial, three Advances in Health Sciences Education editors argue for the importance and impact of adaptive expertise on the future of health professions education and work. They present a sample of the broad range of theory-informed research currently contributing to understanding and applying adaptive expertise in health professions education. They reflect on the unique opportunities that interdisciplinarity offers this endeavour. Finally they offer potential ways forward for continued efforts to advance collective understanding of education, expert development and health professions practice